Mental Health Services in School-Based Health Centers: Systematic Review

Science.gov (United States)

Bains, Ranbir Mangat; Diallo, Ana F.

2016-01-01

Mental health issues affect 20-25% of children and adolescents, of which few receive services. School-based health centers (SBHCs) provide access to mental health services to children and adolescents within their schools. A systematic review of literature was undertaken to review evidence on the effectiveness of delivery of mental health services…

Mental health services in KwaZulu-Natal | Mkize | South African ...

African Journals Online (AJOL)

... is divided into nine sections, namely organisational structure; education, training and research; mental health service provision; highly specialised services; community mental health services; forensic mental health services; mental health and the private sector; pharmaceutical services; and summary of recommendations.

Centralized vs. decentralized child mental health services.

Science.gov (United States)

Adams, M S

1977-09-01

One of the basic tenets of the Community Mental Health Center movement is that services should be provided in the consumers' community. Various centers across the country have attempted to do this in either a centralized or decentralized fashion. Historically, most health services have been provided centrally, a good example being the traditional general hospital with its centralized medical services. Over the years, some of these services have become decentralized to take the form of local health centers, health maintenance organizations, community clinics, etc, and now various large mental health centers are also being broken down into smaller community units. An example of each type of mental health facility is delineated here.

Heterogeneity of Mental Health Service Utilization and High Mental Health Service Use Among Women Eight Years After Initiating Substance Use Disorder Treatment.

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Evans, Elizabeth; Padwa, Howard; Li, Libo; Lin, Veronique; Hser, Yih-Ing

2015-12-01

The aim of this study was to determine mental health service utilization patterns among women treated for substance use disorders (SUD) and identify factors associated with patterns of high mental health service use. Data were provided by 4447 women treated for SUD in California during 2000-2002 for whom mental health services utilization records were acquired. A latent class model was fitted to women's high use of services (>6 services/year over 8 years). Multinomial logistic regression was used to identify predisposing, enabling, and need factors associated with utilization patterns. In 8 years after initiating SUD treatment, 50% of women utilized mental health services. High use probability was consistently low for most women (76.9%); for others, however, it decreased immediately following SUD treatment and then increased over time (8.7%), increased immediately following SUD treatment and then decreased (9.3%), or remained consistently high (5.1%). Consistently high services use was negatively associated with marriage (OR 0.60, pwomen with co-occurring mental health disorders at SUD treatment entry did not receive any mental health treatment in the subsequent 8 years. Mental health services utilization patterns among women treated for SUD are heterogeneous and dynamic. Understanding factors related to women's utilization patterns may aid efforts to optimize care and ensure appropriate use of mental health services. Copyright © 2015 Elsevier Inc. All rights reserved.

Perceived barriers on mental health services by the family of patients with mental illness

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Rr Dian Tristiana

2018-01-01

Conclusion: Families whose members suffered from mental illness still experienced barriers in relation to mental health services even with universal health coverage. Improved mental health services are related to the health insurance coverage, affordability, availability of mental health services and stigma reduction in the health professionals and wide community.

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

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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

Youth experiences of transition from child mental health services to adult mental health services: a qualitative thematic synthesis.

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Broad, Kathleen L; Sandhu, Vijay K; Sunderji, Nadiya; Charach, Alice

2017-11-28

Adolescence and young adulthood is a vulnerable time during which young people experience many development milestones, as well as an increased incidence of mental illness. During this time, youth also transition between Child and Adolescent Mental Health Services (CAMHS) to Adult Mental Health Services (AMHS). This transition puts many youth at risk of disengagement from service use; however, our understanding of this transition from the perspective of youth is limited. This systematic review aims to provide a more comprehensive understanding of youth experiences of transition from CAMHS to AMHS, through a qualitative thematic synthesis of the extant literature in this area. Published and unpublished literature was searched using keywords targeting three subject areas: Transition, Age and Mental Health. Studies were included if they qualitatively explored the perceptions and experiences of youth who received mental health services in both CAMHS and AMHS. There were no limitations on diagnosis or age of youth. Studies examining youth with chronic physical health conditions were excluded. Eighteen studies, representing 14 datasets and the experiences of 253 unique service-users were included. Youth experiences of moving from CAMHS and AMHS are influenced by concurrent life transitions and their individual preferences regarding autonomy and independence. Youth identified preparation, flexible transition timing, individualized transition plans, and informational continuity as positive factors during transition. Youth also valued joint working and relational continuity between CAMHS and AMHS. Youth experience a dramatic culture shift between CAMHS and AMHS, which can be mitigated by individualized and flexible approaches to transition. Youth have valuable perspectives to guide the intelligent design of mental health services and their perspectives should be used to inform tools to evaluate and incorporate youth perspectives into transitional service improvement

EPA guidance on building trust in mental health services.

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Gaebel, W; Muijen, M; Baumann, A E; Bhugra, D; Wasserman, D; van der Gaag, R J; Heun, R; Zielasek, J

2014-02-01

To advance mental health care use by developing recommendations to increase trust from the general public and patients, those who have been in contact with services, those who have never been in contact and those who care for their families in the mental health care system. We performed a systematic literature search and the retrieved documents were evaluated by two independent reviewers. Evidence tables were generated and recommendations were developed in an expert and stakeholder consensus process. We developed five recommendations which may increase trust in mental health care services and advance mental health care service utilization. Trust is a mutual, complex, multidimensional and dynamic interrelationship of a multitude of factors. Its components may vary between individuals and over time. They may include, among others, age, place of residence, ethnicity, culture, experiences as a service user, and type of disorder. For mental health care services, issues of knowledge about mental health services, confidentiality, continuity of treatment, dignity, safety and avoidance of stigma and coercion are central elements to increase trust. Evidence-based recommendations to increase mutual trust of service users and psychiatrists have been developed and may help to increase mental health care service utilization. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

Mental health services in South Africa: taking stock.

Science.gov (United States)

Lund, C; Petersen, I; Kleintjes, S; Bhana, A

2012-11-01

There is new policy commitment to mental health in South Africa, demonstrated in the national mental health summit of April 2012. This provides an opportunity to take stock of our mental health services. At primary care level key challenges include- training and supervision of staff in the detection and management of common mental disorders, and the development of community-based psychosocial rehabilitation programmes for people with severe mental illness (in collaboration with existing non-governmental organizations). At secondary level, resources need to be invested in 72-hour observation facilities at designated district and regional hospitals, in keeping with the Mental Health Care Act. At tertiary level, greater continuity of care with primary and secondary levels is required to prevent "revolving door" patterns of care. There are major challenges and also opportunities related to the high level of comorbidity between mental illness and a range of other public health priorities, notably HIV/AIDS, cardiovascular disease and diabetes. The agenda for mental health services research needs to shift to a focus on evaluating interventions. With current policy commitment, the time to act and invest in evidence-based mental health services is now.

The selling of mental health services: some ethical reflections.

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Neumann, M

1993-01-01

Since the introduction of public mental health services in Israel, the main principle of our work has been to provide equal and free of charge health services to all patients. We were proud of our ability to provide optimal treatment to all patients in all our facilities, regardless of cost or status of insurance. During the last decade, the cost of providing good quality public health services, including mental health services, has constantly increased, and the system has reached a state of financial distress resulting in insufficiency and inability to perform properly. In order to maintain the level of mental health services, the health authorities started planning a system of payment for various mental health services which, until now, were supplied free of charge. This change of policy and attitude towards the population in need poses severe ethical and practical questions and problems. It is questionable that the amount of income ensuing from the sale of mental health services and whether a relatively small financial profit justify possible injury of the population in need of these services, especially the sicker and weaker members of it. This article raises some ethical doubts involved in charging money for psychiatric services that are given to this special group of the mentally ill, and claims that the feasibility of selling services in this area of public health should be reinvestigated.

Mental Health Services in Southern Sudan

African Journals Online (AJOL)

Siegal_D

Editorial: Mental Health Services in Southern Sudan – a. Vision for the Future. Major mental illness exists all over the world with a remarkably .... minus one or both parents. ... There he taught and inspired child health professionals from all over.

Mental health services and R&D in South Korea.

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Roh, Sungwon; Lee, Sang-Uk; Soh, Minah; Ryu, Vin; Kim, Hyunjin; Jang, Jung Won; Lim, Hee Young; Jeon, Mina; Park, Jong-Ik; Choi, SungKu; Ha, Kyooseob

2016-01-01

World Health Organization has asserted that mental illness is the greatest overriding burden of disease in the majority of developed countries, and that the socioeconomic burden of mental disease will exceed that of cancer and cardiovascular disorders in the future. The life-time prevalence rate for mental disorders in Korea is reported at 27.6 %, which means three out of 10 adults experience mental disorders more than once throughout their lifetime. Korea's suicide rate has remained the highest among Organization for Economic Cooperation and Development (OECD) nations for 10 consecutive years, with 29.1 people out of every 100,000 having committed suicide. Nevertheless, a comprehensive study on the mental health services and the Research and Development (R&D) status in Korea is hard to find. Against this backdrop, this paper examines the mental health services and the R&D status in Korea, and examines their shortcomings and future direction. The paper discusses the mental health service system, budget and human resources, followed by the mental health R&D system and budget. And, by a comparison with other OECD countries, the areas for improvement are discussed and based on that, a future direction is suggested. This paper proposes three measures to realize mid and long-term mental health promotion services and to realize improvements in mental health R&D at the national level: first, establish a national mental health system; second, forecast demand for mental health; and third, secure and develop mental health professionals.

Predictors of Healthcare Service Utilization for Mental Health Reasons

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Marie-Josée Fleury

2014-10-01

Full Text Available This study was designed to identify: (1 predictors of 12-month healthcare service utilization for mental health reasons, framed by the Andersen model, among a population cohort in an epidemiological catchment area; and (2 correlates associated with healthcare service utilization for mental health reasons among individuals with and without mental disorders respectively. Analyses comprised univariate, bivariate, and multiple regression analyses. Being male, having poor quality of life, possessing better self-perception of physical health, and suffering from major depressive episodes, panic disorder, social phobia, and emotional problems predicted healthcare service utilization for mental health reasons. Among individuals with mental disorders, needs factors (psychological distress, impulsiveness, emotional problems, victim of violence, and aggressive behavior and visits to healthcare professionals were associated with healthcare service utilization for mental health reasons. Among individuals without mental disorders, healthcare service utilization for mental health reasons is strongly associated with enabling factors such as social support, income, environmental variables, and self-perception of the neighborhood. Interventions facilitating social cohesion and social solidarity in neighborhood settings may reduce the need to seek help among individuals without mental disorders. Furthermore, in their capacity as frontline professionals, general practitioners should be more sensitive in preventing, detecting, and treating mental disorders in routine primary care.

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.

Working Together for Mental Health: Evaluation of a one-day mental health course for human service providers

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Grootemaat, Pam; Gillan, Cathie; Holt, Gillian; Forward, Wayne; Heywood, Narelle; Willis, Sue

2006-01-01

Background The Working Together For Mental Health course is an 8-hour course designed to demystify mental illness and mental health services. The main target group for the course is people working in human service organisations who provide services for people with mental illness. Methods A questionnaire was administered to all participants attending the course during 2003 (n = 165). Participants completed the questionnaire before and immediately after the course, and at three month follow-up. Results A response rate of 69% was achieved with 114 people completing the questionnaire on all three occasions. The responses showed a significant improvement in the self-assessed knowledge and confidence of participants to provide human services to people with a mental health problem or disorder, three months after the course. There was no significant improvement in participants' attitudes or beliefs about people with a mental health problem or disorder at three month follow-up; however, participants' attitudes were largely positive before entering the course. Conclusion The Working Together For Mental Health course was successful in improving participants' confidence and knowledge around providing human services to people with a mental health illness. PMID:17074097

78 FR 45543 - Center for Mental Health Services; Notice of Meeting

Science.gov (United States)

2013-07-29

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Substance Abuse and Mental Health Services Administration Center for Mental Health Services; Notice of Meeting Pursuant to Public Law 92-463, notice is hereby given that the Substance Abuse and Mental Health Services Administration's (SAMHSA) Center for Mental...

Assessing the performance of mental health service facilities for meeting patient priorities and health service responsiveness.

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Bramesfeld, A; Stegbauer, C

2016-10-01

The World Health Organisation has defined health service responsiveness as one of the key-objectives of health systems. Health service responsiveness relates to the ability to respond to service users' legitimate expectations on non-medical issues when coming into contact with the services of a healthcare system. It is defined by the areas showing respect for persons and patient orientation. Health service responsiveness is particularly relevant to mental health services, due to the specific vulnerability of mental health patients but also because it matches what mental health patients consider as good quality of care as well as their priorities when seeking healthcare. As (mental) health service responsiveness applies equally to all concerned services it would be suitable as a universal indicator for the quality of services' performance. However, performance monitoring programs in mental healthcare rarely assess health service performance with respect to meeting patient priorities. This is in part due of patient priorities as an outcome being underrepresented in studies that evaluate service provision. The lack of studies using patient priorities as outcomes transmits into evidence based guidelines and subsequently, into underrepresentation of patient priorities in performance monitoring. Possible ways out of this situation include more intervention studies using patient priorities as outcome, considering evidence from qualitative studies in guideline development and developing performance monitoring programs along the patient pathway and on key-points of relevance for service quality from a patient perspective.

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

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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.

Health system preparedness for integration of mental health services in rural Liberia.

Science.gov (United States)

Gwaikolo, Wilfred S; Kohrt, Brandon A; Cooper, Janice L

2017-07-27

There are increasing efforts and attention focused on the delivery of mental health services in primary care in low resource settings (e.g., mental health Gap Action Programme, mhGAP). However, less attention is devoted to systematic approaches that identify and address barriers to the development and uptake of mental health services within primary care in low-resource settings. Our objective was to prepare for optimal uptake by identifying barriers in rural Liberia. The country's need for mental health services is compounded by a 14-year history of political violence and the largest Ebola virus disease outbreak in history. Both events have immediate and lasting mental health effects. A mixed-methods approach was employed, consisting of qualitative interviews with 22 key informants and six focus group discussions. Additional qualitative data as well as quantitative data were collected through semi-structured assessments of 19 rural primary care health facilities. Data were collected from March 2013 to March 2014. Potential barriers to development and uptake of mental health services included lack of mental health knowledge among primary health care staff; high workload for primary health care workers precluding addition of mental health responsibilities; lack of mental health drugs; poor physical infrastructure of health facilities including lack of space for confidential consultation; poor communication support including lack of electricity and mobile phone networks that prevent referrals and phone consultation with supervisors; absence of transportation for patients to facilitate referrals; negative attitudes and stigma towards people with severe mental disorders and their family members; and stigma against mental health workers. To develop and facilitate effective primary care mental health services in a post-conflict, low resource setting will require (1) addressing the knowledge and clinical skills gap in the primary care workforce; (2) improving physical

Community mental health services in Southern Gauteng: An audit ...

African Journals Online (AJOL)

Background: Community mental health services (CMHS) are a central objective of the National Mental Health Policy Framework and Strategic Plan. Three core components are described: residential facilities, day care and outpatient services. Primary mental health care with specialist support is required according to an ...

Consumers in mental health service leadership: A systematic review.

Science.gov (United States)

Scholz, Brett; Gordon, Sarah; Happell, Brenda

2017-02-01

Contemporary mental health policies call for greater involvement of mental health service consumers in all aspects and at all levels of service planning, delivery, and evaluation. The extent to which consumers are part of the decision-making function of mental health organizations varies. This systematic review synthesizes empirical and review studies published in peer-reviewed academic journals relating to consumers in leadership roles within mental health organizations. The Cochrane Library, Medline, and PsycINFO were searched for articles specifically analysing and discussing consumers' mental health service leadership. Each article was critically appraised against the inclusion criteria, with 36 articles included in the final review. The findings of the review highlight current understandings of organizational resources and structures in consumer-led organizations, determinants of leadership involvement, and how consumer leadership interacts with traditional mental health service provision. It appears that organizations might still be negotiating the balance between consumer leadership and traditional structures and systems. The majority of included studies represent research about consumer-run organizations, with consumer leadership in mainstream mental health organizations being less represented in the literature. Advocates of consumer leadership should focus more on emphasizing how such leadership itself can be a valuable resource for organizations and how this can be better articulated. This review highlights the current gaps in understandings of consumer leadership in mental health, including a need for more research exploring the benefits of consumer leadership for other consumers of services. © 2016 Australian College of Mental Health Nurses Inc.

Subclinical psychotic experiences and subsequent contact with mental health services.

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Bhavsar, Vishal; Maccabe, James H; Hatch, Stephani L; Hotopf, Matthew; Boydell, Jane; McGuire, Philip

2017-03-01

Although psychotic experiences in people without diagnosed mental health problems are associated with mental health service use, few studies have assessed this prospectively or measured service use by real-world clinical data. To describe and investigate the association between psychotic experiences and later mental health service use, and to assess the role of symptoms of common mental health disorders in this association. We linked a representative survey of south-east London (SELCoH-1, n =1698) with health records from the local mental healthcare provider. Cox regression estimated the association of PEs with rate of mental health service use. After adjustments, psychotic experiences were associated with a 1.75-fold increase in the rate of subsequent mental health service use (hazard ratio (HR) 1.75, 95% CI 1.03-2.97) compared with those without PEs. Participants with PEs experienced longer care episodes compared with those without. Psychotic experiences in the general population are important predictors of public mental health need, aside from their relevance for psychoses. We found psychotic experiences to be associated with later mental health service use, after accounting for sociodemographic confounders and concurrent psychopathology. None. © The Royal College of Psychiatrists 2017. This is an open access article distributed under the terms of the Creative Commons Attribution (CC BY) license.

[Stigma: Barrier to Access to Mental Health Services].

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Campo-Arias, Adalberto; Oviedo, Heidi Celina; Herazo, Edwin

2014-01-01

The perceived stigma represents a sociocultural barrier to access mental health services and prevents individuals who meet criteria for a mental disorder the possibility of receiving comprehensive and integred care. To update institutional mechanisms by which stigma related to mental disorders, perceived and perpetrated, acts as a barrier to mental health access. Stigma as a barrier to access to mental health services is due to a reduction in service requests, the allocation of limited resources to mental health, the systematic process of impoverishment of the people who suffer a mental disorder, increased risk of crime, and implications in contact with the legal system, and the invisibility of the vulnerability of these people. Structured awareness and education programs are needed to promote awareness about mental disorders, promote community-based psychosocial rehabilitation, and reintegration into productive life process. In Colombia, the frequency and variables associated with the stigma of mental disorders needs to be studied. This knowledge will enable the implementation of measures to promote the social and labor inclusion of people who meet the criteria for mental disorders. Copyright © 2014 Asociación Colombiana de Psiquiatría. All rights reserved.

77 FR 50519 - Center for Mental Health Services (CMHS); Amendment of Meeting

Science.gov (United States)

2012-08-21

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Substance Abuse and Mental Health Services Administration Center for Mental Health Services (CMHS); Amendment of Meeting Pursuant to Public Law 92-463, notice is... Substance Abuse and Mental Health Services Administration's (SAMHSA), Center for Mental Health Services...

Mental health service utilization in sub-Saharan Africa: is public mental health literacy the problem? Setting the perspectives right.

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Atilola, Olayinka

2016-06-01

The severely constrained resources for mental health service in less-developed regions like sub-Saharan Africa underscore the need for good public mental health literacy as a potential additional mental health resource. Several studies examining the level of public knowledge about the nature and dynamics of mental illness in sub-Saharan Africa in the last decade had concluded that such knowledge was poor and had called for further public enlightenment. What was thought to be mental health 'ignorance' has also been blamed for poor mainstream service utilization. These views however assume that non-alignment of the views of community dwellers in sub-Saharan Africa with the biomedical understanding of mental illness connotes 'ignorance', and that correcting such 'ignorance' will translate to improvements in service utilization. Within the framework of contemporary thinking in mental health literacy, this paper argues that such assumptions are not culturally nuanced and may have overrated the usefulness of de-contextualized public engagement in enhancing mental health service utilization in the region. The paper concludes with a discourse on how to contextualize public mental health enlightenment in the region and the wider policy initiatives that can improve mental health service utilization. © The Author(s) 2015.

Palestinian mothers' perceptions of child mental health problems and services

Science.gov (United States)

THABET, ABDEL AZIZ; EL GAMMAL, HOSSAM; VOSTANIS, PANOS

2006-01-01

The aim of this study was to explore Palestinian mothers' perceptions of child mental health problems and their understanding of their causes; to determine Palestinian mothers' awareness of existing services and sources of help and support; to identify professionals in the community whom Palestinian mothers would consult if their child had mental health problems; and to establish their views on ways of increasing awareness of child mental health issues and services. Checklists exploring the above issues were completed by 249 Palestinian mothers living in refugee camps in the Gaza Strip. Palestinian mothers equally perceived emotional, behavioural and psychotic symptoms as suggestive of mental ill health in childhood. Mothers perceived multiple causes of child mental health problems, including family problems, parental psychiatric illness and social adversity. A substantial proportion (42.6%) had knowledge of local child mental health care services. Overall, mothers preferred Western over traditional types of treatment, and were keen to increase mental health awareness within their society. Despite a different cultural tradition, Palestinian mothers appear open to a range of services and interventions for child mental health problems. As in other non-Western societies, child mental health service provision should be integrated with existing primary health care, schools, and community structures. PMID:16946953

Development of a mental health smartphone app: perspectives of mental health service users.

Science.gov (United States)

Goodwin, John; Cummins, John; Behan, Laura; O'Brien, Sinead M

2016-10-01

Current mental health policy emphasises the importance of service user involvement in the delivery of care. Information Technology can have an effect on quality and efficiency of care. The aim of this study is to gain the viewpoint of service users from a local mental health service in developing a mental health app. A qualitative descriptive approach was used. Eight volunteers aged 18-49 years were interviewed with the aid of a semi-structured questionnaire. Interviewees defined a good app by its ease of use. Common themes included availability of contact information, identifying triggers, the ability to rate mood/anxiety levels on a scale, guided relaxation techniques, and the option to personalise the app. The researchers will aim to produce an app that is easily accessible, highly personalisable and will include functions highlighted as important (i.e. contact information, etc.). This research will assist in the development of an easy-to-use app that could increase access to services, and allow service users to take an active role in their care. In previous studies, apps were developed without the involvement of service users. This study recognises the important role of service users in this area.

Mental Health Services in South Africa: Taking stock | Lund | African ...

African Journals Online (AJOL)

Mental Health Services in South Africa: Taking stock. ... This provides an opportunity to take stock of our mental health services. At primary care level key challenges include- training and ... on evaluating interventions. With current policy commitment, the time to act and invest in evidence-based mental health services is now.

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…

Utilization of Mental Health Services and Mental Health Status Among Children Placed in Out-of-Home Care: A Parallel Process Latent Growth Modeling Approach.

Science.gov (United States)

Yampolskaya, Svetlana; Sharrock, Patty J; Clark, Colleen; Hanson, Ardis

2017-10-01

This longitudinal study examined the parallel trajectories of mental health service use and mental health status among children placed in Florida out-of-home care. The results of growth curve modeling suggested that children with greater mental health problems initially received more mental health services. Initial child mental health status, however, had no effect on subsequent service provision when all outpatient mental health services were included. When specific types of mental health services, such as basic outpatient, targeted case management, and intensive mental health services were examined, results suggested that children with compromised functioning during the baseline period received more intensive mental health services over time. However, this increased provision of intensive mental health services did not improve mental health status, rather it was significantly associated with progressively worse mental health functioning. These findings underscore the need for regular comprehensive mental health assessments focusing on specific needs of the child.

Interventions to increase use of services; Mental Health Awareness in Nigeria.

Science.gov (United States)

Eaton, Julian; Nwefoh, Emeka; Okafor, Godwin; Onyeonoro, Ugochukwu; Nwaubani, Kenneth; Henderson, Claire

2017-01-01

Mental health services in Nigeria consist mainly of large government psychiatric hospitals and there are very few mental health professionals to serve the large population of the country. However, more recently, community mental health services, which have been shown to improve access to care and clinical outcomes are beginning to develop in some locations. Despite efforts to promote more accessible services, low levels of knowledge about effective treatment of mental disorders means that even where these services are available, a very small proportion of people utilise these services. Therefore interventions to increase service use are an essential component of health system. This intervention was designed to increase use of a mental health services through the work of community-based Village Health Workers. Fifteen Village Health Workers in each Local Government Area (district) were selected and trained to create mental health awareness in communities. Their function also include identification and referral of persons with mental illness to trained mental health nurses in the clinics. Attendance data prior to and after intervention were collected and compared. The incident rate for initial period of intervention is five times higher than the baseline rate (95% CI; 3.42-7.56; p awareness raising using volunteers in communities as part of health programme implementation can increase services use by a population. Mechanisms such as informing populations of the existence of a service which they were previously lacking; explanation of causation of mental illness and achieving community leaders' support for a new service can make investment in services more efficient by increasing attendance.

Mental health need and access to mental health services by youths involved with child welfare: a national survey.

Science.gov (United States)

Burns, Barbara J; Phillips, Susan D; Wagner, H Ryan; Barth, Richard P; Kolko, David J; Campbell, Yvonne; Landsverk, John

2004-08-01

This study assessed the relationship between the need for and use of mental health services among a nationally representative sample of children who were investigated by child welfare agencies after reported maltreatment. Data were collected at study entry into the National Survey of Child and Adolescent Well-Being and were weighted to provide population estimates. Nearly half (47.9%) of the youths aged 2 to 14 years (N = 3,803) with completed child welfare investigations had clinically significant emotional or behavioral problems. Youths with mental health need (defined by a clinical range score on the Child Behavior Checklist) were much more likely to receive mental health services than lower scoring youth; still, only one fourth of such youths received any specialty mental health care during the previous 12 months. Clinical need was related to receipt of mental health care across all age groups (odds ratio = 2.7-3.5). In addition, for young children (2-5 years), sexual abuse (versus neglect) increased access to mental health services. For latency-age youths, African-American race and living at home significantly reduced the likelihood of care. Adolescents living at home were also less likely to receive services, whereas having a parent with severe mental illness increased (odds ratio = 2.4) the likelihood of service use. Routine screening for mental health need and increasing access to mental health professionals for further evaluation and treatment should be a priority for children early in their contact with the child welfare system.

Improving mental health service responses to domestic violence and abuse.

Science.gov (United States)

Trevillion, Kylee; Corker, Elizabeth; Capron, Lauren E; Oram, Siân

2016-10-01

Domestic violence and abuse is a considerable international public health problem, which is associated with mental disorders in both women and men. Nevertheless, victimization and perpetration remain undetected by mental health services. This paper reviews the evidence on mental health service responses to domestic violence, including identifying, referring, and providing care for people experiencing or perpetrating violence. The review highlights the need for mental health services to improve rates of identification and responses to domestic violence and abuse, through the provision of specific training on domestic violence and abuse, the implementation of clear information sharing protocols and evidence-based interventions, and the establishment of care referral pathways. This review also highlights the need for further research into mental health service users who perpetrate domestic violence and abuse.

