scholarly journals Mortality and cause of death among psychiatric patients: a 20-year case-register study in an area with a community-based system of care

2009 ◽  
Vol 39 (11) ◽  
pp. 1875-1884 ◽  
Author(s):  
L. Grigoletti ◽  
G. Perini ◽  
A. Rossi ◽  
A. Biggeri ◽  
C. Barbui ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
General Population ◽  
Mental Health Problems ◽  
Systems Of Care ◽  
Psychiatric Patients ◽  
Psychiatric Hospitals ◽  
Community Based ◽  
Case Register ◽  
Associated Risk Factors

BackgroundMost mortality studies of psychiatric patients published to date have been conducted in hospital-based systems of care. This paper describes a study of the causes of death and associated risk factors among psychiatric patients who were followed up over a 20-year period in an area where psychiatric care is entirely provided by community-based psychiatric services.MethodAll subjects in contact with the South Verona Community-based Mental Health Service (CMHS) over a 20-year period with an ICD-10 psychiatric diagnosis were included. Of these 6956 patients, 938 died during the study period. Standardized mortality ratios (SMRs) and Poisson multiple regressions were used to assess the excess of mortality in the sample compared with the general population.ResultsThe overall SMR of the psychiatric patients was 1.88. Mortality was significantly high among out-patients [SMR 1.71, 95% confidence interval (CI) 1.6–1.8], and higher still following the first admission (SMR 2.61, 95% CI 2.4–2.9). The SMR for infectious diseases was higher among younger patients and extremely high in patients with diagnoses of drug addiction (216.40, 95% CI 142.5–328.6) and personality disorders (20.87, 95% CI 5.2–83.4).ConclusionsThis study found that psychiatric patients in contact with a CMHS have an almost twofold higher mortality rate than the general population. These findings demonstrate that, since the closure of long-stay psychiatric hospitals, the physical health care of people with mental health problems is often neglected and clearly requires greater attention by health-care policymakers, services and professionals.

scholarly journals Mortality among people with mental disorders

2010 ◽  
Vol 19 (1) ◽  
pp. 1-3 ◽  
Author(s):  
Francesco Amaddeo ◽  
Michele Tansella
Keyword(s):  
General Population ◽  
Mental Disorders ◽  
Systems Of Care ◽  
Psychiatric Patients ◽  
Psychiatric Hospitals ◽  
Psychiatric Services ◽  
Community Based

Mortality among psychiatric patients has been found to be higher than the general population, not only in those long-term residents in old-fashioned psychiatric hospitals or attending hospital-based psychiatric services (Harris & Barraclough, 1998) but also in those treated in modern community-based systems of care (Amaddeo et al., 1995; Grigoletti et al., 2009).

Needs for care in psychiatric patients: a systematic review. I. General concepts and assessment measures. Needs for services

2000 ◽  
Vol 9 (3) ◽  
pp. 190-213 ◽  
Author(s):  
Antonio Lasalvia ◽  
Benedetta Stefani ◽  
Mirella Ruggeri
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Services ◽  
General Population ◽  
Health Services ◽  
Mental Health Care ◽  
Psychiatric Patients ◽  
Assessment Tools ◽  
Needs For Care ◽  
Number Of Patients

SummaryObjective – In Italy, mental health care is in phase of reorganisation. In this frame the measurement of users' needs may be a useftil tool in planning individualised mental health service interventions and in their evaluation. Aims of the present study are (I) to highlight the basic concepts of 'needs for care' and give a brief description of the main needs assessment tools specifically developed for psychiatric patients; (II) to review studies assessing needs for mental health services in the general population; (III) to discuss the role played by the assessment of needs in planning mental health care. Methods – Studies published in the international literature from January 1980 to June 1999 were reviewed. The studies were located through a computerised search of the databases MEDLINE and PsycLit; in addition, the reference lists of the studies located through the computerised search and the content of main international psychiatric journals were manually scanned in order to avoid possible omissions. Studies assessing needs for services and studies assessing needs on individual level were separately reviewed. Both groups of studies, in turn, were divided in studies assessing needs for mental health care in the general population and in psychiatric patients. Results – Although most studies on needs for services used indirect methodologies and employed quite heterogeneous experimental design, they provide at large overlapping results. In the general population, about 60%- 70% of patients with anxiety, depression and other neurotic disorders and 30%-40% of psychotic patients do not receive any specialist mental health care, suggesting that the majority of subjects suffering from a psychiatric disorder do not receive the mental health care they need. Conclusions – Unmet needs for services show a higher frequency in patients with neurotic and depressive disorders, indicating a shortage in services delivery that should be taken into account both by psychiatrists and mental health planners. Moreover, the finding that a large number of patients suffering from psychotic disorders do not receive any kind of mental health care is of particular relevance for planning mental health services, since these subjects are usually the most problematic and difficult to treat.

