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Bridgett, Christopher, and Paul Polak. "Social systems intervention and crisis resolution. Part 2: Intervention." Advances in Psychiatric Treatment 9, no. 6 (November 2003): 432–38. http://dx.doi.org/10.1192/apt.9.6.432.
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Home treatment as an alternative to acute adult in-patient care is part of the National Health Service's Plan for mental health services in the UK. As a form of crisis intervention, it benefits from an understanding of, and ways of working with, the social systems relevant to the patient in crisis. This article describes the social systems intervention process as an alternative to admission and also considers its application in achieving early in-patient discharge.
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Oeltjen, Lena Katharina, Maike Schulz, Imke Heuer, Georg Knigge, Rebecca Nixdorf, Denis Briel, Patricia Hamer, et al. "Effectiveness of a peer-supported crisis intervention to reduce the proportion of compulsory admissions in acute psychiatric crisis interventions in an outreach and outpatient setting: study protocol for an exploratory cluster randomised trial combined with qualitative methods." BMJ Open 14, no. 5 (May 2024): e083385. http://dx.doi.org/10.1136/bmjopen-2023-083385.
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IntroductionCompulsory admissions are associated with feelings of fear, humiliation and powerlessness. The number of compulsory admissions in Germany and other high-income countries has increased in recent years. Peer support has been shown to increase the self-efficacy of individuals with mental health conditions in acute crises and to reduce the use of coercive measures in clinical settings. The objective of this study is to reduce the number of compulsory admissions by involving peer support workers (PSWs) in acute mental health crises in outreach and outpatient settings.Methods and analysisThis one-year intervention is an exploratory, cluster randomised study. Trained PSWs will join the public crisis intervention services (CIS) in two of five regions (the intervention regions) in the city of Bremen (Germany). PSWs will participate in crisis interventions and aspects of the mental health services. They will be involved in developing and conducting an antistigma training for police officers. The remaining three regions will serve as control regions. All individuals aged 18 and older who experience an acute mental health crisis during the operating hours of the regional CIS in the city of Bremen (around 2000 in previous years) will be included in the study. Semistructured interviews will be conducted with PSWs, 30 patients from control and intervention regions, as well as two focus group discussions with CIS staff. A descriptive comparison between all participants in the intervention and control regions will assess the proportion of compulsory admissions in crisis interventions during the baseline and intervention years, including an analysis of temporal changes.Ethics and disseminationThis study was approved by the Ethics Committee of the University of Bremen (file 2022-09) on 20 June 2022. The results will be presented via scientific conferences, scientific journals and communicated to policy-makers and practitioners.Trial registration numberDRKS00029377.
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McEntee, Maureen K. "Accessibility of Mental Health Services and Crisis Intervention to the Deaf." American Annals of the Deaf 138, no. 1 (1993): 26–30. http://dx.doi.org/10.1353/aad.2012.0569.
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Sanislow, Charles A., John Chapman, and Thomas H. McGlashan. "Crisis Intervention Services in Juvenile Detention Centers." Psychiatric Services 54, no. 1 (January 2003): 107. http://dx.doi.org/10.1176/appi.ps.54.1.107.
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Kerr, Mary Margaret, William Dikel, Jeanette Bailey, and David Sanders. "Community Mental Health Support Services in a Special Education Setting." Behavioral Disorders 20, no. 1 (November 1994): 69–75. http://dx.doi.org/10.1177/019874299402000102.
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This paper describes a state- and county-sponsored program that provides preventive and crisis-intervention services in three schools serving severely emotionally disturbed students. Students in these schools typically have histories of previous mental health diagnoses and treatment, often including hospitalization and/or residential or correctional placements, with little or no follow-up mental health services in the community. These students tend to have untreated disorders such as Attention Deficit Hyperactivity Disorder, mood disorders, and chemical dependency but have “fallen through the cracks” of the mental health system and remain at high risk for deterioration and out-of-home placements. This project utilizes a county social worker in the schools to coordinate services, intervene in crisis situations, and facilitate appropriate treatment for the students by acting as a liaison with students, special educators, school social workers, parents, child protection and child welfare services, the correctional system, and mental health providers. The program is described in detail, with examples of types of interventions and recommendations for future programs.
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Bryant, Richard A., and Allison G. Harvey. "Telephone Crisis Intervention Skills." Crisis 21, no. 2 (March 2000): 90–94. http://dx.doi.org/10.1027//0227-5910.21.2.90.
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Counseling skills were evaluated in a telephone counseling service for Vietnam veterans. Thirty simulated crisis calls were made to telephone counselors by experienced clinical psychologists. The counselors' responses were rated on dimensions that indexed general counseling skills, knowledge of veteran needs, and provision of appropriate advice. Whereas the majority of callers demonstrated adequate counseling skills, many lacked knowledge of veterans' posttraumatic stress, common veteran terminology, and the nature of veterans' experiences. The findings suggest that telephone counseling services that target specific populations should employ comprehensive training to ensure that counselors possess adequate and relevant knowledge about callers and their presenting problems. The simulated caller paradigm appears to be an effective paradigm for training and evaluation of telephone counselors.
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Staite, Emily, Lynne Howey, Clare Anderson, and Paula Maddison. "How well do children in the North East of England function after a crisis: a service evaluation." Mental Health Review Journal 26, no. 2 (February 11, 2021): 161–69. http://dx.doi.org/10.1108/mhrj-09-2020-0065.
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Purpose Data shows that there is an increasing number of young people in the UK needing access to mental health services, including crisis teams. This need has been exacerbated by the current global pandemic. There is mixed evidence for the effectiveness of crisis teams in improving adult functioning, and none, to the authors’ knowledge, that empirically examines the functioning of young people following intervention from child and adolescent mental health services (CAMHS) crisis teams in the UK. Therefore, the purpose of this paper is to use CAMHS Crisis Team data, from an NHS trust that supports 1.4 million people in the North East of England, to examine a young person's functioning following a crisis. Design/methodology/approach This service evaluation compared functioning, as measured by the Outcome Rating Scale (ORS), pre- and post-treatment for young people accessing the CAMHS Crisis Team between December 2018 and December 2019. Findings There were 109 participants included in the analysis. ORS scores were significantly higher at the end of treatment (t(108) = −4.2046, p < 0.001) with a small effect size (d = −0.36). Sixteen (15%) patients exhibited significant and reliable change (i.e. functioning improved). A further four (4%) patients exhibited no change (i.e. functioning did not deteriorate despite being in crisis). No patients significantly deteriorated in functioning after accessing the crisis service. Practical implications Despite a possibly overly conservative analysis, 15% of patients not only significantly improved functioning but were able to return to a “healthy” level of functioning after a mental health crisis following intervention from a CAMHS Crisis Team. Intervention(s) from a CAMHS Crisis Team are also stabilising as some young people’s functioning did not deteriorate following a mental health crisis. However, improvements also need to be made to increase the number of patients whose functioning did not significantly improve following intervention from a CAMHS Crisis Team. Originality/value This paper evaluates a young person’s functioning following a mental health crisis and intervention from a CAMHS Crisis Team in the North East of England.
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Morabito, Melissa S., Amy N. Kerr, Amy Watson, Jeffrey Draine, Victor Ottati, and Beth Angell. "Crisis Intervention Teams and People With Mental Illness." Crime & Delinquency 58, no. 1 (August 26, 2010): 57–77. http://dx.doi.org/10.1177/0011128710372456.
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The Crisis Intervention Team (CIT) program was first developed to reduce violence in encounters between the police and people with mental illness as well as provide improved access to mental health services. Although there is overwhelming popular support for this intervention, scant empirical evidence of its effectiveness is available—particularly whether the program can reduce the use of force. This investigation seeks to fill this gap in the literature by exploring the factors that influence use of force in encounters involving people with mental illness and evaluating whether CIT can reduce the likelihood of its use.
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Morgan, Janice, and John Cordingly. "Police referrals — a crisis intervention approach." Psychiatric Bulletin 15, no. 8 (August 1991): 465–68. http://dx.doi.org/10.1192/pb.15.8.465.
