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Marsden, Debbie, and Michael Wesson. "Gateway to mental heath services." British Journal of Healthcare Management 13, no. 5 (May 2007): 166–70. http://dx.doi.org/10.12968/bjhc.2007.13.5.23872.
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Ferre Navarete, F., and I. Palanca. "Mental health care in Madrid." European Psychiatry 20, S2 (October 2005): s279—s284. http://dx.doi.org/10.1016/s0924-9338(05)80174-9.
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AbstractAimTo describe principles and characteristics of mental health care in Madrid.MethodBased on existing data, service provision, number of professionals working in services, funding arrangements, pathways intocare, user/carer involvement and specific issues are reported.ResultsIn Madrid, mental health services are organized into 11 zones/areas, divided into 36 districts, where there is a mental healthoutpatient service with a multi-disciplinary team. Home treatment and psychosocial rehabilitation services have been developed. Specialist programmes exist for vulnerable client groups, including Children and Adolescents, Addiction/Alcohol and Older People. The Madrid Mental Health Plan (2003–2008) is regarded as the key driver in implementing service improvement and increased mental health and well-being in Madrid. It has a meant global budget increase of more than 10% for mental health services. Results of the first 2 years are: an increase in mental health staff employed (17%), four new hospitalization units, 50% increase in places for children and adolescents Day Hospitals, 62 new beds in long care residential units, development of specific programmes for the homeless and gender-based violence, a significant investment in information systems (450 new computers) and development of best practice and operational guidelines. Mental health system was put to the test with Madrid's March 11th terrorist attack. A Special Mental Health Plan for Affected people was developed.DiscussionUnlike some European countries, public mental health service is the main heath care provider. There are no voluntary agenciescollaborating with mental health care. Continuity of care and coordination between all mental health resources is essential in service delivery. Increased demand of care for minor psychiatric disorders, children and adolescent mental health care, and implementation of rehabilitation and residential facilities for chronic patients are outstanding challenges similar to those in other European capitals. Overall, the mental health system had successfully coped with last year's increased care demand after March 11th terrorist attack in Madrid.
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Way, Bruce B., Don A. Sawyer, Deborah Kahkejian, Catherine Moffitt, and Stephanie N. Lilly. "State Prison Mental Heath Services Recipients Perception of Care Survey." Psychiatric Quarterly 78, no. 4 (August 24, 2007): 269–77. http://dx.doi.org/10.1007/s11126-007-9048-9.
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Tumanggor, Roxsana Devi. "Psychosocial Care Service in the Mental Health Provision." Caring: Indonesian Journal of Nursing Science 2, no. 1 (July 21, 2020): 37–42. http://dx.doi.org/10.32734/ijns.v2i1.4081.
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The approach of health service can be divided into a medical term and psychosocial term that are applied by the mental health professional. The mental heath services help their clients with mental illness by giving a specific treatments particularly from psychological view. The information in this essay were collected from two databases that are CINAHL and Health Science. It also included the University of Wollongong e-journal database for nursing program. Based on the internet research, it is imperative that the intervention can be delivered in the form of case management. This paper therefore will discuss the psychosocial care for mentally ill clients in terms of concept, components, interventions and benefit in the practical area. The strategies to develop the treatment more effective are also discussed in depth. Keywords. psychosocial care, medical care, mental health.
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Mishkind, Matthew C. "Establishing Telemental Heath Services from Conceptualization to Powering up." Psychiatric Clinics of North America 42, no. 4 (December 2019): 545–54. http://dx.doi.org/10.1016/j.psc.2019.08.002.
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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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Killaspy, Helen, Michael King, Frank Holloway, Thomas J. Craig, Sarah Cook, Tim Mundy, Gerard Leavey, et al. "The Rehabilitation Effectiveness for Activities for Life (REAL) study: a national programme of research into NHS inpatient mental health rehabilitation services across England." Programme Grants for Applied Research 5, no. 7 (March 2017): 1–284. http://dx.doi.org/10.3310/pgfar05070.
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BackgroundThe REAL (Rehabilitation Effectiveness for Activities for Life) research programme, funded by the National Institute for Heath Research (NIHR) from 2009 to 2015, investigated NHS mental health rehabiliation services across England. The users of these services are people with longer-term, complex mental health problems, such as schizophrenia, who have additional problems that complicate recovery. Although only around 10% of people with severe mental illness require inpatient rehabilitation, because of the severity and complexity of their problems they cost 25–50% of the total mental health budget. Despite this, there has been little research to help clinicians and commissioners to plan and deliver effective treatments and services. This research aimed to address this gap.MethodsThe programme had four phases. (1) A national survey, using quantitative and qualitative methods, was used to provide a detailed understanding of the scope and quality of NHS mental health rehabilitation services in England and the characteristics of those who use them. (2) We developed a training intervention for staff of NHS inpatient mental health rehabilitation units to facilitate service users’ activities. (3) The clinical effectiveness and cost-effectiveness of the staff training programme was evaluated through a cluster randomised controlled trial involving 40 units that scored below average on our quality assessment tool in the national survey. A qualitative process evaluation and a realistic evaluation were carried out to inform our findings further. (4) A naturalistic cohort study was carried out involving 349 service users of 50 units that scored above average on our quality assessment tool in the national survey, who were followed up over 12 months. Factors associated with better clinical outcomes were investigated through exploratory analyses.ResultsMost NHS trusts provided inpatient mental health rehabilitation services. The quality of care provided was higher than that in similar facilities across Europe and was positively associated with service users’ autonomy. Our cluster trial did not find our staff training intervention to be clinically effective [coefficient 1.44, 95% confidence interval (CI) –1.35 to 4.24]; staff appeared to revert to previous practices once the training team left the unit. Our realistic review suggested that greater supervision and senior staff support could help to address this. Over half of the service users in our cohort study were successfully discharged from hospital over 12 months. Factors associated with this were service users’ activity levels [odds ratio (OR) 1.03, 95% CI 1.01 to 1.05] and social skills (OR 1.13, 95% CI 1.04 to 1.24), and the ‘recovery’ orientation of the unit (OR 1.04, 95% CI 1.00 to 1.08), which includes collaborative care planning with service users and holding hope for their progress. Quality of care was not associated with costs of care. A relatively small investment (£67 per service user per month) was required to achieve the improvement in everyday functioning that we found in our cohort study.ConclusionsPeople who require inpatient mental health rehabilitation are a ‘low-volume, high-needs’ group. Despite this, these services are able to successfully discharge most to the community within 18 months. Our results suggest that this may be facilitated by recovery-orientated practice that promotes service users’ activities and social skills. Further research is needed to identify effective interventions that enhance such practice to deliver these outcomes. Our research provides evidence that NHS inpatient mental health rehabilitation services deliver high-quality care that successfully supports service users with complex needs in their recovery.Main limitationOur programme included only NHS, non-secure, inpatient mental health rehabilitation services.Trial registrationCurrent Controlled Trials ISRCTN25898179.FundingThe NIHR Programme Grants for Applied Research programme.
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Larch, Sue. "Autism, mental health and offending behaviour: a mother’s quest for healthcare." Advances in Autism 2, no. 4 (October 3, 2016): 210–14. http://dx.doi.org/10.1108/aia-05-2016-0011.
