Increasing clinicians' EBT exploration and preparation behavior in youth mental health services by changing organizational culture with ARC.

Science.gov (United States)

Glisson, Charles; Williams, Nathaniel J; Hemmelgarn, Anthony; Proctor, Enola; Green, Philip

2016-01-01

Clinician EBT exploration and preparation behavior is essential to the ongoing implementation of new EBTs. This study examined the effect of the ARC organizational intervention on clinician EBT exploration and preparation behavior and assessed the mediating role of organizational culture as a linking mechanism. Fourteen community mental health agencies that serve youth in a major Midwestern metropolis along with 475 clinicians who worked in those agencies, were randomly assigned to either the three-year ARC intervention or control condition. Organizational culture was assessed with the Organizational Social Context (OSC) measure at baseline and follow-up. EBT exploration and preparation behavior was measured as clinician participation in nine separate community EBT workshops held over a three-year period. There was 69 percent greater odds (OR = 1.69, p organizational culture mediated the positive effect of the ARC intervention on clinicians' workshop attendance (a × b = .21; 95% CI:LL = .05, UL = .40). Organizational interventions that create proficient mental health agency cultures can increase clinician EBT exploration and preparation behavior that is essential to the ongoing implementation of new EBTs in community youth mental health settings. Copyright © 2015 Elsevier Ltd. All rights reserved.

Clinician descriptions of communication strategies to improve treatment engagement by racial/ethnic minorities in mental health services: A systematic review.

Science.gov (United States)

Aggarwal, Neil Krishan; Pieh, Matthew C; Dixon, Lisa; Guarnaccia, Peter; Alegría, Margarita; Lewis-Fernández, Roberto

2016-02-01

To describe studies on clinician communication and the engagement of racial/ethnic minority patients in mental health treatment. Authors conducted electronic searches of published and grey literature databases from inception to November 2014, forward citation analyses, and backward bibliographic sampling of included articles. Included studies reported original data on clinician communication strategies to improve minority treatment engagement, defined as initiating, participating, and continuing services. Twenty-three studies met inclusion criteria. Low treatment initiation and high treatment discontinuation were related to patient views that the mental health system did not address their understandings of illness, care or stigma. Treatment participation was based more on clinician language use, communication style, and discussions of patient-clinician differences. Clinicians may improve treatment initiation and continuation by incorporating patient views of illness into treatment and targeting stigma. Clinicians may improve treatment participation by using simple language, tailoring communication to patient preferences, discussing differences, and demonstrating positive affect. Lack of knowledge about the mental health system and somatic symptoms may delay treatment initiation. Discussions of clinician backgrounds, power, and communication style may improve treatment participation. Treatment continuation may improve if clinicians tailor communication and treatment plans congruent with patient expectations. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Acceptability of contingency management among clinicians and clients within a co-occurring mental health and substance use treatment program.

Science.gov (United States)

Srebnik, Debra; Sugar, Andrea; Coblentz, Patrick; McDonell, Michael G; Angelo, Frank; Lowe, Jessica M; Ries, Richard K; Roll, John

2013-01-01

Emerging evidence supports the effectiveness of contingency management (CM) for addictions treatment among individuals with co-occurring serious mental illness (SMI). Addiction treatment for people with SMI generally occurs within community mental health centers (CMHCs) and it is not known whether CM is acceptable within this context. Client views regarding CM are also unknown. This study is the first to describe CM acceptability among CMHC clinicians, and the first to explore client views. Clinician-level predictors of CM acceptability are also examined. This study examined views about CM among 80 clinicians and 29 clients within a CMHC within the context of a concurrent CM study. Three-quarters of clinicians reported they would use CM if funding were available. Clinicians and clients affirmed that incentives enhance abstinence motivation. Clinician CM acceptability was related to greater years of experience, and identifying as an addictions or co-occurring disorders counselor, more than a mental health clinician. The findings provide preliminary evidence that CMHC clinicians, serving clients with addictions and complicating SMI, and client participants in CM, view CM as motivating and a positive tool to facilitate recovery. As an evidence-based intervention, CM warrants further efforts toward funding and dissemination in CMHCs. Copyright © American Academy of Addiction Psychiatry.

Employment-related information for clients receiving mental health services and clinicians.

Science.gov (United States)

King, Joanne; Cleary, Catherine; Harris, Meredith G; Lloyd, Chris; Waghorn, Geoff

2011-01-01

Clients receiving public mental health services and clinicians require information to facilitate client access to suitable employment services. However, little is known about the specific employment-related information needs of these groups. This study aimed to identify employment-related information needs among clients, clinicians and employment specialists, with a view to developing a new vocational information resource. Employment-related information needs were identified via a series of focus group consultations with clients, clinicians, and employment specialists (n=23). Focus group discussions were guided by a common semi-structured interview schedule. Several categories of information need were identified: countering incorrect beliefs about work; benefits of work; disclosure and managing personal information; impact of earnings on welfare entitlements; employment service pathways; job preparation, planning and selection; and managing illness once working. Clear preferences were expressed about effective means of communicating the key messages in written material. This investigation confirmed the need for information tailored to clients and clinicians in order to activate clients' employment journey and to help them make informed decisions about vocational assistance.

Forensic mental health clinician's experiences with and assessment of alliance regarding the patient's readiness to be released from mechanical restraint

DEFF Research Database (Denmark)

Nielsen, Lea Deichmann; Gildberg, Frederik Alkier; Bech, Per

2018-01-01

One of the main reasons for prolonged duration of mechanical restraint is patient behaviour in relation to the clinician-patient alliance. This article reports on the forensic mental health clinicians experiences of the clinician-patient alliance during mechanical restraint, and their assessment...

Assessing mental health clinicians' intentions to adopt evidence-based treatments: reliability and validity testing of the evidence-based treatment intentions scale.

Science.gov (United States)

Williams, Nathaniel J

2016-05-05

Intentions play a central role in numerous empirically supported theories of behavior and behavior change and have been identified as a potentially important antecedent to successful evidence-based treatment (EBT) implementation. Despite this, few measures of mental health clinicians' EBT intentions exist and available measures have not been subject to thorough psychometric evaluation or testing. This paper evaluates the psychometric properties of the evidence-based treatment intentions (EBTI) scale, a new measure of mental health clinicians' intentions to adopt EBTs. The study evaluates the reliability and validity of inferences made with the EBTI using multi-method, multi-informant criterion variables collected over 12 months from a sample of 197 mental health clinicians delivering services in 13 mental health agencies. Structural, predictive, and discriminant validity evidence is assessed. Findings support the EBTI's factor structure (χ (2) = 3.96, df = 5, p = .556) and internal consistency reliability (α = .80). Predictive validity evidence was provided by robust and significant associations between EBTI scores and clinicians' observer-reported attendance at a voluntary EBT workshop at a 1-month follow-up (OR = 1.92, p adoption at a 12-month follow-up (R (2) = .17, p adopt EBTs. Discussion focuses on research and practice applications.

The effect of clinician-patient alliance and communication on treatment adherence in mental health care: a systematic review

Directory of Open Access Journals (Sweden)

Thompson Laura

2012-07-01

Full Text Available Abstract Background Nonadherence to mental health treatment incurs clinical and economic burdens. The clinician-patient alliance, negotiated through clinical interaction, presents a critical intervention point. Recent medical reviews of communication and adherence behaviour exclude studies with psychiatric samples. The following examines the impact of clinician-patient alliance and communication on adherence in mental health, identifying the specific mechanisms that mobilise patient engagement. Methods In December 2010, a systematic search was conducted in Pubmed, PsychInfo, Web of Science, Cochrane Library, Embase and Cinahl and yielded 6672 titles. A secondary hand search was performed in relevant journals, grey literature and reference. Results 23 studies met the inclusion criteria for the review. The methodological quality overall was moderate. 17 studies reported positive associations with adherence, only four of which employed intervention designs. 10 studies examined the association between clinician-patient alliance and adherence. Subjective ratings of clinical communication styles and messages were assessed in 12 studies. 1 study examined the association between objectively rated communication and adherence. Meta-analysis was not possible due to heterogeneity of methods. Findings were presented as a narrative synthesis. Conclusions Clinician-patient alliance and communication are associated with more favourable patient adherence. Further research of observer rated communication would better facilitate the application of findings in clinical practice. Establishing agreement on the tasks of treatment, utilising collaborative styles of communication and discussion of treatment specifics may be important for clinicians in promoting cooperation with regimens. These findings align with those in health communication. However, the benefits of shared decision making for adherence in mental health are less conclusive than in general medicine.

The effects of training mental health practitioners in medication management to address nonadherence: a systematic review of clinician-related outcomes

Directory of Open Access Journals (Sweden)

Bressington D

2013-05-01

Full Text Available Daniel Bressington,1 Esther Coren,1 Douglas MacInnes21Department of Health, Well-Being and Family, 2Centre for Health and Social Care Research, Canterbury Christ Church University, Canterbury, UKBackground: Nonadherence with medicine prescribed for mental health is a common problem that results in poor clinical outcomes for service users. Studies that provide medication management-related training for the mental health workforce have demonstrated that improvements in the knowledge, attitudes, and skills of staff can help to address nonadherence. This systematic review aims to establish the effectiveness of these training interventions in terms of clinician-related outcomes.Methods: Five electronic databases were systematically searched: PubMed, CINAHL, Medline, PsycInfo, and Google Scholar. Studies were included if they were qualitative or quantitative in nature and were primarily designed to provide mental health clinicians with knowledge and interventions in order to improve service users' experiences of taking psychotropic medications, and therefore potentially address nonadherence issues.Results: A total of five quantitative studies were included in the review. All studies reported improvements in clinicians' knowledge, attitudes, and skills immediately following training. The largest effect sizes related to improvements in clinicians' knowledge and attitudes towards nonadherence. Training interventions of longer duration resulted in the greatest knowledge- and skills-related effect sizes.Conclusion: The findings of this review indicate that training interventions are likely to improve clinician-related outcomes; however, due to the methodological limitations of the current evidence base, future research in this area should aim to conduct robust randomized controlled trials with follow-up and consider collecting qualitative data to explore clinicians' experiences of using the approaches in clinical practice.Keywords: staff training

Clinician's perspectives of the relocation of a regional child and adolescent mental health service from co-located to stand alone premises.

Science.gov (United States)

Francis, K J; Boyd, C P; Sewell, J; Nurse, S

2008-01-01

Australia's National Mental Health Strategy's statement of rights and responsibilities states that children and adolescents admitted to a mental health facility or community program have the right to be separated from adult patients and provided with programs suited to their developmental needs. However, in rural Australia, where a lack of healthcare services, financial constraints, greater service delivery areas and fewer mental healthcare specialists represent the norm, Child and Adolescent Mental Health Services (CAMHS) are sometimes co-located with adult mental health services. The aim of the present study was to evaluate the impact of a recent relocation of a regional CAMHS in Victoria from co-located to stand alone premises. Six CAMHS clinicians who had experienced service delivery at a co-located setting and the current stand-alone CAMHS setting were interviewed about their perceptions of the impact of the relocation on service delivery. An exploratory interviewing methodology was utilized due to the lack of previous research in this area. Interview data were transcribed and analysed according to interpretative phenomenological analysis techniques. Findings indicated a perception that the relocation was positive for clients due to the family-friendly environment at the new setting and separation of CAMHS from adult psychiatric services. However, the impact of the relocation on clinicians was marked by a perceived loss of social capital from adult psychiatric service clinicians. These results provide increased understanding of the effects of service relocation and the influence of co-located versus stand-alone settings on mental health service delivery - an area where little prior research exists.

Working together: a joint initiative between academics and clinicians to prepare undergraduate nursing students to work in mental health settings.

Science.gov (United States)

Curtis, Janette

2007-08-01

There is ongoing concern among mental health professionals regarding the recruitment of newly graduated nurses to this specialist nursing area. Many reasons for the problem have been identified, including the perceived inadequate preparation by the tertiary sector, students' prejudices and anxieties about mental illness, a perceived lack of support while undertaking clinical placement, and the quality of the clinical placement itself. This paper describes a collaborative response to these issues undertaken in the Illawarra region of New South Wales, Australia. The implementation of preclinical undergraduate workshops using problem-based learning and role plays were undertaken. Mental health nursing scenarios were developed in association with experienced clinicians to introduce core concepts in a supportive learning environment. Quantitative and qualitative evaluation data were collected immediately following the workshop and again after the students returned to the university following a mental health clinical placement. A further survey of one cohort was undertaken 12 months after initial state registration and the beginning of a career in mental health nursing. Results showed that both students' and clinicians' attitudes to the workshops were consistently positive and indicated that the workshops were beneficial in preparing students for their clinical placement. Importantly, since the implementation of the workshops and other collaborative initiatives, an increasing number of newly graduated nurses from the region are choosing to work in mental health.

Research priorities in mental health occupational therapy: A study of clinician perspectives.

Science.gov (United States)

Hitch, Danielle; Lhuede, Kate

2015-10-01

The evidence to support mental health occupational therapy has proliferated in the early years of this century, but this growth has tended to be organic rather than targeted. Previous efforts to identify research priorities in this area of practice are either out dated, or encompass discrete areas of practice. The aim of this study was to identify priority areas for research in mental health occupational therapy from clinician's perspectives. A Policy Delphi method was used to enable occupational therapists to define and differentiate their perspectives on research priorities. Forty-two occupational therapists took part in the first two rounds of this method, with 69% (n = 29) going on to complete the third and final round of data collection. A Likert scale was used to rate the importance of each priority, and descriptive quantitative analysis undertaken to identify those most consistently identified as being highly important. Four research priorities were identified as being highly important in this study: (i) working in an occupationally focussed way; (ii) consumer experience of therapy groups; (iii) identifying factors which increase consumer engagement in occupation; and (iv) engaging patients on the inpatient unit in meaningful and positive occupation. Two of the priority areas are already the subject of substantial evidence bases, but there has been far less research into consumer experiences of groups and occupational engagement in acute settings. Collaboration between research teams and greater consumer inclusion are recommended for the future. This study provides an updated indication of research priorities for mental health occupational therapy in Australia. © 2015 Occupational Therapy Australia.

Mental health professionals and media professionals: a survey of attitudes towards one another.

Science.gov (United States)

Chapman, Beth; Shankar, Rohit; Palmer, Joanne; Laugharne, Richard

2017-10-01

The general public regard mass media as their main source of information about mental illness. Psychiatrists are reluctant to engage with the media. There is little understanding of why this is the case. The paper looks to explore attitudes of mental health clinicians and the media towards one another. Media and mental health clinicians in the southwest of England completed self-report surveys. Of 119 questionnaires returned 85 were mental health clinicians and 34 media professionals. Both groups agreed that stigma is a major issue and clinicians have a key role influencing media portrayal of mental illness. The media view their reporting to be more balanced than clinicians and lack awareness of clinician mistrust towards them. Those clinicians with media training (13%) felt significantly more comfortable talking to media and significantly less mistrustful of them. Clinicians who had experience of working with media felt more comfortable doing media work. Only 15% of media professionals had received mental health awareness training. Media training and experience are associated with an increased willingness of mental health professionals to engage with the media. Reciprocal awareness training between media and mental health professionals may be a simple intervention worth pursuing.

The Fountain of Health: Bringing Seniors’ Mental Health Promotion into Clinical Practice

Science.gov (United States)

Thoo, Vanessa; Freer, Janya; Cassidy, Keri-Leigh

2015-01-01

Background The Fountain of Health (FoH) initiative offers valuable evidence-based mental health knowledge and provides clinicians with evaluated tools for translating knowledge into practice, in order to reduce seniors’ risks of mental disorders, including dementia. Methods A presentation on mental health promotion and educational materials were disseminated to mental health clinicians including physicians and other allied health professionals either in-person or via tele-education through a provincial seniors’ mental health network. Measures included: 1) a tele-education quality evaluation form, 2) a knowledge transfer questionnaire, 3) a knowledge translation-to-practice evaluation tool, and 4) a quality assurance questionnaire. Results A total of 74 mental health clinicians received the FoH education session. There was a highly significant (p < .0001) difference in clinicians’ knowledge transfer questionnaire scores pre- and post-educational session. At a two-month follow-up, 19 (25.7%) participants completed a quality assurance questionnaire, with all 19 (100%) of respondents stating they would positively recommend the FoH information to colleagues and patients. Eleven (20.4%) translation-to-practice forms were also collected at this interval, tracking clinician use of the educational materials. Conclusions The use of a formalized network for knowledge transfer allows for education and evaluation of health-care practitioners in both acquisition of practical knowledge and subsequent clinical behavior change. PMID:26740830

Employee Health in the Mental Health Workplace: Clinical, Administrative, and Organizational Perspectives.

Science.gov (United States)

Shah, Jai L; Kapoor, Reena; Cole, Robert; Steiner, Jeanne L

2016-04-01

Issues of mental health and employee health have risen to increasing prominence in recent years. However, there have been few explorations of the clinical and administrative challenges that these issues raise, particularly in settings that are themselves mental health workplaces. In order to identify and understand such challenges, a brief case of acute employee illness in a mental health workplace is described followed by a discussion of salient clinical, administrative, and organizational considerations. The case raises questions about medicolegal responsibilities and relationships between clinicians and patients in mental health settings, illuminates tensions between clinical staff and human resources processes, and draws attention to the need for illness prevention and mental health promotion initiatives in the workplace. Increased awareness of these issues, complications, and potential solutions would benefit clinicians, administrators, and mental health institutions.

Clinical Decision-Making in Community Children's Mental Health: Using Innovative Methods to Compare Clinicians With and Without Training in Evidence-Based Treatment.

Science.gov (United States)

Baker-Ericzén, Mary J; Jenkins, Melissa M; Park, Soojin; Garland, Ann F

2015-02-01

Mental health professionals' decision-making practice is an area of increasing interest and importance, especially in the pediatric research and clinical communities. The present study explored the role of prior training in evidence-based treatments on clinicians' assessment and treatment formulations using case vignettes. Specifically, study aims included using the Naturalistic Decision Making (NDM) cognitive theory to 1) examine potential associations between EBT training and decision-making processes (novice versus expert type), and 2) explore how client and family contextual information affects clinical decision-making. Forty-eight clinicians across two groups (EBT trained=14, Not EBT trained=34) participated. Clinicians were comparable on professional experience, demographics, and discipline. The quasi-experimental design used an analog "think aloud" method where clinicians read case vignettes about a child with disruptive behavior problems and verbalized case conceptualization and treatment planning out-loud. Responses were coded according to NDM theory. MANOVA results were significant for EBT training status such that EBT trained clinicians' displayed cognitive processes more closely aligned with "expert" decision-makers and non-EBT trained clinicians' decision processes were more similar to "novice" decision-makers, following NDM theory. Non-EBT trained clinicians assigned significantly more diagnoses, provided less detailed treatment plans and discussed fewer EBTs. Parent/family contextual information also appeared to influence decision-making. This study offers a preliminary investigation of the possible broader impacts of EBT training and potential associations with development of expert decision-making skills. Targeting clinicians' decision-making may be an important avenue to pursue within dissemination-implementation efforts in mental health practice.

Racial Differences in Mental Health Recovery among Veterans with Serious Mental Illness.

Science.gov (United States)

Ali, Mana K; Hack, Samantha M; Brown, Clayton H; Medoff, Deborah; Fang, Lijuan; Klingaman, Elizabeth A; Park, Stephanie G; Dixon, Lisa B; Kreyenbuhl, Julie A

2018-04-01

Black consumers with serious mental illness (SMI) face significant challenges in obtaining quality mental health care and are at risk for experiencing significant disparities in mental health care outcomes, including recovery from mental illness. Patient-provider interactions may partly contribute to this disparity. The purpose of the current study was to understand the effects of race, psychosis, and therapeutic alliance on mental health recovery orientation among Veterans with SMI. Participants were Veterans who had an SMI being treated at two Veteran Affairs outpatient mental health clinics by a psychiatrist or nurse practitioner. Participants completed the Behavior and Symptom Identification Scale (BASIS-24), Mental Health Recovery Measure, and patient-report Scale to Assess the Therapeutic Relationship (STAR-P) which includes three subscales: positive collaboration, positive clinician input, and non-supportive clinician input. Regression analyses were used to determine interactive effects of race, psychosis severity, and therapeutic alliance variables. The sample was 226 Veterans (50% black, 50% white). Black participants were slightly older (p mental health recovery (p mental health recovery orientation for black participants. Conversely, for white participants, positive collaboration had little effect on the negative relationship between psychosis severity and mental health recovery orientation. Increased levels of psychosis may inhibit patients' perceptions of their ability to recover from SMI. However, for black participants, positive collaboration with mental health providers may moderate the effects of psychotic symptomatology.

Understanding clinician perception of common presentations in South Asians seeking mental health treatment and determining barriers and facilitators to treatment.

Science.gov (United States)

Rastogi, Pramit; Khushalani, Sunil; Dhawan, Swaran; Goga, Joshana; Hemanth, Naveena; Kosi, Razia; Sharma, Rashmi K; Black, Betty S; Jayaram, Geetha; Rao, Vani

2014-02-01

Little is known about the presentation of mental health symptoms among South Asians living in the US. To explore mental health symptom presentation in South Asians in the US and to identify facilitators and barriers to treatment. Focus group study. Four focus groups were conducted with 7-8 participants in each group. All participants (N = 29) were clinicians who had been involved in the care of South Asian patients with emotional problems and/or mental illness in the US. Qualitative content analysis. Key themes identified included: generational differences in symptom presentation, stress was the most common symptom for younger South Asians (40 years of age). Substance abuse and verbal/physical/sexual abuse were not uncommon but were often not reported spontaneously. Stigma and denial of mental illness were identified as major barriers to treatment. Facilitators for treatment included use of a medical model and conducting systematic but patient-centered evaluations. South Asians living in the US present with a variety of mental health symptoms ranging from stress associated with acculturation to major mental illnesses. Facilitating the evaluation and treatment of South Asians with mental illness requires sensitivity to cultural issues and use of creative solutions to overcome barriers to treatment. Copyright © 2013 Elsevier B.V. All rights reserved.

Clinician and Parent Perspectives on Parent and Family Contextual Factors that Impact Community Mental Health Services for Children with Behavior Problems

Science.gov (United States)

Baker-Ericzen, Mary J.; Jenkins, Melissa M.; Brookman-Frazee, Lauren

2010-01-01

The present study employed qualitative methods to examine multiple stakeholder perspectives regarding the role of parent and family contextual factors on community child mental health treatment for children with behavior problems. Findings suggest agreement between clinicians and parents on the number, types and importance of parent and family…

'Admit voluntary, schedule if tries to leave': placing Mental Health Acts in the context of mental health law and human rights.

Science.gov (United States)

Wand, Anne; Wand, Timothy

2013-04-01

Most postgraduate training for clinicians in Australia and New Zealand regarding mental health legislation focuses on the relevant Mental Health Acts (MHAs) rather than the broader principles of mental health law. Key concepts include treatment in the least restrictive environment, voluntary access to mental health services, treatability, reciprocity and due process. Lack of awareness of these principles may result in a more risk-averse interpretation of MHAs, which is inconsistent with the spirit of mental health law and the promotion of human rights. The aim of this paper is to present some fundamental principles of mental health law, which are essential to proper clinical application of MHAs, and to demonstrate why they should form part of the curriculum for psychiatry training and continuing professional development for psychiatrists. A sound understanding of the principles of mental health law is essential for all clinicians who may be enacting aspects of MHAs. This provides the necessary platform to safeguard human rights and optimise the care of people with a mental illness.

Veterans' Mental Health in Higher Education Settings: Services and Clinician Education Needs.

Science.gov (United States)

Niv, Noosha; Bennett, Lauren

2017-06-01

Utilization of the GI Bill and attendance at higher education institutions among student veterans have significantly increased since passage of the Post-9/11 GI Bill. Campus counseling centers should be prepared to meet the mental health needs of student veterans. This study identified the mental health resources and services that colleges provide student veterans and the education needs of clinical staff on how to serve student veterans. Directors of mental health services from 80 California colleges completed a semistructured phone interview. Few schools track the number, demographic characteristics, or presenting needs of student veterans who utilize campus mental health services or offer priority access or special mental health services for veterans. Directors wanted centers to receive education for an average of 5.8 veteran-related mental health topics and preferred workshops and lectures to handouts and online training. Significant training needs exist among clinical staff of campus mental health services to meet the needs of student veterans.

Evidence Translation in a Youth Mental Health Service

Directory of Open Access Journals (Sweden)

Alan P. Bailey

2016-02-01

Full Text Available An evidence–practice gap is well established in the mental health field, and knowledge translation is identified as a key strategy to bridge the gap. This study outlines a knowledge translation strategy, which aims to support clinicians in using evidence in their practice within a youth mental health service (headspace. We aim to evaluate the strategy by exploring clinicians’ experiences and preferences. The translation strategy includes the creation and dissemination of evidence translation resources that summarize the best available evidence and practice guidelines relating to the management of young people with mental disorders. Semi-structured interviews were conducted with 14 youth mental health clinicians covering three topics: experiences with evidence translation resources, preferences for evidence presentation, and suggestions regarding future translation efforts. Interviews were recorded, transcribed verbatim, coded, and analyzed using thematic analysis. Themes were both predetermined by interview topic and identified freely from the data. Clinicians described their experiences with the evidence translation resources as informing decision making, providing a knowledge base, and instilling clinical confidence. Clinicians expressed a preference for brief, plain language summaries and for involvement and consultation during the creation and dissemination of resources. Suggestions to improve the dissemination strategy and the development of new areas for evidence resources were identified. The knowledge translation efforts described support clinicians in the provision of mental health services for young people. The preferences and experiences described have valuable implications for services implementing knowledge translation strategies.

Different Perspectives of Clinicians and Patients with Severe Mental Illness on Motivation for Treatment.

Science.gov (United States)

Jochems, Eline C; van Dam, Arno; Duivenvoorden, Hugo J; Scheffer, Sylvia C M; van der Feltz-Cornelis, Christina M; Mulder, Niels L

2016-09-01

The present study assessed motivation for engaging in treatment as rated by clinicians (n = 57) and patients with severe mental illness (SMI, n = 294) using measures based on three different motivation theories. Questionnaires were derived from self-determination theory, the transtheoretical model and the integral model of treatment motivation. It was investigated to which extent clinicians of patients with SMI were able to estimate their patient's perspective on motivation for engaging in treatment, to which extent they agreed on the patient's motivation and which factors were associated with estimation and agreement on treatment motivation. It was found that clinicians were poorly to moderately capable of estimating their patient's type of motivation and readiness for change. Further, agreement on the level of motivation between patients and clinicians was moderate. These findings were consistent across diagnostic groups (psychotic and personality disorders). A higher quality therapeutic relationship was generally associated with higher clinician-rated motivation. The patient's ethnicity and socially desirable responding were factors that differentiated between scales of different motivation theories. It is concluded that patients with SMI and their clinicians have different perceptions on the patient's motivation for engaging in psychiatric treatment, regardless of the theoretical framework that is used to measure motivation. The findings imply that a negotiated approach is needed where both perceptions of clinicians and patients on motivation for treatment are considered to ensure effective mental health interventions. Copyright © 2015 John Wiley & Sons, Ltd. Clinicians show poor to moderate capability in estimating how patients perceive their motivation for engaging in treatment, especially so when the patient's motives revolve around feelings of shame and guilt. Clinicians generally give higher motivation ratings for patients where they experience a

"You never know who are Sami or speak Sami" Clinicians' experiences with language-appropriate care to Sami-speaking patients in outpatient mental health clinics in Northern Norway.

Science.gov (United States)

Dagsvold, Inger; Møllersen, Snefrid; Stordahl, Vigdis

2016-01-01

The Indigenous population in Norway, the Sami, have a statutory right to speak and be spoken to in the Sami language when receiving health services. There is, however, limited knowledge about how clinicians deal with this in clinical practice. This study explores how clinicians deal with language-appropriate care with Sami-speaking patients in specialist mental health services. This study aims to explore how clinicians identify and respond to Sami patients' language data, as well as how they experience provision of therapy to Sami-speaking patients in outpatient mental health clinics in Sami language administrative districts. Data were collected using qualitative method, through individual interviews with 20 therapists working in outpatient mental health clinics serving Sami populations in northern Norway. A thematic analysis inspired by systematic text reduction was employed. Two themes were identified: (a) identification of Sami patients' language data and (b) experiences with provision of therapy to Sami-speaking patients. Findings indicate that clinicians are not aware of patients' language needs prior to admission and that they deal with identification of language data and offer of language-appropriate care ad hoc when patients arrive. Sami-speaking participants reported always offering language choice and found more profound understanding of patients' experiences when Sami language was used. Whatever language Sami-speaking patients may choose, they are found to switch between languages during therapy. Most non-Sami-speaking participants reported offering Sami-speaking services, but the patients chose to speak Norwegian. However, a few of the participants maintained language awareness and could identify language needs despite a patient's refusal to speak Sami in therapy. Finally, some non-Sami-speaking participants were satisfied if they understood what the patients were saying. They left it to patients to address language problems, only to discover patients

Evaluating the effectiveness of a healthy lifestyle clinician in addressing the chronic disease risk behaviours of community mental health clients: study protocol for a randomised controlled trial.

Science.gov (United States)

Fehily, Caitlin; Bartlem, Kate; Wiggers, John; Wye, Paula; Clancy, Richard; Castle, David; Wutzke, Sonia; Rissel, Chris; Wilson, Andrew; McCombie, Paul; Murphy, Fionna; Bowman, Jenny

2017-06-15

People with a mental illness experience a greater morbidity and mortality from chronic diseases relative to the general population. A higher prevalence of modifiable health risk behaviours such as smoking, poor nutrition, physical inactivity and harmful alcohol consumption contribute substantially to this disparity. Despite clinical practice guidelines recommending that mental health services routinely provide care to address these risk behaviours, the provision of such care is consistently reported to be low internationally and in Australia. This protocol describes a randomised controlled trial that aims to assess the effectiveness of allocating a clinician within a community mental health service to the specific role of providing assessment, advice and referral for clients' chronic disease risk behaviours. Approximately 540 clients of one community mental health service will be randomised to receive either usual care for chronic disease risks provided in routine consultations or usual care plus an additional face-to-face consultation and follow-up telephone call with a 'healthy lifestyle clinician'. The clinician will assess clients' chronic disease risk behaviours, provide advice to change behaviours, and refer at-risk clients to free telephone coaching services (New South Wales (NSW) Quitline and NSW Get Healthy Information and Coaching Service) for specialist behaviour change care. The primary outcomes, regarding referral to and client uptake of the telephone services, will be obtained from the respective services. Telephone interviews of clients at baseline and at 1 and 6 months post baseline follow-ups will assess secondary outcomes: receipt of any assessment, advice and referral from the mental health service; satisfaction with the receipt of such care; satisfaction with the receipt of any care provided by the telephone services; interest and confidence in and perceived importance of changing risk behaviours; and risk behaviour status. This study will add

Electronic Health Records: Overcoming Obstacles to Improve Acceptance and Utilization for Mental Health Clinicians

Science.gov (United States)

Odom, Stephen A.

2017-01-01

The dynamics and progress of the integration of the electronic health record (EHR) into health-care disciplines have been described and examined using theories related to technology adoption. Previous studies have examined health-care clinician resistance to the EHR in primary care, hospital, and urgent care medical settings, but few studies have…

Evaluating the effectiveness of a clinical practice change intervention in increasing clinician provision of preventive care in a network of community-based mental health services: a study protocol of a non-randomized, multiple baseline trial.

Science.gov (United States)

Bartlem, Kate; Bowman, Jennifer; Freund, Megan; Wye, Paula; McElwaine, Kathleen; Knight, Jenny; McElduff, Patrick; Gillham, Karen; Wiggers, John

2013-08-06

People with a mental illness experience substantial disparities in health, including increased rates of morbidity and mortality caused by potentially preventable chronic diseases. One contributing factor to such disparity is a higher prevalence of modifiable health risk behaviors, such as smoking, inadequate fruit and vegetable intake, harmful alcohol consumption, and inadequate physical activity. Evidence supports the effectiveness of preventive care in reducing such risks, and guidelines recommend that preventive care addressing such risks be incorporated into routine clinical care. Although community-based mental health services represent an important potential setting for ensuring that people with a mental illness receive such care, research suggests its delivery is currently sub-optimal. A study will be undertaken to evaluate the effectiveness of a clinical practice change intervention in increasing the routine provision of preventive care by clinicians in community mental health settings. A two-group multiple baseline design will be utilized to assess the effectiveness of a multi-strategic intervention implemented over 12 months in increasing clinician provision of preventive care. The intervention will be implemented sequentially across the two groups of community mental health services to increase provision of client assessment, brief advice, and referral for four health risk behaviors (smoking, inadequate fruit and vegetable consumption, harmful alcohol consumption, and inadequate physical activity). Outcome measures of interest will be collected via repeated cross-sectional computer-assisted telephone interviews undertaken on a weekly basis for 36 months with community mental health clients. This study is the first to assess the effectiveness of a multi-strategic clinical practice change intervention in increasing routine clinician provision of preventive care for chronic disease behavioral risk factors within a network of community mental health services

Mobile telephone apps in mental health practice: uses, opportunities and challenges

OpenAIRE

Marley, Justin; Farooq, Saeed

2015-01-01

Smartphones are used by patients and clinicians alike. Vast numbers of software applications (apps) run on smartphones and carry out useful functions. Clinician- and patient-oriented mental health apps have been developed. In this article, we provide an overview of apps that are relevant for mental health. We look at clinician-oriented apps that support assessment, diagnosis and treatment as well as patient-oriented apps that support education and self-management. We conclude by looking at th...

Identifying the core competencies of mental health telephone triage.

Science.gov (United States)

Sands, Natisha; Elsom, Stephen; Gerdtz, Marie; Henderson, Kathryn; Keppich-Arnold, Sandra; Droste, Nicolas; Prematunga, Roshani K; Wereta, Zewdu W

2013-11-01

The primary aim of this study was to identify the core competencies of mental health telephone triage, including key role tasks, skills, knowledge and responsibilities, in which clinicians are required to be competent to perform safe and effective triage. Recent global trends indicate an increased reliance on telephone-based health services to facilitate access to health care across large populations. The trend towards telephone-based health services has also extended to mental health settings, evidenced by the growing number of mental health telephone triage services providing 24-hour access to specialist mental health assessment and treatment. Mental health telephone triage services are critical to the early identification of mental health problems and the provision of timely, appropriate interventions. In spite of the rapid growth in mental health telephone triage and the important role these services play in the assessment and management of mental illness and related risks, there has been very little research investigating this area of practice. An observational design was employed to address the research aims. Structured observations (using dual wireless headphones) were undertaken on 197 occasions of mental health telephone triage over a three-month period from January to March 2011. The research identified seven core areas of mental health telephone triage practice in which clinicians are required to be competent in to perform effective mental health telephone triage, including opening the call; performing mental status examination; risk assessment; planning and action; termination of call; referral and reporting; and documentation. The findings of this research contribute to the evidence base for mental health telephone triage by articulating the core competencies for practice. The mental health telephone triage competencies identified in this research may be used to define an evidence-based framework for mental health telephone triage practice that aims to

The organizational social context of mental health medicaid waiver programs with family support services: implications for research and practice.

Science.gov (United States)

Glisson, Charles; Williams, Nathaniel J; Green, Philip; Hemmelgarn, Anthony; Hoagwood, Kimberly

2014-01-01

Peer family support specialists (FSS) are parents with practical experience in navigating children's mental health care systems who provide support, advocacy, and guidance to the families of children who need mental health services. Their experience and training differ from those of formally trained mental health clinicians, creating potential conflicts in priorities and values between FSS and clinicians. We hypothesized that these differences could negatively affect the organizational cultures and climates of mental health clinics that employ both FSS and mental health clinicians, and lower the job satisfaction and organizational commitment of FSS. The Organizational Social Context measure was administered on site to 209 FSS and clinicians in 21 mental health programs in New York State. The study compared the organizational-level culture and climate profiles of mental health clinics that employ both FSS and formally trained clinicians to national norms for child mental health clinics, assessed individual-level job satisfaction and organizational commitment as a function of job (FSS vs. clinician) and other individual-level and organizational-level characteristics, and tested whether FSS and clinicians job attitudes were differentially associated with organizational culture and climate. The programs organizational culture and climate profiles were not significantly different from national norms. Individual-level job satisfaction and organizational commitment were unrelated to position (FSS vs. clinician) or other individual-level and organizational-level characteristics except for culture and climate. Both FSS' and clinicians' individual-level work attitudes were associated similarly with organizational culture and climate.

Clinical Decision-Making in Community Children's Mental Health: Using Innovative Methods to Compare Clinicians with and without Training in Evidence-Based Treatment

Science.gov (United States)

Baker-Ericzén, Mary J.; Jenkins, Melissa M.; Park, Soojin; Garland, Ann F.

2015-01-01

Background: Mental health professionals' decision-making practice is an area of increasing interest and importance, especially in the pediatric research and clinical communities. Objective: The present study explored the role of prior training in evidence-based treatments (EBTs) on clinicians' assessment and treatment formulations using…

A Phenomenological Study: Community Mental Health Centers Leaders Influence on Clinician Effectiveness

Science.gov (United States)

Williams, Beth B.

2011-01-01

Some clinical leaders of community mental health centers are not aware of successful methods for supporting and empowering staff to be more effective, specifically when the staff is experiencing change because of new health information technology. Clinical leaders in community mental health face similar management issues as do other business,…

Mental health informatics

CERN Document Server

Song, Insu; Yellowlees, Peter; Diederich, Joachim

2014-01-01

This book introduces approaches that have the potential to transform the daily practice of psychiatrists and psychologists. This includes the asynchronous communication between mental health care providers and clients as well as the automation of assessment and therapy. Speech and language are particularly interesting from the viewpoint of psychological assessment. For instance, depression may change the characteristics of voice in individuals and these changes can be detected by a special form of speech analysis. Computational screening methods that utilise speech and language can detect subtle changes and alert clinicians as well as individuals and caregivers. The use of online technologies in mental health, however, poses ethical problems that will occupy concerned individuals, governments and the wider public for some time. Assuming that these ethical problems can be solved, it should be possible to diagnose and treat mental health disorders online (excluding the use of medication).

