Symbolism of Community II: The Boundary between Community Mental Health Professional and Community

2006 ◽  
Vol 40 (4) ◽  
pp. 318-324
Author(s):  
Damon B. Parker ◽  
Robert J. Barrett

Objective: To study the symbolism of community as understood and practised within a mental health Crisis and Assessment Service in an Australian city. Theoretical approaches: The paper draws on anthropological theories of symbolism, boundary work and social networks. Method: Ethnographic fieldwork techniques were employed for data collection. Ethnographic analysis was then applied to these data. Results: In mental health practice, rules of professional behaviour established a boundary that prohibited mental health professionals from social engagement with members of the community they served. Ethical imperatives prevented them from forming interpersonal bonds with their clients. Rules of privacy and confidentiality meant that they could not relate to the client's social network as a whole. Conclusions: The companion to this paper identified a summarizing symbol, which we designated community, and it specified the social values it represented when appropriated to the task of drawing a boundary between hospital and community. This paper specifies additional social values represented by community when it is appropriated to the task of drawing a boundary between community mental health professionals and the community.

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Roisin McGrath ◽  
Rodrigo Marino ◽  
Julie Satur

Abstract Background This study explored the oral health promotion practices of Australian community mental health professionals working with people living with severe mental illness (SMI). Methods An anonymous cross-sectional web-based survey was distributed to all Community Rehabilitation and Support Workers (CRSWs) working at Neami National (n = 471), an Australian community mental health service. The validated questionnaire assessed participants’ self-rated oral health knowledge and confidence (7 questions); their perceived barriers (9 questions) and attitudes (5 questions) to oral health promotion; and their oral health promotion practices (7 questions). Differences in responses between groups were analysed using Chi-square, Fisher’s exact and Mann–Whitney U tests. Logistic Regression Analysis served to explore the probability of providing oral health support to mental health consumers. Results A total of 141 CRSWs were included in this study, achieving a response rate of 30 percent. Roughly two-fifths (39.0%) of participants had oral health training in the previous 12-months. The majority of CRSWs (89.3%) believed (‘Agreed’ or ‘Strongly agreed’) that mental health support workers have a role to play in promoting oral health. However, less than half (44.0%) of CRSWs practiced oral health promotion activities when working with mental health consumers. When asked about barriers to promoting oral health, ‘lack of consumer interest’ was the most prevalent issue. CRSWs who had oral health training were over three-times (OR 3.5, 95% CI 1.25–9.83, p = 0.017) more likely to provide oral health support. Results showed the provision of oral health support was most strongly associated with self-rated knowledge and confidence (OR 4.089, 95% CI 1.629–10.263, p = 0.003) and attitudes to oral health promotion (OR 3.906, 95% CI 1.77–8.65, p = 0.001). Conclusion The results of this study suggest that mental health support workers who have more positive attitudes to oral health promotion and who have higher self-rated oral health knowledge and confidence are more likely to provide oral health support in their professional role. Training for community mental health professionals is essential to build confidence and skills to promote oral health for mental health consumers.


2018 ◽  
Vol 13 (3) ◽  
pp. 173-186 ◽  
Author(s):  
Catherine Cosgrave ◽  
Myfanwy Maple ◽  
Rafat Hussain

Purpose Some of Australia’s most severe and protracted workforce shortages are in public sector community mental health (CMH) services. Research identifying the factors affecting staff turnover of this workforce has been limited. The purpose of this paper is to identify work factors negatively affecting the job satisfaction of early career health professionals working in rural Australia’s public sector CMH services. Design/methodology/approach In total, 25 health professionals working in rural and remote CMH services in New South Wales (NSW), Australia, for NSW Health participated in in-depth, semi-structured interviews. Findings The study identified five work-related challenges negatively affecting job satisfaction: developing a profession-specific identity; providing quality multidisciplinary care; working in a resource-constrained service environment; working with a demanding client group; and managing personal and professional boundaries. Practical implications These findings highlight the need to provide time-critical supports to address the challenges facing rural-based CMH professionals in their early career years in order to maximise job satisfaction and reduce avoidable turnover. Originality/value Overall, the study found that the factors negatively affecting the job satisfaction of early career rural-based CMH professionals affects all professionals working in rural CMH, and these negative effects increase with service remoteness. For those in early career, having to simultaneously deal with significant rural health and sector-specific constraints and professional challenges has a negative multiplier effect on their job satisfaction. It is this phenomenon that likely explains the high levels of job dissatisfaction and turnover found among Australia’s rural-based early career CMH professionals. By understanding these multiple and simultaneous pressures on rural-based early career CMH professionals, public health services and governments involved in addressing rural mental health workforce issues will be better able to identify and implement time-critical supports for this cohort of workers. These findings and proposed strategies potentially have relevance beyond Australia’s rural CMH workforce to Australia’s broader early career nursing and allied health rural workforce as well as internationally for other countries that have a similar physical geography and health system.


