scholarly journals Barriers and opportunities for refugee mental health services: clinician recommendations from Jordan

2021 ◽  
Vol 8 ◽  
Author(s):  
Majd Al-Soleiti ◽  
Mahmoud Abu Adi ◽  
Ayat Nashwan ◽  
Eric Rafla-Yuan
Keyword(s):  
Mental Health ◽  
Health System ◽  
Mental Health Professionals ◽  
Low Income ◽  
Health Professionals ◽  
Mental Health Treatment ◽  
Qualitative Interviews ◽  
Low Income Countries ◽  
Syrian Refugees ◽  
Increased Risk

Abstract Background Jordan has received more than three million refugees from bordering countries during times of conflict, including over 600 000 Syrian refugees between 2011 and 2021. Amidst this humanitarian crisis, a new mental health system for Syrian refugees has developed in Jordan, with most clinical services administered through non-governmental organizations. Prior studies have identified increased risk of psychiatric disorders in refugee populations and significant barriers for Syrian refugees seeking mental health treatment, but few have reviewed the organization or ability of local systems to meet the needs of this refugee population. Methods Qualitative interviews of mental health professionals working with refugees in Jordan were conducted and thematically analyzed to assess efficacy and organizational dynamics. Results Interviewees described barriers to care inherent in many refugee settings, including financial limitations, shortages of mental health professionals, disparate geographic accessibility, stigma, and limited or absent screening protocols. Additional barriers not previously described in Jordan were identified, including clinician burnout, organizational metrics restricting services, insufficient visibility of services, and security restrictions. Advantages of the Jordanian system were also identified, including a receptive sociopolitical response fostering coordination and collaboration, open-door policies for accessing care, the presence of community and grassroots approaches, and improvements to health care infrastructure benefiting the local populace. Conclusions These findings highlight opportunities and pitfalls for program development in Jordan and other middle- and low-income countries. Leveraging clinician input can promote health system efficacy and improve mental health outcomes for refugee patients.

The Challenges Facing Mental Health Programs for Post-Conflict and Refugee Communities

2004 ◽  
Vol 19 (1) ◽  
pp. 90-96 ◽  
Author(s):  
Derrick Silove
Keyword(s):  
Mental Health ◽  
Mental Health Professionals ◽  
Low Income ◽  
Traumatic Stress ◽  
Health Professionals ◽  
Adaptive Systems ◽  
Small Scale ◽  
Displaced Persons ◽  
Stress Reactions ◽  
Post Conflict

AbstractThe majority of refugees and communities exposed to warfare and oppression live in low-income countries with few resources or special skills. Yet, epidemiological studies have identified high levels of traumatic stress reactions in such populations. These stress reactions can be intensified by harsh policies aimed at deterring survivors from seeking refuge in technologically advanced societies. The scale of the problem of mass violence and displacement creates formidable challenges for mental health professionals in their efforts to develop practical frameworks for responding to the extensive needs of displaced persons. In this article, a model is proposed for low-income, post-conflict countries, based on a two-tiered formulation. At the eco-social level, mental health professionals can play a supportive, but not a lead, role in facilitating recovery of core adaptive systems that hasten natural recovery from stress for the majority of the population. Where small-scale, community mental health services are established, the emphasis should be on assisting persons and their families who are at greatest survival and adaptive risk. Training and promotion of local workers to assume leadership in such programs are essential. In technologically advanced societies in which refugees are in a minority, torture and trauma services can focus more specifically on traumatic stress reactions, acculturation, and resettlement. In a historical epoch in which displaced persons are facing particularly harsh treatment, there is a pressing need for consensus amongst mental health professionals in advocating for their needs.

