Scope for Psychosocial Treatments in Psychosis: An Overview of Collaborative Therapy

2003 ◽  
Vol 11 (2) ◽  
pp. 220-224 ◽  
Author(s):  
Monica Gilbert ◽  
Kathryn Miller ◽  
Lesley Berk ◽  
Velma Ho ◽  
David Castle
Keyword(s):  
Mental Health ◽  
Psychotic Disorders ◽  
Psychosocial Support ◽  
Controlled Trial ◽  
Psychosocial Needs ◽  
Psychosocial Treatments ◽  
Mental Health Consumers ◽  
Collaborative Therapy ◽  
Modular Treatment ◽  
The Impact

Objectives: The psychosocial needs of people with psychotic disorders are not being addressed adequately. The present paper outlines a proposed framework that will help to meet some of this deficit and deliver psychosocial treatments for these individuals, as part of routine clinical practice. Conclusions: The recent Australian study on low prevalence (psychotic) disorders found that, although most Australians (91%) with a psychotic illness were taking medication, few were receiving adequate psychosocial support from mental health services; fully 47% of these saw the need for a particular type of service that was not able to be accessed by them, either because of it simply not being available or not being affordable. The programme described herein will develop, evaluate and disseminate comprehensive modular treatment packages addressing the psychosocial needs of people with psychotic disorders. It is novel in terms of the comprehensiveness of the approach, the rigour of the evaluation (using a controlled experimental design), and the extent of intersectoral and multidisciplinary involvement in mapping needs, developing the interventions, and dissemination. The potential impact for mental health consumers with psychosis is enormous because currently there is no coherent and consistent approach to addressing their psychosocial needs. The impact for the scientific community will be great because there is currently very little by way of controlled trial data in this important area of activity.

scholarly journals Improving mental health and psychosocial wellbeing in humanitarian settings: reflections on research funded through R2HC

2020 ◽  
Vol 14 (1) ◽  
Author(s):  
Wietse A. Tol ◽  
Alastair Ager ◽  
Cecile Bizouerne ◽  
Richard Bryant ◽  
Rabih El Chammay ◽  
...  
Keyword(s):  
Mental Health ◽  
Psychosocial Support ◽  
Scale Up ◽  
Lessons Learned ◽  
Research Projects ◽  
Psychosocial Needs ◽  
Knowledge Gaps ◽  
Humanitarian Settings ◽  
Wide Range ◽  
The Impact

Abstract Major knowledge gaps remain concerning the most effective ways to address mental health and psychosocial needs of populations affected by humanitarian crises. The Research for Health in Humanitarian Crisis (R2HC) program aims to strengthen humanitarian health practice and policy through research. As a significant portion of R2HC’s research has focused on mental health and psychosocial support interventions, the program has been interested in strengthening a community of practice in this field. Following a meeting between grantees, we set out to provide an overview of the R2HC portfolio, and draw lessons learned. In this paper, we discuss the mental health and psychosocial support-focused research projects funded by R2HC; review the implications of initial findings from this research portfolio; and highlight four remaining knowledge gaps in this field. Between 2014 and 2019, R2HC funded 18 academic-practitioner partnerships focused on mental health and psychosocial support, comprising 38% of the overall portfolio (18 of 48 projects) at a value of approximately 7.2 million GBP. All projects have focused on evaluating the impact of interventions. In line with consensus-based recommendations to consider a wide range of mental health and psychosocial needs in humanitarian settings, research projects have evaluated diverse interventions. Findings so far have both challenged and confirmed widely-held assumptions about the effectiveness of mental health and psychosocial interventions in humanitarian settings. They point to the importance of building effective, sustained, and diverse partnerships between scholars, humanitarian practitioners, and funders, to ensure long-term program improvements and appropriate evidence-informed decision making. Further research needs to fill knowledge gaps regarding how to: scale-up interventions that have been found to be effective (e.g., questions related to integration across sectors, adaptation of interventions across different contexts, and optimal care systems); address neglected mental health conditions and populations (e.g., elderly, people with disabilities, sexual minorities, people with severe, pre-existing mental disorders); build on available local resources and supports (e.g., how to build on traditional, religious healing and community-wide social support practices); and ensure equity, quality, fidelity, and sustainability for interventions in real-world contexts (e.g., answering questions about how interventions from controlled studies can be transferred to more representative humanitarian contexts).

scholarly journals Community Health Workers as a Strategy to Tackle Psychosocial Suffering Due to Physical Distancing: A Randomized Controlled Trial

2021 ◽  
Vol 18 (6) ◽  
pp. 3097
Author(s):  
Dorien Vanden Bossche ◽  
Susan Lagaert ◽  
Sara Willems ◽  
Peter Decat
Keyword(s):  
Randomized Controlled Trial ◽  
Community Health ◽  
Health Workers ◽  
Psychosocial Support ◽  
Controlled Trial ◽  
Intervention Group ◽  
Psychosocial Health ◽  
Control Group ◽  
Randomized Controlled ◽  
The Impact