2020 ◽  
Vol 27 (1) ◽  
pp. 72-76
Author(s):  
Marsha Lesley

OBJECTIVE: To raise awareness of the potential for moral injury in nurses working on the frontlines of COVID-19 patient care and to present aspects of mental functioning that may increase the likelihood of psychological distress. Approaches that draw on psychoanalytic thinking to support frontline nurses’ mental health are explained. METHOD: This article draws on recent work that is available from multiple sources, including published journal articles on moral injury, recent reports from news services highlighting the crisis state of the pandemic and effects on nurses, established literature on the structural model of the mind, and recent webinars and online lectures addressing mental health crisis interventions. The author draws on expertise from years of training in the Adult Psychoanalytic Training Program at the Michigan Psychoanalytic Institute and graduation as an academic analyst. RESULTS: How nurses navigate moral hazards inherent in the current state of frontline health care may depend on their existing ego strengths and levels of self-blame and guilt from a harsh superego. CONCLUSIONS: Mental health professionals need to be aware of the mental minefields that frontline nurses must navigate when providing care that, due to circumstances beyond their control, may be morally ambiguous. Educating nurses about the meaning of their own emotional and psychic responses amid the realities in the field may help to decrease the damaging effects of moral injury.


Subject India's efforts to address a mental health crisis. Significance The Indian government is aiming to convert 150,000 primary health centres into health and wellness centres (HWCs) providing comprehensive care, including management of mental disorders. Its plans for secondary and tertiary healthcare include medical insurance for poorer families that will cover treatment of mental illness. According to a 2016 study conducted by India’s National Institute of Mental Health and Neurosciences (NIMHANS), 150 million out of the country’s 1.3 billion people urgently need mental healthcare. Impacts Expanding mental healthcare infrastructure could lead to an overemphasis on a biomedical model of treatment for mental health disorders. The government will come under pressure to increase funding for mental health professionals as well as technological resources. Future budgets will be key indicators of the government’s commitment to its National Mental Health Programme.


2005 ◽  
Vol 40 (3) ◽  
pp. 223-232 ◽  
Author(s):  
Stefan Priebe ◽  
Walid K. H. Fakhoury ◽  
Karin Hoffmann ◽  
Richard A. Powell

2020 ◽  
Vol 2 (6) ◽  
pp. 94-100
Author(s):  
Saba Khurshid ◽  
Sidra Mumtaz ◽  
Hafsa Khalil Toor ◽  
Rubina Hanif

The outbreak of COVID-19 pandemic is constantly posing warning and creating mental health crisis among people without any discrimination. Therefore, the current study purpose is to explore mental health upheaval and transition in future perspectives due to COVID-19. Using exploratory study design, semi structure interviews were conducted. Interviews were recorded, transcribed and analyzed by using Thematic Content Analysis. The major themes which were identified showed that COVID-19 is constantly eliciting panic and mental health issues such as anxiety, stress, and depression, fears of death, xenophobia, OCD and uncertainty about future among general population. Results also indicated the major transition in public future perspectives and perception. Concern related to adjustability in life after pandemic is major emerging future concern among Pakistani People. During pandemic outbreak, people are becoming vulnerable to different mental health problems. To overcome these issues successfully, role of mental health professionals cannot be denied. There is strong need to devise activities and strategies which help people to increase resilience and build strong relationships during the period of social distancing. This paper gives a deep insight into mental health problems among general population due to COVID-19 and it also implicates need of psychological services to overcome these issues.


2005 ◽  
Vol 29 (9) ◽  
pp. 327-329 ◽  
Author(s):  
Tayyeb A. Tahir ◽  
Jonathan I. Bisson ◽  
Jodie Wilcox

Aims and MethodTo assess the views of patients and mental health professionals on the practice of copying clinical letters to patients. Patients and professionals from local community mental health teams were asked to complete a questionnaire regarding their views.ResultsThe questionnaires were completed by 51 patients and 40 mental health professionals. Significantly more patients (83%) than staff (37%) thought that copying letters to patients was a good idea (OR=14.56, 95% CI 4.674 –45.158). Many staff appeared concerned that copying letters to patients could result in breakdown of the therapeutic relationship, causing distress and anxiety.Clinical ImplicationsConsiderable work is needed for clinicians to feel comfortable in copying letters to patients. The creation of working groups, including users, carers, managers and clinicians working in the field of mental health, would facilitate the development of guidelines for this practice.


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