Task-shifting in Mental Health Services: Extent, Impact and Challenges in Ghana

2017 ◽  
Vol 41 (S1) ◽  
pp. S618-S618
Author(s):  
V. Agyapong

AimTo examine the role and scope of practice of community mental health workers (CMHWs) as well as the impact and challenges associated with of work of CMHWs within Ghana's mental health delivery system.MethodsA cross sectional survey of 11 psychiatrists, 29 health policy directors and 164 CMHWs as well as key informant interviews with 3 CMHWs, 5 psychiatrists and 2 health policy directors and three focus group discussions with 21 CMHWs. Results of quantitative data were analysed with SPSS version 20 whilst the results from qualitative data were analysed manually through thematic analysis.ResultsIn addition to duties prescribed in their job descriptions, all the CMHWs identified several jobs that they routinely perform including jobs reserved for higher level cadres such as medication prescribing for which most of the CMHWs have no training. Some CMHWs reported they had considered leaving the mental health profession because of the stigma, risk, lack of opportunities for continuing professional development and career progression as well as poor remuneration. Almost all the stakeholders believed CMHWs in Ghana receive adequate training for the role they are expected to play although many identify some gaps in the training of these mental health workers for the expanded roles they actually play. All the stakeholders expressed concerns about the quality of the care provided by CMHWs.ConclusionThe study highlights several important issues, which facilitate or hinder effective task-shifting arrangements from psychiatrists to CMHWs and impact on the quality of care provided by the latter.Disclosure of interestThe author has not supplied his/her declaration of competing interest.

2021 ◽  
Author(s):  
Xiaolin Liu ◽  
Hongjin Zhu

Abstract Background Mental health workers may face more obstacles in humanistic care during the COVID-19 pandemic, we aimed to explore the humanistic care ability of mental health workers and its potential influencing factors.Method(s) An online cross-sectional survey was conducted among 262 mental health workers working in Chongqing, China from December 1 to 31, 2020. Self-administered questionnaires were used to collect data from the participants. Results Mental health workers’ humanistic care ability score was 186.47 ± 21.34, and most of the them (79.8%) were at a low level. Psychological capital and personality traits were significant influencing factors of humanistic care ability and its sub-dimensions.Conclusion(s) Research has found that the humanistic care ability of mental health workers is at a low level, and psychological capital and personality traits are significant factors influencing the humanistic care ability and its sub-dimensions. Interventions to improve psychological capital of mental health workers or to promote the change of personality traits that they want are recommended, thereby promoting humanistic practice.


2021 ◽  
Author(s):  
Xiaolin Liu ◽  
Hongjin Zhu

Abstract Background Mental health workers may face more obstacles in humanistic care during the COVID-19 pandemic, we aimed to explore the humanistic care ability of mental health workers and its potential influencing factors.Method(s) An online cross-sectional survey was conducted among 262 mental health workers working in Chongqing, China from December 1 to 31, 2020. Self-administered questionnaires were used to collect data from the participants. Results Mental health workers’ humanistic care ability score was 186.47 ± 21.34, and most of the them (79.8%) were at a low level. Psychological capital and personality traits were significant influencing factors of humanistic care ability and its sub-dimensions.Conclusion(s) Research has found that the humanistic care ability of mental health workers is at a low level, and psychological capital and personality traits are significant factors influencing the humanistic care ability and its sub-dimensions. Interventions to improve psychological capital of mental health workers or to promote the change of personality traits that they want are recommended, thereby promoting humanistic practice.


Author(s):  
Sofia Pappa ◽  
Joshua Barnett ◽  
Ines Berges ◽  
Nikolaos Sakkas

The burden of the COVID-19 pandemic on health systems and the physical and mental health of healthcare workers (HCWs) has been substantial. This cross-sectional study aims to assess the effects of COVID-19 on the psychological wellbeing of mental health workers who provide care to a vulnerable patient population that have been particularly affected during this crisis. A total of 387 HCWs from across a large urban mental health service completed a self-administered questionnaire consisting of socio-demographic, lifestyle and work-based information and validated psychometric scales. Depression and anxiety were measured using the Patient Health Questionnaire (PHQ-9) and the Generalized Anxiety Disorder Scale (GAD-7), respectively; sleep problems with the Athens Insomnia Scale (AIS); burnout with the Maslach Burnout Inventory (MBI); and resilience with the Resilience Scale-14 (RS-14). Multivariable logistic regression analysis was performed to determine potential mediating factors. Prevalence of burnout was notable, with 52% recording moderate/severe in Emotional Exhaustion, 19.5% moderate/severe in Depersonalisation, and 55.5% low/moderate Personal Accomplishment. Over half of all respondents (52%) experienced sleep problems; the presence of depressive symptoms was a significant predictor of insomnia. An increase in potentially harmful lifestyle changes, such as smoking, alcohol consumption and overeating was also observed. However, high Resilience was reported by 70% of the samples and the importance of this is highlighted. Female gender was associated with increased levels of depression and emotional exhaustion while those with a history of mental health conditions were most at risk of affective symptoms, insomnia, and burnout. Overall, our study revealed considerable levels of psychological distress and maladaptive coping strategies but also resilience and satisfaction with organizational support provided. Findings can inform tailored interventions in order to mitigate vulnerability and prevent long-term psychological sequelae.


