Satisfaction with primary and specialized mental health care among patients with mental disorders

As mental disorders impact quality of life and result in high costs for society, it is important patients receive timely and adequate care. This scoping review first aims to summarize which factors contribute to specialized mental health care (SMHC) use. Within the Dutch health care system, the general practitioner (GP) is the filter for SMHC and care use costs are relatively low. Second, to organize factors by Andersen and Newman’s care utilization model in illness level, predisposing, and enabling factors. Third, to assess equity of access to SMHC in the Netherlands. A health care system is equitable when illness level and the demographic predisposing factors age and gender account for most variation in care use and inequitable when enabling factors and social predisposing factors such as education predominate. We identified 13 cross-sectional and cohort studies in the Netherlands published between 1970 and September 2020 with 20 assessed factors. Illness level factors, disease severity, diagnosis, personality, and comorbidity contributed the most to SMHC use. Predisposing factors related to a more solitary lifestyle contributed to a lesser degree. Enabling factors income and urbanicity contributed the least to SMHC use. These results imply inequity. Factors that did not fit the care utilization model were GP related, for example the ability to recognize mental disorders. This emphasizes their importance in a system where patients are dependent on GPs for access to SMHC. Focus should be on improving recognition of mental disorders by GPs as well as collaboration with mental health care professionals.

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Many Teens Considering Suicide Do Not Receive Specialized Mental Health Care

PsycEXTRA Dataset ◽

10.1037/e679482012-001 ◽

2012 ◽

Keyword(s):

Mental Health ◽

Health Care ◽

Mental Health Care ◽

Specialized Mental Health

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Religious advisors’ role in mental health care in the European Study of the Epidemiology of Mental Disorders survey

Social Psychiatry and Psychiatric Epidemiology ◽

10.1007/s00127-009-0143-0 ◽

2009 ◽

Vol 45 (10) ◽

pp. 989-998 ◽

Cited By ~ 8

Author(s):

Viviane Kovess-Masfety ◽

◽

Anne Dezetter ◽

Ron de Graaf ◽

Joseph Maria Haro ◽

...

Keyword(s):

Mental Health ◽

Health Care ◽

Mental Disorders ◽

Mental Health Care ◽

European Study

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The importance of peer support in the recovery process of persons with mental disorders

European Journal of Public Health ◽

10.1093/eurpub/ckaa166.1025 ◽

2020 ◽

Vol 30 (Supplement_5) ◽

Author(s):

D Stimac Grbic ◽

I Pavic Simetin ◽

A Istvanovic

Keyword(s):

Mental Health ◽

Health Care ◽

Mental Disorders ◽

Mental Health Care ◽

Peer Support ◽

Community Intervention ◽

Recovery Process ◽

Therapeutic Interventions ◽

Hospital Treatment ◽

Personal Recovery

Abstract Issue Care for people with severe mental disorders requires approach that is focused on a person's strengths, not his weaknesses, and is a shift from a deficit model that is often associated with mental illness. Care users and their family members play an important role in this approach. Description of the Problem Mental disorders are the leading group of diseases in Croatia, according to the number of days of hospital treatment. The number of hospitalizations is high, and the rate of hospitalization for depression has tripled in the last twenty years. Such indicators highlight the need for reorientation of mental health care, from hospital-based to community-based, by organizing mobile community intervention teams. Results In Croatia, psychosocial peer teams were established by the NGO Ludruga, financed by local government, to provide peer support to persons with mental disorders. The main activities are: development of a personal recovery plan, home visits and providing psychological support to persons with mental disorders, organizing support groups and education of peer workers. The teams consist of a peer worker, social worker, psychologist, and operate under the supervision of a psychiatrist. The teams have been operating for five years, have had over a hundred users so far and are a significant help to the healthcare system in preventing rehospitalizations. Lessons The goal of therapeutic interventions in mental health care should be recovery. Recovery involves empowering a person to take responsibility for themselves and their health. Peer workers play an important role in the recovery process, providing hope for recovery. Their role must also be recognized by the health system. Key messages People with mental disorders and their families should be co-creators of care and recovery-oriented interventions. Only by comprehensive interventions, tackling all determinants of health, therapeutic goal can be achieved.

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Cross-Sectional Study of Mental Health Related Knowledge and Attitudes Among Care Assistant Workers in Guangzhou, China

10.21203/rs.3.rs-107392/v1 ◽

2020 ◽

Author(s):

Jie Li ◽

Xiao-Ling Duan ◽

Hua-Qing Zhong ◽

Wen Chen ◽

Sara Evans‑Lacko ◽

...