Specialist mental health treatment in general practice: a meta-analysis

1988 ◽  
Vol 18 (3) ◽  
pp. 711-717 ◽  
Author(s):  
Matteo Balestrieri ◽  
Paul Williams ◽  
Greg Wilkinson
Keyword(s):  
Mental Health ◽  
General Practice ◽  
Success Rate ◽  
Mental Health Professionals ◽  
Health Professionals ◽  
Mental Health Treatment ◽  
Meta Analysis ◽  
Practice Setting ◽  
Health Treatment ◽  
General Practice Setting

SynopsisA meta-analysis of studies was carried out to compare treatment by specialist mental health professionals in the general practice setting and ‘usual GP treatment ’. Overall, treatment by specialist mental health professionals had a 10% greater success rate.

scholarly journals Primary health professionals’ beliefs, experiences, and willingness to treat minor attracted persons

2021 ◽  
Author(s):  
Rebecca Lievesley ◽  
Helen Swaby ◽  
Craig A. Harper ◽  
Ellie Woodward
Keyword(s):  
Mental Health ◽  
Mental Health Professionals ◽  
Health Professionals ◽  
Mental Health Treatment ◽  
Professional Training ◽  
Online Survey ◽  
Healthcare Providers ◽  
Mental Health Settings ◽  
Decision Making Processes ◽  
Treatment Priorities

There is a desire and need among minor attracted persons (MAPs) to access support within the community, and this often begins with an approach to healthcare providers working in general medical/mental health settings. However, little is known about the experiences of these non-specialist professionals in relation to their beliefs, knowledge, and decision-making processes when working with patients who disclose sexual attractions to children. Using an online survey, this study explored the knowledge, comfort, competence, and treatment willingness of 220 non-specialist healthcare providers when faced with patients who disclose sexual attractions to children. We investigated the prevalence of these disclosures, clinician stigma, treatment priorities, and professionals’ willingness to report MAPs to external agencies because of their sexual attractions. Some key differences were found when comparing primary medical vs mental health professionals, including increased likelihood to view MAPs as dangerous, unable to control behaviors and that sexual attractions are an avoidable choice, in the former group. Both groups prioritized mental health treatment targets above controlling attractions and living with stigmatized attractions, although controlling or changing attractions were still relatively high priorities. Results indicated a need for further training, focusing on increasing comfort around working with MAPs, as this was associated with a greater willingness to work with this group. We identify current gaps in service provision for MAPs seeking professional support and discuss recommendations for professional training.

Riflessioni sull'identitŕ degli operatori in psichiatria

2009 ◽  
pp. 545-558
Author(s):  
Pietro Pellegrini
Keyword(s):  
Mental Health ◽  
Social Control ◽  
Health System ◽  
Mental Health Professionals ◽  
Health Professionals ◽  
Psychological Factors ◽  
Work Organization ◽  
Social Revolution ◽  
Cultural Issues ◽  
Political Norms

- The identity of mental health professionals is fragile despite an increasing awareness of the importance of psychological factors in the health system. This crisis stems from work organization, conflicts between therapy and social control, gaps between expectations and actual responses and between needs and interventions, social and cultural issues, identity as reflected by society at large. Responsibilities of mental health professionals are discussed, and the various goals of their mission are analyzed: mental health professionals are supposed to perform as technicians of adaptation, of social revolution, of crisis, of listening, of uncertainty, of pain, and of death. The professionals' identity encompasses all these aspects, that are related also to personality traits, working styles and institutional climates. Finally, the importance of ethical, cultural and political norms is emphasized.

Tilpasningsstrategier på Sexologisk Klinik – En undersøgelse af transkønnede klienters forhandling af identitet

2017 ◽  
Vol 28 (3) ◽  
pp. 41-59
Author(s):  
Ida Friis Thing ◽  
Viola Marie Skovgaard
Keyword(s):  
Mental Health ◽  
Mental Health Professionals ◽  
Health Professionals ◽  
Qualitative Interviews ◽  
Public Healthcare ◽  
Institutional Identity ◽  
Theoretical Concepts ◽  
Negotiation Of Identity ◽  
The Social ◽  
To Receive