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Purpose The purpose of this paper is to describe the experiences of a mother of a son who was diagnosed with Asperger syndrome and psychosis in adulthood, the impact of this on his behaviour, and her quest to obtain healthcare. Design/methodology/approach Case study. Findings While a striking story in its own right, the experiences described have a number of wider implications for the treatment of mental ill heath in ASD, the exclusion of families and carers from the care of their adult children in services, and the impact of this on the individuals directly affected. Research limitations/implications The paper offers a number of practical recommendations for the understanding and management of autism in generic mental health services, and the involvement of families and carers in the care of their relative. Originality/value This is the first paper to describe mental ill health and offending behaviour in ASD, from the perspective of a mother.
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Chihai, J. "Mental heath in republic of moldova: The way from in-patient to community-based care services." European Psychiatry 41, S1 (April 2017): S604. http://dx.doi.org/10.1016/j.eurpsy.2017.01.946.
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IntroductionThe history of mental health in Moldova has been centered on psychiatric institutions. Current reform goals are centered on the reduction in psychiatric hospital beds, shifting the focus towards outpatient therapy, where community mental health centers have a central role in coordinating recovery and social reintegration.Objectivesto collect different data according guidance for establishing a situational analyses about Moldova.Methodologywe elaborated a guidance with outline: the historical perspective:– a. back a 5–10 years events/developments; epidemiologic data;– b. the service delivery system;– c. mental health system: laws/regulations, role of the government as well as civil organizations, mechanisms for data collection, monitoring of performance, costs, quality of care and outcomes;– d. opportunities, barriers, and needed changes/innovations needed to address these.ResultsThe current focus is on moving from a relatively centralized system towards a more community-based approach to psychiatric care and community supports, as well as deinstitutionalization and integration of mental health care with primary care. Besides over reliance on institutionalization, the Moldovan mental health care system faces other challenges, including access to care, workforce limitations, and stigma.ConclusionLooking forward, success in these efforts will require continued strong political will to bring domestic law, policies and practices into line with international standards in the field of human rights for persons with disabilities. By supporting deinstitutionalization and improving the accessibility of mainstream services, more people will have the opportunity for social inclusion and the ability to contribute to the communities’ social and economic growth.Disclosure of interestThe author has not supplied his/her declaration of competing interest.
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Eid, S. "P02-55 - Forensic psychiatric services in Kuwait and the need for mental heath legislation." European Psychiatry 25 (2010): 675. http://dx.doi.org/10.1016/s0924-9338(10)70669-6.
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Huang, Li, Harriet Hiscock, and Kim M. Dalziel. "Parents’ perception of children’s mental health: seeing the signs but not the problems." Archives of Disease in Childhood 104, no. 11 (November 2, 2018): 1102–4. http://dx.doi.org/10.1136/archdischild-2018-315829.
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BackgroundIt is a public heath priority to understand why many children with mental health problems fail to access mental health services. This study aims to quantify under-recognition of children’s mental health problems by parents across income quintiles.MethodsWe estimated under-recognition with parent-reported mental health problems and the Strengths and Difficulties Questionnaire (SDQ) using a nationally representative Australian data set for children aged 4–15 years with 24 269 person-wave observations.ResultsUnder-recognition was the highest in the lowest income quintile, with 11.5% of children from the lowest income quintile families who scored in the clinical range on the SDQ perceived by parents as having no mental health problems. For the highest income quintile this was 2.4%. In terms of gender and age, under-recognition was greater for boys and younger children.ConclusionsParent’s mental health literacy, especially for low-income families, warrants prioritised attention from researchers, clinicians and policymakers.
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Preston, Neil Joseph. "The Health of the Nation Outcome Scales: Validating Factorial Structure and Invariance Across Two Health Services." Australian & New Zealand Journal of Psychiatry 34, no. 3 (June 2000): 512–19. http://dx.doi.org/10.1080/j.1440-1614.2000.00726.x.
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Objective: The Health of the Nation Outcome Scale (HoNOS) was developed in the mid-1990s as an inclusive and comprehensive instrument to measure patient outcomes in four main factors: behaviour, impairment, symptoms and social problems. This paper attempts to investigate whether similar health services rate the HoNOS with equivalent psychometric calibration. Method: The purpose of this study was to test for invariant construct interpretation of the instrument across two equivalent health services, using simultaneous confirmatory factor analysis. Results: Although the four-factor model of the HoNOS was confirmed, structural non-invariance occurred, casting doubt on the equivalent interpretability and generalisability of the instrument across similar heath services. Conclusions: Over-inclusiveness, lack of specificity and questionable independence of observations may have contributed to the non-invariant factor structure between the two health services. Such results shed some doubt on the ability of the HoNOS and like observational instruments to provide equivalent comparisons between health services.
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Killaspy, Helen, Stefan Priebe, Michael King, Sandra Eldridge, Paul McCrone, Geoff Shepherd, Maurice Arbuthnott, et al. "Supported accommodation for people with mental health problems: the QuEST research programme with feasibility RCT." Programme Grants for Applied Research 7, no. 7 (September 2019): 1–82. http://dx.doi.org/10.3310/pgfar07070.
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Background Across England, around 60,000 people live in mental health supported accommodation: residential care, supported housing and floating outreach. Residential care and supported housing provide on-site support (residential care provides the highest level), whereas floating outreach staff visit people living in their own tenancies. Despite their abundance, little is known about the quality and outcomes of these services. Objectives The aim was to assess the quality, costs and effectiveness of mental health supported accommodation services in England. The objectives were (1) to adapt the Quality Indicator for Rehabilitative Care (QuIRC) and the Client Assessment of Treatment scale for use in mental health supported accommodation services; (2) to assess the quality and costs of these services in England and the proportion of people who ‘move on’ to less supported accommodation without placement breakdown (e.g. to move from residential care to supported housing or supported housing to floating outreach, or, for those receiving floating outreach, to manage with fewer hours of support); (3) to identify service and service user factors (including costs) associated with greater quality of life, autonomy and successful move-on; and (4) to carry out a feasibility trial to assess the required sample size and appropriate outcomes for a randomised evaluation of two existing models of supported accommodation. Design Objective 1 – focus groups with staff (n = 12) and service users (n = 16); psychometric testing in 52 services, repeated in 87 services (adapted QuIRC) and with 618 service users (adapted Client Assessment of Treatment scale). Objectives 2 and 3 – national survey and prospective cohort study involving 87 services (residential care, n = 22; supported housing, n = 35; floating outreach, n = 30) and 619 service users followed over 30 months; qualitative interviews with 30 staff and 30 service users. Objective 4 – individually randomised, parallel-group feasibility trial in three centres. Setting English mental health supported accommodation services. Participants Staff and users of mental health supported accomodation services. Interventions Feasibility trial involved two existing models of supported accommodation: supported housing and floating outreach. Main outcome measures Cohort study – proportion of participants who successfully moved to less supported accommodation at 30 months’ follow-up without placement breakdown. Feasibility trial – participant recruitment and withdrawal rates. Results The adapted QuIRC [QuIRC: Supported Accomodation (QuIRC-SA)] had excellent inter-rater reliability, and exploratory factor analysis confirmed its structural validity (all items loaded onto the relevant domain at the > ± 0.3 level). The adapted Client Assessment of Treatment for Supported Accommodation had good internal consistency (Cronbach’s alpha 0.89) and convergent validity (r s = 0.369; p < 0.001). Supported housing services