Closing Comments | ScienceGate

Abstract:There are many barriers to mental health care in the Black Community. These barriers lead to racial disparities in access to treatment and quality of life, along with inappropriate treatment and misdiagnosis in mental and physical health. These disparities directly lead to increased morbidity, mortality and poor mental health in the our communities. Many would question if Black people are not interested in mental health and don’t see it as a needed concern. This talk will address that all cultures are not the same and that there is a fundamental need to address communities on their terms and not make them conform into a "majority culture" approach and perception of mental health care, but rather focus on the individual patient and community needs for mental health care. Often psychiatrists and other mental health professionals are trained in a very academic scientific approach to identification and treatment of mental illness. Too often this model does not fit the needs of all patients due to it not taking into account ethnic differences in communication of mental health and desired outcomes of the patient. This often leads to a lack of understanding on with both sides, the mental health professional and the patient. Too often a patient may see the physician, be given a diagnosis, starts taking a prescription, but then not be able to explain what is their diagnosis, the name of the medication, what it is for, nor what is the medication supposed to do for them. This could lead to unexpected poor outcomes due to the lack of effective communication. This talk will attempt to explain the barriers of communication to the Black community while appreciating and supporting cultural nuance and effective communication. This is needed to help bring mental health to the community in a digestible way and to meet the communities needs on their level. To do this, psychiatry needs to shift it’s focus to understanding cultural characteristics, such as how Black patients may have different cultural needs and may benefit from a unique, customized approach to their mental health. There is a need for psychiatry to take into consideration the spiritual aspects of patients and how many focus not only on needing to improve themselves, but also on how their mental health and behavior are impacting their family and the community as a whole. The traditional model of interview, diagnosis with medication, and follow up for medication adjustment is not fitting all communities leading to the detriment of their mental health.

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The Rise of Nervous Illness

How Everyone Became Depressed ◽

10.1093/oso/9780199948086.003.0006 ◽

2013 ◽

Author(s):

Edward Shorter

Keyword(s):

Health Care ◽

Mental Illness ◽

The Body ◽

Time Out ◽

Humoral Medicine ◽

The Mind ◽

The Brain ◽

Prospect Of Success ◽

The Way

It is much better, people think, for the nerves than the mind to be ill. The nerves are physical structures, and heal in the way that all organs of the body heal naturally. Disorders of the mind are frightening because they are so intangible, and, we think, may well lead to insanity rather than recovery. From time out of mind, people have privileged nervous illness over mental illness. From time out of mind, societies have had expressions for the varieties of frets, anxieties, and dyspepsias to which the flesh is heir. In France and England in the seventeenth and eighteenth centuries, one term was “vapours,” a reference from humoral medicine to supposed exhalations of the viscera that would rise in the body to affect the brain. A major apostle was London physician John Purcell, writing in 1702, of “those who have laboured long under this distemper, [who] are oppressed with a dreadful anguish of mind and a deep melancholy, always reflecting on what can perplex, terrify, and disorder them most, so that at last they think their recovery impossible, and are very angry with those who pretend there is any hopes of it.” He emphasized melancholia and anguish, and for him the “vapours” were something more than a mild attack of the frets. But this was not for everyone. Lady Mary Wortley Montagu, now 60 and living in exile in Italy, described to her estranged husband in 1749 Italian health care arrangements, and how physicians visited rich and poor alike. “This last article would be very hard if we had as many vapourish ladies as in England, but those imaginary ills are entirely unknown here. When I recollect the vast fortunes raised by doctors amongst us [in England], and the eager pursuit after every new piece of quackery that is introduced, I cannot help thinking there is a fund of credulity in mankind . . . and the money formerly given to monks for the health of the soul is now thrown to doctors for the health of the body, and generally with as little real prospect of success.”

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The Economic Consequences of not Treating Depression

The British Journal of Psychiatry ◽

10.1192/s0007125000293379 ◽

1995 ◽

Vol 166 (S27) ◽

pp. 29-33 ◽

Cited By ~ 24

Author(s):

Agnes Rupp

Keyword(s):

Health Care ◽

Mental Illness ◽

Conceptual Framework ◽

Affective Disorders ◽

Cost Benefit ◽

Economic Consequences ◽

Financial Resources ◽

Access To Treatment ◽

Benefit Evaluation ◽

The Cost

Background. A conceptual framework Is described for a broad cost–benefit evaluation of improved financial access to treatment of untreated affective disorders.Method. The analysis provides an estimate of the value of resources needed to provide improved access to treatment, and it compares these resources to the value of resources the improved access to treatment might save.Results. The cost–benefit analyses based on recent cost of mental illness studies provide some evidence that appropriately treating people with untreated affective disorders is cost-beneficial.Conclusion. Patients, providers and buyers of health care should be further encouraged to pay more attention and to commit more financial resources to the treatment of affective disorders.

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Examining interprofessional collaboration, patient care, student training, and the effectiveness of individual cognitive behavioural therapy provided at an urban family health team

10.32920/ryerson.14664459 ◽

2021 ◽

Author(s):

Jennifer R. Rouse

Keyword(s):

Mental Health ◽

Health Care ◽

Graduate Students ◽

Mental Health Services ◽

Health Services ◽

Patient Care ◽

Family Health ◽

Treatment Delivery ◽

Student Training ◽

Improve Access

Mental illness is highly prevalent in Canada and costs the Canadian economy and health care system billions each year. Yet, Canadians generally do not have access to evidence-based psychotherapy that is considered a frontline treatment in countries such as the United Kingdom and Australia. Family health teams (FHTs) have been proposed as a way to improve access to mental health treatment. Yet, limited research has been conducted on the inclusion of Psychology into FHTs or the training of graduate students in this emerging field. To address this research gap, the novel treatment delivery and student training model at the Ryerson University Psychology Training Clinic (PTC) and St. Michael’s Hospital’s FHTs was examined in two studies. First, a pilot study examined the effectiveness of individual CBT provided by graduate students to patients with a primary anxiety or depressive disorder. Eighty percent of participants either no longer met diagnostic criteria for their primary mental disorder or were in partial remission. They experienced a significant reduction in symptoms of overall mental health, depression, and anxiety. As well, participants expressed a high level of satisfaction with the services received and reported having a positive working alliance with their student psychotherapist. Results indicate that student-delivered psychotherapy in a FHT setting is an effective treatment delivery model. Second, a two-part mixed methods study was conducted evaluating perspectives on patient care, interprofessionalism, and student training through an online study and individual interviews with health care providers, clinical supervisors, graduate students, and patients. Results from this study indicate that the PTC was a positive addition to the FHTs that improved access and provided patients with high quality mental health services. