Point prevalence of schizophrenia in immigrant groups in Rotterdam: data from outpatient facilities

2001 ◽  
Vol 16 (3) ◽  
pp. 162-166 ◽  
Author(s):  
A.C. Schrier ◽  
B.J.M. van de Wetering ◽  
P.G.H. Mulder ◽  
J.P. Selten

SummaryObjectiveReports of an increased incidence of schizophrenia in some immigrant groups to The Netherlands are based exclusively on hospital data. The aims of our study were: 1) to determine the treated point prevalence of schizophrenia at outpatient mental health services in Rotterdam and to compare the results for immigrants to those for natives; and 2) to compare groups born in The Netherlands and immigrant groups in terms of the proportions of patients with a previous hospital admission.MethodWe included all patients aged between 20 and 64 who were treated for a non-affective psychosis at any of the outpatient mental health services in Rotterdam on October 1, 1994. The mental health professionals responsible reported on the socio-demographic and clinical characteristics of each patient.ResultsSeven hundred and thirteen patients with a diagnosis of schizophrenia (DSM-III-R) were identified (rate: 2.1 per 1000). The (treated) prevalence of schizophrenia in male immigrants from Surinam and Morocco and in female immigrants from Surinam, the Netherlands Antilles and Cape Verde was significantly higher than that in their native-born counterparts (odds ratios between 2 and 3). The (treated) prevalence was not significantly higher in immigrants from Turkey, female immigrants from Morocco or male immigrants from the Antilles. Proportions of patients with a previous hospital admission were similar in each ethnic group (81–93%).ConclusionThese findings are generally in line with earlier studies, based on the Dutch psychiatric registry, which has reported an increase in the (treated) incidence of schizophrenia in immigrants from Surinam and the Netherlands Antilles and in male immigrants from Morocco, and no increase in the (treated) incidence in immigrants from Turkey or female immigrants from Morocco.

2005 ◽  
Vol 3 (1) ◽  
pp. 13-29 ◽  
Author(s):  
Hongtu Chen ◽  
Elizabeth Kramer ◽  
Teddy Chen ◽  
Jianping Chen ◽  
Henry Chung

Compared to all other racial and ethnic groups, Asian Americans have the lowest utilization of mental health services. Contributing factors include extremely low community awareness about mental health, a lack of culturally competent Asian American mental health professionals, and severe stigma associated with mental illness. This manuscript describes an innovative program that bridges the gap between primary care and mental health services. The Bridge Program, cited in the supplement to the Surgeon’s General’s Report on Mental Health: Culture, Race, and Ethnicity as a model for delivery of mental health services through primary care; (2) to improve capacity by enhancing the skills of primary care providers to identify and treat mental disorders commonly seen in primary care; and (3) to raise community awareness by providing health education on mental health and illness. Results are presented and the potential for replication is addressed.


2021 ◽  
pp. 1-14
Author(s):  
Nina Reinholt ◽  
Morten Hvenegaard ◽  
Anne Bryde Christensen ◽  
Anita Eskildsen ◽  
Carsten Hjorthøj ◽  
...  

<b><i>Introduction:</i></b> The Unified Protocol for Transdiagnostic Treatment of Emotional Disorders (UP) delivered in a group format could facilitate the implementation of evidence-based psychological treatments. <b><i>Objective:</i></b> This study compared the efficacy of group UP and diagnosis-specific cognitive behavioral therapy (dCBT) for anxiety and depression in outpatient mental health services. <b><i>Methods:</i></b> In this pragmatic, multi-center, single-blinded, non-inferiority, randomized controlled trial (RCT), we assigned 291 patients with major depressive disorder, social anxiety disorder, panic disorder, or agoraphobia to 14 weekly sessions in mixed-diagnosis UP or single-diagnosis dCBT groups. The primary test was non-inferiority, using a priori criteria, on the World Health Organisation 5 Well-Being Index (WHO-5) at the end of the treatment. Secondary outcomes were functioning and symptoms. We assessed outcomes at baseline, end-of-treatment, and at a 6-month follow-up. A modified per-protocol analysis was performed. <b><i>Results:</i></b> At end-of-treatment, WHO-5 mean scores for patients in UP (<i>n</i> = 148) were non-inferior to those of patients in dCBT (<i>n</i> = 143; mean difference –2.94; 95% CI –8.10 to 2.21). Results were inconclusive for the WHO-5 at the 6-month follow-up. Results for secondary outcomes were non-inferior at end-of-treatment and the 6-month follow-up. Client satisfaction and rates of attrition, response, remission, and deterioration were similar across conditions. <b><i>Conclusions:</i></b> This RCT demonstrated non-inferior acute-phase outcomes of group-delivered UP compared with dCBT for major depressive disorder, social anxiety disorder, panic disorder, and agoraphobia in outpatient mental health services. The long-term effects of UP on well-being need further investigation. If study findings are replicated, UP should be considered a viable alternative to dCBT for common anxiety disorders and depression in outpatient mental health services.


