An Audit of Mental Health Care Plans in Community Mental Health Services for Older Persons in Rural Communities in a State in Australia

Guided by international best practice and evidence-based medicine, the Qatar mental health service has undergone a major transformation in the last two decades, replacing the institution-based service with an accessible multidisciplinary community-based service. In this paper, we provide a brief historical background to mental health services in Qatar, and the progress and development towards community-based mental health-care provision. We also explore the challenges facing this new model of care in Qatar including social and cultural sensitivities, and the various solutions adopted to overcome these challenges. We outline the comprehensive plans envisaged to further develop Qatar community mental health services, including the provision of accessible, integrated and multimodal mental health care within primary care settings.

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Community Mental Health Services in Greece: development, challenges and future directions

Consortium Psychiatricum ◽

10.17816/cp111 ◽

2021 ◽

Author(s):

Konstantinos Panagiotis Anargyros ◽

Andreas Spyridon Lappas ◽

Nikos Christodoulou

Keyword(s):

Mental Health ◽

Health Care ◽

Mental Health Services ◽

Community Mental Health ◽

Health Services ◽

Mental Health Care ◽

Current System ◽

Community Mental Health Services ◽

Service Development ◽

The European Union

The current system of mental health care in Greece was created in accordance with the European Union and other international principles for mental health care provisions. Whereas Greece has been reforming its system of mental healthcare since at least the 80s, the main recent Greek effort has been Psychargos, a programme which began in 2000 and is still in effect. During the last two decades the Greek mental health system has been gradually shifting to a community-based system of care. Various different services with unique, yet intertwined, responsibilities have been introduced. The Greek system of mental health care still faces challenges, and the mental health reform is on-going. Future goals should be to improve the current framework of care, improve access to care by establishing fit-for-purpose community mental health services across the country, enhance multidisciplinary collaboration and patient involvement, integrate community mental health care with physical and social care services, and to ensure that service development is driven by need. Crucially, such aims demand the adoption of a culture of clinical governance and a consistent shift from traditional therapeutic care to person-centered psychiatry and preventive psychiatry.

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Community mental health care after self-harm: A retrospective cohort study

Australian & New Zealand Journal of Psychiatry ◽

10.1177/0004867416676366 ◽

2016 ◽

Vol 51 (7) ◽

pp. 727-735 ◽

Cited By ~ 7

Author(s):

Matthew J Spittal ◽

Fiona Shand ◽

Helen Christensen ◽

Lisa Brophy ◽

Jane Pirkis

Keyword(s):

Mental Health ◽

Health Care ◽

Community Mental Health ◽

Health Services ◽

Mental Health Care ◽

Psychiatric Inpatient ◽

Community Mental Health Services ◽

Community Mental Health Care ◽

Self Harm

Objective: Presentation to hospital after self-harm is an opportunity to treat underlying mental health problems. We aimed to describe the pattern of mental health contacts following hospital admission focusing on those with and without recent contact with community mental health services (connected and unconnected patients). Methods: We undertook a data linkage study of all individuals admitted as a general or psychiatric inpatient to hospital after self-harm in New South Wales, Australia, between 2005 and 2011. We identified the proportion of admissions where the patient received subsequent in-person community mental health care within 30 days of discharge and the factors associated with receipt of that care. Results: A total of 42,353 individuals were admitted to hospital for self-harm. In 41% of admissions, the patient had contact with a community mental health service after discharge. Patients connected with community mental health services had 5.33 (95% confidence interval = [5.09, 5.59]) times higher odds of follow-up care than unconnected patients. Other factors, such as increasing age and treatment as a psychiatric inpatient, were associated with lower odds of follow-up community care. Conclusion: Our study suggests that full advantage is not being taken of the opportunity to provide comprehensive mental health care for people who self-harm once they have been discharged from the inpatient setting. This is particularly the case for those who have not previously received community mental health care. There appears to be scope for system-level improvement in the way in which those who are treated for self-harm are followed up in the community.

