Individuals at Risk for Suicide

Crisis ◽  
2017 ◽  
Vol 38 (3) ◽  
pp. 158-167 ◽  
Author(s):  
Dana Alonzo ◽  
Claire Moravec ◽  
Benjamin Kaufman
Keyword(s):  
Mental Health ◽  
At Risk ◽  
Mental Health Treatment ◽  
Treatment Engagement ◽  
Service Level ◽  
Semistructured Interview ◽  
Mental Health Clinicians ◽  
Outpatient Mental Health ◽  
Intervention Level ◽  
Suicidal Crisis

Abstract. Background: Individuals experiencing suicidal ideation and/or behaviors are often difficult to engage in treatment. Up to 50% of individuals presenting to an ER for treatment of a suicidal crisis refuse outpatient treatment referrals. This study examined outpatient mental health clinicians' perceptions of the barriers to and facilitators of mental health treatment engagement of individuals at risk for suicide. Method: Thirty-six mental health clinicians working with clients with past and/or current suicidality (ideation, behaviors) in outpatient mental health centers participated in four focus groups. Data were collected using semistructured interview. A process of content analysis was utilized in which data were analyzed thematically. Results: Five main domains of barriers and facilitators emerged including (a) client-level, (b) clinician-level, (c) service-level, (d) agency-level, and (e) intervention-level variables. In all, 38 barriers and 31 facilitators were identified. The most frequently identified facilitator was the clinician's own sense of engagement with the client, identified by 31% of the clinicians. The most frequently identified barrier was housing instability, identified by 34% of the clinicians. Conclusion: Knowledge of clinicians' perspective on treatment engagement of clients at risk for suicide may inform the development and implementation of interventions and guide training/supervision programs for those working with this vulnerable population.

Pilot data of a brief veteran peer intervention and its relationship to mental health treatment engagement.

2018 ◽  
Vol 15 (4) ◽  
pp. 453-456 ◽  
Author(s):  
Elizabeth M. Goetter ◽  
Eric Bui ◽  
Travis P. Weiner ◽  
Laura Lakin ◽  
Thomas Furlong ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Health Treatment ◽  
Treatment Engagement ◽  
Health Treatment ◽  
Pilot Data ◽  
Peer Intervention

scholarly journals Examining ethnic disparities in provider and parent in-session participation engagement

2017 ◽  
Vol 12 (1) ◽  
pp. 47-58 ◽  
Author(s):  
Kelsey S. Dickson ◽  
Sasha M. Zeedyk ◽  
Jonathan Martinez ◽  
Rachel Haine-Schlagel
Keyword(s):  
Mental Health ◽  
Mental Health Treatment ◽  
Parent Participation ◽  
Ethnic Disparities ◽  
Treatment Engagement ◽  
Latino Families ◽  
Observational Coding ◽  
Community Based ◽  
Health Treatment ◽  
Content Type

Purpose Well-documented ethnic disparities exist in the identification and provision of quality services among children receiving community-based mental health services. These disparities extend to parent treatment engagement, an important component of effective mental health services. Currently, little is known about differences in how providers support parents’ participation in treatment and the degree to which parents actively participate in it. The purpose of this paper is to examine potential differences in both provider and parent in-session participation behaviours. Design/methodology/approach Participants included 17 providers providing standard community-based mental health treatment for 18 parent-child dyads, with 44 per cent of the dyads self-identifying as Hispanic/Latino. In-session participation was measured with the parent participation engagement in child psychotherapy and therapist alliance, collaboration, and empowerment strategies observational coding systems. Findings Overall, results indicate significantly lower levels of parent participation behaviours among Hispanic/Latino families compared to their Non-Hispanic/Non-Latino counterparts. No significant differences were seen in providers’ in-session behaviours to support parent participation across Hispanic/Latino and Non-Hispanic/Non-Latino families. Research limitations/implications These findings contribute to the literature on ethnic differences in parent treatment engagement by utilising measures of in-session provider and parent behaviours and suggest that further investigation is warranted to documenting and understanding ethnic disparities in parents’ participation in community-based child mental health treatment. Originality/value This paper contributes to the evaluation of differences in parent treatment engagement through demonstrating the utility of an in-session observational coding system as a measure of treatment engagement.

The Solving Problems in Everyday Living Model: Toward a Demedicalized, Education-Based Approach to “Mental Health”

2017 ◽  
Vol 61 (1) ◽  
pp. 132-151 ◽  
Author(s):  
Tomi Gomory ◽  
Daniel J. Dunleavy ◽  
Angela S. Lieber
Keyword(s):  
Mental Health ◽  
Critical Pedagogy ◽  
Mental Health Treatment ◽  
Medical Model ◽  
Mental Health Clinicians ◽  
Educational Approach ◽  
Supportive Psychotherapy ◽  
Diagnostic And Statistical Manual ◽  
Problems In Living ◽  
Informed Treatment