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Recently, concern has been expressed by mental health professionals, MIND, and the police regarding the management of Section 136 referrals, which at present varies according to the local psychiatric services available. In the majority of London Metropolitan Boroughs a person deemed to be in need of care and control is taken first to a police station where the necessary documentation is completed and then transported, often a considerable distance, to a mental hospital for the purpose of assessment. This can result in lengthy delays in a police cell for the patient, time-consuming negotiations with hospitals for the police, and problems completing the assessment procedure due to lack of availability of social workers. The importance of considering alternatives, particularly with the move towards community care, has been stressed.
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Beer, Dominic, Susan Cope, Janet Smith, and Roger Smith. "The crisis team as part of comprehensive local services." Psychiatric Bulletin 19, no. 10 (October 1995): 616–19. http://dx.doi.org/10.1192/pb.19.10.616.
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An attempt to categorise the nature of the work done by an inner city crisis intervention service (CIS) which is part of a comprehensive community mental health service is described. The work of the CIS as it relates to models of crisis intervention recognised in the literature is outlined. The role of this CIS in providing additional intermittent support to individuals receiving long-term community care is commended.
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Boscarato, Kara, Stuart Lee, Jon Kroschel, Yitzchak Hollander, Alice Brennan, and Narelle Warren. "Consumer experience of formal crisis-response services and preferred methods of crisis intervention." International Journal of Mental Health Nursing 23, no. 4 (February 27, 2014): 287–95. http://dx.doi.org/10.1111/inm.12059.
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Young, Andrew, Jill Fuller, and Briana Riley. "On-scene Mental Health Counseling Provided Through Police Departments." Journal of Mental Health Counseling 30, no. 4 (October 1, 2008): 345–61. http://dx.doi.org/10.17744/mehc.30.4.m125r35864213208.
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The expectation that police officers can address every need in every situation is daunting and unrealistic. Recognizing this, some police departments have instituted special training or used other resources to better serve the needs of citizens. One example is an on-scene crisis counseling unit comprised of volunteer mental health professionals who respond to calls with police officers. These counselors provide mental health services that police officers cannot. This article explains the usefulness of this type of program, and crisis counseling in general, for both officers and victims as they deal with crises like domestic violence, homicide, suicide, and sexual assault. The study examines survey results from victims and police officers about the impact of this intervention. The data support the helpfulness of the program. Implications and recommendations for further research are included.
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Comartin, Erin B., Leonard Swanson, and Sheryl Kubiak. "Mental Health Crisis Location and Police Transportation Decisions: The Impact of Crisis Intervention Team Training on Crisis Center Utilization." Journal of Contemporary Criminal Justice 35, no. 2 (March 17, 2019): 241–60. http://dx.doi.org/10.1177/1043986219836595.
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Crisis Intervention Team (CIT) research has shown increases in officer transports of individuals with serious mental illness to emergency departments (ED) which, while more appropriate than incarceration, can be expensive and lack linkage to long-term mental health services. Mental health crisis centers offer a promising alternative, but impact may be limited by proximal distance and lack of officer awareness. To address this concern, this study asked, “Does CIT training affect officer transport decisions to a crisis center over a nearby ED?” Researchers analyzed crisis call reports in a Midwestern county and found increased use of the crisis center and decreased use of EDs by officers after CIT was implemented. The crisis location affected officer transport decisions, yet CIT officers were more likely than non-CIT officers to travel farther for appropriate linkage. Findings suggest CIT changes officer behavior, which could potentially lead to long-term, low-cost treatment for individuals with serious mental illnesses when there is a mental health crisis center.
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Mutwiri, Robert Kimathi, Caroline Kawila, and Musa Olouch. "Call Centre Influence on the Delivery of Mental Health Services Among Young People: A Case of One2one Call Centre in Nairobi County." International Journal of Health Sciences 7, no. 4 (July 1, 2024): 66–91. http://dx.doi.org/10.47941/ijhs.2031.
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Purpose: The purpose of this study was to examine the influence of call centers on the delivery of mental health services among young people in Nairobi County. Specifically, the study aimed to investigate the impact of crisis intervention, round-the-clock availability, resource sharing, and follow-ups on mental health service delivery. Methodology: The study employed a descriptive-cross-sectional research design to assess the impact of call centers on mental health service delivery. The target demographic consisted of healthcare providers affiliated with the one2one Call Centre in Nairobi County. A sample size of 112 respondents was selected using basic random selection methods. Data was collected through the distribution of questionnaires, and Statistical Package for Social Science (SPSS) version 25 was utilized for data analysis. Descriptive statistics such as mean, standard deviation, frequencies, and percentages were employed, along with correlation and regression analysis to evaluate the relationships between research variables. Findings: The study found that crisis intervention, round-the-clock availability, and resource sharing had a positive impact on the delivery of mental health services among young people in Nairobi County. Specifically, crisis intervention strategies were shown to significantly enhance the overall mental health support system, ensuring timely assistance for young individuals in need. Furthermore, maintaining round-the-clock availability allowed service providers to cater to the diverse needs and schedules of young people seeking assistance, thereby improving the overall delivery of mental health services across the county. Unique Contribution to Theory, Practice, and Policy: This study makes several contributions to theory, practice, and policy in the field of mental health service delivery. Firstly, it adds to the body of literature on the effectiveness of call centers in enhancing accessibility and reachability of mental health services, particularly among young people. Secondly, the findings provide valuable insights for healthcare practitioners and policymakers on the importance of crisis intervention, round-the-clock availability, and resource sharing in improving mental health service delivery.
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Bridgett, Christopher, and Paul Polak. "Social systems intervention and crisis resolution. Part 1: Assessment." Advances in Psychiatric Treatment 9, no. 6 (November 2003): 424–31. http://dx.doi.org/10.1192/apt.9.6.424.
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Home treatment as an alternative to acute adult in-patient care is part of the National Health Service Plan for mental health services in the UK. As a form of crisis intervention, it benefits from an understanding of, and ways of working with, the social systems relevant to the patient in crisis. This article reviews relevant terminology and background theory, and considers the social factors associated with psychiatric admission.
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Denis, J., S. Hendrick, and R. Bruffaerts. "Towards a theory of therapeutic processes in crisis intervention: A grounded qualitative perspective." European Psychiatry 30, S2 (November 2015): S147. http://dx.doi.org/10.1016/j.eurpsy.2015.09.294.
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To provide an effective crisis intervention, there is a need to better understand how these interventions work. The aim of this study was to develop an explanatory theory of therapeutic processes implied in the psychological process of crisis intervention.ObjectivesWe aimed to reduce the gap between clinicians and researchers by showing how a qualitative method may reveal experiences about how professionals explained their clinical practice in crisis intervention and what their representation are of people in crisis.MethodIn depth, semi-structured interviews were conducted, transcribed and independently reviewed by using Grounded Theory Methodology (GTM). Data were analyzed with the constant comparative method. The study was conducted in crisis experts in Psychiatric Emergency Room (PER). A purposive sample of 17 professionals in crisis intervention included in our study.ResultsResults showed that therapeutic processes are managed in multiple interactions and regulations. Crisis intervention is an opportunity to highlight the psychic functioning. There are multiple settings of interventions oriented by the context of the institution and theorical background of professionals. The social realities slow down the possibility to elaborate the end of the intervention.ConclusionThis study illuminates that clinicians and professionals in crisis intervention need guidelines to better improve their therapeutic interventions. They also need a political support to create specialized training and develop medical and psychological services to take in charge people in crisis. This research contributes to show the discrepancy between what the professional thinks to do in their interventions and what he really do.
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Kingdon, David. "The mental health practitioner – bypassing the recruitment bottleneck." Psychiatric Bulletin 26, no. 9 (September 2002): 328–31. http://dx.doi.org/10.1192/pb.26.9.328.
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Lack of resources has been a major restriction on the development of mental health services. However, even with the resources currently available there are insufficient numbers of trained medical, nursing, occupational therapy, psychology and social work staff to maintain services to adequate levels in many areas. This seriously interferes with provision of services, especially in acute wards but also in other areas. It certainly restricts developments and the use of skills attained through training (e.g. from THORN psychosocial intervention courses (Gournay & Birley, 1998)). The introduction of crisis resolution and early intervention teams, as described in the NHS Implementation Guide (Department of Health, 2001a), looks likely to simply deprive in-patient wards and community teams of staff, making the new teams ineffective through lack of core services. This will occur directly by recruitment of staff from them, or competitively through taking new entrants from nursing and social work programmes. Solutions proposed have included increasing numbers of support workers and administration staff; recruitment from abroad; or increased delegation of tasks, but there remains a need for more appropriately-trained professional staff.
