The next step: a strategic focus on physical activity and sedentary behaviour in Irish mental health care

2018 ◽  
pp. 1-3 ◽  
Author(s):  
E. Matthews ◽  
M. Cowman ◽  
S. Denieffe
Keyword(s):  
Mental Health ◽  
Physical Activity ◽  
Health Care ◽  
Mental Health Care ◽  
Sedentary Behaviour ◽  
Mental Health Professionals ◽  
Mental Illnesses ◽  
Multidisciplinary Teams ◽  
Mental Health Nurses ◽  
Health Strategy

People with severe mental illnesses have dramatically reduced life expectancy compared with the general population, which is largely attributed to physical comorbidity. Physical activity and sedentary behaviour interventions offer a safe and viable therapeutic resource for multi-disciplinary mental health care teams. The accumulating evidence supporting the role of these interventions has changed the focus of mental health strategy in some countries, with new developing roles for certain mental health professionals in this field. However, in Ireland the absence of specialised exercise practitioners places a leadership role for mental health nurses in this regard. National mental health strategy in Ireland should prioritise physical activity and sedentary behaviour interventions, make recommendations for the integration of specialised exercise practitioners in all mental health multidisciplinary teams, and recommend the provision of training and awareness for mental health nurses and other multidisciplinary professionals who are already well placed to address this issue.

scholarly journals Pathways to mental health care in Nepal: a 14-center nationwide study

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Anoop Krishna Gupta ◽  
Sulochana Joshi ◽  
Bikram Kafle ◽  
Ranjan Thapa ◽  
Manisha Chapagai ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Mental Health Professionals ◽  
Clinical Presentation ◽  
Service Providers ◽  
Mental Illnesses ◽  
World Health ◽  
Pathways To Care ◽  
Duration Of Untreated Illness

Abstract Background Pathways to care studies are feasible and tested means of finding the actual routes taken by patients before reaching proper care. In view of the predominance of nonprofessional service providers and the lack of previous large studies on pathways in Nepal, this multicenter study is needed. The aim of the study was to trace the various pathways and carers involved in mental health care; assess clinical variables such as the duration of untreated illness, clinical presentation and treatment; and compare geographically and culturally diverse landscapes. Methods This was a cross-sectional, convenience sampling study performed at 14 centers where new cases were being taken. The World Health Organization Study of the Pathways-to-Care Schedule was applied. The Nepali version of the encounter form was used. The data were collected between 17 September and 16 October 2020 and were analyzed using the Statistical Package for the Social Sciences (SPSS). Additionally, perspectives from local investigators were collected and discussed. Results Most of the first carers were native/religious faith healers (28.2%), followed by psychiatrists (26%). The median duration for the first psychiatric consultation was 3 weeks. The duration of untreated illness was 30.72 ± 80.34 (median: 4) weeks, and the time taken for this journey was 94.99 ± 274.58 (median: 30) min. The longest delay from the onset of illness to psychiatric care was for epilepsy {90.0 ± 199.0 (median: 25.5)} weeks, followed by neurotic illness {22.89 ± 73.45 (median: 2)} and psychotic illness {10.54 ± 18.28 (median: 2)} weeks. Overall, most patients with severe mental illnesses (SMIs) had their first contact with faithhealers (49%), then met with medical doctors (13%) or psychiatrists (28%). Marked differences in clinical presentation surfaced when hilly centers were compared with the Terai belt. Conclusions Faith healers, general practitioners and hospital doctors are major carers, and the means of educating them for proper referral can be considered. The investigators see several hindrances and opportunities in the studied pathways. The employment of more mental health professionals and better mental health advocacy, public awareness programs and school education are suggested strategies to improve proper mental health care.

scholarly journals Dilemmas in delivering health promotion activities: findings from a qualitative study of mental health nurses in Denmark

BMJ Open ◽  
2020 ◽  
Vol 10 (12) ◽  
pp. e036403
Author(s):  
Jane Ege Møller ◽  
Anne Møller ◽  
Loni Ledderer
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Health Promotion ◽  
Mental Health Care ◽  
Qualitative Content Analysis ◽  
Mental Healthcare ◽  
Mental Illnesses ◽  
Interactive Approach ◽  
Mental Health Nurses ◽  
Long Term Conditions

ObjectiveRecent studies have shown that people with mental illnesses have higher mortality and morbidity rates due to long-term conditions and lifestyle diseases. This knowledge has led to health promotion initiatives in mental health care to improve the physical health of people with mental illness. This article explores how mental health nurses experience working with health promotion activities in mental healthcare practices.DesignWe adopted a qualitative research design using an interactive approach. Qualitative content analysis was used to develop the analytical framework.ParticipantsFocus groups (n=7; n=5) were conducted with two groups of mental health nurses who attended health specialist training sessions in Denmark in the spring and fall of 2018.ResultsThe findings showed that working with health promotion activities in mental health care created two dilemmas for the mental health nurses: (1) dilemmas related to health promotion that involved discrepancies between the health promotion activities that were offered and patients’ autonomy and wishes, and (2) system-related dilemmas stemming from working with screening for risk factors and documentation programmes. The mental health nurses developed different strategies to navigate these dilemmas, such as devising interview techniques for the screening questions and bending guidelines.ConclusionsMental health nurses found it challenging to implement health promotion activities in mental health care, although they generally found these activities meaningful. The findings show that new health promotion activities need to be adapted to nurses’ existing mental healthcare practices; however, this may require some adaptation of existing nursing practices.

scholarly journals Implementation of health promotion activities in mental health care in Denmark

