scholarly journals Improving access to integrated mental health services in community-based settings in Portugal

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
G Cardoso
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Health Services ◽  
Mental Health Care ◽  
General Hospital ◽  
General Health ◽  
Psychiatric Hospitals ◽  
Health Departments ◽  
Community Based ◽  
Number Of Patients

Abstract Background Scientific evidence has proven greater effectiveness of community-based mental health care offering a diversity of services. Among the main barriers to mental health treatment are difficulties in the access and poor integration with general health services. Description of the problem The current Portuguese National Mental Health Plan promoted the transition from psychiatric hospital-based care to care provided by a network of services in the community with the inpatient unit in the local general hospital. In this presentation we will describe the main aspects of the mental health reform and some figures illustrating the functioning of one of the new mental health departments. Results Since 2006 three large psychiatric hospitals were closed and mental health departments are now in place according to the new model. One example, the HFF department of psychiatry, has developed an innovative comprehensive and integrated model based in the general hospital and the community, ensuring a close coordination with primary care teams and all other relevant stakeholders in the community, offering diverse answers to patients’ needs, and preventing drop-outs. Between 2000 and 2011, the number of admissions went from 486 to 451, first admissions from 40% to 36%, and the average number of patients treated in day hospital from 12 to 24. Liaison psychiatry consultations (2713 to 3684), community teams’ visits (10,201 to 14,756), and home visits (236 to 980) have increased significantly, while rehabilitation programs were developed in two day centers in the community. Conclusions The Portuguese model of mental health care, based on the principles of accessibility and equity, community involvement, recovery and human rights, and continuity of care, has promoted greater accessibility, higher quality of care, and less stigma. An important integration of mental health and general health services has taken place allowing for a close collaboration between services.

Needs for care in psychiatric patients: a systematic review. I. General concepts and assessment measures. Needs for services

2000 ◽  
Vol 9 (3) ◽  
pp. 190-213 ◽  
Author(s):  
Antonio Lasalvia ◽  
Benedetta Stefani ◽  
Mirella Ruggeri
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Services ◽  
General Population ◽  
Health Services ◽  
Mental Health Care ◽  
Psychiatric Patients ◽  
Assessment Tools ◽  
Needs For Care ◽  
Number Of Patients

SummaryObjective – In Italy, mental health care is in phase of reorganisation. In this frame the measurement of users' needs may be a useftil tool in planning individualised mental health service interventions and in their evaluation. Aims of the present study are (I) to highlight the basic concepts of 'needs for care' and give a brief description of the main needs assessment tools specifically developed for psychiatric patients; (II) to review studies assessing needs for mental health services in the general population; (III) to discuss the role played by the assessment of needs in planning mental health care. Methods – Studies published in the international literature from January 1980 to June 1999 were reviewed. The studies were located through a computerised search of the databases MEDLINE and PsycLit; in addition, the reference lists of the studies located through the computerised search and the content of main international psychiatric journals were manually scanned in order to avoid possible omissions. Studies assessing needs for services and studies assessing needs on individual level were separately reviewed. Both groups of studies, in turn, were divided in studies assessing needs for mental health care in the general population and in psychiatric patients. Results – Although most studies on needs for services used indirect methodologies and employed quite heterogeneous experimental design, they provide at large overlapping results. In the general population, about 60%- 70% of patients with anxiety, depression and other neurotic disorders and 30%-40% of psychotic patients do not receive any specialist mental health care, suggesting that the majority of subjects suffering from a psychiatric disorder do not receive the mental health care they need. Conclusions – Unmet needs for services show a higher frequency in patients with neurotic and depressive disorders, indicating a shortage in services delivery that should be taken into account both by psychiatrists and mental health planners. Moreover, the finding that a large number of patients suffering from psychotic disorders do not receive any kind of mental health care is of particular relevance for planning mental health services, since these subjects are usually the most problematic and difficult to treat.

scholarly journals Public Attitudes Toward Psychiatric Hospitals: A Rural-Urban Comparative Public Survey in Odisha State, India

2021 ◽  
Vol 12 ◽  
Author(s):  
Sunita Jena ◽  
Aron Zieger ◽  
Kerem Böge ◽  
Gayatri Salunkhe ◽  
Georg Schomerus ◽  
...  
Keyword(s):  
Public Health ◽  
Mental Health ◽  
Health Care ◽  
Mental Health Services ◽  
Health Services ◽  
Mental Health Care ◽  
Rural Areas ◽  
Psychiatric Hospitals ◽  
Urban Setting ◽  
Negative Attitudes