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Deveau, Lisa. "Police De-Escalation Training & Education: Nationally, Provincially, and Municipally." Journal of Community Safety and Well-Being 6, no. 1 (March 19, 2021): 2–5. http://dx.doi.org/10.35502/jcswb.183.
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In this critical review and social innovation narrative, the current literature on de-escalation and policing is reviewed. The following explores how services train recruits and experienced officers on de-escalation, conflict resolution, and crisis intervention skills. A limited environmental scan was completed to inquire about the number of hours dedicated to de-escalation training compared with tactical and combative training within Ontario law enforcement agencies. The environmental scan also considered how services respond to imminent mental heath crises, as some services rely on mental health professionals to respond to 911 emergencies with police officers, through the Mobile Crisis Team. Within the literature, questions are proposed about the government’s role in overseeing policing, and why there fails to be any federally or provincially mandated training and approach to mental health and de-escalation within Canadian law enforcement. The author ultimately advocates for systemic change by highlighting the priorities, values, and contradictions within Canadian police services which have been influenced by colonization and patriarchal narratives.
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De Clercq†, M., and V. Dubois. "Crisis Intervention Models in the French-Speaking Countries." Crisis 22, no. 1 (January 2001): 32–38. http://dx.doi.org/10.1027//0227-5910.22.1.32.
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The article presents the crisis intervention model devised by Andreoli (Geneva) which is currently being developed in most crisis units and emergency services in the French-speaking countries of Europe. Two clinical examples are presented: the Short Therapy Centre (Geneva, Switzerland) and the crisis unit of the Saint-Luc Clinic (Brussels, Belgium). The following aspects of these approaches are discussed: (a) the need for crisis intervention rather than a simple answer to emergency, (b) the need for crisis intervention in all acute psychiatric disorders and not only in psychosocial problems, (c) the need to integrate psychiatric hospitalization into a coherent mental health policy, (d) the need for well-trained and round-the-clock teams, (e) the need for continuity of care.
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Huxley, Peter, and Michael Kerfoot. "Social services response to psychiatric emergencies." Psychiatric Bulletin 17, no. 5 (May 1993): 282–85. http://dx.doi.org/10.1192/pb.17.5.282.
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This paper reports the results of a nationwide survey of social services responses to psychiatric emergencies. The survey is a companion to that by Johnson & Thornicroft (1991) (J&T) who reviewed the emergency service options available in psychiatry, including the emergency clinic, general hospital services, the emergency ward, acute day hospital and crisis intervention and residential services, as well as considering the role of sectorised services, and community mental health centres (CMHCs). For the purposes of our respective surveys of health and social services in England and Wales, we have defined a psychiatric emergency as “occurring when someone (patient, friend, relative or professional) requests urgent intervention on behalf of someone in the community who is suffering from a mental disorder”.
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Damsa, Cristian, Christopher Hummel, Vedat Sar, Thierry Di Clemente, Susanne Maris, Coralie Lazignac, Odile Massarczyk, and Charles Pull. "Economic impact of crisis intervention in emergency psychiatry: a naturalistic study." European Psychiatry 20, no. 8 (December 2005): 562–66. http://dx.doi.org/10.1016/j.eurpsy.2005.05.003.
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AbstractObjectiveThis is a naturalistic study comparing the outcomes of all emergency psychiatric interventions in the Hospital Center of Luxemburg during two periods of six months each, before and after the introduction of a crisis intervention program. The aim of the study was to investigate the clinical and economic impact of crisis intervention on psychiatric emergency admissions.MethodsAll subjects admitted to the emergency psychiatric unit during the two study periods were considered for participation. Data were collected retrospectively and comparisons were made between patients before (September 1, 2001 to February 28, 2002) and after (September 1, 2002 to February 28, 2003) crisis intervention programs were established.ResultsA comparison between the two patient groups demonstrated a significant decrease in the rate of voluntary hospitalizations after crisis intervention, and a significant increase in the number of patients with subsequent outpatient consultations. The cost increase due to ambulatory follow-ups was widely compensated for by the cost decrease due to hospitalization avoidance.ConclusionThese preliminary findings suggest that crisis intervention leads to a shift from hospitalization to outpatient psychotherapeutic management in emergency psychiatric services, which has a significant economic impact.
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Holingue, Calliope, Luther G. Kalb, Ann Klein, and Joan B. Beasley. "Experiences With the Mental Health Service System of Family Caregivers of Individuals With an Intellectual/Developmental Disability Referred to START." Intellectual and Developmental Disabilities 58, no. 5 (October 1, 2020): 379–92. http://dx.doi.org/10.1352/1934-9556-58.5.379.
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Abstract People with intellectual and developmental disabilities (IDD) frequently have behavioral or mental health needs, but experience obstacles to treatment. Family caregivers are often responsible for coordinating the care of individuals with IDD. This study examined family caregiver experiences using intake data from a national tertiary crisis intervention model designed for people with IDD and mental health needs. Caregivers (n = 488) completed the Family Experiences Interview Schedule. Less than half of families reported satisfaction with the mental health services received. Notable gaps were in crisis, night and weekend services, choice of services and providers, communication and coordination between providers, and specialized training. Experiences were worse for caregiving fathers and individuals with IDD with co-occurring chronic medical conditions.
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Kovess, Vivianne. "Mental health services description. Prospects for the future." Epidemiologia e psichiatria sociale. Monograph Supplement 6, S1 (April 1997): 91–103. http://dx.doi.org/10.1017/s1827433100000861.
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An abundant literature has been published about mental services evaluation and was used for purpose of comparisons between services.Comparisons have mainly concerned care in the traditional psychiatric hospital based mode versus community mental health (Tansella et al., 1982; Kraudy et al., 1987; Kovess et al., 1995) or care in different areas or countries (Sytema et al., 1989).Those comparisons have to rely on crude description of services (Tansella et al., 1986) like psychiatric hospitalisation, day hospitalisation or out patient intervention. Intensive international collaboration underpinned the importance of a more precise description about services which could have extremely different components under the same label.In fact services in mental health are complex to describe to allow meaningful comparisons because they cover many different actions given by a variety of providers and grouped into various structures as: •hospitals: specialised or general, large or small;•day hospitals and centre;•out patients clinics, crisis centres.Care could also be provided by independent workers from the diverse medical and non medical professions involved in the mental health fields in private practice settings.
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Su, Shu-Fang, Jiin-Ru Rong, and Jin-Biau Li. "Development Of Community Psychiatric Crisis Management Indicators And Assessment Framework In Taiwan: A Focus Group Study." European Scientific Journal, ESJ 12, no. 12 (April 28, 2016): 113. http://dx.doi.org/10.19044/esj.2016.v12n12p113.
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This study was to develop the Community Psychiatric Crisis Management (CPCM) Model for community-dwelling psychiatric patients of Taiwan. Purposes of this study were: 1. To develop psychiatric patients’ community crisis management indictors; 2. To develop the psychiatric patients’ community crisis management framework. Methods: Three focus group interviews involving a total of 42 experts, included psychiatrists, psychiatric nurses, social worker, and community mental health service providers were implemented. Interview data were analyzed with qualitative content analysis. Results: The model of CPCM concretized the objectives, crisis assessment indicators, and crisis intervention services for community psychiatric patients, and proved to be an important part of CPCM. The level of crisis severity and impact of patient can be assessed by the four indicators: medical care seeking behaviors, psychiatric symptom severity and impact, history of violence and substance abuse, and protective factors of family and social support system. In addition, the severity and impact of CPCM score could be implement to provide home visiting care and crisis management interventions. The recommended CPCM model enabled community mental health care professionals’ assessment and management the patient’s crisis problems in three stages, from crisis, acute and maintenance stage. Conclusions: The CPCM model was improved practically, and the contents of the intervention were constructed. It is important to integrate crisis management with the preventive intervention to the community psychiatric patient care.