scored higher than residential care and floating outreach on six out of seven QuIRC-SA quality domains. Service users had a high prevalence of severe self-neglect (57%) and vulnerability to exploitation (37%). Those in supported housing (25%) and floating outreach (20%) experienced more crime than those in residential care (4%) but had greater autonomy. Residential care was the most expensive service (mean cost per resident per week was £581 for residential care, £261 for supported housing and £66 for floating outreach) but supported users with the greatest needs. After adjusting for clinical differences, quality of life was similar for users of supported housing and residential care (mean difference –0.138, 95% confidence interval –0.402 to 0.126; p = 0.306), whereas autonomy was greater for supported housing users (mean difference 0.145, 95% confidence interval 0.010 to 0.279; p = 0.035). Qualitative interviews showed that staff and service users shared an understanding of service goals and what constituted effective support. After adjusting for clinical differences, those in floating outreach were more likely to move on successfully at 30 months’ follow-up than those in residential care [odds ratio (OR) 7.96; p < 0.001] and supported housing (OR 2.74; p < 0.001), and this was more likely for users of supported housing than residential care (OR 2.90; p = 0.04). Successful move-on was positively associated with scores on two QuIRC-SA domains: the degree to which the service promoted ‘human rights’ (e.g. facilitating access to advocacy) and ‘recovery-based practice’ (e.g. holding therapeutic optimism and providing collaborative, individualised care planning). Service use costs for those who moved on were significantly lower than for those who did not. Recruitment in the feasibility trial was difficult: 1432 people were screened but only eight were randomised. Barriers included concerns about accommodation being decided at random and a perceived lack of equipoise among clinicians who felt that individuals needed to ‘step down’ from supported housing to floating outreach services. Conclusions We did not find clear evidence on the most effective model(s) of mental health supported accommodation. Indeed, our feasibility study suggests that trials comparing effectiveness cannot be conducted in this country. A range of options are required to provide appropriate support to individuals with differing needs. Future work Future research in this field requires alternatives to trials. Service planners should be guided by the mental health needs of the local population and the pros and cons of the different services that our study identified, rather than purely financial drivers. Trial registration Current Controlled Trials ISRCTN19689576. Funding This programme was funded by the National Institute for Heath Research (NIHR) Programme Grants for Applied Research programme and will be published in full in Programme Grants for Applied Research; Vol. 7, No. 7. See the NIHR Journals Library website for further project information. The fundholders are Camden and Islington NHS Foundation Trust and the research is a collaboration between University College London, Queen Mary University of London, King’s College London, the University of Ulster and Durham University.
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Lasalvia, Antonio, Bruno Gentile, Mirella Ruggeri, Alessandro Marcolin, Flavio Nosè, Lodovico Cappellari, Dario Lamonaca, et al. "Heterogeneity of the Departments of Mental Health in the Veneto Region ten years after the National Plan 1994-96 for Mental Health. Which implication for clinical practice? Findings from the PICOS Project." Epidemiologia e Psichiatria Sociale 16, no. 1 (March 2007): 59–70. http://dx.doi.org/10.1017/s1121189x00004619.
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SUMMARYAims - This study aims to present data on structural and human resources of public mental health services located in the Veneto Region, Italy, and to discuss them in the light of implementation of the first National Target Plan for Mental Health (“Progetto Obiettivo 1994-1996”) ten years after its launch. Methods - The study was conducted in the context of the PICOS (Psychosis Incident Cohort Outcome Study) Project, a large first-presentation multisite study on patients with psychotic disorders attending community mental heath services in the Veneto Region. Human and structural resources were surveyed in 26 study sites using a structured interview administered by the PICOS local referents. Results - CMHCs and Day Centres were homogeneously distributed across the Region and their overall rates per resident population met the national standards; a wide variability in the distribution of Day Hospitals was found, with the overall rate per resident population very far from meeting the national standard; the overall rate for Residential Facilities beds was higher than the recommended national standard, showing however an high variability across sites. The overall rate of mental health professionals per resident population was only slightly below the national standard: this was mainly achieved thanks to non-profit organizations which supplement the public system with unspecialised professionals; however, a wide variability in the local rates per resident population was found, with the 50% of the sites showing rates far lower the national standard. Specific lack of trained professionals involved in the provision of psychosocial interventions was found in most sites. Conclusions - A marked variability in human and structural resources across community mental health services in the Veneto Region was found. Possible reasons for this heterogeneity were analysed and implications for mental health care provision were further discussed.Declaration of Interest: The study has been supported by the Regione del Veneto, Giunta Regionale, Ricerca Sanitaria Finalizzata 2004, Venezia, Italia (grant to Professor M. Ruggeri).
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Breier, Alan, John Lurkins, Jennifer Vohs, Megan Gaunnac, and Michael Francis. "M182. EFFECTIVENESS OF COORDINATED SPECIALTY CARE (CSC) DELIVERED VIA TELE-HEATH COMPARED TO THE STANDARD CSC CLINIC-BASED MODEL." Schizophrenia Bulletin 46, Supplement_1 (April 2020): S205—S206. http://dx.doi.org/10.1093/schbul/sbaa030.494.
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Abstract Background There is a growing body of evidence suggesting that specialized early intervention (EI) programs deliver superior outcomes for individuals with early phase psychosis. Coordinated Specialty Care (CSC) is a recovery-oriented EI treatment program that employs multi-disciplinary team based care with high provider to patient staffing ratios and promotes shared decision making. CSC services are primarily provided in health care clinics. An alternative to “in clinic” service models is tele-health (TH) where clinical care and team interactions occur remotely through TH platforms. The advantages of this model may include reduced costs, bridging geographical distances, decreased stigma and increased flexibility for when and where therapeutic sessions occur. The purpose of this study is to compare the effectiveness of CSC delivered through TH (CSC-TH) versus the standard, clinic-based CSC model (CSC-Clinic). Methods A TH network was established in Indiana, USA to provide statewide CSC services. A “hub” team, comprised of a psychiatrist, therapist, team leader, nurse and data manger, was located in Indianapolis, IN and four “spoke” sites (Ft. Wayne, Anderson, Gary and Bloomington IN), were established across the State. All hub team services were delivered remotely through VIDYO, a leading, HIPPA compliant TH platform which was used on hand-held devices for care deliver in the subjects’ homes, as well as in local CMHCs. The standard clinical CSC program (CSC-Clinic), termed Prevention and Recovery Center (PARC), was located in Indianapolis, IN and all services were obtained through in-person clinic visits. Both the CSC-TH and CSC-Clinic programs employed identical inclusion criteria (16 – 30 years; within 3 years of psychosis onset; and non-substance induced psychotic disorder), assessment instruments, OnTrackNY training for all treatment staff, and outcome measures. Both programs conducted weekly team meetings where all patients were reviewed. Both programs were assessed for fidelity to the CSC model. All CSC patients were newly enrolled over the same treatment period. Data was collected at baseline, 3 months and 6 months. The outcome measures included engagement (drop outs), use of acute services (ER, hospitalization), illness severity (CGI-S), and MIRECC GAF symptoms, occupation/school function and social function. Ratings were independently determined through consensus of the respective treatment teams. Results Thirty-one early phase subjects were enrolled in the CSC-TH and 89 in the CSC-Clinic programs. Analyses demonstrates that CSC-TH was associated with significant and trend level superiority compared to CSC-Clinic for better engagement (3-month: X2=2.89, p=0.09; 6-month: X2=3.12, p=0.05); less use of acute services (3-month: X2= 6.62, p=0.01; 6-month: X2 =7.17, p=0.07); lower MIRECC GAF symptoms (3-month: t=3.2, p=0.002), improved occupation/school function (3-month: t=3.02, p=0.003) and social function (t=3.18, p=0.002). No group differences were found for CGI-S ratings. Discussion These results suggest that CSC-TH was associated with better outcomes compared to CSC-Clinic on key variables. Important caveats, including lack of randomization and blinded ratings, will be discussed. Future studies needed to further evaluate the role of TH in EI programs will be proposed.