scholarly journals Mobile Mental Health Apps in China: Systematic App Store Search (Preprint)

2019 ◽  
Author(s):  
Huifang Yin ◽  
Klaas J Wardenaar ◽  
Yuhao Wang ◽  
Nan Wang ◽  
Wenjin Chen ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Problems ◽  
Mobile Apps ◽  
Psychiatric Patients ◽  
Evidence Based ◽  
Health Apps ◽  
Main Technique ◽  
Stress Relieving ◽  
Mobile Mental Health

BACKGROUND Smartphones have become ubiquitous in China, offering a promising way to deliver mental health interventions; however, little is known about the current use and characteristics of smartphone apps for mental health. OBJECTIVE The purpose of this study was to gain insight into mobile mental health apps available in China as of December 2018. METHODS A systematic search was conducted to identify and evaluate the most downloaded apps from iOS and Android platforms. Apps were categorized according to their main purpose and downloaded to evaluate their content. Each app’s affiliation, cost, target users, information security, and evidence-based nature were evaluated. RESULTS Of the 172 unique apps that were identified, there were 37 apps (21.5%) for psychological counseling, 50 apps (29.1%) for assessment, 12 apps (7.0%) to relieve stress, 24 apps (14.0%) for psychoeducation, and 49 (28.4%) multipurpose apps (ie, a combination of counseling and assessment). Most apps were developed for adults in the general population (166/172, 96.5%), rather than for psychiatric patients. App-based counseling was mostly provided by psychologists, and of the assessed apps, only 40% (70/172) used evidence-based scales to assess mental health problems such as anxiety or depressed mood. Guided meditation was used as the main technique in stress-relieving apps. CONCLUSIONS Many apps contained useful and evidence-based elements, such as good quality information, validated measurements, and useful meditation methods; however, for mobile apps to contribute significantly to mental health care in China, considerable challenges remain, including the need for more patient-focused apps that can actually take on the role of a health care provider. In addition, efficacy studies are needed.

scholarly journals Improving access to integrated mental health services in community-based settings in Portugal

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
G Cardoso
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Health Services ◽  
Mental Health Care ◽  
General Hospital ◽  
General Health ◽  
Psychiatric Hospitals ◽  
Health Departments ◽  
Community Based ◽  
Number Of Patients

Abstract Background Scientific evidence has proven greater effectiveness of community-based mental health care offering a diversity of services. Among the main barriers to mental health treatment are difficulties in the access and poor integration with general health services. Description of the problem The current Portuguese National Mental Health Plan promoted the transition from psychiatric hospital-based care to care provided by a network of services in the community with the inpatient unit in the local general hospital. In this presentation we will describe the main aspects of the mental health reform and some figures illustrating the functioning of one of the new mental health departments. Results Since 2006 three large psychiatric hospitals were closed and mental health departments are now in place according to the new model. One example, the HFF department of psychiatry, has developed an innovative comprehensive and integrated model based in the general hospital and the community, ensuring a close coordination with primary care teams and all other relevant stakeholders in the community, offering diverse answers to patients’ needs, and preventing drop-outs. Between 2000 and 2011, the number of admissions went from 486 to 451, first admissions from 40% to 36%, and the average number of patients treated in day hospital from 12 to 24. Liaison psychiatry consultations (2713 to 3684), community teams’ visits (10,201 to 14,756), and home visits (236 to 980) have increased significantly, while rehabilitation programs were developed in two day centers in the community. Conclusions The Portuguese model of mental health care, based on the principles of accessibility and equity, community involvement, recovery and human rights, and continuity of care, has promoted greater accessibility, higher quality of care, and less stigma. An important integration of mental health and general health services has taken place allowing for a close collaboration between services.