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Ruud, Torleif, and Svein Friis. "Community-based Mental Health Services in Norway." Consortium Psychiatricum 2, no. 1 (March 20, 2021): 47–54. http://dx.doi.org/10.17816/cp43.
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Community-based mental healthcare in Norway consists of local community mental health centres (CMHCs) collaborating with general practitioners and primary mental healthcare in the municipalities, and with psychiatrists and psychologists working in private practices. The CMHCs were developed from the 1980s to give a broad range of comprehensive mental health services in local catchment areas. The CMHCs have outpatient clinics, mobile teams, and inpatient wards. They serve the larger group of patients needing specialized mental healthcare, and they also collaborate with the hospital-based mental health services. Both CMHCs and hospitals are operated by 19 health trusts with public funding.
Increasing resources in community-based mental healthcare was a major aim in a national plan for mental health between 1999 and 2008. The number of beds has decreased in CMHCs the last decade, while there has been an increase in mobile teams including crisis resolution teams (CRTs), early intervention teams for psychosis and assertive community treatment teams (ACT teams). Team-based care for mental health problems is also part of primary care, including care for patients with severe mental illnesses. Involuntary inpatient admissions mainly take place at hospitals, but CMHCs may continue such admissions and give community treatment orders for involuntary treatment in the community.
The increasing specialization of mental health services are considered to have improved services. However, this may also have resulted in more fragmented services and less continuity of care from service providers whom the patients know and trust. This can be a particular problem for patients with severe mental illnesses. As the outcomes of routine mental health services are usually not measured, the effects of community-based mental care for the patients and their families, are mostly unknown.
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Goldman, Matthew L., Megan McDaniel, Deepa Manjanatha, Monica L. Rose, Glenn-Milo Santos, Starley B. Shade, Ann A. Lazar, Janet J. Myers, Margaret A. Handley, and Phillip O. Coffin. "Impact of San Francisco’s New Street crisis response Team on Service use among people experiencing homelessness with mental and substance use disorders: A mixed methods study protocol." PLOS ONE 18, no. 12 (December 5, 2023): e0295178. http://dx.doi.org/10.1371/journal.pone.0295178.
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Mobile crisis services for people experiencing distress related to mental health or substance use are expanding rapidly across the US, yet there is little evidence to support these specific models of care. These new programs present a unique opportunity to expand the literature by utilizing implementation science methods to inform the future design of crisis systems. This mixed methods study will examine the effectiveness and acceptability of the Street Crisis Response Team (SCRT), a new 911-dispatched multidisciplinary mobile crisis intervention piloted in San Francisco, California. First, using quantitative data from electronic health records, we will conduct an interrupted time series analysis to quantitatively examine the impacts of the SCRT on people experiencing homelessness who utilized public behavioral health crisis services in San Francisco between November 2019 and August 2022, across four main outcomes within 30 days of the crisis episode: routine care utilization, crisis care reutilization, assessment for housing services, and jail entry. Second, to understand its impact on health equity, we will analyze racial and ethnic disparities in these outcomes prior to and after implementation of the SCRT. For the qualitative component, we will conduct semi-structured interviews with recipients of the SCRT’s services to understand their experiences of the intervention and to identify how the SCRT influenced their health-related trajectories after the crisis encounter. Once complete, the quantitative and qualitative findings will be further analyzed in tandem to assist with more nuanced understanding of the effectiveness of the SCRT program. This evaluation of a novel mobile crisis response program will advance the field, while also providing a model for how real-world program implementation can be achieved in crisis service settings.
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Ogbolu, RE, BO Oyatokun, K. Ogunsola, TA Adegbite, T. Tade, O. Olafisoye, and OF Aina. "The pattern of crisis calls to a suicide telephone helpline service in Nigeria." Annals of Health Research 6, no. 3 (August 22, 2020): 246–57. http://dx.doi.org/10.30442/ahr.0603-01-87.
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Background: Suicide is the deliberate killing of oneself. Although it is preventable, suicide accounts for over 800,000 global deaths annually. There is the need to scale-up prevention strategies, and one of these strategies is the provision of suicide telephone helplines. Objectives: To describe the pattern of calls received by a suicide telephone helpline and the types of intervention provided in a Nigerian facility. Methods: This was a descriptive study of the first 100 completed calls received on a 24-hour suicide telephone helpline service by trained responders. Results: All the calls emanated from 14 states of the federation, with the majority (83.0%) from the Southern parts of the country. The reasons for the telephone calls varied from crisis situations (47.0%) to telephone number-verification (27.0%), mental health information (20.0%), and others (6.0%). The mean age of the crisis -situation callers was 25.8 years, with a slight female preponderance (53.2%); most were single in marital status (68.1%) and unemployed (70.2%). A majority (72.3%) of the callers had an underlying mental condition, 68.1% had suicidal ideation while 12.8% had previously attempted suicide. All the crisis callers were offered interventions ranging from phone counselling to linkage to the nearest mental health services. Conclusion: A majority of the crisis callers were offered mental health services, raising the possibility that the availability of telephone helplines may play a role in suicide prevention in Nigeria.
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Alqablan, Amal Khalid, Ghadah Mater Alamri, Hanan Saif Alsaif, Maha Saad Almahboub, Jumanah Abdulaziz Alluhaydan, and Nadyah Khalaf Alanazi. "Impact of COVID-19 on mental health of public health workers." International journal of health sciences 4, S1 (January 15, 2020): 14–21. http://dx.doi.org/10.53730/ijhs.v4ns1.14987.
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Aim: This study examines the impact of COVID-19 on the mental health of public health workers and explores the pivotal role of social workers in addressing these challenges. Methods: A comprehensive literature review was conducted to gather data on the mental health effects of COVID-19 on healthcare professionals and the interventions implemented by social workers. Sources included peer-reviewed articles, reports from health organizations, and case studies from various regions affected by the pandemic. Results: The findings indicate that healthcare professionals experience heightened levels of stress, anxiety, depression, and burnout due to increased workloads, lack of resources, and the fear of infection. Social workers play a crucial role in mitigating these effects through mental health support, resource coordination, advocacy, and policy development. They provide individual and group therapy, crisis intervention, and psychoeducation. Social workers also facilitate access to essential resources, support vulnerable populations, and implement telehealth and digital support services to maintain continuity of care. Conclusion: The mental health of healthcare workers is critically impacted by the COVID-19 pandemic. Social workers are essential in providing emotional support, facilitating resource access, and advocating for vulnerable groups. Their interventions help mitigate the psychosocial effects of the pandemic and promote resilience within healthcare teams.
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Oakes, Jane E., Victoria Manning, Simone N. Rodda, and Dan I. Lubman. "A six-step brief intervention to reduce distress and increase treatment readiness in problem gamblers." Australasian Psychiatry 28, no. 4 (May 19, 2020): 418–22. http://dx.doi.org/10.1177/1039856220901471.
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Objective: The majority of people with gambling problems contact helplines when they are in crisis, hampering their capacity to explore suitable treatment options. To date, there has been limited research identifying the best way to support individuals to reduce distress and maximise further treatment-seeking. In this paper, we describe the development and piloting of the resulting six-step brief intervention. Method: A six-step brief intervention was developed based on a literature review of existing interventions for crisis management, semi-structured interviews with 19 participants comprising gambling and crisis support counsellors and consumers, as well as experts in the addiction field. Results: The resulting six-step brief-intervention focusses on (1) acknowledging and measuring distress; (2) normalising and reducing distress; (3) optimising motivation for change; (4) providing a sense of hope; (5) re-measuring distress and, if reduced; (6) exploring options for treatment and support. Conclusion: Whilst developed primarily for helpline counsellors, the intervention has potential application for health practitioners working across telephone, online and face-to-face services. Further research is required to determine its effectiveness in improving treatment engagement amongst people with gambling problems.
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Fucci, G., N. Ratti, R. Gattamorta, R. Godoli, S. Randi, and M. P. Riccipetitoni. "Crisis in the psychiatric patient: A structured illness-management-oriented group intervention." European Psychiatry 33, S1 (March 2016): S568. http://dx.doi.org/10.1016/j.eurpsy.2016.01.2104.
