Evidence-based psychosocial measures in rehabilitation

2016 ◽  
Vol 33 (S1) ◽  
pp. S6-S6
Author(s):  
T. Becker ◽  
U. Guehne ◽  
S. Riedel-Heller

BackgroundPsychosocial interventions are essential tools in mental health care and rehabilitation. A range of interventions relevant to rehabilitation that are covered in a German DGPPN S3 guideline on psychosocial interventions are discussed.MethodsLiterature search and (mostly) systematic reviews were performed for a range of psychosocial interventions.FindingsMilieu therapy (MT) includes measures that impinge on therapeutic milieu/atmosphere in joint professional/user groups in the course of treatment. MT provides a context in which psychosocial interventions can be implemented. There is evidence of its effectiveness in improving mental health outcomes. Peer involvement (PI) and peer support are supported by promising evidence as innovative interventions in mental health care. Findings on case management (CM) are inconsistent. There are difficulties in defining CM. CM strengths include treatment satisfaction and continuity of care. With respect to integration in the labour market for people with severe mental illness supported employment (SE) has been shown to be more effective in achieving job placement. A proportion of SE users fail to find jobs on the general labour market. Other types of work rehabilitation are required, and there is room for pre-vocational training interventions.DiscussionPsychosocial interventions are strong interventions. The strength of the evidence is varied. The use of psychosocial interventions rests on experience, evidence and ethics.ConclusionsPsychosocial interventions are indispensable in building mental health care systems. Vocational interventions and residential services are mandatory. Peer involvement could help in moving mental health services forward.Disclosure of interestThe authors have not supplied their declaration of competing interest.

2021 ◽  
Vol 51 (2) ◽  
pp. 293-303
Author(s):  
Anthony L Pillay ◽  
Anne L Kramers-Olen

The COVID-19 pandemic heralded challenges that were both significant and unfamiliar, placing inordinate burdens on health care systems, economies, and the collective psyche of citizens. The pandemic underscored the tenuous intersections between public mental health care, politics, economics, and psychosocial capital. In South Africa, the inadequacies of the public health system have been laid bare, and the disproportionate privileges of the private health care system exposed. This article critically considers government responses to the COVID-19 pandemic, the psychosocial correlates of lockdown, politics, corruption, and public mental health policy in South Africa.


Author(s):  
Sofie Bäärnhielm ◽  
Mike Mösko ◽  
Aina Basilier Vaage

In this chapter, we discuss the pros and cons of separate versus integrated services for immigrants and refugees. Our discussion is based on experiences from three high-income countries: Germany, Norway, and Sweden. All three, regardless of general public insurance systems covering healthcare costs, have barriers to mental health care for migrants and refugees. Additionally, their mental health care systems are unaccustomed to responding to cultural variety in patients’ expression of distress, explanatory models of illness, consequences of pre-migratory difficulties, and post-migratory adversities. Attention to post-traumatic stress and social determinants of mental health is also restricted. To bridge barriers and improve access to mental health care for immigrants and refugees, we will comment on the importance of adapting care, training of professionals, and outreach programmes. Also emphasized is the value of culturally sensitive mental health-promoting strategies to improve mental health literacy and reduce stigma among immigrants and refugees.


Author(s):  
Joelle Robertson-Preidler ◽  
Nikola Biller-Andorno ◽  
Tricia Johnson

Resource scarcity forces health care systems to set priorities and navigate trade-offs in how they choose to fund different services. Distributive justice principles can help guide health systems to fairly allocate scarce resources in a society. In most countries, mental health care and psychotherapy, in particular, tend to be under-prioritized even though psychotherapy can be an effective treatment for mental health disorders. To create ethical funding systems that support appropriate access to psychotherapy, health care funding systems must consider how they allocate and distribute health care resources through health care financing, coverage criteria, and reimbursement mechanisms. Five health care systems are assessed according to how they finance and reimburse psychotherapy. These health systems use various and often pluralistic approaches that encompass differing distributive justice principles. Although distribution priorities and values may differ, fair and transparent processes that involve all key stakeholders are vital for making ethical decisions on access and distribution.


2021 ◽  
Vol 1 (2) ◽  
Author(s):  
Smith L

The successes and limitations of primary mental health care systems in three countries outside of Ireland are examined in order to inform potential change for the Irish primary mental health care system. Systems currently at work within Scotland, England, and the Netherlands are outlined, all of which employ versions of the “stepped-care” approach to primary care. It is acknowledged that Ireland is attempting to modify primary care to include the stepped-care approach. However, there are significant limitations to the current Irish system. With the Scottish, English, and Dutch systems in mind, an alternative vision of primary mental health care for Ireland is suggested.


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