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
J E Møller ◽  
A Møller ◽  
L Ledderer
Keyword(s):  
Mental Health ◽  
Risk Factors ◽  
Health Care ◽  
Health Promotion ◽  
Mental Health Care ◽  
Qualitative Content Analysis ◽  
Mental Illnesses ◽  
Structural Factors ◽  
Interactive Approach ◽  
Mental Health Nurses

Abstract Background People suffering from serious mental illness face a high risk of lifestyle-related health problems, and higher mortality and morbidity rates than the rest of the population. The solution to the problem has been to integrate health promotion initiatives in mental health care. In Denmark psychiatric departments have implemented a new strategy and mental health nurses are now asked to screen for risk factors. The aim of this study is to explore how mental health nurses experience working with the screening of risk factors amongst patients with mental illnesses as part of their health promotion activities. Methods We employed a qualitative research design using an interactive approach. Two focus group interviews (n = 7; n = 5) were conducted with mental health nurses attending a mental health specialist training in Denmark in 2018. The interviews lasted 1 ½ hours, were recorded and transcribed verbatim. Data were organized using NVivo 12 software and a qualitative content analysis was used to describe experiences in a conceptual form. Results The implementation of health promotion activities in mental health care created two different types of dilemmas for the mental health nurses: 1) dilemmas related to health promotion that involved discrepancies between patients’ autonomy and wishes, and the health promotion activities that were offered; 2) system-related dilemmas originated from structural factors and working with screening for risk factors. The mental health nurses developed various strategies and found new solutions to navigate these dilemmas. Conclusions Mental health nurses found it challenging to implement health promotion activities in mental health care, although they generally found these activities meaningful. They developed new strategies to overcome the dilemmas. Key messages Health promotion initiatives need to be adapted to mental health nurses’ existing mental healthcare practices in order for them to be meaningful. Screening of risk factors is insufficient as a health promotion activity in mental health care.

Handling Ethical Dilemmas in Multidisciplinary Teams

2014 ◽  
Author(s):  
Jill Thistlethwaite ◽  
Wendy Hawksworth
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Mental Health Problems ◽  
Ethical Issues ◽  
Interprofessional Collaboration ◽  
Ethical Dilemmas ◽  
Multidisciplinary Teams ◽  
Team Members ◽  
Secondary Health Care

This chapter explores the concept and practice of teamwork and interprofessional collaboration in the support and treatment of clients with mental health problems. Mental health care provision is complex, ethically challenging, and frequently delivered via mental health care teams (MHCT) in both primary and secondary health care settings. We consider how such teams may work together optimally using values-based and client-centered approaches. We discuss the nature of and reasons for conflict arising in multidisciplinary MHCTs, focusing on ethical dilemmas that occur where there is diversity amongst team members in respect of personal, professional, and/or organizational values. The specific ethical issues discussed are: boundary issues; receiving gifts; confidentiality, and involuntary treatment and restraint. Three case studies are used to provide examples of values in action.

The Greater Vancouver Mental Health Service Society: 20 Years' Experience in Urban Community Mental Health

1993 ◽  
Vol 38 (5) ◽  
pp. 308-314 ◽  
Author(s):  
Nicholas Sladen-Dew ◽  
Douglas A. Bigelow ◽  
Ralph Buckley ◽  
Stephen Bornemann
Keyword(s):  
Mental Health ◽  
Mental Health Service ◽  
Health Service ◽  
Mental Health Professionals ◽  
Mental Illnesses ◽  
Multidisciplinary Teams ◽  
Fully Integrated ◽  
Mentally Disabled ◽  
Community Agencies ◽  
Persons With Schizophrenia

Caring for people in the community with persistent and disabling mental illnesses presents a major challenge to government, planners and mental health professionals. The success with which mentally disabled people are integrated into community life says much about the society in which we live. This article describes the experience of the Greater Vancouver Mental Health Service Society in offering community-based mental health services to persons with schizophrenia and other major mental disorders over the past 20 years. The key to its success lies in a decentralized, relatively non hierarchical organizational structure which allows committed and skilled multidisciplinary teams to work with patients and their families in their community. The resulting services are fully integrated within the fabric of the community and are responsive to local needs. Partnerships among professionals, patients, families and community agencies result in work that is creative, productive and effective.

Pathways to Mental Health Services and Perceptions about the Effectiveness of Treatment

2018 ◽  
Vol 9 (3) ◽  
pp. 388-407 ◽  
Author(s):  
Sirry M. Alang ◽  
Donna D. McAlpine
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Mental Health Problems ◽  
Severity Of Illness ◽  
Mental Illnesses ◽  
Social Characteristics ◽  
Treatment Gap ◽  
Quality Outcomes ◽  
Effectiveness Of Care

The gap between need and effective treatment for mental health problems continues to be a challenge for researchers and policymakers. Much of the attention has been on differences in treatment rates, with insufficient attention to variation in pathways that people take into treatment. Individuals may choose to seek help but may also be substantially influenced by others or coerced into care. The chances of each type of pathway are influenced by social characteristics and may shape perceptions of effectiveness of care. This paper investigates variation in pathways into care and perceived effectiveness of care. We also examine whether choice or coercion into care are associated with whether individuals perceive care as effective and if severity of illness moderates this relationship. We use data from the 2010–2014 National Survey on Drug Use and Health (N = 10,020). Persons who independently sought mental health care were more likely to rate treatment as effective compared to persons ordered into care. Among people with severe mental illnesses, the probability of rating treatment as effective is lowest among those who were ordered into care. Entry into mental health care is not sufficient for closing the treatment gap if coerced care leads to poorer quality outcomes.

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