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IntroductionCrisis prevention and management of the psychiatric patient have obtained a central role in the policies of Mental Health Services. In this context, Mental Health Centre of Ravenna has launched a “Crisis Center”, a rehabilitation group project applied to three types of users: users in an early stage of crisis, users in a post-critical stage and users at high risk of crisis. Intervention was based on the Illness Management and Recovery practice, an evidence-based program which consists in social skills training activities, emotions management, symptom management, coping skills training, psycho-education and, more generally, supporting users in their personal recovery process.ObjectiveObjectives of this project is to prevent crisis and hospitalization and to provide an alternative to institutionalization for mental health users.AimsThe aims of this study was to analyze and show effects and results of the project, in its first three years of life.MethodsThrough the database “Infoclin”, we analyzed data of 94 users who took part in the project between January 2012 and December 2014.ResultsAnalysis showed, primarily, that out of 94 users, 64 (68%) have not needed hospitalization in the following two years after intervention. Furthermore, out of 39 users with a history of one or more hospitalizations at time of entry, 22 (56.4%) have not needed hospitalization in the next two years.ConclusionsDespite the low number of users analyzed, it is believed that this study should be considered a further evidence of the positive effects of the IMR practice within mental health services.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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Ashworth, Emma, Ian Jarman, Philippa McCabe, Molly McCarthy, Serena Provazza, Vivienne Crosbie, Zara Quigg, and Pooja Saini. "Suicidal Crisis among Children and Young People: Associations with Adverse Childhood Experiences and Socio-Demographic Factors." International Journal of Environmental Research and Public Health 20, no. 2 (January 10, 2023): 1251. http://dx.doi.org/10.3390/ijerph20021251.
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Suicide is a major public health issue and a leading cause of death among children and young people (CYP) worldwide. There is strong evidence linking adverse childhood experiences (ACEs) to an increased risk of suicidal behaviours in adults, but there is limited understanding regarding ACEs and suicidal crises in CYP. This study aims to examine the ACEs associated with CYP presenting at Emergency Departments for suicidal crises, and specifically the factors associated with repeat attendances. This is a case series study of CYP (aged 8–16) experiencing suicidal crisis who presented in a paediatric Emergency Department in England between March 2019 and March 2021 (n = 240). The dataset was subjected to conditional independence graphical analysis. Results revealed a significant association between suicidal crisis and several ACEs. Specifically, evidence of clusters of ACE variables suggests two distinct groups of CYP associated with experiencing a suicidal crisis: those experiencing “household risk” and those experiencing “parental risk”. Female sex, history of self-harm, mental health difficulties, and previous input from mental health services were also associated with repeat hospital attendances. Findings have implications for early identification of and intervention with children who may be at a heightened risk for ACEs and associated suicidal crises.
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Uddin, Tasnim, Amina Saadi, Megan Fisher, Sean Cross, and Chris Attoe. "Simulation training for police and ambulance services to improve mental health practice." Journal of Mental Health Training, Education and Practice 15, no. 5 (September 25, 2020): 303–14. http://dx.doi.org/10.1108/jmhtep-04-2020-0020.
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Purpose Emergency services face increasing frontline pressure to support those experiencing mental health crises. Calls have been made for police and ambulance staff to receive training on mental health interventions, prevention of risk and inter-professional collaboration. Mental health simulation training, a powerful educational technique that replicates clinical crises for immersive and reflective training, can be used to develop competencies in emergency staff. This study aims to evaluate the effectiveness of mental health simulation training for police and ambulance staff. Design/methodology/approach In total, 199 participants from the London Metropolitan Police Service and London Ambulance Service attended a one-day simulation training course designed to promote effective and professional responses to mental health crises. Participants took part in one of six simulated scenarios involving mental health crisis before completing structured debriefs with expert facilitators. Participants’ self-efficacy and attitudes towards mental illness were measured quantitatively using pre- and post-course questionnaires while participants’ perceived influence on clinical practice was measured qualitatively using post-course open-text surveys. Findings Statistically significant improvements in self-efficacy and attitudes towards mental illness were found. Thematic analyses of open-text surveys found key themes including improved procedural knowledge, self-efficacy, person-centred care and inter-professional collaboration. Originality/value This study demonstrates that mental health simulation is an effective training technique that improves self-efficacy, attitudes and inter-professional collaboration in police and ambulance staff working with people with mental health needs. This technique has potential to improve community-based responses to mental health crises.
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Burns, T. "Community-Based Mental Health Care in Britain." Consortium Psychiatricum 1, no. 2 (December 4, 2020): 14–20. http://dx.doi.org/10.17650/2712-7672-2020-1-2-14-20.
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Community mental health care in the UK was established by two influential mental health acts (MHAs). The 1930 MHA legislated for voluntary admissions and outpatient clinics. The 1959 MHA required hospitals to provide local follow- up after discharge, required them to work closely with local social services and obliged social services to help with accommodation and support. An effect of this was to establish highly sectorized services for populations of about 50,000. These were served by multidisciplinary teams (generic CMHTs), which accepted all local referrals from family doctors. Sector CMHTs evolved a pragmatic approach with an emphasis on skill-sharing and outreach, depending heavily on community psychiatric nurses. The NHS is funded by central taxation, with no distortion of clinical practice by per-item service fees. It is highly centrally regulated, with a strong emphasis on evidence-based treatments.Since 2000, generic sector teams have gradually been replaced or enhanced by Crisis Resolution Home Treatment teams, Assertive Outreach Teams and Early Intervention Teams. Assertive Outreach Teams were resorbed into CMHTs, based on outcome evidence. The last decade has seen a major expansion in outpatient psychotherapy (Improving Access to Psychological Treatments (IAPT) services) and in specialist teams for personality disorders and perinatal psychiatry. The traditional continuity of care across the inpatient-outpatient divide has recently been broken. During the last decade of austerity, day care services have been decimated, and (along with the reduction in availability of beds) compulsory admission rates have risen sharply. Mental health care is still disadvantaged, receiving 11% of the NHS spend while accounting for 23% of the burden of disease.
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Farchi, M. U. "(A65) Stress & Trauma Studies Program (STSP): Theoretical & Practical Emergency Mental Health Interventions Studies for BA Social Work Students." Prehospital and Disaster Medicine 26, S1 (May 2011): s18. http://dx.doi.org/10.1017/s1049023x11000720.
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The Tel Hai college Department of Social Work established this program as part of its community commitment to ensure that persons with skills in emergency mental health / trauma intervention will be available to the community as first responders when needed. The main goal of the STSP: Training Social work students As First Responders with Very High Professional Standards of Emergency as well as Long Term Mental Health Interventions Qualifications. This program enables the students to integrate between theory and hands-on basic and advanced skills in stress & trauma interventions – from the help to a single traumatized person to mass disasters involving more complex interventions. In addition, program underlines and empowers the students self efficacy and resilience. The studies are carried out in 4 main channels: A. Academic studies and advanced professional workshops. B. Outdoor drills with other help and rescue units: MDA (EMS), IDF, Police, Israel fire and rescue services, local and national rescue units) C. Volunteering in community trauma / first responder units D. Emergency mental health interventions during real time events (Last one: Emergency interventions among the evacuated families during the mount Carmel bushfire) Student's Skills Acquired During the STSP • Theoretical & practical knowledge of the stress & trauma development process. • Differentional diagnosis of the trauma stages (From ASR to C-PTSD). • Identifying all sources of resilience and coping strategies. • Basic & advanced crisis and disaster intervention methods. • Crisis & disaster management & command • Professional self confidence, Independency & Creativity, leadership and leading capabilities. The program, its benefits and latest drills and real time intervention will be discussed as well as demonstrated with videos.
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Caldas De Almeida, J. M. "Innovative mental health policies, plans and interventions: How to manage consequences of economic crisis?" European Psychiatry 64, S1 (April 2021): S69. http://dx.doi.org/10.1192/j.eurpsy.2021.215.