Background: During the COVID-19 pandemic, many primary care professionals were overburdened and experienced difficulties reaching vulnerable patients and meeting the increased need for psychosocial support. This randomized controlled trial (RCT) tested whether a primary healthcare (PHC) based community health worker (CHW) intervention could tackle psychosocial suffering due to physical distancing measures in patients with limited social networks. Methods: CHWs provided 8 weeks of tailored psychosocial support to the intervention group. Control group patients received ‘care as usual’. The impact on feelings of emotional support, social isolation, social participation, anxiety and fear of COVID-19 were measured longitudinally using a face-to-face survey to determine their mean change from baseline. Self-rated change in psychosocial health at 8 weeks was determined. Results: We failed to find a significant effect of the intervention on the prespecified psychosocial health measures. However, the intervention did lead to significant improvement in self-rated change in psychosocial health. Conclusions: This study confirms partially the existing evidence on the effectiveness of CHW interventions as a strategy to address mental health in PHC in a COVID context. Further research is needed to elaborate the implementation of CHWs in PHC to reach vulnerable populations during and after health crises.

scholarly journals Compounded trauma: A qualitative study of the challenges for refugees living with advanced cancer

2021 ◽  
pp. 026921632110002
Author(s):  
Ping Guo ◽  
Sawsan Alajarmeh ◽  
Ghadeer Alarja ◽  
Waleed Alrjoub ◽  
Ayman Al-Essa ◽  
...  
Keyword(s):  
Social Support ◽  
Qualitative Study ◽  
Advanced Cancer ◽  
Psychosocial Support ◽  
Large Population ◽  
Community Support ◽  
Support Network ◽  
Psychosocial Needs ◽  
Physical And Mental Health ◽  
The Impact

Background: Although palliative care is now an essential health service under Universal Health Coverage, ensuring access and appropriate care for refugees is a specific challenge for this large population. Aim: To identify the needs and experiences of adult refugees in Jordan with advanced cancer and informal caregivers. Design: A qualitative study using semi-structured interviews. Setting/participants: Participants were purposively sampled at two Jordanian hospitals to achieve heterogeneity by age, gender, country of origin, and primary diagnosis. Results: Twenty-nine refugees (22 patients, 7 caregivers) participated, and four themes were generated: (1) Psychological distress and sustaining social support. Refugees often experienced unmet psychosocial needs. However, psychosocial support was reported either absent or limited. (2) Knowledge and uncertainty. Lack of information and poor communication between healthcare providers and patients caused significant distress due to uncertainty. (3) Family anxiety and support roles. Being away from the home country cut patients and caregivers off from their wider social support network, which added increased anxiety and responsibilities to caregivers. (4) Compounded trauma and poverty. Many refugees have experienced trauma related to war that may affect their physical and mental health. They faced serious financial crises caused by the rising cost of medicines and treatment. Conclusions: This study reveals the impact of fractured families and networks on social support in advanced cancer, and the compounding trauma of the disease for refugees. Detailed person-centred assessment and emphasis on psychosocial support is essential, and home-based care should not presume community support for patients to remain at home.

scholarly journals Consumer-run services research and implications for mental health care

2016 ◽  
Vol 25 (5) ◽  
pp. 410-416 ◽  
Author(s):  
S. P. Segal ◽  
S. L. Hayes
Keyword(s):  
Mental Health ◽  
Lived Experience ◽  
Self Determination ◽  
Functional Improvement ◽  
Way Of Life ◽  
Services Research ◽  
Self Help ◽  
Mental Health Consumers ◽  
The Individual ◽  
The Impact

Mental health consumers/survivors developed consumer-run services (CRSs) as alternatives to disempowering professionally run services that limited participant self-determination. The objective of the CRS is to promote recovery outcomes, not to cure or prevent mental illness. Recovery outcomes pave the way to a satisfying life as defined by the individual consumer despite repetitive episodes of disorder. Recovery is a way of life, which through empowerment, hope, self-efficacy, minimisation of self-stigma, and improved social integration, may offer a path to functional improvement that may lead to a better way to manage distress and minimise the impact of illness episodes. ‘Nothing about us without us’ is the defining objective of the process activity that defines self-help. It is the giving of agency to participants. Without such process there is a real question as to whether an organisation is a legitimate CRS or simply a non-governmental organisation run by a person who claims lived experience. In considering the effectiveness of CRSs, fidelity should be defined by the extent to which the organisation's process conveys agency. Unidirectional helping often does for people what they can do for themselves, stealing agency. The consequence of the lack of fidelity in CRSs to the origins of the self-help movement has been a general finding in multisite studies of no or little difference in outcomes attributable to the consumer service. This, from the perspective of the research summarised herein, results in the mixing of programmatic efforts, some of which enhance outcomes as they are true mutual assistance programmes and some of which degrade outcomes as they are unidirectional, hierarchical, staff-directed helping efforts making false claims to providing agency. The later CRS interventions may provoke disappointment and additional failure. The indiscriminate combining of studies produces the average: no effect.