2018 ◽  
Vol 23 (1) ◽  
pp. 12-24 ◽  
Author(s):  
Juliette van der Kamp

Purpose The purpose of this paper is to describe the barriers and facilitators to an effective transition from Child and Adolescent Mental Health Services (CAMHS) to Adult Mental Health Services (AMHS). It also presents a new entry into considering how the transition can be improved. Design/methodology/approach Insights into the transition from CAMHS to AMHS were gathered through eight semi-structured interviews with mental health professionals. Two methods of data analysis were employed to explore the emerging themes in the data and the observed deficit approach to organisational development. Findings The findings identified a vast volume of barriers in comparison to facilitators to the transition. Adolescents who transition from CAMHS to AMHS initially experience difficulty adapting to the differences in the services due to the short duration of the transition period. However, despite the established barriers to the transition, adolescents tend to adapt to the differences between the services. Findings also showed a negative framing towards the transition amongst the mental health professionals which resembles a deficit approach to organisational development. Originality/value This paper explores mental health professionals’ perspectives regarding the transition in Dumfries and Galloway, Scotland. The transition is increasingly recognised as an area in health care that requires improvement. This research provides a new way to consider the transition by exploring the perceived deficit approach to organisational development in the services.


Psych ◽  
2021 ◽  
Vol 3 (4) ◽  
pp. 792-799
Author(s):  
Vaios Peritogiannis ◽  
Fotini Tsoli

The Assertive Community Treatment (ACT) model of care has been long considered to be effective in the management of patients with severe mental illness (SMI) in most Western countries. The implementation of the original ACT model may be particularly challenging in rural and remote communities with small and dispersed populations and lack of adequate mental health services. Rural programs may have to adapt the model and modify the ACT fidelity standards to accommodate these limitations, and this is the rationale for the introduction of more flexible, hybrid ACT models. In rural Greece, the so called Mobile Mental Health Units (MMHUs) are well-established community mental health services. For patients with SMI that have difficulties engaging with treatment services, the new hybrid ACT model has been recently launched. The objective of this manuscript is to present the recently launched hybrid ACT model in rural areas in Greece and to explore the challenges and limitations in its implementation from the experience of a team of mental health professionals with ACT experience. Referral criteria have not been strictly set, but the number of previous relapses and hospitalizations is taken under consideration, as well as the history of poor treatment adherence and disengagement from mental health services. The main limitation in the implementation of the hybrid ACT service is that it has been introduced in several areas in the absence of a pre-existing community mental health service. This may impact referrals and limit focus on the difficult cases of patients with SMI, thus making the evaluation of the model inapplicable.


Author(s):  
Eric G. Mart

This chapter provides information designed to assist mental health professionals in effectively marketing their services to courts, attorneys, and the legal system in general. Suggestions are offered to help mental health professionals decide whether they will be comfortable working in an adversarial environment. Methods for developing the skillsets necessary for performing forensic consultations in a competent, ethical manner are provided. Information regarding how to effectively market mental health services to legal professionals are reviewed. Various areas of subspecialty practice are described.