Denne artikel præsenterer resultaterne fra 9 kvalitative interviews med transpersoner, der enten er eller har været i behandling på den offentlige institution Sexologisk Klinik på Rigshospitalet i København. I Danmark har de to offentlige institutioner Sexologisk Klinik og Sexologisk Center Aalborg monopol på behandling af transpersoner. Klienter der ønsker hormonel eller kropsmodificerende behandling må således gennemgå et udredningsforløb på en af disse institutioner. Artiklen viser, hvordan identiteten transseksuel kan siges at udgøre en institutionel identitet på Sexologisk Klinik, som klienterne aktivt udfordrer, følger eller indretter sig strategisk efter. I artiklen analyserer vi, ved hjælp af Goffmans teoriapparat fra hans analyse om den totale institution, hvordan klienterne gør brug af tilpasningsstrategier i et forsøg på at håndtere de institutionelle identiteter, de tilbydes. Vi viser, at klienterne i udpræget grad anvender, hvad Goffman betegner som en koloniserende tilpasningsstrategi på klinikken og således bestræber sig på at få mest ud af institutionens muligheder ved at omstrukturere deres livshistorier, så de passer til institutionens kriterier for godkendelse til behandling. I analysen benyttes en kombination af symbolsk interaktionisme og socialkonstruktivisme til at undersøge den relationelle karakter af reproduktionen af den institutionelle identitet transseksuel. ENGELSK ABSTRACT: Ida Friis Thing and Viola Marie Skovgaard: Strategies ofadaptation at a sexology clinic: a study of transgenderclients’ negotiation of identity This article presents the results from nine qualitative interviews with transgender clients concerning their experiences with a public healthcare sexology clinic. At this institution transgender clients apply for approval to receive hormonal treatment and body modifying surgery. The article analyses the social process of clientisation in encounters between clients and mental health professionals, which involve the construction of the institutional identity transsexual, that is, some conditions for how the clients might perceive and present themselves. We employ Goffman’s theoretical concepts from his analysis of the total institution to describe how clients adapt to this process of clientisation by making use of a variety of strategies. Some clients are continuingly resisting the institution and the mental health professionals, while other clients adapt fully to the institutional ideology of therapy. However most clients take advantage of possibilities within the institution by creating narratives that correspond with the institutional criteria for the diagnosis transsexual. We employ a combination of the symbolic interactionist and the social constructivist approaches to emphasize the relational character of the reproduction of the institutional identity transsexual. Keywords: Clientisation, Adaptation Strategies, Goffman, Institutional Identities, transgender

scholarly journals Burnout in mental health professionals: A systematic review and meta-analysis of prevalence and determinants

2018 ◽  
Vol 53 ◽  
pp. 74-99 ◽  
Author(s):  
Karen O’Connor ◽  
Deirdre Muller Neff ◽  
Steve Pitman
Keyword(s):  
Mental Health ◽  
Systematic Review ◽  
Mental Health Professionals ◽  
Emotional Exhaustion ◽  
Health Professionals ◽  
Meta Analysis ◽  
Maslach Burnout Inventory ◽  
Personal Accomplishment ◽  
Original Research ◽  
Increased Risk

AbstractThis study aimed to estimate the level of burnout in mental health professionals and to identify specific determinants of burnout in this population. A systematic search of MEDLINE/PubMed, PsychINFO/Ovid, Embase, CINAHL/EBSCO and Web of Science was conducted for original research published between 1997 and 2017. Sixty-two studies were identified as meeting the study criteria for the systematic review. Data on the means, standard deviations, and prevalence of the dimensions of burnout were extracted from 33 studies and included in the meta-analysis (n = 9409). The overall estimated pooled prevalence for emotional exhaustion was 40% (CI 31%–48%) for depersonalisation was 22% (CI 15%–29%) and for low levels of personal accomplishment was 19% (CI 13%–25%). The random effects estimate of the mean scores on the Maslach Burnout Inventory indicate that the average mental health professional has high levels of emotional exhaustion [mean 21.11 (95% CI 19.98, 22.24)], moderate levels of depersonalisation [mean 6.76 (95% CI 6.11, 7.42)] but retains reasonable levels of personal accomplishment [mean 34.60 (95% CI 32.99, 36.21)]. Increasing age was found to be associated with an increased risk of depersonalisation but also a heightened sense of personal accomplishment. Work-related factors such as workload and relationships at work, are key determinants for burnout, while role clarity, a sense of professional autonomy, a sense of being fairly treated, and access to regular clinical supervision appear to be protective. Staff working in community mental health teams may be more vulnerable to burnout than those working in some specialist community teams, e.g., assertive outreach, crisis teams.

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