scholarly journals Community Health Workers as a Strategy to Tackle Psychosocial Suffering due to Physical Distancing: A Randomized Controlled Trial

2021 ◽  
Author(s):  
Dorien Vanden Bossche ◽  
Susan Lagaert ◽  
Sara Willems ◽  
Peter Decat
Keyword(s):  
Randomized Controlled Trial ◽  
Community Health ◽  
Health Workers ◽  
Psychosocial Support ◽  
Controlled Trial ◽  
Intervention Group ◽  
Psychosocial Health ◽  
Control Group ◽  
Randomized Controlled ◽  
The Impact

Background: During the COVID-19 pandemic some family physicians were overburdened and experienced difficulties reaching vulnerable patients and meeting the increased need for psycho-social support. This randomized controlled trial (RCT) tested whether a primary healthcare (PHC) based community health worker (CHW) intervention could tackle psychosocial suffering due to physical distancing measures in patients with limited social networks. Methods: CHWs provided 8 weeks of tailored psychosocial support to the intervention group. Control group patients received ‘care as usual’. The impact on feelings of emotional support, social isolation, social participation, anxiety and fear of COVID-19 were measured longitudinally using a face-to-face survey to determine their mean change from baseline. Self-rated change in psychosocial health at 8 weeks was determined. Results: We failed to find a significant effect of the intervention on the prespecified psychosocial health measures. However, the intervention did lead to significant improvement in self-rated change in psychosocial health. Conclusions: This study confirms partially the existing evidence on the effectiveness of CHW in-terventions as a strategy to address mental health in PHC in a COVID context. Further research is needed to elaborate the implementation of CHWs in PHC to reach vulnerable populations during and after health crises.

scholarly journals Users’ perceptions about receiving personalized depression risk information: findings from a qualitative study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Heidi Eccles ◽  
Doaa Nadouri ◽  
Molly Nannarone ◽  
Bonnie Lashewicz ◽  
Norbert Schmitz ◽  
...  
Keyword(s):  
Mental Health ◽  
Qualitative Study ◽  
Risk Communication ◽  
Risk Score ◽  
Controlled Trial ◽  
Qualitative Interviews ◽  
Risk Information ◽  
Depression Risk ◽  
Communication Program ◽  
The Impact

Abstract Objectives To understand users’ perceptions about receiving their personalized depression risk score and to gain an understanding about how to improve the efficiency of risk communication from the user perspective. Methods A qualitative study embedded in a randomized controlled trial (RCT) on evaluating the impact of providing personalized depression risk information on psychological harms and benefits. The participants (20 males and 20 females) were randomly selected from the intervention arm of the RCT after the 12-month assessment. The qualitative interviews were conducted through telephone, audio recorded and transcribed verbatim. We conducted a content analysis to describe the content and contextual meaning of data collected from participants. Results The first theme explained the motivation for receiving a risk score. Most participants chose to receive their personalised depression risk score with the goal of improving their self-awareness. The results revealed three sub-themes surrounding perceptions and implication of receiving their risk score: positive, negative, and neutral. Most participants found that receiving their score was positive because it improved their awareness of their mental health, but some participants could see that some people would have negative feelings when getting the score causing them to be more likely to get depression. The final theme focussed on improvements including: the best delivery methods, having resources and strategies, and targeting younger people. Conclusion The most significant motivation for, and benefit of receiving one’s personalized depression risk score was improved awareness of one’s mental health. A comprehensive risk communication program may improve the uptake and maximize the impact on behavior changes and risk reduction.

The Impact of Marijuana on Mental Health

2018 ◽  
pp. 122-164 ◽  
Author(s):  
Christine L. Miller
Keyword(s):  
Mental Health ◽  
Legal Status ◽  
Psychotic Disorders ◽  
Strong Association ◽  
Marijuana Use ◽  
Psychiatric Epidemiology ◽  
Clinical Findings ◽  
Health Impacts ◽  
Public Health Programs ◽  
The Impact

The association between marijuana use and several mental health outcomes is examined, with particular reference to commonly held views on the lack of proof for a causal basis. Rather than relying on a single, key criterion for proof of causation, a collective approach is taken to the question through reviewing studies testing different criteria. Exploration of the psychiatric epidemiology on marijuana reveals trends in early reports that have been confirmed through more detailed studies in recent years and further bolstered by clinical findings. A significant, causal role for marijuana use in chronic psychotic disorders is substantiated by the literature, as well as a strong association with mood disorders and suicidal behaviors. This chapter reinforces the importance of considering marijuana’s mental health impacts when formulating appropriate public health programs and when fashioning drug control policies concerning its legal status.

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