An Adult Protective Services' view of collaboration with Mental Health Services.

Science.gov (United States)

Teaster, Pamela B; Stansbury, Kim L; Nerenberg, Lisa; Stanis, Patricia

2009-10-01

Mental Health Services (MHS) meet mental health needs of older adults through active, outpatient, community-based care. Adult Protective Services (APS) are involved with needs of older adults who have mental disability and mental illness. Adult Protective Services and MHS staff may to work together when they respond to the needs of victims and adults at risk for abuse, neglect, self-neglect, and exploitation. The purpose of this study was to understand effective APS-MHS collaborations (e.g., leadership, organizational culture, administration, and resources in predicting success). A survey that was sent to members of the National Adult Protective Services Association (NAPSA) revealed that both APS and MHS have strong commitments to protecting clients' rights and autonomy, but there appear to be differences between the two with regard to implementation, apparent in cases involving clients with diminished mental capacity who are at imminent risk, but who refuse help. Strengths of APS-MHS collaborations included improved communication and better service for at-risk clients.

Rearrest and linkage to mental health services among clients of the Clark County mental health court program.

Science.gov (United States)

Herinckx, Heidi A; Swart, Sandra C; Ama, Shane M; Dolezal, Cheri D; King, Steve

2005-07-01

This study examined rearrest and linkage to mental health services among 368 misdemeanants with severe and persistent mental illness who were served by the Clark County Mental Health Court (MHC). This court, established in April 2000, is based on the concepts of therapeutic jurisprudence. This study addressed the following questions about the effectiveness of the Clark County MHC: Did MHC clients receive more comprehensive mental health services? Did the MHC successfully reduce recidivism? Were there any client or program characteristics associated with recidivism? A secondary analysis of use of mental health services and jail data for the MHC clients enrolled from April 2000 through April 2003 was conducted. The authors used a 12-month pre-post comparison design to determine whether MHC participants experienced reduced rearrest rates for new offenses, reduced probation violations, and increased mental health services 12 months postenrollment in the MHC compared with 12 months preenrollment. The overall crime rate for MHC participants was reduced 4.0 times one year postenrollment in the MHC compared with one year preenrollment. One year postenrollment, 54 percent of participants had no arrests, and probation violations were reduced by 62 percent. The most significant factor in determining the success of MHC participants was graduation status from the MHC, with graduates 3.7 times less likely to reoffend compared with nongraduates. The Clark County MHC successfully reduced rearrest rates for new criminal offenses and probation violations and provided the mental health support services to stabilize mental health consumers in the community.

Service user involvement in undergraduate mental health nursing in New Zealand.

Science.gov (United States)

Schneebeli, Carole; O'Brien, Anthony; Lampshire, Debra; Hamer, Helen P

2010-02-01

This paper describes a service user role in the mental health component of an undergraduate nursing programme in New Zealand. The paper provides a background to mental health nursing education in New Zealand and discusses the implications of recent reforms in the mental health sector. The undergraduate nursing programme at the University of Auckland has a strong commitment to service user involvement. The programme aims to educate nurses to be responsive and skillful in meeting the mental health needs of service users in all areas of the health sector and to present mental health nursing as an attractive option for nurses upon graduation. We outline the mental health component of the programme, with an emphasis on the development of the service user role. In the second half of the paper, we present a summary of responses to a student satisfaction questionnaire. The responses indicate that the service user role is an important element of the programme and is well received by a substantial proportion of students. We consider the implications for nursing education and for recruitment into mental health nursing. Finally, we discuss some issues related to service user involvement in the development of new models of mental health service delivery.

Mental health care roles of non-medical primary health and social care services.

Science.gov (United States)

Mitchell, Penny

2009-02-01

Changes in patterns of delivery of mental health care over several decades are putting pressure on primary health and social care services to increase their involvement. Mental health policy in countries like the UK, Australia and New Zealand recognises the need for these services to make a greater contribution and calls for increased intersectoral collaboration. In Australia, most investment to date has focused on the development and integration of specialist mental health services and primary medical care, and evaluation research suggests some progress. Substantial inadequacies remain, however, in the comprehensiveness and continuity of care received by people affected by mental health problems, particularly in relation to social and psychosocial interventions. Very little research has examined the nature of the roles that non-medical primary health and social care services actually or potentially play in mental health care. Lack of information about these roles could have inhibited development of service improvement initiatives targeting these services. The present paper reports the results of an exploratory study that examined the mental health care roles of 41 diverse non-medical primary health and social care services in the state of Victoria, Australia. Data were collected in 2004 using a purposive sampling strategy. A novel method of surveying providers was employed whereby respondents within each agency worked as a group to complete a structured survey that collected quantitative and qualitative data simultaneously. This paper reports results of quantitative analyses including a tentative principal components analysis that examined the structure of roles. Non-medical primary health and social care services are currently performing a wide variety of mental health care roles and they aspire to increase their involvement in this work. However, these providers do not favour approaches involving selective targeting of clients with mental disorders.

Telemental health technology in deaf and general mental-health services: access and use.

Science.gov (United States)

Austen, Sally; McGrath, Melissa

2006-01-01

Long-distance travel to provide mental health services for deaf people has implications for efficiency, safety, and equality of service. However, uptake of Telemental Health (TMH) has been slow in both deaf and general mental health services. A quantitative study was used to investigate access to TMH and whether staff confidence, experience, or demographics affect TMH use. It was concluded that staff in neither deaf mental health services nor general mental health services had adequate knowledge of or access to TMH. Staff expressed concerns over TMH's appropriateness in their work. Previous use of videoconferencing was assosciated significantly with confidence, but previous use of videophones was not. Neither staff in deaf services nor deaf staff were more experienced with or more confident about videoconferencing, whereas, within deaf services, deaf staff were significantly more confident about videophone use. Training implications are discussed.

Child outpatient mental health service use: why doesn't insurance matter?

Science.gov (United States)

Glied, Sherry; Bowen Garrett, A.; Hoven, Christina; Rubio-Stipec, Maritza; Regier, Darrel; Moore, Robert E.; Goodman, Sherryl; Wu, Ping; Bird, Hector

1998-12-01

BACKGROUND: Several recent studies of child outpatient mental health service use in the US have shown that having private insurance has no effect on the propensity to use services. Some studies also find that public coverage has no beneficial effect relative to no insurance. AIMS: This study explores several potential explanations, including inadequate measurement of mental health status, bandwagon effects, unobservable heterogeneity and public sector substitution for private services, for the lack of an effect of private insurance on service use. METHODS: We use secondary analysis of data from the three mainland US sites of NIMH's 1992 field trial of the Cooperative Agreement for Methodological Research for Multi-Site Surveys of Mental Disorders in Child and Adolescent Populations (MECA) Study. We examine whether or not a subject used any mental health service, school-based mental health services or outpatient mental health services, and the number of outpatient visits among users. We also examine use of general medical services as a check on our results. We conduct regression analysis; instrumental variables analysis, using instruments based on employment and parental history of mental health problems to identify insurance choice, and bivariate probit analysis to examine multiservice use. RESULTS: We find evidence that children with private health insurance have fewer observable (measured) mental health problems. They also appear to have a lower unobservable (latent) propensity to use mental health services than do children without coverage and those with Medicaid coverage. Unobserved differences in mental health status that relate to insurance choice are found to contribute to the absence of a positive effect for private insurance relative to no coverage in service use regressions. We find no evidence to suggest that differences in attitudes or differences in service availability in children's census tracts of residence explain the non-effect of insurance

Factors Affecting Mental Health Service Utilization Among California Public College and University Students.

Science.gov (United States)

Sontag-Padilla, Lisa; Woodbridge, Michelle W; Mendelsohn, Joshua; D'Amico, Elizabeth J; Osilla, Karen Chan; Jaycox, Lisa H; Eberhart, Nicole K; Burnam, Audrey M; Stein, Bradley D

2016-08-01

Unmet need for mental health treatment among college students is a significant public health issue. Despite having access to campus mental health providers and insurance to cover services, many college students do not receive necessary services. This study examined factors influencing college students' use of mental health services. Online survey data for 33,943 students and 14,018 staff and faculty at 39 college campuses in California were analyzed by using logistic regressions examining the association between students' use of mental health services and student characteristics, campus environment, and the presence of a formal network of campus mental health clinics. Nineteen percent of students reported current serious psychological distress in the past 30 days, and 11% reported significant mental health-related academic impairment in the past year. Twenty percent reported using mental health services while at their current college, 10% by using campus services and 10% off-campus services. Students on campuses with a formal network of mental health clinics were more likely than students at community colleges to receive mental health services (odds ratio [OR] range=1.68-1.69), particularly campus services (OR=3.47-5.72). Students on campuses that are supportive of mental health issues were more likely to receive mental health services (OR=1.22), particularly on campus (OR=1.65). Students with active (versus low) coping skills were consistently more likely to use mental health services. Establishing more campus mental health clinics, fostering supportive campus environments, and increasing students' coping skills may reduce unmet need for mental health services among college students.

Men's Mental Health: Social Determinants and Implications for Services.

Science.gov (United States)

Affleck, William; Carmichael, Victoria; Whitley, Rob

2018-01-01

Numerous scholars have stated that there is a silent crisis in men's mental health. In this article, we aim to provide an overview of core issues in the field of men's mental health, including a discussion of key social determinants as well as implications for mental health services. Firstly, we review the basic epidemiology of mental disorders with a high incidence and prevalence in men, including suicide and substance use disorder. Secondly, we examine controversies around the low reported rates of depression in men, discussing possible measurement and reporting biases. Thirdly, we explore common risk factors and social determinants that may explain higher rates of certain mental health outcomes in men. This includes a discussion of 1) occupational and employment issues; 2) family issues and divorce; 3) adverse childhood experience; and 4) other life transitions, notably parenthood. Fourthly, we document and analyze low rates of mental health service utilization in men. This includes a consideration of the role of dominant notions of masculinity (such as stubbornness and self-reliance) in deterring service utilization. Fifthly, we note that some discourse on the role of masculinity contains much "victim blaming," often adopting a reproachful deficit-based model. We argue that this can deflect attention away from social determinants as well as issues within the mental health system, such as claims that it is "feminized" and unresponsive to men's needs. We conclude by calling for a multipronged public health-inspired approach to improve men's mental health, involving concerted action at the individual, health services, and societal levels.

Immigrants' use of primary health care services for mental health problems.

Science.gov (United States)

Straiton, Melanie; Reneflot, Anne; Diaz, Esperanza

2014-08-13

Equity in health care across all social groups is a major goal in health care policy. Immigrants may experience more mental health problems than natives, but we do not know the extent to which they seek help from primary health care services. This study aimed to determine a) the rate immigrants use primary health care services for mental health problems compared with Norwegians and b) the association between length of stay, reason for immigration and service use among immigrants. National register data covering all residents in Norway and all consultations with primary health care services were used. We conducted logistic regression analyses to compare Norwegians' with Polish, Swedish, German, Pakistani and Iraqi immigrants' odds of having had a consultation for a mental health problem (P-consultation). After accounting for background variables, all immigrants groups, except Iraqi men had lower odds of a P-consultation than their Norwegian counterparts. A shorter length of stay was associated with lower odds of a P-consultation. Service use varies by country of origin and patterns are different for men and women. There was some evidence of a possible 'healthy migrant worker' effect among the European groups. Together with previous research, our findings however, suggest that Iraqi women and Pakistanis in particular, may experience barriers in accessing care for mental health problems.

Making mental health services accessible for rural Kenyans | IDRC ...

International Development Research Centre (IDRC) Digital Library (Canada)

New research from the Africa Mental Health Foundation (AMHF), funded by the Global ... In 2004 he founded AMHF to address this gap in services. ... in an informal urban settlement to determine whether this strategy for mental health service ...

Utilization of Mental Health Services in School-Based Health Centers

Science.gov (United States)

Bains, Ranbir M.; Cusson, Regina; White-Frese, Jesse; Walsh, Stephen

2017-01-01

Background: We summarize utilization patterns for mental health services in school-based health centers. Methods: Administrative data on school-based health center visits in New Haven, Connecticut were examined for the 2007-2009 school years. Relative frequencies of mental health visits by age were calculated as a percentage of all visits and were…

Barriers to Seeking Mental Health Services among Adolescents in Military Families

Science.gov (United States)

Becker, Sara J.; Swenson, Rebecca; Esposito-Smythers, Christianne; Cataldo, Andrea; Spirito, Anthony

2014-01-01

Military families with adolescents experience high levels of stress associated with parental deployment, but many of these families do not seek or utilize mental health services. The current qualitative study was designed to better understand barriers to mental health treatment experienced by adolescents in military families. Focus groups and individual interviews were conducted with military adolescents (n = 13), military (non-enlisted) parents (n = 12), and mental health service providers who treat adolescents in military families (n = 20). Discussions primarily explored barriers to seeking treatment, with supplemental questions assessing the ideal elements of mental health services for this population. Seven barriers to engaging in mental health services were identified: four internal (confidentiality concerns, stigma, ethic of self-reliance, lack of perceived relevance) and three external (time and effort concerns, logistical concerns, financial concerns). Challenges engaging military adolescents in mental health services are discussed and several recommendations are offered for service providers attempting to work with this population. PMID:25574070

The demand for ambulatory mental health services from specialty providers.

Science.gov (United States)

Horgan, C M

1986-01-01

A two-part model is used to examine the demand for ambulatory mental health services in the specialty sector. In the first equation, the probability of having a mental health visit is estimated. In the second part of the model, variations in levels of use expressed in terms of visits and expenditures are examined in turn, with each of these equations conditional on positive utilization of mental health services. In the second part of the model, users are additionally grouped into those with and without out-of-pocket payment for services. This specification accounts for special characteristics regarding the utilization of ambulatory mental health services: (1) a large part of the population does not use these services; (2) of those who use services, the distribution of use is highly skewed; and (3) a large number of users have zero out-of-pocket expenditures. Cost-sharing does indeed matter in the demand for ambulatory mental health services from specialty providers; however, the decision to use mental health services is affected by the level of cost-sharing to a lesser degree than is the decision regarding the level of use of services. The results also show that price is only one of several important factors in determining the demand for services. The lack of significance of family income and of being female is notable. Evidence is presented for the existence of bandwagon effects. The importance of Medicaid in the probability of use equations is noted. PMID:3721874

Mental Health Services Utilization and Expenditures Among Children Enrolled in Employer-Sponsored Health Plans.

Science.gov (United States)

Walter, Angela Wangari; Yuan, Yiyang; Cabral, Howard J

2017-05-01

Mental illness in children increases the risk of developing mental health disorders in adulthood, and reduces physical and emotional well-being across the life course. The Mental Health Parity and Addiction Equity Act (MHPAEA, 2008) aimed to improve access to mental health treatment by requiring employer-sponsored health plans to include insurance coverage for behavioral health services. Investigators used IBM Watson/Truven Analytics MarketScan claims data (2007-2013) to examine: (1) the distribution of mental illness; (2) trends in utilization and out-of-pocket expenditures; and (3) the overall effect of the MHPAEA on mental health services utilization and out-of-pocket expenditures among privately-insured children aged 3 to 17 with mental health disorders. Multivariate Poisson regression and linear regression modeling techniques were used. Mental health services use for outpatient behavioral health therapy (BHT) was higher in the years after the implementation of the MHPAEA (2010-2013). Specifically, before the MHPAEA implementation, the annual total visits for BHT provided by mental health physicians were 17.1% lower and 2.5% lower for BHT by mental health professionals, compared to years when MHPAEA was in effect. Children covered by consumer-driven and high-deductible plans had significantly higher out-of-pocket expenditures for BHT compared to those enrolled PPOs. Our findings demonstrate increased mental health services use and higher out-of-pocket costs per outpatient visit after implementation of the MHPAEA. As consumer-driven and high-deductible health plans continue to grow, enrollees need to be cognizant of the impact of health insurance benefit designs on health services offered in these plans. Copyright © 2017 by the American Academy of Pediatrics.

Prejudice and discrimination from mental health service providers.

Science.gov (United States)

Nemec, Patricia B; Swarbrick, Margaret; Legere, Lyn

2015-06-01

This column describes the experience of prejudice and discrimination that some mental health service users encounter in their interactions with service providers and organizations. The intent of this column is to highlight potential action steps to address the negative beliefs and attitudes of service providers that contribute to prejudice and discrimination. This description draws from published material and the authors' experience. If the most effective approaches to reduce public prejudice and discrimination toward people diagnosed with a mental illness are education and contact, then those methods may be useful methods to help mental health service providers view and engage persons served from a strengths-based recovery and wellness orientation. (c) 2015 APA, all rights reserved).

Unmet Need for Specialty Mental Health Services Among Children Across Europe.

Science.gov (United States)

Kovess-Masfety, Viviane; Van Engelen, Julia; Stone, Lisanne; Otten, Roy; Carta, Mauro Giovanni; Bitfoi, Adina; Koc, Ceren; Goelitz, Dietmar; Lesinskiene, Sigita; Mihova, Zlatka; Fermanian, Christophe; Pez, Ondine; Husky, Mathilde

2017-08-01

The aim of this study was to examine the determinants of use of mental health services for children across Europe, with a specific focus on differences in the availability of mental health resources. Data were drawn from the School Children Mental Health in Europe Project. Parent- and teacher-reported child mental health status was based on the Strengths and Difficulties Questionnaire. Sociodemographic characteristics of parents and children, as well as academic performance and use of mental health services in the previous 12 months, were collected. Countries were categorized as having high versus low mental health resources. The sample comprised 4,894 schoolchildren in seven countries. Across Europe, only 25.6% of children with a mental disorder had received mental health services in the previous 12 months, including 31.5% in high-resources countries and 18.9% in low-resources countries (p=.001) (N=4,867). The presence of any mental disorder, maternal psychological distress, gender, living in a single-parent home, and low academic performance were determinants of service use. The effect of resources group on the likelihood of receiving services remained significant when the analyses controlled for all predictors (odds ratio=1.41, pchildren with mental disorders, especially in low-resources countries.

Gamification in Healthcare: Perspectives of Mental Health Service Users and Health Professionals.

Science.gov (United States)

Hopia, Hanna; Raitio, Katja

2016-12-01

The purpose of this descriptive qualitative study is to explore the perceptions and experiences that mental health service users (n = 10) and healthcare professionals (n = 32) have regarding the use of gamification in mental health care. Data was gathered by interviews. The mental health service users described promoting and retarding factors in the use of gamification, while professionals described the requirements for using gamification and changes occurring in the work culture. Additional research is needed on how game-playing elements could be integrated as a systematic part of mental health practice and how the digital skills of professionals could be effectively developed.

[Quality of mental health services: a self audit in the South Verona mental health service].

Science.gov (United States)

Allevi, Liliana; Salvi, Giovanni; Ruggeri, Mirella

2006-01-01

To start a process of Continuous Quality Improvement (CQI) in an Italian Community Mental Health Service by using a quality assurance questionnaire in a self audit exercise. The questionnaire was administered to 14 key workers and clinical managers with different roles and seniority. One senior manager's evaluation was used as a benchmark for all the others. Changes were introduced in the service practice according to what emerged from the evaluation. Meetings were scheduled to monitor those changes and renew the CQI process. There was a wide difference in the key workers' answers. Overall, the senior manager's evaluation was on the 60th percentile of the distribution of the other evaluations. Those areas that required prompt intervention were risk management, personnel development, and CQI. The CQI process was followed up for one year: some interventions were carried out to change the practice of the service. A self audit exercise in Community Mental Health Services was both feasible and useful. The CQI process was easier to start than to carry on over the long term.

Size Matters — Determinants of Modern, Community-Oriented Mental Health Services

Science.gov (United States)

Ala-Nikkola, Taina; Pirkola, Sami; Kontio, Raija; Joffe, Grigori; Pankakoski, Maiju; Malin, Maili; Sadeniemi, Minna; Kaila, Minna; Wahlbeck, Kristian

2014-01-01

Governances, structures and contents of mental health services are being reformed across countries. There is a need for data to support those changes. The aim of this study was to explore the quality, i.e., diversity and community orientation, and quantity, i.e., personnel resources, of mental health and substance abuse services (MHS) and evaluate correlation between population needs and quality and quantity of MHS. The European Service Mapping Schedule—Revised (ESMS-R) was used to classify mental health and substance abuse services in southern Finland. Municipal-level aggregate data, local data on unemployment rate, length of education, age of retirement, proportion of single households, alcohol sales and a composite mental health index were used as indicators of population mental health needs. Population size correlated strongly with service diversity, explaining 84% of the variance. Personnel resources did not associate with diversity or community orientation. The indicators of mental health services need did not have the expected association with quality and quantity of services. In terms of service organization, the results may support larger population bases, at least 150,000 adult inhabitants, when aiming for higher diversity. PMID:25153471

Do young people attending addiction services differ from those attending youth mental health services?

Science.gov (United States)

Christie, Grant; Merry, Sally; Robinson, Elizabeth

2010-07-01

We aimed to describe and compare the self-reported substance use, psychopathology and psychosocial morbidity in adolescents attending two adolescent outpatient services, a triage-based mental health service and an engagement-focused addiction service in Auckland, New Zealand. A naturalistic cross-section of 131 (addiction service = 67, mental health service = 64) 14-18-year-old boys and girls attending each service completed a standardised screening and assessment instrument, the Drug Use Screening Inventory-Revised. The Drug Use Screening Inventory-Revised measures self-reported problems across 10 domains of functioning, including substance use, behaviour, psychiatric symptoms and school and family functioning. Descriptive statistics were used to provide an overview of the self-reported morbidity in each group and t-tests were used to determine differences between the two groups. Adolescents attending the addiction service reported significantly more problems with substance use, school performance and peer relationships than those attending the mental health service. There was no significant difference in reported psychiatric symptoms, behavioural problems, social competency, health problems, family problems, difficulties in work functioning or leisure time between the two groups. Young people presenting to engagement-focused substance use services report similar difficulties to those at mental health services across most areas of psychosocial functioning. Addiction services may require equivalent staffing expertise and workforce development to that in mental health to effectively meet young people's needs.

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

NARCIS (Netherlands)

van den Brink, Rob H. S.; Broer, Jan; Tholen, Alfons J.; Winthorst, Wim H.; Visser, Ellen; Wiersma, Durk

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

Mental health service users' experiences of diabetes care by Mental Health Nurses: an exploratory study.

Science.gov (United States)

Nash, M

2014-10-01

This paper is a report of a study exploring mental health service users' (MHSUs') experiences of diabetes care. Diabetes is a growing clinical concern in mental health nursing practice. However, little is known about MHSUs' experience of diabetes care. This is a descriptive qualitative study. Semi-structured telephone interviews were held between June and October 2011, with seven MHSUs who had diabetes. Participants reported experiences of stigma and diagnostic overshadowing (DO) when reporting symptoms of diabetes or when feeling unwell. Participants also encountered a split between their mental health and diabetes care needs, which resulted in a lack of holistic or integrated care. All participants mentioned experiencing complications of diabetes even to the extent of diabetic ketoacidosis. Mental health nurses (MHNs) must critically reflect on their attitudes towards service users that report physical symptoms to ensure that stigma and DO do not constitute barriers to appropriate screening and treatment. The complex relationship that exists between mental illness and diabetes requires MHNs to ensure physical and mental health care are wholly integrated and not split. Education needs are apparent so that symptoms and complications can be recognized and treated accordingly. © 2014 John Wiley & Sons Ltd.

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

OpenAIRE

Larson, S; Chapman, S; Spetz, J; Brindis, CD

2017-01-01

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 (SBHCs) may be one strategy to decrease health disparities.Empirical studies between 2003 and 2013 of US pediatric populations and of US SBHCs were included if rese...

Access to specialty mental health services among women in California.

Science.gov (United States)

Kimerling, Rachel; Baumrind, Nikki

2005-06-01

The Anderson behavioral model was used to investigate racial and ethnic disparities in access to specialty mental health services among women in California as well as factors that might account for such disparities. The study was a cross-sectional examination of a probability sample of 3,750 California women. The main indicators of access to services were perceived need, service seeking, and service use. Multivariate models were constructed that accounted for need and enabling and demographic variables. Significant racial and ethnic variations in access to specialty mental health services were observed. African-American, Hispanic, and Asian women were significantly less likely to use specialty mental health services than white women. Multivariate analyses showed that Hispanic and Asian women were less likely than white women to report perceived need, even after frequent mental distress had been taken into account. Among women with perceived need, African-American and Asian women were less likely than white women to seek mental health services after differences in insurance status had been taken into account. Among women who sought services, Hispanic women were less likely than white women to obtain services after adjustment for the effects of poverty. Need and enabling factors did not entirely account for the observed disparities in access to services. Additional research is needed to identify gender- and culture-specific models for access to mental health services in order to decrease disparities in access. Factors such as perceived need and decisions to seek services are important factors that should be emphasized in future studies.

Service user involvement in mental health care: an evolutionary concept analysis.

Science.gov (United States)

Millar, Samantha L; Chambers, Mary; Giles, Melanie

2016-04-01

The concept of service user involvement is an evolving concept in the mental health-care literature. This study sought to explore and analyse the concept of service user involvement as used in within the field of mental health care. An evolutionary concept analysis was conducted using a literature-based sample extracted from an electronic database search. One hundred and thirty-four papers met the inclusion criteria and were analysed to discover key attributes, antecedents and consequences of service user involvement and to produce a definition of the concept. Five key attributes of service user involvement within the context of mental health care were identified: a person-centred approach, informed decision making, advocacy, obtaining service user views and feedback and working in partnership. Clarity of the attributes and definition of the concept of service user involvement aims to promote understanding of the concept among key stakeholders including mental health professionals, service users and community and voluntary organizations. The findings of the research have utility in the areas of theory and policy development, research on service user involvement in mental health care and service user involvement in mental health practice. Directions for further research regarding the concept are identified. © 2015 John Wiley & Sons Ltd.

Attitudes Toward Mental Health Services Among American Indians by Two Age Groups.

Science.gov (United States)

Roh, Soonhee; Brown-Rice, Kathleen A; Lee, Kyoung Hag; Lee, Yeon-Shim; Yee-Melichar, Darlene; Talbot, Elizabeth P

2015-11-01

This study examined determinants of attitudes toward mental health services with a sample of American Indian younger-old-adults (aged 50-64, n = 158) and American Indian older-old adults (aged 65 and older, n = 69). Adapting Andersen's behavioral model of healthcare utilization, predisposing factors, mental health needs, and enabling factors were considered as potential predictors. Female and those with higher levels of social support tend to report more positive attitudes toward mental health services. Culture-influenced personal belief was associated with negative attitudes toward mental health services among American Indian younger-old -adults. Age and higher chronic medical conditions were significantly related to negative attitudes toward mental health services. Health insurance was positively associated with positive attitudes toward mental health services in the American Indian older-old adults. Findings indicate that practitioners should engage how culture, social support, and chronic conditions influence the response to mental health needs when working with older American Indians.

Service quality and clinical outcomes: an example from mental health rehabilitation services in England.

