scholarly journals Improving the Quality of Children’s Mental Health Care with Progress Measures: A Mixed-Methods Study of PCIT Therapist Attitudes

2021 ◽  
Author(s):  
Corinna C. Klein ◽  
B. Erika Luis Sanchez ◽  
Miya L. Barnett
Keyword(s):  
Mental Health ◽  
Health Care ◽  
General Practice ◽  
Qualitative Interviews ◽  
Behavioral Observation ◽  
Parent Report ◽  
Therapist Attitudes ◽  
Child Interaction ◽  
Report Measure

AbstractProgress measures are an evidence-based technique for improving the quality of mental health care, however, clinicians rarely incorporate them into treatment. Research into how measure type impacts clinician preference has been recommended to help improve measure implementation. Parent–Child Interaction Therapy (PCIT) is an assessment-driven treatment that serves as an ideal intervention through which to investigate measure preferences given its routine use of two types of assessments, a behavioral observation (the Dyadic Parent–Child Interaction Coding System) and a parent-report measure (the Eyberg Child Behavior Inventory). This study investigated PCIT therapist attitudes towards progress measures used within PCIT and children’s mental health treatment generally. A mixed-method (QUAN + QUAL) study design examined PCIT therapist attitudes towards two types of progress measures and measures used in two contexts (PCIT and general practice). Multi-level modeling of a survey distributed to 324 PCIT therapists identified predictors of therapist attitudes towards measures, while qualitative interviews with 23 therapists expanded and clarified the rationale for differing perceptions. PCIT therapists reported more positive attitudes towards a behavioral observation measure, the DPICS, than a parent-report measure, the ECBI, and towards measures used in PCIT than in general practice. Clinician race/ethnicity was significantly related to measure-specific attitudes. Qualitative interviews highlighted how perceptions of measure reliability, type of data offered, ease of use, utility in guiding sessions and motivating clients, and embeddedness in treatment protocol impact therapist preferences. Efforts to implement progress monitoring should consider preferences for particular types of measures, as well as how therapists are trained to embed measures in treatment.

Depressions Plural

2017 ◽  
Author(s):  
K W M (Bill) Fulford ◽  
David Crepaz-Keay ◽  
Giovanni Stanghellini
Keyword(s):  
Quality Of Life ◽  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Personal Values ◽  
The Political ◽  
Medical Law ◽  
Isaiah Berlin ◽  
Political Philosopher

This chapter examines how values influence the heterogeneity of depression. The plurality of values is increasingly significant for contemporary person-centred mental health care with its emphasis on quality of life and development of self-manvnagement skills. Values-based practice is a partner with medical law invn working with the plurality of personal values. The chapter explains what values are, shows how the plurality of values influences the heterogeneity of depression at several levels, and provides an overview of values-based practice. It looks at the resources available for combining values-based practice with medical law in contemporary person-centred care and indicates some of the challenges this raises. It concludes with a brief reflection on these challenges understood as an instance of what the political philosopher Isaiah Berlin called the challenge of pluralism.

scholarly journals The Quality Mental Health Care Network: A roadmap to improving quality mental healthcare in Canada

2021 ◽  
Vol 34 (2) ◽  
pp. 100-106
Author(s):  
Emily J. Follwell ◽  
Siri Chunduri ◽  
Claire Samuelson-Kiraly ◽  
Nicholas Watters ◽  
Jonathan I. Mitchell
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Focus Groups ◽  
Lived Experiences ◽  
Mental Healthcare ◽  
Care Network ◽  
Key Informant ◽  
Health Care Network

Although there are numerous quality of care frameworks, little attention has been given to the essential concepts that encompass quality mental healthcare. HealthCare CAN and the Mental Health Commission of Canada co-lead the Quality Mental Health Care Network (QMHCN), which has developed a quality mental healthcare framework, building on existing provincial, national, and international frameworks. HealthCare CAN conducted an environmental scan, key informant interviews, and focus groups with individuals with lived experiences to develop the framework. This article outlines the findings from this scan, interviews and focus groups.

scholarly journals Trends in treatment for patients with depression in general practice in Norway, 2009–2015: nationwide registry-based cohort study (The Norwegian GP-DEP Study)

