Examining Models of Mental Health Service Delivery in the Emergency Department

2007 ◽  
Vol 41 (10) ◽  
pp. 784-791 ◽  
Author(s):  
Timothy Wand ◽  
Kathryn White

The purpose of the present paper was to review the current models of mental health service delivery used in the emergency department (ED) setting. A search was conducted of the nursing and medical literature from 1990 to 2007 for relevant articles and reports. Consideration was also given to the global and local context influencing contemporary mental health services. Wider sociopolitical and socioeconomic influences and systemic changes in health-care delivery have dictated a considerable shift in attention for mental health services worldwide. The ED is a topical location that has attracted interest and necessitated a response. The mental health liaison nurse (MHLN) role embedded within the ED structure has demonstrated the most positive outcomes to date. This model aims to raise mental health awareness and address concerns over patient-focused outcomes such as reduced waiting times, therapeutic intervention and more efficient coordination of care and follow up for individuals presenting to the ED in psychological distress. Further research is required into all methods of mental health service delivery to the ED. The MHLN role is a cost-effective approach that has gained widespread approval from ED staff and mental health patients and is consistent with national and international expectations for mental health services to become fully integrated within general health care. The mental health nurse practitioner role situated within the ED represents a potentially promising alternative for enhanced public access to specialized mental health care.

2018 ◽  
Vol 7 (1) ◽  
pp. 57-71 ◽  
Author(s):  
Tahir Mahmood Ali ◽  
Sana Gul

Aim This study attempted to analyse the potential of two primary sources of mental health service delivery at a grassroots level, religious/faith healers and community/lady health workers, and how they can be effectively used to deliver mental health services in a resource-scarce country like Pakistan. Method A literature review was carried out for relevant studies conducted in Muslim countries between 2000 to 2015 reporting empirical results. Using the inclusion criteria, thirteen studies were selected for the review. Results The presented studies suggest that the main proportion of mental health patients in countries with major Muslim population including Pakistan, visit religious/faith healers first for treatment, however all studies are silent about the outcomes through these healers. The only potential visible outcome of contacting religious/faith healers is the identification of mental health cases. However, community/lady health workers with minimal training appeared to be a beneficial source of mental health service delivery in communities. Conclusion In a resource scarce country like Pakistan, networking with religious/faith healers can be established for effective identification and referral of mental health cases whereas strong and already existing community/lady health workers system can be used as a first level to deliver mental health service at the doorstep.


2020 ◽  
Vol 26 (3 Special Issue on COVID-19) ◽  
pp. 264-279
Author(s):  
Mehrdad Kazemzadeh Atoofi ◽  
◽  
Nazila Rezaei ◽  
Farzad Kompani ◽  
Fatemeh Shirzad ◽  
...  

Objectives: After the outbreak of a new viral disease in Wuhan, China, in late December 2019, COVID-19 in a very short time and rapidly became a global pandemic. Through a systematic review, the present paper investigated the requirements of Mental Health Services during the COVID-19 outbreak. Methods: A comprehensive search was conducted through PubMed and NLM Gateway (for MEDLINE), Institute of Scientific Information (ISI), and Scopus. PsychINFO and CINAHL data banks were also searched. The primary roots for the development of the search strategy developed based on the keywords of “Covid”, “mental health”, “care”, “services”. All relevant studies were included without any limitation of publication time or the papers’ language as it was not possible to conduct a formal systematic review given the nature of the publications. Instead, it was decided to conduct a mixed systematic and complementary narrative review covering different interested domains. Results: Out of 80 papers, after excluding duplications, 58 articles were selected for the refinement process. Three refining steps based on the titles, abstracts, and full texts led to data extraction from 4 eligible papers. Considering the importance of the problem, related findings, key points, and research findings were summarized and presented in terms of critical components of infrastructure and resources, including policy for at-risk groups, different approaches to mental health service delivery, indirect contexts for mental health service delivery, follow-up attitudes, and complementary research. The results of the study indicate that many studies considered the consequences of physical aspects and diagnostic symptoms. Thus, aspects of mental health have been either less focused or even neglected. In mental health consequences, immediate attention and intensive programs to assess mental health, preparation for support and treatment, and prevention services are emphasized. Conclusion: During the implementation of mental health interventions, to improve services and to consider the limitations and challenges of implementing programs, it is necessary to pay attention to the attitudes of target groups and their preference


2017 ◽  
Vol 6 (4) ◽  
pp. 299 ◽  
Author(s):  
Samuel Adu-Gyamfi

Mental health care in Ghana has been fraught with several challenges leading to stagnant growth in mental health service delivery and in some cases a severe depreciation in the nature of care. The Government of Ghana pays little or no attention to mental health care in the country, a situation that has led to poor service delivery in the three major psychiatric hospitals in Ghana. The implementation of the Ghana Mental Act of 2012 has also been faced with major challenges with no significant progress being made. This studytherefore sought to review and document the development of mental health care services in Ghana. Specifically, the study examined the various legislations on mental health that have been enacted  in Ghana since 1900; investigated the implementation of the current Mental Health Act of Ghana; found out whether the Ghanaian government has prioritise mental health services in the country and assessed the challenges and problems that confronted mental health services in Ghana since 1900.The study concludes that, since 1888 efforts have been made by various governments to legislate the provision of mental services in Ghana. However, these legislations have not always protected the rights and interest of the mentally ill.