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Xia, Ting, Ross Iles, Sharon Newnam, Dan Lubman, and Alex Collie. "O2C.4 Patterns of health care use following work-related injury and illness in australian truck drivers: a latent class analysis." Occupational and Environmental Medicine 76, Suppl 1 (April 2019): A17.1—A17. http://dx.doi.org/10.1136/oem-2019-epi.44.
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PurposeTo identify patterns of health care use in truck drivers with work-related injury or illness and to identify demographic, occupation, injury/condition, claim and geographic factors associated with patterns of care.Method13 371 accepted workers compensation claims from truck drivers lodged between 2004 and 2013 in the state of Victoria were included. Episodes of health care were categorised according to practitioner type as General Practitioner (GP), Specialist Physician, Mental Health, Surgery, Return to Work, or Physical Therapy. Latent class analysis was used to identify and characterise the distinct profiles of users with different patterns of health service use. Multinomial logistic regression was used to examine the associations between latent class and predictors including demographic, claim and injury-related factors.ResultsFour profiles of heath service use were identified: (1) Low Service Users (55% of the sample) were more likely to be younger, have an injury that did not result in time off work and have conditions other than a musculoskeletal injury; (2) High Service Users (10%) tended to be those who were aged between 45 and 64 years, lived in major cities and had musculoskeletal conditions that resulted in time off work; (3) Physical Therapy Users (25%) were more likely to be aged between 45 and 64 years, live in major cities and have non-traumatic injuries that resulted in time off work; and (4) GP/Mental Health Users (10%) were more likely to be over 24 years of age, from the lowest socio-economic band, be employed by smaller organisations and be claiming benefits for a mental health condition.ConclusionsIt is possible to identify distinct patterns of health care use following work-related injury and disease using workers’ compensation claims data. Nature of injury/disease, sociodemographic characteristics and geographic proximity to health services affect patterns of care.
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Hallam, Karen T., Michael Berk, Linda F. Kader, Phillipe Conus, Nellie C. Lucas, Melissa Hasty, Craig M. Macneil, and Patrick D. McGorry. "Seasonal influences on first-episode admission in affective and non-affective psychosis." Acta Neuropsychiatrica 18, no. 3-4 (June 2006): 154–61. http://dx.doi.org/10.1111/j.1601-5215.2006.00147.x.
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Background:Since bipolar affective disorder has been recorded, clinicians treating patients with this disorder have noted the cyclic nature of episodes, particularly an increase in mania in the spring and summer months and depression during winter.Objective:The aim of this study was to investigate seasonality in symptom onset and service admissions over a period of 10 years in a group of patients (n= 359) with first-episode (FE) mania (n= 133), FE schizoaffective disorder (n= 49) and FE schizophrenia (n= 177).Method:Patients were recruited if they were between 15 and 28 years of age and if they resided in the geographical mental health service catchment area. The number of patients experiencing symptom onset and service admission over each month and season was recorded.Results:In terms of seasonality of time of service admission, the results indicate a high overall seasonality (particularly in men), which was observed in both the schizoaffective and the bipolar groups. In terms of seasonality of symptom onset, the results indicate that seasonality remains in the male bipolar group, but other groups have no seasonal trend.Conclusions:This provides further evidence that systems mediating the entrainment of biological rhythms to the environment may be more pronounced in BPAD than in schizoaffective disorder and schizophrenia. These results may help facilitate the preparedness of mental heath services for patients at different times of the year.
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Garralda, Elena. "Child and Adolescent Psychiatry in General Practice." Australian & New Zealand Journal of Psychiatry 35, no. 3 (June 2001): 308–14. http://dx.doi.org/10.1046/j.1440-1614.2001.00904.x.
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Objective: This review discusses the role of general practitioners and primary care health staff in the assessment, treatment and prevention of child and adolescent psychiatric disorders and to consider implications for service delivery. Method: Literature review. Papers were selected as having an empirical evidence base or as describing and documenting new initiatives in general practice. Results: A small proportion of about 3% of children present to general practice with behavioural or emotional problems, but psychiatric disorders in the context of somatic presentations are considerably more common. They are probably higher than in the general population reflecting an increased tendency by children with disorders to consult. Recognition by general practitioners is limited and few children with disorders are referred to specialist clinics. However, referrals are mostly appropriate: the more severely affected children in difficult psychosocial circumstances. A number of pilot studies have shown the feasibility and potential usefulness of setting up shifted specialist clinics in primary care and of training primary care doctors and other staff in the recognition or management of child mental heath problems. Conclusion: Primary care is an appropriate resource to help increase attention to child and adolescent mental health problems. Its potential requires further development and rigorous evaluation. Areas lending themselves to development include: improved medical undergraduate teaching and postgraduate training; suitable information and advice-giving on child mental health problems by the primary care team; the development of specific child and adolescent psychiatric interventions for use in the primary care setting; careful and discriminating development of shifted outpatient clinics for selected child psychiatric disorders; the development of focused protocols for referral to specialist services; further development of mental health promotion clinics in primary care.
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吳, 日嵐, 可如 尹, 景強 羅, 翠然 葉, 學榮 劉, 慧英 羅, 保德 李, and 嘉雯 謝. "香港社區精神健康照顧服務12個月的成效研究." Hong Kong Journal of Social Work 45, no. 01n02 (January 2011): 59–72. http://dx.doi.org/10.1142/s0219246211000076.
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社區精神復康服務在西方國家發展悠久，不同的相關文獻與實証爲本研究 ( evidence-based research) 顯示，該服務形式對生活於社區的精神病康復者有顯著成效。自2005年開始，在政府和非政府機構推動下，社區精神健康照顧服務在香港不同的地方推行。然而，有關本港社區精神健康照顧服務的研究卻相當貧乏。是次研究運用單組前測後測設計 (one group pre-test and post-test design) 方式，評估一個在本港推行的社區精神健康照顧服務，對離院後重返社區生活的服務使用者的成效。是次研究邀請了120名精神病康復者參與研究，共有87名研究對象完成所有測試。當中測試範疇包括精神病徵狀、生活質素、自我效能、社區生活技巧。研究發現在開始接受服務後的6至12個月，社區精神健康照顧服務減少精神病徵狀 ( p <.001)、提高生活質素 ( p <.05)、增強自我效能 ( p <.001)和提升社區生活技巧 ( p <.001) 能夠爲康復者帶來非常正面的效果。 Community mental health care services have been developing in Western countries for decades and have been proved to be effective in facilitating the rehabilitation of people with mental illness into the community in many evidence-based research studies. In Hong Kong, with the support of the government and non-government organisations, community mental health care services have been set up in different districts since 2005. However, research on the services is limited. By using the one-group pre-test and post-test design method, this study examines the effects of one Community Mental Health Care Services on the rehabilitation of people with mental illness discharged from hospitals. A total number of 120 service users participated in the study and 87 subjects completed all the assessments in different areas, including psychiatric symptoms, quality of life, self-efficacy and community living skills, before the commencement of intervention, 6 months after the intervention and at 12 months immediately after the intervention. Results showed that the subjects had lessened psychiatric symptoms ( p <.001), better quality of life ( p <.05), enhanced self-efficacy ( p <.001) and increased community living skills ( p <.001), after the services. The study revealed significant positive effects of the community mental heath care services on people with mental illness in the community.
