scholarly journals Mental health reform under policy mainstreaming: needed, but uncertain

2013 ◽  
Vol 23 (1) ◽  
pp. 11-16 ◽  
Author(s):  
M. Hogan
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Healthcare System ◽  
Health Reform ◽  
50Th Anniversary ◽  
Mental Healthcare ◽  
Well Being ◽  
Mental Health Reform ◽  
Reform Legislation ◽  
People With Mental Illness

October 2013 marks the 50th anniversary of President John F. Kennedy's message to the US Congress on the need to reform mental healthcare. Much has changed in that time. In 2006, Frank and Glied summarized these changes and the forces behind them, finding that the well-being of people with mental illness was ‘better but not well.’ They also conclude that most improvements have been due to ‘mainstreaming,’ the inclusion of those with mental illness in broad reforms such as Medicare, Medicaid and Social Security. With the gradual assimilation of mental health concerns, leadership and resources into mainstream programmes and agencies, future improvements will require that these programmes are accessible and oriented to people with mental illness. The passage of broad health reform legislation in 2010 (the Affordable Care Act) reinforces this change; several of its provisions attempt to make healthcare more relevant to the population with mental illness. In this editorial, I discuss a set of challenges which remain for the population with mental illness in the healthcare system, and the prospects for change. These challenges include: (1) improving basic mental healthcare in primary care, (2) improving mental healthcare for children, (3) earlier detection and treatment of psychotic illness, (4) disability and unemployment and (5) the challenge of sustaining an adequate, speciality public mental healthcare system under conditions of mainstreaming. In general, I conclude that the prospects for successful reform are uncertain. Establishing mental healthcare specialization in mainstream systems has not been notably successful to date.

Mental health-related stigma and attitudes toward patient care among providers of mental health services in a rural Chinese county

2021 ◽  
pp. 002076402199280
Author(s):  
Yuer Deng ◽  
An-Li Wang ◽  
Rosemary Frasso ◽  
Mao-Sheng Ran ◽  
Tian-Ming Zhang ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Healthcare System ◽  
Healthcare Delivery ◽  
Healthcare Providers ◽  
Mental Healthcare ◽  
Educational Background ◽  
Mental Health Recovery ◽  
Public Health Issue ◽  
People With Mental Illness

Background and aims: The increasing prevalence of mental illness and low treatment rate presents a pressing public health issue in China. Pervasive stigma is a significant barrier to mental health recovery and community inclusion. In particular, stigmatizing or supportive attitudes held by healthcare providers could either perpetuate or mitigate self-stigma of people with mental illness. Moreover, mental health resources are unevenly distributed in China, with most of them concentrated in urban centers and provincial capitals. This study explores healthcare providers’ attitudes toward mental illness and the challenges they faced at work in a rural Chinese county. Method: Four focus groups were conducted with 36 healthcare providers from a three-tier mental healthcare system in a rural county in southwestern China. Focus group discussions were recorded and transcribed verbatim. The team employed a conventional content analysis approach for data analysis. All transcripts were double-coded by three bilingual team members who are native Chinese speakers. Coding discrepancies were resolved by consensus. Results: Healthcare providers recruited from the county, township, and village levels varied in educational background, professional qualification, and experience of working with people with mental illness. Five thematic categories identified across four groups include (1) barriers to mental healthcare delivery, (2) keys to mental health recovery, (3) providers’ attitudes toward providing care, (4) providers’ perception toward patients and family members, and (5) providers’ perception of training needs. Conclusions: This is a unique study that included healthcare providers from a three-tier healthcare system. Findings signal the importance of understanding healthcare practitioners’ experiences and views to inform the design of training initiatives in rural or low-resource communities.

scholarly journals Mental health reforms in the Czech Republic

2018 ◽  
Vol 16 (1) ◽  
pp. 4-6 ◽  
Author(s):  
Ondrej Pec
Keyword(s):  
Mental Health ◽  
Czech Republic ◽  
Health Reform ◽  
Mental Healthcare ◽  
Rehabilitation Services ◽  
Community Based ◽  
The Czech Republic ◽  
Mental Health Reform ◽  
Mental Health Reforms ◽  
Community Based Services

This paper describes the history and current provision of mental healthcare in the Czech Republic. After the political changes in 1989, there was an expansion of out-patient care and several non-governmental organisations began to provide social rehabilitation services, but the main focus of care still rested on mental hospitals. In recent years, mental health reform has been in progress, which has involved expanding community-based services and psychiatric wards of general hospitals, simultaneously with educational and destigmatisation programmes.