Discourses of aggression in forensic mental health

DEFF Research Database (Denmark)

Berring, Lene Lauge; Pedersen, Liselotte; Buus, Niels

2015-01-01

aggression is communicated in forensic mental health nursing records. The aim of the study was to gain insight into the discursive practices used by forensic mental health nursing staff when they record observed aggressive incidents. Textual accounts were extracted from the Staff Observation Aggression Scale......Managing aggression in mental health hospitals is an important and challenging task for clinical nursing staff. A majority of studies focus on the perspective of clinicians, and research mainly depicts aggression by referring to patient-related factors. This qualitative study investigates how...

Focus on Exercise: Client and Clinician Perspectives on Exercise in Individuals with Serious Mental Illness.

Science.gov (United States)

Browne, Julia; Mihas, Paul; Penn, David L

2016-05-01

The health benefits of exercise are well established, yet individuals with serious mental illness (SMI) have a shorter life expectancy due in large part to physical health complications associated with poor diet and lack of exercise. There is a paucity of research examining exercise in this population with the majority of studies having examined interventions with limited feasibility and sustainability. Before developing an intervention, a thorough exploration of client and clinician perspectives on exercise and its associated barriers is warranted. Twelve clients and fourteen clinicians participated in focus groups aimed at examining exercise, barriers, incentives, and attitudes about walking groups. Results indicated that clients and clinicians identified walking as the primary form of exercise, yet barriers impeded consistent participation. Distinct themes arose between groups; however, both clients and clinicians reported interest in a combination group/pedometer based walking program for individuals with SMI. Future research should consider examining walking programs for this population.

Helping military children cope with parental deployment: role of attachment theory and recommendations for mental health clinicians and counselors.

Science.gov (United States)

Miller, Laurence; Miller, Halle B; Bjorklund, David

2010-01-01

Military deployment of a parent carries with it a number of stresses for children, all centering around uncertainty, instability and unpredictability. This article conceptualizes military deployment and relocation stress in the context of attachment theory, and describes the types of adverse outcomes that can occur as the result of impaired attachment. It then presents a set of practical recommendations for mental health clinicians and counselors for helping children and families cope productively and negotiate the developmental hurdles associated with maintaining healthy attachment and family stability in the face of military deployment.

Mental Health and Illness in the City

DEFF Research Database (Denmark)

This book highlights a broad range of issues on mental health and illness in large cities. It presents the epidemiology of mental disorders in cities, cultural issues of urban mental health care, and community care in large cities and urban slums. It also includes chapters on homelessness, crime...... and racism - problems that are increasingly prevalent in many cities world wide. Finally, it looks at the increasing challenges of mental disorders in rapidly growing cities. The book is aimed at an international audience and includes contributions from clinicians and researchers worldwide....

Patients' Positive and Negative Responses to Reading Mental Health Clinical Notes Online.

Science.gov (United States)

Denneson, Lauren M; Chen, Jason I; Pisciotta, Maura; Tuepker, Anais; Dobscha, Steven K

2018-05-01

This study describes responses to OpenNotes, clinical notes available online, among patients receiving mental health care and explores whether responses vary by patient demographic or clinical characteristics. Survey data from 178 veterans receiving mental health treatment at a large Veterans Affairs medical center included patient-reported health self-efficacy, health knowledge, alliance with clinicians, and negative emotional responses after reading OpenNotes. Health care data were extracted from the patient care database. Reading OpenNotes helped many participants feel in control of their health care (49%) and have more trust in clinicians (45%), although a few (8%) frequently felt upset after reading their notes. In multivariate models, posttraumatic stress disorder was associated with increased patient-clinician alliance (p=.046) but also with negative emotional responses (p<.01). Patients receiving mental health care frequently reported benefits from reading OpenNotes, yet some experienced negative responses.

Mental health beliefs and barriers to accessing mental health services in youth aging out of foster care.

Science.gov (United States)

Sakai, Christina; Mackie, Thomas I; Shetgiri, Rashmi; Franzen, Sara; Partap, Anu; Flores, Glenn; Leslie, Laurel K

2014-01-01

To examine the perspectives of youth on factors that influence mental health service use after aging out of foster care. Focus groups were conducted with youth with a history of mental health needs and previous service use who had aged out of foster care. Questions were informed by the Health Belief Model and addressed 4 domains: youth perceptions of the "threat of mental health problems," treatment benefits versus barriers to accessing mental health services, self-efficacy, and "cues to action." Data were analyzed using a modified grounded-theory approach. Youth (N = 28) reported ongoing mental health problems affecting their functioning; however, they articulated variable levels of reliance on formal mental health treatment versus their own ability to resolve these problems without treatment. Past mental health service experiences influenced whether youth viewed treatment options as beneficial. Youth identified limited self-efficacy and insufficient psychosocial supports "cueing action" during their transition out of foster care. Barriers to accessing mental health services included difficulties obtaining health insurance, finding a mental health provider, scheduling appointments, and transportation. Youths' perceptions of their mental health needs, self-efficacy, psychosocial supports during transition, and access barriers influence mental health service use after aging out of foster care. Results suggest that strategies are needed to 1) help youth and clinicians negotiate shared understanding of mental health treatment needs and options, 2) incorporate mental health into transition planning, and 3) address insurance and other systemic barriers to accessing mental health services after aging out of foster care. Copyright © 2014 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

Adolescents and the internet: what mental health clinicians need to know.

Science.gov (United States)

Rafla, Malak; Carson, Nicholas J; DeJong, Sandra M

2014-09-01

The Internet's permeation into daily life has profoundly changed the practice of psychiatry with adolescents, who mobilize online social media and related technologies in their efforts to develop identity and "hang out" with peers. Technology offers both challenges and opportunities to mental health professionals working with teens. Practitioners will need a new skill-set, including keeping abreast of technological developments; professionally incorporating technology into clinical assessment and practice; identifying the negative impacts of technology on teens' physical and mental health and the particular vulnerabilities of at-risk patients in a digital world; and guiding patients and parents about interventions. Particular patient factors related to race/ethnicity, gender and sexual orientation, mental health and trauma history, family culture, parenting style, and personality traits will need to be considered. This article provides an overview of the literature on adolescents and the Internet focusing on recent research on Internet and digital technologies used for social communication among youth.

Smartphone Applications for Mental Health

Science.gov (United States)

Vona, Pamela L.; Santostefano, Antonella M.; Ciaravino, Samantha; Miller, Elizabeth; Stein, Bradley D.

2016-01-01

Abstract Many adolescents and adults do not seek treatment for mental health symptoms. Smartphone applications (apps) may assist individuals with mental health concerns in alleviating symptoms or increasing understanding. This study seeks to characterize apps readily available to smartphone users seeking mental health information and/or support. Ten key terms were searched in the Apple iTunes and Google Play stores: mental health, depression, anxiety, schizophrenia, bipolar, trauma, trauma in schools, post traumatic stress disorder (PTSD), child trauma, and bullying. A content analysis of the first 20 application descriptions retrieved per category was conducted. Out of 300 nonduplicate applications, 208 (70%) were relevant to search topic, mental health or stress. The most common purported purpose for the apps was symptom relief (41%; n = 85) and general mental health education (18%; n = 37). The most frequently mentioned approaches to improving mental health were those that may benefit only milder symptoms such as relaxation (21%; n = 43). Most app descriptions did not include information to substantiate stated effectiveness of the application (59%; n = 123) and had no mention of privacy or security (89%; n = 185). Due to uncertainty of the helpfulness of readily available mental health applications, clinicians working with mental health patients should inquire about and provide guidance on application use, and patients should have access to ways to assess the potential utility of these applications. Strategic policy and research developments are likely needed to equip patients with applications for mental health, which are patient centered and evidence based. PMID:27428034

Activity-based funding: implications for mental health services and consultation-liaison psychiatry.

Science.gov (United States)

Wand, Anne

2014-06-01

The aim of this paper is to inform mental health professionals about Activity-based funding (ABF) and the implications for data collection and clinical practice, in particular for consultation-liaison (CL) psychiatry. Activity-based funding may provide an opportunity for mental health services to be more equitably resourced, but much needs to be done to demonstrate that the funding model works in mental health. It is important to ensure that data collected is meaningful and accurate and reflects the diverse roles of mental health clinicians, including in CL. Inpatient and community services should be integrated in the model, as well as safeguards against potential abuse. Clinicians, in partnership with initiatives such as the Australian Mental Health Outcomes and Classification Network, are best placed to guide the development of an ABF system for mental health which appropriately recognises the complexity and variability between patients in different settings. © The Royal Australian and New Zealand College of Psychiatrists 2014.

A Qualitative Study Exploring Facilitators for Improved Health Behaviors and Health Behavior Programs: Mental Health Service Users’ Perspectives

Directory of Open Access Journals (Sweden)

Candida Graham

2014-01-01

Full Text Available Objective. Mental health service users experience high rates of cardiometabolic disorders and have a 20–25% shorter life expectancy than the general population from such disorders. Clinician-led health behavior programs have shown moderate improvements, for mental health service users, in managing aspects of cardiometabolic disorders. This study sought to potentially enhance health initiatives by exploring (1 facilitators that help mental health service users engage in better health behaviors and (2 the types of health programs mental health service users want to develop. Methods. A qualitative study utilizing focus groups was conducted with 37 mental health service users attending a psychosocial rehabilitation center, in Northern British Columbia, Canada. Results. Four major facilitator themes were identified: (1 factors of empowerment, self-value, and personal growth; (2 the need for social support; (3 pragmatic aspects of motivation and planning; and (4 access. Participants believed that engaging with programs of physical activity, nutrition, creativity, and illness support would motivate them to live more healthily. Conclusions and Implications for Practice. Being able to contribute to health behavior programs, feeling valued and able to experience personal growth are vital factors to engage mental health service users in health programs. Clinicians and health care policy makers need to account for these considerations to improve success of health improvement initiatives for this population.

Management of mental health disorders in HIV-positive patients

African Journals Online (AJOL)

Mental Health Guidelines Committee, Southern African HIV Clinicians Society, ... triple diagnosis (HIV/mental disorder/substance use disorder), or mental .... fatigue or loss of energy .... between 20% and 60% of HIV-positive adults suffer from some form ... patients on complex regimens should be reviewed regularly with a.

Influences on recruitment to randomised controlled trials in mental health settings in England: a national cross-sectional survey of researchers working for the Mental Health Research Network.

Science.gov (United States)

Borschmann, Rohan; Patterson, Sue; Poovendran, Dilkushi; Wilson, Danielle; Weaver, Tim

2014-02-17

Recruitment to trials is complex and often protracted; selection bias may compromise generalisability. In the mental health field (as elsewhere), diverse factors have been described as hindering researcher access to potential participants and various strategies have been proposed to overcome barriers. However, the extent to which various influences identified in the literature are operational across mental health settings in England has not been systematically examined. A cross-sectional, online survey of clinical studies officers employed by the Mental Health Research Network in England to recruit to trials from National Health Service mental health services. The bespoke questionnaire invited participants to report exposure to specified influences on recruitment, the perceived impact of these on access to potential participants, and to describe additional positive or negative influences on recruitment. Analysis employed descriptive statistics, the framework approach and triangulation of data. Questionnaires were returned by 98 (58%) of 170 clinical studies officers who reported diverse experience. Data demonstrated a disjunction between policy and practice. While the particulars of trial design and various marketing and communication strategies could influence recruitment, consensus was that the culture of NHS mental health services is not conducive to research. Since financial rewards for recruitment paid to Trusts and feedback about studies seldom reaching frontline services, clinicians were described as distanced from research. Facing continual service change and demanding clinical workloads, clinicians generally did not prioritise recruitment activities. Incentives to trial participants had variable impact on access but recruitment could be enhanced by engagement of senior investigators and integrating referral with routine practice. Comprehensive, robust feasibility studies and reciprocity between researchers and clinicians were considered crucial to

The Organizational Social Context of Mental Health Medicaid Waiver Programs with Family Support Services: Implications for Research and Practice

Science.gov (United States)

Glisson, Charles; Williams, Nathaniel J.; Green, Philip; Hemmelgarn, Anthony; Hoagwood, Kimberly

2013-01-01

Introduction Peer family support specialists (FSS) are parents with practical experience in navigating children’s mental health care systems who provide support, advocacy and guidance to the families of children who need mental health services. Their experience and training differ from those of formally trained mental health clinicians, creating potential conflicts in priorities and values between FSS and clinicians. We hypothesized that these differences could negatively affect the organizational cultures and climates of mental health clinics that employ both FSS and mental health clinicians, and lower the job satisfaction and organizational commitment of FSS. Method The Organizational Social Context (OSC) measure was administered on site to 209 FSS and clinicians in 21 mental health programs in New York State. The study compared the organizational-level culture and climate profiles of mental health clinics that employ both FSS and formally trained clinicians to national norms for child mental health clinics, assessed individual-level job satisfaction and organizational commitment as a function of job (FSS vs. clinician) and other individual-level and organizational-level characteristics, and tested whether FSS and clinicians’ job attitudes are differentially associated with organizational culture and climate. Results The programs’ organizational culture and climate profiles were not significantly different from national norms. Individual-level job satisfaction and organizational commitment were unrelated to position (FSS vs. clinician) or other individual-level and organizational-level characteristics except for culture and climate. Conclusions Organizational culture and climate are not related to the employment of FSS. Both FSS’ and clinicians’ individual-level work attitudes are associated similarly with organizational culture and climate. PMID:24065458

Mental health professionals' natural taxonomies of mental disorders: implications for the clinical utility of the ICD-11 and the DSM-5.

Science.gov (United States)

Reed, Geoffrey M; Roberts, Michael C; Keeley, Jared; Hooppell, Catherine; Matsumoto, Chihiro; Sharan, Pratap; Robles, Rebeca; Carvalho, Hudson; Wu, Chunyan; Gureje, Oye; Leal-Leturia, Itzear; Flanagan, Elizabeth H; Correia, João Mendonça; Maruta, Toshimasa; Ayuso-Mateos, José Luís; de Jesus Mari, Jair; Xiao, Zeping; Evans, Spencer C; Saxena, Shekhar; Medina-Mora, María Elena

2013-12-01

To examine the conceptualizations held by psychiatrists and psychologists around the world of the relationships among mental disorders in order to inform decisions about the structure of the classification of mental and behavioral disorders in World Health Organization's International Classification of Diseases and Related Health Problems 11th Revision (ICD-11). 517 mental health professionals in 8 countries sorted 60 cards containing the names of mental disorders into groups of similar disorders, and then formed a hierarchical structure by aggregating and disaggregating these groupings. Distance matrices were created from the sorting data and used in cluster and correlation analyses. Clinicians' taxonomies were rational, interpretable, and extremely stable across countries, diagnostic system used, and profession. Clinicians' consensus classification structure was different from ICD-10 and the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders 4th Edition (DSM-IV), but in many respects consistent with ICD-11 proposals. The clinical utility of the ICD-11 may be improved by making its structure more compatible with the common conceptual organization of mental disorders observed across diverse global clinicians. © 2013 Wiley Periodicals, Inc.

75 FR 71133 - National Institute of Mental Health; Notice of Closed Meeting

Science.gov (United States)

2010-11-22

... Emphasis Panel; Competitive Revision for Stem Cell Repository Relevant to Mental Disorders. Date: December... Domestic Assistance Program Nos. 93.242, Mental Health Research Grants; 93.281, Scientist Development Award, Scientist Development Award for Clinicians, and Research Scientist Award; 93.282, Mental Health National...

Trends in Mental Health and Substance Abuse Services at the Nation’s Community Health Centers: 1998–2003

Science.gov (United States)

Druss, Benjamin G.; Bornemann, Thomas; Fry-Johnson, Yvonne W.; McCombs, Harriet G.; Politzer, Robert M.; Rust, George

2006-01-01

Objective. We examined trends in delivery of mental health and substance abuse services at the nation’s community health centers. Methods. Analyses used data from the Health Resources and Services Administration (HRSA), Bureau of Primary Care’s (BPHC) 1998 and 2003 Uniform Data System, merged with county-level data. Results. Between 1998 and 2003, the number of patients diagnosed with a mental health/substance abuse disorder in community health centers increased from 210 000 to 800 000. There was an increase in the number of patients per specialty mental health/substance abuse treatment provider and a decline in the mean number of patient visits, from 7.3 visits per patient to 3.5 by 2003. Although most community health centers had some on-site mental health/substance abuse services, centers without on-site services were more likely to be located in counties with fewer mental health/substance abuse clinicians, psychiatric emergency rooms, and inpatient hospitals. Conclusions. Community health centers are playing an increasingly central role in providing mental health/substance abuse treatment services in the United States. It is critical both to ensure that these centers have adequate resources for providing mental health/substance abuse care and that they develop effective linkages with mental health/substance abuse clinicians in the communities they serve. PMID:17008573

Impact and management of dual relationships in metropolitan, regional and rural mental health practice.

Science.gov (United States)

Endacott, Ruth; Wood, Anita; Judd, Fiona; Hulbert, Carol; Thomas, Ben; Grigg, Margaret

2006-01-01

To explore the extent and impact of professional boundary crossings in metropolitan, regional and rural mental health practice in Victoria and identify strategies mental health clinicians use to manage dual relationships. Nine geographically located focus groups consisting of mental health clinicians: four focus groups in rural settings; three in a regional city and two in a metropolitan mental health service. A total of 52 participants were interviewed. Data revealed that professional boundaries were frequently breached in regional and rural settings and on occasions these breaches had a significantly negative impact. Factors influencing the impact were: longevity of the clinician's relationship with the community, expectations of the community, exposure to community 'gossip' and size of the community. Participants reported greater stress when the boundary crossing affected their partner and/or children. Clinicians used a range of proactive and reactive strategies, such as private telephone number, avoidance of social community activities, when faced with a potential boundary crossing. The feasibility of reactive strategies depended on the service configuration: availability of an alternative case manager, requirement for either patient or clinician to travel. The greater challenges faced by rural and regional clinicians were validated by metropolitan participants with rural experience and rural participants with metropolitan experience. No single strategy is used or appropriate for managing dual relationships in rural settings. Employers and professional bodies should provide clearer guidance for clinicians both in the management of dual relationships and the distinction between boundary crossings and boundary violation. Clinicians are clearly seeking to represent and protect the patients' interests; consideration should be given by consumer groups to steps that can be taken by patients to reciprocate.

Adapting the Crisis Intervention Team (CIT) model of police-mental health collaboration in a low-income, post-conflict country: curriculum development in Liberia, West Africa.

Science.gov (United States)

Kohrt, Brandon A; Blasingame, Elise; Compton, Michael T; Dakana, Samuel F; Dossen, Benedict; Lang, Frank; Strode, Patricia; Cooper, Janice

2015-03-01

We sought to develop a curriculum and collaboration model for law enforcement and mental health services in Liberia, West Africa. In 2013 we conducted key informant interviews with law enforcement officers, mental health clinicians, and mental health service users in Liberia, and facilitated a 3-day curriculum workshop. Mental health service users reported prior violent interactions with officers. Officers and clinicians identified incarceration and lack of treatment of mental health service users as key problems, and they jointly drafted a curriculum based upon the Crisis Intervention Team (CIT) model adapted for Liberia. Officers' mental health knowledge improved from 64% to 82% on workshop assessments (t=5.52; P<.01). Clinicians' attitudes improved (t=2.42; P=.03). Six months after the workshop, 69% of clinicians reported improved engagement with law enforcement. Since the Ebola outbreak, law enforcement and clinicians have collaboratively addressed diverse public health needs. Collaborations between law enforcement and mental health clinicians can benefit multiple areas of public health, as demonstrated by partnerships to improve responses during the Ebola epidemic. Future research should evaluate training implementation and outcomes including stigma reduction, referrals, and use of force.

Psychiatric Genomics and Mental Health Treatment: Setting the Ethical Agenda.

Science.gov (United States)

Kong, Camillia; Dunn, Michael; Parker, Michael

2017-04-01

Realizing the benefits of translating psychiatric genomics research into mental health care is not straightforward. The translation process gives rise to ethical challenges that are distinctive from challenges posed within psychiatric genomics research itself, or that form part of the delivery of clinical psychiatric genetics services. This article outlines and considers three distinct ethical concerns posed by the process of translating genomic research into frontline psychiatric practice and policy making. First, the genetic essentialism that is commonly associated with the genomics revolution in health care might inadvertently exacerbate stigma towards people with mental disorders. Secondly, the promises of genomic medicine advance a narrative of individual empowerment. This narrative could promote a fatalism towards patients' biology in ways that function in practice to undermine patients' agency and autonomy, or, alternatively, a heightened sense of subjective genetic responsibility could become embedded within mental health services that leads to psychosocial therapeutic approaches and the clinician-patient therapeutic alliance being undermined. Finally, adopting a genomics-focused approach to public mental health risks shifting attention away from the complex causal relationships between inequitable socio-economic, political, and cultural structures and negative mental health outcomes. The article concludes by outlining a number of potential pathways for future ethics research that emphasizes the importance of examining appropriate translation mechanisms, the complementarity between genetic and psychosocial models of mental disorder, the implications of genomic information for the clinician-patient relationship, and funding priorities and resource allocation decision making in mental health.

Investigating the validity and usability of an interactive computer programme for assessing competence in telephone-based mental health triage.

Science.gov (United States)

Sands, Natisha; Elsom, Stephen; Keppich-Arnold, Sandra; Henderson, Kathryn; King, Peter; Bourke-Finn, Karen; Brunning, Debra

2016-02-01

Telephone-based mental health triage services are frontline health-care providers that operate 24/7 to facilitate access to psychiatric assessment and intervention for people requiring assistance with a mental health problem. The mental health triage clinical role is complex, and the populations triage serves are typically high risk; yet to date, no evidence-based methods have been available to assess clinician competence to practice telephone-based mental health triage. The present study reports the findings of a study that investigated the validity and usability of the Mental Health Triage Competency Assessment Tool, an evidence-based, interactive computer programme designed to assist clinicians in developing and assessing competence to practice telephone-based mental health triage. © 2015 Australian College of Mental Health Nurses Inc.

77 FR 62244 - National Institute of Mental Health; Notice of Closed Meeting

Science.gov (United States)

2012-10-12

... Methods, the Unit on Learning and Plasticity, and the Section on Neuroadaptation and Protein Metabolism... Domestic Assistance Program Nos. 93.242, Mental Health Research Grants; 93.281, Scientist Development Award, Scientist Development Award for Clinicians, and Research Scientist Award; 93.282, Mental Health National...

Foraging for Information in the EHR: The Search for Adherence Related Information by Mental Health Clinicians.

Science.gov (United States)

Gibson, Bryan; Butler, Jorie; Zirkle, Maryan; Hammond, Kenric; Weir, Charlene

2016-01-01

In this project we sought to qualitatively describe clinician's search for information related to the complex construct of adherence. Nineteen think aloud observations and semi-structured interviews were conducted with mental health providers as they prepared for a patient visit. The transcripts were coded according to constructs from information foraging theory (information goal, patch, scent, enrichment, and opportunity cost). The search strategies uncovered were complicated: provider's searches were sometimes multi-staged (e.g. a search of the EHR led to further enquiry when interviewing the patient), and involved multiple 'patches' (i.e. data from the EHR, the patient and other providers were all sought out). In addition, some information that providers considered relevant to understand adherence related questions was non-obvious (e.g. the absence of specific information was considered a useful cue). Providers' information search strategies for complex constructs are at times non-intuitive; implications for the design of EHR summarization tools are discussed.

76 FR 6807 - National Institute of Mental Health; Notice of Closed Meetings

Science.gov (United States)

2011-02-08

... Emphasis Panel; Mental Health Services in Criminal Justice Settings. Date: March 2, 2011. Time: 8 a.m. to 5....nih.gov . (Catalogue of Federal Domestic Assistance Program Nos. 93.242, Mental Health Research Grants; 93.281, Scientist Development Award, Scientist Development Award for Clinicians, and Research...

Psychiatric Comorbidity in Autism Spectrum Disorder: Correspondence between Mental Health Clinician Report and Structured Parent Interview

Science.gov (United States)

Stadnick, Nicole; Chlebowski, Colby; Baker-Ericzén, Mary; Dyson, Margaret; Garland, Ann; Brookman-Frazee, Lauren

2017-01-01

Publicly funded mental health services are critical in caring for children with autism spectrum disorder. Accurate identification of psychiatric comorbidity is necessary for effective mental health treatment. Little is known about psychiatric diagnosis for this population in routine mental health care. This study (1) examined correspondence…

Opportunities in Reform: Bioethics and Mental Health Ethics.

Science.gov (United States)

Williams, Arthur Robin

2016-05-01

Last year marks the first year of implementation for both the Patient Protection and Affordable Care Act and the Mental Health Parity and Addiction Equity Act in the United States. As a result, healthcare reform is moving in the direction of integrating care for physical and mental illness, nudging clinicians to consider medical and psychiatric comorbidity as the expectation rather than the exception. Understanding the intersections of physical and mental illness with autonomy and self-determination in a system realigning its values so fundamentally therefore becomes a top priority for clinicians. Yet Bioethics has missed opportunities to help guide clinicians through one of medicine's most ethically rich and challenging fields. Bioethics' distancing from mental illness is perhaps best explained by two overarching themes: 1) An intrinsic opposition between approaches to personhood rooted in Bioethics' early efforts to protect the competent individual from abuses in the research setting; and 2) Structural forces, such as deinstitutionalization, the Patient Rights Movement, and managed care. These two themes help explain Bioethics' relationship to mental health ethics and may also guide opportunities for rapprochement. The potential role for Bioethics may have the greatest implications for international human rights if bioethicists can re-energize an understanding of autonomy as not only free from abusive intrusions but also with rights to treatment and other fundamental necessities for restoring freedom of choice and self-determination. Bioethics thus has a great opportunity amid healthcare reform to strengthen the important role of the virtuous and humanistic care provider. © 2015 John Wiley & Sons Ltd.

Implementing shared decision making in routine mental health care.

Science.gov (United States)

Slade, Mike

2017-06-01

Shared decision making (SDM) in mental health care involves clinicians and patients working together to make decisions. The key elements of SDM have been identified, decision support tools have been developed, and SDM has been recommended in mental health at policy level. Yet implementation remains limited. Two justifications are typically advanced in support of SDM. The clinical justification is that SDM leads to improved outcome, yet the available empirical evidence base is inconclusive. The ethical justification is that SDM is a right, but clinicians need to balance the biomedical ethical principles of autonomy and justice with beneficence and non-maleficence. It is argued that SDM is "polyvalent", a sociological concept which describes an idea commanding superficial but not deep agreement between disparate stakeholders. Implementing SDM in routine mental health services is as much a cultural as a technical problem. Three challenges are identified: creating widespread access to high-quality decision support tools; integrating SDM with other recovery-supporting interventions; and responding to cultural changes as patients develop the normal expectations of citizenship. Two approaches which may inform responses in the mental health system to these cultural changes - social marketing and the hospitality industry - are identified. © 2017 World Psychiatric Association.

Adapting the Crisis Intervention Team (CIT) Model of Police–Mental Health Collaboration in a Low-Income, Post-Conflict Country: Curriculum Development in Liberia, West Africa

Science.gov (United States)

Blasingame, Elise; Compton, Michael T.; Dakana, Samuel F.; Dossen, Benedict; Lang, Frank; Strode, Patricia; Cooper, Janice

2015-01-01

Objectives. We sought to develop a curriculum and collaboration model for law enforcement and mental health services in Liberia, West Africa. Methods. In 2013 we conducted key informant interviews with law enforcement officers, mental health clinicians, and mental health service users in Liberia, and facilitated a 3-day curriculum workshop. Results. Mental health service users reported prior violent interactions with officers. Officers and clinicians identified incarceration and lack of treatment of mental health service users as key problems, and they jointly drafted a curriculum based upon the Crisis Intervention Team (CIT) model adapted for Liberia. Officers’ mental health knowledge improved from 64% to 82% on workshop assessments (t = 5.52; P < .01). Clinicians’ attitudes improved (t = 2.42; P = .03). Six months after the workshop, 69% of clinicians reported improved engagement with law enforcement. Since the Ebola outbreak, law enforcement and clinicians have collaboratively addressed diverse public health needs. Conclusions. Collaborations between law enforcement and mental health clinicians can benefit multiple areas of public health, as demonstrated by partnerships to improve responses during the Ebola epidemic. Future research should evaluate training implementation and outcomes including stigma reduction, referrals, and use of force. PMID:25602903

Engaging clinicians in health informatics projects.

Science.gov (United States)

Caballero Muñoz, Erika; Hullin Lucay Cossio, Carola M

2010-01-01

This chapter gives an educational overview of: * The importance of the engagement of clinicians within a health informatics project * Strategies required for an effective involvement of clinicians throughout a change management process within a clinical context for the implementation of a health informatics project * The critical aspects for a successful implementation of a health informatics project that involves clinicians as end users * Key factors during the administration of changes during the implementation of an informatics project for an information system in clinical practice.

78 FR 15728 - National Institute of Mental Health; Notice of Closed Meeting

Science.gov (United States)

2013-03-12

... Emphasis Panel; HIV/AIDS Research Education & Training (R25/T32). Date: April 5, 2013. Time: 11:00 a.m. to... Program Nos. 93.242, Mental Health Research Grants; 93.281, Scientist Development Award, Scientist Development Award for Clinicians, and Research Scientist Award; 93.282, Mental Health National Research...

Some Ruminations about Prison Mental Health Work.

Science.gov (United States)

Toch, Hans

1995-01-01

Describes incidents involving mental health services in prison facilities that illustrate "Catch-22" situations, in many of which inmates perceive clinicians as people who "come to watch you drown instead of throwing you a rope." Proposes a supplementation of "administrative clinical" thinking with nonbureaucratic,…

Working overtime in community mental health: Associations with clinician burnout and perceived quality of care.

Science.gov (United States)

Luther, Lauren; Gearhart, Timothy; Fukui, Sadaaki; Morse, Gary; Rollins, Angela L; Salyers, Michelle P

2017-06-01

Funding cuts have increased job demands and threatened clinicians' ability to provide high-quality, person-centered care. One response to increased job demands is for clinicians to work more than their official scheduled work hours (i.e., overtime). We sought to examine the frequency of working overtime and its relationships with job characteristics, work-related outcomes, and quality of care in community health clinicians. One hundred eighty-two clinicians completed demographic and job characteristics questions and measures of burnout, job satisfaction, turnover intention, work-life conflict, and perceived quality of care. Clinicians also reported the importance of reducing stress and their confidence in reducing their stress. Clinicians who reported working overtime were compared to clinicians that did not on demographic and job characteristics and work-related outcomes. Ninety-four clinicians (52%) reported working overtime in a typical week. Controlling for exempt status and group differences in time spent supervising others, those working overtime reported significantly increased burnout and work-life conflict and significantly lower job satisfaction and quality of care than those not working overtime. Clinicians working overtime also reported significantly greater importance in reducing stress but less confidence in their ability to reduce stress than those not working overtime. There were no significant group differences for turnover intention. Working overtime is associated with negative consequences for clinician-related work outcomes and perceived quality of care. Policies and interventions aimed at reducing overtime and work-related stress and burnout may be warranted in order to improve quality of care. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

To act or not to act: responses to electronic health record prompts by family medicine clinicians.

Science.gov (United States)

Zazove, Philip; McKee, Michael; Schleicher, Lauren; Green, Lee; Kileny, Paul; Rapai, Mary; Mulhem, Elie

2017-03-01

A major focus of health care today is a strong emphasis on improving the health and quality of care for entire patient populations. One common approach utilizes electronic clinical alerts to prompt clinicians when certain interventions are due for individual patients being seen. However, these alerts have not been consistently effective, particularly for less visible (though important) conditions such as hearing loss (HL) screening. We conducted hour-long cognitive task analysis interviews to explore how family medicine clinicians view, perceive, and use electronic clinical alerts, and to utilize this information to design a more effective alert using HL identification and referral as a model diagnosis. Four key direct barriers were identified that impeded alert use: poor standardization and formatting, time pressures in primary care, clinic workflow variations, and mental models of the condition being prompted (in this case, HL). One indirect barrier was identified: electronic health record and institution/government regulations. We identified that clinicians' mental model of the condition being prompted was probably the major barrier, though this was often expressed as time pressure. We discuss solutions to each of the 5 identified barriers, such as addressing physicians' mental models, by focusing on physicians' expertise rather than knowledge to improve their comfort when caring for patients with the conditions being prompted. To unleash the potential of electronic clinical alerts, electronic health record and health care institutions need to address some key barriers. We outline these barriers and propose solutions. © The Author 2017. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.com

Feasibility and acceptability of interventions to delay gun access in VA mental health settings.

Science.gov (United States)

Walters, Heather; Kulkarni, Madhur; Forman, Jane; Roeder, Kathryn; Travis, Jamie; Valenstein, Marcia

2012-01-01

The majority of VA patient suicides are completed with firearms. Interventions that delay patients' gun access during high-risk periods may reduce suicide, but may not be acceptable to VA stakeholders or may be challenging to implement. Using qualitative methods, stakeholders' perceptions about gun safety and interventions to delay gun access during high-risk periods were explored. Ten focus groups and four individual interviews were conducted with key stakeholders, including VA mental health patients, mental health clinicians, family members and VA facility leaders (N=60). Transcripts were consensus-coded by two independent coders, and structured summaries were developed and reviewed using a consensus process. All stakeholder groups indicated that VA health system providers had a role in increasing patient safety and emphasized the need for providers to address gun access with their at-risk patients. However, VA mental health patients and clinicians reported limited discussion regarding gun access in VA mental health settings during routine care. Most, although not all, patients and clinicians indicated that routine screening for gun access was acceptable, with several noting that it was more acceptable for mental health patients. Most participants suggested that family and friends be involved in reducing gun access, but expressed concerns about potential family member safety. Participants generally found distribution of trigger locks acceptable, but were skeptical about its effectiveness. Involving Veteran Service Organizations or other individuals in temporarily holding guns during high-risk periods was acceptable to many participants but only with numerous caveats. Patients, clinicians and family members consider the VA health system to have a legitimate role in addressing gun safety. Several measures to delay gun access during high-risk periods for suicide were seen as acceptable and feasible if implemented thoughtfully. Published by Elsevier Inc.

The Prevalence of Postgraduate Education in Youth Health Among High School Clinicians and Associated Student Health Outcomes.

Science.gov (United States)

Denny, Simon; Farrant, Bridget; Utter, Jennifer; Fleming, Theresa; Bullen, Pat; Peiris-John, Roshini; Clark, Terryann

2016-11-01

Despite numerous calls to improve training in adolescent health, there is little known about the prevalence or effectiveness of specialized training in adolescent health. A two-stage random sampling cluster design was used to collect nationally representative data from 8,500 students from 91 high schools. Student data were linked to data from a survey of school health clinicians from participating schools on their level of training in youth health. Multilevel models accounting for demographic characteristics of students were used to estimate the association between nurses and physicians training in youth health and health outcomes among students. Almost all nurses and physicians reported some training in youth health, either having attended lectures or study days in youth health (n = 60, 80%) or completed postgraduate papers in youth health (n = 13, 17.3%). Students in schools where the nurses and physicians had received postgraduate training in youth health were less likely than students from schools with clinicians having attended lectures or study days in youth health to report emotional and behavior difficulties (11.8 vs. 12.7, p = .002) and binge drinking (19.6% vs. 24.9%, p = .03). There were no significant associations between depressive symptoms, suicide risk, cigarette, marijuana, contraception use, or motor vehicle risk behaviors among students and level of training among clinicians in their schools' health service. Postgraduate training in youth health among nurses and physicians in school health services is associated with fewer students reporting mental health difficulties and binge alcohol use. These findings support specialized training in youth health for clinicians working predominantly with young people. Copyright © 2016 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

Screening for Social Determinants of Health Among Children and Families Living in Poverty: A Guide for Clinicians.

Science.gov (United States)

Chung, Esther K; Siegel, Benjamin S; Garg, Arvin; Conroy, Kathleen; Gross, Rachel S; Long, Dayna A; Lewis, Gena; Osman, Cynthia J; Jo Messito, Mary; Wade, Roy; Shonna Yin, H; Cox, Joanne; Fierman, Arthur H

2016-05-01

Approximately 20% of all children in the United States live in poverty, which exists in rural, urban, and suburban areas. Thus, all child health clinicians need to be familiar with the effects of poverty on health and to understand associated, preventable, and modifiable social factors that impact health. Social determinants of health are identifiable root causes of medical problems. For children living in poverty, social determinants of health for which clinicians may play a role include the following: child maltreatment, child care and education, family financial support, physical environment, family social support, intimate partner violence, maternal depression and family mental illness, household substance abuse, firearm exposure, and parental health literacy. Children, particularly those living in poverty, exposed to adverse childhood experiences are susceptible to toxic stress and a variety of child and adult health problems, including developmental delay, asthma and heart disease. Despite the detrimental effects of social determinants on health, few child health clinicians routinely address the unmet social and psychosocial factors impacting children and their families during routine primary care visits. Clinicians need tools to screen for social determinants of health and to be familiar with available local and national resources to address these issues. These guidelines provide an overview of social determinants of health impacting children living in poverty and provide clinicians with practical screening tools and resources. Copyright © 2016 Mosby, Inc. All rights reserved.

Characteristics of school-based health services associated with students' mental health.

Science.gov (United States)

Denny, Simon; Howie, Hamish; Grant, Sue; Galbreath, Ross; Utter, Jennifer; Fleming, Theresa; Clark, Terryann

2018-01-01

Objective School-based health services (SBHS) have been shown to improve access to mental health services but the evidence of their effectiveness on students' mental health is lacking. Our objective was to examine associations between variation in the provision of SBHS and students' mental health. Methods A cross-sectional analysis of a nationally representative health and well-being survey of 8500 New Zealand high school students conducted in March-November 2012. Students' mental health is related to data on school health services obtained from clinic leaders and clinicians from 90 participating high schools. Results After adjustment for socio-demographic differences in students between schools, increasing levels of services were associated with progressively lower levels of student-reported depressive symptoms (p = 0.002), emotional and behavioural difficulties (p = 0.004) and suicidality (p = 0.008). Services with greater levels of nursing hours (p = 0.02) and those that performed routine, comprehensive psychosocial assessments (p = 0.01) were both associated with lower levels of student-reported depressive symptoms. Greater levels of nursing hours and doctor hours were associated with lower self-reported suicidality among students. Conclusions Although a causal association between school-based health services and students' mental health cannot be demonstrated, these findings support the benefit of such services and the need for a cluster randomized trial.

Application of Assessment Tools to Examine Mental Health in Workplaces: Job Stress and Depression.