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ANDRONIC, Anca-Olga, and Răzvan-Lucian ANDRONIC. "COMMUNITY-BASED MENTAL HEALTH SERVICES IN ROMANIA." SCIENTIFIC RESEARCH AND EDUCATION IN THE AIR FORCE 19, no. 2 (July 31, 2017): 19–22. http://dx.doi.org/10.19062/2247-3173.2017.19.2.2.
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ANDRONIC, Anca-Olga, and Răzvan-Lucian ANDRONIC. "REGULATED AND ALTERNATIVE SERVICES ACTING IN MENTAL HEALTH." SCIENTIFIC RESEARCH AND EDUCATION IN THE AIR FORCE 19, no. 2 (July 31, 2017): 15–18. http://dx.doi.org/10.19062/2247-3173.2017.19.2.1.
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Abrahamson, Vanessa, Wenjing Zhang, Patricia Wilson, William Farr, and Ian Male. "Realist Evaluation of Autism ServiCe Delivery (RE-ASCeD): which diagnostic pathways work best, for whom and in what context? Protocol for a rapid realist review." BMJ Open 10, no. 7 (July 2020): e037846. http://dx.doi.org/10.1136/bmjopen-2020-037846.
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IntroductionThe National Health Service (NHS) Long-Term Plan (2019) acknowledges that children and young people with suspected autism wait too long for diagnostic assessment and sets out to reduce waiting times. However, diagnostic pathways vary with limited evidence on what model works best, for whom and in what circumstances. The National Autism Plan for Children (2003) recommended that assessment should be completed within 13 weeks but referral to diagnosis can take as long as 799 days.This Rapid Realist Review (RRR) is the first work package in a national programme of research: a Realist Evaluation of Autism ServiCe Delivery (RE-ASCeD). We explore how particular approaches may deliver high-quality and timely autism diagnostic services for children with possible autism; high quality is defined as compliant with National Institute for Heath and Care Excellence (2011) guidelines, and timely as a pathway lasting no more than one calendar year, based on previous work.Methods and analysisRRR is a well-established approach to synthesising evidence within a compressed timeframe to identify models of service delivery leading to desired outcomes. RRR works backwards from intended outcomes, identified by NICE guidelines and the NHS England Long-Term Plan. The focus is a clearly defined intervention (the diagnostic pathway), associated with specific outcomes (high quality and timely), within a particular set of parameters (Autism and Child & Adolescent Mental Health services in the UK). Our Expert Stakeholder Group consists of policymakers, content experts and knowledge users with a wide range of experience to supplement, tailor and expedite the process. The RRR is consistent with Realist And Meta-narrative Evidence Syntheses: Evolving Standards (RAMESES) and includes identifying the research question, searching for information, quality appraisal, data extraction, synthesising the evidence, validation of findings with experts and dissemination.Ethics and disseminationEthical approval not required. Findings will inform the wider RE-ASCeD evaluation and be reported to NHS England.Trial registration numberNCT04422483. This protocol relates to Pre-results.
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Rahman, Mehtab, and Vernanda Julien. "Improving cardiometabolic health assessments and interventions at St Charles Hospital, London." BJPsych Open 7, S1 (June 2021): S214. http://dx.doi.org/10.1192/bjo.2021.571.
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AimsSt Charles is one of the largest inpatient mental health units in London with 8 wards and covers the boroughs of Kensington & Chelsea and Westminster. This project aimed was set up so that 95% of patients in St Charles Mental Health Centre would have a complete cardiometabolic health assessment by December 2020. This would include Weight, Smoking, Alcohol, Substance Use, Hypertension, Cholesterol and Diabetes assessments with necessary interventions recorded. The outcome of the intervention would improve overall physical health and life expectancy.MethodPeople with serious mental illness experience significantly worse physical health and shorter life expectancy of up to 10 to 15 years than the general population. CNWL is making Physical Health of patients in Mental Health Services a priority. Performance in this area has been challenging across the Trust because of: –Buy in from clinicians.–Staff did not feel empowered to discuss interventions with patients.–High sickness and absence as a result of COVID was found to directly correlate with reduced physical health monitoring/recording.–Lack of training in completing the SystmOne physical health templateThe following cardiometabolic risk monitoring interventions were recorded on SystemOne (electronic documentation platform) and performance reviewed using Tableau : Weight, Smoking, Alcohol, Substance Use, Hypertension, Cholesterol and Diabetes assessments with necessary interventions recorded.ResultPrior to the commencement of this project, the wards in St Charles Mental Health Centre completed physical health assessments on roughly 8% of the patients in February 2020. The QI project was implemented in June 2020. By September 2020, physical health recording across 8 wards across St Charles had increased to 89% following successful implementation of the interventions.ConclusionThe following interventions resulted in a significant improvement in physical health cardiometabolic risk monitoring at a busy inpatient mental health setting: –Monthly physical heath meetings to enable shared learning with ward doctors, nurses and healthcare assistants.–Ongoing one-to-one and group support to train staff with completing and recording physical health assessments.–Tableau Physical Health Report regularly reviewed with MDT during ward round meetings.–Physical health leads given supernumerary days to run physical health clinics on the wards.–Fortnightly Physical health monitoring meetings with the Director of Nursing and Head of Governance.
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Low, Sew Kim, and Wan Ying Lee. "Promoting Better Health Care Services for Mental Health Patients in Malaysia." International Journal of Social Science and Humanity 5, no. 12 (2015): 1030–34. http://dx.doi.org/10.7763/ijssh.2015.v5.599.
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Dr. Sinu. E, Dr Sinu E., and Nathiya E. Nathiya. E. "School Mental Health Services for Children with Learning Disorders." International Journal of Scientific Research 2, no. 9 (June 1, 2012): 414–15. http://dx.doi.org/10.15373/22778179/sep2013/143.
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Heidt, Ryan. "Prevent Depression: Improving Access to Brazil's Mental Health Services." Clinical Social Work and Health Intervention 7, no. 4 (December 17, 2016): 20–24. http://dx.doi.org/10.22359/cswhi_7_4_03.
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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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Gulliver, Amelia, Kylie Bennett, Anthony Bennett, Louise M. Farrer, Julia Reynolds, and Kathleen M. Griffiths. "Privacy Issues in the Development of a Virtual Mental Health Clinic for University Students: A Qualitative Study." JMIR Mental Health 2, no. 1 (March 31, 2015): e9. http://dx.doi.org/10.2196/mental.4294.
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Background There is a growing need to develop online services for university students with the capacity to complement existing services and efficiently address student mental health problems. Previous research examining the development and acceptability of online interventions has revealed that issues such as privacy critically impact user willingness to engage with these services. Objective To explore university student perspectives on privacy issues related to using an online mental health service within the context of the development of an online, university-based virtual mental health clinic. Methods There were two stages of data collection. The first stage consisted of four 1.5-hour focus groups conducted with university students (n=19; 10 female, 9 male, mean age = 21.6 years) to determine their ideas about the virtual clinic including privacy issues. The second stage comprised three 1-hour prototype testing sessions conducted with university students (n=6; 3 male, 3 female, mean age = 21.2 years) using participatory design methods to develop and refine a service model for the virtual clinic and determine student views on privacy within this context. Results The students raised a number of issues related to privacy in relation to the development of the university virtual clinic. Major topics included the types of personal information they would be willing to provide (minimal information and optional mental health data), concern about potential access to their personal data by the university, the perceived stigma associated with registering for the service, and privacy and anonymity concerns related to online forums contained within the virtual clinic. Conclusions Students would be more comfortable providing personal information and engaging with the virtual clinic if they trust the privacy and security of the service. Implications of this study include building the clinic in a flexible way to accommodate user preferences.