Stigma associated with mental illness and its treatment in the Arab culture: A systematic review

2018 ◽  
Vol 64 (6) ◽  
pp. 597-609 ◽  
Author(s):  
Monica Zolezzi ◽  
Maha Alamri ◽  
Shahd Shaar ◽  
Daniel Rainkie
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Qualitative Methodology ◽  
Data Extraction ◽  
Mental Healthcare ◽  
Quantitative Methodology ◽  
Arab Population ◽  
Manual Search ◽  
People With Mental Illness ◽  
Mental Health Treatments

Background: Mental health has not had the same public profile as physical health. This has contributed to the stigma associated with mental illness and to its treatments. Research investigating how the traditions and values amongst those with an Arab heritage contribute to stigmatizing beliefs, attitudes or actions in the provision of mental healthcare has not been widely reported. Aim: To systematically review the literature and summarize the findings of studies reporting stigmatizing beliefs, actions and attitudes toward treatment of people with mental illness in the Arab population. Methods: PubMed, Ovid, Psycharticles and Embase were used to identify original studies of non-institutionalized Arab adults or children reporting findings relevant to stigma toward mental illness. A manual search of the bibliography of all selected original studies was also undertaken. Independent data extraction was performed by two reviewers, who then met to compare data and reach consensus. Findings were classified as stigmatizing beliefs, actions or attitudes toward mental health treatments. Results: A total of 33 articles were retrieved for full review. Those utilizing qualitative methodology provided insight into the many ways mental illness is viewed and defined among those with an Arab heritage. Among the studies using quantitative methodology, most compared stigmatizing beliefs, attitudes toward mental health treatments or stigmatizing actions among different Arab populations, some also investigated correlations between characteristics of the Arab population tested with stigmatizing beliefs, actions and attitudes toward mental health treatments. Findings from studies undertaken in Qatar reported greater stigmatizing beliefs, actions or attitudes toward mental health treatments among Qatari versus non-Qatari Arabs. Conclusion: A large diversity in the stigmatizing beliefs, actions and attitudes toward treatment of mental illness within the Arab population were identified. The influence of cultural variations on stigma should be explored further and used to tailor anti-stigma interventions in this population.

scholarly journals The Mental Capacity Act and mental healthcare in prison: opportunities and challenges

2012 ◽  
Vol 36 (7) ◽  
pp. 241-243 ◽  
Author(s):  
Sharon Davies ◽  
Claire Dimond
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Mental Healthcare ◽  
Legal Framework ◽  
Mental Capacity ◽  
Best Interests ◽  
People With Mental Illness ◽  
Mental Capacity Act 2005 ◽  
Mental Capacity Act ◽  
The Uk

SummaryThe UK Mental Health Act 1983 does not apply in prison. The legal framework for the care and treatment of people with mental illness in prison is provided by the Mental Capacity Act 2005. We raise dilemmas about its use. We highlight how assessing best interests and defining harm involves making challenging judgements. How best interests and harm are interpreted has a potentially significant impact on clinical practice within a prison context.

