The problems of offenders with mental disorders: A plurality of perspectives within a single mental health care organisation

A standardised system of clinical pathways often conflicts with providing patient-centred heterogeneous care. Mental health care organisations are searching for new methods to become responsive towards unique treatment needs. Modularity is a method increasingly suggested to reconcile standardisation and customisation. The aim is to investigate the extent to which modularity can be applied to make clinical pathways in specialist mental health care more flexible in order to stimulate shared decision making (SDM) and thereby customise care processes to patient contexts while maintaining evidence-based standards. Methods consist of literature research and a theory-based case study including document analysis and semi-structured interviews, which were performed at a Dutch specialist mental health care organisation. The results show that in current literature two modularity-based structures are proposed that support flexibility and customisation, i.e., ‘Prototype’ and ‘Menu-based’. This study reveals that departments tend to use the prototype method if they have predictable patient needs, evidence-based methods are available and there is sequency in treatment components. The menu-based method is preferred if there are unpredictable needs, or the evidence needed to create interconnectedness in treatment is lacking. In conclusion, prototype or menu-based methods are both suitable for applying SDM and reaching customisation in practice. The choice is determined by three characteristics: predictability of needs, availability of evidence and the interconnectedness of treatment components.

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Successful implementation of self-managing teams

Leadership in Health Services ◽

10.1108/lhs-11-2017-0066 ◽

2019 ◽

Vol 32 (1) ◽

pp. 113-128 ◽

Cited By ~ 2

Author(s):

Wilke Weerheim ◽

Lisa Van Rossum ◽

Wouter Dirk Ten Have

Keyword(s):

Mental Health ◽

Health Care ◽

Mental Health Care ◽

Success Factors ◽

Successful Implementation ◽

Health Care Organisation ◽

Content Type ◽

Care Organisation ◽

Open Coding ◽

Organisation Structure

Purpose Following health-care organisations, many mental health-care organisations nowadays consider starting to work with self-managing teams as their organisation structure. Although the concept could be effective, the way of implementing self-managing teams in an organisation is crucial to achieve sustainable results. Therefore, this paper aims to examine how working with self-managing teams can be implemented successfully in the mental health-care sector where various factors for the successful implementation are distinguished. Design/methodology/approach This qualitative case study is executed by analysing 18 interviews within two self-managing teams in a mental health-care organisation located in the Netherlands. A coding process is executed in two steps. The first step is open coding, to make small summarising notes within each interview section. The second step is refocused coding, where the open codes were collected, categorised and summarised by searching for recurrence and significance. The coding process is made visible within a code tree. This code tree formed the basis for writing the findings. Findings Success factors for the implementation of a self-managing team that resulted from this research are a clear task portfolio division, good relationships within the team and a coaching trajectory with attention for a possible negative past. Originality/value By having used a specific change management model, the Change Competence Model, it can be concluded that a high change capacity will positively influence the success of a self-managing team in the context of a mental health-care organisation.

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Religious advisors’ role in mental health care in the European Study of the Epidemiology of Mental Disorders survey

Social Psychiatry and Psychiatric Epidemiology ◽

10.1007/s00127-009-0143-0 ◽

2009 ◽

Vol 45 (10) ◽

pp. 989-998 ◽

Cited By ~ 8

Author(s):

Viviane Kovess-Masfety ◽

◽

Anne Dezetter ◽

Ron de Graaf ◽

Joseph Maria Haro ◽

...