Keyword(s):

Mental Health ◽

Health Care ◽

Mental Disorders ◽

Linear Regression ◽

Mental Health Care ◽

Health Staff ◽

Care Providers ◽

Knowledge And Attitudes ◽

Additional Item ◽

Health Related

Abstract Background: Care assistant workers (CAWs) are a part of a new pattern of mental health care providers in China and play a significant role in bridging the human resource shortage. CAWs in China mainly include community cadres, community mental health staff and community policemen. The mental health related knowledge and attitudes of CAWs could influence their mental health care delivery. This study aimed to assess the mental health related knowledge and attitudes of CAWs in Guangzhou, China. Methods: In November 2017, a study was conducted among 381 CAWs from four districts of Guangzhou, China. Participants were assessed using the Perceived Devaluation and Discrimination Scale (PDD), the Mental Health Knowledge Schedule (MAKS), and the Mental illness: Clinicians’ Attitudes (MICA). Data were analyzed by descriptive statistics, ANOVA, Bonferroni corrections and multivariable linear regression. Results: The mean scores (standard deviation) of PDD, MAKS and MICA were 36.45 (6.54), 22.72 (2.56), 51.67 (7.88), respectively. Univariate analyses showed that the older CAWs, community policemen and those who were less willing to deliver care had significant higher MICA scores when compared with other staff (P < 0.001). However, participants who disagreed additional item 1（views towards inpatients) and additional item 2 (affiliate stigma) had a significant lower MICA scores when compared with those who agreed (P < 0.001). Multivariable linear regression showed that after controlling some variables, care willingness and PDD total score were significantly positively associated with the MICA total score (all P < 0.05), while attitudes on additional items were significantly negatively associated with the MICA total score (all P < 0.01).Conclusion: These findings suggest negative attitudes towards people with mental disorders among CAWs are common, especially among older staff. Community policemen suggest that they applied stereotypes of ‘violent mentally ill’ people to all people they deal with who have mental disorders. The results also indicate human rights are being paid attention to now, but need to be improved in the future. Strategies to improve attitudes and to reduce stigma and discrimination should be conducted with particular staff groups.

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The Use of Antidepressants, Anxiolytics, Sedatives and Hypnotics in Europe: Focusing on Mental Health Care in Portugal and Prescribing in Older Patients

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17228612 ◽

2020 ◽

Vol 17 (22) ◽

pp. 8612

Author(s):

Marta Estrela ◽

Maria Teresa Herdeiro ◽

Pedro Lopes Ferreira ◽

Fátima Roque

Keyword(s):

Mental Health ◽

Health Care ◽

Mental Disorders ◽

Mental Health Care ◽

Older Patients ◽

Common Mental Disorders ◽

Health Policies ◽

Depression And Anxiety ◽

Treatment Gap ◽

Mental Health Policies

(1) Background: Mental disorders are a growing concern in the 21st century. The most prevalent common mental disorders include depression and anxiety. It is predicted that half of the population will at some point in their lives experience one or more mental disorders. Although common mental disorders are highly prevalent, some of the most significant related problems are the wide treatment gap and the excessive use of antidepressants, anxiolytics and sedatives/hypnotics, especially among older patients. (2) Methods: This study aimed to analyze mental health care in Portugal, with a focus on the consumption of antidepressants, anxiolytics, sedatives and hypnotics among older patients. (3) Results: The use of antidepressants, anxiolytics, sedatives and hypnotics has increased overall across Europe. In Portugal, a downward trend of sedatives and hypnotics consumption can be observed. Anxiolytics and antidepressants, on the other hand, have been increasing. Patients aged ≥60 years old consume more than half of the aforementioned drugs. (4) Conclusions: Mental health policies should be designed to improve the conscientious use of antidepressants, anxiolytics, sedatives and hypnotics, particularly among older adults.

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Exploring Perceptions of Continuity of Care Among People With Long-Term Mental Disorders in Denmark

Qualitative Health Research ◽

10.1177/1049732319840286 ◽

2019 ◽

Vol 29 (13) ◽

pp. 1916-1929

Author(s):

Anna P. Folker ◽

Mette M. Kristensen ◽

Amalie O. Kusier ◽

Maj Britt D. Nielsen ◽

Sigurd M. Lauridsen ◽

...

Keyword(s):

Mental Health ◽

Health Care ◽

Mental Disorders ◽

Mental Health Care ◽

Continuity Of Care ◽

Service Users ◽

Mental Health Care System ◽

Template Analysis ◽

Depth Interviews

Continuity of mental health care is central to improve the treatment and rehabilitation of people with mental disorders. While most studies on continuity of care fail to take the perspectives of service users into account, the aim of this study was to explore the perceived meanings of continuity of care among people with long-term mental disorders. Fifteen service users participated in semi-structured in-depth interviews. We used template analysis to guide the analysis. The main transversal themes of continuity were “Navigating the system” and “Connecting to people and everyday life.” While the first theme related to the participants’ experiences of their interaction with the mental health care system, the latter related to their hopes and perceived opportunities for a good life as desired outcomes of mental health care. We conclude that efforts to improve continuity of mental health care should be tailored to the priorities of service users.

