Reforming mental health services in Portugal

2011 ◽  
Vol 26 (S2) ◽  
pp. 588-588
Author(s):  
M. Xavier ◽  
P. Mateus ◽  
J. Caldas-Almeida
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Health Plan ◽  
Homeless People ◽  
List Type ◽  
Term Care ◽  
Financing Model ◽  
National Mental Health ◽  
The Impact

IntroductionAnalysis of the mental health system in Portugal reveals some positive aspects in its development through recent decades, namely in what concerns the creation of decentralised services and rehabilitation programs. Despite this, Portuguese mental health services (MHS) still suffer from significant deficiencies, in terms of accessibility, equity and quality of care. There is a large gap between the number of people affected with mental disorders and those receiving treatment: for an estimated prevalence of 16.07%, the number of people receiving treatment in MHS was estimated to be 1.7%.ObjectivesThe major objectives of the new National Mental Health Plan are:1)Assure equal access to care,2)Promote and protect human rights3)Reduce the impact of mental health disorders4)Promote community delivery of care,5)Promote the integration of MHS in the general health services.MethodsA National Coordination Body for Mental Health has been empowered to assure the implementation of the National Mental Health Plan, with external monitoring by WHO.ResultsSince the last three years, there has been significant changes and improvements at the following levels: new legislation, creation of new MHS, forensic services, financing model, residential facilities (long term care), deinstitutionalization, training, programs for homeless people, domestic violence, advocacy and stigma.ConclusionsThe implementation of the mental health plan can help to overcome some of the problems present in MHS in Portugal. Special attention should be given to the financing model, has it represents a crucial restraint to the development of the MHS.

The National Mental Health Policy: Implications for Public Psychiatric Services in Australia

1993 ◽  
Vol 27 (2) ◽  
pp. 186-191 ◽  
Author(s):  
Harvey Whiteford ◽  
Bronwyn Macleod ◽  
Elizabeth Leitch
Keyword(s):  
Mental Health ◽  
Health Policy ◽  
Mental Health Services ◽  
Health Services ◽  
Mental Health Problems ◽  
Mental Health Policy ◽  
Policy Implications ◽  
Australian Community ◽  
National Mental Health ◽  
The Impact

The Health Ministers of all Australian States, Territories and the Commonwealth endorsed National Mental Health Policy in April 1992 [1]. This Policy is intended to set clear direction for the future development of mental health services within Australia. The Policy recognises the high prevalence of mental health problems and mental disorders in the Australian community and the impact of these on consumers, carers, families and society as whole. It also clearly accepts the need to address the problems confronting the promotion of mental health and the provision of mental health services.

scholarly journals Frontline yet at the back of the queue – improving access and adaptations to CBT for Black African and Caribbean communities

2021 ◽  
Vol 14 ◽  
Author(s):  
Leila Lawton ◽  
Melissa McRae ◽  
Lorraine Gordon
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Psychological Intervention ◽  
Evidence Based ◽  
List Type ◽  
Black African ◽  
Psychological Therapies ◽  
The Impact ◽  
Minority Ethnic

Abstract This paper focuses on the Black minority ethnic population (Black British, Black African, Black Caribbean) and uses the term BME in reference to this group. Only 6.2% of BME people access psychological intervention for common mental disorders. In provision of cognitive behavioural therapy (CBT) the diversity in global majority populations1 requires culturally specific informed and responsive approaches. The Improving Access to Psychological Therapies (IAPT) programme needs to be accountable, culturally congruent and strategic, to ensure accessibility and improve outcomes for BME people. According to the Mental Health Foundation (2019), a higher percentage of Black, Asian and other minority ethnic populations (BAME) are diagnosed with common, severe and complex mental health disorders. Despite the weight of literature on this, little has changed. The NHS Implementation Plan outlines trajectories for increased access and reduced attrition within mental health services, addressing inequalities for BAME populations. Evidence-based guidance and audits for provision of culturally sensitive and adapted therapies are presented in the pioneering (IAPT) BAME Positive Practice Guide (PPG). However, there are no funding arrangements or formal integrated frameworks to support implementation. The COVID-19 global pandemic and the high-profile death of George Floyd tragically exposed and highlighted the consequences of systemic racism. Understanding of the importance of service and clinical anti-racist practice is imperative for CBT therapists. Implementation of the BAME PPG audit tool ensures review of race equity in access, engagement, adaptation and workforce within IAPT and other mental health services. This could transform lives. Key learning aims (1) To understand the barriers (individual, societal and systemic) to accessing psychological therapies such as CBT and the impact on CBT treatment outcomes specifically for black minority ethnic (BME) populations. (2) To recognise barriers to implementation of formal frameworks for equitable access to psychological therapies such as CBT for BME communities. (3) To assist services and therapists to implement evidence-based learning, on cultural adaptations, to address barriers in access, retention and completion of CBT. (4) To provide examples of services that have taken successful actions to address the issues identified in the earlier points.