scholarly journals Community Mental Health Services in Italy

10.17816/cp76 ◽  
2021 ◽  
Vol 2 (2) ◽  
pp. 86-92
Author(s):  
Gaia Sampogna ◽  
Valeria Del Vecchio ◽  
Corrado De Rosa ◽  
Vincenzo Giallonardo ◽  
Mario Luciano ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Disorders ◽  
Mental Health Care ◽  
Treatment Options ◽  
Community Mental Health Services ◽  
Psychiatric Hospitals ◽  
Residential Facilities ◽  
Community Based ◽  
Italian Model

In 1978, in Italy, approval of Basaglias reform law marked a shift from an asylum-based to a community-based mental health system. The main aim of the reform was to treat patients in the community and no longer in psychiatric hospitals. Following the Italian model, similar reforms of mental health care have been approved worldwide. The community-based model aims to promote integration and human rights for people with mental disorders on the basis of their freedom to choose treatment options. By 2000, all psychiatric hospitals had been closed and all patients discharged. Mental health care is organized through the Department of Mental Health, which is the umbrella organization responsible for specialist mental health care in the community; this includes psychiatric wards located in general hospitals, residential facilities, mental health centres, and day-hospital and day-care units. Approval of Law 180 led to a practical and ideological shift in the provision of care to patients with mental disorders. In particular, the reform highlighted the need to treat patients in the same way as any other patient, and mental health care moved from a custodialistic to a therapeutic model. Progressive consolidation of the community-based system of mental health care in Italy has been observed in the past 40 years. However, some reasons for concern still exist, including low staffing levels, potential use of community residential facilities as long-stay residential services, and a heterogeneity in the availability of resources for mental health throughout the country.

scholarly journals Mobile Mental Health Apps in China: Systematic App Store Search

10.2196/14915 ◽  
2020 ◽  
Vol 22 (7) ◽  
pp. e14915
Author(s):  
Huifang Yin ◽  
Klaas J Wardenaar ◽  
Yuhao Wang ◽  
Nan Wang ◽  
Wenjin Chen ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Problems ◽  
Mobile Apps ◽  
Psychiatric Patients ◽  
Evidence Based ◽  
Health Apps ◽  
Main Technique ◽  
Stress Relieving ◽  
Mobile Mental Health

Background Smartphones have become ubiquitous in China, offering a promising way to deliver mental health interventions; however, little is known about the current use and characteristics of smartphone apps for mental health. Objective The purpose of this study was to gain insight into mobile mental health apps available in China as of December 2018. Methods A systematic search was conducted to identify and evaluate the most downloaded apps from iOS and Android platforms. Apps were categorized according to their main purpose and downloaded to evaluate their content. Each app’s affiliation, cost, target users, information security, and evidence-based nature were evaluated. Results Of the 172 unique apps that were identified, there were 37 apps (21.5%) for psychological counseling, 50 apps (29.1%) for assessment, 12 apps (7.0%) to relieve stress, 24 apps (14.0%) for psychoeducation, and 49 (28.4%) multipurpose apps (ie, a combination of counseling and assessment). Most apps were developed for adults in the general population (166/172, 96.5%), rather than for psychiatric patients. App-based counseling was mostly provided by psychologists, and of the assessed apps, only 40% (70/172) used evidence-based scales to assess mental health problems such as anxiety or depressed mood. Guided meditation was used as the main technique in stress-relieving apps. Conclusions Many apps contained useful and evidence-based elements, such as good quality information, validated measurements, and useful meditation methods; however, for mobile apps to contribute significantly to mental health care in China, considerable challenges remain, including the need for more patient-focused apps that can actually take on the role of a health care provider. In addition, efficacy studies are needed.

scholarly journals Current Views and Perspectives on E-Mental Health: An Exploratory Survey Study for Understanding Public Attitudes Toward Internet-Based Psychotherapy in Germany

2017 ◽  
Vol 4 (1) ◽  
pp. e8 ◽  
Author(s):  
Jennifer Apolinário-Hagen ◽  
Viktor Vehreschild ◽  
Ramez M Alkoudmani
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Factor Analysis ◽  
Pilot Study ◽  
General Population ◽  
Perceived Stress ◽  
Large Scale ◽  
Mental Health Problems ◽  
Public Attitudes ◽  
Treatment Services