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Abstract BodyAvailable evidence shows that countries may shield their population’s exposure and vulnerability to mental health risks during and after an economic recession by strengthening their policies and reorienting their budgets. Populations’ mental health protection during economic crises can only be achieved by the policies of different sectors. Social protection, social programmes and social safety nets proved to be fundamental buffers against inequalities in mental health. Several actions have proven to be effective in this area, including measures to improve social protection, reduce income inequalities, and mitigate the impacts of unemployment. To address the negative consequences of unemployment, active labour market programmes, including special programmes for unemployed young people and families, programmes to promote the employment of people with disabilities, and debt relief programmes should be implemented. The response of the health system is critical. During and after economic recessions, it is fundamental to ensure the responsiveness and effectiveness of the mental health system. To attain this goal, mental health services that are closer to the populations and that facilitate the early identification of mental health problems and the implementation of integrated interventions should be strengthened. The latter is a crucial approach to tackle the mental health problems that more often worsen in periods of economic instability, such as depression, suicidal behaviour and heavy drinking. A special attention should also be dedicated to strengthening the network of community-based mental health services, promoting the integration of mental health in primary care, and enhancing the coordination between mental health services and social care.DisclosureNo significant relationships.
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Harrison, Judy, and Barry Traill. "What do consultants think about the development of specialist mental health teams?" Psychiatric Bulletin 28, no. 3 (March 2004): 83–86. http://dx.doi.org/10.1192/pb.28.3.83.
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Aims and MethodThe UK Government is promoting three types of specialist team in psychiatry: assertive outreach, crisis resolution and early intervention in psychosis. Policy guidance suggests that psychiatrists be recruited to work exclusively within these teams, but little is known about the views of psychiatrists regarding their development. A postal survey was undertaken to seek the views of consultant psychiatrists in the North West.ResultsSeventy per cent of psychiatrists responded to the questionnaire. Equal numbers agreed and disagreed with the development of specialist roles. Few services had been able to recruit to extra consultant sessions within the new teams and only a third of consultants believed the resources so far available to be reasonable. Overall views of the new teams were positive (mean scores 6.36, 6.51 and 6.03 on a 1–10 visual analogue scale for assertive outreach, crisis resolution and early onset psychosis teams). Consultants are particularly likely to believe that the new teams will increase patient satisfaction and provide a welcome change in role for some psychiatrists. A total of 64% of consultants believe that crisis resolution services could reduce hospital admissions, compared with 41% for assertive outreach and 31% for early onset psychosis teams. The concern most often voiced was that new services are being developed at the expense of existing teams.Clinical ImplicationsConsultants perceive benefits associated with the new teams but are concerned about their impact on the rest of the organisation. If resource and recruitment issues can be addressed, consultants could prove to be supportive of these new models of service.
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Pacichana-Quinayáz, Sara Gabriela, Gisel Viviana Osorio-Cuéllar, Francisco Javier Bonilla-Escobar, Andrés Fandiño-Losada, and María Isabel Gutiérrez-Martínez. "Common Elements Treatment Approach based on a Cognitive Behavioral Intervention: implementation in the Colombian Pacific." Ciência & Saúde Coletiva 21, no. 6 (June 2016): 1947–56. http://dx.doi.org/10.1590/1413-81232015216.07062015.
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Abstract Due to the limited supply of mental health services for Afro-Colombian victims of violence, a Common Elements Treatment Approach (CETA) intervention has been implemented in the Colombian Pacific. Given the importance of improvement in mental health interventions for this population, it is necessary to characterize this process. This article seeks to describe the implementation of CETA for Afro-Colombian victims of violence in Buenaventura and Quibdó, Colombia through case studieswith individual in-depth interviews with Lay Psychosocial Community Workers (LPCW), supervisors, and coordinators responsible for implementing CETA. From this six core categories were obtained: 1. Effect of armed conflict and poverty 2. Trauma severity 3. Perceived changes with CETA 4. Characteristics and LPCW’s performance 5. Afro-Colombian culturalapproach and 6. Strategies to promote users’ well-being.Colombian Pacific’s scenario implies several factors, such as the active armed conflict, economic crisis, and lack of mental health care resources, affecting the implementation process and the intervention effects. This implies the need to establish and strengthen partnerships between institutions in order to administer necessary mental health care for victims of violence in the Colombian Pacific.
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Christodoulou, N. "Economic crisis and mental health – findings from Greece." Die Psychiatrie 14, no. 02 (April 2017): 90–94. http://dx.doi.org/10.1055/s-0038-1669558.
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Summary Background: The direct and indirect effects of the economic crisis in Greece have resulted in inequalities, poverty and unemployment. Public health services, social care and welfare have been both severely curtailed and overstretched by increased demand due to higher private care costs and the refugee crisis. For society’s most vulnerable this is beyond an economic crisis, it is a humanitarian crisis. Method: In this narrative review we report a continued rise in suicides, persistent mental health problems in the population, and continued systemic problems despite some successful reforms and slowing of the economic deterioration. Synergistic effects are identified between pre-existing systemic weaknesses, the effects of the crisis, and the effects of austerity. Outlook: Psychiatrists should promote evidence- based interventions, for example preventing mental illness by supporting vulnerable groups and by reducing inequalities. Evidence-based heurism is advocated for, in the interest of outcome. Psychiatrists also have a political role in tackling stigma towards mental illness, refugees and other vulnerable groups, and in promoting resilience and solidarity.
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Harris, Joseph, Isabel Clarke, and Simon Riches. "Developing 'Comprehend, Cope and Connect' Training for Acute and Crisis Mental Health Services: Staff, Patient and Carer Perspectives." Journal of Psychiatric Intensive Care 19, no. 1 (September 1, 2023): 33–50. http://dx.doi.org/10.20299/jpi.2023.004.
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'Comprehend, Cope and Connect' (CCC) is an evidence-based psychological intervention for psychological crisis designed for use in inpatient settings. The aims of the current study were to gain the perspectives of multidisciplinary team (MDT) staff, patients and carers to inform the design of a potential CCC training programme for MDT staff to deliver CCC interventions. Staff, patient and carer perspectives on developing a CCC training programme were collected through video call-based group consultations and written feedback. Thematic analysis was employed to organise and explore latent themes within the data. Thirteen MDT inpatient staff and an expert patient and carer panel of four participated in the study. Feedback showed that the CCC model supported staff in understanding patients beyond labels in a patient-centred and led capacity, and that CCC was helpful in bringing clarity to crisis. Staff participants stated that learning and practicing psychological skills and encouraging confidence would be important when training staff in CCC. They identified needs to embed CCC into ward culture and integrate CCC with care planning for successful implementation of CCC in inpatient settings. The patient and carer panel focused on the needs of patients, concluding that CCC training should emphasise the need to understand patient experience, and promote compassion and empathy. These findings provide evidence for what staff, patients, and carers consider to be important when training MDT staff to deliver CCC interventions in an inpatient setting and form a foundation for implementation of CCC training.
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Hanlon, Claire Anne, Jennifer Chopra, Jane Boland, David McIlroy, Helen Poole, and Pooja Saini. "James’ Place model: application of a novel clinical, community-based intervention for the prevention of suicide among men." Journal of Public Mental Health 21, no. 1 (January 21, 2022): 82–92. http://dx.doi.org/10.1108/jpmh-09-2021-0123.
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Purpose High suicide rates among men presents a global challenge for commissioners and clinicians. Innovative approaches towards suicide prevention interventions designed for men are needed. The James’ Place (JP) service opened in 2018, and its model of practice is a clinical, community-based intervention for men experiencing suicidal crisis. This paper aims to describe the implementation framework within which the JP model is applied. Design/methodology/approach Fostering a public health case study approach, this paper provides a description of how the JP service operates, including the referral pathways, key components of this innovative model and its impact upon the men who receive the intervention. Illustrative case studies derived from semi-structured interviews from men and therapists are reported. Findings The JP model is dynamic and flexible, allowing the tailoring of a suicidal crisis intervention to suit the needs and priorities of the individual and the wider local community. Clinical and practical implications, such as reduction in suicidality, are discussed. Originality/value Rapidly accessible, effective community-based interventions for men experiencing suicidal crisis are required. Yet, while widely advocated in policy, there remains a dearth of evidence illustrating the real-world application and value of such services within a community-setting. To the best of the authors’ knowledge, the JP model is the first of its kind in the UK and an example of an innovative clinical, community-based suicide prevention intervention offering support for men experiencing suicidal crisis.
