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1
Thornicroft, Graham. "Targeting mental health services to severe mental illness." Epidemiologia e Psichiatria Sociale 4, no. 3 (1995): 181–86. http://dx.doi.org/10.1017/s1121189x00010381.
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SummaryThis paper argues within the mental health services that people who are most disabled by mental illness, the severely mentally ill (SMI), should be afforded the highest priority, and that services should be provided in relation to need. For this to occur the priority groups need first to be defined. Second, if a service wishes to provide for all prevalent cases of people suffering from severe mental illness, then a systematic method of recording local information about these people is required, and this may draw upon information about patients who are in contact with health services, social services, family health services and who contact voluntary sector and other agencies. One approach to estimating the need for services for people with SMI is by using indicative norms for service requirements. Finally, managerial methods are proposed to monitor how far targeting services to the SMI occurs in clinical practice.
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Saraceno, Benedetto, and Corrado Barbui. "Poverty and Mental Illness." Canadian Journal of Psychiatry 42, no. 3 (April 1997): 285–90. http://dx.doi.org/10.1177/070674379704200306.
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Objective To assess the relationship between poverty and mental illness in order to stimulate debate on future international cooperation programs in mental health. Method Epidemiological data in the international literature addressing the issue of material poverty as a risk factor for the development of mental illness and as a prognostic factor for the outcome of mental illness were reviewed. Results The international literature reviewed supports the notion that material poverty is a risk factor for a negative outcome among mentally ill people. In addition, preliminary epidemiological data suggest that service-related variables may be determinants of outcome of mental illnesses. In our view, cooperation with developing countries is a great opportunity to evaluate mental health services in a natural setting. Conclusions A new generation of programs for international cooperation in mental health is needed, in which knowledge and technology transfer is based on a service-research attitude. Attention should be focused on variables related to the poverty of services that might be linked to the course and outcome of mental illnesses.
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Puszka, Stefanie, Kylie M. Dingwall, Michelle Sweet, and Tricia Nagel. "E-Mental Health Innovations for Aboriginal and Torres Strait Islander Australians: A Qualitative Study of Implementation Needs in Health Services." JMIR Mental Health 3, no. 3 (September 19, 2016): e43. http://dx.doi.org/10.2196/mental.5837.
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Background Electronic mental health (e-mental health) interventions offer effective, easily accessible, and cost effective treatment and support for mental illness and well-being concerns. However, e-mental health approaches have not been well utilized by health services to date and little is known about their implementation in practice, particularly in diverse contexts and communities. Objective This study aims to understand stakeholder perspectives on the requirements for implementing e-mental health approaches in regional and remote health services for Indigenous Australians. Methods Qualitative interviews were conducted with 32 managers, directors, chief executive officers (CEOs), and senior practitioners of mental health, well-being, alcohol and other drug and chronic disease services. Results The implementation of e-mental health approaches in this context is likely to be influenced by characteristics related to the adopter (practitioner skill and knowledge, client characteristics, communication barriers), the innovation (engaging and supportive approach, culturally appropriate design, evidence base, data capture, professional development opportunities), and organizational systems (innovation-systems fit, implementation planning, investment). Conclusions There is potential for e-mental health approaches to address mental illness and poor social and emotional well-being amongst Indigenous people and to advance their quality of care. Health service stakeholders reported that e-mental health interventions are likely to be most effective when used to support or extend existing health services, including elements of client-driven and practitioner-supported use. Potential solutions to obstacles for integration of e-mental health approaches into practice were proposed including practitioner training, appropriate tool design using a consultative approach, internal organizational directives and support structures, adaptations to existing systems and policies, implementation planning and organizational and government investment.
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Krumm, Silvia, Thomas Becker, and Silke Wiegand-Grefe. "Mental health services for parents affected by mental illness." Current Opinion in Psychiatry 26, no. 4 (July 2013): 362–68. http://dx.doi.org/10.1097/yco.0b013e328361e580.
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Fan, Cynthia, and Wally Karnilowicz. "Attitudes Towards Mental Illness and Knowledge of Mental Health Services Among the Australian and Chinese Community." Australian Journal of Primary Health 6, no. 2 (2000): 38. http://dx.doi.org/10.1071/py00017.
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The study aimed to examine the attitudes toward mental illness and knowledge of mental health services among Anglo-Australian and Chinese-Australian adults. Participants included 105 Anglo-Australians and 129 Chinese-Australians. Participants were requested to complete a questionnaire on attitudes toward mental illness and knowledge of mental health service available in the community. The results indicated that there was a significant ethnic difference in attitudes towards mental illness. Chinese-Australians endorsed authoritarian, restrictive attitudes towards people with mental illness and interpersonal etiology more than Anglo-Australians. There was also a significant difference in attitudes towards mental illness due to the amount of contact with people with mental illness. The more contact the participants had with people with mental illness, the less they endorsed authoritarian, and restrictive attitudes toward people with mental illness. Though there was a non-significant difference in knowledge of mental health services due to ethnic origin or amount of contact with people with mental illness, there were ethnic differences in the type of mental health services preferred. Among Chinese-Australians, age was positively related to knowledge of services for acute and chronic cases of mental illness. Implications for community mental health education programs are discussed.
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Cookson, Ian B. "Development of Mental Health Services." Bulletin of the Royal College of Psychiatrists 10, no. 7 (July 1986): 180–81. http://dx.doi.org/10.1192/s0140078900027814.
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In the Mersey Regional Health Authority it has been decided that closure of at least one large mental illness hospital will take place within some 10 years and may be complete by 1992. To facilitate this the region has provided funding for every long-stay patient who might be discharged to the care of voluntary organisations or Social Services Departments and joint assessments of patients have been undertaken by the Health Service and Social Services staff.
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Thukral, Vanshika. "Mental Health Camp- A Report." Indian Journal of Youth & Adolescent Health 07, no. 03 (February 3, 2021): 26–30. http://dx.doi.org/10.24321/2349.2880.202016.