Science.gov (United States)

Jeon, Sang Won; Kim, Yong-Ku

2018-06-07

Despite the fact that the lifetime and yearly prevalence rates of mental illness continue rising, such diseases have only been acknowledged as involved in workplace health issue since the 2000s. Additionally, while the number of recognized cases of mental illnesses is rather low compared to their prevalence, they have a high likelihood of causing significant problems, including fatalities. Many workers are terrified of losing their jobs due to mental illness and therefore attempt to hide their mental health problems. For this reason, clinicians involved in occupational and environmental medicine should focus on interviews or screenings to identify such hidden mental health problems. More specifically, it would be helpful to evaluate job stress and depression in workplaces to ensure appropriate preventive actions and thereby reduce the prevalence of mental illness. Job stress not only causes mental illness and dissatisfaction with work, but also can increase the prevalence and morbidity of medical diseases, as well as other physical health problems. Depression is a major contributor to work loss and absence with effects surpassing almost all of the chronic medical disorder. These facts show why measure of job stress and depression should be highlighted in the occupational settings. This article introduces a variety of assessment tools to examine mental health, particularly stress and depression, in workplaces. These tools can be used by clinicians or professionals involved in the mental health, occupational safety, or health service fields for running diagnostics or screening tests.

Building Mobile Apps for Underrepresented Mental Health care Consumers: A Grounded Theory Approach.

Science.gov (United States)

Leung, Ricky; Hastings, Julia F; Keefe, Robert H; Brownstein-Evans, Carol; Chan, Keith T; Mullick, Rosemary

2016-01-01

Cell phone mobile application ("app") use has risen dramatically within the past several years. Many individuals access apps to address mental health issues. Unlike individuals from privileged backgrounds, individuals from oppressed backgrounds may rely on apps rather than costly mental health treatment. To date, very little research has been published evaluating mental health apps' effectiveness. This paper focuses on three methods through which grounded theory can facilitate app development and evaluation for people underrepresented in mental health care. Recommendations are made to advance mobile app technology that will help clinicians provide effective treatment, and consumers to realize positive treatment outcomes.

Building Mobile Apps for Underrepresented Mental Health care Consumers: A Grounded Theory Approach

Science.gov (United States)

Leung, Ricky; Hastings, Julia F.; Keefe, Robert H.; Brownstein-Evans, Carol; Chan, Keith T.; Mullick, Rosemary

2017-01-01

Cell phone mobile application (“app”) use has risen dramatically within the past several years. Many individuals access apps to address mental health issues. Unlike individuals from privileged backgrounds, individuals from oppressed backgrounds may rely on apps rather than costly mental health treatment. To date, very little research has been published evaluating mental health apps’ effectiveness. This paper focuses on three methods through which grounded theory can facilitate app development and evaluation for people underrepresented in mental health care. Recommendations are made to advance mobile app technology that will help clinicians provide effective treatment, and consumers to realize positive treatment outcomes. PMID:29056878

Innocent or Intentional?: Interpreting Oppositional Defiant Disorder in a Preschool Mental Health Clinic.

Science.gov (United States)

El Ouardani, Christine N

2017-03-01

Based on 9 months of ethnographic fieldwork in a U.S. mental health clinic focused on the treatment of preschool-aged children who exhibited extremely disruptive behavior, this article examines the contradictions clinicians faced when trying to identify and attribute "intentionality" to very young children. Disruptive, aggressive behavior is one of the central symptoms involved in a wide-range of childhood psychopathology and the number one reason young children are referred to mental health clinics in the United States. In the clinic where I conducted my research, clinicians were especially interested in diagnosing these children with oppositional defiant disorder (ODD), in order to identify those at risk for more serious mental illness later in the lifecourse. In this article, I look at the different strategies clinicians used in interpreting whether aggressive, defiant behavior was a part of the child's "self," a biologically driven symptom of a disease, or a legitimate reaction to problematic social environments. I argue that conceptualizing intentionality as a developmental, interpersonal process may help to make sense of the multiple discourses and practices clinicians used to try to reconcile the contradictions inherent in diagnosing ODD.

Non-clinicians' judgments about asylum seekers' mental health: how do legal representatives of asylum seekers decide when to request medico-legal reports?

Science.gov (United States)

Wilson-Shaw, Lucy; Pistrang, Nancy; Herlihy, Jane

2012-01-01

Procedures for determining refugee status across Europe are being speeded up, despite the high prevalence of mental health difficulties among asylum seekers. An assurance given is that ''vulnerable applicants'' will be identified and excluded from accelerated procedures. Although experts have recommended assessments to be undertaken by experienced clinicians, this is unlikely to happen for political and financial reasons. Understanding how non-clinically qualified personnel perform assessments of mental health issues is timely and crucial. Misrecognition of refugees due to the inappropriate use of accelerated procedures involves the risk of returning the very people who have the right to protection from further persecution. To examine the decision making of immigration lawyers, who are an example of a group of nonclinicians who decide when and whether to refer asylum-seekers for psychiatric assessment. Semi-structured interviews were conducted with 12 legal representatives working with people seeking refugee or human rights protection in the United Kingdom. The resultant material was analysed using Framework Analysis. Themes clustered around the legal case, the client, the representative and the systems, all with sub-themes. A mapping exercise integrated these themes to show how representatives brought together questions of (1) evidential reasons for a report, influenced by their legal, psychological and case law knowledge, and (2) perceived evidence of mental distress, influenced by professional and personal experiences and expectations. The legal representatives interviewed were well-informed and trained in psychological issues as well as clearly dedicated to their clients. This helped them to attempt quasi-diagnoses of common mental health problems. They nonetheless demonstrated stereotypical understanding of post-traumatic stress disorder and other possible diagnoses and the role of subjectivity. The study has implications for other groups - particularly those

Clinician perceptions of virtual reality to assess and treat returning veterans.

Science.gov (United States)

Kramer, Teresa L; Pyne, Jeffrey M; Kimbrell, Timothy A; Savary, Patricia E; Smith, Jeffrey L; Jegley, Susan M

2010-11-01

Implementation of evidence-based, innovative treatments is necessary to address posttraumatic stress disorder (PTSD) and related mental health problems of Operation Enduring Freedom and Operation Iraqi Freedom (OEF-OIF) military service personnel. The purpose of this study was to characterize mental health clinicians' perceptions of virtual reality as an assessment tool or adjunct to exposure therapy. Focus groups were conducted with 18 prescribing and nonprescribing mental health clinicians within the Veterans Health Administration. Group discussion was digitally recorded, downloaded into Ethnograph software, and coded to arrive at primary, secondary, and tertiary themes. Most frequently mentioned barriers pertained to aspects of virtual reality, followed by veteran characteristics. Organizational barriers were more relevant when implementing virtual reality as a treatment adjunct. Although the study demonstrated that use of virtual reality as a therapy was feasible and acceptable to clinicians, successful implementation of the technology as an assessment and treatment tool will depend on consideration of the facilitators and barriers that were identified.

Mental health research in Ghana: A literature review | Read | Ghana ...

African Journals Online (AJOL)

Context/Background: Mental health is a neglected area in health care in Ghana. With few clinicians and trained researchers in the field, research has been limited both in quantity and quality. Method: A search of the available literature revealed 98 articles published between 1955 and 2009. Sixty-six are reviewed in this ...

Barriers and Facilitators of Responding to Problem Gambling: Perspectives from Australian Mental Health Services.

Science.gov (United States)

Rodda, S N; Manning, V; Dowling, N A; Lee, S J; Lubman, D I

2018-03-01

Despite high rates of comorbidity between problem gambling and mental health disorders, few studies have examined barriers or facilitators to the implementation of screening for problem gambling in mental health services. This exploratory qualitative study identified key themes associated with screening in mental health services. Semi-structured interviews were undertaken with 30 clinicians and managers from 11 mental health services in Victoria, Australia. Major themes and subthemes were identified using qualitative content analysis. Six themes emerged including competing priorities, importance of routine screening, access to appropriate screening tools, resources, patient responsiveness and workforce development. Barriers to screening included a focus on immediate risk as well as gambling being often considered as a longer-term concern. Clinicians perceived problem gambling as a relatively rare condition, but did acknowledge the need for brief screening. Facilitators to screening were changes to system processes, such as identification of an appropriate brief screening instrument, mandating its use as part of routine screening, as well as funded workforce development activities in the identification and management of problem gambling.

Integrative Mental Health (IMH): paradigm, research, and clinical practice.

Science.gov (United States)

Lake, James; Helgason, Chanel; Sarris, Jerome

2012-01-01

This paper provides an overview of the rapidly evolving paradigm of "Integrative Mental Health (IMH)." The paradigm of contemporary biomedical psychiatry and its contrast to non-allopathic systems of medicine is initially reviewed, followed by an exploration of the emerging paradigm of IMH, which aims to reconcile the bio-psycho-socio-spiritual model with evidence-based methods from traditional healing practices. IMH is rapidly transforming conventional understandings of mental illness and has significant positive implications for the day-to-day practice of mental health care. IMH incorporates mainstream interventions such as pharmacologic treatments, psychotherapy, and psychosocial interventions, as well as alternative therapies such as acupuncture, herbal and nutritional medicine, dietary modification, meditation, etc. Two recent international conferences in Europe and the United States show that interest in integrative mental health care is growing rapidly. In response, the International Network of Integrative Mental Health (INIMH: www.INIMH.org) was established in 2010 with the objective of creating an international network of clinicians, researchers, and public health advocates to advance a global agenda for research, education, and clinical practice of evidence-based integrative mental health care. The paper concludes with a discussion of emerging opportunities for research in IMH, and an exploration of potential clinical applications of integrative mental health care. Copyright © 2012 Elsevier Inc. All rights reserved.

Dual diagnosis: co-existence of drug, alcohol and mental health problems.

Science.gov (United States)

Manley, David

The Department of Health (DoH) published a set of good practice implementation guidelines on dual diagnosis in May 2002. This guidance suggests that in order to improve the prognosis for clients who have mental health problems and who drink or take drugs problematically, mental health and substance misuse services should adopt an integrated service model. There is a considerable amount of American-based research supporting this approach, but little evidence from the UK researchers demonstrating its application in the UK. This article offers an example of a service that has been developed in the city of Nottingham and argues that this client group will be served most effectively if mental health services support specialist dual-diagnosis resources. Integrated care pathways for this client group can be developed and led by specialist clinicians acting as consultants to mental health services (DoH, 2002a). This consultancy role within mental health services enhances the links needed between substance misuse and mental health services. As a result, specialist dual-diagnosis teams are best placed to increase positive prognoses for clients by ensuring evidence-based substance misuse skills are utilized and adapted by mental health teams to ensure fully integrated care coordination.

Adolescent Maternal Lifecourse Outcomes: Implications from an Integrated Mental Health Services Approach

Directory of Open Access Journals (Sweden)

Beth S. Russell

2014-06-01

Full Text Available Family intervention literature on adolescent parenting describes the pathways between outcomes for adolescent mothers and their children and the contexts of the pregnancy itself (e.g., poverty, low or no prenatal care, lower educational attainment. The aim of these descriptions is often to inform intervention designs that promote adaptive functioning for the child, the mother, and the dyad. Mental health services are an important component of many of these interventions; these services may be delivered by a clinician within the organization providing the intervention, or the organization may connect mothers with external mental health services in their communities. Using in-house clinicians rather than external providers may be beneficial by decreasing the high attrition rates common to this population. Although this service delivery approach is theoretically appealing, it has not been subject to rigorous empirical evaluation. In the current randomized study, we examine outcomes for teenage mothers based on two service delivery methods: Integrated Mental Health Services (IMHS and the Standard of Care (SoC which outsources clients’ mental health needs through community referrals. Information about the effectiveness of service delivery strategies can help program providers make decisions about how best to allocate limited funds to provide effective services.

Characterisation of mental health conditions in social media using Informed Deep Learning

OpenAIRE

Gkotsis, George; Oellrich, Anika; Velupillai, Sumithra; Liakata, Maria; Hubbard, Tim J P; Dobson, Richard J B; Dutta, Rina

2017-01-01

The number of people affected by mental illness is on the increase and with it the burden on health and social care use, as well as the loss of both productivity and quality-adjusted life-years. Natural language\\ud processing of electronic health records is increasingly used to study mental health conditions and risk behaviours on a large scale. However, narrative notes written by clinicians do not capture first-hand\\ud the patients’ own experiences, and only record cross-sectional, professio...

Attending to physical health in mental health services in Australia: a qualitative study of service users' experiences and expectations.

Science.gov (United States)

Young, Sarah J; Praskova, Anna; Hayward, Nicky; Patterson, Sue

2017-03-01

Evidence is unequivocal: the premature death of people with severe mental health problems is attributable primarily to cardiovascular disease, and healthcare provided is often suboptimal. With the overarching aim of improving outcomes, policies and guidelines oblige mental health services and psychiatrists to monitor cardio-metabolic health of patients and intervene as appropriate. Practice is highly variable; however, with ongoing debate about resourcing and responsibilities dominated by clinicians who have identified disinterest among patients as influencing practice. Seeking to balance discussion, we posed the question 'what do patients experience and expect of mental health services in relation to their physical health?' To answer it, we interviewed a convenience sample of 40 service users recruited from a mental health service in Australia, early in 2015. Data were analysed using the framework approach. With few regarding themselves as healthy, participants were commonly concerned about side effects of medication, weight and fitness but rarely mentioned tobacco smoking. Participants' accounts reinforce extensive research demonstrating variability in attention to physical health in mental health services. Reports by some participants of comprehensive care are encouraging, but widespread uncertainty about reasons for various assessments and denial of requests for management of medication side effects, including weight gain, gives cause for concern. Although participants in this study wanted to improve their health and health-related quality of life, they acknowledged that their motivation and ability to do so fluctuated with mental health. They expected clinicians to work proactively, especially when symptoms compromised capacity for self-care, and mental health services to provide or enable access to health-promoting interventions. Attention should be given, as a matter of priority, to creating conditions (culture and infrastructure) needed to support sustained

A service evaluation of self-referral to military mental health teams

Science.gov (United States)

Kennedy, I.; Jones, N.; Sharpley, J.; Greenberg, N.

2016-01-01

Background The UK military runs a comprehensive mental health service ordinarily accessed via primary care referrals. Aims To evaluate the feasibility of self-referral to mental health services within a military environment. Methods Three pilot sites were identified; one from each service (Royal Navy, Army, Air Force). Socio-demographic information included age, rank, service and career duration. Clinical data included prior contact with general practitioner (GP), provisional diagnosis and assessment outcome. Results Of the 57 self-referrals, 69% (n = 39) had not previously accessed primary care for their current difficulties. After their mental health assessment, 47 (82%) were found to have a formal mental health problem and 41 (72%) were offered a further mental health clinician appointment. The data compared favourably with a large military mental health department that reported 87% of primary care referrals had a formal mental health condition. Conclusions The majority of self-referrals had formal mental health conditions for which they had not previously sought help from primary care; most were offered further clinical input. This supports the view that self-referral may be a useful option to encourage military personnel to seek professional care over and above the usual route of accessing care through their GP. PMID:27121634

A Knowledge Transfer Study of the Utility of the Nova Scotia Seniors’ Mental Health Network in Implementing Seniors’ Mental Health National Guidelines

Science.gov (United States)

Bosma, Mark; Cassidy, Keri-Leigh; Le Clair, J Kenneth; Helsdingen, Sherri; Devichand, Pratima

2011-01-01

Background The Canadian Coalition for Seniors’ Mental Health (CCSMH) developed national best-practice guidelines in seniors’ mental health. Promoting adoption of new guidelines is challenging, as paper dissemination alone has limited impact on practice change. Purpose We hypothesized that the existing knowledge transfer (KT) mechanisms of the Nova Scotia Seniors’ Mental Health Network would prove useful in transferring the CCSMH best-practice guidelines. Methods In this observational KT study, CCSMH best-practice guidelines were delivered through two interactive, case-based teaching modules on Depression & Suicide, and Delirium via a provincial tele-education program and local face-to-face sessions. Usefulness of KT was measured using self-report evaluations of material quality and learning. Evaluation results from the two session topics and from tele-education versus face-to-face sessions were compared. Results Sessions were well attended (N = 347), with a high evaluation return rate (287, 83%). Most participants reported enhanced knowledge in seniors’ mental health and intended to apply knowledge to practice. Ratings did not differ significantly between KT session topics or modes of delivery. Conclusions The KT mechanisms of a provincial seniors’ mental health network facilitated knowledge acquisition and the intention of using national guidelines on seniors’ mental health among Nova Scotian clinicians. Key elements of accelerating KT used in this initiative are discussed. PMID:23251305

Ethical issues in perinatal mental health research.

Science.gov (United States)

Brandon, Anna R; Shivakumar, Geetha; Lee, Simon Craddock; Inrig, Stephen J; Sadler, John Z

2009-11-01

To review the background of current ethical standards for the conduct of perinatal mental health research and describe the ethical challenges in this research domain. Current literature reflects a growing sentiment in the scientific community that having no information regarding the impact of psychiatric treatment on the mother and developing fetus/infant poses dangers that may exceed the risks involved in research. However, without sufficient consensus across the scientific community, both regulatory bodies and perinatal researchers find themselves without a framework for decision making that satisfactorily limits the risks and facilitates the benefits of participation of pregnant and lactating women in clinical research. Psychiatric research in perinatal mental health is critically important as it enables clinicians and patients to participate in informed decision-making concerning treatment for psychiatric disorders. Specific areas of concern include fetal safety, maternal risk, the therapeutic misconception, commercial interests, forensic/legal issues, the informed consent process, and study design. Developing guidelines that address ethical challenges and include the views and concerns of multiple stakeholders could improve the access of perinatal women to the benefits of participation in mental health research in addition to providing evidence-based mental healthcare for this subpopulation.

Economic context analysis in mental health care. Usability of health financing and cost of illness studies for international comparisons.

Science.gov (United States)

Salvador-Carulla, L; Hernández-Peña, P

2011-03-01

This paper discusses an integrated approach to mental health studies on Financing of Illness (FoI) and health accounting, Cost of Illness (CoI) and Burden of Disease (BoD). In order to expand the mental health policies, the following are suggested: (a) an international consensus on the standard scope, methods to collect and to analyse mental health data, as well as to report comparative information; (b) mathematical models are also to be validated and tested in an integrated approach, (c) a better knowledge transfer between clinicians and knowledge engineers, and between researchers and policy makers to translate economic analysis into practice and health planning.

Management of mental health disorders and central nervous system sequelae in HIV-positive children and adolescents

Directory of Open Access Journals (Sweden)

R Nassen

2014-09-01

Full Text Available HIV-positive children and adolescents are at increased risk of both central nervous system (CNS sequelae and mental disorders owing to a number of factors, including the impact of HIV infection on the brain, social determinants of health (e.g. poverty and orphanhood and psychosocial stressors related to living with HIV. Every effort should be made to identify perinatally HIV-infected children and initiate them on antiretroviral therapy early in life. HIV clinicians should ideally screen for mental health and neurocognitive problems, as part of the routine monitoring of children attending antiretroviral clinics. This guideline is intended as a reference tool for HIV clinicians to support the early identification, screening and management of mental health disorders and/or CNS impairment in children and adolescents. This guideline covers mental disorders (section 1 and HIV-associated neurocognitive disorders (section 2 among children and adolescents.

The Islamic prayer (Salah/Namaaz) and yoga togetherness in mental health.

Science.gov (United States)

Sayeed, Shabbir Ahmed; Prakash, Anand

2013-01-01

Religion and its practices have been duly implicated in treating not only problems related to medical health, rather, intervening and preventing such problems as well. In the present article, the authors have reviewed significance of the Islamic prayers (Salah/Namaaz) in healthcare in general and mental health in particular. The nature, procedures, practices and the benefits of Salah have been comprehensively described and discussed. In addition, an attempt to combine yoga and its practices with Salah has been made for intervening and preventing the problems of mental health as an expeditious tool. In upshot, the clinicians in the field of mental health care have been suggested to incorporate these two viewpoints in their intervention program, at least, for the Muslim patients for a more desirable outcome.

Perspectives on Providing And Receiving Preventive Health Care From Primary Care Providers and Their Patients With Mental Illnesses.

Science.gov (United States)

Stumbo, Scott P; Yarborough, Bobbi Jo H; Yarborough, Micah T; Green, Carla A

2018-01-01

Individuals with mental illnesses have higher morbidity rates and reduced life expectancy compared to the general population. Understanding how patients and providers perceive the need for prevention, as well as the barriers and beliefs that may contribute to insufficient care, are important for improving service delivery tailored to this population. Cross-sectional; mixed methods. An integrated health system and a network of federally qualified health centers and safety net clinics. Interviews (n = 30) and surveys (n = 249) with primary care providers. Interviews (n = 158) and surveys (n = 160) with patients diagnosed with schizophrenia, bipolar, anxiety, or major depressive disorders. Semi-structured interviews and surveys. Thematic analysis for qualitative data; frequencies for quantitative data. More than half (n = 131, 53%) of clinicians believed patients with mental illnesses care less about preventive care than the general population, yet 88% (n = 139) of patients reported interest in improving health. Most providers (n = 216, 88%) lacked confidence that patients with mental illnesses would follow preventive recommendations; 82% (n = 129) of patients reported they would try to change lifestyles if their doctor recommended. Clinicians explained that their perception of patients' chaotic lives and lack of interest in preventive care contributed to their fatalistic attitudes on care delivery to this population. Clinicians and patients agreed on substantial need for additional support for behavior changes. Clinicians reported providing informational support by keeping messages simple; patients reported a desire for more detailed information on reasons to complete preventive care. Patients also detailed the need for assistive and tangible support to manage behavioral health changes. Our results suggest a few clinical changes could help patients complete preventive care recommendations and improve health behaviors: improving clinician-patient collaboration on

Psychiatric advance directives in Australian mental-health legislation.

Science.gov (United States)

Ouliaris, Calina; Kealy-Bateman, Warren

2017-12-01

Following the recent widespread reform of mental-health legislation in Australia, psychiatric advance directives (PADs) have now been incorporated in four jurisdictions. We contextualise the potential role for PADs within the Australian legal framework and note their varying introduction across jurisdictions, with a focus on progressive legislation in the Australian Capital Territory (ACT). The formal recognition of PADs effectively shifts the trajectory of mental-health law towards a stronger recognition of consumer autonomy, albeit to varying degrees across jurisdictions. The most inspiring of these changes may be seen in the ACT Act, where an innovative framing of PAD provisions creates a safe space for clinicians and patients to engage, build therapeutic alliances and develop appropriate frameworks for further change.

Primary caregivers' satisfaction with clinicians' response to them as informal carers of young people with first-episode psychosis: a qualitative study.

Science.gov (United States)

McCann, Terence V; Lubman, Dan I; Clark, Eileen

2012-01-01

To explore first-time primary caregivers' experience of the way mental health nurses and other mental health clinicians respond to them as carers of young people with first-episode psychosis. Caregivers have a key role in supporting family members/relatives with mental illness, but their contribution is undervalued frequently by mental health nurses and other mental health clinicians. Design.  Qualitative interpretative phenomenological analysis. A qualitative interpretative design was undertaken, using semi-structured, audio-recorded interviews. Twenty primary caregivers were recruited through Orygen Youth Health, a first-episode psychosis centre in Melbourne. Interpretative phenomenological analysis was used to identify themes in the data. Two competing themes were identified in the data, highlighting caregivers' contrasting experience with mental health nurses and other mental health clinicians. First, most clinical staff were approachable and supportive. Second, several carers felt their contribution was undervalued by some clinical staff. This was as a consequence of being excluded from clinical deliberations because of clinical staffs' concerns and young people's requests about maintaining confidentiality regarding treatment, as well as carers feeling their role was not taken seriously by clinical staff. First-time primary carers have positive and negative experiences with first-episode psychosis mental health nurses and other clinicians, and these competing events are interrelated. Experiences are affected directly by the manner they are treated by clinical staff and this may, in turn, affect carers' commitment to caring, the way they engage with clinical staff on subsequent occasions and towards the first-episode psychosis service generally. Greater appreciation is needed of the contribution, experience and difficulties caregivers encounter in their role and in engaging with mental health nurses and other clinicians. Additional training is required for

Perspectives on Cognitive Therapy Training within Community Mental Health Settings: Implications for Clinician Satisfaction and Skill Development

Directory of Open Access Journals (Sweden)

Shannon Wiltsey Stirman

2012-01-01

Full Text Available Despite the mounting evidence of the benefits of cognitive therapy for depression and suicidal behaviors over usual care, like other evidence-based psychosocial treatments (EBTs, it has not been widely adopted in clinical practice. Studies have shown that training followed by intensive consultation is needed to prepare providers to an appropriate level of competency in complex, multisession treatment packages such as cognitive therapy. Given the critical role of training in EBT implementation, more information on factors associated with the success and challenges of training programs is needed. To identify potential reasons for variation in training outcomes across ten agencies in a large, urban community mental health system, we explored program evaluation data and examined provider, consultant, and training program administrator perspectives through follow-up interviews. Perceptions of cognitive therapy, contextual factors, and reactions to feedback on audio recordings emerged as broad categories of themes identified from interviews. These factors may interact and impact clinician efforts to learn cognitive therapy and deliver it skillfully in their practice. The findings highlight experiences and stakeholder perspectives that may contribute to more or less successful training outcomes.

A service evaluation of self-referral to military mental health teams.

Science.gov (United States)

Kennedy, I; Whybrow, D; Jones, N; Sharpley, J; Greenberg, N

2016-07-01

The UK military runs a comprehensive mental health service ordinarily accessed via primary care referrals. To evaluate the feasibility of self-referral to mental health services within a military environment. Three pilot sites were identified; one from each service (Royal Navy, Army, Air Force). Socio-demographic information included age, rank, service and career duration. Clinical data included prior contact with general practitioner (GP), provisional diagnosis and assessment outcome. Of the 57 self-referrals, 69% (n = 39) had not previously accessed primary care for their current difficulties. After their mental health assessment, 47 (82%) were found to have a formal mental health problem and 41 (72%) were offered a further mental health clinician appointment. The data compared favourably with a large military mental health department that reported 87% of primary care referrals had a formal mental health condition. The majority of self-referrals had formal mental health conditions for which they had not previously sought help from primary care; most were offered further clinical input. This supports the view that self-referral may be a useful option to encourage military personnel to seek professional care over and above the usual route of accessing care through their GP. © The Author 2016. Published by Oxford University Press on behalf of the Society of Occupational Medicine. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Health workers' views of a program to facilitate physical health care in mental health settings: implications for implementation and training.

Science.gov (United States)

Baker, Wendy; Harris, Melanie; Battersby, Malcolm

2014-12-01

Physical comorbidities shorten the lifespan of people with severe mental illness therefore mental health clinicians need to support service users in risk factor-related behaviour change. We investigated mental health care workers' views of a physical health self-management support program in order to identify implementation requirements. Qualitative interviews were conducted with workers who had differing levels of experience with a self-management support program. Themes were identified using interpretive descriptive analysis and then matched against domains used in implementation models to draw implications for successful practice change. Three main themes emerged related to: (1) understandings of disease management within job roles; (2) requirements for putting self-management support into practice; and (3) challenges of coordination in disease management. Priority domains from implementation models were inner and outer health service settings. While staff training is required, practice change for care which takes account of both mental and physical health also requires changes in organisational frameworks. © The Royal Australian and New Zealand College of Psychiatrists 2014.

Workplace mental health: An international review of guidelines.

Science.gov (United States)

Memish, Kate; Martin, Angela; Bartlett, Larissa; Dawkins, Sarah; Sanderson, Kristy

2017-08-01

The aim of this systematic review was to determine the quality and comprehensiveness of guidelines developed for employers to detect, prevent, and manage mental health problems in the workplace. An integrated approach that combined expertise from medicine, psychology, public health, management, and occupational health and safety was identified as a best practice framework to assess guideline comprehensiveness. An iterative search strategy of the grey literature was used plus consultation with experts in psychology, public health, and mental health promotion. Inclusion criteria were documents published in English and developed specifically for employers to detect, prevent, and manage mental health problems in the workplace. A total of 20 guidelines met these criteria and were reviewed. Development documents were included to inform quality assessment. This was performed using the AGREE II rating system. Our results indicated that low scores were often due to a lack of focus on prevention and rather a focus on the detection and treatment of mental health problems in the workplace. When prevention recommendations were included they were often individually focused and did not include practical tools or advice to implement. An inconsistency in language, lack of consultation with relevant population groups in the development process and a failure to outline and differentiate between the legal/minimum requirements of a region were also observed. The findings from this systematic review will inform translation of scientific evidence into practical recommendations to prevent mental health problems within the workplace. It will also direct employers, clinicians, and policy-makers towards examples of best-practice guidelines. Copyright © 2017 Elsevier Inc. All rights reserved.

Seeking asylum in Australia: immigration detention, human rights and mental health care.

Science.gov (United States)

Newman, Louise; Proctor, Nicholas; Dudley, Michael

2013-08-01

The article aims to discuss the impact of mandatory detention and human rights violations on the mental health of asylum seekers and the implications for psychiatrists and health professionals. Advocacy for human rights and engagement in social debate are core ethical and professional responsibilities. Clinicians need to maintain a focus on ethical obligations.

Rural mental health workforce difficulties: a management perspective.

Science.gov (United States)

Moore, T; Sutton, K; Maybery, D

2010-01-01

The recruitment, retention and training of mental health workers is of major concern in rural Australia, and the Gippsland region of Victoria is no exception. Previous studies have identified a number of common factors in these workforce difficulties, including rurality, difficulties of access to professional development and training, and professional and personal isolation. However, those previous studies have often focused on medicine and been based on the perspectives of practitioners, and have almost ignored the perspectives of managers of rural mental health services. The study reported in this article sought to contribute to the development of a more sustainable and effective regional mental health workforce by complementing earlier insights with those of leading administrators, managers and senior clinicians in the field. The study took a qualitative approach. It conducted semi-structured in-person interviews with 24 managers of health/mental-health services and senior administrators and clinicians working in organisations of varying sizes in the public and private sectors. Thematic content analysis of the transcribed interviews identified core difficulties these managers experienced in the recruitment, retention and training of employees. The study found that some of the issues commonly resulting in difficulties in recruiting, retaining and developing a trained workforce in rural areas, such as rurality (implying personal and professional isolation, distances to deliver service and small organisations) and a general shortage of trained personnel, are significant in Gippsland. Through its focus on the perspectives of leaders in the management of rural mental health services, however, the study found other key issues that contribute to workforce difficulties. Many, including the unattractive nature of mental health work, the fragmented administration of the mental health system, short-term and tied funding, and shortcomings in training are external to

Implementing a Measurement Feedback System in Community Mental Health Clinics: A Case Study of Multilevel Barriers and Facilitators.

Science.gov (United States)

Gleacher, Alissa A; Olin, Serene S; Nadeem, Erum; Pollock, Michele; Ringle, Vanesa; Bickman, Leonard; Douglas, Susan; Hoagwood, Kimberly

2016-05-01

Measurement feedback systems (MFSs) have been proposed as a means of improving practice. The present study examined the implementation of a MFS, the Contextualized Feedback System (CFS), in two community-based clinic sites. Significant implementation differences across sites provided a basis for examining factors that influenced clinician uptake of CFS. Following the theoretical implementation framework of Aarons et al. (Adm Policy Mental Health Mental Health Serv Res 38(1):4-23, 2011), we coded qualitative data collected from eighteen clinicians (13 from Clinic U and 5 from Clinic R) who participated in semi-structured interviews about their experience with CFS implementation. Results suggest that clinicians at both clinics perceived more barriers than facilitators to CFS implementation. Interestingly, clinicians at the higher implementing clinic reported a higher proportion of barriers to facilitators (3:1 vs. 2:1); however, these clinicians also reported a significantly higher level of organizational and leadership supports for CFS implementation. Implications of these findings are discussed.

Consequences and Possible Predictors of Health-damaging Behaviors and Mental Health Problems in Pregnancy - A Review.

Science.gov (United States)

Ulrich, F; Petermann, F

2016-11-01

In recent decades, the understanding of the short and longer term effects of health-damaging behaviors and mental health problems in pregnant women and the underlying mechanisms of these behaviors and illnesses has significantly increased. In contrast, little is known about the factors affecting individual pregnant women which contribute to health-damaging behaviors and mental illness. The aim of this paper was therefore to summarize the current state of research into the consequences of nicotine and alcohol consumption, malnutrition, excessive weight gain or obesity, and impaired mental health (depression and anxiety) during pregnancy. In addition, the characteristics of pregnant women which increase their risk of developing such behaviors or mental disorders are described. A better knowledge of these risks should make it easier for clinicians to identify cases at risk early on and put measures of support in place. A review of the literature has shown that certain characteristics of pregnant women (e.g. her relationship with her partner, a previous history of mental illness prior to pregnancy) are associated with various health-damaging behaviors as well as with impaired mental health. Affected women often show an accumulated psychosocial stress which was already present prior to the pregnancy and which may persist even after the birth of the child.

Field trials of the phenomena of concern for psychiatric/mental health nursing: proposed methodology.

Science.gov (United States)

Wilson, H S

1989-10-01

An important step in the development of the American Nurses' Association (ANA) Task Force's Classification of Phenomena of Concern for Psychiatric/Mental Health Nursing is a plan for conducting field trials to determine interrater diagnostic reliability using the classification system. The ANA Task Force identified field testing as stage two in a three-stage process for completion of our work. In this article, we identify methodologic directions that will allow us to answer two important questions. First, what is the interrater reliability of the system of psychiatric nursing diagnoses when applied to clients by psychiatric/mental health nurse clinicians in their practice, and second, how do the clinicians who use this system view its usefulness for planning and evaluating nursing care?

Anger Management for Substance Abuse and Mental Health Clients: A Cognitive Behavioral Therapy Manual [and] Participant Workbook.

Science.gov (United States)

Reilly, Patrick M.; Shopshire, Michael S.; Durazzo, Timothy C.; Campbell, Torri A.

This manual and workbook set focuses on anger management. The manual was designed for use by qualified substance abuse and mental health clinicians who work with substance abuse and mental health clients with concurrent anger programs. The manual describes a 12-week cognitive behavioral anger management group treatment. Each of the 12 90-minute…

School Mental Health Resources and Adolescent Mental Health Service Use

Science.gov (United States)

Green, Jennifer Greif; McLaughlin, Katie A.; Alegría, Margarita; Costello, E. Jane; Gruber, Michael J.; Hoagwood, Kimberly; Leaf, Philip J.; Olin, Serene; Sampson, Nancy A,; Kessler, Ronald C.

2014-01-01

Objective Although schools are identified as critical for detecting youth mental disorders, little is known about whether the number of mental health providers and types of resources they offer influence student mental health service use. Such information could inform the development and allocation of appropriate school-based resources to increase service use. This paper examines associations of school resources with past-year mental health service use among students with 12-month DSM-IV mental disorders. Method Data come from the U.S. National Comorbidity Survey Adolescent Supplement (NCS-A), a national survey of adolescent mental health that included 4,445 adolescent-parent pairs in 227 schools in which principals and mental health coordinators completed surveys about school resources-policies for addressing student emotional problems. Adolescents and parents completed the Composite International Diagnostic Interview and reported mental health service use across multiple sectors. Multilevel multivariate regression was used to examine associations of school mental health resources and individual-level service use. Results Roughly half (45.3%) of adolescents with a 12-month DSM-IV disorder received past-year mental health services. Substantial variation existed in school resources. Increased school engagement in early identification was significantly associated with mental health service use for adolescents with mild/moderate mental and behavior disorders. The ratio of students-to-mental health providers was not associated with overall service use, but was associated with sector of service use. Conclusions School mental health resources, particularly those related to early identification, may facilitate mental health service use and influence sector of service use for youths with DSM disorders. PMID:23622851

Horses for courses? A qualitative exploration of goals formulated in mental health settings by young people, parents, and clinicians.

Science.gov (United States)

Jacob, Jenna; Edbrooke-Childs, Julian; Holley, Simone; Law, Duncan; Wolpert, Miranda

2016-04-01

This research sought to explore and categorise goals set by children and young people, parents/caregivers and jointly by a combination of children/young people, parents/caregivers and/or clinicians within mental health settings across the United Kingdom. Using a dataset of 441 goals formed at the outset of 180 treatment episodes (2007-2010) from UK child mental health services using the Goal-Based Outcomes tool, a grounded theory approach was taken, which built on previous research into child-rated goals to develop frameworks for parent and joint goal data which were then compared with the child goal data. A total of 19 subthemes and four overarching themes were identified for parent goals. A total of 19 subthemes in five overarching themes were identified for joint goals. These were compared with 25 subthemes and three overarching themes for child goals. A comparison of subthemes between parent, child and joint goals demonstrated many consistencies, but also differences. Most commonly rated goals from children focused on coping with specific difficulties, personal growth and independence. Parent goals focused mainly on managing specific difficulties, parent-specific goals and improving self or life. Jointly negotiated goals focused on parent-specific goals, self-confidence and understanding, hopes for the future and managing specific problems. The results suggest that goals may capture areas not captured by other normed outcome measures. In particular, goals may capture higher order, underlying factors, such as confidence, resilience, coping, and parenting factors that may not be explored by other measures. The differences across perspectives also link to existing literature suggesting a different focus on treatment based on perspectives and highlights the potential importance when jointly agreeing goals of ensuring the voice of the child/young person is heard and included in goal setting. © The Author(s) 2015.

Linking Cultural Competence to Functional Life Outcomes in Mental Health Care Settings.

Science.gov (United States)

Michalopoulou, Georgia; Falzarano, Pamela; Butkus, Michael; Zeman, Lori; Vershave, Judy; Arfken, Cynthia

2014-01-01

Minorities in the United States have well-documented health disparities. Cultural barriers and biases by health care providers may contribute to lower quality of services which may contribute to these disparities. However, evidence linking cultural competency and health outcomes is lacking. This study, part of an ongoing quality improvement effort, tested the mediation hypothesis that patients' perception of provider cultural competency indirectly influences patients' health outcomes through process of care. Data were from patient satisfaction surveys collected in seven mental health clinics (n=94 minority patients). Consistent with our hypothesis, patients' perception of clinicians' cultural competency was indirectly associated with patients' self-reported improvements in social interactions, improvements in performance at work or school, and improvements in managing life problems through the patients' experience of respect, trust, and communication with the clinician. These findings indicate that process of care characteristics during the clinical encounter influence patients' perceptions of clinicians' cultural competency and affect functional outcomes. © 2013 National Medical Association. Published by Elsevier Inc. All rights reserved.

