scholarly journals Priorities and preferences for school-based mental health services in India: a multi-stakeholder study with adolescents, parents, school staff, and mental health providers

2019 ◽  
Vol 6 ◽  
Author(s):  
R. Parikh ◽  
D. Michelson ◽  
M. Sapru ◽  
R. Sahu ◽  
A. Singh ◽  
...  

Background.Schools are important settings for increasing reach and uptake of adolescent mental health interventions. There is limited consensus on the focus and content of school-based mental health services (SBMHSs), particularly in low-resource settings. This study elicited the views of diverse stakeholders in two urban settings in India about their priorities and preferences for SBMHSs.Methods.We completed semi-structured interviews and focus group discussions with adolescents (n  =  191), parents (n  =  9), teachers (n  =  78), school counsellors (n  =  15), clinical psychologists/psychiatrists (n  =  7) in two urban sites in India (Delhi and Goa). Qualitative data were obtained on prioritized outcomes, preferred content and delivery methods, and indicated barriers.Results.All stakeholders indicated the need for and acceptability of SBMHSs. Adolescents prioritized resolution of life problems and exhibited a preference for practical guidance. Parents and teachers emphasized functional outcomes and preferred to be involved in interventions. In contrast, adolescents' favored limited involvement from parents and teachers, was related to widespread concerns about confidentiality. Face-to-face counselling was deemed to be the most acceptable delivery format; self-help was less frequently endorsed but was relatively more acceptable if blended with guidance or delivered using digital technology. Structured sensitization was recommended to promote adolescent's engagement. Providers endorsed a stepped care approach to address different levels of mental health need among adolescents.Conclusion.SBMHSs are desired by adolescents and adult stakeholders in this setting where few such services exist. Sensitization activities are required to support implementation. School counsellors have an important role in identifying and treating adolescents with different levels of mental health needs, and a suite of interventions is needed to target these needs effectively and efficiently.

Author(s):  
Maxine Blanche Langdon Starr

A largely unmet need exists for school-based mental health services by students who are of an ethnic minority and who may not have insurance, access, and/or the knowledge of mental health services. These same students may not receive effective, culturally sensitive counseling services, interventions, or valid/accurate measures of psychological testing. In order to resonate and connect with these students who need the most help and support despite these barriers to accessing quality treatment, what is the school-based mental health provider to do? This chapter will initially discuss a comprehensive review of culturally competent interventions for school-based mental health providers as well as recommendations for culturally competent training for mental health providers and school staff to ensure that culturally competent collaboration and appropriate support exists for all students.


Author(s):  
Maxine Blanche Langdon Starr

A largely unmet need exists for school-based mental health services by students who are of an ethnic minority and who may not have insurance, access, and/or the knowledge of mental health services. These same students may not receive effective, culturally sensitive counseling services, interventions, or valid/accurate measures of psychological testing. In order to resonate and connect with these students who need the most help and support despite these barriers to accessing quality treatment, what is the school-based mental health provider to do? This chapter will initially discuss a comprehensive review of culturally competent interventions for school-based mental health providers as well as recommendations for culturally competent training for mental health providers and school staff to ensure that culturally competent collaboration and appropriate support exists for all students.


Author(s):  
Stephanie L. Schmitz ◽  
Kerri L. Clopton ◽  
Nicole R. Skaar ◽  
Stephanie Dredge ◽  
David VanHorn

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.


2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Johanna Frerichs ◽  
Jo Billings ◽  
Nick Barber ◽  
Anjie Chhapia ◽  
Beverley Chipp ◽  
...  

Abstract Background Loneliness is associated with negative outcomes, including increased mortality and is common among people with mental health problems. This qualitative study, which was carried out as part of a feasibility trial, aimed to understand what enables and hinders people with severe depression and/or anxiety under the care of secondary mental health services in the United Kingdom to participate in the Community Navigator programme, and make progress with feelings of depression, anxiety and loneliness. The programme consisted of up to ten meetings with a Community Navigator and three optional group sessions. Methods Semi-structured interviews were carried out with participants (n = 19) shortly after programme completion. A co-produced two-stage qualitative approach, involving narrative and reflexive thematic analysis, was undertaken by members of the study’s working group, which included experts by experience, clinicians and researchers. Results The narrative analysis showed that individuals have varied goals, hold mixed feelings about meeting other people and define progress differently. From the thematic analysis, six themes were identified that explained facilitators and challenges to participating in the programme: desire to connect with others; individual social confidence; finding something meaningful to do; the accessibility of resources locally; the timing of the programme; and the participant’s relationship with the Community Navigator. Conclusions We found that people with severe depression and/or anxiety supported by secondary mental health services may want to address feelings of loneliness but find it emotionally effortful to do so and a major personal challenge. This emotional effort, which manifests in individuals differently, can make it hard for participants to engage with a loneliness programme, though it was through facing personal challenges that a significant sense of achievement was felt. Factors at the individual, interpersonal and structural level, that enable or hinder an individual’s participation should be identified early, so that people are able to make the best use out of the Community Navigator or other similar programmes.


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