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Introduction: Mental health camps serve the purpose of enhancing people’s awareness about mental health and offer to amend related fallacy and stigma and wrong attitude towards mental illness and people with mental illness. Mental health camps offer a potential to local community to receive affordable help and utilise the available resources to identify, counsel or refer people with mental health issues or in crises situations to community agencies for providing mental health care services. Material and Methods: A one day free mental health screening, referral and counselling camp was organized on November 20, 2019 in Jamia Hamdard (deemed to be university), Delhi, premises for students and staff. The camp was conducted with due permission from Registrar with a prior notice to the security officer. Standardized inventories for anxiety, depression and stress were administered. After interpretation of scores, those in need of counselling were given one to one counselling, and further referrals, if required, were done by the mental health professionals. A total of 525 students and staff walked in the camp and 86 students were given spot counselling and referral as required. The results from inventories were later analysed and reported. Result: The analysis of inventories showed that more than 50% respondents had 50% probability of developing major stress induced health problems in the near future. More than 2/3rd participants had moderate level of stress. The camp helped in dispelling the stigma associated with talking about one’s mental health and consolidated the belief that it is okay to talk about one’s mental health.
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Malla, Ashok, Alyssa Frampton, and Bilal Issaoui Mansouri. "Youth Mental Health Services: Promoting Wellness or Treating Mental Illness?" Canadian Journal of Psychiatry 65, no. 8 (April 22, 2020): 531–35. http://dx.doi.org/10.1177/0706743720920033.
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Rhouma, Abdul Hakim, Nusrat Husain, Nadeem Gire, and Imran Bashir Chaudhry. "Mental health services in Libya." BJPsych. International 13, no. 3 (August 2016): 70–71. http://dx.doi.org/10.1192/s2056474000001288.
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Despite all the internal and external criticisms of mental health services in Libya, they remain underdeveloped across the country. The World Health Organization has made efforts to improve the country's mental health services; however, until a stable government is formed, patients with mental illness will continue to be deprived of their basic needs.
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Glover, Gyles. "The Mental Illness Needs Index." Epidemiologia e psichiatria sociale. Monograph Supplement 6, S1 (April 1997): 13–20. http://dx.doi.org/10.1017/s1827433100000794.
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It is well known that the prevalence of mental illness is not uniformly distributed. This has practical consequences for the planning, financing and evaluation of public mental health services. Areas likely to have greater morbidity are likely to require more resources. The question is by how much? This essay describes a method devised in the context of the English health service to provide practical help to mental health planners faced with this type of question.
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Lederman, Oscar, Bonnie Furzer, Kemi Wright, Grace McKeon, Simon Rosenbaum, and Rob Stanton. "Mental Health Considerations for Exercise Practitioners Delivering Telehealth Services." Journal of Clinical Exercise Physiology 10, no. 1 (March 1, 2021): 20–28. http://dx.doi.org/10.31189/2165-7629-10.1.20.
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ABSTRACT In Australia, exercise practitioners (i.e., clinical professionals specializing in exercise assessment and delivery) are increasingly recognized as core mental health team members. In response to the COVID-19 pandemic, exercise practitioners, like other mental health professions, have had to adapt methods of clinical service delivery to ensure social distancing and reduce risk of community transmission. As such, telehealth interventions have rapidly replaced most face-to-face services. To date, evidence surrounding the application of telehealth exercise interventions for people living with mental illness is scarce, and currently there is no consensus or recommendations on how exercise practitioners can provide telehealth services for this population. As such, the aim of this article is to draw on existing research and expert opinion to provide practical and service-based guidance for exercise practitioners delivering telehealth services to people with mental illnesses. Specifically, we explore the potential benefits of telehealth exercise interventions, the various challenges and considerations of telehealth exercise among those with mental illness, and some practical solutions to guide exercise practitioners in delivering telehealth services.
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Attepe Ozden, S., and A. Icagasioglu Coban. "Community mental health services in the eyes of community mental health centers staff." European Psychiatry 41, S1 (April 2017): S602. http://dx.doi.org/10.1016/j.eurpsy.2017.01.940.
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IntroductionCommunity mental health centers (CMHC) are established for providing services to individuals with serious mental illness. In these centers, individual's need of treatment and care are expected to be met with a mental illness in the community as possible. The process of community mental health service creation in Turkey is relatively new and gaining popularity in last 7–8 years. First CMHC was established in 2008. After this date CMHCs’ have been opened and the target of 2016 is reaching across 236 CMHC in Turkey.ObjectivesIn this context, this study aims to provide views of psychiatrists, nurses, social workers, psychologists and occupational therapists who work in CMHC for the services that provided to individuals in these CMHC's and learn how to define their professional roles and responsibilities in CMHC.MethodsThis paper used qualitative research design. Data was collected from 7 CMHC in Ankara through in-depth interviews with a total of 30 people consisting of psychiatrists, nurses, social workers, psychologists and occupational therapists.ResultsThe participants look positively about given services, however, financial pressure in the creation process of services, problems in employee personal rights and lack of policies and services related to mental health forced employee and reduce the quality of services provided.ConclusionsThrough understanding perspectives of the professional staff toward community-based services will help to determine current problems in CMHC for policy makers.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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Gittelman, Martin. "The Evolution of Mental Health/Illness Services." International Journal of Mental Health 32, no. 2 (June 2003): 3–5. http://dx.doi.org/10.1080/00207411.2003.11449581.
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Morral, Kim, and Jordi Morral. "A survey of community pharmacists’ attitudes towards mental illness." Journal of Public Mental Health 15, no. 2 (June 20, 2016): 93–102. http://dx.doi.org/10.1108/jpmh-12-2015-0052.
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Purpose – The purpose of this paper is to compare the pharmacy services provided to people taking psychotropic and cardiovascular medications and examine the association between pharmacists’ attitudes towards mental illness and provision of pharmacy services. The paper also considers pharmacists’ opinions of the pharmaceutical care needs of people with mental illness including their physical health. Design/methodology/approach – A survey instrument was sent by facsimile to a random sample of community pharmacists in England and Wales. Findings – Community pharmacists had generally positive attitudes towards mental illness but provided significantly fewer pharmacy services (and were less comfortable providing them) to patients taking psychotropic medications than to patients taking cardiovascular medications. Awareness of the higher prevalence of physical health conditions among people with severe mental illness was not high. Provision of pharmacy services was associated with pharmacists’ attitudes towards mental illness and comfort providing pharmaceutical care. Other factors that may contribute to these disparities in service provision are discussed. Practical implications – The study findings indicate the need for enhanced mental health education for pharmacy students to improve attitudes, knowledge and confidence in mental health and the inclusion of mental health in pharmacy advanced services. Originality/value – Few studies have examined the relationship between attitudes towards mental illness and provision of pharmacy services. This was the first study to examine the attitudes of British community pharmacists towards mental illness.