Depression Screening Using Daily Mental-Health Ratings from a Smartphone Application for Breast Cancer Patients.

Science.gov (United States)

Kim, Junetae; Lim, Sanghee; Min, Yul Ha; Shin, Yong-Wook; Lee, Byungtae; Sohn, Guiyun; Jung, Kyung Hae; Lee, Jae-Ho; Son, Byung Ho; Ahn, Sei Hyun; Shin, Soo-Yong; Lee, Jong Won

2016-08-04

Mobile mental-health trackers are mobile phone apps that gather self-reported mental-health ratings from users. They have received great attention from clinicians as tools to screen for depression in individual patients. While several apps that ask simple questions using face emoticons have been developed, there has been no study examining the validity of their screening performance. In this study, we (1) evaluate the potential of a mobile mental-health tracker that uses three daily mental-health ratings (sleep satisfaction, mood, and anxiety) as indicators for depression, (2) discuss three approaches to data processing (ratio, average, and frequency) for generating indicator variables, and (3) examine the impact of adherence on reporting using a mobile mental-health tracker and accuracy in depression screening. We analyzed 5792 sets of daily mental-health ratings collected from 78 breast cancer patients over a 48-week period. Using the Patient Health Questionnaire-9 (PHQ-9) as the measure of true depression status, we conducted a random-effect logistic panel regression and receiver operating characteristic (ROC) analysis to evaluate the screening performance of the mobile mental-health tracker. In addition, we classified patients into two subgroups based on their adherence level (higher adherence and lower adherence) using a k-means clustering algorithm and compared the screening accuracy between the two groups. With the ratio approach, the area under the ROC curve (AUC) is 0.8012, indicating that the performance of depression screening using daily mental-health ratings gathered via mobile mental-health trackers is comparable to the results of PHQ-9 tests. Also, the AUC is significantly higher (P=.002) for the higher adherence group (AUC=0.8524) than for the lower adherence group (AUC=0.7234). This result shows that adherence to self-reporting is associated with a higher accuracy of depression screening. Our results support the potential of a mobile mental-health

Moving science into state child and adolescent mental health systems: Illinois' evidence-informed practice initiative.

Science.gov (United States)

Starin, Amy C; Atkins, Marc S; Wehrmann, Kathryn C; Mehta, Tara; Hesson-McInnis, Matthew S; Marinez-Lora, A; Mehlinger, Renee

2014-01-01

In 2005, the Illinois State Mental Health Authority embarked on an initiative to close the gap between research and practice in the children's mental health system. A stakeholder advisory council developed a plan to advance evidence informed practice through policy and program initiatives. A multilevel approach was developed to achieve this objective, which included policy change, stakeholder education, and clinician training. This article focuses on the evidence-informed training process designed following review of implementation research. The training involved in-person didactic sessions and twice-monthly telephone supervision across 6 cohorts of community based clinicians, each receiving 12 months of training. Training content initially included cognitive behavioral therapy and behavioral parent training and was adapted over the years to a practice model based on common element concepts. Evaluation based on provider and parent report indicated children treated by training clinicians generally showed superior outcomes versus both a treatment-as-usual comparison group for Cohorts 1 to 4 and the statewide child population as a whole after 90 days of care for Cohorts 5 to 6. The results indicated primarily moderate to strong effects for the evidence-based training groups. Moving a large public statewide child mental health system toward more effective services is a complex and lengthy process. These results indicate training of community mental health providers in Illinois in evidence-informed practice was moderately successful in positively impacting child-level functional outcomes. These findings also influenced state policy in committing resources to continuing the initiative, even in difficult economic times.

mHealth for mental health in the Middle East: Need, technology use, and readiness among Palestinians in the West Bank.

Science.gov (United States)

Ben-Zeev, Dror; Fathy, Cherie; Jonathan, Geneva; Abuharb, Batoul; Brian, Rachel M; Kesbeh, Lana; Abdelkader, Samer

2017-06-01

Palestinians in the West Bank are at heightened risk for mental health problems. Limited availability of clinicians and a host of geopolitical, topographical, and infrastructural challenges create significant regional barriers to clinic-based care. The objective of this study was to examine whether mHealth approaches that leverage mobile phones for remote mental health treatment may be viable alternatives. We surveyed 272 Palestinian adults in urban, rural, and refugee camp settings. Most participants (93.4%) reported owning mobile phones. The penetration of mobile devices was high across all study sites. Males and females did not differ in their access to this resource. Among mobile phone owners, 79.9% had smartphones, 32.2% had basic mobile phones, and 12.2% owned both. Respondents reported having reliable access to electricity (99.6%) and Wi-Fi (80.9%). Almost all mobile phone owners (99.6%) reported using social media such as Facebook, WhatsApp, or Twitter. When asked to estimate the prevalence of mental health problems in the region, 61.4% of participants reported that over half of the people in their communities struggled with depression, posttraumatic stress, or auditory hallucinations. Most participants indicated that they would personally be interested in mHealth for Mental Health options such as bi-directional texting with clinicians (68.8%), smartphone applications (66.5%), unidirectional support texts (64.7%), or web-based interventions (64.0%). Given the Palestinian populations' broad access to technology and technological infrastructure, need for care, and openness to engage in mobile interventions, mHealth should be considered a promising strategy for mental health services in the West Bank. Copyright © 2017 Elsevier B.V. All rights reserved.

Applying theory-driven approaches to understanding and modifying clinicians' behavior: what do we know?

Science.gov (United States)

Perkins, Matthew B; Jensen, Peter S; Jaccard, James; Gollwitzer, Peter; Oettingen, Gabriele; Pappadopulos, Elizabeth; Hoagwood, Kimberly E

2007-03-01

Despite major recent research advances, large gaps exist between accepted mental health knowledge and clinicians' real-world practices. Although hundreds of studies have successfully utilized basic behavioral science theories to understand, predict, and change patients' health behaviors, the extent to which these theories-most notably the theory of reasoned action (TRA) and its extension, the theory of planned behavior (TPB)-have been applied to understand and change clinician behavior is unclear. This article reviews the application of theory-driven approaches to understanding and changing clinician behaviors. MEDLINE and PsycINFO databases were searched, along with bibliographies, textbooks on health behavior or public health, and references from experts, to find article titles that describe theory-driven approaches (TRA or TPB) to understanding and modifying health professionals' behavior. A total of 19 articles that detailed 20 studies described the use of TRA or TPB and clinicians' behavior. Eight articles describe the use of TRA or TPB with physicians, four relate to nurses, three relate to pharmacists, and two relate to health workers. Only two articles applied TRA or TPB to mental health clinicians. The body of work shows that different constructs of TRA or TPB predict intentions and behavior among different groups of clinicians and for different behaviors and guidelines. The number of studies on this topic is extremely limited, but they offer a rationale and a direction for future research as well as a theoretical basis for increasing the specificity and efficiency of clinician-targeted interventions.

Factors explaining priority setting at community mental health centres: a quantitative analysis of referral assessments.

Science.gov (United States)

Grepperud, Sverre; Holman, Per Arne; Wangen, Knut Reidar

2014-12-14

Clinicians at Norwegian community mental health centres assess referrals from general practitioners and classify them into three priority groups (high priority, low priority, and refusal) according to need where need is defined by three prioritization criteria (severity, effect, and cost-effectiveness). In this study, we seek to operationalize the three criteria and analyze to what extent they have an effect on clinical-level priority setting after controlling for clinician characteristics and organisational factors. Twenty anonymous referrals were rated by 42 admission team members employed at 14 community mental health centres in the South-East Health Region of Norway. Intra-class correlation coefficients were calculated and logistic regressions were performed. Variation in clinicians' assessments of the three criteria was highest for effect and cost-effectiveness. An ordered logistic regression model showed that all three criteria for prioritization, three clinician characteristics (education, being a manager or not, and "guideline awareness"), and the centres themselves (fixed effects), explained priority decisions. The relative importance of the explanatory factors, however, depended on the priority decision studied. For the classification of all admitted patients into high- and low-priority groups, all clinician characteristics became insignificant. For the classification of patients, into those admitted and non-admitted, one criterion (effect) and "being a manager or not" became insignificant, while profession ("being a psychiatrist") became significant. Our findings suggest that variation in priority decisions can be reduced by: (i) reducing the disagreement in clinicians' assessments of cost-effectiveness and effect, and (ii) restricting priority decisions to clinicians with a similar background (education, being a manager or not, and "guideline awareness").

Prevalence of mental illness within families in a regional child-focussed mental health service.

Science.gov (United States)

Naughton, Michael F A; Maybery, Darryl J; Goodyear, Melinda

2018-04-01

Nearly 50% of all mental illnesses begin in childhood before the age of 14 years, and over 20% of parents have a mental illness. Few studies have examined the co-occurrence of mental illnesses in parents and children. In the present study, we examined the extent of mental illness within families of 152 clients attending an Australian regional child and adolescent mental health service (CAMHS). A cross-sectional study design was employed involving a case record review and clinician-completed questionnaire of the children and youth attending a CAMHS. It was found that 79% of these children were living with a parent with mental illness. The predominant diagnosis of both child and parent was an anxiety or mood disorder, and many families had co-occurring risk factors of domestic violence and limited social supports. The findings in this Australian cohort are similar to those of other international research. While novel in nature, the present study has highlighted the extent of both mental illness and scarce supports for both children and parents in the same family. The findings indicate the need for a coordinated multiservice delivery of appropriate and consistent family-focussed interventions, responding to both mental illness and social supports for children and parents. Further research should examine specific components of family need and support, as seen through the eyes of the child and their parent. © 2017 Australian College of Mental Health Nurses Inc.

Making Change Visible: The Possibilities in Assessing Mental Health Counseling Outcomes

Science.gov (United States)

Leibert, Todd W.

2006-01-01

The product of mental health counseling, unlike that of most professions, remains invisible to most people, leaving counselors vulnerable in a competitive market. The author argues that clinicians should recognize the value of, understand, and begin using outcome measures in their work. Research focusing on critical problems in psychotherapy…

An evaluation of communication barriers and facilitators at the time of a mental health diagnosis: a survey of health professional practices.

Science.gov (United States)

Milton, A C; Mullan, B; MacCann, C; Hunt, C

2017-01-24

To examine health professionals' views and practices relating to the specific barriers to communication that arise at the time of mental health diagnosis, and the strategies used to support individuals throughout this process. An online survey of the beliefs and practices of 131 mental health clinicians working in different clinical settings across Australia was conducted. Exploratory factor analysis of the items relating to barriers to communication resulted in three latent factors ('stigma, diagnosis and risk'; 'service structure'; and 'individual circumstances' such as the person receiving the diagnosis being young, having a culturally and linguistically diverse background or being unwell at the time of conversation). Using linear regression it was found that variance in 'stigma, diagnosis and risk' was significantly explained by whether participating clinicians had medical training, their experience working with serious mental health problems, their confidence handling distress and attitude towards diagnosis. Variance in 'individual circumstances' was significantly explained by participating clinicians' confidence handling distress. The most frequently used strategies to support diagnostic discussions centred on the health professionals' communication skills, gauging the individual's perception of their circumstances, responding with empathy, following-up after discussion, addressing stigma concerns, using collaborative practice and setting up for the conversation. Three main areas for health professionals to reflect on, plan for and ultimately address when discussing news with the individual concerned emerged ('stigma, diagnosis and risk'; 'service structure'; and 'individual circumstances'). Variations in practice indicate that practitioners should be cognisant of their own beliefs and background and how this impacts their communication practice.

Preventing HIV among U.S. women of color with severe mental illness: perceptions of mental health care providers working in urban community clinics.

Science.gov (United States)

Agénor, Madina; Collins, Pamela Y

2013-01-01

Given their knowledge of the behavioral issues related to psychiatric illness, mental health care providers are in a unique position to help prevent HIV among women with severe mental illness (SMI). We conducted in-depth interviews with providers at two New York City community clinics. We identified three major, interrelated themes pertaining to HIV prevention among women of color with SMI. Interventions that address the barriers that clinicians face in discussing sex, sexuality, and HIV with patients and train providers in the cultural considerations of cross-cultural mental health care are needed to help prevent HIV among women of color with SMI.

Addressing the physical health of people with serious mental illness: A potential solution for an enduring problem.

Science.gov (United States)

Happell, Brenda; Gaskin, Cadeyrn J; Stanton, Robert

2016-03-01

People with serious mental illness face significant inequalities in physical health care. As a result, the risk of cardiometabolic disorders and premature mortality is far greater than that observed in the general population. Contributiung to this disparity, is the lack of routine physical health screening by mental health clinicians. One possible solution is the implimentation of a physical health nurse consultant, whose role is to monitor and coordinate the physical health care of people with serious mental illness. Current evidence supports the implimentation of such a role, and a failure to address the widening gaps in physical health care will only serve to increase the disparities faced by people with serious mental illness. © The Author(s) 2015.

Significance of mental health legislation for successful primary care for mental health and community mental health services: A review.

Science.gov (United States)

Ayano, Getinet

2018-03-29

 Mental health legislation (MHL) is required to ensure a regulatory framework for mental health services and other providers of treatment and care, and to ensure that the public and people with a mental illness are afforded protection from the often-devastating consequences of mental illness.  To provide an overview of evidence on the significance of MHL for successful primary care for mental health and community mental health servicesMethod: A qualitative review of the literature on the significance of MHL for successful primary care for mental health and community mental health services was conducted.  In many countries, especially in those who have no MHL, people do not have access to basic mental health care and treatment they require. One of the major aims of MHL is that all people with mental disorders should be provided with treatment based on the integration of mental health care services into the primary healthcare (PHC). In addition, MHL plays a crucial role in community integration of persons with mental disorders, the provision of care of high quality, the improvement of access to care at community level. Community-based mental health care further improves access to mental healthcare within the city, to have better health and mental health outcomes, and better quality of life, increase acceptability, reduce associated social stigma and human rights abuse, prevent chronicity and physical health comorbidity will likely to be detected early and managed.  Mental health legislation plays a crucial role in community integration of persons with mental disorders, integration of mental health at primary health care, the provision of care of high quality and the improvement of access to care at community level. It is vital and essential to have MHL for every country.

Different perspectives of clinicians and patients with severe mental illness on motivation for treatment

NARCIS (Netherlands)

Jochems, E.C.; van Dam, A.; Duivenvoorden, H.J.; Scheffer, S.C.M.; van der Feltz-Cornelis, C.M.; Mulder, N.L.

2016-01-01

The present study assessed motivation for engaging in treatment as rated by clinicians (n = 57) and patients with severe mental illness (SMI, n = 294) using measures based on three different motivation theories. Questionnaires were derived from self-determination theory, the transtheoretical model

Child Health Disparities: What Can a Clinician Do?

Science.gov (United States)

Cheng, Tina L; Emmanuel, Mickey A; Levy, Daniel J; Jenkins, Renee R

2015-11-01

Pediatric primary and specialty practice has changed, with more to do, more regulation, and more family needs than in the past. Similarly, the needs of patients have changed, with more demographic diversity, family stress, and continued health disparities by race, ethnicity, and socioeconomic status. How can clinicians continue their dedicated service to children and ensure health equity in the face of these changes? This article outlines specific, practical, actionable, and evidence-based activities to help clinicians assess and address health disparities in practice. These tools may also support patient-centered medical home recognition, national and state cultural and linguistic competency standards, and quality benchmarks that are increasingly tied to payment. Clinicians can play a critical role in (1) diagnosing disparities in one's community and practice, (2) innovating new models to address social determinants of health, (3) addressing health literacy of families, (4) ensuring cultural competence and a culture of workplace equity, and (5) advocating for issues that address the root causes of health disparities. Culturally competent care that is sensitive to the needs, health literacy, and health beliefs of families can increase satisfaction, improve quality of care, and increase patient safety. Clinical care approaches to address social determinants of health and interrupting the intergenerational cycle of disadvantage include (1) screening for new health "vital signs" and connecting families to resources, (2) enhancing the comprehensiveness of services, (3) addressing family health in pediatric encounters, and (4) moving care outside the office into the community. Health system investment is required to support clinicians and practice innovation to ensure equity. Copyright © 2015 by the American Academy of Pediatrics.

Teacher Candidate Mental Health and Mental Health Literacy

Science.gov (United States)

Dods, Jennifer

2016-01-01

Providing teacher candidates with a strong foundation in mental health literacy during their teacher education program is crucial in ensuring novice teachers are prepared to support the mental health needs of their students. In addition to responding to students, teacher candidates are typically at an age when mental health disorders are common…

On the role of correctional officers in prison mental health.

Science.gov (United States)

Dvoskin, Joel A; Spiers, Erin M

2004-01-01

This article discusses the role of correctional line staff in treatment of prison inmates with serious mental illness. The authors assert that many roles and duties traditionally attributed to clinicians can and often should be performed not only by mental health professionals, but by line staff such as correctional officers and nurses. Moreover, the optimal climate for effective treatment is one in which mental health professionals and line staff work collaboratively, especially since line staff alone are in contact with inmates 24 hours per day. The specific activities which comprise mental health treatment in prison are described as: 1) counseling and psychotherapy-talking with inmates, 2) consultation-talking about inmates, 3) special housing, activities, and behavioral programs, and 4) medication. Case examples demonstrate how correctional officers, nurses, and other line staff perform each of these activities. Recognition and nurturance of these activities will improve the quality of services and reduce stress on staff and inmates alike. Consultation with line staff, joint training, and use of multi-disciplinary treatment teams are advocated as methods of reaching these goals.

Using Administrative Mental Health Indicators in Heart Failure Outcomes Research: Comparison of Clinical Records and International Classification of Disease Coding.

Science.gov (United States)

Bender, Miriam; Smith, Tyler C

2016-01-01

Use of mental indication in health outcomes research is of growing interest to researchers. This study, as part of a larger research program, quantified agreement between administrative International Classification of Disease (ICD-9) coding for, and "gold standard" clinician documentation of, mental health issues (MHIs) in hospitalized heart failure (HF) patients to determine the validity of mental health administrative data for use in HF outcomes research. A 13% random sample (n = 504) was selected from all unique patients (n = 3,769) hospitalized with a primary HF diagnosis at 4 San Diego County community hospitals during 2009-2012. MHI was defined as ICD-9 discharge diagnostic coding 290-319. Records were audited for clinician documentation of MHI. A total of 43% (n = 216) had mental health clinician documentation; 33% (n = 164) had ICD-9 coding for MHI. ICD-9 code bundle 290-319 had 0.70 sensitivity, 0.97 specificity, and kappa 0.69 (95% confidence interval 0.61-0.79). More specific ICD-9 MHI code bundles had kappas ranging from 0.44 to 0.82 and sensitivities ranging from 42% to 82%. Agreement between ICD-9 coding and clinician documentation for a broadly defined MHI is substantial, and can validly "rule in" MHI for hospitalized patients with heart failure. More specific MHI code bundles had fair to almost perfect agreement, with a wide range of sensitivities for identifying patients with an MHI. Copyright © 2016 Elsevier Inc. All rights reserved.

Enabling professional development in mental health nursing: the role of clinical leadership.

Science.gov (United States)

Ennis, G; Happell, B; Reid-Searl, K

2015-10-01

Clinical leadership is acknowledged as important to the nursing profession. While studies continue to identify its significance in contributing to positive outcomes for consumers, the role that clinical leadership has in enabling and supporting professional development in mental health nursing is poorly understood. This study utilized a grounded theory methodology to explore the characteristics clinicians consider important for clinical leadership and its significance for mental health nursing in day-to-day clinical practice. Individual face-to-face, semi-structured interviews were conducted with nurses working in mental health settings. Participants described the important role that clinical leaders play in enabling professional development of others through role modelling and clinical teaching. They describe how nurses, whom they perceive as clinical leaders, use role modelling and clinical teaching to influence the professional development of nursing staff and undergraduate nursing students. Attributes such as professionalism and honesty were seen, by participants, as enablers for clinical leaders in effectively and positively supporting the professional development of junior staff and undergraduate nurses in mental health nursing. This paper examines clinical leadership from the perspective of mental health nurses delivering care, and highlights the important role of clinical leaders in supporting professional development in mental health nursing. © 2015 John Wiley & Sons Ltd.

Does Integrated Behavioral Health Care Reduce Mental Health Disparities for Latinos? Initial Findings

Science.gov (United States)

Bridges, Ana J.; Andrews, Arthur R.; Villalobos, Bianca T.; Pastrana, Freddie A.; Cavell, Timothy A.; Gomez, Debbie

2014-01-01

Integrated behavioral health care (IBHC) is a model of mental health care service delivery that seeks to reduce stigma and service utilization barriers by embedding mental health professionals into the primary care team. This study explored whether IBHC service referrals, utilization, and outcomes were comparable for Latinos and non-Latino White primary care patients. Data for the current study were collected from 793 consecutive patients (63.8% Latino; M age = 29.02 years [SD = 17.96]; 35.1% under 18 years; 65.3% women; 54.3% uninsured) seen for behavioral health services in 2 primary care clinics during a 10.5 month period. The most common presenting concerns were depression (21.6%), anxiety (18.5%), adjustment disorder (13.0%), and externalizing behavior problems (9.8%). Results revealed that while Latino patients had significantly lower self-reported psychiatric distress, significantly higher clinician-assigned global assessment of functioning scores, and fewer received a psychiatric diagnosis at their initial visit compared to non-Latino White patients, both groups had comparable utilization rates, comparable and clinically significant improvements in symptoms (Cohen’s d values > .50), and expressed high satisfaction with integrated behavioral services. These data provide preliminary evidence suggesting integration of behavioral health services into primary care clinics may help reduce mental health disparities for Latinos. PMID:25309845

Latino Mental Health

Science.gov (United States)

... How Do Mental Health Conditions Affect the Latino Community? Common mental health disorders among Latinos are generalized anxiety disorder , major ... quality care. Lack of Information and Misunderstanding about Mental Health Overall, the Latino community does not talk about mental health issues. There ...

The attitudes of undergraduate nursing students towards mental health nursing: a systematic review.

Science.gov (United States)

Happell, Brenda; Gaskin, Cadeyrn J

2013-01-01

To present the findings of a systematic review on (1) the attitudes of undergraduate nursing students towards mental health nursing and (2) the influence of undergraduate nursing education on the attitudes of undergraduate nursing students towards mental health nursing. Recruitment and retention of mental health nurses is challenging. Undergraduate nursing students' attitudes towards mental health nursing may influence whether they choose to practice in this specialty upon graduation. A systematic review. Searches of the CINAHL, MEDLINE and PsycINFO electronic databases returned 1400 records, of which 17 met the inclusion criteria for this review. A further four papers were obtained through scanning the reference lists of those articles included from the initial literature search. Research on the attitudes of undergraduate nursing students towards mental health nursing has consistently shown that mental health is one of the least preferred areas of nursing for a potential career. With respect to the influence of undergraduate nursing education on the attitudes of students towards mental health nursing, quasi-experimental studies have generally demonstrated that students tended to have more favourable attitudes towards mental health nursing when they had received more hours of theoretical preparation and undertaken longer clinical placements. Many nursing students regard mental health nursing as the least preferred career option. Education, via classroom teaching and clinical placements, seems to engender more positive attitudes towards mental health nursing. There is no evidence, however, that changing student attitudes results in more graduates beginning careers in mental health nursing. REFERENCE TO CLINICAL PRACTICE: The constancy of negative attitudes to mental health nursing over time suggests the focus of research should shift. Clinicians have the capacity to promote a more positive view of mental health nursing. This requires further exploration. © 2012

Long-term effects of military service on mental health among veterans of the Vietnam War era.

Science.gov (United States)

Brooks, Matthew S; Laditka, Sarah B; Laditka, James N

2008-06-01

Comparing outcomes of veterans who served in Vietnam and those who served elsewhere, we examined treatment of post-traumatic stress disorder, treatment of other mental health conditions, psychiatric treatment location, and six mental health well-being measures. The analytic sample consisted of nationally representative data from the 2001 National Survey of Veterans. Analyses included multivariate logistic regression that controlled for sociodemographic characteristics. Of Vietnam War-era veterans in the National Survey of Veterans (N = 7,914), 3,937 served in Vietnam and 3,977 served elsewhere. These veterans were stratified into or = 60 years of age (N = 1,766). Veterans who served in Vietnam had notably poorer mental health than did those who served elsewhere. There were striking mental health differences between younger and older veterans; younger veterans had substantially worse measures of mental health. These results suggest greater resource needs among younger Vietnam War veterans. Clinicians and the Department of Veterans Affairs should focus on mental health services for younger veterans.

Burnout and compassion fatigue: prevalence and associations among Israeli burn clinicians.

Science.gov (United States)

Haik, Josef; Brown, Stav; Liran, Alon; Visentin, Denis; Sokolov, Amit; Zilinsky, Isaac; Kornhaber, Rachel

2017-01-01

Acute health care environments can be stressful settings with clinicians experiencing deleterious effects of burnout and compassion fatigue affecting their mental health. Subsequently, the quality of patient care and outcomes may be threatened if clinicians experience burnout or compassion fatigue. Therefore, the aim of this descriptive, cross-sectional study was to evaluate the prevalence of burnout and compassion fatigue among burn clinicians in Israel. Fifty-five clinicians from Burns, Plastics and Reconstruction Surgery and Intensive Care completed four validated surveys to assess burnout (Maslach Burnout Inventory), depression (PRIME-MD), health-related quality of life (SF-8), and compassion fatigue (Professional Quality of Life version 5). Burn clinicians were compared with Plastics and Reconstruction Surgery and Intensive Care clinicians. This study identified a high prevalence of burnout (38.2%) among Intensive Care, Plastics and Reconstruction and Burns clinicians, with Burns clinicians having a greatly increased prevalence of burnout compared to Intensive Care clinicians (OR =24.3, P =0.017). Additional factors contributing to compassion fatigue were those without children ( P =0.016), divorced ( P =0.035), of a younger age ( P =0.019), and a registered nurse ( P =0.05). Burnout increased clinicians' risk of adverse professional and personal outcomes and correlated with less free time ( P work-home disputes ( P =0.05), increased depression ( P =0.001) and decreased career satisfaction ( P =0.01). Burnout was also associated with higher physical (mean difference =3.8, P <0.001) and lower mental (mean difference =-3.5, P <0.001) Quality of Life scores. Caring for burn survivors can lead to burnout, compassion fatigue, and vicarious trauma. Identifying strategies to abate these issues is essential to ensure improved clinicial environments and patient outcomes.

Improving Care for Co-Occurring Psychological Health and Substance Use Disorders: An Implementation Evaluation of the Co-Occurring Disorders Clinician Training Program

Science.gov (United States)

2015-01-01

Occurring Disorders and Antisocial Personality Disorder ,” The Journal of Nervous and Mental Disease, Vol. 197, No. 11, 2009, pp. 822–828. Glasner...clinicians respond to the needs of persons who have both substance abuse and psychological health disorders . To assess the effectiveness of this training...combining interventions intended to address substance use and mental disorders in order to treat both disorders , related problems, and the whole person

Child Health Disparities: What Can a Clinician Do?

OpenAIRE

Cheng, Tina L.; Emmanuel, Mickey; Levy, Daniel J.; Jenkins, Renee R.

2015-01-01

Pediatric primary and specialty practice has changed with more to do, more regulation and more family needs. Similarly, the needs of patients have changed with more demographic diversity, family stress and continued health disparities by race, ethnicity and socioeconomic status. How can clinicians continue their dedicated service to children and ensure health equity in the face of these changes? This paper outlines specific, practical, actionable and evidence-based activities for clinicians t...

Effects of electronic emergency-department whiteboards on clinicians' time distribution and mental workload

DEFF Research Database (Denmark)

Hertzum, Morten; Simonsen, Jesper

2016-01-01

Whiteboards are a central tool at emergency departments. We investigate how the substitution of electronic for dry-erase whiteboards affects emergency department clinicians’ mental workload and distribution of their time. With the electronic whiteboard, physicians and nurses spend more...... of their time in the work areas where other clinicians are present and whiteboard information is permanently displayed, and less in the patient rooms. Main reasons for these changes appear to be that the electronic whiteboard facilitates better timeouts and handovers. Physicians and nurses are, however......, in the patient rooms for longer periods at a time, suggesting a more focused patient contact. The physicians’ mental workload has increased during timeouts, whereas the nurses’ mental workload has decreased at the start of shifts when they form an overview of the emergency department. Finally, the secretaries...

Crisis averted: How consumers experienced a police and clinical early response (PACER) unit responding to a mental health crisis.

Science.gov (United States)

Evangelista, Eloisa; Lee, Stuart; Gallagher, Angela; Peterson, Violeta; James, Jo; Warren, Narelle; Henderson, Kathryn; Keppich-Arnold, Sandra; Cornelius, Luke; Deveny, Elizabeth

2016-08-01

When mental health crisis situations in the community are poorly handled, it can result in physical and emotional injuries. The purpose of this study was to ascertain the experiences and opinions of consumers about the way police and mental health services worked together, specifically via the Alfred Police and Clinical Early Response (A-PACER) model, to assist people experiencing a mental health crisis. Semi-structured in-depth interviews were conducted with 12 mental health consumers who had direct contact with the A-PACER team between June 2013 and March 2015. The study highlighted that people who encountered the A-PACER team generally valued and saw the benefit of a joint police-mental health clinician team response to a mental health crisis situation in the community. In understanding what worked well in how the A-PACER team operated, consumers perspectives can be summarized into five themes: communication and de-escalation, persistence of the A-PACER team, providing a quick response and working well under pressure, handover of information, and A-PACER helped consumers achieve a preferred outcome. All consumers acknowledged the complementary roles of the police officer and mental health clinician, and described the A-PACER team's supportive approach as critical in gaining their trust, engagement and in de-escalating the crises. Further education and training for police officers on how to respond to people with a mental illness, increased provision of follow-up support to promote rehabilitation and prevent future crises, and measures to reduce public scrutiny for the consumer when police responded, were proposed opportunities for improvement. © 2016 Australian College of Mental Health Nurses Inc.

Transformation of children's mental health services: the role of school mental health.

Science.gov (United States)

Stephan, Sharon Hoover; Weist, Mark; Kataoka, Sheryl; Adelsheim, Steven; Mills, Carrie

2007-10-01

The New Freedom Commission has called for a transformation in the delivery of mental health services in this country. The commission's report and recommendations have highlighted the role of school mental health services in transforming mental health care for children and adolescents. This article examines the intersection of school mental health programs and the commission's recommendations in order to highlight the role of school mental health in the transformation of the child and adolescent mental health system. Schools are uniquely positioned to play a central role in improving access to child mental health services and in supporting mental health and wellness as well as academic functioning of youths. The New Freedom Commission report articulated several goals related to school mental health: reducing stigma, preventing suicide, improving screening and treating co-occurring disorders, and expanding school mental health programs. The authors suggest strategies for change, including demonstrating relevance to schools, developing consensus among stakeholders, enhancing community mental health-school connections, building quality assessment and improvement, and considering the organizational context of schools.

Mental Health: Keeping Your Emotional Health

Science.gov (United States)

... Basics Sports Safety Injury Rehabilitation Emotional Well-Being Mental Health Sex and Birth Control Sex and Sexuality Birth ... PPD) Home Prevention and Wellness Emotional Well-Being Mental Health Mental Health: Keeping Your Emotional Health Mental Health: ...

Physiotherapy Students' Attitudes toward Psychiatry and Mental Health: A Cross-Sectional Study.

Science.gov (United States)

Connaughton, Joanne; Gibson, William

Purpose: A cross-sectional exploration of Notre Dame Australia physiotherapy students' attitudes toward psychiatry and mental illness, students' perceptions regarding preparation in this area for general clinical practice, and a cross-sectional investigation of current mental health-and psychiatry-related content in physiotherapy curricula across Australia and New Zealand. Methods: A questionnaire including demographic details, level of exposure to mental illness, and the Attitudes Toward Psychiatry-30 items (ATP-30) was completed by pre-clinical and clinically experienced physiotherapy students from the University of Notre Dame Australia. Students with clinical experience were asked additional questions about preparedness for practice. Staff of 10 of 17 physiotherapy programmes across Australia and New Zealand responded to an online questionnaire investigating relevant content and quantity of learning experiences in mental health. Results: Student response rate was 89%. Students generally had a positive attitude about psychiatry and mental health. Women were significantly more positive than men, and students who had completed clinical experience had a significantly more positive attitude. Physiotherapy program responses (response rate=59%) highlighted disparate approaches to psychiatry and mental health learning opportunities in terms of quantity and content. Conclusion: Entry-level physiotherapy students who have clinical experience generally have a more positive attitude toward psychiatry and people with mental illness. Given the prevalence of mental health problems and the increase in physical and mental health comorbidities, it is imperative that future clinicians have positive educational experiences in psychiatry. A coherent, integrated approach to mental illness and psychiatry is suggested for entry-level physiotherapy programmes in Australia and New Zealand.

Barriers and strategies for improving communication between inpatient and outpatient mental health clinicians.

Science.gov (United States)

Stockdale, Susan E; Sherin, Jonathan E; Chan, Jeffrey A; Hermann, Richard C

2011-11-01

To explore hospital leaders' perceptions of organisational factors as barriers and/or facilitators in improving inpatient-outpatient (IP-OP) communication. Semistructured in-person interviews. Constant comparative method of qualitative data. Inpatient psychiatry units in 33 general medical/surgical and specialty psychiatric hospitals in California and Massachusetts (USA). Psychiatry chair/chief, service director or medical director. Importance to leadership, resources, organisational structure and culture. A majority of hospital leaders rated the IP-OP communication objective as highly or moderately important. Hospitals with good IP-OP communication had structures in place to support communication or had changed/implemented new procedures to enhance communication, and anticipated clinicians would 'buy in' to the goal of improved communication. Hospitals reporting no improvement efforts were less likely to have structures supporting IP-OP communication, anticipated resistance among clinicians and reported a need for technological resources such as electronic health records, integrated IT and secure online communication. Most leaders reported a need for additional staff time and information, knowledge or data. For many hospitals, successfully improving communication will require overcoming organisational barriers such as cultures not conducive to change and lack of resources and infrastructure. Creating a culture that values communication at discharge may help improve outcomes following hospitalisation, but changes in healthcare delivery in the past few decades may necessitate new strategies or changes at the systems level to address barriers to effective communication.

Family support programs and adolescent mental health: review of evidence

Directory of Open Access Journals (Sweden)

Kuhn ES

2014-07-01

Full Text Available Emily S Kuhn, Robert D Laird Department of Psychology, University of New Orleans, New Orleans, LA, USA Abstract: Family support programs aim to improve parent wellbeing and parenting as well as adolescent mental and behavioral health by addressing the needs of parents of adolescents experiencing or at risk for mental health problems. Family support programs can be part of the treatment for adolescents diagnosed with mental or behavioral health problems, or family support programs can be delivered as prevention programs designed to prevent the onset or escalation of mental or behavioral health problems. This review discusses the rationale for family support programs and describes the range of services provided by family support programs. The primary focus of the review is on evaluating the effectiveness of family support programs as treatments or prevention efforts delivered by clinicians or peers. Two main themes emerged from the review. First, family support programs that included more forms of support evidenced higher levels of effectiveness than family support programs that provided fewer forms of support. Discussion of this theme focuses on individual differences in client needs and program adaptions that may facilitate meeting diverse needs. Second, family support prevention programs appear to be most effective when serving individuals more in need of mental and behavioral health services. Discussion of this theme focuses on the intensity versus breadth of the services provided in prevention programs. More rigorous evaluations of family support programs are needed, especially for peer-delivered family support treatments. Keywords: intervention, parent, mental and behavioral health

Improving the quality of perinatal mental health: a health visitor-led protocol.

Science.gov (United States)

Lewis, Anne; Ilot, Irene; Lekka, Chrysanthi; Oluboyede, Yemi

2011-02-01

The mental health of mothers is of significant concern to community practitioners. This paper reports on a case study exploring the success factors of a well established, health visitor-led protocol to identify and treat women with mild to moderate depression. Data were collected through interviews with a purposive sample of 12 community practitioners, a focus group of four health visitors and observation of a multidisciplinary steering group meeting. The protocol was described as an evidence-based tool and safety net that could be used flexibly to support clinical judgments and tailored to individual needs. Success factors included frontline clinician engagement and ownership, continuity of leadership to drive development and maintain momentum, comprehensive and on-going staff training, and strategic support for the protocol as a quality indicator at a time of organisational change. Quality and clinical leadership are continuing policy priorities. The protocol enabled frontline staff to lead a service innovation, providing a standardised multiprofessional approach to women's mental health needs through effective support, advice and treatment that can be measured and quality assured.

Reclaiming the best of the biopsychosocial model of mental health care and 'recovery' for older people through a 'person-centred' approach.

Science.gov (United States)

McKay, Roderick; McDonald, Regina; Lie, David; McGowan, Helen

2012-12-01

The 'biopsychosocial', 'person-centred care' (PCC) and 'recovery' models of care can be seen as distinct and competing paradigms. This paper proposes an integration of these valuable perspectives and suggestions for effective implementation in health services for the elderly. An overview of PCC and recovery models, and their application for older people with mental health problems, is provided. Their overlap and contrast with the familiar 'biopsychosocial' model of mental health care is considered, together with obstacles to implementation. Utilisation of PCC and recovery concepts allow clinicians to avoid narrow application of the biopsychosocial approach and encourages clinicians to focus on the person's right to autonomy, their values and life goals. Service reform and development is required to embed these concepts into core clinical processes so as to improve outcomes and the quality of life for older people with mental health problems.

Tensions of difference: reconciling organisational imperatives for risk management with consumer-focused care from the perspectives of clinicians and managers.

Science.gov (United States)

Clancy, Leonie; Happell, Brenda

2014-11-01

To understand the impact of risk management and assessment on the delivery of mental health care from the perspectives of managers and clinicians. The concept of risk is now embedded in contemporary mental health services. A focus on risk has been identified as a barrier to the provision of consumer-focused care; however, there is a paucity of research in this area, particularly being drawn from key stakeholders in the field. Qualitative exploratory methods. In-depth interviews were conducted with managers and clinicians from a large metropolitan aged-care mental health service in Australia. The participants represented a range of disciplines and expertise across practice settings (community, inpatient and residential). The theme tensions of difference emerged from this research. This theme referred to the tensions between accountability and attending to risk issues and consumer-centred care, with concerns being raised that procedural and bureaucratic accountability influence (often negatively) the provision of care. Differences in the perspectives of clinicians and managers were also evident in the perceived contribution of evidence-based practice in relation to risk. Prioritising risk management may be interfering with the capacity of clinicians and managers to provide quality and consumer-focused mental health care. A deeper examination and reconceptualisation of the role and importance of risk in mental health care are needed to ensure the focus of service delivery remains consumer-focused.