2021 ◽  
Vol 33 (3) ◽  
pp. 249-264
Author(s):  
Gert Scheerder ◽  
Sandra Van den Eynde ◽  
Patrick Reyntiens ◽  
Ria Koeck ◽  
Jessika Deblonde ◽  
...  

This cross-sectional survey explored the quality of life in 505 people living with HIV in Belgium. Several domains of quality of life were impaired: 26% had been diagnosed with depression and 43% had weak social support. HIV-related stigma is still widespread, with 49% believing most people with HIV are rejected and 65% having experienced discrimination due to HIV. The impact of HIV was limited on professional life, but 40% experienced a negative impact on life satisfaction and 41% a negative impact on sexual life. For several domains, people with a recent diagnosis of HIV and long-term survivors had significantly worse scores. This survey also uncovered strengths of people living with HIV, such as positive coping and HIV self-image. Expanding the scope of quality of life in people living with HIV may provide a more complete picture of relevant life domains that may be impacted by living with HIV, but this needs further validation.


Author(s):  
Chau Quy Ngo ◽  
Phuong Thu Phan ◽  
Giap Van Vu ◽  
Quyen Thi Le Pham ◽  
Hanh Thi Chu ◽  
...  

Smoking is considered the most critical modifiable factor with regard to lung cancer and remains a public health concern in many countries, including Vietnam, which is among those countries with the highest tobacco consumption rates in the world. This study has examined the impact of national telephone counselling for smoking cessation and has identified the factors associated with the impact of the quitline among male callers in Vietnam. A randomized cross-sectional survey of 469 smokers who sought smoking cessation services via the national quitline was performed from September 2015 to May 2016. The primary outcomes were measured by a self-reported quit rate at the time of assessment, 7 day point prevalence abstinence (PA), 6 month prolonged PA, service satisfaction, and level of motivation. Among the participants, 31.6% were abstinent, and 5.1% of participants successfully stopped smoking and did not need to seek quitline support. Most of the clients were satisfied with the quality of service (88.5%), felt more confident about quitting (74.3%), and took early action via their first quit attempt (81.7%); 18.3% reported a more than 7 day abstinence period at the time of survey. The primary reasons for smoking relapse were surrounding smoking environments (51.6%) and craving symptoms (44.1%). Future smoking cessation efforts should focus on improving the quality of quitline services, client satisfaction, and developing a tailored program and counseling targeting smokers with specific characteristics, especially ones experiencing chronic diseases.


Author(s):  
Gemma Biviá-Roig ◽  
Valentina Lucia La Rosa ◽  
María Gómez-Tébar ◽  
Lola Serrano-Raya ◽  
Juan José Amer-Cuenca ◽  
...  

(1) Background: This study aimed to analyze the impact of the confinement due to the COVID-19 pandemics on the eating, exercise, and quality-of-life habits of pregnant women. (2) Methods: This was an internet-based cross-sectional survey which collected information about adherence to the Mediterranean diet, physical exercise, health-related quality of life (HRQoL), and perceived obstacles (in terms of exercise, preparation for delivery, and medical appointments) of pregnant women before and after the confinement. The survey was conducted in 18–31 May 2020. (3) Results: A total of 90 pregnant women participated in this study. There was a significant decrease in the levels of physical activity (p < 0.01) as well as in HRQoL (p < 0.005). The number of hours spent sitting increased by 50% (p < 0.001), 52.2% were unable to attend delivery preparation sessions because these had been cancelled. However, there were no significant differences in the eating pattern of these women (p = 0.672). Conclusions: These results suggest the need to implement specific online programs to promote exercise and reduce stress, thus improving the HRQoL in this population, should similar confinements need to occur again for any reason in the future.


2015 ◽  
Vol 3 (3) ◽  
pp. 352
Author(s):  
Macarena Quesada ◽  
Manuel Madrigal ◽  
Aurelio Luna ◽  
Maria D Perez-Carceles

Purpose: The aim was to investigate the factors associated with the quality of life (QoL) of family caregivers to palliative care patients. Methods: A cross-sectional survey was conducted of 125 family caregivers of patients in the terminal phase of their illness and included in palliative care programs. Data were collected using WHOQOL-BREF, the socio-demographic characteristics of both caregiver and patient, clinical questions and information about caregiving. Results: The QoL of caregivers was lower than that of the national average for healthy people. Significantly lower QoL scores were obtained in the case of caregivers if they were women, over 55 years, uneducated, unemployed or the patient’s spouse. Cancer diagnosis and patients who were dependent for their Activities of Daily Living also lower caregiver QoL. The factors associated with higher caregiver QoL in each domain differed: being employed in the physical domain (OR:3.3; 95% CI:1.47-7.4), the patient receiving palliative care in hospital in the psychological domain (OR:3.05; 95% CI:1.19-7.7), a higher level of caregiver´s education in the social domain (OR:3.3; 95% CI:1.4-9.8) and caregivers between 45-55 years in the environmental domain (OR:5.4; 95% CI:1.6-9.2).Conclusion: Family caregivers of palliative care patients are highly burdened during caregiving. Characteristics of the patient and caregiver and the conditions under which care is performed, significantly affect QoL. We consider it essential to increase health professionals’ awareness of the importance of the role of the caregiver in providing services to the terminally ill, given the impact of the caregiver’s QoL on the QoL of the palliative care patient and its importance for the delivery of person-centered care at the end of life.    


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