We argue that human existential pain and threat may usefully be helped by a noncoercive educational approach that also resonates with many interpersonally focused psychological approaches, rather than by the widely touted current medical model of “mental health” treatment (using psychoactive drugs and supportive psychotherapy). First, the “progress” leading to the latest Diagnostic and Statistical Manual of Mental Disorders is briefly reviewed, highlighting the scientific limitations of the medical model. Next, an educational model of self-understanding and change, based on Popper’s fallibilism, Freire’s critical pedagogy, and Miller’s feedback-informed treatment is explicated. Finally, some options for funding and testing the model are discussed. We hope this offers mental health clinicians another important alternative to conceptualize the helping encounter to ameliorate personal problems in living.

scholarly journals Perinatal Symptoms and Treatment Engagement in Female Veterans

2021 ◽  
Author(s):  
Elizabeth H Anderson ◽  
Carolyn Morrow ◽  
Kristin M Mattocks ◽  
Geetha Shivakumar
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Symptom Severity ◽  
Psychiatric Diagnosis ◽  
Mental Health Treatment ◽  
Treatment Engagement ◽  
Perinatal Period ◽  
Veterans Health ◽  
Health Treatment ◽  
Pregnancy And Postpartum

ABSTRACT Introduction Women veterans using Veterans Health Care Administration maternity benefits have a high prevalence of mental health disorders, including depression, PTSD, and anxiety. Additionally, women with psychiatric histories often experience a relapse or worsening of symptoms during pregnancy and postpartum. Adequate perinatal mental healthcare engagement is critical to optimizing outcomes for mother and child. Materials and Methods This study evaluated psychiatric symptom severity and predictors of women veteran’s mental health treatment engagement during pregnancy and postpartum at the VA North Texas Health Care System. Seventy women using Veterans Health Administration were assessed longitudinally via chart review and interviews (including the Edinburgh Postnatal Depression Scale) during pregnancy and postpartum. A Friedman test was used to evaluate the change in symptom severity during (1) the 6 months before pregnancy, (2) pregnancy, and (3) postpartum. Multivariate logistic regressions were used to determine predictors of attending outpatient mental health appointments. Potential predictors examined included sociodemographic factors, symptoms of depression, history of military sexual assault, presence of a pre-pregnancy psychiatric diagnosis, and attendance of mental health appointments before pregnancy. Results Approximately 40% of participants demonstrated at least mild psychiatric symptoms before pregnancy, and symptom severity did not significantly change across the perinatal period (pre-pregnancy, pregnancy, and postpartum) X2 (2, n = 70) = 3.56, P = .17. Depressive symptoms during the 2nd or 3rd trimester were a significant predictor for attendance of mental health appointments during both pregnancy (OR = 1.18, 95% CI, 1.04 to 1.34) and postpartum (OR = 1.18, 95% CI, 1.02 to 1.36). An active psychiatric diagnosis during the 6 months before pregnancy was also a significant predictor of attendance following delivery (OR = 14.63, 95% CI, 1.55 to 138.51). Conclusion Our results demonstrate that women with prior histories of mental health conditions will continue to be symptomatic, and this is a good predictor of mental health treatment engagement during the perinatal period.

How mental health clinicians want to evaluate the care they give: a Western Australian study

2013 ◽  
Vol 37 (3) ◽  
pp. 375 ◽  
Author(s):  
Sophie Davison ◽  
Yvonne Hauck ◽  
Philippa Martyr ◽  
Daniel Rock
Keyword(s):  
Mental Health ◽  
Action Research ◽  
Participatory Action Research ◽  
Service Level ◽  
Consumer Involvement ◽  
Mental Health Clinicians ◽  
Participatory Action ◽  
Research Framework ◽  
Clinical Resource ◽  
Western Australian

Objectives. To explore how Western Australian mental health clinicians want to evaluate their care. Methods. Using a participatory action research framework, 10 senior psychiatrists and 11 clinical nurse specialists working in an inpatient mental health setting participated in individual interviews, focus groups and meetings. All interviews were de-identified during transcription and transcripts and field notes were analysed for common themes. Results. Participants identified what they wanted to measure, how they wanted to measure it and how these changes could be implemented. Clinicians stressed the importance of measuring context (physical, clinical and service) and process as well as outcome, and of evaluating care at an individual and service level with consumer involvement. What is known about the topic? Completion rates of mandatory national outcome measures in mental health in Australia are variable and clinicians have mixed views as to their value. Several barriers have been identified as to their use including clinical, resource and ownership issues. What does this paper add? Some studies have identified areas of good practice and elicited practical suggestions for improvement but few have asked clinicians how they actually want to evaluate the care they provide. This study explored how mental health clinicians wanted to evaluate their care, using a participatory action research framework that encouraged participants to pinpoint problems and issues, account for their social context and develop actions to address them. What are the implications for practitioners? Clinicians were enthusiastic for high quality care and evaluation, but pessimistic about their ability to introduce sustainable change. Establishing and supporting active and responsible leadership at service level may solve this, as may encouraging local standard setting and benchmarking in collaboration with consumers and carers.

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