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Shifting to Remotely Delivered Mental Health Care: Quality Improvement in the COVID-19 Pandemic

Psychiatry International ◽

10.3390/psychiatryint1010005 ◽

2020 ◽

Vol 1 (1) ◽

pp. 31-35 ◽

Cited By ~ 1

Author(s):

Patrick Daigle ◽

Abraham Rudnick

Keyword(s):

Mental Health ◽

Health Care ◽

Quality Improvement ◽

Mental Health Care ◽

Health Care Quality ◽

Care Quality ◽

Health Clinic ◽

Quality Improvement Initiative ◽

Service Users ◽

Specialized Mental Health

This paper presents an organizational (ambulatory) case study of shifting mental health care from in-person to remote service delivery due to the current (COVID-19) pandemic as a rapid quality improvement initiative. Remotely delivered mental health care, particularly using synchronous video and phone, has been shown to be cost-effective, especially for rural service users. Our provincial specialized mental health clinic rapidly shifted to such remote delivery during the current pandemic. We report on processes and outputs of this rapid quality improvement initiative, which serves a purpose beyond pandemic circumstances, such as improving access to such specialized mental health care for rural and other service users at any time. In conclusion, shifting specialized mental health care from in-person to remotely delivered services as much as possible could be beneficial beyond the current pandemic. More research is needed to optimize the implementation of such a shift.

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Adolescents with mental disorders while serving time and being subjected to socio-educative measures

Ciência & Saúde Coletiva ◽

10.1590/1413-81232014193.13042013 ◽

2014 ◽

Vol 19 (3) ◽

pp. 891-898 ◽

Cited By ~ 1

Author(s):

Natália Pereira Gonçalves Vilarins

Keyword(s):

Mental Health ◽

Health Care ◽

Mental Disorders ◽

Mental Health Care ◽

Participant Observation ◽

Federal District ◽

Adolescent Offenders ◽

Structured Interviews ◽

Research Committee ◽

Ethics Research

This article examines how adolescent offenders with mental disorders are treated by socio-educative internment treatment. These adolescents come under the aegis of medicine and justice in a contradictory relationship between full protection, vulnerability of a developing person with a mental disorder and a juvenile delinquency offense. In this respect, the legal punishment prevails to the detriment of health care. After approval of the research project by an Ethics Research Committee, field research was conducted in the Youth Detention Unit of the Pilot Plan of the Brazilian Federal District. Data were collected through research of documents involving 35 medical records of adolescent users of psychotropic drugs in 2010, as well as participant observation and semi-structured interviews with professionals from the Youth Detention Unit and adolescent judiciary. In the review of the care provided to adolescent offenders with mental disorders under the childhood and youth policy and the mental health policy, it was revealed that the mental health care provided in the Youth Detention Unit or in the external mental health care services involved the prescription of medication.

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A certificate in youth psychiatry: meeting the training needs of psychiatrists

Australasian Psychiatry ◽

10.1177/1039856220943015 ◽

2020 ◽

pp. 103985622094301

Author(s):

Iain Macmillan ◽

Andrew Thompson ◽

Megan Kalucy ◽

Daniel Pellen ◽

Eóin Killackey ◽

...

Keyword(s):

Mental Health ◽

Health Care ◽

Young People ◽

Mental Disorders ◽

Mental Health Care ◽

Youth Mental Health ◽

Training Needs ◽

Specialty Training ◽

Optimal Care ◽

Adult Psychiatry

Objective: This paper provides the rationale for the development of sub-specialty training in youth psychiatry. Method: Training needs for youth psychiatry are discussed and the opportunities provided by sub-specialisation in youth psychiatry are presented. Results: The majority of mental disorders have their onset prior to 25 years. There has been substantial recent growth in services to meet the clinical needs of young people. The development of these services has exposed gaps in current training for psychiatrists, which varies considerably between child and adolescent, and adult psychiatry. Competencies acquired by psychiatrists in youth mental health are non-standardised, which may hinder optimal care. Conclusions: Sub-specialty training in youth psychiatry is needed to meet workforce demands. The development of a certificate in youth psychiatry, by the RANZCP Section for Youth Mental Health, is underway. This will complement existing training and provide trainees and psychiatrists the opportunity to develop specialist skills in the provision of mental health care for young people negotiating the transition between adolescence and adulthood.

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