Keyword(s):

Mental Health ◽

Health Care ◽

Mental Disorders ◽

Mental Health Care ◽

European Study

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The importance of peer support in the recovery process of persons with mental disorders

European Journal of Public Health ◽

10.1093/eurpub/ckaa166.1025 ◽

2020 ◽

Vol 30 (Supplement_5) ◽

Author(s):

D Stimac Grbic ◽

I Pavic Simetin ◽

A Istvanovic

Keyword(s):

Mental Health ◽

Health Care ◽

Mental Disorders ◽

Mental Health Care ◽

Peer Support ◽

Community Intervention ◽

Recovery Process ◽

Therapeutic Interventions ◽

Hospital Treatment ◽

Personal Recovery

Abstract Issue Care for people with severe mental disorders requires approach that is focused on a person's strengths, not his weaknesses, and is a shift from a deficit model that is often associated with mental illness. Care users and their family members play an important role in this approach. Description of the Problem Mental disorders are the leading group of diseases in Croatia, according to the number of days of hospital treatment. The number of hospitalizations is high, and the rate of hospitalization for depression has tripled in the last twenty years. Such indicators highlight the need for reorientation of mental health care, from hospital-based to community-based, by organizing mobile community intervention teams. Results In Croatia, psychosocial peer teams were established by the NGO Ludruga, financed by local government, to provide peer support to persons with mental disorders. The main activities are: development of a personal recovery plan, home visits and providing psychological support to persons with mental disorders, organizing support groups and education of peer workers. The teams consist of a peer worker, social worker, psychologist, and operate under the supervision of a psychiatrist. The teams have been operating for five years, have had over a hundred users so far and are a significant help to the healthcare system in preventing rehospitalizations. Lessons The goal of therapeutic interventions in mental health care should be recovery. Recovery involves empowering a person to take responsibility for themselves and their health. Peer workers play an important role in the recovery process, providing hope for recovery. Their role must also be recognized by the health system. Key messages People with mental disorders and their families should be co-creators of care and recovery-oriented interventions. Only by comprehensive interventions, tackling all determinants of health, therapeutic goal can be achieved.

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Cross-Sectional Study of Mental Health Related Knowledge and Attitudes Among Care Assistant Workers in Guangzhou, China

10.21203/rs.3.rs-107392/v1 ◽

2020 ◽

Author(s):

Jie Li ◽

Xiao-Ling Duan ◽

Hua-Qing Zhong ◽

Wen Chen ◽

Sara Evans‑Lacko ◽

...

Keyword(s):

Mental Health ◽

Health Care ◽

Mental Disorders ◽

Linear Regression ◽

Mental Health Care ◽

Health Staff ◽

Care Providers ◽

Knowledge And Attitudes ◽

Additional Item ◽

Health Related

Abstract Background: Care assistant workers (CAWs) are a part of a new pattern of mental health care providers in China and play a significant role in bridging the human resource shortage. CAWs in China mainly include community cadres, community mental health staff and community policemen. The mental health related knowledge and attitudes of CAWs could influence their mental health care delivery. This study aimed to assess the mental health related knowledge and attitudes of CAWs in Guangzhou, China. Methods: In November 2017, a study was conducted among 381 CAWs from four districts of Guangzhou, China. Participants were assessed using the Perceived Devaluation and Discrimination Scale (PDD), the Mental Health Knowledge Schedule (MAKS), and the Mental illness: Clinicians’ Attitudes (MICA). Data were analyzed by descriptive statistics, ANOVA, Bonferroni corrections and multivariable linear regression. Results: The mean scores (standard deviation) of PDD, MAKS and MICA were 36.45 (6.54), 22.72 (2.56), 51.67 (7.88), respectively. Univariate analyses showed that the older CAWs, community policemen and those who were less willing to deliver care had significant higher MICA scores when compared with other staff (P < 0.001). However, participants who disagreed additional item 1（views towards inpatients) and additional item 2 (affiliate stigma) had a significant lower MICA scores when compared with those who agreed (P < 0.001). Multivariable linear regression showed that after controlling some variables, care willingness and PDD total score were significantly positively associated with the MICA total score (all P < 0.05), while attitudes on additional items were significantly negatively associated with the MICA total score (all P < 0.01).Conclusion: These findings suggest negative attitudes towards people with mental disorders among CAWs are common, especially among older staff. Community policemen suggest that they applied stereotypes of ‘violent mentally ill’ people to all people they deal with who have mental disorders. The results also indicate human rights are being paid attention to now, but need to be improved in the future. Strategies to improve attitudes and to reduce stigma and discrimination should be conducted with particular staff groups.