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Drew, Leslie R. H. "Mortality and Mental Illness." Australian & New Zealand Journal of Psychiatry 39, no. 3 (March 2005): 194–97. http://dx.doi.org/10.1080/j.1440-1614.2005.01543.x.
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Background: The finding by Lawrence, Holman and Jablensky (Duty to Care) that mortality among the mentally ill in Western Australia was 2.5 times that of the general population, seemingly, has great significance for public policy concerning the mentally ill. ‘Mortality’ could be a useful outcome measure for mental health services. Objectives: To replicate that study in the Australian Capital territory (ACT), comparing mortality rates in the mentally ill with those of the total population. Method: A list of all people who contacted the ACT mental health services between 1985 and 2000 was compiled. Using the national register of deaths (Australian Institute of Health and Welfare), persons known to the mental health services who died between 1990 and 2000 were identified and sex, date of birth, date of death, cause of death and place of death were noted. Using Australian Bureau of Statistics data for all deaths in the ACT, deaths in the total population and in the mentally ill population were tabulated for the period 1996–2000. With 1996 data as the base, using total population data from the ABS and mental health population data derived by amending ‘the list’ to remove duplications, pre1996 deaths and post1996 additions, mortality rates for the period 1996–2000 were compared. Results: The gender and age distribution of the mentally ill population and the total population, and of deaths in those populations, were very different. One third of all deaths in the mentally ill occurred outside of the ACT. Compared with the general population, mortality in the mentally ill (including deaths outside of the ACT) was only slightly excessive for ‘all causes’ and ischaemic heart disease but grossly excessive for ‘suicide’. Conclusions: This study did not confirm the excessive mortality rate in the mentally ill reported by Lawrence et al. except for suicide. Many methodological issues in using population studies to attempt to measure the size of the increase were identified. Differences in method between the ACT and WA studies probably explain the differences in results. Caution is urged in using the results of mortality studies as determinants of public policy or to evaluate services.
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Blom-Cooper, Louis, and Elaine Murphy. "Mental health services and resources." Psychiatric Bulletin 15, no. 2 (February 1991): 65–68. http://dx.doi.org/10.1192/pb.15.2.65.
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Of the very large sum of money spent on mental health services, almost all comes from the public directly in the form of central or local government taxation. In 1990, approximately £2 billion was spent in the National Health Service directly on mental health services. That represents 10% of total health service expenditure. In addition, local authority social services departments spend around £50 million annually on residential and day care services for people with mental problems. A further £100 million is spent on supplementary benefit for board and lodgings payments and a considerable amount expended by prisons, courts and the police. These figures omit the growing amount of money spent on supporting elderly people with senile dementia outside mental illness hospitals, in residential and nursing homes. Almost two thirds of all residential care for elderly people provide care for those with mental disorder, adding a further staggering £5–600 million by 1990. The current direct care costs of disabling mental disorder to the public purse is approximately £3,000 million (£3 billion). For all the huge amount of money, resources appear inadequate, ill-directed and uncoordinated. Several actions need to be taken to improve the use of these vast resources.
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Oshodi, Abiola, and Gavin Rush. "Recovery from mental illness: changing the focus of mental health services." Irish Journal of Psychological Medicine 28, no. 3 (September 2011): 161–64. http://dx.doi.org/10.1017/s0790966700012180.
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AbstractThe concept of recovery entered the lexicon of the mental health services in the 1980s following the publication of a series of studies and personal narratives which demonstrated that the course of mental illness was not always one of inevitable deterioration and that people diagnosed with severe mental illness could reclaim or recover meaningful lives. For a long time, recovery was not thought possible by many family members, service providers and researchers. However globally, specific policy and clinical strategies are being developed to implement recovery principles although key questions remain. In fact, the possibility of recovery is still debated by some. In this paper, we include information about the recovery model and the medical model; we provide evidence for recovery and document changes in mental health practices and policies incorporating recovery as the guiding principle. We also attempt to address the debate as to whether recovery is an evidence based practice. We propose that evidence based practice should be complementary to value-based and narrative-based practices and we suggest an integrative model that maximises the virtues and minimises the weaknesses of each practices (see Figure 1).
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Audini, Bernard, Michael Crowe, Joan Feldman, Anna Higgitt, Andrew Kent, Paul Lelliott, Heather McKee, et al. "Monitoring inner London mental illness services." Psychiatric Bulletin 19, no. 5 (May 1995): 276–80. http://dx.doi.org/10.1192/pb.19.5.276.
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Our objective was to establish a mechanism for monitoring indicators of the state of health of inner London's mental illness services. Data were collected for a census week around 15 June 1994. Local data collection was coordinated by consultant pyschiatrists working in inner London services. Twelve services participated with a combined catchment population of 2.6 m. They included ten London services which were among the 17 most socially deprived areas of England. Main indicators were admission bed occupancy levels (including an estimate of the total requirement), proportion of patients detained under the Mental Health Act, number of assaults committed by inpatients, number of emergency assessments and CPN caseloads. The mean true bed occupancy (which reflects the number of patients who were receiving, or required, in-patient care on census day) was 130%. To meet all need for acute psychiatric care, including for patients who should have been admitted and those discharged prematurely because beds were full, a further 426 beds would have been required. Fifty per cent of patients were legally detained. Physical assaults were virtually a daily occurrence on the admission units. Average community pyschiatric nurse caseloads were 37, suggesting that the majority were not working intensively with limited caseloads of patients with severe mental illness. These indicators, although imperfect, will allow for some measurement of the impact of local and central initiatives on the poor state of London's mental illness services.
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Davison, Karen. "Primary Health Care, Mental Health, And the Dietitian's Role." Canadian Journal of Dietetic Practice and Research 67, S1 (September 2006): S47—S53. http://dx.doi.org/10.3148/67.0.2006.s47.