Science.gov (United States)

Killaspy, Helen; Marston, Louise; Omar, Rumana Z; Green, Nicholas; Harrison, Isobel; Lean, Melanie; Holloway, Frank; Craig, Tom; Leavey, Gerard; King, Michael

2013-01-01

Current health policy assumes better quality services lead to better outcomes. To investigate the relationship between quality of mental health rehabilitation services in England, local deprivation, service user characteristics and clinical outcomes. Standardised tools were used to assess the quality of mental health rehabilitation units and service users' autonomy, quality of life, experiences of care and ratings of the therapeutic milieu. Multiple level modelling investigated relationships between service quality, service user characteristics and outcomes. A total of 52/60 (87%) National Health Service trusts participated, comprising 133 units and 739 service users. All aspects of service quality were positively associated with service users' autonomy, experiences of care and therapeutic milieu, but there was no association with quality of life. Quality of care is linked to better clinical outcomes in people with complex and longer-term mental health problems. Thus, investing in quality is likely to show real clinical gains.

Factors Associated with Mental Health Service Utilization among Korean American Immigrants

Science.gov (United States)

Park, So-Youn; Cho, Sunhee; Park, Yeddi; Bernstein, Kunsook S.; Shin, Jinah K.

2014-01-01

This study adapted Andersen's Health Belief Model to examine the predictors of mental health services utilization among Korean American (KA) immigrants. A cross-sectional survey was used to gather data on 363 KA immigrants 18 years and older residing in New York City. Predisposing factors included gender, age, marital status, education, length of stay in the US, and religion; the need factor was depression; and enabling factors included health insurance, English proficiency, income, and perceived need for help. Approximately 8.5 % of participants reported having utilized mental health services, while 23 % reported having depressive symptoms. Shorter duration of residence in the US, lower income, and the presence of perceived need for help were significantly related to use of mental health services. The perceived need for help mediated the relationship between depression and mental health service utilization. Failure to perceive the need for psychological help continues to be a major reason that KA immigrants do not use mental health services. PMID:23417654

Infusing Early Childhood Mental Health into Early Intervention Services

Science.gov (United States)

Grabert, John C.

2009-01-01

This article describes the process of enhancing early childhood mental health awareness and skills in non-mental health staff. The author describes a pilot training model, conducted the U.S. Army's Early Intervention Services, that involved: (a) increasing early childhood mental health knowledge through reflective readings, (b) enhancing…

Mental health service use among South Africans for mood, anxiety ...

African Journals Online (AJOL)

Background. Europe and North America have low rates of mental health service use despite high rates of mental disorder. Little is known about mental health service use among South Africans. Design. A nationally representative survey of 4 351 adults. Twelve-month DSM-IV (Diagnostic and Statistical Manual, 4th edition) ...

Internet-based mental health services in Norway and Sweden: characteristics and consequences.

Science.gov (United States)

Andersen, Anders Johan W; Svensson, Tommy

2013-03-01

Internet-based mental health services increase rapidly. However, national surveys are incomplete and the consequences for such services are poorly discussed. This study describes characteristics of 60 Internet-based mental health services in Norway and Sweden and discusses their social consequences. More than half of the services were offered by voluntary organisations and targeted towards young people. Professionals answered service users' questions in 60% of the services. Eight major themes were identified. These characteristics may indicate a shift in the delivery of mental health services in both countries, and imply changes in the understanding of mental health.

Enhancing early engagement with mental health services by young people

Directory of Open Access Journals (Sweden)

Burns J

2014-11-01

Full Text Available Jane Burns, Emma Birrell Young and Well Cooperative Research Centre, Abbotsford, VIC, Australia Abstract: International studies have shown that the prevalence of mental illness, and the fundamental contribution it make to the overall disease burden, is greatest in children and young people. Despite this high burden, adolescents and young adults are the least likely population group to seek help or to access professional care for mental health problems. This issue is particularly problematic given that untreated, or poorly treated, mental disorders are associated with both short- and long-term functional impairment, including poorer education and employment opportunities, potential comorbidity, including drug and alcohol problems, and a greater risk for antisocial behavior, including violence and aggression. This cycle of poor mental health creates a significant burden for the young person, their family and friends, and society as a whole. Australia is enviably positioned to substantially enhance the well-being of young people, to improve their engagement with mental health services, and – ultimately – to improve mental health. High prevalence but potentially debilitating disorders, such as depression and anxiety, are targeted by the specialized youth mental health service, headspace: the National Youth Mental Health Foundation and a series of Early Psychosis Prevention and Intervention Centres, will provide early intervention specialist services for low prevalence, complex illnesses. Online services, such as ReachOut.com by Inspire Foundation, Youthbeyondblue, Kids Helpline, and Lifeline Australia, and evidence-based online interventions, such as MoodGYM, are also freely available, yet a major challenge still exists in ensuring that young people receive effective evidence-based care at the right time. This article describes Australian innovation in shaping a comprehensive youth mental health system, which is informed by an evidence

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.

Using Technology to Improve Access to Mental Health Services.

Science.gov (United States)

Cortelyou-Ward, Kendall; Rotarius, Timothy; Honrado, Jed C

Mental ill-health is a public health threat that is prevalent throughout the United States. Tens of millions of Americans have been diagnosed along the continuum of mental ill-health, and many more millions of family members and friends are indirectly affected by the pervasiveness of mental ill-health. Issues such as access and the societal stigma related to mental health issues serve as deterrents to patients receiving their necessary care. However, technological advances have shown the potential to increase access to mental health services for many patients.

Characteristics of U.S. Mental Health Facilities That Offer Suicide Prevention Services.

Science.gov (United States)

Kuramoto-Crawford, S Janet; Smith, Kelley E; McKeon, Richard

2016-01-01

This study characterized mental health facilities that offer suicide prevention services or outcome follow-up after discharge. The study analyzed data from 8,459 U.S. mental health facilities that participated in the 2010 National Mental Health Services Survey. Logistic regression analyses were used to compare facilities that offered neither of the prevention services with those that offered both or either service. About one-fifth of mental health facilities reported offering neither suicide prevention services nor outcome follow-up. Approximately one-third offered both, 25% offered suicide prevention services only, and 21% offered only outcome follow-up after discharge. Facilities that offered neither service were less likely than facilities that offered either to offer comprehensive support services or special programs for veterans; to offer substance abuse services; and to be accredited, licensed, or certified. Further examination of facilitators and barriers in implementing suicide prevention services in mental health facilities is warranted.

Use of mental health services by nursing home residents after hurricanes.

Science.gov (United States)

Brown, Lisa M; Hyer, Kathryn; Schinka, John A; Mando, Ahed; Frazier, Darvis; Polivka-West, Lumarie

2010-01-01

A growing body of research supports the value of mental health intervention to treat people affected by disasters. This study used a mixed-methods approach to evaluate pre- and posthurricane mental health service use in Florida nursing homes. A questionnaire was administered to 258 directors of nursing, administrators, and owners of nursing homes, representing two-thirds of Florida's counties, to identify residents' mental health needs and service use. In four subsequent focus group meetings with 22 nursing home administrators, underlying factors influencing residents' use of services were evaluated. Although most nursing homes provided some type of mental health care during normal operations, disaster-related mental health services were not routinely provided to residents. Receiving facilities were more likely than evacuating facilities to provide treatment to evacuated residents. Nursing home staff should be trained to deliver disaster-related mental health intervention and in procedures for making referrals for follow-up evaluation and formal intervention.

National Mental Health Services Survey (N-MHSS-2010)

Data.gov (United States)

U.S. Department of Health & Human Services — The National Mental Health Services Survey (N-MHSS) is an annual survey designed to collect statistical information on the numbers and characteristics of all known...

Indicators predicting use of mental health services in Piedmont, Italy.

Science.gov (United States)

Tibaldi, Giuseppe; Munizza, Carmine; Pasian, Sherri; Johnson, Sonia; Salvador-Carulla, Luis; Zucchi, Serena; Cesano, Simona; Testa, Cristina; Scala, Elena; Pinciaroli, Luca

2005-06-01

Since the 1978 Italian reform, an integrated network of community mental health services has been introduced. With few exceptions, research on determinants of mental health service use at the district level has focused on inpatient activities and social deprivation indicators. The European Psychiatric Care Assessment Team (EPCAT) standardized methodology allows for an evidence-based comparison of mental health systems between geographical areas. To compare service provision and utilization between local catchment areas; to explore quantitative relationships between residential and community service use and socio-demographic indicators at the ecological level. The European Socio-demographic Schedule (ESDS) was used to describe area characteristics, and the European Service Mapping Schedule (ESMS) to measure service provision and utilization in 18 catchment areas in Piedmont. Substantial variation in service use emerged. Acute hospital bed occupancy rates were lower in areas with more intensive community continuing care service users and with a smaller percentage of the population living alone. The non-acute hospital bed occupancy rate was directly related to the percentage of the population living alone or in overcrowded conditions, and to the level of mobile continuing care service users. Community continuing care service use was highest in areas with a larger percentage of the population living alone. Multiple regression models explained between 48 and 55% of the variation in inpatient and community service use between areas. Relationships based on ecological characteristics do not necessarily apply to the individual. This level of assessment, however, is necessary in evaluating mental health policy and service systems, and in allocating resources. The distribution of mental health care resources should be weighted in terms of indicators of social deprivation shown to be important predictors of both inpatient and community service use, as these are likely to be

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

Mental Health Service Providers: College Student Perceptions of Helper Effectiveness

Science.gov (United States)

Ackerman, Ashley M.; Wantz, Richard A.; Firmin, Michael W; Poindexter, Dawn C.; Pujara, Amita L.

2014-01-01

Undergraduate perceptions of the overall effectiveness of six types of mental health service providers (MHSPs) were obtained with a survey. Although many mental health services are available to consumers in the United States, research has indicated that these services are underutilized. Perceptions have been linked to therapeutic outcomes and may…

Resources available for school based mental health services in ...

African Journals Online (AJOL)

Resources available for school based mental health services in Enugu urban and head teachers' knowledge of childhood mental health problems. ... PROMOTING ACCESS TO AFRICAN RESEARCH. AFRICAN JOURNALS ONLINE (AJOL) ...

The role of community mental health services in supporting oral health outcomes among consumers.

Science.gov (United States)

Meldrum, Rebecca; Ho, Hillary; Satur, Julie

2018-04-16

People with a lived experience of mental illness are at a higher risk for developing oral diseases and having poorer oral health than the broader population. This paper explores the role of Australian community mental health services in supporting the prevention and management of poor oral health among people living with mental illness. Through focus groups and semi-structured interviews, participants identified the value of receiving oral health support within a community mental health setting, in particular the delivery of basic education, preventive strategies, assistance with making or attending appointments and obtaining priority access to oral health services. Engagement with Community Health Services and referrals generated through the priority access system were identified as key enablers to addressing oral health issues. This study provides new insight into the importance of undertaking an integrated approach to reducing the oral health disparities experienced by those living with mental illness.

Utilization of Mental Health Services in School-Based Health Centers.

Science.gov (United States)

Bains, Ranbir M; Cusson, Regina; White-Frese, Jesse; Walsh, Stephen

2017-08-01

We summarize utilization patterns for mental health services in school-based health centers. Administrative data on school-based health center visits in New Haven, Connecticut were examined for the 2007-2009 school years. Relative frequencies of mental health visits by age were calculated as a percentage of all visits and were stratified by sex, ethnicity/race, and insurance status. Mental health visits accounted for the highest proportion of visits (31.8%). The proportion of mental health visits was highest at 8 years (42.8%) and at 13 years (39.0%). The proportion of mental health visits among boys (38.4%) was higher than among girls (26.7%). Hispanic students had a lower proportion of mental health visits than black students (23.5% vs 35.8%) in all but 2 age groups. Students in the white/other ethnicity category had higher proportions of mental health visits than Hispanic and black students between ages 12 and 15. Students with no health insurance (22.5%) had lower proportions of mental health visits than students covered by Medicaid (34.3%) or private insurance (33.9%). The percentage of mental health visits by students with private insurance was highest (37.2%-49%) in the 13-15 age range. Usage patterns for mental health issues show pronounced, nonrandom variation relative to age and other demographic characteristics especially with 8-year-old boys. © 2017, American School Health Association.

Factors associated with adolescent mental health service need and utilization

NARCIS (Netherlands)

Zwaanswijk, Marieke; Ende, J. van der; Verhaak, P.F.M.; Bensing, J.; Verhulst, F.C.

2003-01-01

Objective: To determine the association of parent, family, and adolescent variables with adolescent mental health service need and utilization. Method: Correlates of adolescent mental health service utilization, self-perceived need and unmet need were investigated in a general population sample of

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

Ethnic differences in mental illness and mental health service use among Black fathers.

Science.gov (United States)

Doyle, Otima; Joe, Sean; Caldwell, Cleopatra H

2012-05-01

We have presented nationally representative data on the prevalence and correlates of mental illness and mental health service use among African American and Caribbean Black (US-born and foreign-born) fathers in the United States. We have reported national estimates of lifetime and 12-month prevalence rates of mental illness, correlates, and service use among African American (n = 1254) and Caribbean Black (n = 633) fathers using data from the National Survey of American Life, a national household survey of Black Americans. We used bivariate cross-tabulations and Cox proportional hazards regression approaches and adjusted for the National Survey of American Life's complex sample design. The prevalence of mental illness, sociodemographic correlates, and service use among Black fathers varied by ethnicity and nativity. US-born Caribbean Black fathers had alarmingly high rates of most disorders, including depression, anxiety, and substance disorders. Mental health service use was particularly low for African American and foreign-born Caribbean Black fathers. These results demonstrate the need for more research on the causes and consequences of mental illness and the help-seeking behavior of ethnically diverse Black fathers.

Collaboration in the provision of mental health care services

DEFF Research Database (Denmark)

Jaruseviciene, L.; Valius, L.; Lazarus, J.V.

2012-01-01

collaboration with mental health teams were a lack of GPs'confidence in their communication skills and ability to diagnose the most frequent mental disorders, prompt referral to mental health team specialists, low estimation of the prevalence of non-managed mental disorders, and location of mental health team......Background. General practitioners (GPs) often become the first point of care for mental health issues. Improved collaboration between GPs and mental health teams can make a GP's mental health services more efficient. Objective. The aim of this study was to assess the collaboration between GPs...... and mental health team members and determine predictors for better collaboration. Methods. In this cross-sectional study, a 41- item questionnaire was distributed to a random sample of 797 Lithuanian GPs. The purpose of this questionnaire was to obtain knowledge about current practices of GPs in providing...

Investigating service features to sustain engagement in early intervention mental health services.

Science.gov (United States)

Becker, Mackenzie; Cunningham, Charles E; Christensen, Bruce K; Furimsky, Ivana; Rimas, Heather; Wilson, Fiona; Jeffs, Lisa; Madsen, Victoria; Bieling, Peter; Chen, Yvonne; Mielko, Stephanie; Zipursky, Robert B

2017-08-23

To understand what service features would sustain patient engagement in early intervention mental health treatment. Mental health patients, family members of individuals with mental illness and mental health professionals completed a survey consisting of 18 choice tasks that involved 14 different service attributes. Preferences were ascertained using importance and utility scores. Latent class analysis revealed segments characterized by distinct preferences. Simulations were carried out to estimate utilization of hypothetical clinical services. Overall, 333 patients and family members and 183 professionals (N = 516) participated. Respondents were distributed between a Professional segment (53%) and a Patient segment (47%) that differed in a number of their preferences including for appointment times, individual vs group sessions and mode of after-hours support. Members of both segments shared preferences for many of the service attributes including having crisis support available 24 h per day, having a choice of different treatment modalities, being offered help for substance use problems and having a focus on improving symptoms rather than functioning. Simulations predicted that 60% of the Patient segment thought patients would remain engaged with a Hospital service, while 69% of the Professional segment thought patients would be most likely to remain engaged with an E-Health service. Patients, family members and professionals shared a number of preferences about what service characteristics will optimize patient engagement in early intervention services but diverged on others. Providing effective crisis support as well as a range of treatment options should be prioritized in the future design of early intervention services. © 2017 John Wiley & Sons Australia, Ltd.

Rural Women Veterans' Use and Perception of Mental Health Services.

Science.gov (United States)

Ingelse, Kathy; Messecar, Deborah

2016-04-01

While the total number of veterans in the U.S. is decreasing overall, the number of women veterans is significantly increasing. There are numerous barriers which keep women veterans from accessing mental health care. One barrier which can impact receiving care is living in a rural area. Veterans in rural areas have access to fewer mental health services than do urban residing veterans, and women veterans in general have less access to mental health care than do their male colleagues. Little is known about rural women veterans and their mental health service needs. Women, who have served in the military, have unique problems related to their service compared to their male colleagues including higher rates of post-traumatic stress disorder (PTSD) and military sexual trauma (MST). This qualitative study investigated use of and barriers to receiving mental health care for rural women veterans. In-depth interviews were conducted with ten women veterans who have reported experiencing problems with either MST, PTSD, or combat trauma. All ten women had utilized mental health services during active-duty military service, and post service, in Veterans Administration (VA) community based-outpatient clinics. Several recurring themes in the women's experience were identified. For all of the women interviewed, a sentinel precipitating event led to seeking mental health services. These precipitating events included episodes of chronic sexual harassment and ridicule, traumatic sexual assaults, and difficult combat experiences. Efforts to report mistreatment were unsuccessful or met with punishment. All the women interviewed reported that they would not have sought services without the help of a supportive peer who encouraged seeking care. Barriers to seeking care included feeling like they were not really a combat veteran (in spite of serving in a combat unit in Iraq); feeling stigmatized by providers and other military personnel, being treated as crazy; and a lack of interest

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.

77 FR 54783 - Improving Access to Mental Health Services for Veterans, Service Members, and Military Families

Science.gov (United States)

2012-09-05

... develops formal arrangements with community-based providers, such as community mental health clinics... effectiveness of community partnerships in helping to meet the mental health needs of veterans in a timely way... networks that supports the use of community mental health services, including telehealth services and...

Mental Health Service Use Among Lesbian, Gay, and Bisexual Older Adults.

Science.gov (United States)

Stanley, Ian H; Duong, Jeffrey

2015-07-01

Empirical efforts to measure use of mental health services among lesbian, gay, and bisexual (LGB) older adults have been notably lacking. Thus this study assessed associations between sexual orientation and mental health service use among older adults and determined the mediating role of nonspecific psychological distress, excessive alcohol use, and self-perceived poor general medical health. Data from the 2011 New York City Community Health Survey were analyzed. The analytic sample comprised 5,138 adults ages 50 and over. Logistic regression modeling was used to examine associations between sexual orientation (LGB versus heterosexual) and past-year mental health service use (counseling or medication), adjusting for sociodemographic and clinical characteristics. Mediation analyses using bootstrapping were conducted. Among LGB older adults, 23.9% reported receiving counseling, and 23.4% reported taking psychiatric medication in the past year. LGB respondents were significantly more likely than heterosexuals to have received counseling (adjusted odds ratio [AOR]=2.16, 95% confidence interval [CI]=1.49-3.13) and psychiatric medication (AOR=1.97, CI=1.36-2.86). Psychological distress, excessive alcohol use, and self-perceived poor general medical health did not mediate the association between sexual orientation and mental health service use. LGB older adults were more likely than heterosexuals to utilize mental health services, and this association was not explained by indicators of general medical, mental, or behavioral health.

Creating an innovative youth mental health service in the United Kingdom: The Norfolk Youth Service.

Science.gov (United States)

Wilson, Jon; Clarke, Tim; Lower, Rebecca; Ugochukwu, Uju; Maxwell, Sarah; Hodgekins, Jo; Wheeler, Karen; Goff, Andy; Mack, Robert; Horne, Rebecca; Fowler, David

2017-08-04

Young people attempting to access mental health services in the United Kingdom often find traditional models of care outdated, rigid, inaccessible and unappealing. Policy recommendations, research and service user opinion suggest that reform is needed to reflect the changing needs of young people. There is significant motivation in the United Kingdom to transform mental health services for young people, and this paper aims to describe the rationale, development and implementation of a novel youth mental health service in the United Kingdom, the Norfolk Youth Service. The Norfolk Youth Service model is described as a service model case study. The service rationale, national and local drivers, principles, aims, model, research priorities and future directions are reported. The Norfolk Youth Service is an innovative example of mental health transformation in the United Kingdom, comprising a pragmatic, assertive and "youth-friendly" service for young people aged 14 to 25 that transcends traditional service boundaries. The service was developed in collaboration with young people and partnership agencies and is based on an engaging and inclusive ethos. The service is a social-recovery oriented, evidence-based and aims to satisfy recent policy guidance. The redesign and transformation of youth mental health services in the United Kingdom is long overdue. The Norfolk Youth Service represents an example of reform that aims to meet the developmental and transitional needs of young people at the same time as remaining youth-oriented. © 2017 John Wiley & Sons Australia, Ltd.

Mental Health Service Use in Schools and Non-School-Based Outpatient Settings: Comparing Predictors of Service Use.

Science.gov (United States)

Langer, David A; Wood, Jeffrey J; Wood, Patricia A; Garland, Ann F; Landsverk, John; Hough, Richard L

2015-09-01

Researchers have consistently documented a gap between the large number of US youth meeting criteria for a mental health disorder with significant associated impairment, and the comparatively few youth receiving services. School-based mental health care may address the need-services gap by offering services more equitably to youth in need, irrespective of family economic resources, availability of transportation, and other factors that can impede access to community clinics. However, diagnoses alone do not fully capture the severity of an individual's mental health status and need for services. Studying service use only in relation to diagnoses may restrict our understanding of the degree to which service use is reflective of service need, and inhibit our ability to compare school and non-school-based outpatient settings on their responsiveness to service need. The present study evaluated predictors of mental health service use in school- and community-based settings for youth who had had an active case in one of two public sectors of care, comparing empirically-derived dimensional measurements of youth mental health service need and impairment ratings against non-need variables (e.g., ethnicity, income). Three dimensions of youth mental health service need were identified. Mental health service need and non-need variables each played a significant predictive role. Parent-rated impairment was the strongest need-based predictor of service use across settings. The impact of non-need variables varied by service setting, with parental income having a particularly noticeable effect on school-based services. Across time, preceding service use and impairment each significantly predicted future service use.

Community/hospital indicators in South African public sector mental health services.

Science.gov (United States)

Lund, Crick; Flisher, Alan J

2003-12-01

The need to balance resources between community and hospital-based mental health services in the post-deinstitutionalisation era has been well-documented. However, few indicators have been developed to monitor the relationship between community and hospital services, in either developed or developing countries. There is a particular need for such indicators in the South African context, with its history of inequitable services based in custodial institutions under apartheid, and a new policy that proposes the development of more equitable community-based care. Indicators are needed to measure the distribution of resources and the relative utilisation of community and hospital-based services during the reform process. These indicators are potentially useful for assessing the implementation of policy objectives over time. To develop and document community/hospital indicators in public sector mental health services in South Africa. A questionnaire was distributed to provincial mental health coordinators requesting numbers of full-time equivalent (FTE) staff who provide mental health care at all service levels, annual patient admissions to hospitals and annual patient attendances at ambulatory care facilities. The information was supplemented by consultations with mental health coordinators in each of the 9 provinces. Population data were obtained from preliminary findings of the 1996 census. The community/hospital indicator measuring staff distribution was defined as the ratio of staff employed in community settings to all staff, expressed as a percentage. The community/hospital indicator measuring patient service utilisation was defined as the ratio of the annual ambulatory care attendance rate per 100,000 population to the sum of this rate and the annual hospital admission rate per 100,000 population, expressed as a percentage. Of psychiatric public sector staff, 25% are located in community settings in South Africa (provincial range: 11-70%). If hospital outpatient

Recent changes in Medicaid policy and their possible effects on mental health services.

Science.gov (United States)

Buck, Jeffrey A

2009-11-01

As Medicaid has emerged as the primary funder of public mental health services, its character has affected the organization and delivery of such services. Recent changes to the program, however, promise to further affect the direction of changes in states' mental health service systems. One group of changes will further limit the flexibility of Medicaid mental health funding, while increasing provider accountability and the authority of state Medicaid agencies. Others will increase incentives for deinstitutionalization and community-based care and promote person-centered treatment principles. These changes will likely affect state mental health systems, mental health providers, and the nature of service delivery.

Mental Health Service Use for Patients with Co-occurring Mental and Physical Chronic Health Care Needs in Primary Care Settings

Science.gov (United States)

Haynes-Maslow, Lindsey; Roberts, Megan C.; Dusetzina, Stacie B.

2016-01-01

Background Individuals with mental illness experience poor health and may die prematurely from chronic illness. Understanding whether the presence of co-occurring chronic physical health conditions complicates mental health treatment is important, particularly among patients seeking treatment in primary care settings. Objectives Examine (1) whether the presence of chronic physical conditions is associated with mental health service use for individuals with depression who visit a primary care physician, and (2) whether race modifies this relationship. Research Design Secondary analysis of the National Ambulatory Medical Care Survey, a survey of patient-visits collected annually from a random sample of 3,000 physicians in office-based settings. Subjects Office visits from 2007–2010 were pooled for adults ages 35–85 with a depression diagnosis at the time of visit (N=3,659 visits). Measures Mental health services were measured using a dichotomous variable indicating whether mental health services were provided during the office visit or a referral made for: (1) counseling, including psychotherapy and other mental health counseling and/or (2) prescribing of psychotropic medications. Results Most patient office visits (70%) where a depression diagnosis was recorded also had co-occurring chronic physical conditions recorded. The presence of at least one physical chronic condition was associated with a 6% decrease in the probability of receiving any mental health services (pneeded on medical care delivery among patients with co-occurring health conditions, particularly as the health care system moves towards an integrated care model. PMID:26147863

Family inclusion in mental health services: Reality or rhetoric?

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Martin, Robyn M; Ridley, Sophie C; Gillieatt, Sue J

2017-09-01

Contemporary mental health policies require family inclusion in the design, implementation and evaluation of services. This scoping review considers the factors in mental health practice which either mediate or promote family inclusion. A wide range of factors are reported to obstruct family inclusion, while a smaller number of studies report that meaningful family inclusion rests on a partnership approach which values the input of families and services users. When it comes to family inclusion, there is a gap between policy and service delivery practice. Changes in service delivery attitudes, values and culture are necessary to meaningfully and systematically include families and service users.

Developing mental health services in Nigeria : the impact of a community-based mental health awareness programme.

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Eaton, Julian; Agomoh, Ahamefula O

2008-07-01

This grass-roots level mental health awareness programme considerably increased use of community-based mental health services in a part of Nigeria where knowledge about treatability of mental illness was limited. The benefits of the programme were sustained for a significant period after the initial awareness programme. In order for attitude changes to be reinforced, similar awareness programmes must be repeated at regular intervals.

How Medicaid agencies administer mental health services: results from a 50-state survey.