The art and science of using routine outcome measurement in mental health benchmarking.

Science.gov (United States)

McKay, Roderick; Coombs, Tim; Duerden, David

2014-02-01

To report and critique the application of routine outcome measurement data when benchmarking Australian mental health services. The experience of the authors as participants and facilitators of benchmarking activities is augmented by a review of the literature regarding mental health benchmarking in Australia. Although the published literature is limited, in practice, routine outcome measures, in particular the Health of the National Outcomes Scales (HoNOS) family of measures, are used in a variety of benchmarking activities. Use in exploring similarities and differences in consumers between services and the outcomes of care are illustrated. This requires the rigour of science in data management and interpretation, supplemented by the art that comes from clinical experience, a desire to reflect on clinical practice and the flexibility to use incomplete data to explore clinical practice. Routine outcome measurement data can be used in a variety of ways to support mental health benchmarking. With the increasing sophistication of information development in mental health, the opportunity to become involved in benchmarking will continue to increase. The techniques used during benchmarking and the insights gathered may prove useful to support reflection on practice by psychiatrists and other senior mental health clinicians.

What Is Mental Health?

Science.gov (United States)

... Myths and Facts Recovery Is Possible What Is Mental Health? Mental health includes our emotional, psychological, and social ... mental health problems and where to find help . Mental Health and Wellness Positive mental health allows people to: ...

Peer support relationships: an unexplored interpersonal process in mental health.

Science.gov (United States)

Coatsworth-Puspoky, R; Forchuk, C; Ward-Griffin, C

2006-10-01

Consumer-survivors (C/Ss) identify peer support as a resource that facilitates their recovery. However, little is known about the factors that influence or how the peer support relationship (PSR) develops/deteriorates. The purpose of the study was to explore and describe the PSR within the subculture of mental health. Using an ethnonursing method, the study focused on informants from two C/S organizations who received peer support (n = 14). Findings revealed that the PSRs may develop or deteriorate through three, overlapping phases. Contextual factors that influenced the development/deterioration of the PSR are discussed. Understanding the processes and factors that contribute to the development/deterioration of PSRs will enable clinicians and C/Ss to assess and promote the development of healthy, supportive PSRs in mental health.

Assessment, authorization and access to medicaid managed mental health care.

Science.gov (United States)

Masland, Mary C; Snowden, Lonnie R; Wallace, Neal T

2007-11-01

Examined were effects on access of managed care assessment and authorization processes in California's 57 county mental health plans. Primary data on managed care implementation were collected from surveys of county plan administrators; secondary data were from Medicaid claims and enrollment files. Using multivariate fixed effects regression, we found that following implementation of managed care, greater access occurred in county plans where assessments and treatment were performed by the same clinician, and where service authorizations were made more rapidly. Lower access occurred in county plans where treating clinicians authorized services themselves. Results confirm the significant effects of managed care processes on outcomes and highlight the importance of system capacity.

Forming a joint dialogue among faith healers, traditional healers and formal health workers in mental health in a Kenyan setting: towards common grounds.

Science.gov (United States)

Musyimi, Christine W; Mutiso, Victoria N; Nandoya, Erick S; Ndetei, David M

2016-01-07

Qualitative evidence on dialogue formation and collaboration is very scanty in Kenya. This study thus aimed at the formation of dialogue and establishment of collaboration among the informal (faith and traditional healers) and formal health workers (clinicians) in enhancing community-based mental health in rural Kenya. Qualitative approach was used to identify barriers and solutions for dialogue formation by conducting nine Focus Group Discussions each consisting of 8-10 participants. Information on age, gender and role in health care setting as well as practitioners' (henceforth used to mean informal (faith and traditional healers) and formal health workers) perceptions on dialogue was collected to evaluate dialogue formation. Qualitative and quantitative data analysis was performed using thematic content analysis and Statistical Package Social Sciences (SPSS) software respectively. We identified four dominant themes such as; (i) basic understanding about mental illnesses, (ii) interaction and treatment skills of the respondents to mentally ill persons, (iii) referral gaps and mistrust among the practitioners and (iv) dialogue formation among the practitioners. Although participants were conversant with the definition of mental illness and had interacted with a mentally ill person in their routine practice, they had basic information on the causes and types of mental illness. Traditional and faith healers felt demeaned by the clinicians who disregarded their mode of treatment stereotyping them as "dirty". After various discussions, majority of practitioners showed interest in collaborating with each other and stated that they had joined the dialogue in order interact with people committed to improving the lives of patients. Dialogue formation between the formal and the informal health workers is crucial in establishing trust and respect between both practitioners and in improving mental health care in Kenya. This approach could be scaled up among all the

Parental mental health, childhood psychiatric disorders, and asthma attacks in island Puerto Rican youth.

Science.gov (United States)

Ortega, Alexander N; Goodwin, Renee D; McQuaid, Elizabeth L; Canino, Glorisa

2004-01-01

Previous research documents an association of poor parental mental health with asthma in children. This study aims to determine whether the associations between parental mental health problems and childhood asthma attacks persist after controlling for childhood anxiety and depression and other confounding factors. A community household sample of youth ages 4 to 17 years and their primary caregivers from the US Commonwealth of Puerto Rico was studied to determine the associations between parental mental health and childhood asthma attacks. Regression models that predicted asthma attacks in youth controlled for parental mental health problems, childhood anxiety and depression, zone of residence, and parents' age, education, and perception of poverty. After adjusting for children's depressive and anxiety disorders as well as other important confounders, associations between parental depression, suicide attempts, ataque de nervios, and history of mental health treatment and asthma attacks in offspring, by parental report, persisted. Additionally, the frequency of parental mental health problems was associated with children's asthma attacks. Parents with mental health problems were more likely to report histories of asthma attacks in their children compared with parents without mental health problems in Puerto Rico. These associations were not attributable to internalizing disorders in youth but persisted independent of childhood psychopathology and other confounding factors. Clinicians and researchers should recognize the relations between poor parental mental health and childhood asthma and explore the potential role of family psychosocial and behavioral factors related to the manifestation of the disease.

Mental Health Services in Special Education: An Analysis of Quality of Care

Science.gov (United States)

Santiago, Catherine DeCarlo; Kataoka, Sheryl H.; Forness, Steven R.; Miranda, Jeanne

2014-01-01

This article presents a collaborative study conducted in a large urban school district, in which the authors surveyed 55 clinicians within the special education system, with a focus on the mental health services provided to students who were receiving related-services counseling as a mandated component of their individualized education plan.…

MENTAL HEALTH: ISLAMIC PERSPECTIVE

OpenAIRE

Muzdalifah M. Rahman

2015-01-01

The purpose of this paper was to explain the concept of mental health perspective Contemporary Psychology, describes the mental health of an Islamic perspective and describes how mental health recovery. The theory used is the concept of mental health perspective Contemporary Psychology, and the concept of mental health perspective Islamic Psychology Writing is writing method using qualitative research methods. Mental health is avoiding an Islamic perspective of all symptoms, complaints and...

Differential stigmatizing attitudes of healthcare professionals towards psychiatry and patients with mental health problems : Something to worry about? A pilot study

NARCIS (Netherlands)

Gras, L.M.; Swart, M.; Slooff, C.; van Weeghel, J.; Knegtering, H.; Castelein, S.

2015-01-01

Purpose This study compares stigmatizing attitudes of different healthcare professionals towards psychiatry and patients with mental health problems. Methods The Mental Illness Clinicians Attitude (MICA) questionnaire is used to assess stigmatizing attitudes in three groups: general practitioners

Clinicians and journalists responding to disasters.

Science.gov (United States)

Newman, Elana; Shapiro, Bruce

2014-02-01

Mass casualty events pose dilemmas for community clinicians, often challenging their existing clinical toolkits. However, few clinicians were trained to be experts in explaining the unfolding events to the community, creating resources, and interacting with journalists. The objective of this article is to explain knowledge, skills, and attitudes that mental health professionals need to consider when working with journalists, especially those covering children affected by disaster. In service of these objectives, this article reviews controversies, evidence, and best practices to facilitate effective collaborations and consultations with journalists. Advice includes information on how to be a good source to journalists. Clinicians can ethically and effectively help journalists tell accurate and compelling stories about the psychological effects of disasters when they understand and respect the aims, culture, and ethics of journalism.

Construct Validity of the SF-12v2 for the Homeless Population with Mental Illness: An Instrument to Measure Self-Reported Mental and Physical Health.

Science.gov (United States)

Chum, Antony; Skosireva, Anna; Tobon, Juliana; Hwang, Stephen

2016-01-01

Self-reported health measures are important indicators used by clinicians and researchers for the evaluation of health interventions, outcome assessment of clinical studies, and identification of health needs to improve resource allocation. However, the application of self-reported health measures relies on developing reliable and valid instruments that are suitable across diverse populations. The main objective of this study is to evaluate the construct validity of the SF-12v.2, an instrument for measuring self-rated physical and mental health, for homeless adults with mental illness. Various interventions have been aimed at improving the health of homeless people with mental illness, and the development of valid instruments to evaluate these interventions is imperative. We measured self-rated mental and physical health from a quota sample of 575 homeless people with mental illness using the SF-12v2, EQ-5D, Colorado Symptoms Index, and physical/mental health visual analogue scales. We examined the construct validity of the SF-12v2 through confirmatory factor analyses (CFA), and using ANOVA/correlation analyses to compare the SF-12v2 to the other instruments to ascertain discriminant/convergent validity. Our CFA showed that the measurement properties of the original SF-12v2 model had a mediocre fit with our empirical data (χ2 = 193.6, df = 43, p physical and mental health status for a homeless population with mental illness.

Differential stigmatizing attitudes of healthcare professionals towards psychiatry and patients with mental health problems : something to worry about? A pilot study

NARCIS (Netherlands)

Gras, Laura M.; Swart, Marte; Slooff, Cees J.; van Weeghel, Jaap; Knegtering, Henderikus; Castelein, Stynke

This study compares stigmatizing attitudes of different healthcare professionals towards psychiatry and patients with mental health problems. The Mental Illness Clinicians Attitude (MICA) questionnaire is used to assess stigmatizing attitudes in three groups: general practitioners (GPs, n = 55),

Integrating mental health into primary care for displaced populations: the experience of Mindanao, Philippines

Directory of Open Access Journals (Sweden)

Gil Tatiana

2011-03-01

Full Text Available Abstract Background For more than forty years, episodes of violence in the Mindanao conflict have recurrently led to civilian displacement. In 2008, Medecins Sans Frontieres set up a mental health program integrated into primary health care in Mindanao Region. In this article, we describe a model of mental health care and the characteristics and outcomes of patients attending mental health services. Methods Psychologists working in mobile clinics assessed patients referred by trained clinicians located at primary level. They provided psychological first aid, brief psychotherapy and referral for severe patients. Patient characteristics and outcomes in terms of Self-Reporting Questionnaire (SRQ20 and Global Assessment of Functioning score (GAF are described. Results Among the 463 adult patients diagnosed with a common mental disorder with at least two visits, median SRQ20 score diminished from 7 to 3 (p Conclusions Brief psychotherapy sessions provided at primary level during emergencies can potentially improve patients' symptoms of distress.

Relationship of Evidence-Based Practice and Treatments: A Survey of Community Mental Health Providers

Science.gov (United States)

DiMeo, Michelle A.; Moore, G. Kurt; Lichtenstein, Carolyn

2012-01-01

Evidence-based treatments (EBTs) are "interventions" that have been proven effective through rigorous research methodologies. Evidence-based practice (EBP), however, refers to a "decision-making process" that integrates the best available research, clinician expertise, and client characteristics. This study examined community mental health service…

Validity of assessing people experiencing mental illness who have offended using the Camberwell Assessment of Need-Forensic and Health of the Nation Outcome Scales-Secure.

Science.gov (United States)

Abou-Sinna, Rana; Luebbers, Stefan

2012-10-01

Evidence-based practices for forensic mental health services have been slow to develop, and there is a lack of measures that assess the mental health and criminogenic needs of people experiencing mental illness who have offended. The present study aimed to investigate the interrelationship between a clinician-rated forensic mental health needs assessment (Health of the Nation Outcomes Scales-Secure (HoNOS-S)), a forensic mental health needs assessment that considers both clinician and patient perspectives (Camberwell Assessment of Need-Forensic (CANFOR)), and measures of general and violent recidivism (Level Service-Case Management Inventory (LS-CMI) and HCR-20 Violence Risk Assessment Scheme (HCR-20)). Needs were assessed for 72 forensic patients aged between 20 and 62 years of age, located in a secure forensic mental health facility. The findings revealed significant positive correlations between the HoNOS-S, CANFOR, and HCR-20. Only the CANFOR was positively correlated with the LS-CMI, and uniquely contributed variance to the HCR-20. Patients and nurses differed in the total number of needs and met needs they identified as present. The findings suggest that the collaborative approach of the CANFOR might be more appropriate for measuring outcomes in the treatment of individuals experiencing mental illness who have offended. © 2012 The Authors. International Journal of Mental Health Nursing © 2012 Australian College of Mental Health Nurses Inc.

Rel8: demonstrating the feasibility of delivering an 8-week social skills program in a public mental health setting.

Science.gov (United States)

Wauchope, Bronwyn; Terlich, Alissa; Lee, Stuart

2016-06-01

As community mental health services integrate recovery-oriented practices, treatments that focus on skills development and social integration are desirable. This study aimed to examine the feasibility of implementing "Rel8", an 8-week social skills training group adapted to suit a public community mental health setting. A retrospective audit was conducted of quantitative and qualitative data from four groups run between 2011 and 2013. Pre- and post-group measures were collected, assessing self-rated friendships and confidence with social skills and clinician-rated social skill performance. Qualitative feedback about group participation was also collected through use of a developed questionnaire. Analysis revealed significant improvements in participants' confidence with their social skills following group participation, with a trend also found for improved social skill performance. "Rel8", an adapted 8-week social skills training group, is a feasible program in the context of community mental health services. The program added to the recovery-centred practice of the community mental health service while also adding to the diversity of clinician skills for psychosocial-oriented practice. © The Royal Australian and New Zealand College of Psychiatrists 2015.

Undergraduate mental health nursing education in Australia: More than Mental Health First Aid.

Science.gov (United States)

Happell, Brenda; Wilson, Rhonda; McNamara, Paul

2015-01-01

Mental Health First Aid training is designed to equip people with the skills to help others who may be developing mental health problems or experiencing mental health crises. This training has consistently been shown to increase: (1) the recognition of mental health problems; (2) the extent to which course trainees' beliefs about treatment align with those of mental health professionals; (3) their intentions to help others; and (4) their confidence in their abilities to assist others. This paper presents a discussion of the potential role of Mental Health First Aid training in undergraduate mental health nursing education. Three databases (CINAHL, Medline, and PsycINFO) were searched to identify literature on Mental Health First Aid. Although Mental Health First Aid training has strong benefits, this first responder level of education is insufficient for nurses, from whom people expect to receive professional care. It is recommended that: (1) Mental Health First Aid training be made a prerequisite of preregistration nurse education, (2) registered nurses make a larger contribution to addressing the mental health needs of Australians requiring care, and (3) current registered nurses take responsibility for ensuring that they can provided basic mental health care, including undertaking training to rectify gaps in their knowledge.

Disaster Mental Health and Positive Psychology-Considering the Context of Natural and Technological Disasters: An Introduction to the Special Issue.

Science.gov (United States)

Schulenberg, Stefan E

2016-12-01

This article serves as an introduction to the Journal of Clinical Psychology's special issue on disaster mental health and positive psychology. The special issue comprises two sections. The first section presents a series of data-driven articles and research-informed reviews examining meaning and resilience in the context of natural and technological disasters. The second section presents key topics in the area of disaster mental health, with particular relevance for positive psychology and related frameworks. The special issue is intended to bridge the gap between these two areas of applied science, with the audience being experienced clinicians or clinicians in training. © 2016 Wiley Periodicals, Inc.

Mental Health Mobile Apps: From Infusion to Diffusion in the Mental Health Social System.

Science.gov (United States)

East, Marlene Lynette; Havard, Byron C

2015-01-01

The roles of mental health educators and professionals in the diffusion of mental health mobile apps are addressed in this viewpoint article. Mental health mobile apps are emerging technologies that fit under the broad heading of mobile health (mHealth). mHealth, encompassed within electronic health (eHealth), reflects the use of mobile devices for the practice of public health. Well-designed mental health mobile apps that present content in interactive, engaging, and stimulating ways can promote cognitive learning, personal growth, and mental health enhancement. As key influencers in the mental health social system, counselor educators and professional associations may either help or hinder diffusion of beneficial mHealth technologies. As mental health mobile apps move towards ubiquity, research will continue to be conducted. The studies published thus far, combined with the potential of mental health mobile apps for learning and personal growth, offer enough evidence to compel mental health professionals to infuse these technologies into education and practice. Counselor educators and professional associations must use their influential leadership roles to train students and practitioners in how to research, evaluate, and integrate mental health mobile apps into practice. The objectives of this article are to (1) increase awareness of mHealth and mental health mobile apps, (2) demonstrate the potential for continued growth in mental health mobile apps based on technology use and acceptance theory, mHealth organizational initiatives, and evidence about how humans learn, (3) discuss evidence-based benefits of mental health mobile apps, (4) examine the current state of mHealth diffusion in the mental health profession, and (5) offer solutions for impelling innovation diffusion by infusing mental health mobile apps into education, training, and clinical settings. This discussion has implications for counselor educators, mental health practitioners, associations

The Mental Health of Older LGBT Adults.

Science.gov (United States)

Yarns, Brandon C; Abrams, Janet M; Meeks, Thomas W; Sewell, Daniel D

2016-06-01

There are approximately one million older lesbian, gay, bisexual, and transgender (LGBT) adults in the USA. Their mental health issues result from interactions between genetic factors and stress associated with membership in a sexual minority group. Although advancements in acceptance and equal treatment of LGBT individuals have been occurring, sexual minority status remains associated with risks to physical and mental well-being. Older LGBT adults are more likely to have experienced mistreatment and discrimination due to living a majority of their lives prior to recent advancements in acceptance and equal treatment. All LGBT adults experience one common developmental challenge: deciding if, when, and how to reveal to others their gender identity and/or sexual orientation. LGBT individuals have higher rates of anxiety, depression, and substance use disorders and also are at increased risk for certain medical conditions like obesity, breast cancer, and human immunodeficiency virus (HIV). Improved education and training of clinicians, coupled with clinical research efforts, holds the promise of improved overall health and life quality for older LGBT adults.

Characterisation of mental health conditions in social media using Informed Deep Learning

Science.gov (United States)

Gkotsis, George; Oellrich, Anika; Velupillai, Sumithra; Liakata, Maria; Hubbard, Tim J. P.; Dobson, Richard J. B.; Dutta, Rina

2017-03-01

The number of people affected by mental illness is on the increase and with it the burden on health and social care use, as well as the loss of both productivity and quality-adjusted life-years. Natural language processing of electronic health records is increasingly used to study mental health conditions and risk behaviours on a large scale. However, narrative notes written by clinicians do not capture first-hand the patients’ own experiences, and only record cross-sectional, professional impressions at the point of care. Social media platforms have become a source of ‘in the moment’ daily exchange, with topics including well-being and mental health. In this study, we analysed posts from the social media platform Reddit and developed classifiers to recognise and classify posts related to mental illness according to 11 disorder themes. Using a neural network and deep learning approach, we could automatically recognise mental illness-related posts in our balenced dataset with an accuracy of 91.08% and select the correct theme with a weighted average accuracy of 71.37%. We believe that these results are a first step in developing methods to characterise large amounts of user-generated content that could support content curation and targeted interventions.

Public and Private Responsibility for Mental Health: Mental Health's Fourth Revolution.

Science.gov (United States)

Dokecki, Paul R.

Three revolutions in the history of mental health were identified by Nicholas Hobbs: the humane revolution, the scientific and therapeutic revolution, and the public health revolution. The shift of responsibilities for mental health and substance abuse services from the public to the private sector may constitute a fourth mental health revolution.…

Fostering Recovery from Life-Transforming Mental Health Disorders: A Synthesis and Model.

Science.gov (United States)

Green, Carla A

2004-11-01

In the past, "recovery" from serious mental health problems has been variously defined and generally considered rare. Current evidence suggests that some form of recovery is both possible and common, yet we know little about the processes that differentiate those who recover from those who do not. This paper discusses approaches to defining recovery, proposes a model for fostering, understanding, and studying recovery, and suggests questions for clinicians, researchers, and policy makers. The proposed model is a synthesis of work from the field of mental health as well as from other disciplines. Environment, resources, and strains, provide the backdrop for recovery; core recovery processes include development, learning, healing, and their primary behavioral manifestation, adaptation. Components facilitating recovery include sources of motivation (hope, optimism, and meaning), prerequisites for action (agency, control, and autonomy), and capacity (competence and dysfunction). Attending to these aspects of the recovery process could help shape clinical practice, and systems that provide and finance mental health care, in ways that promote recovery.

Common mental health problems in immigrants and refugees: general approach in primary care

Science.gov (United States)

Kirmayer, Laurence J.; Narasiah, Lavanya; Munoz, Marie; Rashid, Meb; Ryder, Andrew G.; Guzder, Jaswant; Hassan, Ghayda; Rousseau, Cécile; Pottie, Kevin

2011-01-01

appropriate indicators of social, vocational and family functioning over time will allow clinicians to recognize problems in adaptation and undertake mental health promotion, disease prevention or treatment interventions in a timely way. PMID:20603342

Common mental health problems in immigrants and refugees: general approach in primary care.

Science.gov (United States)

Kirmayer, Laurence J; Narasiah, Lavanya; Munoz, Marie; Rashid, Meb; Ryder, Andrew G; Guzder, Jaswant; Hassan, Ghayda; Rousseau, Cécile; Pottie, Kevin

2011-09-06

family functioning over time will allow clinicians to recognize problems in adaptation and undertake mental health promotion, disease prevention or treatment interventions in a timely way.

Mental Health

Science.gov (United States)

Mental health includes our emotional, psychological, and social well-being. It affects how we think, feel and act as ... stress, relate to others, and make choices. Mental health is important at every stage of life, from ...

Evidence-Based Mental Health Practices with Children Self-Efficacy Scale: Development and Preliminary Findings

Science.gov (United States)

McMeel, Lorri S.; Leathers, Sonya J.; Strand, Tonya C.

2017-01-01

This article reviews existing measures related to evidence-based practices with children and self-efficacy and describes the development and psychometric properties of the Evidence-Based Mental Health Practices With Children Efficacy Scale. This scale was developed to assess students' and clinicians' self-efficacy in their abilities to use…

How do patients come to be seen as 'difficult'?: a mixed-methods study in community mental health care

NARCIS (Netherlands)

Koekkoek, B.; Hutschemaekers, G.; van Meijel, B.; Schene, A.

2011-01-01

Across all health care settings, certain patients are perceived as 'difficult' by clinicians. This paper's aim is to understand how certain patients come to be perceived and labelled as 'difficult' patients in community mental health care, through mixed-methods research in The Netherlands between

Observation of influences of mental health promotion and mental intervention on mental health status of professionals

OpenAIRE

Jiang, Shu-Qiang; Zhang, Jian-Ling

2015-01-01

Objective: To observe the influences of mental health promotion and mental intervention on mental health status of professionals. Method: 2878 professionals for physical examination were selected and randomly divided into treatment group and control group, with 1443 professionals and 1435 professionals, respectively. Then, the difference of mental health status before and after mental intervention between two groups was compared. Results: In treatment group, the proportion of people with heal...

Induced abortion and adolescent mental health.

Science.gov (United States)

Stotland, Nada L

2011-10-01

Induced abortion is widely believed - by the public, healthcare professionals, and policy-makers - to lead to adverse mental health sequelae. This belief is false, as it applies both to adult women and adolescents. However, it has been used to rationalize, and been quoted in, restrictive and intrusive legislation in several states and in proposed federal legislation. It is essential for gynecologists to have accurate information, as clinicians, for their patients, and, as key experts, for policy makers. New articles concluding that there are adverse psychological outcomes from induced abortion continue to be published. The methodological flaws in these articles are so serious as to invalidate those conclusions. Several recent scholarly analyses detail these flaws. Methodologically sound studies and reviews continue to demonstrate that psychosocial problems play a role in unwanted conception and the decision to abort unwanted pregnancies but are not the result of abortion. Clinicians may have to reassure patients making decisions about their pregnancies that abortion does not cause psychiatric illness. They can do so on the basis of recent analyses substantiating that finding. (C) 2011 Lippincott Williams & Wilkins, Inc.

School-related and social-emotional outcomes of providing mental health services in schools.

Science.gov (United States)

Ballard, Kristin L; Sander, Mark A; Klimes-Dougan, Bonnie

2014-02-01

This study evaluated student outcomes of an expanded school mental health (ESMH) model that placed community mental health clinicians on-site in schools to identify and treat children with mental health needs. The first aim of this study was to consider school-related outcomes (suspension rates and attendance rates) for those students who received ESMH treatment (n = 159) were compared to a matched high-risk sample that did not receive such services (n = 148). Results demonstrated differences between groups over time on measures of suspensions and attendance but not academic achievement. The second aim of this study was to evaluate change in social-emotional functioning (Strengths and Difficulties Questionnaire Scores) over time for the treatment group. Results indicated significant improvements on several parent and teacher ratings. Despite limitations of the ESMH framework examined in this study, the overall results suggest some promising advantages for students who received ESMH services.

Burnout and compassion fatigue: prevalence and associations among Israeli burn clinicians

Directory of Open Access Journals (Sweden)

Haik J

2017-06-01

Full Text Available Josef Haik,1–3 Stav Brown,1,2 Alon Liran,1 Denis Visentin,4 Amit Sokolov,2 Isaac Zilinsky,1,2 Rachel Kornhaber1,4 1Department of Plastic and Reconstruction Surgery, The National Burns Center, Sheba Medical Center, Tel Hashomer, 2Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, 3Talpiot Medical Leadership Program, Sheba Medical Center, Tel Hashomer, Israel; 4School of Health Sciences, Faculty of Health, University of Tasmania, Sydney, NSW, Australia Abstract: Acute health care environments can be stressful settings with clinicians experiencing deleterious effects of burnout and compassion fatigue affecting their mental health. Subsequently, the quality of patient care and outcomes may be threatened if clinicians experience burnout or compassion fatigue. Therefore, the aim of this descriptive, cross-sectional study was to evaluate the prevalence of burnout and compassion fatigue among burn clinicians in Israel. Fifty-five clinicians from Burns, Plastics and Reconstruction Surgery and Intensive Care completed four validated surveys to assess burnout (Maslach Burnout Inventory, depression (PRIME-MD, health-related quality of life (SF-8, and compassion fatigue (Professional Quality of Life version 5. Burn clinicians were compared with Plastics and Reconstruction Surgery and Intensive Care clinicians. This study identified a high prevalence of burnout (38.2% among Intensive Care, Plastics and Reconstruction and Burns clinicians, with Burns clinicians having a greatly increased prevalence of burnout compared to Intensive Care clinicians (OR =24.3, P=0.017. Additional factors contributing to compassion fatigue were those without children (P=0.016, divorced (P=0.035, of a younger age (P=0.019, and a registered nurse (P=0.05. Burnout increased clinicians’ risk of adverse professional and personal outcomes and correlated with less free time (P<0.001, increased risk of experiencing work-home disputes (P=0.05, increased depression (P=0

How does maternal oxytocin influence children's mental health problem and maternal mental health problem?

Science.gov (United States)

Tse, Wai S; Siu, Angela F Y; Wong, Tracy K Y

2017-12-01

This study aims to explore the interrelationship among maternal oxytocin (OT) responsiveness, maternal mental health, maternal parenting behavior, and mental health of children under a free-play interaction. 61 mother-child dyads were recruited for the study. Maternal mental health problem and parenting self-efficacy were measured using self-reported questionnaires. The mental health problems of children were also evaluated using a mother-reported questionnaire. Furthermore, salivary OT was collected before and after a standardized 10min free-play interaction. Parenting behaviors, including eye gaze and touch, were measured during the free-play interaction. Maternal OT responsiveness was significantly associated with less maternal mental health problem, touch frequency, and mental health problem of children but not with parenting self-efficacy. In the multivariate linear regression analysis that considers maternal OT responsiveness and maternal and children's mental health problems, maternal OT responsiveness was not associated with the mental health problems of children. This result suggested that maternal mental health problem played a mediational role between maternal OT responsiveness and the mental health problem of children. Results supported the assertion that maternal OT responsiveness contributed to the increased risk of maternal mental health problems and, subsequently, the risk of mental health problems of their children. Copyright © 2017 Elsevier B.V. All rights reserved.

Mental health professionals' family-focused practice with families with dependent children: a survey study.

Science.gov (United States)

Tungpunkom, Patraporn; Maybery, Darryl; Reupert, Andrea; Kowalenko, Nick; Foster, Kim

2017-12-08

Many people with a mental illness are parents caring for dependent children. These children are at greater risk of developing their own mental health concerns compared to other children. Mental health services are opportune places for healthcare professionals to identify clients' parenting status and address the needs of their children. There is a knowledge gap regarding Thai mental health professionals' family-focused knowledge and practices when working with parents with mental illness and their children and families. This cross -sectional survey study examined the attitudes, knowledge and practices of a sample (n = 349) of the Thai mental health professional workforce (nurses, social workers, psychologists, psychiatrists) using a translated version of the Family-Focused Mental Health Practice Questionnaire (FFMHPQ). The majority of clinicians reported no training in family (76.8%) or child-focused practice (79.7%). Compared to other professional groups, psychiatric nurses reported lower scores on almost all aspects of family-focused practice except supporting clients in their parenting role within the context of their mental illness. Social workers scored highest overall including having more workplace support for family-focused practice as well as a higher awareness of family-focused policy and procedures than psychiatrists; social workers also scored higher than psychologists on providing support to families and parents. All mental health care professional groups reported a need for training and inter-professional practice when working with families. The findings indicate an important opportunity for the prevention of intergenerational mental illness in whose parents have mental illness by strengthening the professional development of nurses and other health professionals in child and family-focused knowledge and practice.

Uncovering the hidden impacts of inequality on mental health: a global study.

Science.gov (United States)

Yu, Shoukai

2018-05-18

Women are nearly twice as likely as men to suffer from mental illness. This gender disparity in depressive disorders may relate to social inequalities and living standards across nations. Currently, these disparities were not reflected at the level of health policies. This study utilized global data for depressive disorders and socioeconomic data from the United Nations' World Bank databases and Global Burden of Disease database to demonstrate the correlation between social inequality and gender disparities in mental health. This study investigated the association among the ratio of female to male depressive disorder rates, gross domestic product, the GINI Index, and the gender inequality index for 122 countries. The research yielded some major findings. First, there exists a significant correlation between gender inequality and gender disparities in mental health. Second, the GINI index is significantly associated with male-but not female-depressive disorder rates. Third, gender disparities in depressive disorders are associated with a country's wealth. These findings can help to inform society, policy-makers, and clinicians to improve the overall health level globally.

Urgent Need for Improved Mental Health Care and a More Collaborative Model of Care

Science.gov (United States)

Lake, James; Turner, Mason Spain

2017-01-01

Current treatments and the dominant model of mental health care do not adequately address the complex challenges of mental illness, which accounts for roughly one-third of adult disability globally. These circumstances call for radical change in the paradigm and practices of mental health care, including improving standards of clinician training, developing new research methods, and re-envisioning current models of mental health care delivery. Because of its dominant position in the US health care marketplace and its commitment to research and innovation, Kaiser Permanente (KP) is strategically positioned to make important contributions that will shape the future of mental health care nationally and globally. This article reviews challenges facing mental health care and proposes an agenda for developing a collaborative care model in primary care settings that incorporates conventional biomedical therapies and complementary and alternative medicine approaches. By moving beyond treatment delivery via telephone and secure video and providing earlier interventions through primary care clinics, KP is shifting the paradigm of mental health care to a collaborative care model focusing on prevention. Recommendations are to expand current practices to include integrative treatment strategies incorporating evidence-based biomedical and complementary and alternative medicine modalities that can be provided to patients using a collaborative care model. Recommendations also are made for an internal research program aimed at investigating the efficacy and cost-effectiveness of promising complementary and alternative medicine and integrative treatments addressing the complex needs of patients with severe psychiatric disorders, many of whom respond poorly to treatments available in KP mental health clinics. PMID:28898197

Economics and ethics in mental health care: traditions and trade-offs.

Science.gov (United States)

Chisholm, Daniel; Stewart, Alan

1998-07-01

BACKGROUND: Both economic and ethical perspectives are exerting increasing influence at all levels of mental health policy and practice; yet there is little consensus on how these two different perspectives are to be reconciled or explicitly incorporated into decision-making. AIM: This review article is directed towards a fuller understanding of the complex trade-offs and compromises that are or may be made by clinicians, managers and policy-makers alike in the context of mental health care planning and delivery. METHOD: We briefly outline a number of key principles of health care economics and ethics, and then focus on the particular incentives and trade-offs that are raised by these principles at three levels of the mental health system: government and society; purchasers and providers; and users and carers. RESULTS: At the level of government and society, we find (economically influenced) attempts to reform mental health care offset by concerns revolving around access to care: whether society is prepared to forgo economic benefits in exchange for improved equity depends to a considerable extent on the prevailing ethical paradigm. The implementation of these reforms at the level of purchasers and providers has helped to focus attention on evaluation and prioritization, but has also introduced "perverse incentives" such as cost-shifting and cream-skimming, which can impede access to or continuity of appropriate care for mentally ill people. Finally, we detect opportunities for moral hazard and other forms of strategic behaviour that are thrown up by the nature of the carer:user relationship in mental health care. CONCLUSION: We conclude by highlighting the need to move towards a more open, accountable and evidence-based mental health care system. Acknowledgement of and progress towards these three requirements will not deliver ideal levels of efficiency or equity, but will foster a greater understanding of the relevance of ethical considerations to mental health

School Mental Health Resources and Adolescent Mental Health Service Use

Science.gov (United States)

Green, Jennifer Greif; McLaughlin, Katie A.; Alegria, Margarita; Costello, E. Jane; Gruber, Michael J.; Hoagwood, Kimberly; Leaf, Philip J.; Olin, Serene; Sampson, Nancy A.; Kessler, Ronald C.

2013-01-01

Objective: Although schools are identified as critical for detecting youth mental disorders, little is known about whether the number of mental health providers and types of resources that they offer influence student mental health service use. Such information could inform the development and allocation of appropriate school-based resources to…

Deployment, Mental Health Problems, Suicidality, and Use of Mental Health Services Among Military Personnel.

Science.gov (United States)

Chu, Carol; Stanley, Ian H; Hom, Melanie A; Lim, Ingrid C; Joiner, Thomas E

2016-01-01

Following deployment, soldiers may struggle to cope with the after-effects of combat service and experience increased suicidality. Therefore, connection to mental health services is vital. Research regarding the relationship between deployment, suicidality, and mental health connections has been equivocal, with some studies finding a link between deployment history and mental health outcomes, and others not. The purpose of this study was to examine the effects of military deployment on mental health and service utilization outcomes using a longitudinal design. Deployment history, mental health visits, symptoms of suicidality, and various mental health outcomes were assessed in a sample of 1,566 Army recruiters at study entry and 18-months follow-up. Deployment history was positively associated with mental health visits, number of major depressive episodes, and acquired capability for suicide at baseline; however, no significant relationship between deployment, mental health visits, and any other suicide or mental health-related outcomes emerged at baseline or follow-up. Findings suggest a disconnection from mental health services among military personnel. Implications for treatment and suicide prevention efforts among military personnel are discussed.

The Roles of Individual and Organizational Factors in Burnout among Community-Based Mental Health Service Providers

Science.gov (United States)

Green, Amy E.; Albanese, Brian J.; Shapiro, Nicole M.; Aarons, Gregory A.

2014-01-01

Public sector mental health care providers are at high risk for burnout which negatively affects not only provider well-being but also the quality of services for clients and the functioning of organizations. This study examines the influence of demographics, work characteristic, and organizational variables on levels of burnout among child and adolescent mental health service providers operating within a public sector mental health service system. Additionally, given the dearth of research examining differences in burnout levels among mental health sub-disciplines (e.g., social work, psychology, marital and family therapy) and mental health programs (e.g., outpatient, day treatment, Wraparound, case management), analyses were conducted to compare levels of burnout among multiple mental health disciplines and program types. Surveys were completed by 285 providers across 49 mental health programs in a large urban public mental health system. Variables representing dimensions of organizational climate and transformational leadership accounted for the greatest amount of variance in provider reported burnout. Analyses demonstrated significantly lower levels of depersonalization among Wraparound providers compared to traditional case managers. Age was the only demographic variable related to burnout. Additionally, no significant effects were found for provider discipline or for agency tenure and caseload size. Results suggest the need to consider organizational development strategies aimed at creating more functional and less stressful climates and increasing levels of transformational leadership behaviors in order to reduce levels of burnout among clinicians working in public mental health settings for youth and families. PMID:24564442

Significance of mental health legislation for successful primary care for mental health and community mental health services: A review

Directory of Open Access Journals (Sweden)

Getinet Ayano

2018-03-01

Conclusion: Mental health legislation plays a crucial role in community integration of persons with mental disorders, integration of mental health at primary health care, the provision of care of high quality and the improvement of access to care at community level. It is vital and essential to have MHL for every country.

[Relationship of personality with job burnout and psychological stress risk in clinicians].

Science.gov (United States)

Huang, Lei; Zhou, Dinglun; Yao, Yongcheng; Lan, Yajia

2015-02-01

To analyze the job burnout and mental health status of clinicians and the relationship of personality with job burnout and psychological stress, and to investigate the direct or indirect effects of personality on psychological stress. Maslach Burnout Inventory-General Survey (MBI-GS), Eysenck Personality Questionnaire-Revised Short Scale (EPQ-RSC), and Kessler 10 Scale were administered to 775 clinicians. Of all clinicians, 29.5% had mild burnout, with a score of 22.7 ± 8.18 for psychological stress risk. The effect of personality on emotional exhaustion and cynicism was greater than that on personal accomplishment. Clinicians with a personality of introversion, neuroticism, and psychoticism suffered a higher risk of psychological stress. Personality had both direct and indirect effects on psychological stress. Neuroticism had the strongest effect on psychological stress, with an effect size of 0.55. Clinicians have a high level of both job burnout and mental psychological stress risk. Personality is significantly correlated with job burnout and psychological stress risk. Measures depending on personality should be taken for effective intervention.

