Improving Ghana's Mental Health Care Through Task Shifting – Psychiatrists and Health Policy Directors Views

2016 ◽  
Vol 33 (S1) ◽  
pp. S488-S488
Author(s):  
V. Agyapong ◽  
E. McAuliffe ◽  
C. Farren

BackgroundCurrently, Ghana has only twelfth psychiatrists in active service providing for the mental health needs of a population of nearly 25 million people. Ghana has therefore adopted a system of task-shifting to address the critical shortage of psychiatrists.AimTo examine the perception of psychiatrists and health policy directors about the government's policy to expand metal health care delivery in Ghana through a system of task-shifting from psychiatrists to community mental health workers (CMHWs).MethodsA self-administered semi-structured questionnaire was developed and administered to 11 psychiatrists and 29 health policy directors.ResultsOnly one psychiatrist and 3 (10.3%) health policy directors reported they were not aware of task-shifting within Ghana's mental health delivery system. Ten (91.1%) psychiatrists and 23 (79.3%) health policy directors were aware of a policy of the Government of Ghana to improve on the human resource base within mental health through a system task-shifting. Overall, 5 (45.5%) of the psychiatrists and 9 (31%) health policy directors perceived there are some resistance to the implementation of a policy of task shifting including resistance from traditional and spiritual healers, some psychiatrists, some community psychiatric nurses and psychologists. The majority of psychiatrists and health policy directors were of the view that CMHWs should be allowed to assess, diagnose and treat most of the common mental disorders.ConclusionPsychiatrists and health policy directors in Ghana support Governments policy to expand on mental health care delivery through a system of task-shifting despite their knowledge of resistance from certain professionals.Disclosure of interestThe authors have not supplied their declaration of competing interest.

2011 ◽  
Vol 26 (S2) ◽  
pp. 539-539 ◽  
Author(s):  
I. Grammatikopoulos ◽  
S. Koupidis ◽  
E. Petelos ◽  
P. Theodorakis

IntroductionBudgets allocated for mental health make up a relatively small proportion of total health expenditures, although there is an increasing burden of mental disorders.ObjectivesTo review the mental health situation in Greece with regards to mental health policy through review of relevant literature.AimsTo explore the basic implications of the economic crisis from a health policy perspective, reporting constraints and opportunities.MethodsA narrative review in PubMed/Medline along with a hand search in selected Greek biomedical journals was undertaken, relevant to mental health policy.ResultsGreece is among the OECD countries with high health expenditure as a percentage of Gross Domestic Product (9.7% of GDP in 2008) but it doesn’t have a specified budget for mental health and is mostly depended in out-of-pocket expenditure (48%). The system is plagued by problems, including geographical inequalities, overcentralization, bureaucratic management and poor incentives in the public sector. The lack of cost-effectiveness and the informal payments comprise a major source of inequity and inefficiency. Uneven regional distribution of psychiatrists exists and rural areas are mostly uncovered by mental health care facilities, as well as extramural mental health units and rehabilitation places, despite the current reorganization of the whole mental health care delivery system.ConclusionsThe core problem with mental health services in Greece is the shrinking budget with poor financial administration consistent with inadequate implementation of mental health policy. A clear authority with defined responsibility for overall mental health policy and budgetary matters is needed.


1977 ◽  
Vol 5 (2) ◽  
pp. 229-291 ◽  
Author(s):  
John J. Ensminger ◽  
Patrick Reilly

There have been a number of findings in the research on aftercare which have significance for courts and legislatures faced with choices involving planning and implementation of mental health systems. Both the older and newer methods of community mental health care delivery are analyzed. There appear to be cogent reasons for emphasizing the provision of aftercare facilities to poverty communities. Certain reasons for failures in aftercare treatment are identified. An analysis of the literature on aftercare indicates that there are certain elements important for the effective functioning of an aftercare system.


2018 ◽  
Vol 52 (11) ◽  
pp. 2234-2250 ◽  
Author(s):  
Heini Sisko Maarit Taiminen ◽  
Saila Saraniemi ◽  
Joy Parkinson

Purpose This paper aims to enhance the current understanding of digital self-services (computerized cognitive behavioral therapy [cCBT]) and how they could be better incorporated into integrated mental health care from the physician’s perspective. Service marketing and information systems literature are combined in the context of mental health-care delivery. Design/methodology/approach An online survey of 412 Finnish physicians was undertaken to understand physicians’ acceptance of cCBT. The study applies thematic analysis and structural equation modeling to answer its research questions. Findings Adopting a service marketing perspective helps understand how digital self-services can be incorporated in health-care delivery. The findings suggest that value creation within this context should be seen as an intertwined process where value co-creation and self-creation should occur seamlessly at different stages. Furthermore, the usefulness of having a value self-creation supervisor was identified. These value creation logic changes should be understood and enabled to incorporate digital self-services into integrated mental health-care delivery. Research limitations/implications Because health-care systems vary across countries, strengthening understanding through exploring different contexts is crucial. Practical implications Assistance should be provided to physicians to enable better understanding of the application and suitability of digital self-service as a treatment option (such as cCBT) within their profession. Additionally, supportive facilitating conditions should be created to incorporate them as part of integrated care chain. Social implications Digital self-services have the potential to serve goals beyond routine activities in a health-care setting. Originality/value This study demonstrates the relevance of service theories within the health-care context and improves understanding of value creation in digital self-services. It also offers a profound depiction of the barriers to acceptance.


2021 ◽  
pp. appi.ps.2020007
Author(s):  
Matthew Towicz ◽  
Wei Xiao Yang ◽  
Steven Moylan ◽  
Rachel Tindall ◽  
Michael Berk

2000 ◽  
Vol 28 (2) ◽  
pp. 263-266
Author(s):  
Michael C. Gottlieb ◽  
Caren C. Cooper

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