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Verdier, James; Barrett, Allison

2008-10-01

This brief report describes some notable variations in how state Medicaid agencies administer and fund Medicaid mental health services. Hour-long telephone interviews were conducted with all state and District of Columbia Medicaid directors or their designees. Responses indicated that Medicaid and mental health agencies were located within the same umbrella agency in 28 states, potentially facilitating collaboration. The mental health agency provided funding for some Medicaid mental health services in 32 states, and counties provided such funding in 22 states. Medicaid agencies generally delegated more authority to state mental health agencies in states where some Medicaid funding came from mental health sources and also in states where both agencies were in the same umbrella agency. The increasing role of Medicaid in funding state mental health services, combined with new federal limits on Medicaid financing of these services, underscores the importance of interagency collaboration and better alignment of Medicaid and mental health responsibilities.

Mental health care reforms in Asia: the urgency of now: building a recovery-oriented, community mental health service in china.

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Tse, Samson; Ran, Mao-Sheng; Huang, Yueqin; Zhu, Shimin

2013-07-01

For the first time in history, China has a mental health legal framework. People in China can now expect a better life and more accessible, better-quality health care services for their loved ones. Development of a community mental health service (CMHS) is at a crossroads. In this new column on mental health reforms in Asia, the authors review the current state of the CMHS in China and propose four strategic directions for future development: building on the strengths of the "686 Project," the 2004 initiative that launched China's mental health reform; improving professional skills of the mental health workforce, especially for a recovery approach; empowering families and caregivers to support individuals with severe mental illness; and using information and communications technology to promote self-help and reduce the stigma associated with psychiatric disorders.

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.

Mental health services costs within the Alberta criminal justice system.

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Jacobs, Philip; Moffatt, Jessica; Dewa, Carolyn S; Nguyen, Thanh; Zhang, Ting; Lesage, Alain

2016-01-01

Mental illness has been widely cited as a driver of costs in the criminal justice system. The objective of this paper is to estimate the additional mental health service costs incurred within the criminal justice system that are incurred because of people with mental illnesses who go through the system. Our focus is on costs in Alberta. We set up a model of the flow of all persons through the criminal justice system, including police, court, and corrections components, and for mental health diversion, review, and forensic services. We estimate the transitional probabilities and costs that accrue as persons who have been charged move through the system. Costs are estimated for the Alberta criminal justice system as a whole, and for the mental illness component. Public expenditures for each person diverted or charged in Alberta in the criminal justice system, including mental health costs, were $16,138. The 95% range of this estimate was from $14,530 to $19,580. Of these costs, 87% were for criminal justice services and 13% were for mental illness-related services. Hospitalization for people with mental illness who were reviewed represented the greatest additional cost associated with mental illnesses. Treatment costs stemming from mental illnesses directly add about 13% onto those in the criminal justice system. Copyright © 2016 Elsevier Ltd. All rights reserved.

42 CFR 51.46 - Disclosing information obtained from a provider of mental health services.

Science.gov (United States)

2010-10-01

... mental health services. 51.46 Section 51.46 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND... a provider of mental health services. (a) Except as provided in paragraph (b) of this section, if a... of mental health services, it may not disclose information from such records to the individual who is...

School-Based Mental Health Program Evaluation: Children's School Outcomes and Acute Mental Health Service Use

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Kang-Yi, Christina D.; Mandell, David S.; Hadley, Trevor

2013-01-01

Background: This study examined the impact of school-based mental health programs on children's school outcomes and the utilization of acute mental health services. Methods: The study sample included 468 Medicaid-enrolled children aged 6 to 17 years who were enrolled 1 of 2 school-based mental health programs (SBMHs) in a metropolitan area…

Envisioning Transformation in VA Mental Health Services Through Collaborative Site Visits.

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Kearney, Lisa K; Schaefer, Jeanne A; Dollar, Katherine M; Iwamasa, Gayle Y; Katz, Ira; Schmitz, Theresa; Schohn, Mary; Resnick, Sandra G

2018-04-16

This column reviews the unique contributions of multiple partners in establishing a standardized site visit process to promote quality improvement in mental health care at the Veterans Health Administration. Working as a team, leaders in policy and operations, staff of research centers, and regional- and facility-level mental health leaders developed a standardized protocol for evaluating mental health services at each site and using the data to help implement policy goals. The authors discuss the challenges experienced and lessons learned in this systemwide process and how this information can be part of a framework for improving mental health services on a national level.

Collaboration with Community Mental Health Service Providers: A Necessity in Contemporary Schools

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Villarreal, Victor; Castro-Villarreal, Felicia

2016-01-01

Schools have played an increasingly central role in providing mental health services to youth, but there are limitations to the services that are available through school-based mental health professionals. Thus, collaboration with non-school-based community mental health providers is oftentimes necessary. As collaboration can address limitations…

Consumer-providers of care for adult clients of statutory mental health services.

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Pitt, Veronica; Lowe, Dianne; Hill, Sophie; Prictor, Megan; Hetrick, Sarah E; Ryan, Rebecca; Berends, Lynda

2013-03-28

In mental health services, the past several decades has seen a slow but steady trend towards employment of past or present consumers of the service to work alongside mental health professionals in providing services. However the effects of this employment on clients (service recipients) and services has remained unclear.We conducted a systematic review of randomised trials assessing the effects of employing consumers of mental health services as providers of statutory mental health services to clients. In this review this role is called 'consumer-provider' and the term 'statutory mental health services' refers to public services, those required by statute or law, or public services involving statutory duties. The consumer-provider's role can encompass peer support, coaching, advocacy, case management or outreach, crisis worker or assertive community treatment worker, or providing social support programmes. To assess the effects of employing current or past adult consumers of mental health services as providers of statutory mental health services. We searched the Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library 2012, Issue 3), MEDLINE (OvidSP) (1950 to March 2012), EMBASE (OvidSP) (1988 to March 2012), PsycINFO (OvidSP) (1806 to March 2012), CINAHL (EBSCOhost) (1981 to March 2009), Current Contents (OvidSP) (1993 to March 2012), and reference lists of relevant articles. Randomised controlled trials of current or past consumers of mental health services employed as providers ('consumer-providers') in statutory mental health services, comparing either: 1) consumers versus professionals employed to do the same role within a mental health service, or 2) mental health services with and without consumer-providers as an adjunct to the service. Two review authors independently selected studies and extracted data. We contacted trialists for additional information. We conducted analyses using a random-effects model, pooling studies that measured

Transitions between child and adult mental health services: service design, philosophy and meaning at uncertain times.

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Murcott, W J

2014-09-01

A young person's transition of care from child and adolescent mental health services to adult mental health services can be an uncertain and distressing event that can have serious ramifications for their recovery. Recognition of this across many countries and recent UK media interest in the dangers of mental health services failing young people has led practitioners to question the existing processes. This paper reviews the current theories and research into potential failings of services and encourages exploration for a deeper understanding of when and how care should be managed in the transition process for young people. Mental health nurses can play a vital role in this process and, by adopting the assumptions of this paradigm, look at transition from this unique perspective. By reviewing the current ideas related to age boundaries, service thresholds, service philosophy and service design, it is argued that the importance of the therapeutic relationship, the understanding of the cultural context of the young person and the placing of the young person in a position of autonomy and control should be central to any decision and process of transfer between two mental health services. © 2014 John Wiley & Sons Ltd.

A Peer-Led Electronic Mental Health Recovery App in an Adult Mental Health Service: Study Protocol for a Pilot Trial.

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Gulliver, Amelia; Banfield, Michelle; Reynolds, Julia; Miller, Sarah; Galati, Connie; Morse, Alyssa R

2017-12-07

There is growing demand for peer workers (people who use their own lived experience to support others in their recovery) to work alongside consumers to improve outcomes and recovery. Augmenting the workforce with peer workers has strong capacity to enhance mental health and recovery outcomes and make a positive contribution to the workforce within mental health systems and to the peer workers themselves. Technology-based applications are highly engaging and desirable methods of service delivery. This project is an exploratory proof-of-concept study, which aims to determine if a peer worker-led electronic mental (e-mental) health recovery program is a feasible, acceptable, and effective adjunct to usual treatment for people with moderate to severe mental illness. The study design comprises a recovery app intervention delivered by a peer worker to individual consumers at an adult mental health service. Evaluation measures will be conducted at post-intervention. To further inform the acceptability and feasibility of the model, consumers will be invited to participate in a focus group to discuss the program. The peer worker, peer supervisor, and key staff at the mental health service will also be individually interviewed to further evaluate the feasibility of the program within the health service and further inform its future development. The program will be delivered over a period of approximately 4 months, commencing June 2017. If the peer worker-led recovery app is found to be feasible, acceptable, and effective, it could be used to improve recovery in mental health service consumers. ©Amelia Gulliver, Michelle Banfield, Julia Reynolds, Sarah Miller, Connie Galati, Alyssa R Morse. Originally published in JMIR Research Protocols (http://www.researchprotocols.org), 07.12.2017.

Evidence Translation in a Youth Mental Health Service

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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.

Service Development for Intellectual Disability Mental Health: A Human Rights Approach

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Evans, E.; Howlett, S.; Kremser, T.; Simpson, J.; Kayess, R.; Trollor, J.

2012-01-01

Background: People with intellectual disability (ID) experience higher rates of major mental disorders than their non-ID peers, but in many countries have difficulty accessing appropriate mental health services. The aim of this paper is to review the current state of mental health services for people with ID using Australia as a case example, and…

Balancing the balanced scorecard for a New Zealand mental health service.

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Coop, Colleen F

2006-05-01

Given the high prevalence of mental disorders, there is a need to evaluate mental health services to ensure they are efficient, effective, responsive and accessible. One method that is being used is the "balanced scorecard" which uses performance indicators in four quadrants to assess various dimensions of service provision. This case study describes the steps taken by a New Zealand mental health service to improve service management through greater use of key performance indicators in relation to preset targets using this approach.

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

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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

Quebec mental health services networks: models and implementation

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Marie-Josée Fleury

2005-06-01

Full Text Available Purpose: In the transformation of health care systems, the introduction of integrated service networks is considered to be one of the main solutions for enhancing efficiency. In the last few years, a wealth of literature has emerged on the topic of services integration. However, the question of how integrated service networks should be modelled to suit different implementation contexts has barely been touched. To fill that gap, this article presents four models for the organization of mental health integrated networks. Data sources: The proposed models are drawn from three recently published studies on mental health integrated services in the province of Quebec (Canada with the author as principal investigator. Description: Following an explanation of the concept of integrated service network and a description of the Quebec context for mental health networks, the models, applicable in all settings: rural, urban or semi-urban, and metropolitan, and summarized in four figures, are presented. Discussion and conclusion: To apply the models successfully, the necessity of rallying all the actors of a system, from the strategic, tactical and operational levels, according to the type of integration involved: functional/administrative, clinical and physician-system is highlighted. The importance of formalizing activities among organizations and actors in a network and reinforcing the governing mechanisms at the local level is also underlined. Finally, a number of integration strategies and key conditions of success to operationalize integrated service networks are suggested.

School-Based Mental Health Services: Definitions and Models of Effective Practice

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Doll, Beth; Nastasi, Bonnie K.; Cornell, Laura; Song, Samuel Y.

2017-01-01

School-based mental health services are those delivered by school-employed and community-employed providers in school buildings. With the implementation of provisions of the Patient Protection and Affordable Care Act (2010) that funds school-based health centers, school-based mental health services could become more broadly available in…

Pre-Service Teacher Education for Mental Health and Inclusion in Schools

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Atkins, Melanie-Anne; Rodger, Susan

2016-01-01

Pre-service teacher education in mental health and mental health literacy is essential to creating the conditions necessary to support the mental health and wellness of children and youth in schools. Many teachers report never having received any education about mental health, but recognize the importance of this knowledge in meeting the needs of…

Eradicating Barriers to Mental Health Care Through Integrated Service Models: Contemporary Perspectives for Psychiatric-Mental Health Nurses.

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Ellis, Horace; Alexander, Vinette

2016-06-01

There has been renewed, global interest in developing new and transformative models of facilitating access to high-quality, cost-effective, and individually-centered health care for severe mentally-ill (SMI) persons of diverse racial/ethnic, cultural and socioeconomic backgrounds. However, in our present-day health-service delivery systems, scholars have identified layers of barriers to widespread dispersal of well-needed mental health care both nationally and internationally. It is crucial that contemporary models directed at eradicating barriers to mental health services are interdisciplinary in context, design, scope, sequence, and best-practice standards. Contextually, nurses are well-positioned to influence the incorporation and integration of new concepts into operationally interdisciplinary, evidence-based care models with measurable outcomes. The aim of this concept paper is to use the available evidence to contextually explicate how the blended roles of psychiatric mental health (PMH) nursing can be influential in eradicating barriers to care and services for SMI persons through the integrated principles of collaboration, integration and service expansion across health, socioeconomic, and community systems. A large body of literature proposes that any best-practice standards aimed at eliminating barriers to the health care needs of SMI persons require systematic, well-coordinated interdisciplinary partnerships through evidence-based, high-quality, person-centered, and outcome-driven processes. Transforming the conceptual models of collaboration, integration and service expansion could be revolutionary in how care and services are coordinated and dispersed to populations across disadvantaged communities. Building on their longstanding commitment to individual and community care approaches, and their pivotal roles in research, education, leadership, practice, and legislative processes; PMH nurses are well-positioned to be both influential and instrumental in

Student and Nonstudent National Guard Service Members/Veterans and their Use of Services for Mental Health Symptoms

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Bonar, Erin E.; Bohnert, Kipling M.; Walters, Heather M.; Ganoczy, Dara; Valenstein, Marcia

2016-01-01

Objective To compare mental health symptoms and service utilization among returning student and nonstudent Service Members/Veterans (SM/Vs). Participants SM/Vs (N=1439) were predominately white (83%) men (92%); half were over age 30 (48%) and 24% were students. Methods SM/Vs completed surveys six months post-deployment (October 2011–July 2013). Results Students and nonstudent SM/Vs did not differ in positive screens for depression, anxiety, hazardous drinking, or Post-traumatic Stress Disorder (PTSD). Students (n=81) and nonstudents (n=265) with mental health symptoms had low levels of mental health service use (e.g., VA, civilian, or military facilities), at 47% and 57% respectively. Fewer students used VA mental health services. Common barriers to treatment-seeking included not wanting treatment on military records and embarrassment. Conclusions Like other returning SM/Vs, student SM/Vs have unmet mental health needs. The discrepancy between potential need and treatment-seeking suggests that colleges might be helpful in further facilitating mental health service use for student SM/Vs. PMID:25337770

Barriers to mental health service use among distressed family caregivers of lung cancer patients.

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Mosher, C E; Given, B A; Ostroff, J S

2015-01-01

Although family caregivers of patients with lung and other cancers show high rates of psychological distress, they underuse mental health services. This qualitative study aimed to identify barriers to mental health service use among 21 distressed family caregivers of lung cancer patients. Caregivers had not received mental health services during the patient's initial months of care at a comprehensive cancer centre in New York City. Thematic analysis of interview data was framed by Andersen's model of health service use and Corrigan's stigma theory. Results of our analysis expand Andersen's model by providing a description of need variables (e.g. psychiatric symptoms), enabling factors (e.g. finances), and psychosocial factors associated with caregivers' non-use of mental health services. Regarding psychosocial factors, caregivers expressed negative perceptions of mental health professionals and a desire for independent management of emotional concerns. Additionally, caregivers perceived a conflict between mental health service use and the caregiving role (e.g. prioritising the patient's needs). Although caregivers denied stigma associated with service use, their anticipated negative self-perceptions if they were to use services suggest that stigma may have influenced their decision to not seek services. Findings suggest that interventions to improve caregivers' uptake of mental health services should address perceived barriers. © 2014 John Wiley & Sons Ltd.

Barriers to Mental Health Service Use among Hematopoietic Stem Cell Transplant Survivors

OpenAIRE

Mosher, Catherine E.; DuHamel, Katherine N.; Rini, Christine M.; Li, Yuelin; Isola, Luis; Labay, Larissa; Rowley, Scott; Papadopoulos, Esperanza; Moskowitz, Craig; Scigliano, Eileen; Grosskreutz, Celia; Redd, William H.

2009-01-01

Summary This study examined barriers to mental health service use and their demographic, medical, and psychosocial correlates among hematopoietic stem cell transplant (HSCT) survivors. A sample of 253 HSCT survivors who were 1- to 3-years post-transplant completed measures of demographic, physical, psychological, and social characteristics as well as a newly modified measure of barriers to mental health service use. Only 50% of distressed HSCT survivors had received mental health services. An...

Mental Health Status, Health Care Utilisation, and Service Satisfaction among Immigrants in Montreal: An Epidemiological Comparison.

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Whitley, Rob; Wang, JiaWei; Fleury, Marie-Josee; Liu, Aihua; Caron, Jean

2017-08-01

To examine variations between immigrants and nonimmigrants in 1) prevalence of common mental disorders and other mental health variables; 2) health service utilisation for emotional problems, mental disorders, and addictions, and 3) health service satisfaction. This article is based on a longitudinal cohort study conducted from May 2007 to the present: the Epidemiological Catchment Area Study of Montreal South-West (ZEPSOM). Participants were followed up at 4 time points (T1, n = 2433; T4, n = 1095). Core exposure variables include immigrant status (immigrant vs. nonimmigrant), duration of residence, and region of origin. Key outcome variables included mental health status, health service utilisation, and health service satisfaction. Data were analysed both cross-sectionally and longitudinally. Immigrants had been in Canada for 20 years on average. Immigrants had significantly lower rates of high psychological distress (32.6% vs. 39.1%, P = 0.016), alcohol dependence (1.4% vs. 3.9%, P =0.010), depression (5.2% vs. 9.2%, P = 0.008), and various other mental disorders. They had significantly higher scores of mental well-being (48.9 vs. 47.1 score, P = 0.014) and satisfaction with social (34.0 vs. 33.4 score, P = 0.021) and personal relationships (16.7 vs. 15.6 score, P Immigrants had significantly lower rates of health service utilisation for emotional problems, mental disorders, and addictions and significantly higher rates of health service satisfaction at all time points. Asian and African immigrants had particularly low rates of utilisation and high rates of satisfaction. Immigrants had better overall mental health than nonimmigrants.

Mental Health Service Utilization Among Lesbian, Gay, Bisexual, and Questioning or Queer College Students.

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Dunbar, Michael S; Sontag-Padilla, Lisa; Ramchand, Rajeev; Seelam, Rachana; Stein, Bradley D

2017-09-01

College students are at high risk for mental health problems, yet many do not receive treatment even when services are available. Treatment needs may be even higher among sexual minority students, but little is known about how these students differ from heterosexual peers in terms of mental health needs and service utilization. A total of 33,220 California college students completed an online survey on mental health needs (e.g., current serious psychological distress and mental health-related academic impairment) and service utilization. Using logistic regressions, we examined differences in student characteristics, mental health service use, and perceived barriers to using on-campus services by sexual minority status. Approximately 7% of students self-identified as sexual minorities. Compared with heterosexual students, sexual minority students endorsed higher rates of psychological distress (18% vs. 26%, p mental health-related academic impairment (11% vs. 17%, p mental health services. Sexual minority students were also more likely to report using off-campus services and to endorse barriers to on-campus service use (e.g., embarrassed to use services and uncertainty over eligibility for services). Sexual minority individuals represent a sizeable minority of college students; these students use mental health services at higher rates than heterosexual peers but have high rates of unmet treatment need. Efforts to address commonly reported barriers to on-campus service use, foster sexual minority-affirmative campus environments, and promote awareness of campus services may help reduce unmet treatment need in this population. Copyright © 2017 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

Variations in prison mental health services in England and Wales.

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Forrester, Andrew; Exworthy, Tim; Olumoroti, Olumuyiwa; Sessay, Mohammed; Parrott, Janet; Spencer, Sarah-Jane; Whyte, Sean

2013-01-01

In responding to high levels of psychiatric morbidity amongst prisoners and recognising earlier poor quality prison mental health care, prison mental health in-reach teams have been established in England and Wales over the last decade. They are mostly provided by the National Health Service (NHS), which provides the majority of UK healthcare services. Over the same period, the prison population has grown to record levels, such that prisons in England and Wales now contain almost 90,000 of the world's overall prison population of over 10 million people (roughly the size of Paris or Istanbul). This study provides an overview of mental health in-reach services in prisons in England and Wales, including variations between them, through a telephone survey of senior staff in all prisons and young offender institutions in England and Wales. 73% of prisons took part; of them 13% had no in-reach team at all (usually low security establishments) and the majority of services were run by NHS teams, usually according to a generic community mental health team (CMHT) model rather than other specialist models. Team size was unrelated to prison size. Each nurse covered around 500 prisoners, each doctor over 3700. Many provided few or no healthcare cells and 24-h psychiatric cover (including on-call cover) was uncommon. Despite developments in recent years, mental health in-reach services still fall short of community equivalence and there is wide variation in service arrangements that cannot be explained by prison size or function. The aim of community equivalence has not yet been reached in prison healthcare and a more sophisticated measure of service improvement and standardisation would now be useful to drive and monitor future development. Copyright © 2013 Elsevier Ltd. All rights reserved.

Professionals' views on mental health service users' education: challenges and support.

Science.gov (United States)

Nieminen, I; Kaunonen, M

2017-02-01

WHAT IS KNOWN ON THE SUBJECT?: Mental health service users (MHSUs) may experience disruptions in their education. However, education has been shown to have a positive influence on their recovery, potentially offering them broader employment opportunities. The literature suggests that providing support for MHSUs in their educational efforts may be beneficial and is wished for by the service users themselves. However, there is a lack of mental health professionals' views on the topic in the setting of a community mental health centre. WHAT DOES THIS PAPER ADD TO THE EXISTING KNOWLEDGE?: In the perception of mental health professionals, the predominance of disease in the life of MHSUs and their marginalization may form barriers to their success in education. Professionals can support MHSUs in their educational efforts by strengthening the MHSUs' internal resources and creating a supportive environment with professional expertise available. A service user-centred education might further help MHSUs to achieve their educational goals. Our findings confirm previous knowledge of a recovery-oriented approach to supporting MHSUs' education. This study explored the topic from the professionals' perspective in the context of community mental health centres, which is a fresh view in the research literature. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: The findings suggest which types of support professionals perceive to be required for MHSUs to advance their studies. Knowledge of adequate forms of support can be applied in the mental health nursing practice to develop support measures for service users to advance in their studies. All levels of the community mental health centres should be aware of and adopt a recovery-oriented approach. MHSUs and professionals need to have a shared opinion on the definition of recovery orientation. This requires mutual discussion and the more active involvement of MHSUs in the design of their own rehabilitation process. Introduction Studies show

EPA guidance on building trust in mental health services

NARCIS (Netherlands)

Gaebel, W.; Muijen, M.; Baumann, A.E.; Bhugra, D.; Wasserman, D.; Gaag, R.J. van der; Heun, R.; Zielasek, J.

2014-01-01

PURPOSE: To advance mental health care use by developing recommendations to increase trust from the general public and patients, those who have been in contact with services, those who have never been in contact and those who care for their families in the mental health care system. METHODS: We

Students with Dual Diagnosis: Can School-Based Mental Health Services Play a Role?

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Lambros, Katina; Kraemer, Bonnie; Wager, James Derek; Culver, Shirley; Angulo, Aidee; Saragosa, Marie

2016-01-01

This article describes and investigates initial findings from the Esperanza Mental Health Services (EMHS) Program, which is an intensive outpatient program that provides individual and group mental health services for students with "dual diagnosis" or developmental disabilities and co-occurring mental health problems. Previous research…

VHA mental health information system: applying health information technology to monitor and facilitate implementation of VHA Uniform Mental Health Services Handbook requirements.

Science.gov (United States)

Trafton, Jodie A; Greenberg, Greg; Harris, Alex H S; Tavakoli, Sara; Kearney, Lisa; McCarthy, John; Blow, Fredric; Hoff, Rani; Schohn, Mary

2013-03-01

To describe the design and deployment of health information technology to support implementation of mental health services policy requirements in the Veterans Health Administration (VHA). Using administrative and self-report survey data, we developed and fielded metrics regarding implementation of the requirements delineated in the VHA Uniform Mental Health Services Handbook. Finalized metrics were incorporated into 2 external facilitation-based quality improvement programs led by the VHA Mental Health Operations. To support these programs, tailored site-specific reports were generated. Metric development required close collaboration between program evaluators, policy makers and clinical leadership, and consideration of policy language and intent. Electronic reports supporting different purposes required distinct formatting and presentation features, despite their having similar general goals and using the same metrics. Health information technology can facilitate mental health policy implementation but must be integrated into a process of consensus building and close collaboration with policy makers, evaluators, and practitioners.

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

User violence towards nursing professionals in mental health services and emergency units

Directory of Open Access Journals (Sweden)

Bartolomé Llor-Esteban

2017-01-01

Full Text Available Workplace violence is present in many work sectors, but in the area of mental health, nurses have a higher risk due to the close relationship they have with users. This study analyzed hostile user statements against nursing professionals of Mental Health Services and Emergency Units in Health Service (MHS hospitals in Murcia, Spain, and determined the frequency of exposure to the different violent user behaviors. The study was carried out with a sample of 518 nursing professionals from four hospital services: Mental Health, Emergency Units, Medical Hospitalization, and Maternal-and-Child. The nursing staff of Mental Health and Emergency Units was the most exposed to violence. Non-physical violence was more frequent in Emergency Units, whereas physical violence was more frequent in Mental Health. Among the consequences of exposure to non-physical violence are workers’ emotional exhaustion and the presence of psychological distress.

Staff and bed distribution in public sector mental health services in ...

African Journals Online (AJOL)

Background. The Eastern Cape Province of South Africa is a resource-limited province with a fragmented mental health service. Objective. To determine the current context of public sector mental health services in terms of staff and bed distribution, and how this corresponds to the population distribution in the province.

Utilization of health services in relation to mental health problems in adolescents: A population based survey

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Zachrisson, Henrik D; Rödje, Kjetil; Mykletun, Arnstein

2006-01-01

Background Only a minority of adolescents reporting symptoms above case-levels on screenings for mental health seeks and receives help from specialist health services. The objective of this study was to a) examine help-seeking for symptoms of anxiety and depression in relation to symptom load dimensionally, b) identify the level of specialization in mental health among service-providers, and c) identify associations between mental health problems and contact with different types of health services. Methods This cross-sectional school-based study (response-rate 88%, n = 11154) is based on Norwegian health surveys among 15 and 16 year olds. Results We found a dose-response association between symptom-load and help seeking. Only 34% of individuals with mental symptom-load above 99th percentile reported help-seeking in the last 12 months. Forty percent of help seekers were in contact with specialists (psychiatrists or psychologists), the remaining were mainly in contact with GPs. Mental health problems increased help seeking to all twelve service providers examined. Conclusion It might not be reasonable to argue that all adolescents with case-level mental health problems are in need of treatment. However, concerning the 99th percentile, claiming treatment need is less controversial. Even in the Norwegian context where mental health services are relatively available and free of charge, help-seeking in individuals with the highest symptom-loads is still low. Most help seekers achieved contact with health care providers, half of them at a non specialized level. Our results suggest that adolescents' recognition of mental health problems or intention to seek help for these are the major "filters" restricting treatment. PMID:16480522

Do adult mental health services identify child abuse and neglect? A systematic review.