MENTAL HEALTH: ISLAMIC PERSPECTIVE

Directory of Open Access Journals (Sweden)

Muzdalifah M. Rahman

2015-02-01

of mental health, especially mental health needs to be developed with an Islamic perspective various studies and research, especially the development of mental health recovery means Islamic perspective.

Motivation and treatment engagement intervention trial (MotivaTe-IT: the effects of motivation feedback to clinicians on treatment engagement in patients with severe mental illness

Directory of Open Access Journals (Sweden)

Jochems Eline C

2012-11-01

Full Text Available Abstract Background Treatment disengagement and non-completion poses a major problem for the successful treatment of patients with severe mental illness. Motivation for treatment has long been proposed as a major determinant of treatment engagement, but exact mechanisms remain unclear. This current study serves three purposes: 1 to determine whether a feedback intervention based on the patients’ motivation for treatment is effective at improving treatment engagement (TE of severe mentally ill patients in outpatient psychiatric treatment, 2 to gather insight into motivational processes and possible mechanisms regarding treatment motivation (TM and TE in this patient population and 3 to determine which of three theories of motivation is most plausible for the dynamics of TM and TE in this population. Methods/design The Motivation and Treatment Engagement Intervention Trial (MotivaTe-IT is a multi-center cluster randomized trial investigating the effectiveness of feedback generated by clinicians regarding their patients’ treatment motivation upon the patients’ TE. The primary outcome is the patients’ TE. Secondary outcomes are TM, psychosocial functioning and quality of life. Patients whose clinicians generate monthly motivation feedback (additional to treatment as usual will be compared to patients who receive treatment as usual. An estimated 350 patients, aged 18 to 65 years, with psychotic disorders and/or severe personality disorders will be recruited from outpatient community mental health care. The randomization will be performed by a computerized randomization program, with an allocation ratio of 1:1 (team vs. team or clinician vs. clinician and patients, but not clinicians, will be blind to treatment allocation at baseline assessment. Due to the nature of the trial, follow-up assessment can not be blinded. Discussion The current study can provide important insights regarding motivational processes and the way in which motivation

Motivation and treatment engagement intervention trial (MotivaTe-IT): the effects of motivation feedback to clinicians on treatment engagement in patients with severe mental illness.

Science.gov (United States)

Jochems, Eline C; Mulder, Cornelis L; van Dam, Arno; Duivenvoorden, Hugo J; Scheffer, Sylvia C M; van der Spek, Willem; van der Feltz-Cornelis, Christina M

2012-11-24

Treatment disengagement and non-completion poses a major problem for the successful treatment of patients with severe mental illness. Motivation for treatment has long been proposed as a major determinant of treatment engagement, but exact mechanisms remain unclear. This current study serves three purposes: 1) to determine whether a feedback intervention based on the patients' motivation for treatment is effective at improving treatment engagement (TE) of severe mentally ill patients in outpatient psychiatric treatment, 2) to gather insight into motivational processes and possible mechanisms regarding treatment motivation (TM) and TE in this patient population and 3) to determine which of three theories of motivation is most plausible for the dynamics of TM and TE in this population. The Motivation and Treatment Engagement Intervention Trial (MotivaTe-IT) is a multi-center cluster randomized trial investigating the effectiveness of feedback generated by clinicians regarding their patients' treatment motivation upon the patients' TE. The primary outcome is the patients' TE. Secondary outcomes are TM, psychosocial functioning and quality of life. Patients whose clinicians generate monthly motivation feedback (additional to treatment as usual) will be compared to patients who receive treatment as usual. An estimated 350 patients, aged 18 to 65 years, with psychotic disorders and/or severe personality disorders will be recruited from outpatient community mental health care. The randomization will be performed by a computerized randomization program, with an allocation ratio of 1:1 (team vs. team or clinician vs. clinician) and patients, but not clinicians, will be blind to treatment allocation at baseline assessment. Due to the nature of the trial, follow-up assessment can not be blinded. The current study can provide important insights regarding motivational processes and the way in which motivation influences the treatment engagement and clinical outcomes. The

Motivation and treatment engagement intervention trial (MotivaTe-IT): the effects of motivation feedback to clinicians on treatment engagement in patients with severe mental illness

Science.gov (United States)

2012-01-01

Background Treatment disengagement and non-completion poses a major problem for the successful treatment of patients with severe mental illness. Motivation for treatment has long been proposed as a major determinant of treatment engagement, but exact mechanisms remain unclear. This current study serves three purposes: 1) to determine whether a feedback intervention based on the patients’ motivation for treatment is effective at improving treatment engagement (TE) of severe mentally ill patients in outpatient psychiatric treatment, 2) to gather insight into motivational processes and possible mechanisms regarding treatment motivation (TM) and TE in this patient population and 3) to determine which of three theories of motivation is most plausible for the dynamics of TM and TE in this population. Methods/design The Motivation and Treatment Engagement Intervention Trial (MotivaTe-IT) is a multi-center cluster randomized trial investigating the effectiveness of feedback generated by clinicians regarding their patients’ treatment motivation upon the patients’ TE. The primary outcome is the patients’ TE. Secondary outcomes are TM, psychosocial functioning and quality of life. Patients whose clinicians generate monthly motivation feedback (additional to treatment as usual) will be compared to patients who receive treatment as usual. An estimated 350 patients, aged 18 to 65 years, with psychotic disorders and/or severe personality disorders will be recruited from outpatient community mental health care. The randomization will be performed by a computerized randomization program, with an allocation ratio of 1:1 (team vs. team or clinician vs. clinician) and patients, but not clinicians, will be blind to treatment allocation at baseline assessment. Due to the nature of the trial, follow-up assessment can not be blinded. Discussion The current study can provide important insights regarding motivational processes and the way in which motivation influences the treatment

Challenges and Ideas from a Research Program on High Quality, Evidence-Based Practice in School Mental Health

Science.gov (United States)

Weist, Mark D.; Youngstrom, Eric A.; Stephan, Sharon; Lever, Nancy; Fowler, Johnathan; Taylor, Leslie; McDaniel, Heather; Chappelle, Lori; Paggeot, Samantha; Hoagwood, Kimberly

2013-01-01

Objective Reviews the progression of a research program designed to develop, implement and study the implementation of “achievable” evidence-based practices (EBPs) in schools. Reviews challenges encountered and ideas to overcome them to enhance this avenue of research. Method Presents two federally funded randomized controlled trials involving comparison of a four-component targeted intervention (Quality Assessment and Improvement, Family Engagement and Empowerment, Modular Evidence-Based Practice, Implementation Support) versus a comparison intervention focused on Personal Wellness. In both studies primary aims focused on changes in clinician attitudes and behavior, including the delivery of high quality, evidence-based practices and secondary aims focused on student level impacts. Results A number of challenges, many not reported in the literature are reviewed, and ideas for overcoming them are presented. Conclusions Given the reality that the majority of youth mental health services are delivered in schools and the potential of school mental health (SMH) services to provide a continuum of mental health care from promotion to intervention, it is critical that the field consider and address the logistical and methodological challenges associated with implementing and studying EBP implementation by clinicians. PMID:24063310

Challenges and ideas from a research program on high-quality, evidence-based practice in school mental health.

Science.gov (United States)

Weist, Mark D; Youngstrom, Eric A; Stephan, Sharon; Lever, Nancy; Fowler, Johnathan; Taylor, Leslie; McDaniel, Heather; Chappelle, Lori; Paggeot, Samantha; Hoagwood, Kimberly

2014-01-01

This article reviews the progression of a research program designed to develop, implement, and study the implementation of "achievable" evidence-based practices (EBPs) in schools. We review challenges encountered and ideas to overcome them to enhance this avenue of research. The article presents two federally funded randomized controlled trials involving comparison of a four-component targeted intervention (Quality Assessment and Improvement, Family Engagement and Empowerment, Modular Evidence-Based Practice, Implementation Support) versus a comparison intervention focused on personal wellness. In both studies, primary aims focused on changes in clinician attitudes and behavior, including the delivery of high-quality EBPs and secondary aims focused on student-level impacts. A number of challenges, many not reported in the literature, are reviewed, and ideas for overcoming them are presented. Given the reality that the majority of youth mental health services are delivered in schools and the potential of school mental health services to provide a continuum of mental health care from promotion to intervention, it is critical that the field consider and address the logistical and methodological challenges associated with implementing and studying EBP implementation by clinicians.

Does empowerment mediate the effects of psychological factors on mental health, well-being, and recovery in young people?

Science.gov (United States)

Grealish, Annmarie; Tai, Sara; Hunter, Andrew; Emsley, Richard; Murrells, Trevor; Morrison, Anthony P

2017-09-01

There is consensus that empowerment is key to recovery from mental health problems, enabling a person to take charge of their life and make informed choices and decisions about their life. However, little is known about the mechanisms through which empowerment affects mental health in young people. The current study involved young people aged 16-29 years and examined empowerment as a potential mediator of the relationship between psychological factors (psychosocial, cognition, coping, and control) and mental health, well-being, and recovery from personal problems. A cross-sectional, Internet-based questionnaire study recruited 423 young people aged between 16 and 29 attending universities in England (n = 336) and Ireland (n = 87). Psychological factors, mental well-being, empowerment, and recovery from personal problems were measured using self-report measures. Mediation analysis in both the single and one over-arching mediator models revealed that empowerment mediates the relationship between psychological factors (psychosocial, self-efficacy, thinking style, coping, and control) and mental health, well-being, and recovery from general life problems. This study demonstrates the importance of empowerment, showing that it mediates the relationship between psychological processes and mental health, well-being, and recovery in young people. Clinical implications for working with young people within mental health services, and facilitating their empowerment are discussed. Empowerment is currently a poorly defined concept. This study demonstrates how empowerment mediates the relationship between psychological processes and mental health, well-being, and recovery in young people. Clinicians working with young people might benefit from a structured means of understanding and assessing the different ways in which individuals manage their thinking styles. Empowerment in young people is influenced by the manner in which clinicians facilitate them in establishing social

Disaster mental health

DEFF Research Database (Denmark)

Henderson, Silja; Berliner, Peter; Elsass, Peter

2015-01-01

In this chapter we focus on disaster mental health, particularly theoretical and research-based implications for intervention. The field of disaster mental health research is vast and impossible to cover in a single chapter, but we will visit central research, concepts, and understandings within...... disaster mental health and intervention, and refer to further literature where meaningful. We conclude the chapter with recommendations for further research....

Mental health screening in immigration detention: A fresh look at Australian government data.

Science.gov (United States)

Young, Peter; Gordon, Michael S

2016-02-01

The poor mental health of asylum seekers and refugees in immigration detention has consistently been reported in peer-reviewed literature internationally; however, data on the mental health of asylum seekers and refugees detained in Australian immigration has been very limited. We re-analysed mental health screening data obtained by the Human Rights Commission. Longer time in detention was associated with higher self-reported depression scores, with female individuals being more vulnerable to time in detention than those of male gender. Approximately one-half of the refugee group who agreed to complete the Harvard Trauma Questionnaire had post-traumatic stress disorder symptoms. On clinician-rated measures, one-third of the children, adolescents and adults suffered with clinical symptoms requiring tertiary outpatient assessment. This paper consolidates the findings of the 2014 Australian Human Rights Commission report and it provides an argument for public reporting of refugee data. © The Royal Australian and New Zealand College of Psychiatrists 2016.

College Health: Health Services and Common Health Problems

Science.gov (United States)

... Many colleges also have a counseling center which students should go to for mental health concerns. How can I get seen at the ... services that I need? The staff at your student health center will know ... gynecologists, and mental health clinicians in the community in case you ...

Consumer attitudes towards evidence based mental health services among American mental health consumers.

Science.gov (United States)

Teh, Lisa B; Hayashi, Kentaro; Latner, Janet; Mueller, Charles W

2016-10-01

The Consumer Attitudes towards Evidence Based Services (CAEBS) scale is a 29-item questionnaire designed to assess public views on the role of science in helping to guide mental health treatment. The aim of the current study was to assess the Factor structure the CAEBS in an online sample of adults seeking information about mental health services. The CAEBS was administered to a nationwide sample of participants from websites offering classified advertisements for mental health related study participation (n = 312). An Exploratory Factor Analysis (EFA) suggested four factors based on 26 of the items: Beliefs Regarding Therapists' Practices, Attitudes about Mental Health Policy, Negative Personal-Level Attitudes toward EBPs, and Negative Societal-Level Attitudes towards EBPs. In order to increase consumer empowerment within the mental health-care system and develop policies supporting EBP usage, mental health professionals need to increase communication with the public to address these concerns and leverage positive attitudes. © 2016 Australian College of Mental Health Nurses Inc.

Poor Employment Conditions Adversely Affect Mental Health Outcomes Among Surgical Trainees.

Science.gov (United States)

Kevric, Jasmina; Papa, Nathan; Perera, Marlon; Rashid, Prem; Toshniwal, Sumeet

Poor mental health in junior clinicians is prevalent and may lead to poor productivity and significant medical errors. We aimed to provide contemporary data on the mental health of surgical trainees and identify risk factors relating to poorer mental health outcomes. A detailed questionnaire was developed comprising questions based on the 36-item short-form health survey (SF-36) and Physical Activity Questionnaire. Each of the questionnaires has proven validity and reliability in the clinical context. Ethics approval was obtained from the Royal Australasian College of Surgeons. The questionnaire was aimed at surgical registrars. We used Physical Activity Questionnaire, SF-36 scores and linear regression to evaluate the effect of putative predictors on mental health. A total of 83 responses were collected during the study period, of which 49 (59%) were from men and 34 (41%) were from women. The mean Mental Component Summary (MCS) score for both sexes was significantly lower than the population mean at ages 25-34 (p work culture and a feeling of a lack of support at work were extremely strong predictors of a lower MCS score (p Hours of overtime worked, particularly unpaid overtime, were also strong predictors of a poorer score. Australian surgical trainees reported lower MCS scores from the SF-36 questionnaire compared to the general population. Increasing working hours, unpaid overtime, poor job security, and job satisfaction were associated with poorer scores among trainees. Interventions providing improved working conditions need to be considered by professional training bodies and employers. Copyright © 2018 Association of Program Directors in Surgery. All rights reserved.

Caring for clients with dual diagnosis in rural communities in Australia: the experience of mental health professionals.

Science.gov (United States)

Deans, C; Soar, R

2005-06-01

This paper identifies and describes the experiences of 13 rural mental health professionals who care for clients diagnosed with a mental illness and a coexisting alcohol and other drug disorder (dual diagnosis). Dual diagnosis is a common problem which is often poorly understood and managed by mental health professionals. The effect of excessive substance use on a person's mental well-being can present as a diagnostic challenge as each condition may mask symptoms of the other. The authors utilized a phenomenological approach to discover the experiences of a group of mental health professionals working in rural communities in Victoria, Australia. Caring for clients diagnosed with dual diagnosis was found to be a complex and stressful role that involved high levels of skill and knowledge. Despite the fact that health professionals in rural areas are expected to deliver the most appropriate care to individuals with a dual diagnosis, a number of these rural health professionals have limited preparation and experience in dealing with arising clinical diagnosis issues. Clinicians experience frustration, resentment and powerlessness in their attempt to understand their clients' drug misuse whilst simultaneously endeavouring to provide a quality mental health service.

Mental Health Mobile Apps: From Infusion to Diffusion in the Mental Health Social System

OpenAIRE

East, Marlene Lynette; Havard, Byron C

2015-01-01

The roles of mental health educators and professionals in the diffusion of mental health mobile apps are addressed in this viewpoint article. Mental health mobile apps are emerging technologies that fit under the broad heading of mobile health (mHealth). mHealth, encompassed within electronic health (eHealth), reflects the use of mobile devices for the practice of public health. Well-designed mental health mobile apps that present content in interactive, engaging, and stimulating ways can pro...

Psychosis screening practices in schools: A survey of school-based mental health providers.

Science.gov (United States)

Kline, Emily R; Chokran, Cole; Rodenhiser-Hill, Janine; Seidman, Larry J; Woodberry, Kristen A

2018-05-04

Many school districts in the United States employ mental health professionals to provide assessment, counselling and crisis interventions within the school setting; however, little is known about actual clinical practices of psychosis screening in schools. The aim of the present study is to examine attitudes and practices regarding psychosis screening among school mental health providers in metropolitan Boston, Massachusetts. School-based mental health clinicians (N = 100) completed an anonymous survey assessing familiarity, screening, and involvement with psychosis and psychosis risk prior to attending trainings on psychosis. Providers reported screening for psychosis less often than other mental health problems and rated themselves as less confident treating psychosis relative to other mental health concerns. Frequency of screening for psychosis was significantly associated with familiarity with psychosis assessment and case management, confidence providing treatment for individuals experiencing psychosis, and the number of students with or at risk for psychosis with whom providers had been involved. Frequency of screening for psychosis was not associated with years of practice, suggesting that both novice and experienced school-based providers may benefit from training on this issue. Community outreach via school-based provider training on assessment and management of psychosis may help to increase providers' understanding of psychosis and increase the practice of verbal or written screening for psychosis and psychosis risk within schools. © 2018 John Wiley & Sons Australia, Ltd.

Motivational interviewing to enhance treatment attendance in mental health settings: A systematic review and meta-analysis.

Science.gov (United States)

Lawrence, P; Fulbrook, P; Somerset, S; Schulz, P

2017-11-01

WHAT IS KNOWN ON THE SUBJECT?: Despite differences between samples, some literature reviews have suggested that MI is effective in enhancing treatment attendance for individuals with mental health issues. Little is known regarding the effects of MI as a pre-treatment on individuals who are not seeking treatment for mental health issues. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: This systematic review of the literature and meta-analysis demonstrates that MI is most beneficial for individuals who are not seeking mental health treatment. MI represents an opportunity for health promotion when patients are unmotivated but may otherwise be amenable to an intervention. MI is effective as a pre-treatment intervention to motivate individuals to attend further post-MI treatment and counselling. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: MI is a process and a useful tool for clinicians in all therapeutic interactions, to motivate their patients to seek further assistance for mental heath issues. Health promotion and encouragement to attend further treatment sessions can be facilitated through telephone contact. Introduction The stages of change model suggests that individuals seeking treatment are in the "preparation" or the "action" stage of change, which is the desired outcome of successful Motivational Interviewing (MI) interventions. MI is known to enhance treatment attendance among individuals with mental health problems. Aim This study examined the published research on MI as a pre-treatment to enhance attendance among individuals treatment-seeking and non-treatment-seeking for mental health issues. Methods Fourteen randomized controlled trials were identified, and MI efficacy was examined dichotomously: attendance or non-attendance for post-MI therapy. Subgroup analysis investigated treatment-seeking and non-treatment-seeking groups. Results Despite wide variations in sample sizes, blinding and monitoring, intervention fidelity was absent in the majority of published

Pakistan mental health country profile.

Science.gov (United States)

Karim, Salman; Saeed, Khalid; Rana, Mowaddat Hussain; Mubbashar, Malik Hussain; Jenkins, Rachel

2004-01-01

The Republic of Pakistan is a South East Asian country with a population of over 140.7 million. Its population is fast growing and the majority (70%) live in rural areas with a feudal or tribal value system. The economy is dependent on agriculture and 35% of the population live below the poverty line. Islam is the main religion and 'mental illnesses' are stigmatized and widely perceived to have supernatural causes. The traditional healers along with psychiatric services are the main mental health service providers. The number of trained mental health professionals is small as compared to the population demands and specialist services are virtually non-existent. Lack of data on prevalence of various mental illnesses and monitory constraints are the major hurdles in the development of mental health services. A number of innovative programmes to develop indigenous models of care like the 'Community Mental Health Programme' and 'Schools Mental Health Programme' have been developed. These programmes have been found effective in reducing stigma and increase awareness of mental illness amongst the adults and children living in rural areas. Efforts by the government and mental health professionals have led to the implementation of a 'National Mental Health Policy' and 'Mental Health Act' in 2001. These aim at integrating mental health services with the existing health services, improving mental health care delivery and safeguarding the rights of mentally ill people. A favourable political will and the help of international institutions like the World Health Organization are required to achieve these aims.

[Mental Health: Concepts, Measures, Determinants].

Science.gov (United States)

Doré, Isabelle; Caron, Jean

Objectives This article aims to situate the concept of mental health in a historical perspective. This article presents the most commonly used measurement tools in Canada and elsewhere in the world to assess specific and multiple dimensions of mental health; when available, psychometric properties are discussed. Finally, research findings on quality of life and mental health determinants are presented.Methods A literature review of concepts, measurement and determinants of mental health is presented in this paper. The selection of measurement scales presented is based on the findings of the research reports conducted by the second author, an expert on mental health measures, for Health Canada and Statistics Canada.Results Mental health is more than the absence of mental illness; rather it is a state of complete well-being, which refers to our ability to enjoy life and deal with the challenges we face. Accordingly, mental health and mental illness are not extremes of the same continuum, but distinct yet correlated concepts. The traditional conceptualization suggesting that mental health represents simply the absence of mental illness has been replaced, in the last few decades, by a more holistic characterization, which directly concerns public health. The components of mental health include emotional well-being/quality of life (QOL) and psychological and social well-being. Mental health influences the personal and social functioning of individuals, justifying the importance of intervening upstream to promote mental health. Specific scales are relevant for obtaining a detailed measure of one aspect of well-being in particular (emotional/quality of life, psychological or social well-being); however, to account for the global mental health status, measurement tools that integrate all three forms of well-being (emotional, psychological and social) should be privileged. A diversity of determinants at the individual, social and neighbourhood levels influence quality of

The roles of individual and organizational factors in burnout among community-based mental health service providers.

Science.gov (United States)

Green, Amy E; Albanese, Brian J; Shapiro, Nicole M; Aarons, Gregory A

2014-02-01

Public-sector mental health care providers are at high risk for burnout, which negatively affects not only provider well-being but also the quality of services for clients and the functioning of organizations. This study examines the influence of demographics, work characteristic, and organizational variables on levels of burnout among child and adolescent mental health service providers operating within a public-sector mental health service system. Additionally, given the dearth of research examining differences in burnout levels among mental health subdisciplines (e.g., social work, psychology, marital and family therapy) and mental health programs (e.g., outpatient, day treatment, wraparound, case management), analyses were conducted to compare levels of burnout among multiple mental health disciplines and program types. Surveys were completed by 285 providers across 49 mental health programs in a large urban public mental health system. Variables representing dimensions of organizational climate and transformational leadership accounted for the greatest amount of variance in provider reported burnout. Analyses demonstrated significantly lower levels of depersonalization among wraparound providers compared to traditional case managers. Age was the only demographic variable related to burnout. Additionally, no significant effects were found for provider discipline or for agency tenure and caseload size. Results suggest the need to consider organizational development strategies aimed at creating more functional and less stressful climates and increasing levels of transformational leadership behaviors in order to reduce levels of burnout among clinicians working in public mental health settings for youth and families. PsycINFO Database Record (c) 2014 APA, all rights reserved.

Mental Health and African Americans

Science.gov (United States)

... Minority Population Profiles > Black/African American > Mental Health Mental Health and African Americans Poverty level affects mental health ... compared to 120% of non-Hispanic whites. 1 MENTAL HEALTH STATUS Serious psychological distress among adults 18 years ...

Mental Health Nurse Incentive Program: facilitating physical health care for people with mental illness?

Science.gov (United States)

Happell, Brenda; Platania-Phung, Chris; Scott, David

2013-10-01

People with serious mental illness have increased rates of physical ill-health and reduced contact with primary care services. In Australia, the Mental Health Nurse Incentive Program (MHNIP) was developed to facilitate access to mental health services. However, as a primary care service, the contribution to physical health care is worthy of consideration. Thirty-eight nurses who were part of the MHNIP participated in a national survey of nurses working in mental health about physical health care. The survey invited nurses to report their views on the physical health of consumers and the regularity of physical health care they provide. Physical health-care provision in collaboration with general practitioners (GPs) and other health-care professionals was reported as common. The findings suggest that the MHNIP provides integrated care, where nurses and GPs work in collaboration, allowing enough time to discuss physical health or share physical health activities. Consumers of this service appeared to have good access to physical and mental health services, and nurses had access to primary care professionals to discuss consumers' physical health and develop their clinical skills in the physical domain. The MHNIP has an important role in addressing physical health concerns, in addition to the mental health issues of people accessing this service. © 2012 The Authors; International Journal of Mental Health Nursing © 2012 Australian College of Mental Health Nurses Inc.

The impact of inter-organizational alignment (IOA) on implementation outcomes: evaluating unique and shared organizational influences in education sector mental health.

Science.gov (United States)

Lyon, Aaron R; Whitaker, Kelly; Locke, Jill; Cook, Clayton R; King, Kevin M; Duong, Mylien; Davis, Chayna; Weist, Mark D; Ehrhart, Mark G; Aarons, Gregory A

2018-02-07

Integrated healthcare delivered by work groups in nontraditional service settings is increasingly common, yet contemporary implementation frameworks typically assume a single organization-or organizational unit-within which system-level processes influence service quality and implementation success. Recent implementation frameworks predict that inter-organizational alignment (i.e., similarity in values, characteristics, activities related to implementation across organizations) may facilitate the implementation of evidence-based practices (EBP), but few studies have evaluated this premise. This study's aims examine the impact of overlapping organizational contexts by evaluating the implementation contexts of externally employed mental health clinicians working in schools-the most common integrated service delivery setting for children and adolescents. Aim 1 is to estimate the effects of unique intra-organizational implementation contexts and combined inter-organizational alignment on implementation outcomes. Aim 2 is to examine the underlying mechanisms through which inter-organizational alignment facilitates or hinders EBP implementation. This study will conduct sequential, exploratory mixed-methods research to evaluate the intra- and inter-organizational implementation contexts of schools and the external community-based organizations that most often employ school-based mental health clinicians, as they relate to mental health EBP implementation. Aim 1 will involve quantitative surveys with school-based, externally-employed mental health clinicians, their supervisors, and proximal school-employed staff (total n = 120 participants) to estimate the effects of each organization's general and implementation-specific organizational factors (e.g., climate, leadership) on implementation outcomes (fidelity, acceptability, appropriateness) and assess the moderating role of the degree of clinician embeddedness in the school setting. Aim 2 will explore the mechanisms

Access to primary and specialized somatic health care for persons with severe mental illness: a qualitative study of perceived barriers and facilitators in Swedish health care.

Science.gov (United States)

Björk Brämberg, Elisabeth; Torgerson, Jarl; Norman Kjellström, Anna; Welin, Peder; Rusner, Marie

2018-01-09

Persons with severe mental illness (e.g. schizophrenia, bipolar disorder) have a high prevalence of somatic conditions compared to the general population. Mortality data in the Nordic countries reveal that these persons die 15-20 years earlier than the general population. Some factors explaining this high prevalence may be related to the individuals in question; others arise from the health care system's difficulty in offering somatic health care to these patient groups. The aim of the present study was therefore to explore the experiences and views of patients, relatives and clinicians regarding individual and organizational factors which facilitate or hinder access to somatic health care for persons with severe mental illness. Flexible qualitative design. Data was collected by means of semi-structured individual interviews with patients with severe mental illness, relatives and clinicians representing primary and specialized health care. In all, 50 participants participated. The main barrier to accessing somatic care is the gap between the organization of the health care system and the patients' individual health care needs. This is observed at both individual and organizational level. The health care system seems unable to support patients with severe mental illness and their psychiatric-somatic comorbidity. The main facilitators are the links between severe mental illness patients and medical departments. These links take the form of functions (i.e. systems which ensure that patients receive regular reminders), or persons (i.e. professional contacts who facilitate patients' access the health care). Health care services for patients with severe mental illness need reorganization. Organizational structures and systems that facilitate cooperation between different departments must be put in place, along with training for health care professionals about somatic disease among psychiatric patients. The links between individual and organizational levels could be

Information in mental health: qualitative study of mental health service users

OpenAIRE

Powell, John; Clarke, Aileen

2006-01-01

Background  Despite the widespread proliferation of consumer health information provision, little is known about information needs or information‐seeking behaviour in mental health. A qualitative study was therefore undertaken to explore these issues for mental health service users.

The influence of framing on clinicians' judgments of the biological basis of behaviors.

Science.gov (United States)

Kim, Nancy S; Ahn, Woo-kyoung; Johnson, Samuel G B; Knobe, Joshua

2016-03-01

Practicing clinicians frequently think about behaviors both abstractly (i.e., in terms of symptoms, as in the Diagnostic and Statistical Manual of Mental Disorders, 5th ed., DSM-5; American Psychiatric Association, 2013) and concretely (i.e., in terms of individual clients, as in DSM-5 Clinical Cases; Barnhill, 2013). Does abstract/concrete framing influence clinical judgments about behaviors? Practicing mental health clinicians (N = 74) were presented with hallmark symptoms of 6 disorders framed abstractly versus concretely, and provided ratings of their biological and psychological bases (Experiment 1) and the likely effectiveness of medication and psychotherapy in alleviating them (Experiment 2). Clinicians perceived behavioral symptoms in the abstract to be more biologically and less psychologically based than when concretely described, and medication was viewed as more effective for abstractly than concretely described symptoms. These findings suggest a possible basis for miscommunication and misalignment of views between primarily research-oriented and primarily practice-oriented clinicians; furthermore, clinicians may accept new neuroscience research more strongly in the abstract than for individual clients. (c) 2016 APA, all rights reserved).

Population mental health: evidence, policy, and public health practice

National Research Council Canada - National Science Library

Cohen, Neal L; Galea, Sandro

2011-01-01

... on population mental health with public mental health policy and practice. Issues covered in the book include the influence of mental health policies on the care and well-­ being of individuals with mental illness, the interconnectedness of physical and mental disorders, the obstacles to adopting a public health orientation to mental health/mental ill...

Romantic relationships and mental health.

Science.gov (United States)

Braithwaite, Scott; Holt-Lunstad, Julianne

2017-02-01

This paper reviews the research on relationships and mental health. Individuals who are more mentally healthy are more likely to select into relationships, but relationships are also demonstrably associated with mental health. The type of relationship matters - evidence suggests that more established, committed relationships, such as marriage, are associated with greater benefits than less committed unions such as cohabitation. The association between relationships and mental health is clearly bidirectional, however, stronger effects are observed when mental health is the outcome and relationships are the predictor, suggesting that the causal arrow flows more strongly from relationships to mental health than vice versa. Moreover, improving relationships improves mental health, but improving mental health does not reliably improve relationships. Our review of research corroborates the view that relationships are a keystone component of human functioning that have the potential to influence a broad array of mental health outcomes. Copyright © 2016. Published by Elsevier Ltd.

Acute mental health care according to recent mental health ...

African Journals Online (AJOL)

Objective: This is the third of three reports on the follow-up review of mental health care at Helen Joseph Hospital (HJH). The study reviewed existing South African standards for mental health care facilities. Architectural principles and implications for the use of space were deducted from recent legislation. Objectives were to ...

Child Mental Health: MedlinePlus Health Topic

Science.gov (United States)

... events and children (Medical Encyclopedia) Also in Spanish Topic Image MedlinePlus Email Updates Get Child Mental Health ... in childhood Traumatic events and children Related Health Topics Bullying Child Behavior Disorders Mental Disorders Mental Health ...

Physical health monitoring in mental health settings: a study exploring mental health nurses' views of their role.

Science.gov (United States)

Mwebe, Herbert

2017-10-01

To explore nurses' views of their role in the screening and monitoring of the physical care needs of people with serious mental illness in a mental health service provider. There is increasing awareness through research that people with serious mental illness disproportionately experience and die early from physical health conditions. Mental health nurses are best placed as front-line workers to offer screening, monitoring and interventions; however, their views on physical care interventions are not studied often. Qualitative exploratory study. The study was carried out in a mental health inpatient centre in England. Volunteer sampling was adopted for the study with a total target sample of (n = 20) nurses from three inpatient wards. Semistructured interviews were conducted with (n = 10) registered mental health nurses who had consented to take part in the study. Inductive data analysis and theme development were guided by a thematic analytic framework. Participants shared a clear commitment regarding their role regarding physical health screening and monitoring in mental health settings. Four themes emerged as follows: features of current practice and physical health monitoring; perceived barriers to physical health monitoring; education and training needs; and strategies to improve physical health monitoring. Nurses were unequivocal in their resolve to ensure good standard physical health monitoring and screening interventions in practice. However, identified obstacles have to be addressed to ensure that physical health screening and monitoring is integrated adequately in everyday clinical activities. Achieving this would require improvements in nurses' training, and an integrated multiservice and team-working approach. Attending to the physical health needs of people with serious mental illness has been associated with multiple improvements in both mental and physical health; nurses have a vital role to play in identifying and addressing causes of poor

Workplace Violence in Mental Health: A Victorian Mental Health Workforce Survey.

Science.gov (United States)

Tonso, Michael A; Prematunga, Roshani Kanchana; Norris, Stephen J; Williams, Lloyd; Sands, Natisha; Elsom, Stephen J

2016-10-01

The international literature suggests workplace violence in mental health settings is a significant issue, yet little is known about the frequency, nature, severity and health consequences of staff exposure to violence in Australian mental health services. To address this gap, we examined these aspects of workplace violence as reported by mental health services employees in Victoria, Australia. The project used a cross-sectional, exploratory descriptive design. A random sample of 1600 Health and Community Services Union members were invited to complete a survey investigating exposure to violence in the workplace, and related psychological health outcomes. Participants comprised employees from multiple disciplines including nursing, social work, occupational therapy, psychology and administration staff. A total of 411 members responded to the survey (26% response rate). Of the total sample, 83% reported exposure to at least one form of violence in the previous 12 months. The most frequently reported form of violence was verbal abuse (80%) followed by physical violence (34%) and then bullying/mobbing (30%). Almost one in three victims of violence (33%) rated themselves as being in psychological distress, 54% of whom reported being in severe psychological distress. The more forms of violence to which victims were exposed, the greater the frequency of reports of psychological distress. Workplace violence is prevalent in mental health facilities in Victoria. The nature, severity and health impact of this violence represents a serious safety concern for mental health employees. Strategies must be considered and implemented by healthcare management and policy makers to reduce and prevent violence. © 2016 Australian College of Mental Health Nurses Inc.

Abortion and mental health: quantitative synthesis and analysis of research published 1995-2009.

Science.gov (United States)

Coleman, Priscilla K

2011-09-01

Given the methodological limitations of recently published qualitative reviews of abortion and mental health, a quantitative synthesis was deemed necessary to represent more accurately the published literature and to provide clarity to clinicians. To measure the association between abortion and indicators of adverse mental health, with subgroup effects calculated based on comparison groups (no abortion, unintended pregnancy delivered, pregnancy delivered) and particular outcomes. A secondary objective was to calculate population-attributable risk (PAR) statistics for each outcome. After the application of methodologically based selection criteria and extraction rules to minimise bias, the sample comprised 22 studies, 36 measures of effect and 877 181 participants (163 831 experienced an abortion). Random effects pooled odds ratios were computed using adjusted odds ratios from the original studies and PAR statistics were derived from the pooled odds ratios. Women who had undergone an abortion experienced an 81% increased risk of mental health problems, and nearly 10% of the incidence of mental health problems was shown to be attributable to abortion. The strongest subgroup estimates of increased risk occurred when abortion was compared with term pregnancy and when the outcomes pertained to substance use and suicidal behaviour. This review offers the largest quantitative estimate of mental health risks associated with abortion available in the world literature. Calling into question the conclusions from traditional reviews, the results revealed a moderate to highly increased risk of mental health problems after abortion. Consistent with the tenets of evidence-based medicine, this information should inform the delivery of abortion services.

Parent-reported Mental Health Problems and Mental Health Services Use in South Australian School-aged Children

Directory of Open Access Journals (Sweden)

Jing Wu

2016-09-01

Full Text Available Background:Monitoring and reporting childhood mental health problems and mental health services utilization over time provide important information to identify mental health related issues and to guide early intervention. This paper aims to describe the recent prevalence of parent-reported mental health problems among South Australian (SA children; to identify mental health problems associated characteristics; and to describe mental health services utilization and its related characteristics among this population. Methods:Parent-reported mental health problems were assessed against the first item of the Strength and Difficulties Questionnaire. School-aged children were randomly sampled monthly and data were collected using a surveillance system between 2005 and 2015. Associations between mental health problems and various factors were analysed using univariable analysis and multivariable logistic regression modelling. Results:Prevalence of parent-reported mental health problems among children was 9.1% and 9.3% for children aged 5 to 11 years and children aged 12 to 15 years, respectively. No change in prevalence was observed during the past decade. Mental health problems were associated with male sex, long-term illness or pain, negative school experiences, not living with biological parents, and living in a rental dwelling. Less than half (48.7% of the children with mental health problems received professional help. An increasing trend was found in mental health services utilisation among children aged 5 to 15 years. Utilization of mental health services was associated with male sex, older age, long-term illness or pain, and feeling unhappy at school. Conclusion:This study reports the prevalence of parent-reported mental and mental health services utilisation among SA school-aged children. Identified characteristics associated with mental health problems and mental health services utilisation provide useful information for the planning of

Community mental health nurses’ experience of decentralised and integrated psychiatric-mental health care services in the Southern mental health region of Botswana (part 1

Directory of Open Access Journals (Sweden)

M.K. Maphorisa

2002-09-01

Full Text Available Since the inception of the decentralisation and integration of psychiatric mental health care services into the general health care delivery system in Botswana, there has never been a study to investigate what community mental health nurses are experiencing due to the policy. Many of these nurses have been leaving the scantily staffed mental health care services in increasing numbers to join other sectors of health or elsewhere since the beginning of the implementation of the policy. During the research study, phenomenological in-depth interviews were conducted with three groups of 12 community mental health nurses altogether. An open central question was posed to each group followed by probing questions to explore and describe these nurses’ experience of the decentralisation and integration of psychiatric-mental health care services. After the data was analysed, related literature was incorporated and guidelines for advanced psychiatric nurses were formulated and described to assist these nurses to cope with the decentralisation and integration of psychiatric-mental health care services. The guidelines were set up for the management of the community mental health nurses who are experiencing obstacles in the quest for mental health which also interfere with their capabilities as mental health care providers.

