scholarly journals Sexual violence and mental health services: a call to action

2019 ◽  
Vol 28 (6) ◽  
pp. 594-597 ◽  
Author(s):  
Elizabeth Hughes ◽  
Michael Lucock ◽  
Charlie Brooker
Keyword(s):  
Mental Health ◽  
Sexual Assault ◽  
Mental Health Services ◽  
Health Services ◽  
Sexual Violence ◽  
Routine Care ◽  
Call To Action ◽  
Clear Association ◽  
History Of

AbstractPeople who experience sexual violence are highly likely to experience psychological and/or mental health (MH) problems as a result. People who use MH services often have a history of sexual assault and are also likely to be revictimised as an adult. Yet despite there being a very clear association, MH services are not yet performing routine enquiry, and even if they do, are not confident about how to record and manage disclosures. There is some emerging evidence that people with MH problems are exposed to sexual violence in inpatient MH settings, perpetrated by both other patients or members of staff. In this editorial, we explore the evidence to support a wider focus on sexual violence as a part of routine care, as well as some recommendations about how staff can more effectively discuss sexual issues including that of sexual victimisation.

scholarly journals From Research to Practice: Ten Lessons in Delivering Digital Mental Health Services

2019 ◽  
Vol 8 (8) ◽  
pp. 1239 ◽  
Author(s):  
Nickolai Titov ◽  
Heather D. Hadjistavropoulos ◽  
Olav Nielssen ◽  
David C. Mohr ◽  
Gerhard Andersson ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Psychological Treatment ◽  
Large Body ◽  
Routine Care ◽  
Outcome Data ◽  
Lessons Learned ◽  
Funding Policy ◽  
Four Levels

There is a large body of research showing that psychological treatment can be effectively delivered via the internet, and Digital Mental Health Services (DMHS) are now delivering those interventions in routine care. However, not all attempts to translate these research outcomes into routine care have been successful. This paper draws on the experience of successful DMHS in Australia and Canada to describe ten lessons learned while establishing and delivering internet-delivered cognitive behavioural therapy (ICBT) and other mental health services as part of routine care. These lessons include learnings at four levels of analysis, including lessons learned working with (1) consumers, (2) therapists, (3) when operating DMHS, and (4) working within healthcare systems. Key themes include recognising that DMHS should provide not only treatment but also information and assessment services, that DMHS require robust systems for training and supervising therapists, that specialist skills are required to operate DMHS, and that the outcome data from DMHS can inform future mental health policy. We also confirm that operating such clinics is particularly challenging in the evolving funding, policy, and regulatory context, as well as increasing expectations from consumers about DMHS. Notwithstanding the difficulties of delivering DMHS, we conclude that the benefits of such services for the broader community significantly outweigh the challenges.

Geographical Resource Allocation for Public Mental Health Services in Victoria

1997 ◽  
Vol 31 (1) ◽  
pp. 95-104 ◽  
Author(s):  
Graham Meadows
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Private Sector ◽  
Public Mental Health ◽  
Background Information ◽  
Major Influence ◽  
The Usa ◽  
History Of ◽  
The Uk

Objective:To provide background information on the approach of area based funding models for mental health services, to describe the considerations which have come to bear in the development process of the Victorian model, to explore the impacts of different models, and to suggest courses for further development. Method:The history of this approach to funding in the UK and the USA is summarised, then an account is given of the development of the Victorian model. The position is put that the validation of such models is hampered by having only sparse relevant data. Suggestions are made for improving this situation. Results:The Victorian model has come to include adjustments for socioeconomic disadvantage, the age, sex and marital status structure of the population, and a variable discounting for estimated substitutive activity of the private sector. Different methods of combining these adjustments into a working formula can be seen to have very different impacts. Conclusions:The approach taken in development of this model can be expected to have major influence on funding within Victoria, but also more widely in Australia. The impacts of differing assumptions within these models are significant. Specifically targeted epidemiological research, and activity analysis of the private sector will be necessary to enhance the validity of models of this type.

scholarly journals Improving Implementation of eMental Health for Mood Disorders in Routine Practice: Systematic Review of Barriers and Facilitating Factors

2018 ◽  
Vol 5 (1) ◽  
pp. e20 ◽  
Author(s):  
Christiaan Vis ◽  
Mayke Mol ◽  
Annet Kleiboer ◽  
Leah Bührmann ◽  
Tracy Finch ◽  
...  
Keyword(s):  
Mental Health ◽  
Systematic Review ◽  
Health Care ◽  
Mental Health Services ◽  
Health Services ◽  
Mental Health Care ◽  
Mood Disorders ◽  
Routine Care ◽  
System Level ◽  
Routine Practice