Depression in the Workplace

2017 ◽  
Author(s):  
Alan Bogg ◽  
Sarah Green
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Mental Health Problems ◽  
Legal Protection ◽  
Well Being ◽  
Legal Framework ◽  
People With Mental Illness ◽  
Working People ◽  
Labour Standards ◽  
Being There

This chapter discusses depression in the workplace from the perspective of employment law. Despite the myth that people with mental illness are unable to work, it is almost certain most working people will be working alongside someone who has experienced mental illness. The idea that mental health at work is a marginal concern is no longer sustainable, and reflects ingrained fears and prejudices about the ‘otherness’ of mental illness. The legal framework regulating employment is important in ensuring that work and employment have a constructive part to play in public health strategies to promote mental health and well-being. There are several avenues of legal protection available to those with mental illness such as depression. This chapter explores three regulatory approaches to depression at work that should be regarded as complementary, each with a distinctive contribution to achieving the so-called ‘inclusive workplace’ for those with mental health problems such as depression: the private law approach, the equality law approach, and the labour standards approach.

scholarly journals Preferences of people with mental illness for engaging in exercise programs under COVID-19 restrictions

2020 ◽  
pp. 103985622097529
Author(s):  
Justin J Chapman ◽  
Emily Hielscher ◽  
Sue Patterson ◽  
Nicola Reavley ◽  
Wendy J Brown ◽  
...  
Keyword(s):  
Mental Health ◽  
Physical Activity ◽  
Mental Illness ◽  
Well Being ◽  
Mental Illnesses ◽  
Physical Activity Program ◽  
Exercise Programs ◽  
Activity Program ◽  
People With Mental Illness ◽  
The Impact

Objectives: People with mental illness may be vulnerable to decline in mental health and reduced physical activity because of the COVID-19 pandemic and associated restrictions. The aim of this study was to inform the design of physical activity interventions for implementation under these conditions to improve/maintain well-being and physical activity in this population. Methods: People with mental illness who had participated in a physical activity program prior to the pandemic were invited to complete a survey about the impact of COVID-19 on mental health and physical activity and their preferences for engaging in a physical activity program under pandemic-related restrictions. Results: More than half the 59 respondents reported worse mental health and lower physical activity during the pandemic. The preferred format for a physical activity program was one-on-one exercise instruction in-person in a park. Program components endorsed as helpful included incentivization, provision of exercise equipment and fitness devices, and daily exercise programs. About a third of the participants reported limitations in using technology for a physical activity program. Conclusions: In-person exercise support is preferred by people with mental illnesses during pandemic-related restrictions. Enablement strategies such as providing equipment and self-monitoring devices should be utilized; assistance may be needed to incorporate the use of technology in exercise programs.

scholarly journals Understanding what it means to be socially included for people with a lived experience of mental illness

2019 ◽  
Vol 65 (5) ◽  
pp. 413-424 ◽  
Author(s):  
Kate Filia ◽  
Henry Jackson ◽  
Sue Cotton ◽  
Eoin Killackey
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Lived Experience ◽  
Community Involvement ◽  
Social Inclusion ◽  
Well Being ◽  
Community Members ◽  
People With Mental Illness ◽  
Stable Housing ◽  
General Community

Aims: Social inclusion is increasingly understood to have positive and beneficial implications for the mental health outcomes of people with severe mental illness. The concept is plagued by definitional inconsistencies and a lack of consensus regarding what it means to be socially included, in particular for groups most vulnerable to social exclusion, such as people with mental illness. The aim of this study was to obtain a consensus regarding the key contributors to social inclusion from the perspective of people with and without a lived experience of mental illness (consumers of mental health services, carers, and general community members). Methods: Delphi methodology was employed to reach consensus agreement. The Delphi questionnaire was based on a previous review of the literature and consisted of 147 items categorized into 13 domains. It was presented to participants over three rounds. Participants ( N  = 104) were recruited into three groups (32 consumers, 32 carers of people with a mental illness, and 40 members of the general community – neither consumers nor carers). Retention of participants from Round 1 to Round 3 was 79.8%. Results: Similarities and differences were observed between the groups. A number of items were very strongly endorsed as key contributors to social inclusion, relating to social participation, social supports, housing, neighbourhood, community involvement, employment and education, health and well-being and service utilization. Conclusion: Findings supported previous work, indicating the importance of having a strong sense of connection with others as well as the importance of safe and stable housing, support services and personal motivation and hope. We obtained a well-rounded perspective among groups regarding the key contributors to social inclusion, with a particular relevance to people living with mental illness. This perspective has significant clinical and research utility.

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