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Read, John; Harper, David; Tucker, Ian; Kennedy, Angela

2018-02-01

Child abuse and neglect play a causal role in many mental health problems. Knowing whether users of mental health services were abused or neglected as children could be considered essential for developing comprehensive formulations and effective treatment plans. In the present study we report the findings of a systematic review, using independent searches of three databases designed to discover how often mental health staff find out whether their clients were abused or neglected as children. Twenty-one relevant studies were identified. Most people who use mental health services are never asked about child abuse or neglect. The majority of cases of child abuse or neglect are not identified by mental health services. Only 28% of abuse or neglect cases identified by researchers are found in the clients' files: emotional abuse, 44%; physical abuse, 33%; sexual abuse, 30%; emotional neglect, 17%; and physical neglect, 10%. Between 0% and 22% of mental health service users report being asked about child abuse. Men and people diagnosed with psychotic disorders are asked less than other people. Male staff ask less often than female staff. Some improvement over time was found. Policies compelling routine enquiry, training, and trauma-informed services are required. © 2017 Australian College of Mental Health Nurses Inc.

Child responsible personnel in adult mental health services.

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Lauritzen, Camilla; Reedtz, Charlotte

2016-01-01

Children who have parents with mental health problems are a vulnerable group. Intervening early to support parents with a mental illness can contribute to improve outcomes for children. Rigging the adult mental health system in such a manner that child responsible personnel are designated in wards is a strategy to systematically address the needs of families. It has since 2010 been mandatory for Norwegian hospitals to appoint such personnel in all hospital wards. The current study aimed to investigate the appointment of child responsible personnel in the adult mental health services in a regional hospital with local clinics. Additionally, to describe the characteristics of child responsible staff in terms of gender and educational background, their competence, clinical practice and knowledge about parental mental illness. A final aim was to study whether or not the clinics had established collaboration with other services concerning follow-up for the children of parents with mental illness. Participants in this study are the staff at psychiatric clinics in a large university hospital in Norway. Practitioners were asked to answer a questionnaire prior to the initial process of implementing the new legislation in 2010 (N = 219). After a three-year period of implementing routines to adopt the new law in the clinic, the same survey was sent out to the staff in 2013 (N = 185) to monitor if changes were taking place. To study if the changes were sustained within the clinics, we conducted a two-year follow up in 2015 (N = 108). The results indicated that the systematic work to change clinical practice in the participating hospital had made a difference. Routines to follow up children's patients after the new legislation had to some extent been implemented. The child responsible personnel had more knowledge and awareness about the consequences of parental mental illness for children. The results of this study suggested that the systems change of establishing child

Investigating the efficacy of a whole team, psychologically informed, acute mental health service approach.

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Araci, David; Clarke, Isabel

2017-08-01

Service user demand and service changes, from hospital based, to community and hospital mix, within acute adult mental health services, focus the need for psychologically informed, holistic, approaches. (1) Describe and report feasibility of a psychologically led Intensive Support Programme (ISP) to meet this need. (2) Present results of a pilot evaluation of this programme. ISP was implemented in four acute mental health services of the Southern Health NHS Trust, available to both inpatient and outpatient acute services. Evaluation of the service one month after data collection, illustrates operation and level of uptake across different professional roles. The programme was evaluated by assessing psychological distress (CORE-10) and confidence in self-management (Mental Health Confidence Scale) of participating service users before and after intervention. The service evaluation demonstrated extensive roll out of this programme across acute services of an extensive NHS Trust. Repeated measure t-tests demonstrated significant decrease in distress (p mental health (p mental health service and results in improvement in self management skills and facilitation of recovery.

A systemic approach to understanding mental health and services.

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Cohen, Mark

2017-10-01

In the UK mental health and associated NHS services face considerable challenges. This paper aims to form an understanding both of the complexity of context in which services operate and the means by which services have sought to meet these challenges. Systemic principles as have been applied to public service organisations with reference to interpersonal relations, the wider social culture and its manifestation in service provision. The analysis suggests that the wider culture has shaped service demand and the approaches adopted by services resulting in a number of unintended consequences, reinforcing loops, increased workload demands and the limited value of services. The systemic modelling of this situation provides a necessary overview prior to future policy development. The paper concludes that mental health and attendant services requires a systemic understanding and a whole system approach to reform. Crown Copyright © 2017. Published by Elsevier Ltd. All rights reserved.

A situational analysis of child and adolescent mental health services ...

African Journals Online (AJOL)

findings of a situational analysis of CA mental health policy and services in ... are part of a 5 year study, the Mental Health and Poverty Project, which aims to provide new knowledge regarding ..... children, they think its bad omen” (SSI, key.

What does mental health nursing contribute to improving the physical health of service users with severe mental illness? A thematic analysis.

Science.gov (United States)

Gray, Richard; Brown, Eleanor

2017-02-01

Authors have generally reported that mental health nurses (MHNs) have positive attitudes to providing physical health care to service users with severe mental illness. In the present study, we aimed to explore if this positive attitude translates to enhanced clinical practice by interviewing MHNs and the service users they work with. Semistructured interviews were completed with 15 service users and 18 MHNs from acute, rehabilitation, and community services. These were then transcribed and analysed using thematic analysis. Six themes emerged: (i) not the work of MHNs; (ii) the physical effects of psychiatric drugs are ignored; (iii) the need to upskill; (iv) keeping busy; (v) horrible hospital food/living on takeaways; and (vi) motivation to change. Our overarching meta-theme was of unmet physical health need among service users. © 2016 Australian College of Mental Health Nurses Inc.

What would an ideal mental health service for primary care look like?

Science.gov (United States)

2011-01-01

The creation of GP commissioning consortia offers potential opportunities for GPs to challenge a number of divisions and distinctions that are currently taken for granted in mental health services, but may be neither necessary nor logical. I examine a range of these and suggest what GPs and patients might reasonably expect if we challenged them in order to imagine and commission an ideal mental health service for primary care. Among its features, an ideal service would cross the boundaries of mental and physical care, individual and family care, and the mental, social and economic domains. It would also transcend mental health ideologies, geographical borders and the artificial distinction between making a diagnosis, offering treatment and holding a therapeutic conversation. PMID:25949648

The right location? Experiences of refugee adolescents seen by school-based mental health services.

Science.gov (United States)

Fazel, Mina; Garcia, Jo; Stein, Alan

2016-07-01

Access to needed mental health services can be particularly difficult for newly arrived refugee and asylum-seeking adolescents, although many attend school. This study examined young refugees' impressions and experience of mental health services integrated within the school system. Semi-structured interviews were conducted with 40 adolescent refugees discharged by three school-based mental health services across the United Kingdom. Two-thirds preferred to be seen at school. Rumination and worry about insecurity in the asylum process had a negative impact particularly on the adolescents' social functioning and ability to focus at school. The important role played by teachers in supporting and mediating contact with mental health services was valued by those interviewed. The study confirms that schools offer an important location for mental health services for adolescent refugees and provide an important portal for integration of services. © The Author(s) 2016.

Assessing and changing organizational social contexts for effective mental health services.

Science.gov (United States)

Glisson, Charles; Williams, Nathaniel J

2015-03-18

Culture and climate are critical dimensions of a mental health service organization's social context that affect the quality and outcomes of the services it provides and the implementation of innovations such as evidence-based treatments (EBTs). We describe a measure of culture and climate labeled Organizational Social Context (OSC), which has been associated with innovation, service quality, and outcomes in national samples and randomized controlled trials (RCTs) of mental health and social service organizations. The article also describes an empirically supported organizational intervention model labeled Availability, Responsiveness, and Continuity (ARC), which has improved organizational social context, innovation, and effectiveness in five RCTs. Finally, the article outlines a research agenda for developing more efficient and scalable organizational strategies to improve mental health services by identifying the mechanisms that link organizational interventions and social context to individual-level service provider intentions and behaviors associated with innovation and effectiveness.

Greek mental health reform: views and perceptions of professionals and service users.

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Loukidou, E; Mastroyiannakis, A; Power, T; Craig, T; Thornicroft, G; Bouras, N

2013-01-01

The Greek mental health system has been undergoing radical reforms for over the past twenty years. In congruence with trends and practices in other European countries, Greek mental health reforms were designed to develop a community-based mental health service system. The implementation of an extensive transformation became possible through the "Psychargos" program, a national strategic and operational plan, which was developed by the Ministry of Health and Social Solidarity. The Psychargos program was jointly funded by the European Union by 75% of the cost over a period of 5 years and the Greek State. After the period of 5 years, the entire cost of the new services became the responsibility of the Greek National Budget. Over the years the Psychargos program became almost synonymous with the deinstitutionalisation of long term psychiatric patients with the development of a wide range of community mental health services. The Psychargos program ended in December 2009. This article presents the views of service providers and service users as part an ex-post evaluation of the Psychargos program carried out in 2010. Data derived for this part of the evaluation are from the application of the qualitative method of focus groups. The outcomes of the study identified several positive and noteworthy achievements by the reforms of the Greek mental health system as well as weaknesses. There was considerable similarity of the views expressed by both focus groups. In addition the service users' focus group emphasized more issues related to improving their mental health wellbeing and living a satisfying, hopeful, and contributing life.

Mental health services in Cambodia, challenges and opportunities in a post-conflict setting.

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Jegannathan, Bhoomikumar; Kullgren, Gunnar; Deva, Parameshvara

2015-02-01

Cambodia had suffered enormously due to war and internecine conflict during the latter half of the twentieth century, more so during the Vietnam War. Total collapse of education and health systems during the Pol Pot era continues to be a challenge for developing the necessary infrastructure and human resources to provide basic minimum mental health care which is compounded by the prevailing cultural belief and stigma over mental, neurological and substance abuse disorders (MNSDs). The mental health research and services in Cambodia had been predominantly 'trauma focused', a legacy of war, and there is a need to move toward epidemiologically sound public health oriented mental health policy and service development. Integrating mental health program with primary health care services with specifically stated minimum package of activities at primary level and complementary package of activities at secondary level is an opportunity to meet the needs and rights of persons with mental, neurological and substance abuse disorders (PWMNSDs) in Cambodia, provided there is mental health leadership, government commitment and political will. Copyright © 2014 Elsevier B.V. All rights reserved.

[Advanced nursing practice: a must for the quality of care and mental health services].

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Ricard, Nicole; Page, Claire; Laflamme, France

2014-01-01

New professional legislation and reorganization of mental health services have had a significant influence on mental health nursing practice. Many nurses have demonstrated clinical leadership and have been able to adapt their services to the needs of the population specially in the primary health care setting. However, many believe that the role of nurses is not sufficiently known and optimally utilized in mental health services. In this article we take a critical look at the mental health nursing practice in Quebec and at the essential requirements for its development. This review aims to: 1) describe current trends in the changing roles and the modernization of mental health nursing practice in Quebec, 2) provide an overview of the development of advanced nursing practice and its impact on the quality of mental health services; 3) clarify the concept of advanced nursing practice and position its development in Quebec and 4) propose various strategies for optimizing the role of nurses and their complementarity with other professionals providing mental health services. This review presents innovative practices developed by nurses in the context of the restructuring of mental health services. For example, new nursing roles have been developed to improve the collaboration with general practitioners groups in primary care settings and facilitate the evaluation and monitoring of patient presenting medical and psychological problems. Another interesting innovation was set up by nurses in developing a new service to allow timely access to integrated care for patients with substance abuse and mental health problems. The various testimonies reported in this article illustrate the potential contribution of these nursing innovations in improving the mental health services in Quebec. Also, in few countries, the reform of mental health services has been a good time to recognize this potential. Thus, some countries have repositioned the role of mental health nurses and

Perceptions of Recidivism Among Incarcerated Youth: The Relationship Between Exposure to Childhood Trauma, Mental Health Status, and the Protective Effect of Mental Health Services in Juvenile Justice Settings

Directory of Open Access Journals (Sweden)

Jamie R. Yoder

2017-09-01

Full Text Available Research suggests that youth involved the juvenile justice system have trauma histories that are two times higher than the general youth population. Juvenile justice-involved youth also have high rates of mental health symptoms. Fewer studies have examined how trauma links to mental health symptoms among youth offenders, and even less research focuses on how mental health status and service delivery can impact their perceived likelihood for success. This study examines the effects of mental health screening and service delivery on perceived future criminal justice interactions— arrest and incarceration—among adjudicated youth (n=7,073 housed in correctional facilities. Secondary data were used to examine trauma histories, mental health needs, and mental health screening and service delivery. Significant relationships between traumatic events and mental health problems were found, along with relationships between mental health problems and mental health screening and service delivery. Most interestingly, results pointed to the strong inverse relationship between mental health service delivery and youth’s perceived likelihood for recidivism. These findings show the promise of juvenile justice systems appropriately responding to the mental health concerns of youth.

Key performance indicators for Australian mental health court liaison services.

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Davidson, Fiona; Heffernan, Ed; Greenberg, David; Butler, Tony; Burgess, Philip

2017-12-01

The aim of this paper is to describe the development and technical specifications of a framework and national key performance indicators (KPIs) for Australian mental health Court Liaison Services (CLSs) by the National Mental Health Court Liaison Performance Working Group (Working Group). Representatives from each Australian State and Territory were invited to form a Working Group. Through a series of national workshops and meetings, a framework and set of performance indicators were developed using a review of literature and expert opinion. A total of six KPIs for CLSs have been identified and a set of technical specifications have been formed. This paper describes the process and outcomes of a national collaboration to develop a framework and KPIs. The measures have been developed to support future benchmarking activities and to assist services to identify best practice in this area of mental health service delivery.

Child & Adolescent Mental Health Services - first annual report 2008

LENUS (Irish Health Repository)

2009-10-01

This Annual Report provides the first comprehensive survey carried out on community CAMHS teams and includes preliminary data collected by The Health Research Board on the admission of young people under the age of 18 years to inpatient mental health facilities. As many measures in this report do not have historic comparators it provides a baseline foundation that will be built upon in subsequent years providing an indication of trends that cannot yet be drawn on the basis of this report. The next report will include day hospital, liaison and inpatient services. Subsequent reports will further extend the mapping of mental health services for young people.

Making public mental-health services accessible to deaf consumers: Illinois Deaf Services 2000.

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Munro-Ludders, Bruce; Simpatico, Thomas; Zvetina, Daria

2004-01-01

Illinois Deaf Services 2000 (IDS2000), a public/private partnership, promotes the creation and implementation of strategies to develop and increase access to mental health services for deaf, hard of hearing, late-deafened, and deaf-blind consumers. IDS2000 has resulted in the establishment of service accessibility standards, a technical support and adherence monitoring system, and the beginnings of a statewide telepsychiatry service. These system modifications have resulted in increase by 60% from baseline survey data in the number of deaf, hard of hearing, late-deafened, and deaf-blind consumers identified in community mental-health agencies in Illinois. Depending on the situation of deaf services staff and infrastructure, much of IDS2000 could be replicated in other states in a mostly budget-neutral manner.

Protocol: A grounded theory of 'recovery'-perspectives of adolescent users of mental health services.

Science.gov (United States)

Palmquist, Lucianne; Patterson, Sue; O'Donovan, Analise; Bradley, Graham

2017-07-20

Policies internationally endorse the recovery paradigm as the appropriate foundation for youth mental health services. However, given that this paradigm is grounded in the views of adults with severe mental illness, applicability to youth services and relevance to young people is uncertain, particularly as little is known about young people's views. A comprehensive understanding of the experiences and expectations of young people is critical to developing youth mental health services that are acceptable, accessible, effective and relevant. To inform development of policy and youth services, the study described in this protocol aims to develop a comprehensive account of the experiences and expectations of 12-17 year olds as they encounter mental disorders and transition through specialist mental health services. Data will be analysed to model recovery from the adolescents' perspective. This grounded theory study will use quantitative and qualitative data collected in interviews with 12-17 year olds engaged with specialist Child/Youth Mental Health Service in Queensland, Australia. Interviews will explore adolescents' expectations and experiences of mental disorder, and of services, as they transition through specialist mental health services, including the meaning of their experiences and ideas of 'recovery' and how their experiences and expectations are shaped. Data collection and analysis will use grounded theory methods. Adolescents' experiences will be presented as a mid-range theory. The research will provide tangible recommendations for youth-focused mental health policy and practice. Findings will be disseminated within academic literature and beyond to participants, health professionals, mental health advocacy groups and policy and decision makers via publications, research summaries, conferences and workshops targeting different audiences. Ethical and research governance approvals have been obtained from relevant Human Research Ethics committees and all

Care coordinators: a controlled evaluation of an inpatient mental health service innovation.

Science.gov (United States)

Stewart, Malcolm W; Wilson, Michael; Bergquist, Karla; Thorburn, John

2012-02-01

The study aimed to evaluate the impact of introducing designated care coordinators into an acute mental health inpatient unit in terms of service delivery, clinical outcomes, and service user and significant other perceptions. A pre-post-controlled design was implemented with a consecutive sample of 292 service users admitted and staying more than 5 days in two wards, with care coordinators introduced in one ward. Data were obtained from clinical records, standard measures, and service user and significant other surveys. Care coordinator input was associated with significant improvements in service delivery and stronger involvement of significant others and community resources. Care-coordinated clients showed significantly better clinical outcomes, including the Health of Nations Outcome Scales behaviour subscale, less time in the intensive care subunit, less community crisis team input in the week following discharge, and lower rates of readmission in the month following discharge. Care-coordinated service users and their significant others gave higher ratings of service delivery, outcome, and satisfaction. The results indicate that designated care coordinators significantly improve care processes, outcomes, and service user experience in acute inpatient mental health settings. © 2011 The Authors. International Journal of Mental Health Nursing © 2011 Australian College of Mental Health Nurses Inc.

Convergence of service, policy, and science toward consumer-driven mental health care.

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Carroll, Christopher D; Manderscheid, Ronald W; Daniels, Allen S; Compagni, Amelia

2006-12-01

A common theme is emerging in sentinel reports on the United States health care system. Consumer relevance and demands on service systems and practices are influencing how mental health care is delivered and how systems will be shaped in the future. The present report seeks to assemble a confluence of consumer-driven themes from noteworthy reports on the state of the mental health system in the U.S. It also explores innovative efforts, promising practices, collaborative efforts, as well as identification of barriers to consumer-directed care, with possible solutions. The report reviews the relevant public mental health policy and data used in published work. The findings indicate an increasing public and private interest in promoting consumer-driven care, even though historical systems of care predominate, and often create, barriers to wide-spread redesign of a consumer-centered mental health care system. Innovative consumer-driven practices are increasing as quality, choice, and self-determination become integral parts of a redesigned U.S. mental health care system. The use of consumer-driven approaches in mental health is limited at best. These programs challenge industry norms and traditional practices. Limitations include the need for additional and thorough evaluations of effectiveness (cost and clinical) and replicability of consumer-directed programs. Consumer-driven services indicate that mental health consumers are expecting to be more participative in their mental health care. This expectation will influence how traditional mental health services and providers become more consumer-centric and meet the demand. Public and private interest in consumer-driven health care range from creating cost-conscious consumers to individualized control of recovery. The health care sector should seek to invest more resources in the provision of consumer-driven health care programs. The results of this study have implications and are informative for other countries where

Service users' experiences of participation in decision making in mental health services.

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Dahlqvist Jönsson, P; Schön, U-K; Rosenberg, D; Sandlund, M; Svedberg, P

2015-11-01

Despite the potential positive impact of shared decision making on service users knowledge and experience of decisional conflict, there is a lack of qualitative research on how participation in decision making is promoted from the perspective of psychiatric service users. This study highlights the desire of users to participate more actively in decision making and demonstrates that persons with SMI struggle to be seen as competent and equal partners in decision-making situations. Those interviewed did not feel that their strengths, abilities and needs were being recognized, which resulted in a feeling of being omitted from involvement in decision-making situations. The service users describe some essential conditions that could work to promote participation in decision making. These included having personal support, having access to knowledge, being involved in a dialogue and clarity about responsibilities. Mental health nurses can play an essential role for developing and implementing shared decision making as a tool to promote recovery-oriented mental health services. Service user participation in decision making is considered an essential component of recovery-oriented mental health services. Despite the potential of shared decision making to impact service users knowledge and positively influence their experience of decisional conflict, there is a lack of qualitative research on how participation in decision making is promoted from the perspective of psychiatric service users. In order to develop concrete methods that facilitate shared decision making, there is a need for increased knowledge regarding the users' own perspective. The aim of this study was to explore users' experiences of participation in decisions in mental health services in Sweden, and the kinds of support that may promote participation. Constructivist Grounded Theory (CGT) was utilized to analyse group and individual interviews with 20 users with experience of serious mental illness. The core

Going global: do consumer preferences, attitudes, and barriers to using e-mental health services differ across countries?

Science.gov (United States)

Clough, Bonnie A; Zarean, Mostafa; Ruane, Ilse; Mateo, Niño Jose; Aliyeva, Turana A; Casey, Leanne M

2017-08-31

e-Mental health services have the capacity to overcome barriers to care and reduce the unmet need for psychological services, particularly in developing countries. However, it is unknown how acceptable e-mental health interventions may be to these populations. The purpose of the current study was to examine consumer attitudes and perceived barriers to e-mental health usage across four countries: Australia, Iran, the Philippines and South Africa. An online survey was completed by 524 adults living in these countries, assessing previous contact with e-mental health services, willingness to use e-mental health services, and perceived barriers and needs for accessing e-mental health services. Although previous contact with e-mental health services was low, the majority of respondents in each sample reported a willingness to try e-mental health services if offered. Barriers toward e-mental health usage were higher among the developing countries than Australia. The most commonly endorsed barriers concerned needing information and assurances regarding the programmes. Across countries, participants indicated a willingness to use e-mental health programmes if offered. With appropriate research and careful implementation, e-mental health has the potential to be a valuable part of mental healthcare in developing countries.

Modeling the mental health service utilization decisions of university undergraduates: A discrete choice conjoint experiment.

Science.gov (United States)

Cunningham, Charles E; Zipursky, Robert B; Christensen, Bruce K; Bieling, Peter J; Madsen, Victoria; Rimas, Heather; Mielko, Stephanie; Wilson, Fiona; Furimsky, Ivana; Jeffs, Lisa; Munn, Catharine

2017-01-01

We modeled design factors influencing the intent to use a university mental health service. Between November 2012 and October 2014, 909 undergraduates participated. Using a discrete choice experiment, participants chose between hypothetical campus mental health services. Latent class analysis identified three segments. A Psychological/Psychiatric Service segment (45.5%) was most likely to contact campus health services delivered by psychologists or psychiatrists. An Alternative Service segment (39.3%) preferred to talk to peer-counselors who had experienced mental health problems. A Hesitant segment (15.2%) reported greater distress but seemed less intent on seeking help. They preferred services delivered by psychologists or psychiatrists. Simulations predicted that, rather than waiting for standard counseling, the Alternative Service segment would prefer immediate access to E-Mental health. The Usual Care and Hesitant segments would wait 6 months for standard counseling. E-Mental Health options could engage students who may not wait for standard services.

Homelessness, Mental Health and Suicidality Among LGBTQ Youth Accessing Crisis Services.

Science.gov (United States)

Rhoades, Harmony; Rusow, Joshua A; Bond, David; Lanteigne, Amy; Fulginiti, Anthony; Goldbach, Jeremy T

2018-01-10

LGBTQ youth experience increased risks of homelessness, mental health disorder symptoms, and suicidality. Utilizing data from LGBTQ youth contacting a suicide crisis services organization, this study examined: (a) rates of homelessness among crisis services users, (b) the relationship between disclosure of LGBTQ identity to parents and parental rejection and homelessness, and (c) the relationship between homelessness and mental health disorder outcomes and suicidality. A nationwide sample of LGBTQ youth was recruited for a confidential online survey from an LGBTQ-focused crisis services hotline. Overall, nearly one-third of youth contacting the crisis services hotline had experienced lifetime homelessness, and those who had disclosed their LGBTQ identity to parents or experienced parental rejection because of LGBTQ status experienced higher rates of homelessness. Youth with homelessness experiences reported more symptoms of several mental health disorders and higher rates of suicidality. Suggestions for service providers are discussed.

The mental health service crisis of neoliberalism -- an antipodean perspective.

Science.gov (United States)

Carney, Terry

2008-01-01

Major transformations in forms of governance of the liberal state have been wrought over the course of the last century, including the rise of neoliberalism and 'new public management.' Mental health too has witnessed change, with pharmacological treatment displacing residential care, a shift to community-based services, mainstreaming with general health care, and greater reliance on civil society institutions such as the family or markets. This article considers whether mental health law, and its court/tribunal 'gatekeepers' have kept pace with those changes. It argues that the focus of the liberal project needs to shift to measures which will better guarantee access to mental health services, and keep a more watchful eye on both 'hidden' coercion of people on community treatment orders, and passive neglect of human need.

Mental Health Services to State Corrections Inmates. Staff Brief 86-10.

Science.gov (United States)

Henkel, Jane R.

This report was written for the Advisory Committee on Mentally Ill Inmates of the Wisconsin State Legislative Council's Special Committee on Mental Health Issues. It describes mental health services to inmates of Wisconsin's state prisons. Part I describes the organization of state level responsibilities for corrections, including the state…

Managing risk: clinical decision-making in mental health services.

Science.gov (United States)

Muir-Cochrane, Eimear; Gerace, Adam; Mosel, Krista; O'Kane, Debra; Barkway, Patricia; Curren, David; Oster, Candice

2011-01-01

Risk assessment and management is a major component of contemporary mental health practice. Risk assessment in health care exists within contemporary perspectives of management and risk aversive practices in health care. This has led to much discussion about the best approach to assessing possible risks posed by people with mental health problems. In addition, researchers and commentators have expressed concern that clinical practice is being dominated by managerial models of risk management at the expense of meeting the patient's health and social care needs. The purpose of the present study is to investigate the risk assessment practices of a multidisciplinary mental health service. Findings indicate that mental health professionals draw on both managerial and therapeutic approaches to risk management, integrating these approaches into their clinical practice. Rather than being dominated by managerial concerns regarding risk, the participants demonstrate professional autonomy and concern for the needs of their clients.

The Relation between Food Insecurity and Mental Health Care Service Utilization in Ontario.

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Tarasuk, Valerie; Cheng, Joyce; Gundersen, Craig; de Oliveira, Claire; Kurdyak, Paul

2018-01-01

To determine the relationship between household food insecurity status over a 12-month period and adults' use of publicly funded health care services in Ontario for mental health reasons during this period. Data for 80,942 Ontario residents, 18 to 64 years old, who participated in the Canadian Community Health Survey in 2005, 2007-2008, 2009-2010, or 2011-2012 were linked to administrative health care data to determine individuals' hospitalizations, emergency department visits, and visits to psychiatrists and primary care physicians for mental health reasons. Household food insecurity over the past 12 months was assessed using the Household Food Security Survey Module. Logistic regression models were used to estimate the odds of mental health service utilization in the past 12 months by household food insecurity status, adjusting for sociodemographic factors and prior use of mental health services. In our fully adjusted models, in comparison to food-secure individuals, the odds of any mental health care service utilization over the past 12 months were 1.15 (95% confidence interval [CI], 1.04 to 1.29) for marginally food-insecure individuals, 1.39 (95% CI, 1.19 to 1.42) for moderately food-insecure individuals, and 1.50 (95% CI, 1.35 to 1.68) for severely food-insecure individuals. A similar pattern persisted across individual types of services, with odds of utilization highest with severe food insecurity. Household food insecurity status is a robust predictor of mental health service utilization among working-age adults in Ontario. Policy interventions are required to address the underlying causes of food insecurity and the particular vulnerability of individuals with mental illness.