Background Despite the advanced development of evidence-based psychological treatment services, help-seeking persons with mental health problems often fail to receive appropriate professional help. Internet-delivered psychotherapy has thus been suggested as an efficient strategy to overcome barriers to access mental health care on a large scale. However, previous research indicated poor public acceptability as an issue for the dissemination of Internet-delivered therapies. Currently, little is known about the expectations and attitudes toward Internet-delivered therapies in the general population. This is especially the case for countries such as Germany where electronic mental health (e-mental health) treatment services are planned to be implemented in routine care. Objective This pilot study aimed to determine the expectations and attitudes toward Internet-based psychotherapy in the general population in Germany. Furthermore, it aimed to explore the associations between attitudes toward Internet-based therapies and perceived stress. Methods To assess public attitudes toward Internet-based psychotherapy, we conducted both Web-based and paper-and-pencil surveys using a self-developed 14-item questionnaire (Cronbach alpha=.89). Psychological distress was measured by employing a visual analogue scale (VAS) and the 20-item German version of the Perceived Stress Questionnaire (PSQ). In addition, we conducted explorative factor analysis (principal axis factor analysis with promax rotation). Spearman’s rank correlations were used to determine the associations between attitudes toward Internet-based therapies and perceived stress. Results Descriptive analyses revealed that most respondents (N=1558; female: 78.95%, 1230/1558) indicated being not aware of the existence of Internet-delivered therapies (83.46%, 1141/1367). The average age was 32 years (standard deviation, SD 10.9; range 16-76). Through exploratory factor analysis, we identified 3 dimensions of public attitudes toward Internet-based therapies, which we labeled “usefulness or helpfulness,” “relative advantage or comparability,” and “accessibility or access to health care.” Analyses revealed negative views about Internet-based therapies on most domains, such as perceived helpfulness. The study findings further indicated ambivalent attitudes: Although most respondents agreed to statements on expected improvements in health care (eg, expanded access), we observed low intentions to future use of Internet-delivered therapies in case of mental health problems. Conclusions This pilot study showed deficient “e-awareness” and rather negative or ambivalent attitudes toward Internet-delivered therapies in the German-speaking general population. However, research targeting determinants of the large-scale adoption of Internet-based psychotherapy is still in its infancy. Thus, further research is required to explore the “black box” of public attitudes toward Internet-delivered therapies with representative samples, validated measures, and longitudinal survey designs.

Lock-down, social distancing and mental health during the covid-19 pandemic: perspectives, challenges, and opportunities in African settings: A Case of Democratic Republic of Congo (Preprint)

2020 ◽  
Author(s):  
Mutume Vivalya ◽  
Jimmy BEN FORRY ◽  
Okesina AKEEM AYODEJI ◽  
Kalima Nzanzu Adelard ◽  
Paluku Mwalitsa Jean-Paul ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Primary Health Care ◽  
Democratic Republic ◽  
Mental Health Problems ◽  
Democratic Republic Of Congo ◽  
Community Based ◽  
Republic Of Congo ◽  
Primary Health ◽  
Therapy Strategy

UNSTRUCTURED The COVID-19 pandemic has led to the resolution of a total lockdown both developed and developing countries. The lock-down has worsened the prevailing economic crisis, affected the health and political system, exacerbated unemployment levels and cost of managing health conditions in African settings and especially the Democratic Republic of Congo; which tends to have detrimental effects on the mental health of the affected population. Also, it is extremely expensive to access professional health care services. We ought to provide insight into policy-relevant approaches including integrative community based organization, digital heath, systematic screening of mental health problems in primary health care, given that failure to treat those who are emotionally affected will result in long-term social and economic outcomes and costs to society. The primary health workers should be trained on mental health care delivered through the internet and digital support. Helping affected community by COVID-19 to feel mentally better will require the integration of online telehealth among primary health care for the online mental health screening and psychotherapy centred on a supportive therapy strategy, anger/stress management, and the establishing of integrative community based organisation. Any partners during the COVID-19 should plan for the workshop on online mental health services and training to allow its integration and the reportage from patient’s home to the health centres and hospitals.

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