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Zhu, Y., X. Li, and M. Zhao. "Promotion of Mental Health Rehabilitation in China: Community- Based Mental-Health Services." Consortium Psychiatricum 1, no. 2 (December 4, 2020): 21–27. http://dx.doi.org/10.17650/2712-7672-2020-1-1-21-27.
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Community-based mental health services are important for the treatment and recovery of patients with mental health disorders. The Chinese government has made the establishment of a highly efficient community-based health service an enduring priority. Since the 1960s, community-based mental health services have been developed in many Chinese cities and provinces. National policies, including mental health regulations and five-year national mental health working plans, have been issued to support the development of quality of mental health services. The accessibility and efficiency of community-based mental health services are now highly promoted to community residents. According to the National Standards for Primary Public Health Services, community-based mental health services are one of the most important components of primary public health services. They are mainly provided via Community Health Service Centres (CHCs), by a combination of general practitioners, public health physicians, nurses and social workers. Patients receive individualized and continuous health services according to their rehabilitation status. These services include regular physical examination, health education, rehabilitation guidance, social function rehabilitation training, vocational training and referral services; family members also receive care and psychological support. Future work will focus on expanding mental health service coverage and usage, increasing awareness of mental health and decreasing stigma, and strengthening service capability to establish an integrated model to enhance the overall efficiency of mental health services.
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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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Ballarin, Maria Luisa Gazabim Simões, Sabrina Helena Ferigato, and Fábio Bruno Carvalho. "Serviços de atenção à saúde mental: reflexões sobre os desafios da atenção integral à saúde da mulher." O Mundo da Saúde 32, no. 4 (December 6, 2008): 511–18. http://dx.doi.org/10.15343/0104-7809.200832.4.13.
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WILLIAMS, JENNIE, and PETER LINDLEY. "Working with Mental Health Service Users to Change Mental Health Services." Journal of Community & Applied Social Psychology 6, no. 1 (May 1996): 1–14. http://dx.doi.org/10.1002/(sici)1099-1298(199602)6:1<1::aid-casp359>3.0.co;2-k.
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Apolinário-Hagen, Jennifer, Jessica Kemper, and Carolina Stürmer. "Public Acceptability of E-Mental Health Treatment Services for Psychological Problems: A Scoping Review." JMIR Mental Health 4, no. 2 (April 3, 2017): e10. http://dx.doi.org/10.2196/mental.6186.
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Background Over the past decades, the deficient provision of evidence-based interventions for the prevention and treatment of mental health problems has become a global challenge across health care systems. In view of the ongoing diffusion of new media and mobile technologies into everyday life, Web-delivered electronic mental health (e-mental health) treatment services have been suggested to expand the access to professional help. However, the large-scale dissemination and adoption of innovative e-mental health services is progressing slowly. This discrepancy between potential and actual impact in public health makes it essential to explore public acceptability of e-mental health treatment services across health care systems. Objective This scoping review aimed to identify and evaluate recent empirical evidence for public acceptability, service preferences, and attitudes toward e-mental health treatments. On the basis of both frameworks for technology adoption and previous research, we defined (1) perceived helpfulness and (2) intentions to use e-mental health treatment services as indicators for public acceptability in the respective general population of reviewed studies. This mapping should reduce heterogeneity and help derive implications for systematic reviews and public health strategies. Methods We systematically searched electronic databases (MEDLINE/PubMed, PsycINFO, Psyndex, PsycARTICLES, and Cochrane Library, using reference management software for parallel searches) to identify surveys published in English in peer-reviewed journals between January 2010 and December 2015, focusing on public perceptions about e-mental health treatments outside the context of clinical, psychosocial, or diagnostic interventions. Both indicators were obtained from previous review. Exclusion criteria further involved studies targeting specific groups or programs. Results The simultaneous database search identified 76 nonduplicate records. Four articles from Europe and Australia were included in this scoping review. Sample sizes ranged from 217 to 2411 participants of ages 14-95 years. All included studies used cross-sectional designs and self-developed measures for outcomes related to both defined indicators of public acceptability. Three surveys used observational study designs, whereas one study was conducted as an experiment investigating the impact of brief educational information on attitudes. Taken together, the findings of included surveys suggested that e-mental health treatment services were perceived as less helpful than traditional face-to-face interventions. Additionally, intentions to future use e-mental health treatments were overall smaller in comparison to face-to-face services. Professional support was essential for help-seeking intentions in case of psychological distress. Therapist-assisted e-mental health services were preferred over unguided programs. Unexpectedly, assumed associations between familiarity with Web-based self-help for health purposes or “e-awareness” and intentions to use e-mental health services were weak or inconsistent. Conclusions Considering the marginal amount and heterogeneity of pilot studies focusing on public acceptability of e-mental health treatments, further research using theory-led approaches and validated measures is required to understand psychological facilitator and barriers for the implementation of innovative services into health care.
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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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Bell, Louise. "Developing service quality in mental health services." International Journal of Health Care Quality Assurance 17, no. 7 (December 2004): 401–6. http://dx.doi.org/10.1108/09526860410563212.
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Draper, Brian, Tanya Jochelson, David Kitching, John Snowdon, Henry Brodaty, and Bob Russell. "Mental Health Service Delivery to Older People in New South Wales: Perceptions of Aged Care, Adult Mental Health and Mental Health Services for Older People." Australian & New Zealand Journal of Psychiatry 37, no. 6 (December 2003): 735–40. http://dx.doi.org/10.1080/j.1440-1614.2003.01259.x.
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Objective: To compare the perceptions of aged care services, adult mental health services and mental health services for older people regarding aspects of mental health service delivery for older people in New South Wales, Australia. Method: The NSW Branch of the Faculty of Psychiatry of Old Age in association with the NSW Centre for Mental Health, sent a postal survey to all aged care services, adult mental health services and mental health services for older people in NSW. The survey canvassed issues ranging across service profiles, regional variations, availability of resources, processes of care, views on working relationships between services, difficulties and gaps experienced, and ways to improve co-ordination and service delivery. Clinical issues such as the management and practice of psychiatric disorders of old age, educational/training requirements and skill and experience in working with older people were explored. Results: An overall response rate of 86% was achieved, including 95% from aged care services (n = 58), 74% from adult mental health services (n = 62) and 90% from mental health services for older people (n = 20). Only 59% of aged care services and adult mental health services considered that their local mental health services for older people provided an adequate service; resource and budget limitations were portrayed as the main constraint. Mental health services for older people varied widely in structure, settings and activities undertaken. Access to mental health beds for older people was also variable, and alongside staffing levels was considered problematic. Lack of staff training and/or inexperience in psychogeriatrics posed a challenge for aged care services and adult mental health services. Conclusion: Relationships between aged care services, adult mental health services and mental health services for older people are affected by lack of access to psychogeriatric staff, resource limitations of mental health services for older people, and inadequate liaison and support between the service types. Joint case conferences, education, increased funding of mental health services for older people, and cross referrals were considered ways to address these issues.