India mental health country profile.

Science.gov (United States)

Khandelwal, Sudhir K; Jhingan, Harsh P; Ramesh, S; Gupta, Rajesh K; Srivastava, Vinay K

2004-01-01

India, the second most populated country of the world with a population of 1.027 billion, is a country of contrasts. It is characterized as one of the world's largest industrial nations, yet most of the negative characteristics of poor and developing countries define India too. The population is predominantly rural, and 36% of people still live below poverty line. There is a continuous migration of rural people into urban slums creating major health and economic problems. India is one of the pioneer countries in health services planning with a focus on primary health care. Improvement in the health status of the population has been one of the major thrust areas for social development programmes in the country. However, only a small percentage of the total annual budget is spent on health. Mental health is part of the general health services, and carries no separate budget. The National Mental Health Programme serves practically as the mental health policy. Recently, there was an eight-fold increase in budget allocation for the National Mental Health Programme for the Tenth Five-Year Plan (2002-2007). India is a multicultural traditional society where people visit religious and traditional healers for general and mental health related problems. However, wherever modern health services are available, people do come forward. India has a number of public policy and judicial enactments, which may impact on mental health. These have tried to address the issues of stigma attached to the mental illnesses and the rights of mentally ill people in society. A large number of epidemiological surveys done in India on mental disorders have demonstrated the prevalence of mental morbidity in rural and urban areas of the country; these rates are comparable to global rates. Although India is well placed as far as trained manpower in general health services is concerned, the mental health trained personnel are quite limited, and these are mostly based in urban areas. Considering this

Mental Health and Mental Disorder Recommendation Programs.

Science.gov (United States)

Ruchiwit, Manyat

2017-12-01

The characteristic differences among the Greater Mekong Subregion (GMS) countries in terms of trade and investment, society and cultural values, medical information and technology, and the living and working environment have become major health problems in terms of mental disorders. The purpose of this article is to identify the gaps in those aspects, to propose mental health and mental disorder recommendation programs, and to recommend policies for policy makers and research investors. A comparative analysis and literature review of existing policy, including overviews of previous research were used to generate a synthesis of the existing knowledge of the mental health and mental disorder recommendation programs. The review results recommend mental health and mental disorder programs for policy makers, research investors, and stakeholders in order to strengthen the directions for implementing these programs in the future. The healthcare provision in each country will not be limited only to its citizens; the healthcare markets and target groups are likely to expand to the neighboring countries in the context of changes in domestic and international factors, which have both positive and negative impacts according to the political, economic, and social situations of the influencing countries.

Examining the Role of Mental Health and Clinical Issues within Talent Development

Directory of Open Access Journals (Sweden)

Andy eHill

2016-01-01

Full Text Available Although significant research supports the association between physical activity and mental wellbeing, current literature acknowledges that athletes are no less susceptible to mental illness than the general population. Despite welcomed initiatives aimed at improving mental health within elite sport, these programs often fail to target young athletes; an important concern given that the genesis of many mental illnesses are recognized to occur during this critical period. Given the importance of early intervention and effective treatment, and the potentially devastating consequences of clinical issues going undiagnosed, the implications for talent identification and development become obvious. With this in mind, this study sought to examine the range of mental health issues that may impact upon developing athletes and potential consequences for the development process, specific risk and protective factors associated with talent development, along with an examination of current practices concerning the identification of mental health issues in such environments. Qualitative interviews were conducted with purposively sampled clinicians (n = 8 experienced in working with adolescents and/or young athletes. Inductive content analysis was undertaken, identifying four main themes: key behavioral indicators; associated risk factors; associated protective factors; and issues around identification and diagnosis. Key behavioral indicators included behavioral change, along with behaviors associated with eating disorders, anxiety and depression. Risk factors centered on family background, the performance environment, and issues surrounding adolescence. Protective factors were primarily social in nature. Finally, a lack of awareness and understanding of clinical issues, multiple causes of symptoms, non-disclosure and the need for triangulation of assessment were identified. The need for improved identification and intervention strategies was apparent, with

Examining the Role of Mental Health and Clinical Issues within Talent Development.

Science.gov (United States)

Hill, Andy; MacNamara, Áine; Collins, Dave; Rodgers, Sheelagh

2015-01-01

Although significant research supports the association between physical activity and mental wellbeing, current literature acknowledges that athletes are no less susceptible to mental illness than the general population. Despite welcomed initiatives aimed at improving mental health within elite sport, these programs often fail to target young athletes; an important concern given that the genesis of many mental illnesses are recognized to occur during this critical period. Given the importance of early intervention and effective treatment, and the potentially devastating consequences of clinical issues going undiagnosed, the implications for talent identification and development (TID) become obvious. With this in mind, this study sought to examine the range of mental health issues that may impact upon developing athletes and potential consequences for the development process, specific risk and protective factors associated with talent development, along with an examination of current practices concerning the identification of mental health issues in such environments. Qualitative interviews were conducted with purposively sampled clinicians (n = 8) experienced in working with adolescents and/or young athletes. Inductive content analysis was undertaken, identifying four main themes: key behavioral indicators; associated risk factors; associated protective factors; and issues around identification and diagnosis. Key behavioral indicators included behavioral change, along with behaviors associated with eating disorders, anxiety and depression. Risk factors centered on family background, the performance environment, and issues surrounding adolescence. Protective factors were primarily social in nature. Finally, a lack of awareness and understanding of clinical issues, multiple causes of symptoms, non-disclosure and the need for triangulation of assessment were identified. The need for improved identification and intervention strategies was apparent, with coaches

Examining the Role of Mental Health and Clinical Issues within Talent Development

Science.gov (United States)

Hill, Andy; MacNamara, Áine; Collins, Dave; Rodgers, Sheelagh

2016-01-01

Although significant research supports the association between physical activity and mental wellbeing, current literature acknowledges that athletes are no less susceptible to mental illness than the general population. Despite welcomed initiatives aimed at improving mental health within elite sport, these programs often fail to target young athletes; an important concern given that the genesis of many mental illnesses are recognized to occur during this critical period. Given the importance of early intervention and effective treatment, and the potentially devastating consequences of clinical issues going undiagnosed, the implications for talent identification and development (TID) become obvious. With this in mind, this study sought to examine the range of mental health issues that may impact upon developing athletes and potential consequences for the development process, specific risk and protective factors associated with talent development, along with an examination of current practices concerning the identification of mental health issues in such environments. Qualitative interviews were conducted with purposively sampled clinicians (n = 8) experienced in working with adolescents and/or young athletes. Inductive content analysis was undertaken, identifying four main themes: key behavioral indicators; associated risk factors; associated protective factors; and issues around identification and diagnosis. Key behavioral indicators included behavioral change, along with behaviors associated with eating disorders, anxiety and depression. Risk factors centered on family background, the performance environment, and issues surrounding adolescence. Protective factors were primarily social in nature. Finally, a lack of awareness and understanding of clinical issues, multiple causes of symptoms, non-disclosure and the need for triangulation of assessment were identified. The need for improved identification and intervention strategies was apparent, with coaches

Mental Health staff views on improving burnout and mental toughness

OpenAIRE

Posner, Zoe; Janssen, Jessica; Roddam, Hazel

2017-01-01

Purpose- Burnout in mental health staff is acknowledged as a major problem. The purpose of this paper is to gain an understanding of mental health staff views on improving burnout and mental toughness in mental health staff.\\ud Design/methodology/approach-Ten participants from two mental health rehabilitation units across the North West of England took part in a Nominal Group Technique (NGT). Participants consisted of mental health workers from varied roles in order to\\ud capture views from a...

Malaysian mental health law.

Science.gov (United States)

Khan, Nusrat N; Yahya, Badi'ah; Abu Bakar, Abd Kadir; Ho, Roger C

2015-05-01

The Malaysian Mental Health Act 2001 did not come into effect until the Mental Health Regulations 2010 came into force. The Act provides a framework for the delivery of comprehensive care, treatment, control, protection and rehabilitation of those with mental disorders. The Act governs the establishment of private and government psychiatric hospitals, psychiatric nursing homes and community mental health centres. This paper outlines the provisions of the Act and the Regulations.

Stigma and Mental Illness: Investigating Attitudes of Mental Health and Non-Mental-Health Professionals and Trainees

Science.gov (United States)

Smith, Allison L.; Cashwell, Craig S.

2010-01-01

The authors explored attitudes toward adults with mental illness. Results suggest that mental health trainees and professionals had less stigmatizing attitudes than did non-mental-health trainees and professionals. Professionals receiving supervision had higher mean scores on the Benevolence subscale than did professionals who were not receiving…

Mental health in prisons: A public health agenda.

Science.gov (United States)

Fraser, A

2009-01-01

Mental illness affects the majority of prisoners. Mental health issues are beginning to take a central position in the development of prison health services, reflecting this burden of disease. This change in focus is not before time. But prison mental health services cannot exist in isolation. Public health systems should lead provision of care for patients with acute and severe illness. A whole prison approach to health and, specifically, mental health will offer the greatest likelihood that offenders will thrive, benefit from imprisonment, and lead law-abiding lives after release. Public awareness of the scale and commitment of prisons to mental health and illness, and understanding of prisons' role in society, are necessary developments that would protect and enhance public mental health, as well as creating a healthier and safer society. This article draws on recent reviews, information and statements to set out a public health agenda for mental health in prisons.

Navigating the challenges of digital health innovation: considerations and solutions in developing online and smartphone-application-based interventions for mental health disorders.

Science.gov (United States)

Hill, Claire; Martin, Jennifer L; Thomson, Simon; Scott-Ram, Nick; Penfold, Hugh; Creswell, Cathy

2017-08-01

This article presents an analysis of challenges and considerations when developing digital mental health innovations. Recommendations include collaborative working between clinicians, researchers, industry and service users in order to successfully navigate challenges and to ensure e-therapies are engaging, acceptable, evidence based, scalable and sustainable. © The Royal College of Psychiatrists 2017.

Horizon 2020 Priorities in Clinical Mental Health Research: Results of a Consensus-Based ROAMER Expert Survey

Directory of Open Access Journals (Sweden)

Iman Elfeddali

2014-10-01

Full Text Available Within the ROAMER project, which aims to provide a Roadmap for Mental Health Research in Europe, a two-stage Delphi survey among 86 European experts was conducted in order to identify research priorities in clinical mental health research. Expert consensus existed with regard to the importance of three challenges in the field of clinical mental health research: (1 the development of new, safe and effective interventions for mental disorders; (2 understanding the mechanisms of disease in order to be able to develop such new interventions; and (3 defining outcomes (an improved set of outcomes, including alternative outcomes to use for clinical mental health research evaluation. Proposed actions involved increasing the utilization of tailored approaches (personalized medicine, developing blended eHealth/mHealth decision aids/guidance tools that help the clinician to choose between various treatment modalities, developing specific treatments in order to better target comorbidity and (further development of biological, psychological and psychopharmacological interventions. The experts indicated that addressing these priorities will result in increased efficacy and impact across Europe; with a high probability of success, given that Europe has important strengths, such as skilled academics and a long research history. Finally, the experts stressed the importance of creating funding and coordinated networking as essential action needed in order to target the variety of challenges in clinical mental health research.

National Institute of Mental Health

Science.gov (United States)

... to content Home Health Information Health Information Home Mental Health Information Statistics Consumer Health Publications Help for Mental ... signs and symptoms of depression in men. More Mental Health Services Research Conference Register now for the nation’s ...

"We Are Not Really Marketing Mental Health": Mental Health Advocacy in Zimbabwe.

Directory of Open Access Journals (Sweden)

Reuben Hendler

Full Text Available Few people with mental disorders in low and middle-income countries (LMICs receive treatment, in part because mental disorders are highly stigmatized and do not enjoy priority and resources commensurate with their burden on society. Advocacy has been proposed as a means of building political will and community support for mental health and reducing stigma, but few studies have explored the practice and promise of advocacy in LMICs.We conducted 30 semi-structured interviews with leaders in health and mental health in Zimbabwe to explore key stakeholder perceptions on the challenges and opportunities of the country's mental health system. We coded the transcripts using the constant comparative method, informed by principles of grounded theory. Few interview questions directly concerned advocacy, yet in our analysis, advocacy emerged as a prominent, cross-cutting theme across participants and interview questions.Two thirds of the respondents discussed advocacy, often in depth, returning to the concept throughout the interview and emphasizing their belief in advocacy's importance. Participants described six distinct components of advocacy: the advocates, to whom they advocate ("targets", what they advocate for ("asks", how advocates reach their targets ("access", how they make their asks ("arguments", and the results of their advocacy ("outcomes".Despite their perception that mental health is widely misunderstood and under-appreciated in Zimbabwe, respondents expressed optimism that strategically speaking out can reduce stigma and increase access to care. Key issues included navigating hierarchies, empowering service users to advocate, and integrating mental health with other health initiatives. Understanding stakeholder perceptions sets the stage for targeted development of mental health advocacy in Zimbabwe and other LMICs.

"We Are Not Really Marketing Mental Health": Mental Health Advocacy in Zimbabwe.

Science.gov (United States)

Hendler, Reuben; Kidia, Khameer; Machando, Debra; Crooks, Megan; Mangezi, Walter; Abas, Melanie; Katz, Craig; Thornicroft, Graham; Semrau, Maya; Jack, Helen

2016-01-01

Few people with mental disorders in low and middle-income countries (LMICs) receive treatment, in part because mental disorders are highly stigmatized and do not enjoy priority and resources commensurate with their burden on society. Advocacy has been proposed as a means of building political will and community support for mental health and reducing stigma, but few studies have explored the practice and promise of advocacy in LMICs. We conducted 30 semi-structured interviews with leaders in health and mental health in Zimbabwe to explore key stakeholder perceptions on the challenges and opportunities of the country's mental health system. We coded the transcripts using the constant comparative method, informed by principles of grounded theory. Few interview questions directly concerned advocacy, yet in our analysis, advocacy emerged as a prominent, cross-cutting theme across participants and interview questions. Two thirds of the respondents discussed advocacy, often in depth, returning to the concept throughout the interview and emphasizing their belief in advocacy's importance. Participants described six distinct components of advocacy: the advocates, to whom they advocate ("targets"), what they advocate for ("asks"), how advocates reach their targets ("access"), how they make their asks ("arguments"), and the results of their advocacy ("outcomes"). Despite their perception that mental health is widely misunderstood and under-appreciated in Zimbabwe, respondents expressed optimism that strategically speaking out can reduce stigma and increase access to care. Key issues included navigating hierarchies, empowering service users to advocate, and integrating mental health with other health initiatives. Understanding stakeholder perceptions sets the stage for targeted development of mental health advocacy in Zimbabwe and other LMICs.

The development of a model of training in child psychiatry for non-physician clinicians in Ethiopia

Science.gov (United States)

2014-01-01

Background The lack of trained mental health professionals has been an important barrier to establishing mental health services in low income countries. The purpose of this paper is to describe the development and implementation of child psychiatry training within a graduate program in mental health for non-physician clinicians in Ethiopia. Methods The existing needs for competent practitioners in child psychiatry were identified through discussions with psychiatrists working in Ethiopia as well as with relevant departments within the Federal Ministry of Health Ethiopia (FMOHE). As part of a curriculum for a two year Master of Science (MSC) in Mental Health program for non-physician clinicians, child psychiatry training was designed and implemented by Jimma University with the involvement of experts from Addis Ababa University (AAU), Ethiopia, and Ludwig-Maximillian’s University, (LMU), Germany. Graduates gave feedback after completing the course. The World Health Organization’s (WHO) Mental Health Gap Action Program (mhGAP) intervention guide (IG) adapted for Ethiopian context was used as the main training material. Results A two-week child psychiatry course and a four week child psychiatry clinical internship were successfully implemented during the first and the second years of the MSC program respectively. During the two week psychiatry course, trainees learned to observe the behavior and to assess the mental status of children at different ages who had a variety of mental health conditions. Assessment of the trainees’ clinical skills was done by the instructors at the end of the child psychiatry course as well as during the subsequent four week clinical internship. The trainees generally rated the course to be ‘very good’ to ‘excellent’. Many of the graduates have become faculty at the various universities in Ethiopia. Conclusion Child psychiatry training for non-physician mental health specialist trainees was developed and successfully

Peruvian Mental Health Reform: A Framework for Scaling-up Mental Health Services

Science.gov (United States)

Toyama, Mauricio; Castillo, Humberto; Galea, Jerome T.; Brandt, Lena R.; Mendoza, María; Herrera, Vanessa; Mitrani, Martha; Cutipé, Yuri; Cavero, Victoria; Diez-Canseco, Francisco; Miranda, J. Jaime

2017-01-01

Background: Mental, neurological, and substance (MNS) use disorders are a leading cause of disability worldwide; specifically in Peru, MNS affect 1 in 5 persons. However, the great majority of people suffering from these disorders do not access care, thereby making necessary the improvement of existing conditions including a major rearranging of current health system structures beyond care delivery strategies. This paper reviews and examines recent developments in mental health policies in Peru, presenting an overview of the initiatives currently being introduced and the main implementation challenges they face. Methods: Key documents issued by Peruvian governmental entities regarding mental health were reviewed to identify and describe the path that led to the beginning of the reform; how the ongoing reform is taking place; and, the plan and scope for scale-up. Results: Since 2004, mental health has gained importance in policies and regulations, resulting in the promotion of a mental health reform within the national healthcare system. These efforts crystallized in 2012 with the passing of Law 29889 which introduced several changes to the delivery of mental healthcare, including a restructuring of mental health service delivery to occur at the primary and secondary care levels and the introduction of supporting services to aid in patient recovery and reintegration into society. In addition, a performance-based budget was approved to guarantee the implementation of these changes. Some of the main challenges faced by this reform are related to the diversity of the implementation settings, eg, isolated rural areas, and the limitations of the existing specialized mental health institutes to substantially grow in parallel to the scaling-up efforts in order to be able to provide training and clinical support to every region of Peru. Conclusion: Although the true success of the mental healthcare reform will be determined in the coming years, thus far, Peru has achieved a

Peruvian Mental Health Reform: A Framework for Scaling-up Mental Health Services

Directory of Open Access Journals (Sweden)

Mauricio Toyama

2017-09-01

Full Text Available Background Mental, neurological, and substance (MNS use disorders are a leading cause of disability worldwide; specifically in Peru, MNS affect 1 in 5 persons. However, the great majority of people suffering from these disorders do not access care, thereby making necessary the improvement of existing conditions including a major rearranging of current health system structures beyond care delivery strategies. This paper reviews and examines recent developments in mental health policies in Peru, presenting an overview of the initiatives currently being introduced and the main implementation challenges they face. Methods Key documents issued by Peruvian governmental entities regarding mental health were reviewed to identify and describe the path that led to the beginning of the reform; how the ongoing reform is taking place; and, the plan and scope for scale-up. Results Since 2004, mental health has gained importance in policies and regulations, resulting in the promotion of a mental health reform within the national healthcare system. These efforts crystallized in 2012 with the passing of Law 29889 which introduced several changes to the delivery of mental healthcare, including a restructuring of mental health service delivery to occur at the primary and secondary care levels and the introduction of supporting services to aid in patient recovery and reintegration into society. In addition, a performance-based budget was approved to guarantee the implementation of these changes. Some of the main challenges faced by this reform are related to the diversity of the implementation settings, eg, isolated rural areas, and the limitations of the existing specialized mental health institutes to substantially grow in parallel to the scaling-up efforts in order to be able to provide training and clinical support to every region of Peru. Conclusion Although the true success of the mental healthcare reform will be determined in the coming years, thus far, Peru

Barriers to participation in mental health research: findings from the Genetics and Psychosis (GAP) Study.

Science.gov (United States)

Woodall, Anna; Howard, Louise; Morgan, Craig

2011-01-01

The aim of this study was to investigate why people with a first episode of psychosis choose or decline to participate in mental health research, using a qualitative study design. Participants were recruited via referrals from the Genetics and Psychosis (GAP) study. A total of 26 individuals with a first-episode of psychosis (nine of whom declined participation in the GAP study and 17 who participated) were individually interviewed and asked about their attitudes towards mental health research participation. Thematic analysis of interview transcripts was used to determine dominant themes and sub-themes on what constituted barriers and facilitators to participation. Reasons for research participation identified included a desire to help others, curiosity, and positive experiences with clinicians. Decisions to participate or not were also influenced by practical issues, including the timing of the approach, researchers' communication skills and whether individuals had concerns that it may be potentially harmful to their health. Other barriers to participation included patients' conceptualizations of mental health problems and the influence of other inpatients. Information on barriers and facilitators to recruitment in mental health research could inform recruitment strategies, thereby maximizing recruitment rates and minimizing the risk of selection biases.

Mental health in schools and public health

OpenAIRE

Adelman, Howard S; Taylor, Linda

2006-01-01

Health policy and practice call for health and mental health parity and for a greater focus on universal interventions to promote, prevent, and intervene as early after problem onset as is feasible. Those in the public health field are uniquely positioned to help promote the mental health of young people and to reshape how the nation thinks about and addresses mental health. And schools are essential partners for doing the work.

Using the Delphi expert consensus method in mental health research.

Science.gov (United States)

Jorm, Anthony F

2015-10-01

The article gives an introductory overview of the use of the Delphi expert consensus method in mental health research. It explains the rationale for using the method, examines the range of uses to which it has been put in mental health research, and describes the stages of carrying out a Delphi study using examples from the literature. To ascertain the range of uses, a systematic search was carried out in PubMed. The article also examines the implications of 'wisdom of crowds' research for how to conduct Delphi studies. The Delphi method is a systematic way of determining expert consensus that is useful for answering questions that are not amenable to experimental and epidemiological methods. The validity of the approach is supported by 'wisdom of crowds' research showing that groups can make good judgements under certain conditions. In mental health research, the Delphi method has been used for making estimations where there is incomplete evidence (e.g. What is the global prevalence of dementia?), making predictions (e.g. What types of interactions with a person who is suicidal will reduce their chance of suicide?), determining collective values (e.g. What areas of research should be given greatest priority?) and defining foundational concepts (e.g. How should we define 'relapse'?). A range of experts have been used in Delphi research, including clinicians, researchers, consumers and caregivers. The Delphi method has a wide range of potential uses in mental health research. © The Royal Australian and New Zealand College of Psychiatrists 2015.

Contradictions In Mental Health: Stigma, Mental Health Literacy And Disclosure (Or Not Of A Mental Disorder Diagnosis.

Directory of Open Access Journals (Sweden)

manuel torres cubeiro

2018-05-01

Full Text Available Mental illnesses affect 25% of any given population. The literacy of human population about mental health doesn’t not much the scientific knowledge available about Mental disorders (MDs. Developed countries invest in mental health less than their 9% of their GDPs. There is a contradiction, or discrepancy, between the incidence of MD in human population and how human societies react about them. This discrepancy has long been evident in the literature of medical sociology. In this article we analyze three medical sociology related concepts that have been coined to understand this contradiction: first, mental health literacy; second, stigma of mental ailments; and finally, the disclosure (or not of the diagnosis of a mental illness. With this article we try to solve short use of these concepts in medical sociology in Spanish.

Role of the police in linking individuals experiencing mental health crises with mental health services

Science.gov (United States)

2012-01-01

Background The police are considered frontline professionals in managing individuals experiencing mental health crises. This study examines the extent to which these individuals are disconnected from mental health services, and whether the police response has an influence on re-establishing contact. Methods Police records were searched for calls regarding individuals with acute mental health needs and police handling of these calls. Mental healthcare contact data were retrieved from a Psychiatric Case Register. Results The police were called upon for mental health crisis situations 492 times within the study year, involving 336 individuals (i.e. 1.7 per 1000 inhabitants per year). Half of these individuals (N=162) were disengaged from mental health services, lacking regular care contact in the year prior to the crisis (apart from contact for crisis intervention). In the month following the crisis, 21% of those who were previously disengaged from services had regular care contact, and this was more frequent (49%) if the police had contacted the mental health services during the crisis. The influence of police referral to the services was still present the following year. However, for the majority (58%) of disengaged individuals police did not contact the mental health services at the time of crisis. Conclusions The police deal with a substantial number of individuals experiencing a mental health crisis, half of whom are out of contact with mental health services, and police play an important role in linking these individuals to services. Training police officers to recognise and handle mental health crises, and implementing practical models of cooperation between the police and mental health services in dealing with such crises may further improve police referral of individuals disengaged from mental health services. PMID:23072687

Training community mental health staff in Guangzhou, China: evaluation of the effect of a new training model.

Science.gov (United States)

Li, Jie; Li, Juan; Thornicroft, Graham; Yang, Hui; Chen, Wen; Huang, Yuanguang

2015-10-26

Increasing numbers of people with mental disorders receive services at primary care in China. The aims of this study are to evaluate impact of a new training course and supervision for community mental health staff to enhance their levels of mental health knowledge and to reduce their stigmatization toward people with mental illness. A total of 77 community mental health staff from eight regions in Guangzhou in China were recruited for the study.4 regions were randomly allocated to the new training model group, and 4 to the old training model group. Levels of mental health knowledge were measured by purpose-made assessment schedule and by the Mental Health Knowledge Schedule (MAKS). Stigma was evaluated by the Mental Illness: Clinicians' Attitudes Scale (MICA) and the Reported and Intended Behavior Scale (RIBS). Evaluation questionnaires were given at the beginning of course, at the end, and at 6 month and at 12 month follow-up. After the training period, the 6-month, and the 12-month, knowledge scores of the intervention group were higher than the control group. At 6-month and 12-month follow-up, means scores of MAKS of the intervention group increased more than the control group (both p training, at 6-months, and at 12-months, mean scores of RIBS of the intervention group increased more than the control (p training course and supervision, the new course improved community mental health staff knowledge of mental disorders, improving their attitudes toward people with mental disorder, and increasing their willingness to have contact with people with mental disorder.

Public mental health.

Science.gov (United States)

Lindert, Jutta; Bilsen, Johan; Jakubauskiene, Marija

2017-10-01

Public mental health (PMH) is a major challenge for public health research and practice. This article is organized in six parts. First, we will highlight the significance of PMH; second, we will define mental health and mental disorders; third, we identify and describe determinants of mental health and mental disorders on which we worked in the past 10 years since the establishment of the PMH section such as social determinants and violence. Fourth, we will describe the development of the EUPHA PMH section and provide details on vulnerable groups in the field of PMH, on violence as a main determinant and on suicide as an outcome which affects all countries in the European region. Fifth, we describe policy and practice implications of the development of PMH and highlight the European dimension of PMH. We will conclude this article by providing an outlook on potential further development of PMH as regards research and policy and practice. Finally, we hope that the EUPHA PMH section will contribute to public health in the next 25 years and we can contribute to improvement of PMH in Europe. © The Author 2017. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

Common Mental Health Issues

Science.gov (United States)

Stock, Susan R.; Levine, Heidi

2016-01-01

This chapter provides an overview of common student mental health issues and approaches for student affairs practitioners who are working with students with mental illness, and ways to support the overall mental health of students on campus.

Acute mental health care and South African mental health legislation

African Journals Online (AJOL)

information on mental health care outcome, to do a cost analysis and to establish a quality assurance cycle that may facilitate a cost ... clinical record reviews of mental health service delivery, training ... (d) describe the demographic and clinical profile of HIV positive ..... accommodate the differentiated but integrated care of.

Holistic Health: Does It Really Include Mental Health?

Directory of Open Access Journals (Sweden)

Kimberly K. McClanahan

2006-01-01

Full Text Available Holistic health, incorporating mind and body as equally important and unified components of health, is a concept utilized in some health care arenas in the United States (U.S. over the past 30 years. However, in the U.S., mental health is not seen as conceptually integral to physical health and, thus, holistic health cannot be realized until the historical concept of mind-body dualism, continuing stigma regarding mental illness, lack of mental health parity in insurance, and inaccurate public perceptions regarding mental illness are adequately addressed and resolved. Until then, mental and physical health will continue to be viewed as disparate entities rather than parts of a unified whole. We conclude that the U.S. currently does not generally incorporate the tenets of holistic health in its view of the mental and physical health of its citizens, and provide some suggestions for changing that viewpoint.

Holistic health: does it really include mental health?

Science.gov (United States)

McClanahan, Kimberly K; Huff, Marlene B; Omar, Hatim A

2006-03-14

Holistic health, incorporating mind and body as equally important and unified components of health, is a concept utilized in some health care arenas in the United States (U.S.) over the past 30 years. However, in the U.S., mental health is not seen as conceptually integral to physical health and, thus, holistic health cannot be realized until the historical concept of mind-body dualism, continuing stigma regarding mental illness, lack of mental health parity in insurance, and inaccurate public perceptions regarding mental illness are adequately addressed and resolved. Until then, mental and physical health will continue to be viewed as disparate entities rather than parts of a unified whole. We conclude that the U.S. currently does not generally incorporate the tenets of holistic health in its view of the mental and physical health of its citizens, and provide some suggestions for changing that viewpoint.

PERCC Tools: Public Health Preparedness for Clinicians

Centers for Disease Control (CDC) Podcasts

CDC’s Office of Public Health Preparedness and Response funds Preparedness and Emergency Response Research Centers (PERRCs) to examine components of the public health system. This podcast is an overview of mental and behavioral health tools developed by the Johns Hopkins PERRC.

Rural Mental Health Ecology: A Framework for Engaging with Mental Health Social Capital in Rural Communities.

Science.gov (United States)

Wilson, Rhonda L; Wilson, G Glenn; Usher, Kim

2015-09-01

The mental health of people in rural communities is influenced by the robustness of the mental health ecosystem within each community. Theoretical approaches such as social ecology and social capital are useful when applied to the practical context of promoting environmental conditions which maximise mental health helping capital to enhance resilience and reduce vulnerably as a buffer for mental illness. This paper explores the ecological conditions that affect the mental health and illness of people in rural communities. It proposes a new mental health social ecology framework that makes full use of the locally available unique social capital that is sufficiently flexible to facilitate mental health helping capital best suited to mental health service delivery for rural people in an Australian context.

Mental health policy and development in Egypt - integrating mental health into health sector reforms 2001-9

Directory of Open Access Journals (Sweden)

Siekkonen Inkeri

2010-06-01

Full Text Available Abstract Background Following a situation appraisal in 2001, a six year mental health reform programme (Egymen 2002-7 was initiated by an Egyptian-Finnish bilateral aid project at the request of a former Egyptian minister of health, and the work was incorporated directly into the Ministry of Health and Population from 2007 onwards. This paper describes the aims, methodology and implementation of the mental health reforms and mental health policy in Egypt 2002-2009. Methods A multi-faceted and comprehensive programme which combined situation appraisal to inform planning; establishment of a health sector system for coordination, supervision and training of each level (national, governorate, district and primary care; development workshops; production of toolkits, development of guidelines and standards; encouragement of intersectoral liaison at each level; integration of mental health into health management systems; and dedicated efforts to improve forensic services, rehabilitation services, and child psychiatry services. Results The project has achieved detailed situation appraisal, epidemiological needs assessment, inclusion of mental health into the health sector reform plans, and into the National Package of Essential Health Interventions, mental health masterplan (policy guidelines to accompany the general health policy, updated Egyptian mental health legislation, Code of Practice, adaptation of the WHO primary care guidelines, primary care training, construction of a quality system of roles and responsibilities, availability of medicines at primary care level, public education about mental health, and a research programme to inform future developments. Intersectoral liaison with education, social welfare, police and prisons at national level is underway, but has not yet been established for governorate and district levels, nor mental health training for police, prison staff and teachers. Conclusions The bilateral collaboration programme

Children's Mental Health

Science.gov (United States)

... Español (Spanish) Recommend on Facebook Tweet Share Compartir Mental health in childhood means reaching developmental and emotional milestones, ... is doing to improve access to care. Children’s Mental Health: What's New Article: U.S. Children with Diagnosed Anxiety ...

What is mental health? Evidence towards a new definition from a mixed methods multidisciplinary international survey

Science.gov (United States)

Manwell, Laurie A; Barbic, Skye P; Roberts, Karen; Durisko, Zachary; Lee, Cheolsoon; Ware, Emma; McKenzie, Kwame

2015-01-01

Objective Lack of consensus on the definition of mental health has implications for research, policy and practice. This study aims to start an international, interdisciplinary and inclusive dialogue to answer the question: What are the core concepts of mental health? Design and participants 50 people with expertise in the field of mental health from 8 countries completed an online survey. They identified the extent to which 4 current definitions were adequate and what the core concepts of mental health were. A qualitative thematic analysis was conducted of their responses. The results were validated at a consensus meeting of 58 clinicians, researchers and people with lived experience. Results 46% of respondents rated the Public Health Agency of Canada (PHAC, 2006) definition as the most preferred, 30% stated that none of the 4 definitions were satisfactory and only 20% said the WHO (2001) definition was their preferred choice. The least preferred definition of mental health was the general definition of health adapted from Huber et al (2011). The core concepts of mental health were highly varied and reflected different processes people used to answer the question. These processes included the overarching perspective or point of reference of respondents (positionality), the frameworks used to describe the core concepts (paradigms, theories and models), and the way social and environmental factors were considered to act. The core concepts of mental health identified were mainly individual and functional, in that they related to the ability or capacity of a person to effectively deal with or change his/her environment. A preliminary model for the processes used to conceptualise mental health is presented. Conclusions Answers to the question, ‘What are the core concepts of mental health?’ are highly dependent on the empirical frame used. Understanding these empirical frames is key to developing a useful consensus definition for diverse populations. PMID:26038353

Development of Mental Health Indicators in Korea

Science.gov (United States)

Han, Hyeree; Ahn, Dong Hyun; Song, Jinhee; Hwang, Tae Yeon

2012-01-01

Objective Promoting mental health and preventing mental health problems are important tasks for international organizations and nations. Such goals entail the establishment of active information networks and effective systems and indicators to assess the mental health of populations. This being said, there is a need in Korea develop ways to measure the state of mental health in Korea. Methods This paper reviews the mental health indicator development policies and practices of seven organizations, countries, and regions: WHO, OECD, EU, United States, Australia, UK, and Scotland. Using Delphi method, we conducted two surveys of mental health indicators for experts in the field of mental health. The survey questionnaire included 5 domains: mental health status, mental health factor, mental health system, mental health service, and quality of mental health services. We considered 124 potential mental health indicators out of more than 600 from indicators of international organizations and foreign countries. Results We obtained the top 30 mental health indicators from the surveys. Among them, 10 indicators belong to the mental health system. The most important five mental health indicators are suicide rate, rate of increase in mental disorder treatment, burden caused by mental disorders, adequacy of identifying problems of mental health projects and deriving solutions, and annual prevalence of mental disorders. Conclusion Our study provides information about the process for indicator development and the use of survey results to measure the mental health status of the Korean population. The aim of mental health indicator development is to improve the mental health system by better grasping the current situation. We suggest these mental health indicators can monitor progress in efforts to implement reform policies, provide community services, and involve users, families and other stakeholders in mental health promotion, prevention, care and rehabilitation. PMID:23251193

Mental Health, Racism, and Sexism.

Science.gov (United States)

Willie, Charles V., Ed.; And Others

This volume, successor to the 1973 volume "Racism and Mental Health," presents a range of perspectives on mental health, prejudice, and discrimination. Contributors are of multiracial, multiethnic, and gender-diverse backgrounds. They use their existential experiences to analyze pressing mental health and mental illness issues. Contributions…

Costs and Performance of English Mental Health Providers.

Science.gov (United States)

Moran, Valerie; Jacobs, Rowena

2017-06-01

Despite limited resources in mental health care, there is little research exploring variations in cost performance across mental health care providers. In England, a prospective payment system for mental health care based on patient needs has been introduced with the potential to incentivise providers to control costs. The units of payment under the new system are 21 care clusters. Patients are allocated to a cluster by clinicians, and each cluster has a maximum review period. The aim of this research is to explain variations in cluster costs between mental health providers using observable patient demographic, need, social and treatment variables. We also investigate if provider-level variables explain differences in costs. The residual variation in cluster costs is compared across providers to provide insights into which providers may gain or lose under the new financial regime. The main data source is the Mental Health Minimum Data Set (MHMDS) for England for the years 2011/12 and 2012/13. Our unit of observation is the period of time spent in a care cluster and costs associated with the cluster review period are calculated from NHS Reference Cost data. Costs are modelled using multi-level log-linear and generalised linear models. The residual variation in costs at the provider level is quantified using Empirical Bayes estimates and comparative standard errors used to rank and compare providers. There are wide variations in costs across providers. We find that variables associated with higher costs include older age, black ethnicity, admission under the Mental Health Act, and higher need as reflected in the care clusters. Provider type, size, occupancy and the proportion of formal admissions at the provider-level are also found to be significantly associated with costs. After controlling for patient- and provider-level variables, significant residual variation in costs remains at the provider level. The results suggest that some providers may have to increase

Mental Health Counseling in the Islamic Republic of Iran: A Marriage of Religion, Science, and Practice

Science.gov (United States)

Priester, Paul E.

2008-01-01

This article explores the state of mental health counseling in the Islamic Republic of Iran. Topics that are addressed include training of clinicians, theoretical developments in Islamic-based theories of psychology, and issues related to the practice of counseling. Counseling issues in the Islamic Republic of Iran are influenced by its unique…

Comparing profiles of mental disorder across birth cohorts: results from the 2007 Australian National Survey of Mental Health and Wellbeing.

Science.gov (United States)

Sunderland, Matthew; Carragher, Natacha; Buchan, Heather; Batterham, Philip J; Slade, Tim

2014-05-01

To describe and compare individuals with any DSM-IV mental disorder from three different birth cohorts - young (16-34 years), middle age (35-59 years) and older age (60-85 years) - on a range of clinically relevant factors. Data were derived from the 2007 Australian National Survey of Mental Health and Wellbeing. Individuals from three birth cohorts with a range of mental health and substance use disorders were identified using DSM-IV criteria and compared using regression analysis. The specific factors that were compared include: (1) type of disorder/disorders present; (2) suicidality; (3) number of co-occurring disorders; (4) levels of distress and impairment; (5) self-assessed physical and mental health; (6) presence of physical conditions; (7) size and quality of social support/network; and (8) treatment-seeking behaviour. The birth cohorts differed dramatically in terms of the specific disorders that were present. The older cohort were significantly more likely to experience internalising disorders and significantly less likely to experience externalising disorders in comparison to the young cohort. The older cohort were significantly more likely to experience co-morbid physical conditions as well as lower life satisfaction, poorer self-rated physical health, increased functional impairment, and more days out of role. The younger cohort had a significantly larger peer group that they could confide in and rely on in comparison to the older cohort. Clinicians and researchers need to be cognisant that mental disorders manifest as highly heterogeneous constructs. The presentation of a disorder in a younger individual could be vastly different from the presentation of the same disorder in an older individual. The additional burden associated with these factors and how they apply to different birth cohorts must be taken into consideration when planning mental health services and effective treatment for the general population.