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Purpose: Individuals with mental illness are at nutritional risk because of health, social, and economic factors. To address this problem, the Canadian Collaborative Mental Health Initiative (CCMHI) and Dietitians of Canada (DC) commissioned the development of a toolkit that outlines the role of the registered dietitian (RD) and advocates for RDs in primary health care (PHC) mental health programs. Methods: The development of the toolkit followed a fourstage process: a comprehensive literature review, a focus group discussion with a national working group, interviews with consumers about RD services, and evaluation of the toolkit. Results: The costs of mental illness in Canada are at least $6.85 billion per year. Currently, little evidence exists on how RD services can reduce these expenses. The focus group identified accessibility as the predominant issue facing individuals with mental illness. To explain consumer experiences with RD services, a three-tier theory based on in-depth interviews was developed. Consumer experiences with RDs occur in five categories: financial concerns, perception of service, status of mental illness, engagement, and self-esteem (tier 1). These are further influenced by five individual and contextual factors, e.g., social environment, the mental illness (tier 2), which are weighed as benefits and barriers instrumental in determining actions (tier 3). Conclusions: The evaluation of the final draft of the RD toolkit confirmed that it reflected the visions of PHC. The toolkit is intended to act as a blueprint for action. Dietitians are encouraged to use its contents to advocate for positions in mental health PHC settings.
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Forrester, A., A. Till, A. Simpson, and J. Shaw. "Mental illness and the provision of mental health services in prisons." British Medical Bulletin 127, no. 1 (August 14, 2018): 101–9. http://dx.doi.org/10.1093/bmb/ldy027.
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Johnson, William C., Michael LaForest, Brett Lissenden, and Steven Stern. "Variation in mental illness and provision of public mental health services." Health Services and Outcomes Research Methodology 17, no. 1 (December 24, 2016): 1–30. http://dx.doi.org/10.1007/s10742-016-0167-3.
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de Cates, Angharad, Saverio Stranges, Amy Blake, and Scott Weich. "Mental well-being: An important outcome for mental health services?" British Journal of Psychiatry 207, no. 3 (September 2015): 195–97. http://dx.doi.org/10.1192/bjp.bp.114.158329.
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SummaryMental well-being is being used as an outcome measure in mental health services. The recent Chief Medical Officer's (CMO's) report raised questions about mental well-being in people with mental illness, including how to measure it. We discuss whether mental well-being has prognostic significance or other utility in this context.
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Bates, Ann, Vivien Kemp, and Mohan Isaac. "Peer Support Shows Promise in Helping Persons Living with Mental Illness Address Their Physical Health Needs." Canadian Journal of Community Mental Health 27, no. 2 (September 1, 2008): 21–36. http://dx.doi.org/10.7870/cjcmh-2008-0015.
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The physical health of individuals with long-term mental illnesses has long been of concern. In Western Australia, the overall mortality rate from preventable causes of people living with mental illness was reported to be 2.5 times greater than that of the general population. A trial peer support service was initiated to assist people with mental illness to attend to their physical health needs. This paper presents the planning, implementation, and results of this collaborative initiative involving nongovernment agencies, the public mental health service, consumers of mental health services, and the University of Western Australia.
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King, Robert, Geoffrey Waghorn, Chris Lloyd, Pat Mcleod, Terene Mcmah, and Cliff Leong. "Enhancing Employment Services for People with Severe Mental Illness: The Challenge of the Australian Service Environment." Australian & New Zealand Journal of Psychiatry 40, no. 5 (May 2006): 471–77. http://dx.doi.org/10.1080/j.1440-1614.2006.01824.x.
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Objectives: Comparatively few people with severe mental illness are employed despite evidence that many people within this group wish to obtain, can obtain and sustain employment, and that employment can contribute to recovery. This investigation aimed to: (i) describe the current policy and service environment within which people with severe mental illness receive employment services; (ii) identify evidence-based practices that improve employment outcomes for people with severe mental illness; (iii) determine the extent to which the current Australian policy environment is consistent with the implementation of evidence-based employment services for people with severe mental illness; and (iv) identify methods and priorities for enhancing employment services for Australians with severe mental illness through implementation of evidence-based practices. Method: Current Australian practices were identified, having reference to policy and legal documents, funding body requirements and anecdotal reports. Evidence-based employment services for people with severe mental illness were identified through examination of published reviews and the results of recent controlled trials. Results: Current policy settings support the provision of employment services for people with severe mental illness separate from clinical services. Recent studies have identified integration of clinical and employment services as a major factor in the effectiveness of employment services. This is usually achieved through co-location of employment and mental health services. Conclusions: Optimal evidence-based employment services are needed by Australians with severe mental illness. Providing optimal services is a challenge in the current policy environment. Service integration may be achieved through enhanced intersectoral links between employment and mental health service providers as well as by co-locating employment specialists within a mental health care setting.
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Wieck, A. "Risks and Challenges in Perinatal Mental Health." European Psychiatry 41, S1 (April 2017): S64. http://dx.doi.org/10.1016/j.eurpsy.2017.01.060.
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Mental illness affects 1 in 5 women during pregnancy and the first year postnatal and in about 1 in 20 women the condition is serious. When a woman with major mental illness becomes pregnant she and her child face a number of risks. These include poor pregnancy and neonatal outcomes and a sharp rise of psychiatric admissions after childbirth. Mental illness is also one of the leading causes of maternal death. Risks to children are impaired parenting and developmental disadvantage in emotional, behavioral and cognitive domains. Parental mental illness also has a significant role in infanticide and abuse-related serious harm to children, with infants <1 year old being most at risk.A recent analysis has shown that the resulting economic costs to public services and the wider society are extremely high. In view of the wide-ranging consequences, a number of European countries have set up specialized perinatal mental health services. These consist of specialized inpatient units and community teams. The essential components of their service are preconception counselling, expert advice on the use of medication during pregnancy and breastfeeding, joint inpatient admissions of mothers and babies, interventions to improve parenting, and advice to children's social services. None of these countries, however, are yet offering universal access.In order to improve service provision and outcomes it is important that perinatal mental health is acknowledged more widely as a public health priority. The workshop will provide an opportunity for participants to discuss approaches to raise awareness and promote perinatal service developments.Disclosure of interestThe author has not supplied his declaration of competing interest.
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Mlambo, Kupukai. "Does mental health matter? Commentary on the provision of mental health services in Mozambique." International Psychiatry 9, no. 2 (May 2012): 36–38. http://dx.doi.org/10.1192/s1749367600003064.