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Sabine Ruths ◽  
Inger Haukenes ◽  
Øystein Hetlevik ◽  
Tone Smith-Sivertsen ◽  
Stefan Hjørleifsson ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
General Practice ◽  
Cohort Study ◽  
Drug Treatment ◽  
Time Trends ◽  
Older Patients ◽  
Antidepressant Drug ◽  
Depression Care ◽  
Patient Gender

Abstract Background Depression is highly prevalent, but knowledge is scarce as to whether increased public awareness and strengthened government focus on mental health have changed how general practitioners (GPs) help their depressed patients. This study aimed to examine national time trends in GP depression care and whether trends varied regarding patient gender, age, and comorbidity. Methods Nationwide registry-based cohort study, Norway. The study population comprised all residents aged 20 years or older with new depression diagnoses recorded in general practice, 2009–2015. We linked reimbursement claims data from all consultations in general practice for depression with information on demographics and antidepressant medication. The outcome was type(s) of GP depression care during 12 months from the date of diagnosis: (long) consultation, talking therapy, antidepressant drug treatment, sickness absence certification, and referral to secondary mental health care. Covariates were patient gender, age, and comorbidity. The data are presented as frequencies and tested with generalized linear models. Results We included 365,947 new depression diagnoses. Mean patient age was 44 years (SD = 16), 61.9 % were women, 41.2 % had comorbidity. From 2009 to 2015, proportions of patients receiving talking therapy (42.3–63.4 %), long consultations (56.4–71.8 %), and referral to secondary care (16.6–21.6 %) increased, while those receiving drug treatment (31.3–25.9 %) and sick-listing (58.1–50 %) decreased. The trends were different for gender (women had a greater increase in talking therapy and a smaller decrease in sick-listing, compared to men), age (working-aged patients had a smaller increase in talking therapy, a greater increase in long consultations, and a smaller decrease in antidepressant drug use, compared to older patients) and comorbidity (patients with mental comorbidity had a smaller increase in talking therapy and a greater increase in long consultations, compared to those with no comorbidity and somatic comorbidity). Conclusions The observed time trends in GP depression care towards increased provision of psychological treatment and less drug treatment and sick-listing were in the desired direction according to Norwegian health care policy. However, the large and persistent differences in treatment rates between working-aged and older patients needs further investigation.

scholarly journals Inpatient Volume and Quality of Mental Health Care Among Patients With Unipolar Depression

2018 ◽  
Vol 69 (7) ◽  
pp. 797-803 ◽  
Author(s):  
Line Ryberg Rasmussen ◽  
Jan Mainz ◽  
Mette Jørgensen ◽  
Poul Videbech ◽  
Søren Paaske Johnsen
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Unipolar Depression

scholarly journals Improving the quality of mental health care

2009 ◽  
Vol 21 (6) ◽  
pp. 415-420 ◽  
Author(s):  
M. Funk ◽  
C. Lund ◽  
M. Freeman ◽  
N. Drew
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care

Determinants of Quality of Life during the COVID-19 pandemic: An analysis of a large sample of Brazilian Health Professionals

2021 ◽  
Author(s):  
Jonas Jardim de Paula ◽  
Danielle de Souza Costa ◽  
Antônio Geraldo Silva ◽  
Débora Marques de Miranda ◽  
Leandro Malloy-Diniz
Keyword(s):  
Quality Of Life ◽  
Mental Health ◽  
Risk Factors ◽  
Health Care ◽  
Social Relations ◽  
Health Professionals ◽  
World Health ◽  
Large Sample ◽  
Explained Variance