Predictive analytics in mental health: applications, guidelines, challenges and perspectives.

Science.gov (United States)

Hahn, T; Nierenberg, A A; Whitfield-Gabrieli, S

2017-01-01

The emerging field of 'predictive analytics in mental health' has recently generated tremendous interest with the bold promise to revolutionize clinical practice in psychiatry paralleling similar developments in personalized and precision medicine. Here, we provide an overview of the key questions and challenges in the field, aiming to (1) propose general guidelines for predictive analytics projects in psychiatry, (2) provide a conceptual introduction to core aspects of predictive modeling technology, and (3) foster a broad and informed discussion involving all stakeholders including researchers, clinicians, patients, funding bodies and policymakers.

Chronic disease health risk behaviours amongst people with a mental illness.

Science.gov (United States)

Bartlem, Kate M; Bowman, Jennifer A; Bailey, Jacqueline M; Freund, Megan; Wye, Paula M; Lecathelinais, Christophe; McElwaine, Kathleen M; Campbell, Elizabeth M; Gillham, Karen E; Wiggers, John H

2015-08-01

Amongst people with a mental illness, modifiable health risk behaviours contribute substantially to increased chronic disease morbidity and mortality. This study examined the prevalence of and interest in changing such behaviours amongst community mental health service clients in Australia. A telephone interview was undertaken with Australian community mental health service clients. Participants reported engagement in four health risk behaviours: tobacco smoking, fruit and vegetable consumption, alcohol consumption, and physical activity. Participants were classified as at risk based upon Australian national guidelines. At-risk participants were asked whether they were considering improving their health risk behaviour within the next month. The association between psychiatric diagnosis and risk, and interest in improving health risk behaviours was examined. Risk prevalence was highest for inadequate vegetable consumption (78.3%), followed by inadequate fruit consumption (60%), smoking (50.7%), physical inactivity (46.8%), short-term alcohol risk (40.3%) and chronic alcohol risk (35.3%). A majority of at-risk participants were considering improving their health risk behaviour for smoking, physical inactivity and inadequate fruit and vegetable consumption (65.1%, 71.1%, and 53.3%, respectively). After adjusting for demographic factors, no diagnostic categories were associated with risk for any behaviour. Those with a diagnosis of depression were more likely to be interested in quitting smoking and increasing physical activity. Regardless of diagnosis, a high prevalence of chronic disease health risk behaviours was identified, with many participants expressing an interest in improving these behaviours. Such findings reinforce recommendations that preventive care addressing the chronic disease risks of clients be provided routinely by mental health clinicians. Australian New Zealand Clinical Trials Registry (ANZCTR) ACTRN12613000693729. URL: www.anzctr.org.au/. © The

Global mental health and the National Institute of Mental Health Research Domain Criteria.

Science.gov (United States)

Weine, Stevan Merill; Langenecker, Scott; Arenliu, Aliriza

2018-05-01

The National Institute of Mental Health (NIMH) Research Domain Criteria (RDoC) project presents innovative ways of investigating mental illness based on behavioral and neurobiological measures of dimensional processes. Although cultural psychiatrists have critiqued RDoC's implications and limitations for its under-developed focus on context and experience, RDoC presents opportunities for synergies with global mental health. It can capture aspects of clinical or sub-clinical behavior which are less dependent upon Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-5) and perhaps better elucidate the role of culture in disease expression and resilience. Aim/Results: This article uses the example of migration to describe several starting points for new research: (1) providing components for building an investigable conceptual framework to understand individual's mental health, resilience and adjustment to migration challenges or social adversities in low- and middle-income countries (LMICs) and (2) identifying measurable factors which determine resilience or vulnerability, to guide development and evaluation of targeted prevention, treatment and recovery strategies for mental health in LMICs. In such ways, RDoC frameworks could help put the new cutting edge neurobiological dimensional scientific advances in a position to contribute to addressing mental health problems amid social adversities in LMICs. However, this would require a much-expanded commitment by both RDoC and global mental health researchers to address contextual and experiential dimensions.

The Meaning and Predictive Value of Self-rated Mental Health among Persons with a Mental Health Problem.

Science.gov (United States)

McAlpine, Donna D; McCreedy, Ellen; Alang, Sirry

2018-06-01

Self-rated health is a valid measure of health that predicts quality of life, morbidity, and mortality. Its predictive value reflects a conceptualization of health that goes beyond a traditional medical model. However, less is known about self-rated mental health (SRMH). Using data from the Medical Expenditure Panel Survey ( N = 2,547), we examine how rating your mental health as good-despite meeting criteria for a mental health problem-predicts outcomes. We found that 62% of people with a mental health problem rated their mental health positively. Persons who rated their mental health as good (compared to poor) had 30% lower odds of having a mental health problem at follow-up. Even without treatment, persons with a mental health problem did better if they perceived their mental health positively. SRMH might comprise information beyond the experience of symptoms. Understanding the unobserved information individuals incorporate into SRMH will help us improve screening and treatment interventions.

Maternity care for trafficked women: Survivor experiences and clinicians' perspectives in the United Kingdom's National Health Service.

Science.gov (United States)

Bick, Debra; Howard, Louise M; Oram, Sian; Zimmerman, Cathy

2017-01-01

Although trafficked women and adolescents are at risk of unprotected or forced sex, there is little research on maternity care among trafficking survivors. We explored health care needs, service use and challenges among women who became pregnant while in the trafficking situation in the United Kingdom (UK) and clinicians' perspectives of maternity care for trafficked persons. Cross-sectional survey and qualitative interviews with trafficking survivors recruited from statutory and voluntary sector organisations in England and qualitative interviews with maternity clinicians and family doctors undertaken to offer further insight into experiences reported by these women. Twenty-eight (29%) of 98 women who took part in a large study of trafficking survivors reported one or more pregnancies while trafficked, whose data are reported here. Twelve (42.8%) of these women reported at least one termination of pregnancy while in the trafficking situation and 25 (89.3%) experienced some form of mental health disorder. Nineteen (67.9%) women experienced pre-trafficking physical abuse and 9 (32.%) sexual abuse. A quarter of women were trafficked for sexual exploitation, six for domestic servitude and two for manual labour. Survivors and clinicians described service challenges, including restrictions placed on women's movements by traffickers, poor knowledge on how to access maternity care, poor understanding of healthcare entitlements and concerns about confidentiality. Maternity care clinicians recognised potential indicators of trafficking, but considered training would help them identify and respond to victims. Main limitations include that findings reflect women who had exited the trafficking situation, however as some had only recently exited the trafficking situation, difficulties with recall were likely to be low. More than one in four women became pregnant while trafficked, indicating that maternity services offer an important contact point for identification and care

Mental Health Service Delivery Systems and Perceived Qualifications of Mental Health Service Providers in School Settings

Science.gov (United States)

Dixon, Decia Nicole

2009-01-01

Latest research on the mental health status of children indicates that schools are key providers of mental health services (U.S. Department of Health and Human Services, 2003). The push for school mental health services has only increased as stakeholders have begun to recognize the significance of sound mental health as an essential part of…

Once a clinician, always a clinician: a systematic review to develop a typology of clinician-researcher dual-role experiences in health research with patient-participants

Directory of Open Access Journals (Sweden)

E. Jean C. Hay-Smith

2016-08-01

Full Text Available Abstract Background Many health researchers are clinicians. Dual-role experiences are common for clinician-researchers in research involving patient-participants, even if not their own patients. To extend the existing body of literature on why dual-role is experienced, we aimed to develop a typology of common catalysts for dual-role experiences to help clinician-researchers plan and implement methodologically and ethically sound research. Methods Systematic searching of Medline, CINAHL, PsycINFO, Embase and Scopus (inception to 28.07.2014 for primary studies or first-person reflexive reports of clinician-researchers’ dual-role experiences, supplemented by reference list checking and Google Scholar scoping searches. Included articles were loaded in NVivo for analysis. The coding was focused on how dual-role was evidenced for the clinician-researchers in research involving patients. Procedures were completed by one researcher (MB and independently cross-checked by another (JHS. All authors contributed to extensive discussions to resolve all disagreements about initial coding and verify the final themes. Results Database searching located 7135 records, resulting in 29 included studies, with the addition of 7 studies through reference checks and scoping searches. Two overarching themes described the most common catalysts for dual-role experiences – ways a research role can involve patterns of behaviour typical of a clinical role, and the developing connection that starts to resemble a clinician-patient relationship. Five subthemes encapsulated the clinical patterns commonly repeated in research settings (clinical queries, perceived agenda, helping hands, uninvited clinical expert, and research or therapy and five subthemes described concerns about the researcher-participant relationship (clinical assumptions, suspicion and holding back, revelations, over-identification, and manipulation. Clinician-researchers use their clinical skills in health

Acute mental health care and South African mental health legislation ...

African Journals Online (AJOL)

Objective: This is the first of three reports on a follow-up review of mental health care at Helen Joseph Hospital (HJH). In this first part, qualitative and quantitative descriptions were made of the services and of demographic and clinical data on acute mental health care users managed at HJH, in a retrospective review of ...

Mental Health and Asian Americans

Science.gov (United States)

... Data > Minority Population Profiles > Asian American > Mental Health Mental Health and Asian Americans Suicide was the 9th leading ... Americans is half that of the White population. MENTAL HEALTH STATUS Serious psychological distress among adults 18 years ...

States Pass Diverse Slate of Mental Health Legislation in 2013. Mental Health: 2013 Legislative Session

Science.gov (United States)

Thomsen, Jennifer

2014-01-01

Recent violence in schools and on college campuses has brought into sharp focus the need to address mental health issues in educational settings. Getting students with mental health problems the help they need, without stigmatizing mental illness, may help prevent future tragedies. Children with mental health problems face a host of challenges,…

Consensus Among International Ethical Guidelines for the Provision of Videoconferencing-Based Mental Health Treatments

Science.gov (United States)

Wakefield, Claire E; McGill, Brittany C; Wilson, Helen L; Patterson, Pandora

2016-01-01

specific "firm" and a further 123 "tentative-level" recommendations regarding the appropriateness of e-mental health, competence, legal and regulatory issues, confidentiality, consent, professional boundaries, and crisis management. International consensus yielded firm guidance across almost all areas except professional boundaries and some aspects of determining the appropriateness of e-mental health. Few guidelines specifically addressed special populations. Overall guideline quality varied; however, 42% (8/19) of the guidelines scored at least 5 out of 7. Conclusions This synthesis of guidelines provides a foundation for clinicians and researchers utilizing e-mental health worldwide. The lack of specific guidance relating to special populations is an area warranting further attention in order to strengthen mental health professionals’ and researchers’ capacity to ethically and effectively tailor e-mental health interventions to these groups. PMID:27192931

Poverty and mental health: What should we know as mental health professionals?

Science.gov (United States)

Lepiéce, Brice; Reynaert, Christine; Jacques, Denis; Zdanowicz, Nicolas

2015-09-01

Social inequality as a social and economic phenomenon has become an issue of common interest in Europe and other societies worldwide, mainly after the recent global financial and economic crisis that occurred in 2008. The increasing gap observed between socioeconomically advantaged and disadvantaged people has caused intensive debates in politics, social sciences and in the field of public health. Today, poverty is considered as a major variable adversely influencing health. In this paper we will discuss the link between poverty and mental health. We conducted a literature search focusing on three main objectives: (I) to investigate the definition of "poverty"; (II) to determine the association between poverty and major mental health problems; and (III) to discuss the extent to which poverty could be both a cause and a consequence of mental health. We identified a total of 142 relevant papers, published between 1995 and 2014, only 32 were retained. Main findings are summarised in this paper. Poverty can be considered as a risk factor for mental illness. Yet the relation between poverty and mental health is complex, without direct causation, and bidirectional. As poverty has severe consequences not only on health but also on the whole society, combating poverty should be placed high on the political agenda.

"A constant struggle to receive mental health care": health care professionals' acquired experience of barriers to mental health care services in Rwanda.

Science.gov (United States)

Rugema, Lawrence; Krantz, Gunilla; Mogren, Ingrid; Ntaganira, Joseph; Persson, Margareta

2015-12-16

In Rwanda, many people are still mentally affected by the consequences of the genocide and yet mental health care facilities are scarce. While available literature explains the prevalence and consequences of mental disorders, there is lack of knowledge from low-income countries on health care seeking behavior due to common mental disorders. Therefore, this study sought to explore health care professionals' acquired experiences of barriers and facilitators that people with common mental disorders face when seeking mental health care services in Rwanda. A qualitative approach was applied and data was collected from six focus group discussions (FGDs) conducted in October 2012, including a total of 43 health care professionals, men and women in different health professions. The FGDs were performed at health facilities at different care levels. Data was analyzed using manifest and latent content analysis. The emerging theme "A constant struggle to receive mental health care for mental disorders" embraced a number of barriers and few facilitators at individual, family, community and structural levels that people faced when seeking mental health care services. Identified barriers people needed to overcome were: Poverty and lack of family support, Fear of stigmatization, Poor community awareness of mental disorders, Societal beliefs in traditional healers and prayers, Scarce resources in mental health care and Gender imbalance in care seeking behavior. The few facilitators to receive mental health care were: Collaboration between authorities and organizations in mental health and having a Family with awareness of mental disorders and health insurance. From a public health perspective, this study revealed important findings of the numerous barriers and the few facilitating factors available to people seeking health for mental disorders. Having a supportive family with awareness of mental disorders who also were equipped with a health insurance was perceived as vital for

Public mental health – using the Mental Health Gap Action Program to put all hands to the pumps

Directory of Open Access Journals (Sweden)

RICHARD eUWAKWE

2014-04-01

Full Text Available Mental ill health constitutes a huge portion of the GBD but the majority of people with mental health problems do not receive any treatment, a scenario much worse in developing countries where mental health personnel are in gross short supply. The mhGAP was launched to address this gap, especially by training non-mental health professionals to deliver effective services for selected priority mental health problems. Especially in developing countries, people with mental health problems consult traditional healers either as a first step in the pathway to biomedical mental health care or as the sole mental health service providers. Bridging the gap between mental health needs and available services in developing countries must incorporate traditional healers, who are ubiquitously available, easily accessible and acceptable to the natives. Although there are barriers in forging collaborations between traditional and biomedical mental health care providers, with mutual respect, understanding and adapted training using the mhGAP guide it should be possible to get some traditional healers to understand the core principles of some priority mental health problems identification, treatment and referral.

Mental health and disorders. Editorial.

Science.gov (United States)

Wittchen, Hans-Ulrich

2014-01-01

Mental health and mental disorders pose a tremendous challenge to the societal, health, and research policies in Europe, and sound advice is needed on a potential strategy for mental health research investment. Toward this goal, the ROAMER initiative ("Roadmap for Mental Health Research in Europe") was launched to map the current state of the art, to identify gaps and to delineate advances needed in various areas and domains of mental health research in Europe. To further stimulate discussions among the scientific community and stakeholders on how to improve mental health research and to promote an improved research agenda for the next decade, this IJMPR topic issue presents the overall ROAMER methodology as well as a series of selected papers highlighting critical issues of psychological approaches and interventions as outcomes of the ROAMER work package 5 "Psychological research and treatments". Copyright © 2013 John Wiley & Sons, Ltd.

Physiotherapy and Mental Health

OpenAIRE

Probst, Michel

2017-01-01

Physiotherapy in mental health care and psychiatry is a recognized specialty within physiotherapy. It offers a rich variety of observational and evaluation tools as well as a range of interventions that are related to the patient’s physical and mental health problems based on evidence-based literature and a 50-year history. Physiotherapy in mental health care addresses human movement, function, physical activity and exercise in individual and group therapeutic settings. Additionally, it conne...

Understanding and Responding to the Needs of Commercially Sexually Exploited Youth: Recommendations for the Mental Health Provider.

Science.gov (United States)

Ijadi-Maghsoodi, Roya; Cook, Mekeila; Barnert, Elizabeth S; Gaboian, Shushanik; Bath, Eraka

2016-01-01

Mental health providers are frequently at the forefront of addressing the multifaceted needs of commercially sexually exploited youth. This article provides an overview of the definition of commercial sexual exploitation of children and relevant legislation including the shift toward decriminalization of commercially sexually exploited youth. To provide clinicians with tools needed to deliver competent care to this population, a review of risk factors for commercial sexual exploitation of children and the role of the clinician in identification, assessment, and treatment of commercially sexually exploited youth are discussed. Published by Elsevier Inc.

Mental Health - Multiple Languages

Science.gov (United States)

... and Well-Being 1 - Stress - Amarɨñña / አማርኛ (Amharic) MP3 Siloam Family Health Center Health and Well-Being ... Well-Being 2 - Mental Health - Amarɨñña / አማርኛ (Amharic) MP3 Siloam Family Health Center What Is Mental Distress - ...

Measurement-based management of mental health quality and access in VHA: SAIL mental health domain.

Science.gov (United States)

Lemke, Sonne; Boden, Matthew Tyler; Kearney, Lisa K; Krahn, Dean D; Neuman, Matthew J; Schmidt, Eric M; Trafton, Jodie A

2017-02-01

We outline the development of a Mental Health Domain to track accessibility and quality of mental health care in the United States Veterans Health Administration (VHA) as part of a broad-based performance measurement system. This domain adds an important element to national performance improvement efforts by targeting regional and facility leadership and providing them a concise yet comprehensive measure to identify facilities facing challenges in their mental health programs. We present the conceptual framework and rationale behind measure selection and development. The Mental Health Domain covers three important aspects of mental health treatment: Population Coverage, Continuity of Care, and Experience of Care. Each component is a composite of existing and newly adapted measures with moderate to high internal consistency; components are statistically independent or moderately related. Development and dissemination of the Mental Health Domain involved a variety of approaches and benefited from close collaboration between local, regional, and national leadership and from coordination with existing quality-improvement initiatives. During the first year of use, facilities varied in the direction and extent of change. These patterns of change were generally consistent with qualitative information, providing support for the validity of the domain and its component measures. Measure maintenance remains an iterative process as the VHA mental health system and potential data resources continue to evolve. Lessons learned may be helpful to the broader mental health-provider community as mental health care consolidates and becomes increasingly integrated within healthcare systems. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Mental health-related discrimination as a predictor of low engagement with mental health services.

Science.gov (United States)

Clement, Sarah; Williams, Paul; Farrelly, Simone; Hatch, Stephani L; Schauman, Oliver; Jeffery, Debra; Henderson, R Claire; Thornicroft, Graham

2015-02-01

This study aimed to test the hypothesis that mental health-related discrimination experienced by adults receiving care from community mental health teams is associated with low engagement with services and to explore the pathways between these two variables. In this cross-sectional study, 202 adults registered with inner-city community mental health teams in the United Kingdom completed interviews assessing their engagement with mental health services (service user-rated version of the Service Engagement Scale), discrimination that they experienced because of mental illness, and other variables. Structural equation modeling was conducted to examine the relationship of experienced discrimination and service engagement with potential mediating and moderating variables, such as anticipated discrimination (Questionnaire on Anticipated Discrimination), internalized stigma (Internalized Stigma of Mental Illness Scale), stigma stress appraisal (Stigma Stress Appraisal), mistrust in services, the therapeutic relationship (Scale to Assess Therapeutic Relationships), difficulty disclosing information about one's mental health, and social support. Analyses controlled for age, race-ethnicity, and symptomatology. No evidence was found for a direct effect between experienced discrimination and service engagement. The total indirect effect of experienced discrimination on service engagement was statistically significant (coefficient=1.055, 95% confidence interval [CI]=.312-2.074, p=.019), mainly via mistrust in mental health services and therapeutic relationships (coefficient=.804, CI=.295-1.558, p=.019). A 1-unit increase in experienced discrimination via this pathway resulted in .804-unit of deterioration in service engagement. Findings indicate the importance of building and maintaining service users' trust in mental health services and in therapeutic relationships with professionals and countering the discrimination that may erode trust.

Mental health leadership and patient access to care: a public-private initiative in South Africa.

Science.gov (United States)

Szabo, Christopher Paul; Fine, Jennifer; Mayers, Pat; Naidoo, Shan; Zabow, Tuviah

2017-01-01

Mental health leadership is a critical component of patient access to care. More specifically, the ability of mental health professionals to articulate the needs of patients, formulate strategies and engage meaningfully at the appropriate level in pursuit of resources. This is not a skill set routinely taught to mental health professionals. A public-private mental health leadership initiative, emanating from a patient access to care programme, was developed with the aim of building leadership capacity within the South African public mental health sector. The express aim was to equip health care professionals with the requisite skills to more effectively advocate for their patients. The initiative involved participants from various sites within South Africa. Inclusion was based on the proposal of an ongoing "project", i.e. a clinician-initiated service development with a multidisciplinary focus. The projects were varied in nature but all involved identification of and a plan for addressing an aspect of the participants' daily professional work which negatively impacted on patient care due to unmet needs. Six such projects were included and involved 15 participants, comprising personnel from psychiatry, psychology, occupational therapy and nursing. Each project group was formally mentored as part of the initiative, with mentors being senior professionals with expertise in psychiatry, public health and nursing. The programme design thus provided a unique practical dimension in which skills and learnings were applied to the projects with numerous and diverse outcomes. Benefits were noted by participants but extended beyond the individuals to the health institutions in which they worked and the patients that they served. Participants acquired both the skills and the confidence which enabled them to sustain the changes that they themselves had initiated in their institutions. The initiative gave impetus to the inclusion of public mental health as part of the curriculum

Tobacco use and its treatment among young people in mental health settings: a qualitative analysis.

Science.gov (United States)

Prochaska, Judith J; Fromont, Sebastien C; Wa, Christina; Matlow, Ryan; Ramo, Danielle E; Hall, Sharon M

2013-08-01

Youth with psychiatric disorders are at increased risk of tobacco use. Outpatient mental health settings have received little investigation for delivering tobacco treatment. This study obtained formative data to guide development of a tobacco cessation program for transitional age youth with co-occurring psychiatric disorders with a focus on outpatient mental health settings. Applying qualitative methods, we analyzed transcripts from interviews with 14 mental health clients (aged 16-23) and 8 mental health providers. The youth identified internal (nicotine addiction and mood), social, parental, and media influences to their use of tobacco. Providers' viewed youth tobacco use as a normative developmental process, closely tied to management of psychiatric symptoms, supported by parents, and of lower priority relative to youth alcohol and illicit drug use. Youth and providers believed that clinicians can do more to address tobacco use in practice and emphasized nonjudgmental support and nondirective approaches. Top recommended quitting strategies, however, differed notably for the youth (cold turkey, support from friends, physical activity, hobbies) and providers (cessation pharmacotherapy, cessation groups, treatment referrals). Mental health providers' greater prioritization of other substances and view of youth smoking as developmentally normative and a coping strategy for psychopathology are likely contributing to the general lack of attention to tobacco use currently. Integrating care within mental health settings would serve to reach youth in an arena where clinical rapport is already established, and study findings suggest receptivity for system improvements. Of consideration, however, is the apparent disconnect between provider and youth recommended strategies for supporting cessation.

Sustained improvements in students' mental health literacy with use of a mental health curriculum in Canadian schools.

Science.gov (United States)

Mcluckie, Alan; Kutcher, Stan; Wei, Yifeng; Weaver, Cynthia

2014-12-31

Enhancement of mental health literacy for youth is a focus of increasing interest for mental health professionals and educators alike. Schools are an ideal site for addressing mental health literacy in young people. Currently, there is limited evidence regarding the impact of curriculum-based interventions within high school settings. We examined the effect of a high-school mental health curriculum (The Guide) in enhancing mental health literacy in Canadian schools. We conducted a secondary analysis on surveys of students who participated in a classroom mental health course taught by their usual teachers. Evaluation of students' mental health literacy (knowledge/attitudes) was completed before and after classroom implementation and at 2-month follow-up. We used paired-samples t-tests and Cohen's d value to determine the significance and impact of change. There were 265 students who completed all surveys. Students' knowledge significantly improved between pre- and post-tests (p mental health. This is the first study to demonstrate the positive impact of a curriculum-based mental health literacy program in a Canadian high school population.

Medical Student Beliefs about Disclosure of Mental Health Issues: A Qualitative Study.

Science.gov (United States)

Winter, Peter; Rix, Andrew; Grant, Andrew

In 2012 the United Kingdom's General Medical Council (GMC) commissioned research to develop guidance for medical schools on how best to support students with mental illness. One of the key findings from medical student focus groups in the study was students' strong belief that medical schools excluded students on mental health grounds. Students believed mental illness was a fitness to practice matter that led to eventual dismissal, although neither personal experience nor empirical evidence supported this belief. The objective of the present study was a deeper exploration of this belief and its underlying social mechanisms. This included any other beliefs that influenced medical students' reluctance to disclose a mental health problem, the factors that reinforced these beliefs, and the feared consequences of revealing a mental illness. The study involved a secondary analysis of qualitative data from seven focus groups involving 40 student participants across five UK medical schools in England, Scotland, and Wales. Student beliefs clustered around (1) the unacceptability of mental illness in medicine, (2) punitive medical school support systems, and (3) the view that becoming a doctor is the only successful career outcome. Reinforcing mechanisms included pressure from senior clinicians, a culture of "presenteeism," distrust of medical school staff, and expectations about conduct. Feared consequences centered on regulatory "fitness to practice" proceedings that would lead to expulsion, reputational damage, and failure to meet parents' expectations. The study's findings provide useful information for veterinary medical educators interested in creating a culture that encourages the disclosure of mental illness and contributes to the debate about mental illness within the veterinary profession.

Mental health triage in emergency medicine.

Science.gov (United States)

Smart, D; Pollard, C; Walpole, B

1999-02-01

The aim of this study was to: (i) develop a triage scale consistent with the National Triage Scale (NTS) for patients with mental health problems attending emergency departments; and (ii) to reduce emergency waiting times, transit times and improve skills assessing mental health problems. We developed a Mental Health Triage Scale (MHTS) consistent with the NTS. The MHTS was then implemented using a structured education package, and evaluated from March to August 1994. Further evaluation occurred after 2 years. A four-tiered MHTS was produced: category 2, violent, aggressive or suicidal, danger to self or others or with police escort; category 3, very distressed or psychotic, likely to deteriorate, situational crisis, danger to self or others; category 4, long-standing semi-urgent mental health disorder, supporting agency present; and category 5, long-standing non-acute mental health disorder, no support agency present. Patients with illness, injury or self-harm were triaged using combined mental health and medical information. Mean emergency waiting times and transit times were reduced. More consistent triaging for mental health patients occurred, and more consistent admission rates by urgency. Reduced mental health 'did not waits' showed improved customer satisfaction. Mental Health Triage Scale was considered appropriate by liaison psychiatry and its use has continued at 2 years follow-up. A systematic approach to mental health triaging produced a workable scale, reduced waiting times, transit times, and provided effective and consistent integration of mental health patients into a general emergency department.

Cultural diversity and mental health.

Science.gov (United States)

Gopalkrishnan, Narayan; Babacan, Hurriyet

2015-12-01

Cultural diversity and its impact on mental health has become an increasingly important issue in a globalised world where the interactions between cultures continue to grow exponentially. This paper presents critical areas in which culture impacts on mental health, such as how health and illness are perceived, coping styles, treatment-seeking patterns, impacts of history, racism, bias and stereotyping, gender, family, stigma and discrimination. While cultural differences provide a number of challenges to mental health policy and practice they also provide a number of opportunities to work in unique and effective ways towards positive mental health. Ethno-specific approaches to mental health that incorporate traditional and community-based systems can provide new avenues for working with culturally diverse populations. © The Royal Australian and New Zealand College of Psychiatrists 2015.

Teen Mental Health: MedlinePlus Health Topic

Science.gov (United States)

... Trichotillomania (Nemours Foundation) Health Check Tools How's Your Self-Esteem? (Quiz) (Nemours Foundation) Statistics and Research Combinations of Types of Mental Health Services Received in the Past Year Among Young Adults (Substance Abuse and Mental Health Services Administration) ...

Economic constraints and quality assurance in mental health services: sensitive indicators.

Science.gov (United States)

el-Guebaly, N; Papineau, D

1984-03-01

Clinicians in the field of mental health are met with the dual challenge of increased accountability and shrinking resources. Funds are often allocated through the use of crude administrative monitors. This is of little solace to the clinician faced with unmet patients' wants and needs. A set of clinical monitors is outlined requiring the practitioner's cooperation. The presentation of an accurate composite picture is a must in the process of resource allocation. Such clinical monitors include the analysis of characteristics of patients such as the repeaters at emergency, "the revolving door" pool of patients and those falling in between networks. Reviews of waiting lists and lengths of stay, an evaluation of nursing care variables, the auditing of the choice of therapeutic modalities and the use of restraints are other suggested contributors to the assessment of service needs.

Mental health service delivery following health system reform in Colombia.

Science.gov (United States)

Romero-González, Mauricio; González, Gerardo; Rosenheck, Robert A

2003-12-01

In 1993, Colombia underwent an ambitious and comprehensive process of health system reform based on managed competition and structured pluralism, but did not include coverage for mental health services. In this study, we sought to evaluate the impact of the reform on access to mental health services and whether there were changes in the pattern of mental health service delivery during the period after the reform. Changes in national economic indicators and in measures of mental health and non-mental health service delivery for the years 1987 and 1997 were compared. Data were obtained from the National Administrative Department of Statistics of Colombia (DANE), the Department of National Planning and Ministry of the Treasury of Colombia, and from national official reports of mental health and non-mental health service delivery from the Ministry of Health of Colombia for the same years. While population-adjusted access to mental health outpatient services declined by -2.7% (-11.2% among women and +5.8% among men), access to general medical outpatient services increased dramatically by 46%. In-patient admissions showed smaller differences, with a 7% increase in mental health admissions, as compared to 22.5% increase in general medical admissions. The health reform in Colombia imposed competition across all health institutions with the intention of encouraging efficiency and financial autonomy. However, the challenge of institutional survival appears to have fallen heavily on mental health care institutions that were also expected to participate in managed competition, but that were at a serious disadvantage because their services were excluded from the compulsory standardized package of health benefits. While the Colombian health care reform intended to close the gap between those who had and those who did not have access to health services, it appears to have failed to address access to specialized mental health services, although it does seem to have promoted a

Mental health care in Nepal: current situation and challenges for development of a district mental health care plan.

Science.gov (United States)

Luitel, Nagendra P; Jordans, Mark Jd; Adhikari, Anup; Upadhaya, Nawaraj; Hanlon, Charlotte; Lund, Crick; Komproe, Ivan H

2015-01-01

Globally mental health problems are a serious public health concern. Currently four out of five people with severe mental illness in Low and Middle Income Countries (LMIC) receive no effective treatment. There is an urgent need to address this enormous treatment gap. Changing the focus of specialist mental health workers (psychiatrists and psychologists) from only service delivery to also designing and managing mental health services; building clinical capacity of the primary health care (PHC) workers, and providing supervision and quality assurance of mental health services may help in scaling up mental health services in LMICs. Little is known however, about the mental health policy and services context for these strategies in fragile-state settings, such as Nepal. A standard situation analysis tool was developed by the PRogramme for Improving Mental health carE (PRIME) consortium to systematically analyze and describe the current gaps in mental health care in Nepal, in order to inform the development of a district level mental health care plan (MHCP). It comprised six sections; general information (e.g. population, socio-economic conditions); mental health policies and plans; mental health treatment coverage; district health services; and community services. Data was obtained from secondary sources, including scientific publications, reports, project documents and hospital records. Mental health policy exists in Nepal, having been adopted in 1997, but implementation of the policy framework has yet to begin. In common with other LMICs, the budget allocated for mental health is minimal. Mental health services are concentrated in the big cities, with 0.22 psychiatrists and 0.06 psychologists per 100,000 population. The key challenges experienced in developing a district level MHCP included, overburdened health workers, lack of psychotropic medicines in the PHC, lack of mental health supervision in the existing system, and lack of a coordinating body in the Ministry

D-day for mental health.

Science.gov (United States)

2005-02-16

THERE COULD be no better time for a review of mental health nursing. It is 11 years since the last one, which in itself suggests change must be overdue if professional practice is to keep pace with health service reforms. As the largest professional group in mental health care, nurses will be relied on to deliver the reforms outlined in the Mental Health Bill, as well as the measures to improve race equality in the service. Nurses will also be promoting good mental health as outlined in last autumn's public health white paper. All these initiatives can only benefit from the chance to take stock.

Chronic Childhood Trauma, Mental Health, Academic Achievement, and School-Based Health Center Mental Health Services

Science.gov (United States)

Larson, Satu; Chapman, Susan; Spetz, Joanne; Brindis, Claire D.

2017-01-01

Background: Children and adolescents exposed to chronic trauma have a greater risk for mental health disorders and school failure. Children and adolescents of minority racial/ethnic groups and those living in poverty are at greater risk of exposure to trauma and less likely to have access to mental health services. School-based health centers…

Science discovery in clinician-economist collaboration: legacy and future challenges.

Science.gov (United States)

Wells, Kenneth B

2002-06-01

2002 Carl Taube Lecture at the NIMH Mental Health Economics Meeting. To analyze the contribution and process of clinician/economist collaboration. Personal scientific autobiography, using relationships with three economists as case examples. In joint efforts by clinicians and economists, clinicians bring an interest in case examples and in responding to unmet need, while economists bring structured analysis methods and respect for a societal perspective. Through mutual respect and discovery, both clinicians and economists can define unmet need in clinical and economic terms and help develop models and programs to improve clinical care, while maintaining a societal evaluation perspective. Key to scientific discovery is the principle that the emotions generated by data, such as hope and despair, need to be acknowledged and utilized rather than avoided or buried, provided that such feelings are used in a balanced manner in research. According to the author, collaboration helps maintain such a balance. Collaboration requires and builds trust, and improves the depth of research by combining different personal and disciplinary perspectives and strengths. Young investigators should be encouraged to explore collaboration and to consider their feelings in response to health and economic data as an important scientific and creative resource.

Holistic Health: Does It Really Include Mental Health?

OpenAIRE

McClanahan, Kimberly K.; Huff, Marlene B.; Omar, Hatim A.

2006-01-01

Holistic health, incorporating mind and body as equally important and unified components of health, is a concept utilized in some health care arenas in the United States (U.S.) over the past 30 years. However, in the U.S., mental health is not seen as conceptually integral to physical health and, thus, holistic health cannot be realized until the historical concept of mind-body dualism, continuing stigma regarding mental illness, lack of mental health parity in insurance, and inaccurate publi...

The prevalence of psychopathology in siblings of children with mental health problems: a 20-year systematic review.

Science.gov (United States)

Ma, Nylanda; Roberts, Rachel; Winefield, Helen; Furber, Gareth

2015-02-01

While the importance of looking at the entire family system in the context of child and adolescent mental health is well recognised, siblings of children with mental health problems (MHPs) are often overlooked. The existing literature on the mental health of these siblings needs to be reviewed. A systematic search located publications from 1990 to 2011 in four electronic databases. Thirty-nine relevant studies reported data on the prevalence of psychopathology in siblings of target children with MHPs. Siblings of target children had higher rates of at least one type of psychopathology than comparison children. Risk of psychopathology varied across the type of MHP in the target child. Other covariates included sibling age and gender and parental psychopathology. Significant variations and limitations in methodology were found in the existing literature. Methodological guidelines for future studies are outlined. Implications for clinicians, parents, and for future research are discussed.

Shared decision-making, stigma, and child mental health functioning among families referred for primary care-located mental health services.

Science.gov (United States)

Butler, Ashley M

2014-03-01

There is growing emphasis on shared decision making (SDM) to promote family participation in care and improve the quality of child mental health care. Yet, little is known about the relationship of SDM with parental perceptions of child mental health treatment or child mental health functioning. The objectives of this preliminary study were to examine (a) the frequency of perceived SDM with providers among minority parents of children referred to colocated mental health care in a primary care clinic, (b) associations between parent-reported SDM and mental health treatment stigma and child mental health impairment, and (c) differences in SDM among parents of children with various levels of mental health problem severity. Participants were 36 Latino and African American parents of children (ages 2-7 years) who were referred to colocated mental health care for externalizing mental health problems (disruptive, hyperactive, and aggressive behaviors). Parents completed questions assessing their perceptions of SDM with providers, child mental health treatment stigma, child mental health severity, and level of child mental health impairment. Descriptive statistics demonstrated the majority of the sample reported frequent SDM with providers. Correlation coefficients indicated higher SDM was associated with lower stigma regarding mental health treatment and lower parent-perceived child mental health impairment. Analysis of variance showed no significant difference in SDM among parents of children with different parent-reported levels of child mental health severity. Future research should examine the potential of SDM for addressing child mental health treatment stigma and impairment among minority families.

Developing and Sustaining Recovery-Orientation in Mental Health Practice: Experiences of Occupational Therapists.

Science.gov (United States)

Nugent, Alexandra; Hancock, Nicola; Honey, Anne

2017-01-01

Internationally, mental health policy requires clinicians to shift from a medical to a recovery-oriented approach. However, there is a significant lag in the translation of policy into practice. Occupational therapists have been identified as ideally situated to be recovery-oriented yet limited research exploring how they do this exists. This study aimed to explore Australian occupational therapists' experiences of developing and sustaining recovery-orientation in mental health practice. Semistructured, in-depth interviews were conducted with twelve occupational therapists working across different mental health service types. Participants identified themselves as being recovery-oriented. Data were analysed using constant comparative analysis. Occupational therapists described recovery-oriented practice as an active, ongoing, and intentional process of seeking out knowledge, finding fit between understandings of recovery-oriented practice and their professional identity, holding hope, and developing confidence through clinical reasoning. Human and systemic aspects of therapists' workplace environment influenced this process. Being a recovery-oriented occupational therapist requires more than merely accepting a specific framework. It requires commitment and ongoing work to develop and sustain recovery-orientation. Occupational therapists are called to extend current leadership activity beyond their workplace and to advocate for broader systemic change.

What does self rated mental health represent