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Introducing Shared Mental Health Care in Northwestern Ontario: An Analysis of Changing Referral Patterns of Primary Care Providers

Canadian Journal of Community Mental Health ◽

10.7870/cjcmh-2015-020 ◽

2015 ◽

Vol 34 (2) ◽

pp. 63-72 ◽

Cited By ~ 1

Author(s):

Graham Gaylord ◽

S. Kathleen Bailey ◽

John M. Haggarty

Keyword(s):

Mental Health ◽

Primary Care ◽

Health Care ◽

Mental Health Services ◽

Health Services ◽

Mental Health Care ◽

Community Mental Health Services ◽

Primary Care Providers ◽

Care Providers ◽

Referral Patterns

This study describes a shared mental health care (SMHC) model introduced in Northern Ontario and examines how its introduction affected primary care provider (PCP) mental health referral patterns. A chart review examined referrals (N = 4,600) from 5 PCP sites to 5 outpatient community mental health services from January 2001 to December 2005. PCPs with access to SMHC made significantly more mental health referrals (p < 0.001). Two demographically similar PCPs were then compared, one co-located with SMHC. Referrals for depression to non-SMHC mental health services were 1.69 times more likely to be from the PCP not co-located with SMHC (p < 0.001). Findings suggest SMHC increases access to care and decreases demand on existing mental health services.

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Compulsory community mental health care: Oceania

10.1093/med/9780198788065.003.0020 ◽

2016 ◽

Author(s):

Anthony J. O’Brien

Keyword(s):

Mental Health ◽

Health Care ◽

Developing Countries ◽

Mental Health Services ◽

Community Mental Health ◽

Health Services ◽

Mental Health Care ◽

Developed Countries ◽

Community Treatment ◽

Community Mental Health Care

Oceania is characterized by the diversity of countries and by highly variable provision of mental health services and community mental health care. Countries such as Australian and New Zealand have well-developed mental health services with a high level of provision, but many less developed countries lack mental health infrastructure. Some developing countries such as Samoa and Tonga have passed mental health legislation with provision for community treatment orders, but this legal measure is probably not a useful mechanism for advancing mental health care in developing countries. Instead, efforts to improve provision of care seem best directed to the primary care sector, and to the general health workforce, rather than to specialists. The UN CRPD offer extensions of human rights to people with mental illness and most countries in Oceania have signed it. However, the absence of a regional rights tribunal potentially limits the realization of those rights.

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The Role of Non-Governmental Organisations (NGOs) in Community-based Mental Health Services in Northern Nigeria: Prospects and Challenges

TEXILA INTERNATIONAL JOURNAL OF PUBLIC HEALTH ◽

10.21522/tijph.2013.09.04.art003 ◽

2021 ◽

Vol 9 (4) ◽

pp. 24-37

Author(s):

Emmanuel Ejembi Anyebe

Keyword(s):

Mental Health ◽

Health Care ◽

Mental Health Services ◽

Community Mental Health ◽

Health Services ◽

Mental Health Care ◽

Northern Nigeria ◽

Health Issues ◽

Community Based

Despite the role of non-governmental organisations (NGOs) in many health issues, their role in community mental health services in parts of northern Nigeria is unknown. This study explored the availability and role of NGOs in community-mental health care services, with a view to identifying the prospects and challenges. Using the convergent mixed methods approach, a self-constructed questionnaire and in-depth interviews were used to collect data from 205 conveniently and purposively selected study participants. Descriptive and thematic analyses were done and then triangulated to meet research objectives. There is a scarcity of mental health-related NGOs in the study areas; only one NGO engaged in the mental health activities was identified (13.4%). Surprisingly attempts by the only available NGO at providing the needed community-based mental health care were “frustrated” by certain government policy directions, which appear to paralyse activities and intentions of the only existing one. NGOs for mental health care are lacking. There is a dire need for NGO activities in mental health care. Efforts should be made to attract NGOs to the study areas in view of the increasing burden of mental health issues in the communities in the setting. Governments at all levels, community-based organisations and traditional institutions can be instrumental to this. NGOs within and outside the study areas focusing on community health in general and mental health care, in particular, may also interrogate this situation further for urgent intervention.