Background: Integration of psychiatric care with public health services and offering mental health care services to patients from lower socioeconomic status remains a global challenge. Scarcity of funds and professional workforce in psychiatric hospitals contribute to this situation. However, negative attitudes in the population are also a known impediment to patients seeking mental health services. This study aimed to assess the attitudes toward psychiatric hospitals among the urban and rural population in India.Subjects and Methods: The study was carried out amongst the general population in Odisha, India. The total sample (n = 988) includes 496 respondents from an urban-setting, and 492 respondents from rural parts of the district. Participants were selected by using simple random-sampling from the Asian Institute of Public Health (AIPH) data base. A standardized seven-item questionnaire was adopted, with responses indicated on a 5-point Likert-scale. Interviews were fully structured and conducted face-to-face.Results: Level of education (B = −0.192, ß = −0.320, p < 0.000) and urban-rural comparison (B = −0.272, ß = −0.189, p < 0.000) significantly influenced attitudes toward psychiatric hospitals. Gender, age, and religious beliefs did not show any significant effect on attitudes toward psychiatric hospitals. Individuals in rural areas and those with lower education levels showed more negative attitudes toward psychiatric hospitals.Conclusion: Negative attitudes toward psychiatric hospitals from those living in rural areas as well as those with lesser education may be reflective of the lack of availability, accessibility, affordability, and credibility of such mental health services. The Mental Health Care Act in India is a progressive legislation which might improve the situation of the provided services and, consequently, reduce negative attitudes in the years to come.

scholarly journals Mental Health Service in Ghana: A Review of the Case

2017 ◽  
Vol 6 (4) ◽  
pp. 299 ◽  
Author(s):  
Samuel Adu-Gyamfi
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Service ◽  
Mental Health Services ◽  
Health Service ◽  
Health Services ◽  
Service Delivery ◽  
Mental Health Care ◽  
Psychiatric Hospitals ◽  
The Government

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.

scholarly journals Community Mental Health Services in Italy

10.17816/cp76 ◽  
2021 ◽  
Vol 2 (2) ◽  
pp. 86-92
Author(s):  
Gaia Sampogna ◽  
Valeria Del Vecchio ◽  
Corrado De Rosa ◽  
Vincenzo Giallonardo ◽  
Mario Luciano ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Disorders ◽  
Mental Health Care ◽  
Treatment Options ◽  
Community Mental Health Services ◽  
Psychiatric Hospitals ◽  
Residential Facilities ◽  
Community Based ◽  
Italian Model

In 1978, in Italy, approval of Basaglias reform law marked a shift from an asylum-based to a community-based mental health system. The main aim of the reform was to treat patients in the community and no longer in psychiatric hospitals. Following the Italian model, similar reforms of mental health care have been approved worldwide. The community-based model aims to promote integration and human rights for people with mental disorders on the basis of their freedom to choose treatment options. By 2000, all psychiatric hospitals had been closed and all patients discharged. Mental health care is organized through the Department of Mental Health, which is the umbrella organization responsible for specialist mental health care in the community; this includes psychiatric wards located in general hospitals, residential facilities, mental health centres, and day-hospital and day-care units. Approval of Law 180 led to a practical and ideological shift in the provision of care to patients with mental disorders. In particular, the reform highlighted the need to treat patients in the same way as any other patient, and mental health care moved from a custodialistic to a therapeutic model. Progressive consolidation of the community-based system of mental health care in Italy has been observed in the past 40 years. However, some reasons for concern still exist, including low staffing levels, potential use of community residential facilities as long-stay residential services, and a heterogeneity in the availability of resources for mental health throughout the country.

scholarly journals The Role of Non-Governmental Organisations (NGOs) in Community-based Mental Health Services in Northern Nigeria: Prospects and Challenges

2021 ◽  
Vol 9 (4) ◽  
pp. 24-37
Author(s):  
Emmanuel Ejembi Anyebe
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Services ◽  
Community Mental Health ◽  
Health Services ◽  
Mental Health Care ◽  
Northern Nigeria ◽  
Health Issues ◽  
Community Based

Despite the role of non-governmental organisations (NGOs) in many health issues, their role in community mental health services in parts of northern Nigeria is unknown. This study explored the availability and role of NGOs in community-mental health care services, with a view to identifying the prospects and challenges. Using the convergent mixed methods approach, a self-constructed questionnaire and in-depth interviews were used to collect data from 205 conveniently and purposively selected study participants. Descriptive and thematic analyses were done and then triangulated to meet research objectives. There is a scarcity of mental health-related NGOs in the study areas; only one NGO engaged in the mental health activities was identified (13.4%). Surprisingly attempts by the only available NGO at providing the needed community-based mental health care were “frustrated” by certain government policy directions, which appear to paralyse activities and intentions of the only existing one. NGOs for mental health care are lacking. There is a dire need for NGO activities in mental health care. Efforts should be made to attract NGOs to the study areas in view of the increasing burden of mental health issues in the communities in the setting. Governments at all levels, community-based organisations and traditional institutions can be instrumental to this. NGOs within and outside the study areas focusing on community health in general and mental health care, in particular, may also interrogate this situation further for urgent intervention.

scholarly journals Qatar Community Mental Health Care: Achievements and Challenges

10.17816/cp78 ◽  
2021 ◽  
Vol 2 (2) ◽  
pp. 76-80
Author(s):  
Mohamed Ali Ahmed ◽  
Suhaila Ali Ghuloum
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Services ◽  
Community Mental Health ◽  
Health Services ◽  
Mental Health Care ◽  
Best Practice ◽  
Community Mental Health Services ◽  
Historical Background ◽  
Community Based