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O'Dea, Bridianne, Catherine King, Mirjana Subotic-Kerry, Kathleen O'Moore, and Helen Christensen. "School Counselors’ Perspectives of a Web-Based Stepped Care Mental Health Service for Schools: Cross-Sectional Online Survey." JMIR Mental Health 4, no. 4 (November 20, 2017): e55. http://dx.doi.org/10.2196/mental.8369.
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Background Mental health problems are common among youth in high school, and school counselors play a key role in the provision of school-based mental health care. However, school counselors occupy a multispecialist position that makes it difficult for them to provide care to all of those who are in need in a timely manner. A Web-based mental health service that offers screening, psychological therapy, and monitoring may help counselors manage time and provide additional oversight to students. However, for such a model to be implemented successfully, school counselors’ attitudes toward Web-based resources and services need to be measured. Objective This study aimed to examine the acceptability of a proposed Web-based mental health service, the feasibility of providing this type of service in the school context, and the barriers and facilitators to implementation as perceived by school counselors in New South Wales (NSW), Australia. Methods This study utilized an online cross-sectional survey to measure school counselors’ perspectives. Results A total of 145 school counselors completed the survey. Overall, 82.1% (119/145) thought that the proposed service would be helpful to students. One-third reported that they would recommend the proposed model, with the remaining reporting potential concerns. Years of experience was the only background factor associated with a higher level of comfort with the proposed service (P=.048). Personal beliefs, knowledge and awareness, Internet accessibility, privacy, and confidentiality were found to influence, both positively and negatively, the likelihood of school counselors implementing a Web-based school mental health service. Conclusions The findings of this study confirmed that greater support and resources are needed to facilitate what is already a challenging and emotionally demanding role for school counselors. Although the school counselors in this study were open to the proposed service model, successful implementation will require that the issues outlined are carefully addressed.
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Gaebel, W. "EPA Guidance on Quality of Mental Health Services." European Psychiatry 26, S2 (March 2011): 2198. http://dx.doi.org/10.1016/s0924-9338(11)73901-3.
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IntroductionCentral to improving quality of mental health services is an optimization of the structures and processes provided to people with mental disorders in Europe.ObjectivesTo improve the quality of mental health services in Europe by developing a European guidance focusing on the quality of mental health service structures in Europe.AimsThe main aim of this guidance is to provide recommendations based on the best available evidence for optimal structures of mental health services by identifying and evaluating the available evidence including a comparison between the efficacy of different service structures wherever possible.MethodsSystematic literature review and expert consensus survey about questions of the structural and process quality in European mental health services.ResultsSixteen recommendations were developed for mental health service structures, five for mental health service processes, and four for both mental health services and structures. The recommendations span a large number of mental health services factors including - among others - structural aspects of mental health services, psychiatric workforce numbers, kinds of inpatient and outpatient services and their integration, mental health monitoring and mental health education, admission procedures and safety aspects.ConclusionsEvidence regarding the quality of mental health services is mainly limited due to the small number of studies and the national or regional peculiarities of mental health service structures which make generalizations difficult. Nevertheless, twenty-five recommendations could be arrived at and future research should aim at investigating whether the implementation of these guidelines is effective in improving European mental health service structures.
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Lal, Shalini, Winnie Daniel, and Lysanne Rivard. "Perspectives of Family Members on Using Technology in Youth Mental Health Care: A Qualitative Study." JMIR Mental Health 4, no. 2 (June 23, 2017): e21. http://dx.doi.org/10.2196/mental.7296.
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Background Information and communication technologies (ICTs) are increasingly recognized as having an important role in the delivery of mental health services for youth. Recent studies have evaluated young people’s access and use of technology, as well as their perspectives on using technology to receive mental health information, services, and support; however, limited attention has been given to the perspectives of family members in this regard. Objective The aim of this study was to explore the perspectives of family members on the use of ICTs to deliver mental health services to youth within the context of specialized early intervention for a first-episode psychosis (FEP). Methods Six focus groups were conducted with family members recruited from an early intervention program for psychosis. Twelve family members participated in the study (target sample was 12-18, and recruitment efforts took place over the duration of 1 year). A 12-item semistructured focus group guide was developed to explore past experiences of technology and recommendations for the use of technology in youth mental health service delivery. A qualitative thematic analysis guided the identification and organization of common themes and patterns identified across the dataset. Results Findings were organized by the following themes: access and use of technology, potential negative impacts of technology on youth in recovery, potential benefits of using technology to deliver mental health services to youth, and recommendations to use technology for (1) providing quality information in a manner that is accessible to individuals of diverse socioeconomic backgrounds, (2) facilitating communication with health care professionals and services, and (3) increasing access to peer support. Conclusions To our knowledge, this is among the first (or the first) to explore the perspectives of family members of youth being treated for FEP on the use of technology for mental health care. Our results highlight the importance of considering diverse experiences and attitudes toward the role of technology in youth mental health, digital literacy skills, phases of recovery, and sociodemographic factors when engaging family members in technology-enabled youth mental health care research and practice. Innovative methods to recruit and elicit the perspectives of family members on this topic are warranted. It is also important to consider educational strategies to inform and empower family members on the role, benefits, and use of ICTs in relation to mental health care for FEP.
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Davey, Sanjeev, Santosh Kumar Raghav, Jai Vir Singh, Anuradha Davey, Nirankar Singh, and Chaitanya Maheshwari. "Psycho-social needs fulfilment- can it be a predictor of otorhinolaryngological services outcome of a rural heath training centre?: a study by wellness triangle analysis." International Journal Of Community Medicine And Public Health 4, no. 4 (March 28, 2017): 1032. http://dx.doi.org/10.18203/2394-6040.ijcmph20171320.
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Background: Primary health care approach in ENT health care delivery; has shown to be a budding strategy in alleviating the ENT disease burden in the rural of India, as evident from literature. However the impact of Psycho-social needs fulfillment associated with ENT diseases for achieving optimum ENT care has not been studied till now, which was the main issue addressed by this study. Methods: A Prospective study was done on needs of ENT patients in 6 villages (sampled randomly); in a catchment area of a rural health training centre (RHTC) of a Medical College in western Uttar Pradesh (Muzaffarnagar) from 1st January 2015 to 30th June 2016 by way of a Wellness Triangle approach of WHO exploring Physical, Social and Mental needs from ENT Specialist Services. All the needs of patients were studied by a Semi-structured Performa and data was analyzed by appropriate statistical software’s. Results: Among 384 patients, who attended ENT Specialist services at RHTC for 1.6 years- the majority of patients availing ENT care at RHTC were initially dissatisfied with Psycho-social support provided by ENT Specialists(77%,n=296). However when Psycho-social Component of Patients (n=311, 81%) were fulfilled by both ENT & Community Medicine faculties -the ENT Curative treatment % was higher (n=212, 55.2% vs. n=13, 3.3%, OR=9.8, RR=1.5) and this difference was also statistically significant( p<0.00001). Conclusions: Greater psycho-social support is needed by ENT patients; apart from focus on pure curative approach by otorhinolaryngologist. The full-filing of psycho-social needs of ENT patients, needs more attention by both ENT specialists and community physicians for delivering ENT care by primary health care approach.
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Owen, Cathy, Christopher Tennant, Deslee Jessie, Michael Jones, and Valerie Rutherford. "A Model for Clinical and Educational Psychiatric Service Delivery in Remote Communities." Australian & New Zealand Journal of Psychiatry 33, no. 3 (June 1999): 372–78. http://dx.doi.org/10.1046/j.1440-1614.1999.00578.x.