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The Use of Antidepressants, Anxiolytics, Sedatives and Hypnotics in Europe: Focusing on Mental Health Care in Portugal and Prescribing in Older Patients

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17228612 ◽

2020 ◽

Vol 17 (22) ◽

pp. 8612

Author(s):

Marta Estrela ◽

Maria Teresa Herdeiro ◽

Pedro Lopes Ferreira ◽

Fátima Roque

Keyword(s):

Mental Health ◽

Health Care ◽

Mental Disorders ◽

Mental Health Care ◽

Older Patients ◽

Common Mental Disorders ◽

Health Policies ◽

Depression And Anxiety ◽

Treatment Gap ◽

Mental Health Policies

(1) Background: Mental disorders are a growing concern in the 21st century. The most prevalent common mental disorders include depression and anxiety. It is predicted that half of the population will at some point in their lives experience one or more mental disorders. Although common mental disorders are highly prevalent, some of the most significant related problems are the wide treatment gap and the excessive use of antidepressants, anxiolytics and sedatives/hypnotics, especially among older patients. (2) Methods: This study aimed to analyze mental health care in Portugal, with a focus on the consumption of antidepressants, anxiolytics, sedatives and hypnotics among older patients. (3) Results: The use of antidepressants, anxiolytics, sedatives and hypnotics has increased overall across Europe. In Portugal, a downward trend of sedatives and hypnotics consumption can be observed. Anxiolytics and antidepressants, on the other hand, have been increasing. Patients aged ≥60 years old consume more than half of the aforementioned drugs. (4) Conclusions: Mental health policies should be designed to improve the conscientious use of antidepressants, anxiolytics, sedatives and hypnotics, particularly among older adults.

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Exploring Perceptions of Continuity of Care Among People With Long-Term Mental Disorders in Denmark

Qualitative Health Research ◽

10.1177/1049732319840286 ◽

2019 ◽

Vol 29 (13) ◽

pp. 1916-1929

Author(s):

Anna P. Folker ◽

Mette M. Kristensen ◽

Amalie O. Kusier ◽

Maj Britt D. Nielsen ◽

Sigurd M. Lauridsen ◽

...

Keyword(s):

Mental Health ◽

Health Care ◽

Mental Disorders ◽

Mental Health Care ◽

Continuity Of Care ◽

Service Users ◽

Mental Health Care System ◽

Template Analysis ◽

Depth Interviews

Continuity of mental health care is central to improve the treatment and rehabilitation of people with mental disorders. While most studies on continuity of care fail to take the perspectives of service users into account, the aim of this study was to explore the perceived meanings of continuity of care among people with long-term mental disorders. Fifteen service users participated in semi-structured in-depth interviews. We used template analysis to guide the analysis. The main transversal themes of continuity were “Navigating the system” and “Connecting to people and everyday life.” While the first theme related to the participants’ experiences of their interaction with the mental health care system, the latter related to their hopes and perceived opportunities for a good life as desired outcomes of mental health care. We conclude that efforts to improve continuity of mental health care should be tailored to the priorities of service users.

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Adolescents with mental disorders while serving time and being subjected to socio-educative measures

Ciência & Saúde Coletiva ◽

10.1590/1413-81232014193.13042013 ◽

2014 ◽

Vol 19 (3) ◽

pp. 891-898 ◽

Cited By ~ 1

Author(s):

Natália Pereira Gonçalves Vilarins

Keyword(s):