Adequacy of Mental Health Services for HIV-Positive Patients with Depression

DEFF Research Database (Denmark)

Choi, Stephanie K Y; Boyle, Eleanor; Cairney, John

2016-01-01

use and antidepressant use, as well as mental health care for depression in accordance with existing Canadian guidelines for HIV-positive patients with depression in Ontario, Canada. METHODS: We conducted a prospective cohort study linking data from the Ontario HIV Treatment Network Cohort Study...... income or educational attainment, or as non-native English speakers or immigrants to Canada were less likely to obtain care. Of 493 patients using mental health services, 250 (51%) received mental health care for depression in accordance with existing Canadian guidelines. CONCLUSIONS: Our results showed......BACKGROUND: Major depression can profoundly impact clinical and quality-of-life outcomes of people living with HIV, and this disease is underdiagnosed and undertreated in many HIV-positive individuals. Here, we describe the prevalence of publicly funded primary and secondary mental health service...

Mental Health Service Use Among Immigrants in the United States: A Systematic Review

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Derr, Amelia Seraphia

2016-01-01

Objective Immigrants face stressors unique to the experience of migration that may exacerbate or cause mental health problems but access care at rates far below the general population, leaving them at risk of untreated mental health conditions. This review synthesizes current findings on mental health service utilization among immigrants to inform future research efforts addressing disparities in access to care. Methods A systematic literature search of seven databases yielded 62 articles that met inclusion criteria: peer-reviewed reports of empirical studies based in the United States with an explicit focus on immigrant mental health service use. Each article was evaluated, and information was extracted by using a structured abstracting form. Results Studies have shown that immigrants from Asia, Latin America, and Africa use mental health services at lower rates than nonimmigrants, despite an equal or greater need. Lower usage has been found to be more pronounced among men, the uninsured, and the undocumented. Structural barriers to service use reported included lack of insurance, high cost, and language barriers. Studies have shown that social support is particularly important for immigrants and that those who seek help for mental health concerns tend to turn first to family, friends, or religious leaders. Conclusions Important areas for future research on disparities in mental health service use among immigrants include expanding research and analytic design to emphasize understudied groups and the heterogeneity of immigrant experiences over time, studying interventions that foster collaboration between formal and informal service sectors, and examining the role of social support in problem recognition and treatment initiation. PMID:26695493

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

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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.

Innovation in mental health services: what are the key components of success?

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Brooks, Helen; Pilgrim, David; Rogers, Anne

2011-10-26

Service development innovation in health technology and practice is viewed as a pressing need within the field of mental health yet is relatively poorly understood. Macro-level theories have been criticised for their limited explanatory power and they may not be appropriate for understanding local and fine-grained uncertainties of services and barriers to the sustainability of change. This study aimed to identify contextual influences inhibiting or promoting the acceptance and integration of innovations in mental health services in both National Health Service (NHS) and community settings. A comparative study using qualitative and case study data collection methods, including semi-structured interviews with key stakeholders and follow-up telephone interviews over a one-year period. The analysis was informed by learning organisation theory. Drawn from 11 mental health innovation projects within community, voluntary and NHS settings, 65 participants were recruited including service users, commissioners, health and non-health professionals, managers, and caregivers. The methods deployed in this evaluation focused on process-outcome links within and between the 11 projects. Key barriers to innovation included resistance from corporate departments and middle management, complexity of the innovation, and the availability and access to resources on a prospective basis within the host organisation. The results informed the construction of a proposed model of innovation implementation within mental health services. The main components of which are context, process, and outcomes. The study produced a model of conducive and impeding factors drawn from the composite picture of 11 innovative mental health projects, and this is discussed in light of relevant literature. The model provides a rich agenda to consider for services wanting to innovate or adopt innovations from elsewhere. The evaluation suggested the importance of studying innovation with a focus on context, process

Three models of community mental health services In low-income countries

Directory of Open Access Journals (Sweden)

De Silva Mary

2011-01-01

Full Text Available Abstract Objective To compare and contrast three models of community mental health services in low-income settings. Data Sources/Study Setting Primary and secondary data collected before, during, and after site visits to mental health programs in Nigeria, the Philippines, and India. Study Design Qualitative case study methodology. Data Collection Data were collected through interviews and observations during site visits to the programs, as well as from reviews of documentary evidence. Principal Findings A set of narrative topics and program indicators were used to compare and contrast three community mental health programs in low-income countries. This allowed us to identify a diversity of service delivery models, common challenges, and the strengths and weaknesses of each program. More definitive evaluations will require the establishment of data collection methods and information systems that provide data about the clinical and social outcomes of clients, as well as their use of services. Conclusions Community mental health programs in low-income countries face a number of challenges. Using a case study methodology developed for this purpose, it is possible to compare programs and begin to assess the effectiveness of diverse service delivery models.

Mental Health Service Use among High School Students Exposed to Interpersonal Violence

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Green, Jennifer Greif; Johnson, Renee M.; Dunn, Erin C.; Lindsey, Michael; Xuan, Ziming; Zaslavsky, Alan M.

2014-01-01

Background: Violence-exposed youth rarely receive mental health services, even though exposure increases risk for academic and psychosocial problems. This study examines the association between violence exposure and mental health service contact. The 4 forms of violence exposure were peer, family, sexual, and witnessing. Methods: Data are from…

Experience from mental health clinics held during medical service camps in Fiji.

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Sivakumaran, Hemalatha; George, Kuruvilla; Naker, Gunu; Nadanachandran, Kathir

2015-12-01

We aim to describe the experience and findings of mental health clinics held during medical service camps in the rural settings of Fiji. Descriptive data collated at the end of the medical camps across 2011-2014 are used to highlight the main findings. The exposure to mental health assessments and brief interventions at these camps was a validating experience for both individuals and medical students attending the clinics. The most common presentations can be categorised under symptoms of depression, anxiety and relationship problems. The accessibility of mental health support services is a challenge in Fiji. Medical service camps can form an important pathway in promoting mental health awareness, especially amongst the rural communities of Fiji, and a useful platform for medical students to acquire some clinical exposure. © The Royal Australian and New Zealand College of Psychiatrists 2015.

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.

Qualitative Methods in Mental Health Services Research

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Palinkas, Lawrence A.

2014-01-01

Qualitative and mixed methods play a prominent role in mental health services research. However, the standards for their use are not always evident, especially for those not trained in such methods. This paper reviews the rationale and common approaches to using qualitative and mixed methods in mental health services and implementation research based on a review of the papers included in this special series along with representative examples from the literature. Qualitative methods are used to provide a “thick description” or depth of understanding to complement breadth of understanding afforded by quantitative methods, elicit the perspective of those being studied, explore issues that have not been well studied, develop conceptual theories or test hypotheses, or evaluate the process of a phenomenon or intervention. Qualitative methods adhere to many of the same principles of scientific rigor as quantitative methods, but often differ with respect to study design, data collection and data analysis strategies. For instance, participants for qualitative studies are usually sampled purposefully rather than at random and the design usually reflects an iterative process alternating between data collection and analysis. The most common techniques for data collection are individual semi-structured interviews, focus groups, document reviews, and participant observation. Strategies for analysis are usually inductive, based on principles of grounded theory or phenomenology. Qualitative methods are also used in combination with quantitative methods in mixed method designs for convergence, complementarity, expansion, development, and sampling. Rigorously applied qualitative methods offer great potential in contributing to the scientific foundation of mental health services research. PMID:25350675

An Exploratory Study of Student Service Members/Veterans' Mental Health Characteristics by Sexual Orientation.

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Pelts, Michael D; Albright, David L

2015-01-01

Explore the mental health differences of student veterans by sexual orientation. Student service members/veterans (N = 702) from the Fall 2011 National College Health Assessment. Descriptive statistics and 2-sample proportion and mean tests were used to compare mental health characteristics. Student veterans who identify as lesbian, gay, bisexual, or unsure had higher levels of mental health symptoms and treatment. Results suggest a need for continued examination of student service members/veterans as related to disparities in mental health by sexual orientation.

Examining relationships between receiving mental health services in the Pennsylvania prison system and time served.

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Metraux, Stephen

2008-07-01

This study examined a cohort of 7,046 men who were released from the Pennsylvania State prison system between 1999 and 2002 to Philadelphia County to assess the relationships between receipt of mental health services in prison and prison exit. Administrative data on prison stays for 7,046 men released from Pennsylvania prisons to Philadelphia locations were analyzed. Of the 7,046 men, 8.7% received ongoing or intensive mental health services and 25.9% received mental health services while incarcerated. Multivariate analyses indicate that use of mental health services was positively associated with increased odds of serving the full prison sentence (as opposed to receiving parole), although the relationship between mental health services received and length of prison episode was inconclusive. Dynamics related to prison release warrant further attention in efforts to reduce the prevalence of mental illness in prisons and to facilitate community reentry for persons so diagnosed.

[Determining Factors in the Access to Mental Health Services by the Adult Colombian Population].

Science.gov (United States)

González, Lina María; Peñaloza, Rolando Enrique; Matallana, María Alexandra; Gil, Fabián; Gómez-Restrepo, Carlos; Landaeta, Angela Patricia Vega

2016-12-01

Access to mental health services by people with mental disorders has traditionally been limited, and is associated with attitudinal, social, and structural variables. To analyse the factors that determine access to mental health services by the adult population (18-44 years old) in Colombia, from the results obtained in the 2015 National Mental Health Survey. Analysis of variables of access to attention in mental health care for adults. The reasons for not consulting were classified as barriers of behavioural supply and demand. To analyse the factors associated with access to mental health services in the Colombian adult population, the use of health services in the last 12 months for emotional, nervous or mental health problems was taken into account, as well as associated variables such as demographic characteristics, occupational activity, affiliation to social security, and health status variables. The relationships between these variables were estimated using bivariate multinomial logistic regression models. Rural residence, being married, and having a chronic disease were associated with the decision to consult or not to consult the doctor. Further studies should be conducted to evaluate the situation as regards mental health care access, as well as to determine the potential factors associated with these limitations. Copyright © 2016 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.

Nine key principles to guide youth mental health: development of service models in New South Wales.

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Howe, Deborah; Batchelor, Samantha; Coates, Dominiek; Cashman, Emma

2014-05-01

Historically, the Australian health system has failed to meet the needs of young people with mental health problems and mental illness. In 2006, New South Wales (NSW) Health allocated considerable funds to the reform agenda of mental health services in NSW to address this inadequacy. Children and Young People's Mental Health (CYPMH), a service that provides mental health care for young people aged 12-24 years, with moderate to severe mental health problems, was chosen to establish a prototype Youth Mental Health (YMH) Service Model for NSW. This paper describes nine key principles developed by CYPMH to guide the development of YMH Service Models in NSW. A literature review, numerous stakeholder consultations and consideration of clinical best practice were utilized to inform the development of the key principles. Subsequent to their development, the nine key principles were formally endorsed by the Mental Health Program Council to ensure consistency and monitor the progress of YMH services across NSW. As a result, between 2008 and 2012 YMH Services across NSW regularly reported on their activities against each of the nine key principles demonstrating how each principle was addressed within their service. The nine key principles provide mental health services a framework for how to reorient services to accommodate YMH and provide a high-quality model of care. [Corrections added on 29 November 2013, after first online publication: The last two sentences of the Results section have been replaced with "As a result, between 2008 and 2012 YMH Services across NSW regularly reported on their activities against each of the nine key principles demonstrating how each principle was addressed within their service."]. © 2013 Wiley Publishing Asia Pty Ltd.

Correlates of mental health services utilization 18 months and almost 4 years postdisaster among adults with mental health problems

NARCIS (Netherlands)

van der Velden, Peter G.; Yzermans, C. Joris; Kleber, Rolf J.; Gersons, B. P. R.

2007-01-01

The authors assess the correlates of mental health services utilization (MHS) after a disaster among adults with mental health problems. Data of a three-wave longitudinal study among adult survivors of a fireworks disaster (T1: 2-3 weeks, T2: 18 months, T3: almost 4 years postdisaster) were linked

Technology in Mental Health: Creating New Knowledge and Inventing the Future of Services.

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Ben-Zeev, Dror

2017-02-01

The mental health services now in place are intrinsically linked with the technology that has been at our disposal for decades of research and practice. Advancements in Web, mobile, sensor, and informatics technology can do more than serve as tools to enhance existing models of care. Novel technologies can help us better understand the very nature of mental illness and revise our fundamental assumptions about the structure, boundaries, and modalities of mental health treatment. Recognizing the unprecedented opportunities new technology offers to improve the outcomes of people with mental illness, Psychiatric Services announces a new column on technology and mental health.

Racial-ethnic variation in U.S. mental health service use among Latino and Asian non-U.S. citizens.

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Lee, Sungkyu; Laiewski, Laurel; Choi, Sunha

2014-01-01

This study examined the factors associated with service utilization for mental health conditions among Latino and Asian non-U.S. citizens in the United States by service type and race. Data were obtained from the National Latino and Asian American Study (NLAAS). The sample for this study was 849 Latino and 595 Asian non-U.S. citizens between ages 18 and 64 (N=1,444). Mental health services obtained through three types of service providers were examined: specialty mental health services, general medical services, and other services. Guided by the modified Andersen health behavioral model, analyses involved logistic regression models conducted with penalized maximum likelihood estimation. Although having a psychiatric disorder increased mental health service use in both groups, only 32% of Latino and 52% of Asian non-U.S. citizens with psychiatric needs reported using mental health services during the past 12 months. Overall, noncitizen Latinos and Asians were more likely to use mental health services from general health care providers and other providers than from specialty mental health providers. Several significant predisposing, enabling, and need factors, such as age, health insurance, and having psychiatric conditions, also interacted with race. Findings of the study suggest that there are ethnoracial variations in mental health service use between Latino and Asian non-U.S. citizens. Mental health professionals should consider developing tailored mental health interventions that account for cultural variations to enhance access to services for these vulnerable subgroups of Latinos and Asians. Further research should examine ethnic disparities in mental health service use among various non-U.S. citizen racial-ethnic subgroups.

Service user governors in mental health foundation trusts: accountability or business as usual?

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MacDonald, Dee; Barnes, Marian; Crawford, Mike; Omeni, Edward; Wilson, Aaron; Rose, Diana

2015-12-01

National Health Foundation Trusts present opportunities for individual mental health service users to be active in the governance of trusts. This is one of a range of mechanisms for patient and public involvement and one which promotes an individual rather than collective approach to involvement. Within the context of a broader study of the impact of service user involvement in mental health services, the objective of this article was to explore the experience of service user governors in foundation trusts and their capacity to hold boards to account. The Council of Governors in three foundation trusts were observed for a year. Focus groups with service user governors were undertaken in each trust. Service users had different expectations and understandings of the role and approached it in different ways. Key themes that emerged concerned: the role of a governor, conduct and content of meetings, agenda setting, relationships and representation. The experiences of mental health service user governors need to be understood within the complex environment of patient and public involvement in general and of mental health service user involvement in particular. The dislocation of the service user governor role from other forms of service user activity and involvement result in confusion about how notions of holding a trust to account and representation of other service users can be addressed within a boundaried institutional environment. © 2014 John Wiley & Sons Ltd.

A collaborative approach to improve the assessment of physical health in adult consumers with schizophrenia in Queensland mental health services.

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Plever, Sally; McCarthy, Irene; Anzolin, Melissa; Emmerson, Brett; Khatun, Mohsina

2016-02-01

The objective of this study was to apply a quality improvement collaborative to increase the number of physical health assessments conducted with consumers diagnosed with schizophrenia in adult community mental health services across Queensland. Sixteen adult mental health service organisations voluntarily took part in the statewide collaborative initiative to increase the number of physical health assessments completed on persons with a diagnosis of schizophrenia spectrum disorders managed through the community mental health service. Improvement in the physical health assessment clinical indicator was demonstrated across the state over a 3-year period with an increase in the number of physical health assessments recorded from 12% to 58%. Significant improvements were made over a 3-year period by all mental health services involved in the collaborative, supporting the application of a quality improvement methodology to drive change across mental health services. © The Royal Australian and New Zealand College of Psychiatrists 2015.

From admission to discharge in mental health services: a qualitative analysis of service user involvement.

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Wright, Nicola; Rowley, Emma; Chopra, Arun; Gregoriou, Kyriakos; Waring, Justin

2016-04-01

User involvement and recovery are now widely used terms within the mental health policy, research and practice discourse. However, there is a question mark about the impact these ideas have in everyday practice. Of interest is the degree of involvement in key transitions of care. In particular, admission to and discharge from acute inpatient mental health wards. To explore the nature of service user involvement in the admission and discharge process into and out of acute inpatient mental health care. A qualitative study using focus groups. One acute, inpatient mental health ward was the focus of the study. Seven uniprofessional focus group interviews were conducted with ward staff, community staff and service users (total number of participants = 52). Conventional, thematic qualitative techniques were used to analyse the data. The data analysed and presented in this article relate to the loss of the service user voice at the key transition points into and out of acute inpatient care. Due to the lack of resources (inpatient beds and community care follow-up), the role service users could play was diminished. In their narratives, clinical staff associated the person with the process and used language which dehumanized the individual. Service users experience numerous care transitions into and out of hospital. As there is the potential for these encounters to have a lasting negative effect, the importance of ensuring service users have a voice in what is happening to them is crucial. © 2015 John Wiley & Sons Ltd.

Contact With Mental Health Services Prior to Suicide: A Systematic Review and Meta-Analysis.

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Walby, Fredrik A; Myhre, Martin Øverlien; Kildahl, Anine Therese

2018-04-16

Access to mental health care is regarded as a central suicide prevention strategy. This is the first systematic review and meta-analysis of the prevalence of contact with mental health services preceding suicide. A systematic search for articles reporting prevalence of contact with mental health services before suicide was conducted in MEDLINE and PsycINFO, restricted to studies published from January 1, 2000, to January 12, 2017. A random-effects meta-analysis with double arcsine transformations was conducted, with meta-regression used to explore heterogeneity. Thirty-five studies were included in the systematic review, and 20 were included in the meta-analysis. Among suicide decedents in the population, 3.7% (95% confidence interval [CI]=2.6%-4.8%) were inpatients at the time of death. In the year before death, 18.3% (CI=14.6%-22.4%) of suicide decedents had contact with inpatient mental health services, 26.1% (CI=16.5%-37.0%) had contact with outpatient mental health services, and 25.7% (CI=22.7%-28.9%) had contact with inpatient or outpatient mental health services. Meta-regression showed that women had significantly higher levels of contact compared with men and that the prevalence of contact with inpatient or outpatient services increased according to the sample year. Contact with services prior to suicide was found to be common and contact with inpatient or outpatient mental health services before suicide seems to be increasing. However, the reviewed studies were mainly conducted in Western European and North American countries, and most studies focused on psychiatric hospitalization, which resulted in limited data on contact with outpatient services. Better monitoring and data on suicides that occur during and after treatment seem warranted.

Are Posttraumatic Stress Symptoms Related to Mental Health Service Use?

DEFF Research Database (Denmark)

Madsen, Trine; Andersen, Søren Bo; Karstoft, Karen-Inge

2016-01-01

BACKGROUND: Investigating the use of mental health services by combat veterans can help illuminate utilization and unmet needs of this population. The aims of this study were to estimate the use of mental health services and to examine how such use is associated with self-reported symptoms...... of posttraumatic stress disorder (PTSD) in soldiers before and after deployment to Afghanistan. METHODS: Prospectively, 703 Danish soldiers who deployed from January 2009 to August 2009 were followed up with 6 assessments from predeployment to 2.5 years postdeployment in 2012. At assessments, the soldiers...

California's historic effort to reduce the stigma of mental illness: the Mental Health Services Act.

Science.gov (United States)

Clark, Wayne; Welch, Stephanie N; Berry, Sandra H; Collentine, Ann M; Collins, Rebecca; Lebron, Dorthy; Shearer, Amy L

2013-05-01

In a historic effort to reduce the stigma of mental illness, California voters approved the Mental Health Services Act in 2004. The law funds a comprehensive statewide prevention initiative that places stigma and discrimination reduction at its center, with 25 projects providing interventions at the institutional, societal, and individual levels. Stakeholders selected specific strategies from the research-based California Strategic Plan on Reducing Stigma and Discrimination. Strategies range from social marketing to increase public knowledge to capacity building at the local level, including training that emphasizes participation by consumers of mental health services and cultural competence. Collectively, these strategies aim to foster permanent change in the public perception of mental illness and in the individual experience of stigma. We examined the context, planning, programming, and evaluation of this effort.

Barriers and facilitators of disclosures of domestic violence by mental health service users: qualitative study.

Science.gov (United States)

Rose, Diana; Trevillion, Kylee; Woodall, Anna; Morgan, Craig; Feder, Gene; Howard, Louise

2011-03-01

Mental health service users are at high risk of domestic violence but this is often not detected by mental health services. To explore the facilitators and barriers to disclosure of domestic violence from a service user and professional perspective. A qualitative study in a socioeconomically deprived south London borough, UK, with 18 mental health service users and 20 mental health professionals. Purposive sampling of community mental health service users and mental healthcare professionals was used to recruit participants for individual interviews. Thematic analysis was used to determine dominant and subthemes. These were transformed into conceptual maps with accompanying illustrative quotations. Service users described barriers to disclosure of domestic violence to professionals including: fear of the consequences, including fear of Social Services involvement and consequent child protection proceedings, fear that disclosure would not be believed, and fear that disclosure would lead to further violence; the hidden nature of the violence; actions of the perpetrator; and feelings of shame. The main themes for professionals concerned role boundaries, competency and confidence. Service users and professionals reported that the medical diagnostic and treatment model with its emphasis on symptoms could act as a barrier to enquiry and disclosure. Both groups reported that enquiry and disclosure were facilitated by a supportive and trusting relationship between the individual and professional. Mental health services are not currently conducive to the disclosure of domestic violence. Training of professionals in how to address domestic violence to increase their confidence and expertise is recommended.

Mental Health Services, Free Appropriate Public Education, and Students with Disabilities: Legal Considerations in Identifying, Evaluating, and Providing Services

Science.gov (United States)

Yell, Mitchell; Smith, Carl; Katsiyannis, Antonis; Losinski, Mickey

2018-01-01

In the past few years, the provision of mental health services in public schools has received considerable attention. When students with disabilities are eligible for special education and related services under the Individuals With Disabilities Education Act (IDEA), mental health services are required if such services are needed to provide…

Budget and financing of mental health services: baseline information on 89 countries from WHO's project atlas.

Science.gov (United States)

Saxena, Shekhar; Sharan, Pratap; Saraceno, Benedetto

2003-09-01

Very little information is available on budget and financing of mental health services in the world. During year 2001, WHO collected information from all countries on resources available for mental health care as a part of Project Atlas. The present report seeks to describe the situation regarding federal budgets and financing of mental health care at the country level. It also examines the association between relative allocation of health budget to mental health and mental health policy, programme and resource indicators in 89 countries. The information was collected through a questionnaire (with an accompanying glossary) that was sent to the mental health focal point in the Ministry of Health of each country. Eighty nine countries provided information on their mental health budget as a proportion of health budget. In addition, information was obtained on policy, programme and mental health resource indicators (beds, personnel, services to special population and availability of drugs). The results showed that 32% of 191 countries did not have a specified budget for mental health. Of the 89 countries that supplied the requisite information 36% spent less than 1% of their total health budget on mental health. Many countries from Africa (79%) and the South East Asia (63%) were in this subgroup. Comparison with the Global Burden of Disease data showed a marked disparity between burden and resources. Lower income countries allocated a lesser proportion of their health budget on mental health in comparison to higher income countries. The primary method of financing mental health care in most countries was tax-based (60.2%), but many low-income countries depended on out-of-pocket expenditure (16.4%). The presence of mental health policies and programmes in general was not associated with the proportion of health budget allocated to mental health. Counties categorized based on the proportion of mental health budget to health budget, differed significantly in terms of

Mental health service use among high school students exposed to interpersonal violence

Science.gov (United States)

Johnson, Renee M.; Dunn, Erin C.; Lindsey, Michael; Xuan, Ziming; Zaslavsky, Alan M.

2013-01-01

BACKGROUND Violence-exposed youth rarely receive mental health services, even though exposure increases risk for academic and psychosocial problems. This study examines the association between violence exposure and mental health service contact. The four forms of violence exposure were peer, family, sexual, and witnessing. METHODS Data are from 1,534 Boston public high school students who participated in a 2008 self-report survey of violence exposure and its correlates. Multivariate logistic regressions estimated associations between each form of violence with service contact, then examined whether associations persisted when controlling for suicidality and self-injurious behaviors. RESULTS In unadjusted models, violence-exposed students more often reported service contact than their peers. However, in multivariate models, only exposure to family (OR=1.69, CI=1.23–2.31) and sexual violence (OR=2.34, CI=1.29–4.20) were associated with service contact. Associations attenuated when controlling for suicidality and self-injurious behaviors, indicating they were largely explained by self-harm. Sexual violence alone remained associated with mental health service contact in fully adjusted models, but only for girls (OR=3.32, CI=1.30–8.45), suggesting gender-specific pathways. CONCLUSIONS Associations between adolescent violence exposure and mental health service contact vary by form of exposure. Outreach to a broader set of exposed youth may reduce the impact of violence and its consequences for vulnerable students. PMID:25099429

Development of Community Mental Health Services: The Case of Emilia‐Romagna Italian Region

Directory of Open Access Journals (Sweden)

Angelo Fioritti

2014-06-01

Full Text Available Italian psychiatry has gained International attention after its radical reform of 1978, which established the progressive closure of mental hospitals and the establishment of community services throughout the country. However it is technically inappropriate to talk about Italian psychiatry as the devolution process has transferred to the regions all competences about policy, planning and evaluating health services. This explains the variety of “community psychiatries” that can be found along the peninsula and the reasons of interest that can arise from their comparison. The development of community psychiatry in Emilia‐Romagna, a region of 4 million inhabitants in Northern Italy, has proceeded through two partially overlapping phases of deinstitutionalization (1978‐1997 and development of integrated mental health departments (1990‐2008. The analysis of raw data about allocation of resources and professional capital development give way to tentative comparisons with the current Portuguese situation of implementation of a similar reform. In 2006 the regional Council launched a three year project aimed at rethinking the welfare system and the integration of social and health services, considering the dramatic social and demographic changes occurring in the region. This project has implied also a three year process of redrafting mental health policy finalised in the Emilia‐Romagna Mental Health Action Plan 2009‐2011 approved by the council in March 2009. It basically follows two strategies: integration of health and social services and further qualification of health services. The former is pursued through a reshaping of the planning and commissioning bodies of both health and social services, previously separated and now merging. They are taking responsibility on many issues related to mental health care, such as prevention, mental health promotion, supported employment, supported housing, subsidies, self‐help. The improvement of

Planning estimates for the provision of core mental health services in Queensland 2007 to 2017.