2020 ◽  
Vol 41 (Supplement_1) ◽  
pp. S21-S22
Author(s):  
Andrew McAleavey ◽  
Mariel Emrich ◽  
Adina R Jick ◽  
Collette L McGuire ◽  
JoAnn Difede

Abstract Introduction Psychological distress, including posttraumatic stress disorder, acute stress disorder, and depressive disorders, are common after burn injury. These conditions are major determinants of long-term quality of life and productivity loss among burn patients, yet are generally under treated. Among the many reasons for limited treatment are lack of accessible quality care, limited clinical staff expertise in assessing these conditions, and patient avoidance of effective services. Methods During December 2018 to September, 2019, patients awaiting outpatient visits at an urban burn center were asked to complete brief standardized self-report questionnaires assessing symptoms of posttraumatic distress, anxiety, and depression. Using pre-defined criteria, we attempted to reach individuals with greater than moderate distress using contact information provided voluntarily and engage these patients in outpatient mental health services. Results 747 questionnaires were completed by 511 individuals in the assessment period, and of these 98 (19.2%) individuals had a likely PTSD diagnosis. Visual analog scale assessments for current anxiety, depression and stress all suggested high average distress in the overall group. Using pre-defined criteria to identify potential distress, we identified 195 people (38.2%) to whom we would proactively offer services. Only 159 provided contact information, and several more were not eligible for available clinical services so were not contacted. We called 128 individuals (81%). This led to direct communication with 48 patients (37.5% of those contacted), but only 22 individuals (17.2% of all those contacted) still endorsed distress at the time of the phone call (which was planned to occur within one week of the patients’ report) and 11 individuals were interested in seeking mental health services. Of these, 4 were referred to other services, 3 declined specific offers of service, 4 were scheduled for appointments and only 2 individuals attended appointments with the in-hospital psychological trauma group. Conclusions Psychological distress is highly prevalent in the burn outpatient clinic, with roughly one in five patients likely meeting criteria for PTSD. However, engaging patients in psychological and psychiatric treatment remains a major challenge for the effective care in this population. We discuss strategies tried here and systemic barriers to overcome in future research and care. Applicability of Research to Practice High prevalence of PTSD in outpatient burn clinics and difficulty engaging patients in separate outpatient mental health services suggest co-located and collaborative care models would be highly helpful in this population.


1997 ◽  
Vol 2 (6) ◽  
pp. 398-399
Author(s):  
Ian G Manion ◽  
Simon Davidson ◽  
Christina Norris ◽  
Sarah Brandon

Abstract Today's youth are at a disturbingly high risk for mental health and illness problems and are largely dissatisfied with the existing mental health services. Youth Net/Réseau Ado (YN/RA), supported by input from mental health professionals, is a bilingual mental health promotion program that seeks out the opinions and attitudes of youth regarding mental health and illness issues, while connecting them with appropriate resources and mental health services. This paper describes the Youth Net/Réseau Ado program and provides some guidelines for the identification of mental health and illness problems, including indicators of the risk of suicide.


2020 ◽  
Vol 50 (2) ◽  
pp. 616-633 ◽  
Author(s):  
Michael Bonnet ◽  
Nicola Moran

Abstract The number of people detained under the 1983 Mental Health Act has risen significantly in recent years and has recently been the subject of an independent review. Most existing research into the rise in detentions has tended to prioritise the perspectives of psychiatrists and failed to consider the views of Approved Mental Health Professionals (AMHPs), usually social workers, who ultimately determine whether detention is appropriate. This mixed-methods study focused on AMHPs’ views on the reasons behind the rise in detentions and potential solutions. It included a national online survey of AMHPs (n = 160) and semi-structured interviews with six AMHPs within a Community Mental Health Team in England. AMHPs reported that demand for mental health services vastly exceeded supply and, due to inadequate resources, more people were being detained in hospital. AMHPs argued that greater investment in preventative mental health services and ‘low intensity’ support would help to mitigate the impact of social risk factors on mental health; and greater investment in crisis services, including non-medical alternatives to hospital, was required. Such investment at either end of the spectrum was expected to be more effective than changes to the law and lead to better outcomes for mental health service users.


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