Guided by international best practice and evidence-based medicine, the Qatar mental health service has undergone a major transformation in the last two decades, replacing the institution-based service with an accessible multidisciplinary community-based service. In this paper, we provide a brief historical background to mental health services in Qatar, and the progress and development towards community-based mental health-care provision. We also explore the challenges facing this new model of care in Qatar including social and cultural sensitivities, and the various solutions adopted to overcome these challenges. We outline the comprehensive plans envisaged to further develop Qatar community mental health services, including the provision of accessible, integrated and multimodal mental health care within primary care settings.

scholarly journals The development of community based adult mental health services

1992 ◽  
Vol 16 (2) ◽  
pp. 73-75
Author(s):  
Jackie Powell ◽  
Robin Lovelock
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Health Services ◽  
Mental Health Care ◽  
Professional Practice ◽  
Hospital Setting ◽  
Community Based ◽  
Successful Development ◽  
Adult Mental Health ◽  
Community Based Services

Service initiatives such as the decentralisation of adult mental health care by way of multidisciplinary patch teams have wide-ranging implications for professional practice. The successful development of community based services demands that staff adopt different roles from those appropriate to the hospital setting.

Regionalised Tertiary Psychiatric Residential Facilities

2008 ◽  
Vol 17 (1) ◽  
pp. 38-46 ◽  
Author(s):  
Alain Lesage ◽  
David Groden ◽  
Elliot M. Goldner ◽  
Daniel Gelinas ◽  
Leslie M. Arnold
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Psychiatric Hospitals ◽  
Residential Facilities ◽  
Full Time ◽  
Community Based ◽  
Staffing Levels ◽  
Care Facilities

SummaryAims– Psychiatric hospitals remain the main venue for long-term mental health care and, despite widespread closures and downsizing, no country that built asylums in the last century has done away with them entirely – with the recent exception of Italy. Differentiated community-based residential alternatives have been developed over the past decades, with staffing levels that range from full-time professional, to daytime only, to part-time/on-call.Methods– This paper reviews the characteristics of community-based psychiatric residential care facilities as an alternative to long-term care in psychiatric hospitals. It describes five factors decision makers should consider: 1. number of residential places needed; 2. staffing levels; 3. physical setting; 4. programming; and 5. governance and financing.Results– In Italy, facilities with full-time professional staff have been developed since the mid-1990s to accommodate the last cohorts of patients discharged from psychiatric hospitals. In the United Kingdom, experiments withhostel wardssince the 1980s have shown that home-like, small-scale facilities with intensive treatment and rehabilitation programming can be effective for the most difficult-to-place patients. More recently in Australia,Community Care Units(CCUs) have been applying this concept. In the Canadian province of British Columbia (BC),Tertiary Psychiatric Residential Facilities (TPRFs)have been developed as part of an effort to regionalise health and social services and downsize and ultimately close its only psychiatric hospital.Conclusions– This type of service must be further developed in addition to the need for forensic, acute-care and intermediate-level beds, as well as for community-based care such as assertive community treatment and intensive case management. All these types of services, together with long-term community-based residential care, constitute the elements of a balanced mental health care system. As part of a region's balanced mental health care plan, these Tertiary Psychiatric Care Facilities have the potential to act as hubs of expertise not only for treatment, rehabilitation, community integration and ser-vice co-ordination for the severely mentally ill, but also for research and training.Declaration of Interest: None.

Putting Diagnosis Into Brackets: Franco Basaglia, Radical Psychiatry, and Contemporary Mental Health Services

2016 ◽  
Vol 26 (3) ◽  
pp. 187-199 ◽  
Author(s):  
Ian Cummins
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Services ◽  
Health Services ◽  
Mental Health Care ◽  
Current Crisis ◽  
Community Based ◽  
1960S And 1970S ◽  
The 1960S ◽  
Community Based Services

Mental health services in England and Wales are facing a crisis. The vision of properly funded, flexible, and service-user focused community-based services, that was one of the key drivers of deinstitutionalization, has never been realized. This article argues that the failure of community care was the result of underinvestment. The current crisis is linked to the politics of austerity. The current landscape is a bleak one with a shortage of community-based alternatives, a shortage of beds leading to delays in admissions or patients being admitted to units far from their homes, and the Criminal Justice System becoming a default provider of mental health care. Mental health services have become dominated by a bureaucratic, risk assessment focused model of practice. The article uses John Foot’s recent magisterial biography of Franco Basaglia—a key figure in the anti-psychiatry movement of the 1960s—as a basis for a different approach to the provision of mental health care. Basaglia, a charismatic intellectual led a series of radical reforms to asylums in Italy in the 1960s and 1970s. These resulted in Law 180 sometimes referred to as Basaglia’s Law which resulted in the closure of the Trieste asylum. At the core of this work is a belief that services need to be based on relational therapeutic approaches. It concludes that far from being banished to the shores of 1968 radical movement excesses, Basgalia’s work has many important insights for mental health services today.

Sign in / Sign up

Export Citation Format

Share Document