Outcomes of promotion, prevention, treatment and care

2016 ◽  
Vol 33 (S1) ◽  
pp. S3-S3
Author(s):  
M. Muijen

The WHO European Mental Health Action Plan encompasses promotion, prevention, treatment and recovery, within the context of a model of mental health that proposes a set of socio-economic and biological determinants that predispose to vulnerabilities and increase the risk of disorders. These determinants also negatively affect access to and quality of care. Such risk factors are shared with common non-communicable disorders, increasing the risk of morbidity and early mortality for people with mental disorders.Mental health promotion and prevention actions should therefore be addressing determinants such as alcohol and smoking. However, such determinants are not equally distributed in the population, but cluster among vulnerable groups, such as those with a low income, the unemployed and minority groups. These groups overlap with the populations services struggle to reach. In addition, both primary care and specialist mental health services struggle to identify and treat people with co-morbidities. This suggests that connections need to be established between public health, primary care and specialist mental health services.WHO is focussing on the strengthening of primary care and the interface with mental health services. In particular, there is an urgent need to screen people who present with symptoms of NCDs or mental disorders for common determinants and co-morbidities. Effective health promotion activities need to be offered to populations at risk, in addition to universal health promotion interventions such as taxation or advertising bans. Some examples will be presented.Disclosure of interestThe author has not supplied his declaration of competing interest.

Author(s):  
Kilda Çela Gusha ◽  
Irena Shala ◽  
Remila Kalo

Mental health problems are conditions that do not meet the criteria for disease but affect the normal quality and continuity of everyday life. They are the emotional and psychological difficulties of the individual, which occur as a result of circumstantial or persistent stresses or of a reflection of the emotions between the individual and the environment where he lives (WHO, 2005). Health is seen as "not just a lack of sickness or disability," but rather as "a complete physical, mental and social well-being." This definition significantly expands the concept of mental health, which should not be defined in a restrictive manner as the absence of mental disorders, but should be defined in a positive and comprehensive view (WHO, 1985). Ultimately, mental health is defined as "a state of well-being in which the individual realizes his or her own potential, is able to cope with daily life concerns, is productive and fruitfully in his work, and is capable of delivering his contribution to the community where he lives (WHO, 2001). Mental health problems are usually associated with important concerns in social, professional, or other important activities. In many cases, there appears to be a continuity between mental health problems and mental disorders, making the diagnosis even more complex (CDC, 2011). Policies and Legislative Frameworks. Law on MS – 1996. Implementation of LLL remains low as a consequence of inadequate infrastructure (health, social and legal). There is no national or local body to monitor human or patient rights in the institutions of the MS.Policy on the Development of Mental Health Services in Albania - March 2003. Action Plan for the Development of Mental Health Services in Albania - May 2005. Mental and emotional problems are a concern for many elderly people. Depression often occurs as a result of the death of a spouse or close friends. Even this kind of loss and even more important and more common is the loss of respect of others. With retirement an individual does not feel more useful to his family, to society, and even more to himself.


2021 ◽  
pp. 1-4
Author(s):  
Ovais Wadoo ◽  
Sami Ouanes ◽  
Mohamed Ali Siddig Ahmed ◽  
Iman Saeed Ahmed Saeid ◽  
Samya Ahmad AlAbdulla ◽  
...  

Primary care is geared to manage patients with mild to moderate presentations of common mental disorders and to refer patients with more severe mental disorders to specialist mental health services. With growing demand for specialty care, the quality of the referral is increasingly important to ensure efficient patient flow across the primary/secondary care interface and appropriate use of secondary services. We report on an initiative in a Qatari mental health clinic to improve the quality of referrals from primary care to specialist mental health services through an educational intervention for family physicians. We highlight the problem, the intervention and the outcome of our initiative, which was the first of its kind in the region. The number of inappropriate referrals fell by 93%, and the number of referrals with inadequate clinical information declined from 15 (January 2019) to 1 (September 2019). Feedback was very positive; respondents reported feeling supported, with better understanding of care pathways, the scope of primary care and mental health services.


2002 ◽  
Vol 10 (3) ◽  
pp. 253-258 ◽  
Author(s):  
Ian Hickie ◽  
Tracey Davenport ◽  
Elizabeth Scott ◽  
Hugh Morgan

Objective: To highlight opportunities for enhancing mental health services in primary care through utilisation of e-health systems. Specifically, an information-based website (provided by ‘beyondblue: the national depression initiative’) and a web-based support system for general practitioners (provided by ‘SPHERE: a national depression project’) are described. Conclusions: Recommendations regarding potential roles for e-health systems in association with Australian primary care are outlined.


2020 ◽  
Author(s):  
Lidia Gouveia ◽  
Kathryn Lovero ◽  
Wilza Fumo ◽  
Afonso Mazine Tiago Fumo ◽  
Palmira Dos Santos ◽  
...  