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Changes in community mental health services availability and suicide mortality in the US: A retrospective study

10.21203/rs.3.rs-15835/v1 ◽

2020 ◽

Author(s):

Peiyin Hung ◽

Susan Busch ◽

Yi-Wen Shih ◽

Alecia McGregor ◽

Shi-Yi Wang

Keyword(s):

Mental Health ◽

Health Care ◽

Mental Health Services ◽

Community Mental Health ◽

Health Services ◽

Mental Health Care ◽

Mental Health Professionals ◽

The United States ◽

Suicide Mortality ◽

Per Capita

Abstract Background: Despite the fact that the overwhelming majority of mental health services are delivered in outpatient settings, the effect of changes in non-hospital-based mental health care on increased suicide rates is largely unknown. This study examines the association between changes in community mental health center (CMHC) supply and suicide mortality in the United States. Methods: Retrospective analysis was performed using data from National Mental Health Services Survey (N-MHSS) and the Centers for Disease Control and Prevention (CDC) Wide-Ranging Online Data for Epidemiologic Research (WONDER) (2014-2017). Population-weighted multiple linear regressions were used to examine within-state associations between CMHCs per capita and suicide mortality. Models controlled for state-level characteristics (i.e., number of hospital psychiatric units per capita, number of mental health professionals per capita, age, race, and percent low-income), year and state. Results: From 2014 to 2017, the number of CMHCs decreased by 14% nationally (from 3,406 to 2,920). Suicide increased by 9.7% (from 15.4 to 16.9 per 100,000) in the same time period. We find a small but negative association between the number of CMHCs and suicide deaths (-0.52, 95% CI -1.08 to 0.03; p=0.066). Declines in the number of CMHCs from 2014 to 2017 may be associated with approximately 6% of the national increase in suicide, representing 263 additional suicide deaths. Conclusions: State governments should avoid the declining number of CMHCs and the services these facilities provide, which may be an important component of suicide prevention efforts. Keywords: Suicide, Deinstitutionalization, Access to mental health care, Community mental health

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Borderline personality disorder: resource utilisation costs in Ireland

Irish Journal of Psychological Medicine ◽

10.1017/ipm.2018.30 ◽

2018 ◽

pp. 1-8 ◽

Cited By ~ 5

Author(s):

J. Bourke ◽

A. Murphy ◽

D. Flynn ◽

M. Kells ◽

M. Joyce ◽

...

Keyword(s):

Mental Health ◽

Health Care ◽

Mental Health Services ◽

Community Mental Health ◽

Health Services ◽

Resource Use ◽

Community Mental Health Services ◽

Borderline Personality ◽

Resource Utilisation ◽

Care Costs

Objectives Borderline personality disorder (BPD) is characterised by recurring crises, hospitalisations, self-harm, suicide attempts, addictions, episodes of depression, anxiety and aggression and lost productivity. The objective of this study is to determine the use of direct health care resources by persons with BPD in Ireland and the corresponding costs. Methods This prevalence-based micro-costing study was undertaken on a sample of 196 individuals with BPD attending publicly funded mental health services in Ireland. All health care costs were assessed using a resource utilisation questionnaire completed by mental health practitioners. A probabilistic sensitivity analysis, using a Monte Carlo simulation, was performed to examine uncertainty. Results Total direct healthcare cost per individual was €10 844 annually (ranging from 5228 to 20 609). Based on a prevalence of 1% and an adult population (18–65 years) of 2.87 million, we derived that there were 28 725 individuals with BPD in Ireland. Total yearly cost of illness was calculated to be up to €311.5 million. Conclusions There is a dearth of data on health care resource use and costs of community mental health services in Ireland. The absence of this data is a considerable constraint to research and decision-making in the area of community mental health services. This paper contributes to the limited literature on resource use and costs in community mental health services in Ireland. The absence of productivity loss data (e.g. absenteeism and presenteeism), non-health care costs (e.g. addiction treatment), and indirect costs (e.g. informal care) from study participants is a limitation of this study.

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