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Jennings, Paul, and Catherine B. Matheson-Monnet. "Multi-agency mentoring pilot intervention for high intensity service users of emergency public services: the Isle of Wight Integrated Recovery Programme." Journal of Criminological Research, Policy and Practice 3, no. 2 (June 12, 2017): 105–18. http://dx.doi.org/10.1108/jcrpp-01-2017-0007.
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Purpose The purpose of this paper is to describe the design, implementation and evaluation of a small UK case study of a mentoring style pilot intervention integrating a specially trained police officer alongside mental health professionals to support highly intensive service users of emergency services. Design/methodology/approach The development of the conceptual framework informing the mentoring intervention is described and its implementation evaluated using a range of qualitative and quantitative outcome measures. Findings The four high intensity service users involved in the pilot had internalised the need to participate in recommended recovery pathways. Mental health nurses reported improved compliance with treatment. Although the sample was small, the number of police mental health crisis detentions was reduced by 66 per cent after one year and by 100 per cent after 18 months. Usage of other emergency public services had also drastically reduced, or been eliminated altogether. Research limitations/implications Limited time and resources and the need for a solution that could be implemented as soon as possible meant a pragmatic design, implementation and evaluation. Practical implications The study indicated that a wider roll out of the new multi-agency mentoring model would be beneficial. Originality/value This is the first intervention to integrate mental health professionals and a trained police officer directly into the care pathway of repeated users of emergency public services with complex mental health needs.
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Ismayilov, Fuad Nadir. "Community-Based Mental Health Services in Azerbaijan: a Course Toward Development." Consortium Psychiatricum 3, no. 1 (January 15, 2022): 106–12. http://dx.doi.org/10.17816/cp141.
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Community mental health care in Azerbaijan was established in 2011 in the line with the countrys mental health reform. The main directions of the reform, as described in the National Mental Health Strategy, were deinstitutionalization, improving quality of care, integration of mental health into primary healthcare, and implementation of modern community-based services. Over the last decade, the number of beds in psychiatric hospitals has significantly decreased, and many psychiatrists and psychiatric nurses have been transferred to primary care facilities. At the same time, programs focusing on comprehensive care have been implemented in different regions of the country.
Community mental health services currently employ various kinds of mental health professional including psychiatrists, clinical psychologists, social workers, occupational therapists, and nurses to ensure a multidisciplinary approach to care provision. Team-based care may focus on crisis resolution, psychosocial rehabilitation, case management, family support, and early intervention for psychosis.
Among the barriers preventing development of community mental health services, one should note, in particular, stigma belittling the priority of mental healthcare, uncertainty in distribution of authority between the Ministry of Health and the State Agency for Mandatory Health Insurance, and a general scarcity of human resources, especially in the rural regions. Nevertheless, the mental health care in Azerbaijan is continuing its transition from an institutional model to community-based services.
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Warrington, Claire. "Repeated Police Mental Health Act Detentions in England and Wales: Trauma and Recurrent Suicidality." International Journal of Environmental Research and Public Health 16, no. 23 (November 29, 2019): 4786. http://dx.doi.org/10.3390/ijerph16234786.
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Most police Mental Health Act (Section 136) detentions in England and Wales relate to suicide prevention. Despite attempts to reduce detention rates, numbers have risen almost continually. Although Section 136 has been subject to much academic and public policy scrutiny, the topic of individuals being detained on multiple occasions remains under-researched and thus poorly understood. A mixed methods study combined six in-depth interviews with people who had experienced numerous suicidal crises and police intervention, with detailed police and mental health records. A national police survey provided wider context. Consultants with lived experience of complex mental health problems jointly analysed interviews. Repeated detention is a nationally recognised issue. In South East England, it almost exclusively relates to suicide or self-harm and accounts for a third of all detentions. Females are detained with the highest frequencies. The qualitative accounts revealed complex histories of unresolved trauma that had catastrophically damaged interviewee’s relational foundations, rendering them disenfranchised from services and consigned to relying on police intervention in repeated suicidal crises. A model is proposed that offers a way to conceptualise the phenomenon of repeated detention, highlighting that long-term solutions to sustain change are imperative, as reactive-only responses can perpetuate crisis cycles.
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Vindhya, U., Sunayana Swain, Praful Kapse, and Nachiket Sule. "Farmers’ Suicides and Psychosocial Intervention." Psychology and Developing Societies 34, no. 1 (March 2022): 104–24. http://dx.doi.org/10.1177/09713336221083048.
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Farmers’ suicides in India, exemplifying the agrarian crisis, have been a contemporary cause of grave concern. The Vidarbha Psychosocial Support and Care Program (VPSCP) in western India is an example of a psychosocial intervention being implemented to address the psychological consequences of adverse circumstances triggered by the agrarian distress of farmers through a multi-pronged strategy of delivery of mental health care services to those in need dovetailed with livelihood/employment support schemes. This article, which forms part of a larger evaluation carried out on the impact and effectiveness of the VPSCP, focuses primarily on the process and functioning of the programme; its strengths and challenges through the perspectives of key stakeholders; and perceptions of psychosocial stress in the community. Although firmer linkages with the government health care programme and with employment support/welfare schemes is needed, the VPSCP can be taken as a viable template for the integration of socio-economic determinants and mental health concerns in the agrarian context in order to reduce the incidence of suicide.
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Saputra, Danny Eka Wahyu, Wawan Sundawan Suherman, Sigit Nugroho, Panut Sumardi, and Puji Asmawati. "Post-Covid-19 health promotion in universities: mental health and social media promotion." Fizjoterapia Polska 23, no. 5 (December 31, 2023): 85–94. http://dx.doi.org/10.56984/8zg20b900.
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The crisis due to the Covid-19 pandemic has impacted the way of life, work, and learning processes. The government has issued a policy of adopting a new custom order to suppress the transmission of Covid-19 and continue to move people’s habits. Universities as educational centers have interdisciplinary, multidisciplinary, and transdisciplinary roles and contributions through health promotion research and outreach activities by taking a role in overcoming the Covid-19 pandemic. Universities have an innovative role in preparing for the Covid-19 endemic through their work in education, research, and counseling. With the pandemic and post-Covid-19 preparations, universities are intensifying support in terms of providing health services for the academic community, one of which is sustainable health promotion services. Health promotion on campus after the Covid-19 pandemic can be done by adopting general health promotion strategies, including 1) cross-sectoral coordination, 2) importance and sustainability, 3) empowerment and involvement of the academic community, and 4) equity. Mental health for students and teachers after online teaching is very important. Social media has great potential to promote health and other health interventions as it overcomes some of the limitations of traditional health communication by increasing accessibility, interaction, engagement, empowerment, and adaptation. Health promotion in universities by utilizing social media has several advantages, namely accessibility, convenience, low cost, interaction with end-users, flexibility, status, and visibility. With the good momentum of social media engagement coupled with the new need to focus on health promotion, offering digital media-based online health promotion services is one of the possible actions. Digital media has significant promise for health promotion and other health intervention activities.
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Bareham, Bethany, Deepti John, Amy O’Donnell, Jennifer Liddle, and Barbara Hanratty. "ADDRESSING CO-OCCURRING ALCOHOL AND MENTAL HEALTH PROBLEMS IN OLDER ADULTS: CO-DESIGNED DIRECTIONS FOR PRACTICE." Innovation in Aging 7, Supplement_1 (December 1, 2023): 571. http://dx.doi.org/10.1093/geroni/igad104.1871.