Abstract BackgroundIn Mozambique, human and financial resources for public mental health services are extremely limited. Understanding the mental health needs of those seeking healthcare can inform efficient targeting of mental health services. We examined if the frequency of mental disorders in a health facility varied based on the level of specialization of such facility, from primary care without mental health specialists (PrCMH-), to those with mental health specialists (PrCMH+) and tertiary care (TerC), where both inpatient and outpatient mental health services are available.MethodsParticipants were adults seeking health or mental health services at six facilities (2 PrCMH+, 3 PrCMH-, and 1 TerC) in the cities of Maputo and Nampula in Mozambique. Mental disorders were assessed by the MINI International Neuropsychiatric Interview (MINI) 4.0.0. We compared the sociodemographic characteristics and MINI diagnoses across the three types of health facilities. Multiple logistic regression models determined the likelihood that a person seeking services at each type of facility would have any mental disorder, common mental disorders (CMD), severe mental disorders (SMD), substance use disorders (SUD), and moderate-to-high suicide risk, adjusting for sociodemographic factors. ResultsOf the 612 total participants, 52.6% (n=322) were positive for at least one mental disorder: 37.1% were positive for CMD, 28.9% for SMD, 13.2% for SUD, and 10.5% had suicide risk. Presence of any mental disorder was highest in TerC (62.5%) and lowest in PrCMH- (48.4%). Adjusting for sociodemographic covariates, participants in PrCMH+ were significantly more likely to have SMD (OR: 1.85, 95%CI: 1.10-3.11) and SUD (OR: 2.79, 95%CI: 1.31-5.94) than participants in PrCMH-; participants in TerC were more likely to have CMD (OR: 1.70, 95%CI: 1.01-2.87) and SUD (OR: 2.57, 95%CI: 1.14-5.79) than in PrCMH-. Suicide risk was the only condition that did not differ across facility types.ConclusionsAs anticipated, people with mental disorders were more likely to be cared for at facilities with mental health specialists. However, our study suggests there is a remarkably high frequency of mental disorders across different types of facilities within the Mozambican healthcare system. These results suggest a need to increase mental health services at the primary care level.


2015 ◽  
Vol 2015 ◽  
pp. 1-5 ◽  
Author(s):  
Jidda Mohammed Said ◽  
Abdulmalik Jibril ◽  
Rabbebe Isah ◽  
Omeiza Beida

Mental and neurological disorders are common in the primary health care settings. The organization of mental health services focuses on a vertical approach. The northeast as other low income regions has weak mental health services with potentially huge mental health burden. The manner of presentations and utilization of these services by the population may assist in determining treatment gap. We investigated the pattern and geographical distribution of presentations with mental disorders and explored the linkages with primary care in northeastern Nigeria over the last decade. A retrospective review of hospital-based records of all the available mental health service units in the region was conducted over a decade spanning between January 2001 and December 2011. A total of 47, 664 patients attended available mental health facilities within the past decade in the northeast. Overwhelming majority (83%,n=39,800) attended the region’s tertiary mental health facility. A substantial proportion (30%,n=14,440) had primary physical illness, while 18%,n=8606, had primary neurologic disorders. The commonest physical comorbidity was hypertension (4%) and diabetes (2%). A significant proportion of the populace with mental disorders appeared not to be accessing mental health care services, even when it is available. Meaningful efforts to improve access to mental health services in the northeast region of Nigeria will require successful integration of mental health into primary and general medical services.


Author(s):  
Getinet Ayano

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


2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
J M T Mendonca ◽  
A A Freire ◽  
T Rewa ◽  
D Zorzi ◽  
C N Monteiro ◽  
...  

Abstract Introduction Although it is already known that 14% of the global disease burden is attributed to Mental, neurological and substance use disorders, three quarters of people affected by mental disorders in low-income countries do not access treatment. Launched by WHO in 2008, the mhGAP Intervention Guide is a simple technical tool based on scientific evidence which facilitates the management of priority mental health conditions, using protocols for clinical decision in the PHC centers. Objective This work aims to describe the methodology of training the primary care staff and specialized mental health workers from São Paulo, Brazil, in the mhGAP Intervention Guide. Methods The training was designed in three steps. In the first step, mhGAP Training of Trainers and Supervisors (ToTS) capacitated 76 trainers. In the second a working group (WG) responsible for planning the replication for 100% of the technical staff of 13 PHC centers and 3 mental health community services was formed. The WG defined that the trainers should attend in two alignment moments to guarantee uniformity. And the third stage is the replication, divided in nine groups with forty participants, throughout the year 2020. Results The training promotes the exchange of experiences between the participants, who share their personal experiences, enriching the discussions. They also approximate the relationship between PHC and Mental Health services, as well as favors the interdisciplinary and collaborative practice. The PHC workers are more aware of their responsibility in mental health care and feel more empowered. As a challenge, the PHC professionals showed insecurity and reluctance to give the training. Conclusions The training provides evidence-based tools for the assessment and integrated management of priority mental disorders by PHC professionals. Key messages The mhGAP Intervention Guide training strengths the relationship between Primary Care and Mental Health services and improves Mental Health treatment access. The training improves integrated management of priority mental disorders by PHC professionals.


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