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Despite attempts made in recent years to address the diagnosis and treatment of mental illness in Mozambique, service provision remains deficient. The present paper focuses on the attitudes to mental illness and its diagnosis and treatment in Mozambique. This paper is based on both a thorough literature search and on the results of qualitative interviews carried out with six individuals of Mozambican origin now living in the UK.
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Weaver, T., P. Madden, V. Charles, G. Stimson, A. Renton, P. Tyrer, T. Barnes, et al. "Comorbidity of substance misuse and mental illness in community mental health and substance misuse services." British Journal of Psychiatry 183, no. 4 (October 2003): 304–13. http://dx.doi.org/10.1192/bjp.183.4.304.
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BackgroundImproved management of mental illness and substance misuse comorbidity is a National Health Service priority, but little is known about its prevalence and current management.AimsTo measure the prevalence of comorbidity among patients of community mental health teams (CMHTs) and substance misuse services, and to assess the potential for joint management.MethodCross-sectional prevalence survey in four urban UK centres.ResultsOf CMHT patients, 44% (95% CI 38.1-49.9) reported past-year problem drug use and/or harmful alcohol use; 75% (95% CI 68.2-80.2) of drug service and 85% of alcohol service patients (95% CI 74.2-931) had a past-year psychiatric disorder. Most comorbidity patients appear ineligible for cross-referral between services. Large proportions are not identified by services and receive no specialist intervention.ConclusionsComorbidity is highly prevalent in CMHT, drug and alcohol treatment populations, but may be difficult to manage by cross-referral psychiatric and substance misuse services as currently configured and resourced.
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Jacobi, John V. "Parity and Difference: The Value of Parity Legislation for the Seriously Mentally Ill." American Journal of Law & Medicine 29, no. 2-3 (2003): 185–201. http://dx.doi.org/10.1017/s009885880000280x.
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Mental illness affects the health status of about one in five Americans each year. More than five percent of adult Americans have a “serious” mental illness—an illness that interferes with social functioning. About two and one-half percent have “severe and persistent” mental illness, a categorization for the most disabling forms of mental illness, such as schizophrenia and bipolar disorder. All mental illness interferes to some degree with social activities. Left untreated, serious mental illness can be disabling—disrupting family life, employment status and the ability to maintain housing. Nevertheless, privately insured people in the United States (that is, the majority of insured people in the United States) are not covered for mental health services to the same extent that they are covered for physical health services. Second-class coverage of mental health services reduces access to care for people with mental illness because cost becomes a significant barrier to service. The resulting lack of treatment fuels the disabling potential of mental illness.
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Huxley, Peter. "Describing mental health services: the development of a mental health census in the North-West of England." Epidemiologia e psichiatria sociale. Monograph Supplement 6, S1 (April 1997): 71–80. http://dx.doi.org/10.1017/s1827433100000848.
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In the United Kingdom, national policy and local service provision both direct provision towards people with a severe mental illness (NHS and Community Care Act, 1990; Department of Health, 1993, 1994). An independent report by the Mental Health Foundation (1994), a leading mental health charity, recommended that the Department of Health “promulgates a practical definition of severe mental illness (SMI) in order to concentrate attention and services on those in greatest need”.In order to assess the extent to which a provider or a purchaser has focused attention upon the SMI, definitions are being developed in most services in the UK; this will facilitate the quantification of the number and proportion of SMI in contact with services. The definitional approach uses a (variable) number of criteria to determine status as a severely mentally ill person. It is essentially categorical because the individual is placed in one of two categories, SMI or not-SMI.
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Blankenhorn, D., R. Kilian, and T. Becker. "Management of physical illness in mental health services." Die Psychiatrie 09, no. 03 (July 2012): 143–51. http://dx.doi.org/10.1055/s-0038-1671715.
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SummaryThere is excess morbidity and mortality from physical illness in people with mental disorders. Problems of somatic care in this patient group comprise difficulties of access to care, problems of equity and adequate use of diagnostic procedures and interventions. There are deficits in routine screening and monitoring, e.g. of metabolic and cardiovascular risks. Measures to ensure adequate physical health care include practical steps to increase service uptake and screening, service-level change such as integrated care models, preventive health interventions and optimisation of psychotropic drug treatment to reduce risk profiles. Issues of stigma and discrimination are important, and the level of staff training and quality of professionals are likely to be pivotal in bringing about change.
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Ben-Zeev, Dror. "Mobile Health for All: Public-Private Partnerships Can Create a New Mental Health Landscape." JMIR Mental Health 3, no. 2 (June 6, 2016): e26. http://dx.doi.org/10.2196/mental.5843.
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Research has already demonstrated that different mHealth approaches are feasible, acceptable, and clinically promising for people with mental health problems. With a robust evidence base just over the horizon, now is the time for policy makers, researchers, and the private sector to partner in preparation for the near future. The Lifeline Assistance Program is a useful model to draw from. Created in 1985 by the U.S. Federal Communications Commission (FCC), Lifeline is a nationwide program designed to help eligible low-income individuals obtain home phone and landline services so they can pursue employment, reach help in case of emergency, and access social services and healthcare. In 2005, recognizing the broad shift towards mobile technology and mobile-cellular infrastructure, the FCC expanded the program to include mobile phones and data plans. The FCC provides a base level of federal support, but individual states are responsible for regional implementation, including engagement of commercial mobile phone carriers. Given the high rates of disability and poverty among people with severe mental illness, many are eligible to benefit from Lifeline and research has shown that a large proportion does in fact use this program to obtain a mobile phone and data plan. In the singular area of mobile phone use, the gap between people with severe mental illness and the general population in the U.S. is vanishing. Strategic multi-partner programs will be able to grant access to mHealth for mental health programs to those who will not be able to afford them—arguably, the people who need them the most. Mobile technology manufacturing costs are dropping. Soon all mobile phones in the marketplace, including the more inexpensive devices that are made available through subsidy programs, will have “smart” capabilities (ie, internet connectivity and the capacity to host apps). Programs like Lifeline could be expanded to include mHealth resources that capitalize on “smart” functions, such as secure/encrypted clinical texting programs and mental health monitoring and illness-management apps. Mobile phone hardware and software development companies could be engaged to add mHealth programs as a standard component in the suite of tools that come installed on their mobile phones; thus, in addition to navigation apps, media players, and games, the new Android or iPhone could come with guided relaxation videos, medication reminder systems, and evidence-based self-monitoring and self-management tools. Telecommunication companies could be encouraged to offer mHealth options with their data plans. Operating system updates pushed out by the mobile carrier companies could come with optional mHealth applications for those who elect to download them. In the same manner in which the Lifeline Assistance Program has helped increase access to fundamental opportunities to so many low-income individuals, innovative multi-partner programs have the potential to put mHealth for mental health resources in the hands of millions in the years ahead.