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Harris, Meredith G; Buckingham, William J; Pirkis, Jane; Groves, Aaron; Whiteford, Harvey

2012-10-01

To derive planning estimates for the provision of public mental health services in Queensland 2007-2017. We used a five-step approach that involved: (i) estimating the prevalence and severity of mental disorders in Queensland, and the number of people at each level of severity treated by health services; (ii) benchmarking the level and mix of specialised mental health services in Queensland against national data; (iii) examining 5-year trends in Queensland public sector mental health service utilisation; (iv) reviewing Australian and international planning benchmarks; and (v) setting resource targets based on the results of the preceding four steps. Best available evidence was used where possible, supplemented by value judgements as required. Recommended resource targets for inpatient service were: 20 acute beds per 100,000 population, consistent with national average service provision but 13% above Queensland provision in 2005; and 10 non-acute beds per 100,000, 65% below Queensland levels in 2005. Growth in service provision was recommended for all other components. Adult residential rehabilitation service targets were 10 clinical 24-hour staffed beds per 100,000, and 18 non-clinical beds per 100,000. Supported accommodation targets were 35 beds per 100,000 in supervised hostels and 35 places per 100,000 in supported public housing. A direct care clinical workforce of 70 FTE per 100,000 for ambulatory care services was recommended. Fifteen per cent of total mental health funding was recommended for community support services provided by non-government organisations. The recommended targets pointed to specific areas for priority in Queensland, notably the need for additional acute inpatient services for older persons and expansion of clinical ambulatory care, residential rehabilitation and supported accommodation services. The development of nationally agreed planning targets for public mental health services and the mental health community support sector were

Do online mental health services improve help-seeking for young people? A systematic review.

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Kauer, Sylvia Deidre; Mangan, Cheryl; Sanci, Lena

2014-03-04

Young people regularly use online services to seek help and look for information about mental health problems. Yet little is known about the effects that online services have on mental health and whether these services facilitate help-seeking in young people. This systematic review investigates the effectiveness of online services in facilitating mental health help-seeking in young people. Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, literature searches were conducted in PubMed, PsycINFO, and the Cochrane library. Out of 608 publications identified, 18 studies fulfilled the inclusion criteria of investigating online mental health services and help-seeking in young people aged 14-25 years. Two qualitative, 12 cross-sectional, one quasi-experimental, and three randomized controlled trials (RCTs) were reviewed. There was no change in help-seeking behavior found in the RCTs, while the quasi-experimental study found a slight but significant increase in help-seeking. The cross-sectional studies reported that online services facilitated seeking help from a professional source for an average of 35% of users. The majority of the studies included small sample sizes and a high proportion of young women. Help-seeking was often a secondary outcome, with only 22% (4/18) of studies using adequate measures of help-seeking. The majority of studies identified in this review were of low quality and likely to be biased. Across all studies, young people regularly used and were generally satisfied with online mental health resources. Facilitators and barriers to help-seeking were also identified. Few studies examine the effects of online services on mental health help-seeking. Further research is needed to determine whether online mental health services effectively facilitate help-seeking for young people.

E-Mental Health Innovations for Aboriginal and Torres Strait Islander Australians: A Qualitative Study of Implementation Needs in Health Services.

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Puszka, Stefanie; Dingwall, Kylie M; Sweet, Michelle; Nagel, Tricia

2016-09-19

Electronic mental health (e-mental health) interventions offer effective, easily accessible, and cost effective treatment and support for mental illness and well-being concerns. However, e-mental health approaches have not been well utilized by health services to date and little is known about their implementation in practice, particularly in diverse contexts and communities. This study aims to understand stakeholder perspectives on the requirements for implementing e-mental health approaches in regional and remote health services for Indigenous Australians. Qualitative interviews were conducted with 32 managers, directors, chief executive officers (CEOs), and senior practitioners of mental health, well-being, alcohol and other drug and chronic disease services. The implementation of e-mental health approaches in this context is likely to be influenced by characteristics related to the adopter (practitioner skill and knowledge, client characteristics, communication barriers), the innovation (engaging and supportive approach, culturally appropriate design, evidence base, data capture, professional development opportunities), and organizational systems (innovation-systems fit, implementation planning, investment). There is potential for e-mental health approaches to address mental illness and poor social and emotional well-being amongst Indigenous people and to advance their quality of care. Health service stakeholders reported that e-mental health interventions are likely to be most effective when used to support or extend existing health services, including elements of client-driven and practitioner-supported use. Potential solutions to obstacles for integration of e-mental health approaches into practice were proposed including practitioner training, appropriate tool design using a consultative approach, internal organizational directives and support structures, adaptations to existing systems and policies, implementation planning and organizational and government

Identifying mental health services in clinical genetic settings.

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Cappelli, M; Esplen, M J; Wilson, B J; Dorval, M; Bottorff, J L; Ly, M; Carroll, J C; Allanson, J; Humphreys, E; Rayson, D

2009-10-01

The purpose of this study was to examine the mental health needs of individuals at risk for adult onset hereditary disorder (AOHD) from the perspective of their genetic service providers, as it is unknown to what extent psychosocial services are required and being met. A mail-out survey was sent to 281 providers on the membership lists of the Canadian Association of Genetic Counsellors and the Canadian College of Medical Geneticists. The survey assessed psychosocial issues that were most commonly observed by geneticists, genetic counsellors (GCs), and nurses as well as availability and types of psychosocial services offered. Of the 129 respondents, half of genetic service providers reported observing signs of depression and anxiety, while 44% noted patients' concerns regarding relationships with family and friends. In terms of providing counselling to patients, as the level of psychological risk increased, confidence in dealing with these issues decreased. In addition, significantly more GCs reported that further training in psychosocial issues would be most beneficial to them if resources were available. As a feature of patient care, it is recommended that gene-based predictive testing include an integrative model of psychosocial services as well as training for genetic service providers in specific areas of AOHD mental health.

Trends in mental health services utilization and stigma in US soldiers from 2002 to 2011.

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Quartana, Phillip J; Wilk, Joshua E; Thomas, Jeffrey L; Bray, Robert M; Rae Olmsted, Kristine L; Brown, Janice M; Williams, Jason; Kim, Paul Y; Clarke-Walper, Kristina; Hoge, Charles W

2014-09-01

We characterized trends in mental health services utilization and stigma over the course of the Afghanistan and Iraq wars among active-component US soldiers. We evaluated trends in mental health services utilization and stigma using US Army data from the Health-Related Behavior (HRB) surveys from 2002, 2005, and 2008 (n = 12,835) and the Land Combat Study (LCS) surveys administered to soldiers annually from 2003 to 2009 and again in 2011 (n = 22,627). HRB and LCS data suggested increased mental health services utilization and decreased stigma in US soldiers between 2002 and 2011. These trends were evident in soldiers with and without posttraumatic stress disorder (PTSD), major depressive disorder (MDD), or PTSD and MDD. Despite the improving trends, more than half of soldiers with mental health problems did not report seeking care. Mental health services utilization increased and stigma decreased over the course of the wars in Iraq and Afghanistan. Although promising, these findings indicate that a significant proportion of US soldiers meeting criteria for PTSD or MDD do not utilize mental health services, and stigma remains a pervasive problem requiring further attention.

Integrating mental health services into primary HIV care for women: the Whole Life project.

OpenAIRE

Dodds, Sally; Nuehring, Elane M.; Blaney, Nancy T.; Blakley, Theresa; Lizzotte, Jean-Marie; Lopez, Myriam; Potter, JoNell E.; O'Sullivan, Mary J.

2004-01-01

The high rate of mental health problems in HIV-infected women jeopardizes the health of this vulnerable population, and constitutes a mandate for integrating mental health services into HIV primary care. The Whole Life project-a collaboration of the departments of Psychiatry and Obstetrics/Gynecology at the University of Miami School of Medicine-successfully integrated mental health services into primary HIV care for women. This article describes the conceptual framework of the integration, i...

Description of physiotherapy services in a mental health institution in Nigeria

Directory of Open Access Journals (Sweden)

C.A. Gbiri

2011-01-01

Full Text Available Physiotherapy  has  long  been  recognised  as  adjunct  to  drug therapy in the management of individuals with mental illness. however, little evidence existed on the utilization of physiotherapy in mental health especially in developing worlds.This study reviewed the utilization of physiotherapy in a Mental health  Institution in lagos, nigeria and determined its contribution to quality of  patient-care in the hospital.This study involved review of clients’ activity profile and patients’ record in a federal neuro-psychiatric hospital in lagos, nigeria between 2002 and 2006. The hospital records were used as source of information for socio- demographic details. Information on the physical diagnosis was extracted from the patients’ records in the departmental records. Data were summarized using descriptive statistics.Six thousand, four hundred and seventy-three (3.3% out of the 195,686  patients of the hospital within the study period enjoyed physiotherapy ser vices. only 766 (14% of the hospital in-patients enjoyed physiotherapy services. In addition, 808 clients enjoyed the health promotion services. low back pain (85; 21.7%, osteo-arthritis (82; 20.9%, stroke (64; 16.3% and shoulder pain  (29; 7.4% were the most common co-existing health problems referred for physiotherapy.The importance of physiotherapy in mental health is evidenced in the number of patients/clients who benefited from its services. Therefore, physiotherapy is an integral and indispensible member of the mental health team. however, physiotherapy  is  still  under-utilized  in  the  hospital.  This  points  to  the  need  for  proper  integration  of  physiotherapy  into mental health team in the hospital and other similar health institutions.

Implementation of the Strengths Model at an area mental health service.

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Chopra, Prem; Hamilton, Bridget; Castle, David; Smith, Jenny; Mileshkin, Cris; Deans, Michael; Wynne, Brad; Prigg, Glenn; Toomey, Nigel; Wilson, Michael

2009-06-01

The objectives of this paper are to provide an overview of recovery-focused models of care and discuss the implementation of the Strengths Model at St. Vincent's Mental Health Melbourne (SVMH), Victoria, Australia. The implementation of the Strengths Model at SVMH is discussed with particular emphasis on the process of implementation, service implications, practical challenges and dilemmas that have arisen, and proposed evaluation. Recovery-focused care is feasible and can enhance current practice of mental health services.

Beyond satisfaction, what service users expect of inpatient mental health care: a literature review.

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Hopkins, J E; Loeb, S J; Fick, D M

2009-12-01

To provide efficient and effective inpatient mental health services, it is imperative to not only ascertain if service users are satisfied with the care received from nurses, but also the degree to which initial expectations are being met. Ten reports of primary research on service users' experiences, perceptions and expectations of inpatient mental health care were examined to understand what service users' expect of inpatient mental health care and the implications for nursing practice. The World Health Organization's description of responsiveness to service users' non-medical expectations of care was used as a framework for retrieving literature and organizing the research outcomes. Responsiveness includes seven categories of healthcare performance ranging from respect for the dignity of the person, to adequacy of amenities, and choice of provider. Service users expect to form interpersonal relationships with nurses; however, non-clinical responsibilities serve as barriers which consume considerable available nursing time that otherwise could be spent developing therapeutic relationships. In addition, inpatient programming ideas are identified for the provision of better services. Hospitals' expectations of mental health nurses will need to be reconsidered if these nurses are to provide the time and resources necessary to meet current service users' expectations.

Within-person analysis of welfare transitions in a longitudinal panel survey reveals change in mental health service use.

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Pymont, C; Schofield, T P; Butterworth, P

2017-12-01

While international research shows that receipt of welfare benefits is associated with poor mental health, less is known about the relationship between welfare receipt and mental health service use. We investigate whether within-person change in welfare recipient status is associated with change in mental health service use. Analysis of two waves of data from an Australian national household survey. Random- and fixed-effect models considered the effect of change in welfare receipt status, and assessed whether change in mental health service use differed by type of welfare benefit or the direction of welfare transition. Individuals were more likely to report greater mental health service use at times of welfare receipt. These associations were attenuated, but remained significant, after adjusting for mental health. Increased health service use was not tied to specific types of welfare benefits. The increase in mental health service use associated with a transition onto welfare benefits was much greater than the decline in service use associated with the transition off benefits. Within individuals, welfare receipt is associated with greater mental health service use. While this does reflect poorer mental health at the time of welfare receipt, other factors seem to facilitate health service use. © The Author 2016. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Australian mental health consumers contributions to the evaluation and improvement of recovery-oriented service provision.

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Marshal, Sarah L; Oades, Lindsay G; Growe, Trevor P

2010-01-01

One key component of recovery-oriented mental health services, typically overlooked, involves genuine collaboration between researchers and consumers to evaluate and improve services delivered within a recovery framework. Eighteen mental health consumers working with staff who had received training in the Collaborative Recovery Model (CRM) took part in in-depth focus group meetings, of approximately 2.5 hours each, to generate feedback to guide improvement of the CRM and its use in mental health services. Consumers identified clear avenues for improvement for the CRM both specific to the model and broadly applicable to recovery-oriented service provision. Findings suggest consumers want to be more engaged and empowered in the use of the CRM from the outset. Improved sampling procedures may have led to the identification of additional dissatisfied consumers. Collaboration with mental health consumers in the evaluation and improvement of recovery-oriented practice is crucial with an emphasis on rebuilding mental health services that are genuinely oriented to support recovery.

Mental Health Services for Students at Postsecondary Institutions: A National Survey

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Jaworska, Natalia; De Somma, Elisea; Fonseka, Bernice; Heck, Emma

2016-01-01

Objective: Although the high prevalence of mental health issues among postsecondary students is well documented, comparatively little is known about the adequacy, accessibility, and adherence to best practices of mental health services (MHSs)/initiatives on postsecondary campuses. We evaluated existing mental health promotion, identification, and intervention initiatives at postsecondary institutions across Canada, expanding on our previous work in one Canadian province. Methods: A 54-question online survey was sent to potential respondents (mainly front-line workers dealing directly with students [e.g., psychologists/counsellors, medical professionals]) at Canada’s publicly funded postsecondary institutions. Data were analyzed overall and according to institutional size (small [students], medium [2000–10 000 students], large [>10 000 students]). Results: In total, 168 out of 180 institutions were represented, and the response rate was high (96%; 274 respondents). Most institutions have some form of mental health promotion and outreach programs, although most respondents felt that these were not a good use of resources. Various social supports exist at most institutions, with large ones offering the greatest variety. Most institutions do not require incoming students to disclose mental health issues. While counselling services are typically available, staff do not reliably have a diverse complement (e.g., gender or race diversity). Counselling sessions are generally limited, and follow-up procedures are uncommon. Complete diagnostic assessments and the use of standardized diagnostic systems are rare. Conclusions: While integral MHSs are offered at most Canadian postsecondary institutions, the range and depth of available services are variable. These data can guide policy makers and stakeholders in developing comprehensive campus mental health strategies. PMID:27310230

The gender gap in mental health service use.

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Pattyn, E; Verhaeghe, M; Bracke, P

2015-07-01

This study examines why men engage less in mental health service use, by studying how gender is performed in interactions, following the doing gender perspective. We hypothesize that seeking help for mental illness may constitute a gendered role conflict among men since help seeking is associated with femininity. Therefore, we expect that men will recommend reliance on self-care options to other men, and in cases in which professional treatment is recommended, they will prefer medication to psychotherapy. We also expect that men will report greater stigmatizing attitudes. The survey Stigma in a Global Context-Belgian Mental Health Study (2009) conducted interviews of a representative sample of the Belgian general population (N = 743). The vignette technique, depicting depressive and schizophrenic symptoms, was used. Multiple linear and logistic models were estimated in SPSS. In male vignettes, self-care is more likely to be recommended, both by male and female respondents. Men are less likely to acknowledge the helpfulness of psychotherapy and women rate psychotherapy as less helpful when judging a man compared to a woman. Men rate tranquilizers as more helpful for other males than that women do for other females. Furthermore, male respondents seem to ascribe more shame and blame to the situation. The gender gap in mental health service use is due not only to men and their negative attitudes toward help seeking, but also to structured social norms that are reconstructed in interactions. Women also contribute to the maintenance of masculinity norms.

Managing Mental Health Problems Among Immigrant Women Attending Primary Health Care Services.

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Straiton, Melanie L; Powell, Kathryn; Reneflot, Anne; Diaz, Esperanza

2016-01-01

Researchers in Norway explore treatment options in primary care for immigrant women with mental health problems compared with nonimmigrant women. Three national registers were linked together for 2008. Immigrant women from Sweden, Poland, the Philippines, Thailand, Pakistan, and Russia were selected for analysis and compared with Norwegian women. Using logistic regression, we investigated whether treatment type varied by country of origin. Rates of sickness leave and psychiatric referrals were similar across all groups. Conversational therapy and use of antidepressants and anxiolytics were lower among Filipina, Thai, Pakistani, and Russian women than among Norwegians. Using the broad term "immigrants" masks important differences in treatment and health service use. By closely examining mental health treatment differences by country of origin, gaps in service provision and treatment uptake may be identified and addressed with more success.

Effects of perceived discrimination on mental health and mental health services utilization among gay, lesbian, bisexual and transgender persons.

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Burgess, Diana; Tran, Alisia; Lee, Richard; van Ryn, Michelle

2007-01-01

Previous research has found that lesbian, gay, bisexual and transgender (LGBT) individuals are at risk for a variety of mental health disorders. We examined the extent to which a recent experience of a major discriminatory event may contribute to poor mental health among LGBT persons. Data were derived from a cross-sectional strata-cluster survey of adults in Hennepin County, Minnesota, who identified as LGBT (n=472) or heterosexual (n=7,412). Compared to heterosexuals, LGBT individuals had poorer mental health (higher levels of psychological distress, greater likelihood of having a diagnosis of depression or anxiety, greater perceived mental health needs, and greater use of mental health services), more substance use (higher levels of binge drinking, greater likelihood of being a smoker and greater number of cigarettes smoked per day), and were more likely to report unmet mental healthcare needs. LGBT individuals were also more likely to report having experienced a major incident of discrimination over the past year than heterosexual individuals. Although perceived discrimination was associated with almost all of the indicators of mental health and utilization of mental health care that we examined, adjusting for discrimination did not significantly reduce mental health disparities between heterosexual and LGBT persons. LGBT individuals experienced more major discrimination and reported worse mental health than heterosexuals, but discrimination did not account for this disparity. Future research should explore additional forms of discrimination and additional stressors associated with minority sexual orientation that may account for these disparities.

Increasing use of mental health services in remote areas using mobile technology: a pre-post evaluation of the SMART Mental Health project in rural India.

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Maulik, Pallab K; Kallakuri, Sudha; Devarapalli, Siddhardha; Vadlamani, Vamsi Krishna; Jha, Vivekanand; Patel, Anushka

2017-06-01

About 25% of the Indian population experience common mental disorders (CMD) but only 15-25% of them receive any mental health care. Stigma, lack of adequate mental health professionals and mental health services account for this treatment gap, which is worse in rural areas. Our project evaluated task shifting and mobile-technology based electronic decision support systems to enhance the ability of primary care health workers to provide evidence-based mental health care for stress, depression, and suicidal risk in 30 remote villages in the state of Andhra Pradesh, India. The Systematic Medical Appraisal Referral and Treatment (SMART) Mental Health project between May 2014 and April 2016 trained lay village health workers (Accredited Social Health Activists - ASHAs) and primary care doctors to screen, diagnose and manage individuals with common mental disorders using an electronic decision support system. An anti-stigma campaign using multi-media approaches was conducted across the villages at the outset of the project. A pre-post evaluation using mixed methods assessed the change in mental health service utilization by screen positive individuals. This paper reports on the quantitative aspects of that evaluation. Training was imparted to 21 ASHAs and 2 primary care doctors. 5007 of 5167 eligible individuals were screened, and 238 were identified as being positive for common mental disorders and referred to the primary care doctors for further management. Out of them, 2 (0.8%) had previously utilized mental health services. During the intervention period, 30 (12.6%) visited the primary care doctor for further diagnosis and treatment, as advised. There was a significant reduction in the depression and anxiety scores between start and end of the intervention among those who had screened positive at the beginning. Stigma and mental health awareness in the broader community improved during the project. The intervention led to individuals being screened for common mental

Increasing use of mental health services in remote areas using mobile technology: a pre–post evaluation of the SMART Mental Health project in rural India

Science.gov (United States)

Maulik, Pallab K; Kallakuri, Sudha; Devarapalli, Siddhardha; Vadlamani, Vamsi Krishna; Jha, Vivekanand; Patel, Anushka

2017-01-01

Background About 25% of the Indian population experience common mental disorders (CMD) but only 15–25% of them receive any mental health care. Stigma, lack of adequate mental health professionals and mental health services account for this treatment gap, which is worse in rural areas. Our project evaluated task shifting and mobile–technology based electronic decision support systems to enhance the ability of primary care health workers to provide evidence–based mental health care for stress, depression, and suicidal risk in 30 remote villages in the state of Andhra Pradesh, India. Methods The Systematic Medical Appraisal Referral and Treatment (SMART) Mental Health project between May 2014 and April 2016 trained lay village health workers (Accredited Social Health Activists – ASHAs) and primary care doctors to screen, diagnose and manage individuals with common mental disorders using an electronic decision support system. An anti–stigma campaign using multi–media approaches was conducted across the villages at the outset of the project. A pre–post evaluation using mixed methods assessed the change in mental health service utilization by screen positive individuals. This paper reports on the quantitative aspects of that evaluation. Results Training was imparted to 21 ASHAs and 2 primary care doctors. 5007 of 5167 eligible individuals were screened, and 238 were identified as being positive for common mental disorders and referred to the primary care doctors for further management. Out of them, 2 (0.8%) had previously utilized mental health services. During the intervention period, 30 (12.6%) visited the primary care doctor for further diagnosis and treatment, as advised. There was a significant reduction in the depression and anxiety scores between start and end of the intervention among those who had screened positive at the beginning. Stigma and mental health awareness in the broader community improved during the project. Conclusions The intervention

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

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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.

A Pilot Demonstration of Comprehensive Mental Health Services in Inner-City Public Schools

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Walter, Heather J.; Gouze, Karen; Cicchetti, Colleen; Arend, Richard; Mehta, Tara; Schmidt, Janet; Skvarla, Madelynn

2011-01-01

Background: National policy statements increasingly espouse the delivery of comprehensive mental health services in schools. In response to the limited evidence supporting this recommendation, the purpose of this study was to assess the need for, and feasibility, desirability, and outcomes of a full model of comprehensive mental health services in…

Is it time to abandon care planning in mental health services? A qualitative study exploring the views of professionals, service users and carers.

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Brooks, Helen L; Lovell, Karina; Bee, Penny; Sanders, Caroline; Rogers, Anne

2018-06-01

It has been established that mental health-care planning does not adequately respond to the needs of those accessing services. Understanding the reasons for this and identifying whose needs care plans serve requires an exploration of the perspectives of service users, carers and professionals within the wider organizational context. To explore the current operationalization of care planning and perceptions of its function within mental health services from the perspectives of multiple stakeholders. Participants included 21 mental health professionals, 29 service users and 4 carers from seven Mental Health Trusts in England. All participants had experience of care planning processes within secondary mental health-care services. Fifty-four semi-structured interviews were conducted with participants and analysed utilizing a qualitative framework approach. Care plans and care planning were characterized by a failure to meet the complexity of mental health needs, and care planning processes were seen to prioritize organizational agendas and risk prevention which distanced care planning from the everyday lives of service users. Care planning is recognized, embedded and well established in the practices of mental health professionals and service users. However, it is considered too superficial and mainly irrelevant to users for managing mental health in their everyday lives. Those responsible for the planning and delivery of mental health services should consider ways to increase the relevance of care planning to the everyday lives of service users including separating risk from holistic needs assessment, using support aids and utilizing a peer workforce in this regard. © 2017 The Authors Health Expectations published by John Wiley & Sons Ltd.

Protocol: A grounded theory of ‘recovery’—perspectives of adolescent users of mental health services

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Palmquist, Lucianne; Patterson, Sue; O'Donovan, Analise; Bradley, Graham

2017-01-01

Introduction Policies internationally endorse the recovery paradigm as the appropriate foundation for youth mental health services. However, given that this paradigm is grounded in the views of adults with severe mental illness, applicability to youth services and relevance to young people is uncertain, particularly as little is known about young people’s views. A comprehensive understanding of the experiences and expectations of young people is critical to developing youth mental health services that are acceptable, accessible, effective and relevant. Aim To inform development of policy and youth services, the study described in this protocol aims to develop a comprehensive account of the experiences and expectations of 12–17 year olds as they encounter mental disorders and transition through specialist mental health services. Data will be analysed to model recovery from the adolescents’ perspective. Method and analysis This grounded theory study will use quantitative and qualitative data collected in interviews with 12–17 year olds engaged with specialist Child/Youth Mental Health Service in Queensland, Australia. Interviews will explore adolescents’ expectations and experiences of mental disorder, and of services, as they transition through specialist mental health services, including the meaning of their experiences and ideas of ‘recovery’ and how their experiences and expectations are shaped. Data collection and analysis will use grounded theory methods. Ethics and dissemination Adolescents’ experiences will be presented as a mid-range theory. The research will provide tangible recommendations for youth-focused mental health policy and practice. Findings will be disseminated within academic literature and beyond to participants, health professionals, mental health advocacy groups and policy and decision makers via publications, research summaries, conferences and workshops targeting different audiences. Ethical and research governance approvals

The Personal Norm of Reciprocity among mental health service users: conceptual development and measurement.

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Matejkowski, Jason; McCarthy, Kevin S; Draine, Jeffrey

2011-01-01

A measure of an individual's level of internalization of the norm of reciprocity may signal exchange preferences and indicate whether "active" or "passive" mental health services are preferable to consumers. We evaluated the psychometric properties of one such measure, the Personal Norm of Reciprocity (PNR) scale. We recruited 70 persons receiving mental health services and 65 comparison participants to complete questionnaires assessing reciprocity tendencies and correlates of mental illness. Two of three subscales of a shortened PNR showed evidence of reliability and validity. Consumers endorsed higher levels of the reciprocity norm than persons not seeking services. Persons in "active" service settings displayed greater rigidity in application of the reciprocity norm than individuals in "passive" service settings or comparison participants. The shortened PNR can be a useful measure of individual reciprocity preferences. Measurement of the internalization of the norm of reciprocity may assist practitioners in identifying what types of services are more likely to retain and benefit mental health service consumers.

Mental Health Need, Awareness, and Use of Counseling Services among International Graduate Students

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Hyun, Jenny; Quinn, Brian; Madon, Temina; Lustig, Steve

2007-01-01

Objective and Participants: The authors examined the prevalence of mental health needs in international graduate students, their knowledge of mental health services, and their use of on-campus and off-campus counseling services. Methods: All registered graduate students in the Spring 2004 semester received an e-mail invitation to participate in a…

Pakistan mental health country profile.