2020 ◽  
Author(s):  
Tracey A Davenport ◽  
Vanessa Wan Sze Cheng ◽  
Frank Iorfino ◽  
Blake Hamilton ◽  
Eva Castaldi ◽  
...  

UNSTRUCTURED The demand for mental health services is projected to rapidly increase as a direct and indirect result of the COVID-19 pandemic. Given that young people are disproportionately disadvantaged by mental illness and will face further challenges related to the COVID-19 pandemic, it is crucial to deliver appropriate mental health care to young people as early as possible. Integrating digital health solutions into mental health service delivery pathways has the potential to greatly increase efficiencies, enabling the provision of “right care, first time.” We propose an innovative digital health solution for demand management intended for use by primary youth mental health services, comprised of (1) a youth mental health model of care (ie, the Brain and Mind Centre Youth Model) and (2) a health information technology specifically designed to deliver this model of care (eg, the InnoWell Platform). We also propose an operational protocol of how this solution could be applied to primary youth mental health service delivery processes. By “flipping” the conventional service delivery models of majority in-clinic and minority web-delivered care to a model where web-delivered care is the default, this digital health solution offers a scalable way of delivering quality youth mental health care both in response to public health crises (such as the COVID-19 pandemic) and on an ongoing basis in the future.


1997 ◽  
Vol 12 (S2) ◽  
pp. 70s-78s ◽  
Author(s):  
FJ Huyse ◽  
T Herzog ◽  
A Lobo ◽  
JS Lyons ◽  
JPJ Slaets ◽  
...  

SummaryMental health service delivery in the general health care sector is restricted with regard to understanding the magnitude and impact of mental illness in the medically ill (co-morbidity), as well as the significance of current mental health service delivery. A new model in development in the framework of a Biomed2 grant is presented. It consists of case-finding through complexity of hospital care prediction (COMPRI) followed by an integral health service needs assessment (INTERMED). It might serve to develop a more structural relation with the general health care sector for the management of mentally co-morbid high utilizing patients.


10.2196/24578 ◽  
2020 ◽  
Vol 7 (12) ◽  
pp. e24578
Author(s):  
Tracey A Davenport ◽  
Vanessa Wan Sze Cheng ◽  
Frank Iorfino ◽  
Blake Hamilton ◽  
Eva Castaldi ◽  
...  

The demand for mental health services is projected to rapidly increase as a direct and indirect result of the COVID-19 pandemic. Given that young people are disproportionately disadvantaged by mental illness and will face further challenges related to the COVID-19 pandemic, it is crucial to deliver appropriate mental health care to young people as early as possible. Integrating digital health solutions into mental health service delivery pathways has the potential to greatly increase efficiencies, enabling the provision of “right care, first time.” We propose an innovative digital health solution for demand management intended for use by primary youth mental health services, comprised of (1) a youth mental health model of care (ie, the Brain and Mind Centre Youth Model) and (2) a health information technology specifically designed to deliver this model of care (eg, the InnoWell Platform). We also propose an operational protocol of how this solution could be applied to primary youth mental health service delivery processes. By “flipping” the conventional service delivery models of majority in-clinic and minority web-delivered care to a model where web-delivered care is the default, this digital health solution offers a scalable way of delivering quality youth mental health care both in response to public health crises (such as the COVID-19 pandemic) and on an ongoing basis in the future.


2017 ◽  
Vol 52 (2) ◽  
pp. 163-172 ◽  
Author(s):  
Leonie Segal ◽  
Sophie Guy ◽  
Gareth Furber

Objectives: The study aim was to estimate the current level of ambulatory mental health service delivery to young people aged 0–24 years in Australia and associated government expenditure. Recognising the importance of the early years for the development of mental illness and socioeconomic outcomes, we were particularly interested in service access by infants and young children. Methods: We extracted information from government administrative datasets on the number of people who received mental health services, number of services and expenditure through the health sector for 2014–2015. Results are primarily reported by age groups 0–4, 5–11, 12–17 and 18–24 years. Results: Less than 1% of 0- to 4-year-olds received a mental health service in any one service setting, whereas nearly 11% of 18- to 24-year-olds received a mental health service through the Medicare Benefits Schedule Better Access programme alone. Many more services were delivered to 12- to 24-year-olds (>4 million) than to 0- to 11-year-olds (552,000). Medicare Benefits Schedule Better Access delivers services to more children and youth than do state/territory community mental health services, although the latter provide more services per client. In 2013–2014, Australian Government expenditure on ambulatory mental health services for 0- to 24-year-olds was AUD428 million, similar to the AUD491 million spent by state/territory governments. Conclusion: The study provides a benchmark for data-driven service planning to ensure that the mental health needs of infants, children and young people are met. Our results indicate that the youngest age group are underserviced relative to need, even noting infants and children may receive services for behavioural/mental health issues from providers not captured in our study (such as paediatricians). The developmental origins of mental illness underlies the urgency of adequate provision by governments of perinatal, infant and child mental health services to avoid loss of life potential and reduce the pressures on the justice, child protection and welfare systems.


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