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McKenzie, Kwame. "Improving mental healthcare for ethnic minorities." Advances in Psychiatric Treatment 14, no. 4 (July 2008): 285–91. http://dx.doi.org/10.1192/apt.bp.107.004366.
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Multicultural societies offer a significant challenge to mental health services. Different groups have different rates of illness, illness models, ideas of what a suitable pathway of care is and what suitable care looks like. Trying to set up services to meet all these needs can be difficult. There may need to be modifications in clinical practice, service configuration and the way services are commissioned. Ethnic minority communities face complex problems and, consequently, strategies to deal with them can be complex, requiring support from the non-statutory sector, social services and other branches of medicine. Service development often needs research, staff training, race-equality schemes and sufficient funding to make change possible. I offer here a scheme for considering how to think through service development in this area as well as introducing the government strategy, Delivering Race Equality.
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Harris, Dawn, Tarik Endale, Unn Hege Lind, Stephen Sevalie, Abdulai Jawo Bah, Abdul Jalloh, and Florence Baingana. "Mental health in Sierra Leone." BJPsych International 17, no. 1 (July 22, 2019): 14–16. http://dx.doi.org/10.1192/bji.2019.17.
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Sierra Leone is a West African country with a population of just over 7 million. Many Sierra Leoneans lived through the psychologically distressing events of the civil war (1991–2002), the 2014 Ebola outbreak and frequent floods. Traditionally, mental health services have been delivered at the oldest mental health hospital in sub-Saharan Africa, with no services available anywhere else in the country. Mental illness remains highly stigmatised. Recent advances include revision of the Mental Health Policy and Strategic Plan and the strengthening of mental health governance and district services. Many challenges lie ahead, with the crucial next steps including securing a national budget line for mental health, reviewing mental health legislation, systematising training of mental health specialists and prioritising the procurement of psychotropic medications. National and international commitment must be made to reduce the treatment gap and provide quality care for people with mental illness in Sierra Leone.
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Rogers, Erin S., and Scott E. Sherman. "Quitline Services for Smokers with Mental Illness." International Journal of Mental Health 40, no. 1 (April 2011): 85–91. http://dx.doi.org/10.2753/imh0020-7411400105.
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Lloyd, Chris, Helen Kanowski, and Pam Samra. "Developing Occupational Therapy Services within an Integrated Mental Health Service." British Journal of Occupational Therapy 61, no. 5 (May 1998): 214–18. http://dx.doi.org/10.1177/030802269806100509.
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Health care reform has been taking place in a number of countries around the world. Changes have been occurring in Australian government mental health policies regarding service delivery for people with a mental illness. The National Mental Health Policy and Plan 1992 and the Queensland Mental Health Plan 1994 have set the directions for the reform of mental health services. As a result, occupational therapists have been required to examine and develop their role in service delivery within integrated mental health services. Occupational therapists within one integrated mental health service have responded by developing their practice across service components with a focus on the consumer and with service development links.
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Hardie, M. "Living after mental illness. Innovations in services." Health Policy 12, no. 3 (August 1989): 324–25. http://dx.doi.org/10.1016/0168-8510(89)90085-7.
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Owens, Christabel, Nicholas Booth, Martin Briscoe, Clive Lawrence, and Keith Lloyd. "Suicide Outside the Care of Mental Health Services." Crisis 24, no. 3 (May 2003): 113–21. http://dx.doi.org/10.1027//0227-5910.24.3.113.
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Summary: Background: Three-quarters of people who commit suicide are not in contact with mental health services at the time of death. No previous UK study has focused specifically on this group of suicides. Aims: To identify the characteristics of people who commit suicide while outside the care of mental health services. Method: A case-control study was conducted in SW England involving 100 individuals who committed suicide while not in contact with mental health services and 100 age-sex matched controls drawn from the living population. Data were collected by means of semistructured interviews with key informants and from medical records. Results: Key predictors of suicide were previous attempted suicide, social and interpersonal problems, current mental illness, past mental illness, and previous contact with specialist services. However, nearly a third of cases (32%) appeared to have no current mental disorder. Conclusion: This group is distinguished by a markedly lower rate of mental illness than has previously been recorded. The findings highlight the difficulty of identifying individuals outside specialist mental health care who are at risk of suicide and therefore support the continued development of broad population-based measures rather than the targeting of high-risk groups.
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Bird, Jennifer, Darlene Rotumah, James Bennett-Levy, and Judy Singer. "Diversity in eMental Health Practice: An Exploratory Qualitative Study of Aboriginal and Torres Strait Islander Service Providers." JMIR Mental Health 4, no. 2 (May 29, 2017): e17. http://dx.doi.org/10.2196/mental.7878.
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Background In Australia, mental health services are undergoing major systemic reform with eMental Health (eMH) embedded in proposed service models for all but those with severe mental illness. Aboriginal and Torres Strait Islander service providers have been targeted as a national priority for training and implementation of eMH into service delivery. Implementation studies on technology uptake in health workforces identify complex and interconnected variables that influence how individual practitioners integrate new technologies into their practice. To date there are only two implementation studies that focus on eMH and Aboriginal and Torres Strait Islander service providers. They suggest that the implementation of eMH in the context of Aboriginal and Torres Strait Islander populations may be different from the implementation of eMH with allied health professionals and mainstream health services. Objective The objective of this study is to investigate how Aboriginal and Torres Strait Islander service providers in one regional area of Australia used eMH resources in their practice following an eMH training program and to determine what types of eMH resources they used. Methods Individual semistructured qualitative interviews were conducted with a purposive sample of 16 Aboriginal and Torres Strait Islander service providers. Interviews were co-conducted by one indigenous and one non-indigenous interviewer. A sample of transcripts were coded and thematically analyzed by each interviewer and then peer reviewed. Consensus codes were then applied to all transcripts and themes identified. Results It was found that 9 of the 16 service providers were implementing eMH resources into their routine practice. The findings demonstrate that participants used eMH resources for supporting social inclusion, informing and educating, assessment, case planning and management, referral, responding to crises, and self and family care. They chose a variety of types of eMH resources to use with their clients, both culturally specific and mainstream. While they referred clients to online treatment programs, they used only eMH resources designed for mobile devices in their face-to-face contact with clients. Conclusions This paper provides Aboriginal and Torres Strait islander service providers and the eMH field with findings that may inform and guide the implementation of eMH resources. It may help policy developers locate this workforce within broader service provision planning for eMH. The findings could, with adaptation, have wider application to other workforces who work with Aboriginal and Torres Strait Islander clients. The findings highlight the importance of identifying and addressing the particular needs of minority groups for eMH services and resources.
