Discharge planning, an intervention study - and where to go next?

2011 ◽  
Vol 26 (S2) ◽  
pp. 2041-2041
Author(s):  
T. Becker ◽  
S. Steffen ◽  
B. Puschner ◽  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Service Use ◽  
Discharge Planning ◽  
Control Group ◽  
Differential Effectiveness ◽  
Study Results ◽  
Planning Intervention

BackgroundProcess evaluation should be an integral part of randomised controlled trials (RCTs), and this is important in examining complex interventions with a number of active ingredients.ObjectiveTo analyse effectiveness and effect moderators in a multi-centre RCT of needs-oriented discharge planning vs. treatment as usual (TAU) for high utilisers of mental health care.MethodFrom April 2006 to July 2007, 491 adults with high utilisation of mental health care for psychotic disorders gave informed consent to participate in a multi-site RCT at five German psychiatric inpatient services. Subjects allocated to the intervention group were offered a manualised needs-led discharge planning intervention of two 45 minute sessions delivered by a trained study worker. Outcomes (service use, needs, psychopathology, depression, quality of life, direct costs) were assessed at four measurement points during 18-month follow-up. Latent class modelling was used to scrutinise differential effectiveness. Characteristics of subgroups of participants showing variable treatment response will be described.ResultsThere was improvement both in the intervention and (TAU) control group but no differential effectiveness of the discharge planning intervention. Only few variables significantly moderated effects. Effect moderators pertained to quality of delivery and intervention dose.ConclusionsStudy results could help to tailor interventions to local conditions and guide future implementation of discharge planning in routine care. Further research should focus on scrutinising study process, ensuring ecological suitability of interventions and on head-to-head comparison studies.

Depressions Plural

2017 ◽  
Author(s):  
K W M (Bill) Fulford ◽  
David Crepaz-Keay ◽  
Giovanni Stanghellini
Keyword(s):  
Quality Of Life ◽  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Personal Values ◽  
The Political ◽  
Medical Law ◽  
Isaiah Berlin ◽  
Political Philosopher

This chapter examines how values influence the heterogeneity of depression. The plurality of values is increasingly significant for contemporary person-centred mental health care with its emphasis on quality of life and development of self-manvnagement skills. Values-based practice is a partner with medical law invn working with the plurality of personal values. The chapter explains what values are, shows how the plurality of values influences the heterogeneity of depression at several levels, and provides an overview of values-based practice. It looks at the resources available for combining values-based practice with medical law in contemporary person-centred care and indicates some of the challenges this raises. It concludes with a brief reflection on these challenges understood as an instance of what the political philosopher Isaiah Berlin called the challenge of pluralism.

scholarly journals The Quality Mental Health Care Network: A roadmap to improving quality mental healthcare in Canada

2021 ◽  
Vol 34 (2) ◽  
pp. 100-106
Author(s):  
Emily J. Follwell ◽  
Siri Chunduri ◽  
Claire Samuelson-Kiraly ◽  
Nicholas Watters ◽  
Jonathan I. Mitchell
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Focus Groups ◽  
Lived Experiences ◽  
Mental Healthcare ◽  
Care Network ◽  
Key Informant ◽  
Health Care Network

Although there are numerous quality of care frameworks, little attention has been given to the essential concepts that encompass quality mental healthcare. HealthCare CAN and the Mental Health Commission of Canada co-lead the Quality Mental Health Care Network (QMHCN), which has developed a quality mental healthcare framework, building on existing provincial, national, and international frameworks. HealthCare CAN conducted an environmental scan, key informant interviews, and focus groups with individuals with lived experiences to develop the framework. This article outlines the findings from this scan, interviews and focus groups.

scholarly journals Inpatient Volume and Quality of Mental Health Care Among Patients With Unipolar Depression

2018 ◽  
Vol 69 (7) ◽  
pp. 797-803 ◽  
Author(s):  
Line Ryberg Rasmussen ◽  
Jan Mainz ◽  
Mette Jørgensen ◽  
Poul Videbech ◽  
Søren Paaske Johnsen
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Unipolar Depression

scholarly journals Improving the quality of mental health care

2009 ◽  
Vol 21 (6) ◽  
pp. 415-420 ◽  
Author(s):  
M. Funk ◽  
C. Lund ◽  
M. Freeman ◽  
N. Drew
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care

Mental health care in Italy: Basaglia’s ashes in the wind of the crisis of the last decade