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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.

Research into Australian emergency services personnel mental health and wellbeing: An evidence map.

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Varker, Tracey; Metcalf, Olivia; Forbes, David; Chisolm, Katherine; Harvey, Sam; Van Hooff, Miranda; McFarlane, Alexander; Bryant, Richard; Phelps, Andrea J

2018-02-01

Evidence maps are a method of systematically characterising the range of research activity in broad topic areas and are a tool for guiding research priorities. 'Evidence-mapping' methodology was used to quantify the nature and distribution of recent peer-reviewed research into the mental health and wellbeing of Australian emergency services personnel. A search of the PsycINFO, EMBASE and Cochrane Library databases was performed for primary research articles that were published between January 2011 and July 2016. In all, 43 studies of primary research were identified and mapped. The majority of the research focused on organisational and individual/social factors and how they relate to mental health problems/wellbeing. There were several areas of research where very few studies were detected through the mapping process, including suicide, personality, stigma and pre-employment factors that may contribute to mental health outcomes and the use of e-health. No studies were detected which examined the prevalence of self-harm and/or harm to others, bullying, alcohol/substance use, barriers to care or experience of families of emergency services personnel. In addition, there was no comprehensive national study that had investigated all sectors of emergency services personnel. This evidence map highlights the need for future research to address the current gaps in mental health and wellbeing research among Australian emergency services personnel. Improved understanding of the mental health and wellbeing of emergency services personnel, and the factors that contribute, should guide organisations' wellbeing policies and procedures.

Service user involvement in care planning: the mental health nurse's perspective.

Science.gov (United States)

Anthony, P; Crawford, P

2000-10-01

A dissonance between espoused values of consumerism within mental health care and the 'reality' of clinical practice has been firmly established in the literature, not least in terms of service user involvement in care planning. In order to begin to minimize such dissonance, it is vital that mental health nurse perceptions of service user involvement in the core activity of care planning are better understood. The main findings of this qualitative study, which uses semistructured interviews, suggest that mental health nurses value the concept of user involvement but consider it to be problematic in certain circumstances. The study reveals that nurses hold similar views about the 'meaning' of patient involvement in care planning but limited resources, individual patients characteristics and limitations in nursing care are the main inhibiting factors. Factors perceived as promoting and increasing user involvement included: provision of accurate information, 'user-friendly' documentation, mechanisms for gaining service user feedback, and high staff morale.

Barriers to mental health service use and preferences for addressing emotional concerns among lung cancer patients.

Science.gov (United States)

Mosher, Catherine E; Winger, Joseph G; Hanna, Nasser; Jalal, Shadia I; Fakiris, Achilles J; Einhorn, Lawrence H; Birdas, Thomas J; Kesler, Kenneth A; Champion, Victoria L

2014-07-01

This study examined barriers to mental health service use and preferences for addressing emotional concerns among lung cancer patients (N=165) at two medical centers in the Midwestern United States. Lung cancer patients completed an assessment of anxiety and depressive symptoms, mental health service use, barriers to using these services, and preferences for addressing emotional concerns. Only 45% of distressed patients received mental health care since their lung cancer diagnosis. The most prevalent patient-reported barriers to mental health service use among non-users of these services (n=110) included the desire to independently manage emotional concerns (58%) and inadequate knowledge of services (19%). In addition, 57% of distressed patients who did not access mental health services did not perceive the need for help. Seventy-five percent of respondents (123/164) preferred to talk to a primary care physician if they were to have an emotional concern. Preferences for counseling, psychiatric medication, peer support, spiritual care, or independently managing emotional concerns also were endorsed by many patients (range=40-50%). Older age was associated with a lower likelihood of preferring to see a counselor. Findings suggest that many distressed lung cancer patients underuse mental health services and do not perceive the need for such services. Efforts to increase appropriate use of services should address patients' desire for autonomy and lack of awareness of services. Copyright © 2014 John Wiley & Sons, Ltd.

Hurricane Hugo: Emergency Preparedness Planning and Response for Mental Health Services.

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Carter, Nancy C.; And Others

This report describes how, in the aftermath of Hurricane Hugo, the South Carolina Department of Mental Health activated its Emergency Preparedness Plan to assist mental health centers and their staff in providing crisis counseling services to the general public. The first section explains the history and structure of the involvement by the…

The good, the bad, and the severely mentally ill: Official and informal labels as organizational resources in community mental health services.

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Dobransky, Kerry

2009-09-01

Research on labeling mental illness has focused relatively little attention on practical organizational concerns in the process of labeling in community mental health services. This paper examines this issue through an ethnographic study of two multi-service community mental health services organizations for people labeled severely and persistently mentally ill in the Midwest United States. The findings show that the labeling process is structured by cultural and policy environments in which mental health services are able to provide resources otherwise difficult to obtain. Within organizations, official labels can be applied for reasons other than clinical practice; they channel resources to both organizations and clients. Informal organizational labels regarding client mental illness are not tethered to the bureaucratic apparatus granting access to and paying for services. Instead, they reflect workers' real assessments of clients, which can differ from official ones. These informal labels determine how organizations deal with clients when rules and routines are violated.

Awareness of venous thromboembolism in mental health services for older people.

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van Zyl, M; Wieczorek, G; Reilly, J

2014-05-01

Venous thromboembolism (VTE) is an important safety issue in the inpatient mental health care of older people. In a survey of specialist mental health staff, knowledge of deep vein thrombosis was good. More variable awareness of the presentation and risk factors for pulmonary embolism indicates the need for training integrated into regular physical health care updates. Currently, failure to adequately screen and prevent venous thromboembolism (VTE) is estimated to cause between 25,000 and 32,000 potentially avoidable deaths annually in the United Kingdom. The authors aimed to assess the awareness of VTE in clinical staff working in Mental Health Services for Older People, Tees, Esk and Wear Valleys National Health Service Foundation Trust. A questionnaire was devised to assess knowledge of VTE symptoms, risk factors, prevention, and treatment in clinical staff working in Mental Health Service for Older Peoples' inpatient units. Forty-nine nurses, 12 consultant psychiatrists, and 11 clinical pharmacists responded. A significant proportion of staff had previous involvement in VTE treatment. Staff had significantly more limited knowledge of pulmonary embolism compared to deep vein thrombosis with areas for improvement in presentation, risk factors, and prevention. The study confirms a need for improved awareness among all clinical staff including nurses, pharmacists, and doctors, which can be met by including VTE awareness in First Response training, and encouraging use of the Department of Health VTE e-learning tool. © 2013 John Wiley & Sons Ltd.

Setting up an IAPT site: the Ealing Mental Health & Well-Being Service.

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Ruprah-Shah, Baljeet

2009-01-01

IAPT will succeed or fail on the extent to which it enables partnerships. For years I have been working to integrate mental health services in Ealing. Improving Access to Psychological Therapies (IAPT) offers the best chance I have ever known to achieve this, and to make a coordinated impact on the health of the people of Ealing. IAPT is an exciting opportunity for us in Ealing and we have grabbed it with both hands. We are incorporating it into our beliefs, values and passion to produce a service that will reflect our vision for holistic primary care services. A service which is financially sound. A service which does not believe that there is one answer to everyone's mild to moderate mental health problems. A service which recognises that working in silos is detrimental to our patients' health. A service which is constantly striving to improve relationships with our partners. A service which is mindful about the people we see, and the staff who see them.

Mental health service use for adult patients with co-occurring depression and physical chronic health care needs, 2007-2010.

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Jolles, Mónica Pérez; Haynes-Maslow, Lindsey; Roberts, Megan C; Dusetzina, Stacie B

2015-08-01

Individuals with mental illness experience poor health and may die prematurely from chronic illness. Understanding whether the presence of co-occurring chronic physical health conditions complicates mental health treatment is important, particularly among patients seeking treatment in primary care settings. Examine (1) whether the presence of chronic physical conditions is associated with mental health service use for individuals with depression who visit a primary care physician, and (2) whether race modifies this relationship. Secondary analysis of the National Ambulatory Medical Care Survey, a survey of patient-visits collected annually from a random sample of 3000 physicians in office-based settings. Office visits from 2007 to 2010 were pooled for adults aged 35-85 with a depression diagnosis at the time of visit (N=3659 visits). Mental health services were measured using a dichotomous variable indicating whether mental health services were provided during the office visit or a referral made for: (1) counseling, including psychotherapy and other mental health counseling and/or (2) prescribing of psychotropic medications. Most patient office visits (70%) where a depression diagnosis was recorded also had co-occurring chronic physical conditions recorded. The presence of at least 1 physical chronic condition was associated with a 6% decrease in the probability of receiving any mental health services (Phealth conditions, particularly as the health care system moves toward an integrated care model.

The clients’ readiness to use mental health care services: Experiences and perceptions from Iranian context

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Alavi, Mousa; Irajpour, Alireza

2013-01-01

Background: Underutilization of mental health care services has been a challenge for the health care providers for many years. This challenge could be met in part by improving the clients’ readiness to use such services. This study aimed to introduce the important aspects of the clients’ readiness to use mental health services in the Iranian context. Materials and Methods: A thematic analysis of in-depth interviews was undertaken using a constant comparative approach. Participants (11 health professionals consisting of 3 physicians, 7 nurses, 1 psychologist, and 5 patients/their family members) were recruited from educational hospitals affiliated with Isfahan University of Medical Sciences, Iran. The credibility and trustworthiness was grounded on four aspects: factual value, applicability, consistency, and neutrality. Results: The study findings uncovered two important aspects of the clients’ readiness for utilizing mental health care services. These are described through two themes and related sub-themes: “The clients’ awareness” implies the cognitive aspect of readiness and “the clients’ attitudes” implies the psychological aspect of readiness, both of which have perceived to cultivate a fertile context through which the clients could access and use the mental health services more easily. Conclusions: For the health care system in Isfahan, Iran to be successful in delivering mental health services, training programs directed to prepare service users should be considered. Improving the clients’ favorable attitudes and awareness should be considered. PMID:24554948

The clients' readiness to use mental health care services: Experiences and perceptions from Iranian context.

Science.gov (United States)

Alavi, Mousa; Irajpour, Alireza

2013-11-01

Underutilization of mental health care services has been a challenge for the health care providers for many years. This challenge could be met in part by improving the clients' readiness to use such services. This study aimed to introduce the important aspects of the clients' readiness to use mental health services in the Iranian context. A thematic analysis of in-depth interviews was undertaken using a constant comparative approach. Participants (11 health professionals consisting of 3 physicians, 7 nurses, 1 psychologist, and 5 patients/their family members) were recruited from educational hospitals affiliated with Isfahan University of Medical Sciences, Iran. The credibility and trustworthiness was grounded on four aspects: factual value, applicability, consistency, and neutrality. The study findings uncovered two important aspects of the clients' readiness for utilizing mental health care services. These are described through two themes and related sub-themes: "The clients' awareness" implies the cognitive aspect of readiness and "the clients' attitudes" implies the psychological aspect of readiness, both of which have perceived to cultivate a fertile context through which the clients could access and use the mental health services more easily. For the health care system in Isfahan, Iran to be successful in delivering mental health services, training programs directed to prepare service users should be considered. Improving the clients' favorable attitudes and awareness should be considered.

Experiences of volunteering: a partnership between service users and a mental health service in the UK.

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Fegan, Colette; Cook, Sarah

2012-01-01

The aim of the study was to investigate how people with serious mental illness perceived the experience of volunteering for the health care organisation in which they had received a service. The study took a qualitative approach and in phase one, eleven service user volunteers were purposefully sampled and interviewed. In depth interviews were analysed using grounded theory. This paper describes the findings from phase one, and highlights the following themes to represent the volunteering experience: 1) rehearsing for a new direction; 2) treading carefully at first; 3) discovering my new self; and, 4) using my experience and extending relationships. These themes further support a tentative theoretical framework that considers supported volunteering to enhance recovery because it fosters positive risk taking and gives individuals a valued identity that integrates their mental health experience. In phase two, this framework will be tested with service users in more diverse volunteer positions. The findings of my study suggest that mental health services are in a unique position to build partnerships with service users to support their recovery and journeys toward employment by providing opportunities for volunteering.

Developing a New Zealand casemix classification for mental health services.

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Eagar, Kathy; Gaines, Phillipa; Burgess, Philip; Green, Janette; Bower, Alison; Buckingham, Bill; Mellsop, Graham

2004-10-01

This study aimed to develop a casemix classification of characteristics of New Zealand mental health services users. Over a six month period, patient information, staff time and service costs were collected from 8 district health boards. This information was analysed seeking the classification of service user characteristics which best predicted the cost drivers of the services provided. A classification emerged which explained more than two thirds of the variance in service user costs. It can be used to inform service management and funding, but it is premature to have it determine funding.

Hidden care: Revelations of a case-note audit of physical health care in a community mental health service.

Science.gov (United States)

Lawn, Sharon; Zabeen, Sara; Rowlands, Nikki; Picot, Sharon

2018-05-24

People with severe mental illness (SMI) are widely reported to be at an increased risk of morbidity and premature death due to physical health conditions. Mental health nurses are ideally placed to address physical and mental health comorbidity as part of their day-to-day practice. This study involved an audit of hardcopy and electronic clinical case-notes of a random sample of 100 people with SMI case managed by community mental health service in metropolitan South Australia, to determine how well physical health conditions and risk factors, screening, and follow-up are recorded within their service records. Every contact between 1 July 2015 and 30 June 2016 was read. One-way ANOVA, Scheffe's test, and Fisher's exact test determined any significant associations across audit variables, which included gender, age, income, living arrangement, diagnosis, lifestyle factors, recording of physical health measures, and carer status. A focus on physical health care was evident from everyday case-note records; however, because this information was 'buried' within the plethora of entries and not brought to the fore with other key information about the person's psychiatric needs, it remained difficult to gain a full picture of potential gaps in physical health care for this population. Under-reporting, gaps and inconsistencies in the systematic recording of physical health information for this population are likely to undermine the quality of care they receive from mental health services, the ability of mental health service providers to respond in a timely way to their physical healthcare needs, and their communication with other healthcare providers. © 2018 Australian College of Mental Health Nurses Inc.

Older Californians and the Mental Health Services Act: Is an Older Adult System of Care Supported?

Science.gov (United States)

Kietzman, Kathryn G; Dupuy, Danielle; Damron-Rodriguez, JoAnn; Palimaru, Alina; del Pino, Homero E; Frank, Janet C

2018-01-01

This policy brief summarizes findings from the first study to evaluate how California's public mental health delivery system has served older adults (60 years of age and over) since the passage of the Mental Health Services Act (MHSA) in 2004. Study findings indicate that there are unmet needs among older adults with mental illness in the public mental health delivery system. There are deficits in the involvement of older adults in the required MHSA planning processes and in outreach and service delivery, workforce development, and outcomes measurement and reporting. There is also evidence of promising programs and strategies that counties have advanced to address these deficits. Recommendations for improving mental health services for older adults include designating a distinct administrative and leadership structure for older adult services in each county; enhancing older adult outreach and documentation of unmet need; promoting standardized geriatric training of providers; instituting standardized data-reporting requirements; and increasing service integration efforts, especially between medical, behavioral health, aging, and substance use disorder services.

Twelve-month and lifetime health service use in Te Rau Hinengaro: The New Zealand Mental Health Survey.

Science.gov (United States)

Oakley Browne, Mark A; Wells, J Elisabeth; McGee, Magnus A

2006-10-01

To estimate the 12 month and lifetime use of health services for mental health problems. A nationwide face-to-face household survey carried out in 2003-2004. A fully structured diagnostic interview, the World Health Organization Composite International Diagnostic Interview (CIDI 3.0) was used. There were 12 992 completed interviews from participants aged 16 years and over. The overall response rate was 73.3%. In this paper, the outcomes reported are 12 month and lifetime health service use for mental health and substance use problems. Of the population, 13.4% had a visit for a mental health reason in the 12 months before interview. Of all 12 month cases of mental disorder, 38.9% had a mental health visit to a health or non-health-care provider in the past 12 months. Of these 12 month cases, 16.4% had contact with a mental health specialist, 28.3% with a general medical provider, 4.8% within the human services sector and 6.9% with a complementary or alternative medicine practitioner. Most people with lifetime disorders eventually made contact if their disorder continued. However, the percentages seeking help at the age of onset were small for most disorders and several disorders had large percentages who never sought help. The median duration of delay until contact varies from 1 year for major depressive disorder to 38 years for specific phobias. A significant unmet need for treatment for people with mental disorder exists in the New Zealand community, as in other comparable countries.

Reconstructing continuity of care in mental health services : a multilevel conceptual framework

NARCIS (Netherlands)

Wierdsma, Andre; Mulder, Cornelis; de Vries, Sanne; Sytema, Sjoerd

Continuity of mental health care is a key issue in the organization and evaluation of services for patients with disabling chronic conditions. Over many years, health services researchers have been exploring the conceptual boundaries between continuity of care and other service characteristics. On

Children with mental versus physical health problems: differences in perceived disease severity, health care service utilization and parental health literacy.

Science.gov (United States)

Dey, Michelle; Wang, Jen; Jorm, Anthony Francis; Mohler-Kuo, Meichun

2015-03-01

To compare children with mental and physical health problems regarding (1) perceived disease severity; (2) the impact of their condition on their families; (3) their utilization of health care services (including satisfaction with care); and (4) parents' health literacy about their child's condition and its treatment. Furthermore, we examined whether parents' health literacy differs between types of mental health condition. Parental reports about their 9- to 14-year-old children with mental (n = 785) or physical health problems (n = 475) were analyzed from the population-based National Survey of Children with Special Health Care Needs in Switzerland. Mental health problems were perceived as being more severe (p mental health problem mentioned having a particular person or place to contact if they needed information or advice regarding the child's condition (p = 0.004) and were satisfied with the health care services their child received (p mental health problems vs. parents of children with physical health problems (OR in the adjusted model = 1.92; 95 % CI 1.47-2.50; p mental health problem (although only a trend was observable for internalizing problems). The large impact of children's mental health conditions on themselves and their families might be reduced by adapting the provision of health care and by increasing parents' health literacy.

Attitudes Toward e-Mental Health Services in a Community Sample of Adults: Online Survey.

Science.gov (United States)

March, Sonja; Day, Jamin; Ritchie, Gabrielle; Rowe, Arlen; Gough, Jeffrey; Hall, Tanya; Yuen, Chin Yan Jackie; Donovan, Caroline Leanne; Ireland, Michael

2018-02-19

Despite evidence that e-mental health services are effective, consumer preferences still appear to be in favor of face-to-face services. However, the theory of planned behavior (TPB) suggests that cognitive intentions are more proximal to behavior and thus may have a more direct influence on service use. Investigating individual characteristics that influence both preferences and intentions to use e-mental health services is important for better understanding factors that might impede or facilitate the use of these services. This study explores predictors of preferences and intentions to access e-mental health services relative to face-to-face services. Five domains were investigated (demographics, technology factors, personality, psychopathology, and beliefs), identified from previous studies and informed by the Internet interventions model. We expected that more participants would report intentions to use e-mental health services relative to reported preferences for this type of support and that these 5 domains would be significantly associated with both intentions and preferences toward online services. A mixed sample of 308 community members and university students was recruited through social media and the host institution in Australia. Ages ranged between 17 and 68 years, and 82.5% (254/308) were female. Respondents completed an online survey. Chi-square analysis and t tests were used to explore group differences, and logistic regression models were employed to explore factors predicting preferences and intentions. Most respondents (85.7%, 264/308) preferred face-to-face services over e-mental health services. Relative to preferences, a larger proportion of respondents (39.6%, 122/308) endorsed intentions to use e-mental health services if experiencing mental health difficulties in the future. In terms of the 5 predictor domains, 95% CIs of odds ratios (OR) derived from bootstrapped standard errors suggested that prior experience with online services

A Population-Based Study of Postpartum Mental Health Service Use by Immigrant Women in Ontario, Canada.

Science.gov (United States)

Vigod, Simone; Sultana, Anjum; Fung, Kinwah; Hussain-Shamsy, Neesha; Dennis, Cindy-Lee

2016-11-01

Postpartum mental disorders are twice as common among immigrant women compared to nonimmigrant women in developed countries. Immigrant women may experience barriers to access and use of postpartum mental health services, but little is known about their service use on a population level. We described postpartum mental health service use of immigrant mothers living in Ontario, Canada, comparing to a referent group of mothers who were either born in Canada or had lived in Ontario or another Canadian province since 1985. Among all women in Ontario, Canada, delivering a live infant from 2008 to 2012 (n = 450,622), we described mental health service use within 1 year postpartum, including mental health physician visits, psychiatric emergency department visits, and psychiatric hospitalization. Adjusted odds ratios (aORs) and 95% confidence intervals (CIs) comparing immigrant women to the referent group were adjusted for maternal age, parity, income, rurality, mental health services in prior 2 years, and maternal and newborn health. Immigrant women (n = 123,231; 27%) were less likely to use mental health services than women in the referent group (14.1% vs. 21.4%; aOR, 0.59; 95% CI, 0.58 to 0.61), including for physician-based (13.9% vs. 21.1%; aOR, 0.59; 95% CI, 0.58 to 0.61) and emergency department (0.6% vs. 1.3%; aOR, 0.63; 95% CI, 0.57 to 0.68) services. Hospitalization risk was lower among immigrants (0.20% vs. 0.33%) but became similar after covariate adjustment (aOR, 0.92; 95% CI, 0.79 to 1.06). Underuse of postpartum mental health services may be contributing to the high burden of postpartum mental disorders among immigrant women. © The Author(s) 2016.

Geography of Service Delivery: On the Role of Mental Health Service Structure in Community Senior Services for Puerto Rican Older Adults

Science.gov (United States)

Velez Ortiz, Daniel

2009-01-01

The main purpose of this study was to examine the role of mental health services structure in community senior centers and how it interacts with Puerto Rican older adults' historical, social, and cultural experiences to relate to their perceptions, awareness, and utilization of mental health services. The study was carried out within a concurrent…

Ethnic Differences in Mental Health Status and Service Utilization: A Population-Based Study in Ontario, Canada.

Science.gov (United States)

Chiu, Maria; Amartey, Abigail; Wang, Xuesong; Kurdyak, Paul

2018-01-01

The purpose of this study was to compare the prevalence of self-reported mental health factors, mental health service use, and unmet needs across the 4 largest ethnic groups in Ontario, Canada: white, South Asian, Chinese, and black groups. The study population was derived from the Canadian Community Health Survey, using a cross-sectional sample of 254,951 white, South Asian, Chinese, and black residents living in Ontario, Canada, between 2001 and 2014. Age- and sex-standardized prevalence estimates for mental health factors, mental health service use, and unmet needs were calculated for each of the 4 ethnic groups overall and by sociodemographic characteristics. We found that self-reported physician-diagnosed mood and anxiety disorders and mental health service use were generally lower among South Asian, Chinese, and black respondents compared to white respondents. Chinese individuals reported the weakest sense of belonging to their local community and the poorest self-rated mental health and were nearly as likely to report suicidal thoughts in the past year as white respondents. Among those self-reporting fair or poor mental health, less than half sought help from a mental health professional, ranging from only 19.8% in the Chinese group to 50.8% in the white group. The prevalence of mental health factors and mental health service use varied widely across ethnic groups. Efforts are needed to better understand and address cultural and system-level barriers surrounding high unmet needs and to identify ethnically tailored and culturally appropriate clinical supports and practices to ensure equitable and timely mental health care.

Increasing use of mental health services in remote areas using mobile technology: a pre-post evaluation of the SMART Mental Health project in rural India.

OpenAIRE

Maulik, PK; Kallakuri, S; Devarapalli, S; Vadlamani, VK; Jha, V; Patel, A

2017-01-01

BACKGROUND: About 25% of the Indian population experience common mental disorders (CMD) but only 15-25% of them receive any mental health care. Stigma, lack of adequate mental health professionals and mental health services account for this treatment gap, which is worse in rural areas. Our project evaluated task shifting and mobile-technology based electronic decision support systems to enhance the ability of primary care health workers to provide evidence-based mental health care for stress,...

Informing the development of services supporting self-care for severe, long term mental health conditions: a mixed method study of community based mental health initiatives in England

Directory of Open Access Journals (Sweden)

Steve Gillard

2012-07-01

Full Text Available Abstract Background Supporting self-care is being explored across health care systems internationally as an approach to improving care for long term conditions in the context of ageing populations and economic constraint. UK health policy advocates a range of approaches to supporting self-care, including the application of generic self-management type programmes across conditions. Within mental health, the scope of self-care remains poorly conceptualised and the existing evidence base for supporting self-care is correspondingly disparate. This paper aims to inform the development of support for self-care in mental health by considering how generic self-care policy guidance is implemented in the context of services supporting people with severe, long term mental health problems. Methods A mixed method study was undertaken comprising standardised psychosocial measures, questionnaires about health service use and qualitative interviews with 120 new referrals to three contrasting community based initiatives supporting self-care for severe, long term mental health problems, repeated nine months later. A framework approach was taken to qualitative analysis, an exploratory statistical analysis sought to identify possible associations between a range of independent variables and self-care outcomes, and a narrative synthesis brought these analyses together. Results Participants reported improvement in self-care outcomes (e.g. greater empowerment; less use of Accident and Emergency services. These changes were not associated with level of engagement with self-care support. Level of engagement was associated with positive collaboration with support staff. Qualitative data described the value of different models of supporting self-care and considered challenges. Synthesis of analyses suggested that timing support for self-care, giving service users control over when and how they accessed support, quality of service user-staff relationships and decision

Young Men, Help-Seeking, and Mental Health Services: Exploring Barriers and Solutions.

Science.gov (United States)

Lynch, Louise; Long, Maggie; Moorhead, Anne

2018-01-01

International research has identified young men as reluctant to seek help for mental health problems. This research explored barriers and solutions to professional help seeking for mental health problems among young men living in the North West of Ireland. A qualitative approach, using two focus groups with six participants each and five face-to-face interviews, was conducted with men aged 18 to 24 years (total N = 17). Data were analyzed using thematic analysis. Seven key themes of barriers to professional help seeking were identified: "acceptance from peers," "personal challenges," "cultural and environmental influences," "self-medicating with alcohol," "perspectives around seeking professional help," "fear of homophobic responses," and "traditional masculine ideals." Five key themes of solutions to these barriers included "tailored mental health advertising," "integrating mental health into formal education," "education through semiformal support services," "accessible mental health care," and "making new meaning." Interesting findings on barriers include fear of psychiatric medication, fear of homophobic responses from professionals, the legacy of Catholic attitudes, and the genuine need for care. This study offers an in-depth exploration of how young men experience barriers and uniquely offers solutions identified by participants themselves. Youth work settings were identified as a resource for engaging young men in mental health work. Young men can be encouraged to seek help if services and professionals actively address barriers, combining advertising, services, and education, with particular attention and respect to how and when young men seek help and with whom they want to share their problems.