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Objective: A model of intermittent psychiatric service provision to rural and remote New South Wales communities by metropolitan psychiatrists and mental health professionals has been evaluated. The services provided included peer support to lone mental health and generic health workers, direct psychiatric care to clients in their own environment and skills development education sessions to general health staff and other professionals affiliated with health care (e.g. police and ambulance officers). Method: There were 10 visits of teams made up of a psychiatrist and another mental health professional to six rural and remote locations. Outcomes of the services delivered were examined including clinical services and teaching skills training sessions. Indirect outcome measures included changes to Pharmaceutical Benefits Scheme prescription patterns in areas serviced and data regarding transfer of clients for psychiatric care in regional centres. Difficulties in evaluation are discussed. Results: The feasibility of intermittent service provision was demonstrated. Education packages were well received and a positive change in workers' attitudes toward mental health practice was found. Conclusion: Intermittent psychiatric services in remote settings add value to health care delivery particularly when dovetailed with skills-based education sessions.
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Wing, John. "Mental Heath Services in Europe: Ten Years On. By H. L. Freeman, T. Fryers and J. H. Henderson Copenhagen: WHO Regional Office for Europe. 1985. Pp 112. Sw.Fr. 11.00." British Journal of Psychiatry 148, no. 6 (June 1986): 756–57. http://dx.doi.org/10.1192/s0007125000212087.
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Wilkinson, Greg. "Mental Health Services Planning." Bulletin of the Royal College of Psychiatrists 9, no. 7 (July 1985): 138. http://dx.doi.org/10.1192/s0140078900022161.
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A timely conference on Mental Health Services Planning, organized jointly by the Royal College of Psychiatrists and the Department of Health and Social Security, took place in London in March 1985. The conference concentrated on difficulties associated with the implementation of government policies for mental health service planning in England and Wales. Particular emphasis was given to the problems of transition from hospital-based services to community-based services.
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Molchanova, E. "Survivors of gender-based violence and role of official psychiatry in recovery process." European Psychiatry 33, S1 (March 2016): S171. http://dx.doi.org/10.1016/j.eurpsy.2016.01.354.
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Consequences of events in the Southern region of the Kyrgyz Republic continue to have impact on communities to the present day. One of the most significant is a number of undiagnosed cases of rapes and other types of gender-based violence (GBV), which happened during the events of 2010. Accurate prevalence rates of GBV cases is still unknown. According to official data of Ministry of Internal Affairs, there were only seven cases of rape, however, according to the crisis center reports, there were 325. Even more alarming, witnesses of the Osh events suggest one out of three women in Osh and Jalal-Abad were either raped or suffered from other types of GBV. Those acts included undressing and unveiling, and cutting women's hair to a shamelessly short length. Cultural stereotypes dictate women hide their ‘shame’, which is why only a small percentage of victims with PTSD symptoms that developed after GBV sought out services from professionals, such as from crisis centers, psychologists and psychiatrists and, of course, police. Author analyzed several cases of women raped during the Osh massacre and suffered from PTSD signs afterwards. The previous painful experience of GBV was uncovered during treatment. The problem is that mental heath care specialists are the last stop for applying for help. This paper analyses several ways of solving the problem, including creating a number of normative documents in collaboration with Ministry of Internal Affairs and Ministry of Health of the Kyrgyz Republic.Disclosure of interestThe author has not supplied his/her declaration of competing interest.
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Upadhyaya, Kapil Dev. "Mental Health & Community Mental Health in Nepal: Major Milestones in the development of Modern Mental Health Care." Journal of Psychiatrists' Association of Nepal 4, no. 1 (February 21, 2017): 60–67. http://dx.doi.org/10.3126/jpan.v4i1.16746.
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Bir Hospital, the first general hospital with specialist services was established in the country in 1889 A.D. When I came back to Nepal after MBBS in 1971, most of the specialties like Medicine, Surgery, Gynae & Obs, Opthalmology, ENT, Psychiatry, Anesthesiology, Radiology, Emergency department with 24 hours service were there. Paediatric OPD service was available, and children were admitted in Kanti children hospital Kathmandu. So mental health service in Nepal was started in a general hospital with different specialties.
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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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Pozner, Adam, and Bob Grove. "Service Development Network for mental health employment services." A Life in the Day 4, no. 2 (May 2000): 28. http://dx.doi.org/10.1108/13666282200000016.
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Hewitt, Maria, and Julia H. Rowland. "Mental Health Service Use Among Adult Cancer Survivors: Analyses of the National Health Interview Survey." Journal of Clinical Oncology 20, no. 23 (December 1, 2002): 4581–90. http://dx.doi.org/10.1200/jco.2002.03.077.
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PURPOSE: Analyses were conducted to obtain national estimates of mental health service use, unmet need for such services, and the prevalence of mental health problems among individuals reporting a cancer history. METHODS: Of a nationally representative sample of 95,615 adults in the United States interviewed as part of the 1998, 1999, and 2000 National Health Interview Survey, 4,878 reported a history of cancer (excluding superficial skin cancer). Analyses assessed whether cancer survivors relative to those without a self-reported history of cancer had increased use of mental health services and had increased reports of unmet need for such services. Analyses were also conducted to ascertain demographic and health characteristics associated with service use and unmet need. RESULTS: Compared with individuals without a cancer history, cancer survivors reported significantly greater contact in the past year with a mental health provider (7.2% v 5.7%). Cancer survivors were more likely to have used mental health services (odds ratio, 1.60 among those without other chronic illnesses and 3.04 among those with other chronic illnesses), and mental health service use was significantly greater among those who were under age 65 and diagnosed at younger ages, were formerly married, or had other comorbid chronic conditions. If all cancer survivors with mental health problems or who needed but could not access mental health services due to cost had received such care, mental health service use would have increased from 7.2% to 11.7%, a 62% increase in use. CONCLUSION: Cancer seems to be one of several chronic illnesses that precipitates the need for and use of mental health services. Improvements are needed in recognizing mental health problems among cancer survivors and reducing barriers to psychosocial service use.
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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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Mitchell, Penny, Abd Malak, and David Small. "Bilingual Professionals in Community Mental Health Services." Australian & New Zealand Journal of Psychiatry 32, no. 3 (June 1998): 424–33. http://dx.doi.org/10.3109/00048679809065537.
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Objective: This paper presents results from research that explored the roles of bilingual professionals in community mental health services in the Sydney metropolitan area of New South Wales. There were two main objectives to the research: (i) to identify and describe the roles of bilingual professionals that are important in improving the quality of community mental health services for clients from non-English-speaking backgrounds (NESB); and (ii) to identify and describe the factors that facilitate and inhibit the conduct of these roles. Method: Data collection involved indepth interviews with bilingual professionals and team leaders in community mental health services and various other community health services; and various staff responsible for policy and service development with regard to cultural diversity. Results: Bilingual mental health workers were found to have at least four critical roles. These were (i) direct clinical service provision to NESB clients; (ii) mental health promotion and community development; (iii) cultural consultancy; and (iv) service development. Respondents reported that the latter three roles were seriously underdeveloped compared to the clinical service provision role. Conclusions: It is critical that service managers implement strategies to make better use of the linguistic and cultural skills of bilingual professionals. In addition to their role in clinical service provision ways must be found to facilitate the community-focused, cultural consultancy and service development roles of bilingual professionals employed in mental health services.