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Abstract Older people in the UK experience the highest rates of alcohol-related harm of all age groups, due to reduced tolerance to alcohol with age. Most older people drinking at harmful levels have co-occurring mental health problems. This population fall between services, which are ill-equipped to address their complex and multifaceted needs. This study aimed to co-design directions for integrated services to support this group in North East/North Cumbria, England. Co-design was guided by Intervention Mapping, and was informed by four workshops with older people with co-occurring alcohol/mental health problems; informal caregivers and supporting practitioners. Workshops built on evidence from i) a preceding qualitative study with these groups examining lived experience, support needs, and challenges in supporting this group and ii) a literature review of existing interventions/services for older people with alcohol or mental health problems. Findings highlight the importance of availability, accessibility and flexibility of support for older people, who often present in crisis, and can face additional barriers to accessing services such as hearing/mobility issues. Mental health practitioners should be trained in identifying and addressing harmful drinking in older people. Practitioners must be knowledgeable of relevant, local services and prepared to signpost appropriately. Care should encompass peer support, and support and advocacy to address wider issues that impact mental health and alcohol use including finances, social isolation and illness. This study informs the development of integrated community alcohol/mental health support for this patient group. Applicability of directions to other care systems is considered.
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De Gaglia, J. "Effect of Small Group Crisis Intervention (Defusing) on Negative Affect and Agreeableness to Seeking Mental Health Services." Brief Treatment and Crisis Intervention 6, no. 4 (November 2006): 308–15. http://dx.doi.org/10.1093/brief-treatment/mhl010.
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Seeman, Mary V. "Intervention to Prevent Child Custody Loss in Mothers with Schizophrenia." Schizophrenia Research and Treatment 2012 (2012): 1–6. http://dx.doi.org/10.1155/2012/796763.
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Depending on jurisdiction, time period studied, and specifics of the population, approximately 50 percent of mothers who suffer from schizophrenia lose custody of their children. The aim of this paper is to recommend interventions aimed at preventing unnecessary custody loss. This paper reviews the social work, nursing, psychology, psychiatry, and law literature on mental illness and custody loss, 2000–2011. Recommendations to mothers are to (a) ensure family health (b) prevent psychotic relapse, (c) prepare in advance for crisis, (d) document daily parenting activities, (e) take advantage of available parenting resources, and f) become knowledgeable about legal issues that pertain to mental health and custody. From a policy perspective, child protection and adult mental health agencies need to dissolve administrative barriers and collaborate. Access to appropriate services will help mothers with schizophrenia to care appropriately for their children and allow these children to grow and develop within their family and community.
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Bagchi, Dhruba, George Tadros, and Opeyemi Odejimi. "A narrative literature review of the typology of psychiatric emergency services in the UK." BJPsych Open 7, S1 (June 2021): S235. http://dx.doi.org/10.1192/bjo.2021.629.
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AimsThis study aims to provide a detailed literature review of the different forms of Psychiatric Emergency Services currently available within the UK.Background1 in 6 individuals have one form of mental health disorders. Mental health crisis resulting in an individual requiring access to Psychiatric Emergency Service (PES) can occur at any time. Psychiatric Emergency Service (PES) is described as one that provides an immediate response to an individual in crisis within the first 24 hours. Presently, several PESs are available in the UK with the aim of providing prompt and effective assessment, management and in some cases treatment and/or referral. Over the years, economic and political influences have greatly determined the service delivery models of PES. Indeed, these services vary in name, accessibility, structure, professionals involved, outcomes and many more.MethodElectronic search of five key databases (MEDLINE, PsychINFO, EMBASE, AMED and PUBMED) was carried out to identify various models of PES in the UK. Various combinations of search terms were used and studies which met the inclusion criteria were selected. Studies were included if they were written in English, conducted within the United Kingdom, and described a form of PES. Search was not limited by years and this is to help have a comprehensive overview as well as show changes over time of the various models of psychiatric emergency services. Studies which did not meet any of the criteria detailed above were excluded.ResultIn total, 59 relevant studies were found which identified nine type of PES-Crisis resolution home treatment, police officer intervention, street triage, mental health liaison services in the Emergency Department, psychiatric assessment unit, integrated services, voluntary services and crisis house. There were more papers describing Crisis resolution home treatment services than the others. Furthermore, majority of the papers reported services within England than other countries within the UK.ConclusionAll forms of PES are beneficial, particularly to mental health service users, but not without some shortcomings. There is a need to continue carrying out methodological research that evaluate impact, cost-effectiveness as well as identify methods of optimising the beneficial outcomes of all models of PES. This will inform researchers, educationist, policy makers and commissioners, service users and carers, service providers and many more on how to ensure current and future PES meet the needs as well as aid recovery of mental health service users.
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Hilton, Emily, Jacqueline Smith, Andrew Szeto, Stephanie Knaak, Eric Chan, Rachel Grimminck, Jennifer Smith, Sarah Horn, and Wafa Mustapha. "Exploring Mental health Barriers in Emergency Rooms (EMBER)." Canadian Journal of Emergency Nursing 46, no. 1 (May 11, 2023): 15–16. http://dx.doi.org/10.29173/cjen209.
Full textAbstract:
Background: Mental illness stigma is a complex public health issue that creates barriers for clients seeking services. For many clients, an ED visit may be their first point of contact with the health-care system for a mental illness/addiction crisis – but it often results in poor outcomes and negative experiences due to discriminatory and structural inequities. Calgary Health Foundation has funded a five-year multiphase study (EMBER) to explore stigma holistically through patients, families, physicians, psychiatrists, nurses, and protective services in FMC ED. The goal is to explore, address, understand, and evaluate interventions that mitigate stigma at both the individual and organizational levels. Methods: The EMBER research team is working collaboratively with AHS Policy Services team to examine mental health and addiction-related policies that may be connected to institutional stigma and practices that create barriers to access, help-seeking and the provision of mental health and addiction services. The ORBIT model is being used as a conceptual framework to support the cross-disciplinary approaches used by the research team to explore clinical and public health policy needs (phases 1 & 2); multiple intervention strategies (phase 3); targeted changes in health behaviors related to mental health stigma; and the potential of behavioral treatments to affect health outcomes (phases 4 & 5). Intervention implementation considerations include: (1) the perceived fit between proposed training and identified learning needs; (2) the suitability of intervention content for different learner groups; (3) intervention length; (4) format of delivery; (5) size of training groups; (6) mix of professionals within groups; (7) incentives for participation; (8) sustainability; (9) support for reinforcement of training over time; (10) anticipated implementation challenges and how to address them; and (11) expected or desired outcomes. Evaluation Methods: Addressing structural and resource inequities in the delivery of mental health/addiction care is a focal point of our study and an evidenced based pathway to ensure improved health outcomes for all Albertans. We are employing a mixed-method approach to capture quantitative and qualitative findings related to the experiences of patients/families, health care providers, and protective services as well as the policies that inform the delivery of care in ED settings. Evaluation throughout Phases 1/2 included thematic analysis of interview and focus group transcripts. In Phase 1, baseline surveys were used to collect demographics of participants and current levels of stigma amongst ED staff. Phase 2a, includes policy review through a human rights lens. In Phase 3, quantitative and qualitative surveys will be used pre- and post-intervention, and at follow up points (TBD). In Phases 4/5, the intervention data will be synthesized and used to inform recommendations for scale and spread. Results: Based on in-depth 60–90-minute focus groups or interviews with patients/families, health care providers, and protective services in phase one, the following results were captured using thematic analysis. Structural Stigma · Mental health rooms in the ED feel like “jail cells” · Staffing and other resource inequities for mental health care · Lack of training and role confusion Interpersonal Stigma · Patients/families: perceived lack of mental health training and resources, leading to unsatisfactory experiences, including in many cases, experiences of harm · Staff: inadequate mental illness training and occupational distress contribute to staff burnout and compassion fatigue Intrapersonal Stigma · Patients/families: lack of communication and dehumanizing interactions with staff contributing to feelings of isolation, shame, and hopelessness · Staff: vulnerability in disclosing personal mental health struggles Advice and Lessons Learned: Including a patient research partner in this study ensures that the voices of patients/families are heard, respected, and represented, and that a focus on patient-identified priorities and outcomes is maintained. Our PRP is an active and important member of our research team who acts as a liaison and role model during focus group discussions with patients and families. She assists with stigma reduction by using her lived experience and voice to educate others. More recently, we have identified professional silos within the healthcare system that have become the catalyst for promoting collaboration between EMBER researchers, AHS AMH clinical and operational leaders, and the Calgary Health Foundation (funder). Prioritizing the engagement of multiple stakeholders who have a direct interest in the process and outcomes of this study and how it is translated back into structural, policy and practice changes, is an important pathway to achieving sustained positive impact.