Quality of Life (QoL) is a multidimensional estimate of biopsychosocial health and wellbeing.1 The COVID-19 pandemic led to an abrupt change in our lifestyle, demanding resilience and coping mechanisms2. Health care providers are in the frontline of COVID-19 patients’ diagnosis, treatment, and rehabilitation, and there is a well-documented impact of this context on their physical and mental health2. This might impact their wellbeing and reduce their quality of life. In this research letter, we investigated which factors are associated with QoL in Brazilian healthcare professionals. We aim to investigate both protective and risk factors for the four main aspects of QoL: physical, psychological, social relations, and environment. We assessed 97.771 Brazilian adults, most (92.3%) health professionals of different professions from all the five-country regions. All included individuals agreed in a written consent to participate. Participants showed an average of 35.45 years old (±9.49) and were predominantly female (80%). They answered an online questionnaire about sociodemographic aspects, measures of mental health, and quality of life in the first semester of 2020. A detailed description of the sample and procedures can be found elsewhere3. All participants answered the WHOQoL-BREF, a standardized tool for QoL assessment developed by the World Health Organization. Stepwise linear regression analysis was used to assess the role of sociodemographic factors, previously diagnosed mental disorders, COVID-19 related symptoms as well a series of specific questions regarding participants worries and perceptions about the pandemic, including the protective behaviors' adoption (social distancing, usage of masks and sanitizer, among others). A full list of variables (64 in total) is available on the SAMBE webpage (http://abpbrasil.org.br/pcabp/). Since we have a large sample size our statistical power is about 99% (alpha=0.01) to detect small effect sizes. To simplify our results and allow a more direct application to real-life settings we only included significant predictors which showed at least 1% of adjusted explained variance in the stepwise models. The stepwise regression model was summarized in the figure below. All regression models were significant (p<0.001) as well all the predictors reported in the Figure. Total explained variance was 26% for Physical QoL, 27% for Psychological, 13% for Social Relations, and 19% for Environmental. A history of previous depression, presence of Headache, and the perception of worsening in home relationships were risk factors for lower QoL in all four domains. Our results suggest a multidimensional pattern of determinants of QoL in health care professionals in the early days of the pandemic. Interesting features emerged as predictors of QoL such as changes in home relationships, worsening in work productivity, and mental health. Expected and new predictors may shed light on which factors should be considered in interventions aiming at the development of mitigation of impact QoL in these populations.

Guidelines for Adapting Mindfulness-Based School Interventions with Underserved Youth

2021 ◽  
Author(s):  
Mary Lynd Phan ◽  
Tyler L Renshaw
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Health Disparities ◽  
Quality Of Care ◽  
Health Services ◽  
Social Emotional ◽  
Emotional Competencies ◽  
Underserved Youth ◽  
Diverse Youth

Low-income and ethnically diverse youth in the United States have unmet needs for mental health services; however, these same youth are unlikely to be connected with high-quality mental health care. Promoting social-emotional competencies through school-based service delivery is one potential solution for improving the accessibility and quality of care for diverse youth facing mental health disparities. Mindfulness, conceived as a set of practices to cultivate social-emotional competencies, can therefore be useful for improving the accessibility and quality of care for diverse youth facing mental health disparities. Given the growing interest in MBSIs and the need to enhance equity in youth mental health services more generally, we provide guidelines to help practicing clinicians successfully adapt and implement MBSIs with underserved youth. First, we offer recommendations for clinicians to enhance underserved youths’ engagement with MBSIs. Next, we overview implementation approaches that clinicians could use for increasing access to MBIs in school settings. Following, we discuss strategies clinicians might employ when working with teachers to effectively implement MBSIs with underserved youth in their classrooms. Ultimately, we hope the guidelines offered in this paper might help inform better practice—as well as motivate further, better research—that advances equitable mental health care in schools with underserved youth.

scholarly journals Prevention of burn-out

1997 ◽  
Vol 3 (5) ◽  
pp. 282-289 ◽  
Author(s):  
Glenn A. Roberts
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Medical Association ◽  
Job Stress ◽  
Quality Of Health Care ◽  
Medical Profession ◽  
British Medical Association ◽  
Drugs And Alcohol ◽  
Burn Out

There is a widespread concern that the medical profession is itself sick. This is represented in professional disillusionment and demoralisation, an increasing inclination to consider leaving the profession, and the ill-health of its practitioners in terms of their mental health, marriages and use of drugs and alcohol (British Medical Association, 1992). These trends have been attributed, at least in part, to protracted job stress and dissatisfaction, which may in turn be a major determinant in the quality of health care (Caplan, 1994). Although these issues have been cautiously acknowledged for some time, the concept of ‘burn-out’ has provided an opportunity for more open acceptance and creative debate.

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