Mental Health ◽

Health Care ◽

Mental Disorders ◽

Mental Health Care ◽

Participant Observation ◽

Federal District ◽

Adolescent Offenders ◽

Structured Interviews ◽

Research Committee ◽

Ethics Research

This article examines how adolescent offenders with mental disorders are treated by socio-educative internment treatment. These adolescents come under the aegis of medicine and justice in a contradictory relationship between full protection, vulnerability of a developing person with a mental disorder and a juvenile delinquency offense. In this respect, the legal punishment prevails to the detriment of health care. After approval of the research project by an Ethics Research Committee, field research was conducted in the Youth Detention Unit of the Pilot Plan of the Brazilian Federal District. Data were collected through research of documents involving 35 medical records of adolescent users of psychotropic drugs in 2010, as well as participant observation and semi-structured interviews with professionals from the Youth Detention Unit and adolescent judiciary. In the review of the care provided to adolescent offenders with mental disorders under the childhood and youth policy and the mental health policy, it was revealed that the mental health care provided in the Youth Detention Unit or in the external mental health care services involved the prescription of medication.

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A certificate in youth psychiatry: meeting the training needs of psychiatrists

Australasian Psychiatry ◽

10.1177/1039856220943015 ◽

2020 ◽

pp. 103985622094301

Author(s):

Iain Macmillan ◽

Andrew Thompson ◽

Megan Kalucy ◽

Daniel Pellen ◽

Eóin Killackey ◽

...

Keyword(s):

Mental Health ◽

Health Care ◽

Young People ◽

Mental Disorders ◽

Mental Health Care ◽

Youth Mental Health ◽

Training Needs ◽

Specialty Training ◽

Optimal Care ◽

Adult Psychiatry

Objective: This paper provides the rationale for the development of sub-specialty training in youth psychiatry. Method: Training needs for youth psychiatry are discussed and the opportunities provided by sub-specialisation in youth psychiatry are presented. Results: The majority of mental disorders have their onset prior to 25 years. There has been substantial recent growth in services to meet the clinical needs of young people. The development of these services has exposed gaps in current training for psychiatrists, which varies considerably between child and adolescent, and adult psychiatry. Competencies acquired by psychiatrists in youth mental health are non-standardised, which may hinder optimal care. Conclusions: Sub-specialty training in youth psychiatry is needed to meet workforce demands. The development of a certificate in youth psychiatry, by the RANZCP Section for Youth Mental Health, is underway. This will complement existing training and provide trainees and psychiatrists the opportunity to develop specialist skills in the provision of mental health care for young people negotiating the transition between adolescence and adulthood.

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Expanding the Role of Primary Health Care in the Provision of Mental Health Services to the Population of the Kyrgyz Republic

European Psychiatry ◽

10.1016/j.eurpsy.2017.01.954 ◽

2017 ◽

Vol 41 (S1) ◽

pp. S606-S606

Author(s):

T. Galako

Keyword(s):

Mental Health ◽

Health Care ◽

Primary Health Care ◽

Mental Health Services ◽

Mental Disorders ◽

Health Services ◽

Mental Health Care ◽

Kyrgyz Republic ◽

Family Doctors ◽

Primary Health

Providing comprehensive, integrated services in the field of mental health in primary health care (PHC) is a component of the state mental health program for the population of the Kyrgyz republic (KR) in the 2017–2030 biennium. In order to develop an action plan in this area a situational analysis of resources of psychiatric care at PHC level was carried out. There was revealed a significant deficit of specialists, such as family doctors, mental health care professionals. In spite of the need for 3,300 family doctors, only 1706 work, and 80% of them are of retirement age.The results of a research showed a low level of knowledge and skills of family physicians for the early detection of mental disorders and provision of appropriate medical care. There are also a limited number of psychiatrists, especially in rural regions (77% of the required quantity).During recent years, there have been implemented significant changes in the system of mental health services, aimed at improving its quality, the approach to the place of residence of the patient and the prevalence of psychosocial services.Since 2016 in 8 southern regions in the Kyrgyz Republic has been introduced a new model for the provision of comprehensive health care services. Piloting this model involves psychosocial rehabilitation of patients with mental disorders, the help of mobile teams at the place of patient residence, as well as psychoeducation, training, and support to family doctors. These and other measures will help to optimise mental health care at PHC level.Disclosure of interestThe author has not supplied his/her declaration of competing interest.

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