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Li, Han Z., and Annette J. Browne. "Defining Mental Illness and Accessing Mental Health Services: Perspectives of Asian Canadians." Canadian Journal of Community Mental Health 19, no. 1 (April 2000): 143–59. http://dx.doi.org/10.7870/cjcmh-2000-0008.
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Buck, Jeffrey A., Judith L. Teich, Linda Graver, Don Schroeder, and Dian Zheng. "Utilization of Public Mental Health Services by Adults with Serious Mental Illness." Administration and Policy in Mental Health 32, no. 1 (September 2004): 3–15. http://dx.doi.org/10.1023/b:apih.0000039659.07516.1a.
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Kates, Nick, Lindsey George, Anne Marie Crustolo, and Michele Mach. "Findings from A Comparison of Mental Health Services in Primary Care and Outpatient Mental Health Services." Canadian Journal of Community Mental Health 27, no. 2 (September 1, 2008): 93–103. http://dx.doi.org/10.7870/cjcmh-2008-0020.
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This project used the Colorado Client Assessment Record to compare individuals being seen by mental health teams in primary care with individuals being seen in outpatient services in the same community and to look at the implications for service delivery. While more individuals with a psychotic illness were seen in outpatient settings, many individuals seen in primary care had similar levels of need to those in outpatient clinics. Family physicians were more actively involved in the care of patients being seen in primary care. These findings suggest that a stronger role could be played by primary care in delivering mental health care, while differentiating which populations are best served in which setting.
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Oates, Jennifer, and Rasiha Hassan. "Occupational health in mental health services: a qualitative study." International Journal of Workplace Health Management 13, no. 1 (December 10, 2019): 32–44. http://dx.doi.org/10.1108/ijwhm-02-2019-0021.
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Purpose The purpose of this paper is to explore occupational health (OH) clinicians’ perspectives on employee mental health in the mental health workplace in the English National Health Service. Design/methodology/approach Thematic analysis of data from seven semi-structured interviews is performed in this paper. Findings Three themes emerged under the core theme of “Situating OH services”: “the Uniqueness of the mental health service setting”, “the Limitations of OH services” and “the Meaning of mental health at work”. An important finding came from the first theme that management referrals in mental health may be due to disputes about workers’ fitness to face violence and aggression, a common feature of their working environment. Research limitations/implications This was a small scale study of a previously unresearched population. Practical implications These findings should be used to refine and standardise OH provision for mental healthcare workers, with a particular focus on exposure to violence and workers’ potential “lived experience” of mental illness as features of the mental health care workplace. Originality/value This is the first study to explore OH clinicians’ perspectives on the mental health service working environment.
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Akhuly, Ajanta, and Mrinmoyi Kulkarni. "Public mental health services in Mumbai." International Psychiatry 7, no. 4 (October 2010): 97–99. http://dx.doi.org/10.1192/s1749367600006056.
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Mumbai, India's largest city, also has the distinction of being the most populous city in the world. The association between urbanisation and mental illness has been widely documented (Harpham & Blue, 1995, especially pp. 41–60). Mumbai is characterised by dense slums housing large migrant populations facing stressful lives. The state of publicly funded mental health facilities in Mumbai has special significance in this context, since they are the only resource available to a large economic ally vulnerable section of the population. The objective of the present study was to evaluate the public mental health services in Mumbai and to identify areas for improvement.
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Bhugra, Dinesh, and Peter Jones. "Migration and mental illness." Advances in Psychiatric Treatment 7, no. 3 (May 2001): 216–22. http://dx.doi.org/10.1192/apt.7.3.216.
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Human beings have moved from place to place since time immemorial. The reasons for and the duration of these migrations put extraordinary stress on individuals and their families. Such stress may not be related to an increase in mental illness for all conditions or to the same extent across all migrant groups. In this paper, we provide an overview of some observations in the field of migration and mental health, hypothesise why some individuals and groups are more vulnerable to psychiatric conditions, and consider the impact of migration experiences on provision of services and care.
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Williams, Anne, Ellie Fossey, John Farhall, Fiona Foley, and Neil Thomas. "Recovery After Psychosis: Qualitative Study of Service User Experiences of Lived Experience Videos on a Recovery-Oriented Website." JMIR Mental Health 5, no. 2 (May 8, 2018): e37. http://dx.doi.org/10.2196/mental.9934.
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Background Digital interventions offer an innovative way to make the experiences of people living with mental illness available to others. As part of the Self-Management And Recovery Technology (SMART) research program on the use of digital resources in mental health services, an interactive website was developed including videos of people with lived experience of mental illness discussing their recovery. These peer videos were designed to be watched on a tablet device with a mental health worker, or independently. Objective Our aim was to explore how service users experienced viewing the lived experience videos on this interactive website, as well as its influence on their recovery journey. Methods In total, 36 service users with experience of using the website participated in individual semistructured qualitative interviews. All participants had experience of psychosis. Data analysis occurred alongside data collection, following principles of constructivist grounded theory methodology. Results According to participants, engaging with lived experience videos was a pivotal experience of using the website. Participants engaged with peers through choosing and watching the videos and reflecting on their own experience in discussions that opened up with a mental health worker. Benefits of seeing others talking about their experience included “being inspired,” “knowing I’m not alone,” and “believing recovery is possible.” Experiences of watching the videos were influenced by the participants’ intrapersonal context, particularly their ways of coping with life and use of technology. The interpersonal context of watching the videos with a worker, who guided website use and facilitated reflection, enriched the experience. Conclusions Engaging with lived experience videos was powerful for participants, contributing to their feeling connected and hopeful. Making websites with lived experience video content available to service users and mental health workers demonstrates strong potential to support service users’ recovery.