Background Electronic mental health interventions (eMental health or eMH) can be used to increase accessibility of mental health services for mood disorders, with indications of comparable clinical outcomes as face-to-face psychotherapy. However, the actual use of eMH in routine mental health care lags behind expectations. Identifying the factors that might promote or inhibit implementation of eMH in routine care may help to overcome this gap between effectiveness studies and routine care. Objective This paper reports the results of a systematic review of the scientific literature identifying those determinants of practices relevant to implementing eMH for mood disorders in routine practice. Methods A broad search strategy was developed with high sensitivity to four key terms: implementation, mental health care practice, mood disorder, and eMH. The reach, effectiveness, adoption, implementation, and maintenance (RE-AIM) framework was applied to guide the review and structure the results. Thematic analysis was applied to identify the most important determinants that facilitate or hinder implementation of eMH in routine practice. Results A total of 13,147 articles were screened, of which 48 studies were included in the review. Most studies addressed aspects of the reach (n=33) of eMH, followed by intervention adoption (n=19), implementation of eMH (n=6), and maintenance (n=4) of eMH in routine care. More than half of the studies investigated the provision of mental health services through videoconferencing technologies (n=26), followed by Internet-based interventions (n=20). The majority (n=44) of the studies were of a descriptive nature. Across all RE-AIM domains, we identified 37 determinants clustered in six main themes: acceptance, appropriateness, engagement, resources, work processes, and leadership. The determinants of practices are expressed at different levels, including patients, mental health staff, organizations, and health care system level. Depending on the context, these determinants hinder or facilitate successful implementation of eMH. Conclusions Of the 37 determinants, three were reported most frequently: (1) the acceptance of eMH concerning expectations and preferences of patients and professionals about receiving and providing eMH in routine care, (2) the appropriateness of eMH in addressing patients’ mental health disorders, and (3) the availability, reliability, and interoperability with other existing technologies such as the electronic health records are important factors for mental health care professionals to remain engaged in providing eMH to their patients in routine care. On the basis of the taxonomy of determinants of practices developed in this review, implementation-enhancing interventions can be designed and applied to achieve better implementation outcomes. Suggestions for future research and implementation practice are provided.

scholarly journals Sexual Violence and Its Associated Psychosocial Effects in Ireland

2020 ◽  
pp. 088626052097819
Author(s):  
Frédérique Vallières ◽  
Brynne Gilmore ◽  
Ann Nolan ◽  
Peggy Maguire ◽  
Kristina Bondjers ◽  
...  
Keyword(s):  
Mental Health ◽  
Sexual Abuse ◽  
Sexual Assault ◽  
Sexual Violence ◽  
Mental Health Problems ◽  
Psychosocial Outcomes ◽  
Current Data ◽  
Self Report ◽  
Psychosocial Effects ◽  
History Of

Current data on the prevalence and psychosocial correlates of sexual violence in the Republic of Ireland is lacking, with the most recent sexual abuse and violence survey dating back to 2001. The current study sought to identify what proportion of Irish adults have experienced sexual violence, if there are sex differences in exposure to different forms of sexual violence, and to what extent different forms of sexual violence are associated with adverse psychosocial outcomes. To achieve these objectives, we carried out a nationally representative sample of Irish adults ( N = 1,020) completed self-report measures of history of sexual violence and mental health. Results suggest that approximately one-in-three (34.4%) Irish adults experienced some form of sexual violence, including 14.8% who were sexually assaulted (raped) and 31.1% who were sexually harassed. Women were significantly more likely than men to have experienced all forms of sexual violence ( ps < .001), with the exception of sexual assault by a parent or guardian. All forms of sexual violence were associated with an increased likelihood of serious mental health problems, with sexual assault by a parent/guardian associated with several other psychosocial outcomes in life, including education achievement, history of being taken into state care, salary, and employment status. Sexual violence is a common experience in the general population and women are disproportionately affected (1-in-2 women versus 1-in-5 men). Additional resources to increase mental health care among survivors of sexual violence is urgently needed. How our findings compare to Ireland’s previous sexual abuse and violence survey and the implications of our findings for policy are discussed.

scholarly journals The psychosis treatment gap and its consequences in rural Ethiopia

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Abebaw Fekadu ◽  
Girmay Medhin ◽  
Crick Lund ◽  
Mary DeSilva ◽  
Medhin Selamu ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Health Beliefs ◽  
Treatment Gap ◽  
Care Needs ◽  
Cross Sectional Survey ◽  
Important Indicator ◽  
Holistic Understanding ◽  
History Of

Abstract Background The “treatment gap” (TG) for mental disorders, widely advocated by the WHO in low-and middle-income countries, is an important indicator of the extent to which a health system fails to meet the care needs of people with mental disorder at the population level. While there is limited research on the TG in these countries, there is even a greater paucity of studies looking at TG beyond a unidimensional understanding. This study explores several dimensions of the TG construct for people with psychosis in Sodo, a rural district in Ethiopia, and its implications for building a more holistic capacity for mental health services. Method The study was a cross-sectional survey of 300 adult participants with psychosis identified through community-based case detection and confirmed through subsequent structured clinical evaluations. The Butajira Treatment Gap Questionnaire (TGQ), a new customised tool with 83 items developed by the Ethiopia research team, was administered to evaluate several TG dimensions (access, adequacy and effectiveness of treatment, and impact/consequence of the treatment gap) across a range of provider types corresponding with the WHO pyramid service framework. Results Lifetime and current access gap for biomedical care were 41.8 and 59.9% respectively while the corresponding figures for faith and traditional healing (FTH) were 15.1 and 45.2%. Of those who had received biomedical care for their current episode, 71.7% did not receive minimally adequate care. Support from the community and non-governmental organisations (NGOs) were negligible. Those with education (Adj. OR: 2.1; 95% CI: 1.2, 3.8) and history of use of FTH (Adj. OR: 3.2; 95% CI: 1.9–5.4) were more likely to use biomedical care. Inadequate biomedical care was associated with increased lifetime risk of adverse experiences, such as history of restraint, homelessness, accidents and assaults. Conclusion This is the first study of its kind. Viewing TG not as a unidimensional, but as a complex, multi-dimensional construct, offers a more realistic and holistic understanding of health beliefs, help-seeking behaviors, and need for care. The reconceptualized multidimensional TG construct could assist mental health services capacity building advocacy and policy efforts and allow community and NGOs play a larger role in supporting mental healthcare.

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