National Mental Health Plan: An Opportunity to Implement Psychoeducation in Portugal?

2009 ◽  
Vol 24 (S1) ◽  
pp. 1-1
Author(s):  
M. Xavier ◽  
M. Goncalves-Pereira ◽  
J. Caldas de Almeida
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Health Plan ◽  
Mentally Ill ◽  
Scientific Evidence ◽  
Care Needs ◽  
Family Interventions ◽  
Effective Response ◽  
National Mental Health

It is well known that due to deinstitutionalization, faster discharge from wards and insufficient community resources, direct contact of the severe mentally ill patients with their families has increased a lot in the last years.In the last two decades, mental health services across Europe developed a diversified offer of programmes, including psychoeducation and family interventions, in order to ensure an effective response to the different care needs.In Portugal, the lack of planning and consistent support in the improvement of mental health services means that the country is lagging behind significantly in this field in relation to other European countries.Concerning the specific subject of psychoeducation and family interventions for psychotic patients and their families, its true that treatment in Portugal seldom comport with the best scientific evidence, but so far there has been no pressure on the services to change this oddly situation.The new National Mental Health Plan, launched in 2008, sets that i. People with mental disorders should be involved and participate in the planning and development of the services they benefit from, and that ii. Family members of the mentally ill should be considered as important partners in care provision, and encouraged to participate in this provision and to receive the necessary training and education.Based on these principles, the Mental Health Plan may be a critical opportunity to implement psychoeducation and family interventions in Portugal. The authors address this issue, discussing also the potential role of new models of contracting, financing, accounting and monitoring.

scholarly journals Implementing a digital health model of care in Australian youth mental health services: protocol for impact evaluation

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Sarah Piper ◽  
Tracey A. Davenport ◽  
Haley LaMonica ◽  
Antonia Ottavio ◽  
Frank Iorfino ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Impact Evaluation ◽  
Digital Health ◽  
Youth Mental Health ◽  
Model Of Care ◽  
Health Service Provision ◽  
Industrial Grade ◽  
The Impact

Abstract Background The World Economic Forum has recently highlighted substantial problems in mental health service provision and called for the rapid deployment of smarter, digitally-enhanced health services as a means to facilitate effective care coordination and address issues of demand. In mental health, the biggest enabler of digital solutions is the implementation of an effective model of care that is facilitated by integrated health information technologies (HITs); the latter ensuring the solution is easily accessible, scalable and sustainable. The University of Sydney’s Brain and Mind Centre (BMC) has developed an innovative digital health solution – delivered through the Youth Mental Health and Technology Program – which incorporates two components: 1) a highly personalised and measurement-based (data-driven) model of youth mental health care; and 2) an industrial grade HIT registered on the Australian Register of Therapeutic Goods. This paper describes a research protocol to evaluate the impact of implementing the BMC’s digital health solution into youth mental health services (i.e. headspace - a highly accessible, youth-friendly integrated service that responds to the mental health, physical health, alcohol or other substance use, and vocational concerns of young people aged 12 to 25 years) within urban and regional areas of Australia. Methods The digital health solution will be implemented into participating headspace centres using a naturalistic research design. Quantitative and qualitative data will be collected from headspace health professionals, service managers and administrators, as well as from lead agency and local Primary Health Network (PHN) staff, via service audits, Implementation Officer logs, online surveys, and semi-structured interviews, at baseline and then three-monthly intervals over the course of 12 months. Discussion At the time of publication, six headspace centres had been recruited to this study and had commenced implementation and impact evaluation. The first results are expected to be submitted for publication in 2021. This study will focus on the impact of implementing a digital health solution at both a service and staff level, and will evaluate digital readiness of service and staff adoption; quality, usability and acceptability of the solution by staff; staff self-reported clinical competency; overall impact on headspace centres as well as their lead agencies and local PHNs; and social return on investment.

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