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Sartorius, N. H. "Empowerment and mental health." European Psychiatry 26, S2 (March 2011): 2100. http://dx.doi.org/10.1016/s0924-9338(11)73803-2.
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The word empowerment has been used to describe the efforts to give disadvantaged groups in the population a better chance to state their opinion and influence decisions affecting the population as a whole as well as themselves. In psychiatry the word is used both when talking about the process of raising self-confidence of an individual and in speaking about the need to increase the role of people with a mental illness and of their families in the shaping of the services which are to serve them.In these and other instances it would be possible to expect two positive outcomes if empowerment were to happen: firstly, disadvantaged individuals (including people with mental illness) who were empowered would feel better and be more likely to participate in the work of the group that has helped them to gain or regain self-confidence; and secondly, if given a chance people who were empowered would help to shape services that are to help them in harmony with their needs and the environment in which they are to work. The presentation will exemplify some of these points by a description of the experience gained in programmes that fought stigma and consequent discrimination.
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Mechanic, David. "Integrating Mental Health Services through Reimbursement Reform and Managed Mental Health Care." Journal of Health Services Research & Policy 2, no. 2 (April 1997): 86–93. http://dx.doi.org/10.1177/135581969700200206.
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People with serious and persistent mental illness require a range of community services typically provided by different specialized agencies. At the clinical level, assertive team case management is the strategy commonly used to achieve integration of services across specialized sectors. The USA also has used various financial and organizational approaches to reduce fragmentation and increase effectiveness, including development of stronger public mental health authorities, use of financial incentives to change professional and institutional behavior, requirements to allocate savings from hospital closures to community systems of care, and introduction of mental health managed care on a broad scale. These approaches have potential but also significant problems and there is often a large gap between theory and implementation. These US developments are discussed with attention to the implications for mental health services in the UK.
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Bland, Roger C. "Psychiatry and the Burden of Mental Illness." Canadian Journal of Psychiatry 43, no. 8 (October 1998): 801–10. http://dx.doi.org/10.1177/070674379804300804.
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Objective: To examine the morbidity produced by mental disorders, to project changes in morbidity likely to be produced by demographic and economic change, and to review the possible role of psychiatry in the health care system. Methods: Using prevalence data for psychiatric disorders and population projections, this paper presents the likely changes in morbidity over the next 20 years. A review of social and economic information indicates changes in social attitudes and their effects on mental health. This paper examines the determinants of health and how they are likely to change and explores some possible directions for changes in health care delivery. Results: Psychiatric disorders have been greatly underestimated as a cause of disability but account for 5 of the 10 leading causes of disability and 47.2% of all years lived with a disability (YLD) in developed countries. By 2016, there will be significant changes in the distribution and type of psychiatric disorders seen in the population, with cases of dementia almost doubling. Most of the population growth will be in the older age-groups, who will be well informed and will demand high standards of service. The gap between rich and poor will increase, and the results of childhood poverty and abuse will become more apparent. The disadvantaged, including many mentally ill, will suffer deprivation as disability payments decline, but youth unemployment will improve, possibly reducing crime rates. Forced early retirements will decline. Alternative medicine will make inroads into health care. A crisis in subsidized accommodation for the elderly can be anticipated, which perhaps will lead to reopening institutions that are currently being closed or to developing new forms of care. As the baby boomers pass 50 years of age and begin consuming health care services, governments will revise plans and eligibility for services; users will pay for services more directly. Conclusions: Psychiatry is very vulnerable to minor changes in health care schemes and will increasingly be called on to show economic arguments to justify its services. Pressure to support a primary care model by changing practice styles, developing new skills, and training practitioners will probably occur. The major growth area likely will be geriatric psychiatry.
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Schrank, B., N. Jovanovic, E. Abiskup, Dimech C., M. Luciano, C. Mahlke, O. Ness, M. Pintodacosta, L. van der Krieke, and S. Priebe. "What mental health services should be available after the postnatal period?" European Psychiatry 41, S1 (April 2017): 911. http://dx.doi.org/10.1017/s0924933800284496.
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IntroductionMothers with severe mental illness may require mental health support through postnatal services. However, little is known about what services are actually provided to support parents after the postnatal period in Europe.AimsTo explore existing services for parents with severe mental illness after the postnatal period across Europe.MethodsMental health specialists from major cities in nine European countries were asked to identify all health and social services available for mothers with psychosis after the postnatal period. They received two case vignettes and completed a data collection sheet for every identified service. Data analysis used semi-quantitative methods to describe the identified services.ResultsA wide range of different services was identified with no systematic coverage of specific target groups or target problems. Likewise, their scope was extremely diverse, ranging from simple telephone advice to multi-professional support for multiple complex problems. Most services targeted parents or families in general but would at least in principle be available for parents with severe mental illness. A much smaller number specialized on targeted help for parents with mental illness.ConclusionsPatchy and heterogeneous service provision may make it difficult to navigate support systems for both patients and professionals. Systematic research is required, e.g. on the use, the costs, and patient experiences in different types of services, so that service provision can be based on some evidence. Given the differences in service provision across European countries, such research might use international comparisons for evaluating the benefits of different types of services for parents with severe illnesses.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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Doey, Tamison, Pamela Hines, Bonnie Myslik, JoAnn Elizabeth Leavey, and Jamie A. Seabrook. "Creating Primary Care Access for Mental Health Care Clients in A Community Mental Health Setting." Canadian Journal of Community Mental Health 27, no. 2 (September 1, 2008): 129–38. http://dx.doi.org/10.7870/cjcmh-2008-0023.
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Successful support of persons living with a mental illness in the community is challenged by the lack of primary care accessible to this population. The Canadian Mental Health Association–Windsor Essex County Branch explored options to provide mental and physical health care, initially creating an integrated primary care clinic and later a larger community health clinic co-located with its mental health care services and staffed by a multidisciplinary team. A retrospective review of 805 charts and a client satisfaction survey were conducted in 2001 to evaluate this service. Findings indicate that access to primary care and mental health care co-located at a community-based clinic has reduced the number of emergency room visits and admissions, and length of stay in hospital, for individuals with moderate to serious mental illness. A client survey in January 2008 supports these preliminary findings.