2020 ◽  
Vol 66 (4) ◽  
pp. 321-330 ◽  
Author(s):  
Mauro G Carta ◽  
Matthias C Angermeyer ◽  
Anita Holzinger
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Psychiatric Hospitals ◽  
Scientific Methods ◽  
Italian Experience ◽  
Italian Regions ◽  
Care Culture ◽  
Health Care Culture

Background and Aims: The purpose is to highlight the legal and ethical principles that inspired the reform of mental health care in Italy, the only country to have closed its psychiatric hospitals. The article will also try to verify some macro-indicators of the quality of care and discuss the crisis that the mental health care system in Italy is experiencing. Methods: Narrative review. Results: The principal changes in the legislation on mental health care in Italy assumed an important role in the evolution of morals and common sense of the civil society of that country. We describe three critical points: first, the differences in implementation in the different Italian regions; second, the progressive lack of resources that cannot be totally attributed to the economic crisis and which has compromised application of the law; and finally, the scarce attention given to measurement of change with scientific methods. Conclusion: Italy created a revolutionary approach to mental health care in a historical framework in which it produced impressive cultural expressions in many fields. At that time, people were accustomed to ‘believing and doing’ rather than questioning results and producing research, and this led to underestimating the importance of a scientific approach. With its economic and cultural crisis, Italy has lost creativity as well as interest in mental health, which has been guiltily neglected. Any future humanitarian approach to mental health must take the Italian experience into account, but must not forget that verification is the basis for any transformation in health care culture.

scholarly journals Realist Evaluation of the Use of Patient Experience Data to Improve the Quality of Inpatient Mental Health Care (EURIPIDES) in England: study protocol

BMJ Open ◽  
2018 ◽  
Vol 8 (6) ◽  
pp. e021013 ◽  
Author(s):  
Scott Weich ◽  
Sarah-Jane Hannah Fenton ◽  
Kamaldeep Bhui ◽  
Sophie Staniszewska ◽  
Jason Madan ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Patient Experience ◽  
Study Protocol ◽  
Realist Evaluation ◽  
Inpatient Mental Health

scholarly journals Treatment gap and mental health service use among Syrian refugees in Turkey

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
D C Fuhr ◽  
C Ataturk ◽  
M McGrath ◽  
Z Ilkkursun ◽  
A Woodward ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Service Use ◽  
Mental Health Problems ◽  
Mental Health Service Use ◽  
Continuing Care ◽  
Syrian Refugees ◽  
Depression And Anxiety ◽  
Treatment Gap

Abstract Introduction Turkey hosts the highest number of Syrian refugees in Europe. Refugees are often vulnerable to situational forms of psychosocial distress as a consequence of exposure to war and violence which may result in more profound mental health problems if no treatment is sought. The aim of this study is to report evidence on mental health and psychosocial support (MHPSS) needs, access and barriers to MHPSS care among Syrians refugees living in Istanbul, Turkey. Methods A cross-sectional survey was conducted among Syrian refugees aged 18 years or over in Istanbul (Sultanbeyli) between February and May 2018. Data among 1’678 Syrian refugees were collected on mental health outcomes using the Posttraumatic Stress Disorder (PTSD) Checklist (PCL-5) and the Hopkins Symptoms Checklist (HSCL-25) for depression and anxiety. We also collected data on health care utilization, barriers to seeking and continuing care as well as knowledge and attitudes towards mental health. Descriptive analyses were used. Results The prevalence of PTSD, depression and anxiety was 19.6%, 34.7% and 36.1% respectively. The treatment gap was 89% for PTSD, 90% for anxiety and 88% for depression. 249 respondents (15%) screened positive for either PTSD, depression or anxiety in our survey and self-reported emotional/behavioural problems since arriving in Sultanbeyli. Several structural and attitudinal barriers for not seeking care were reported. Conclusions To overcome the treatment gap, mental health care programmes need to be more responsive to the needs of Syrian refugees. Barriers to seeking and continuing care can be overcome by providing MHPSS services in the community which facilitate access to care. Community-based programmes of care should be supported by activities which increase awareness about mental health issues and tackle negative attitudes towards mental illness. Key messages This study provides the first nationally representative data on the mental health of Syrian refugees in Turkey, and shows that refugees have high mental health needs. Syrian refugees do not seek mental health care despite availability of mental health services in the community.

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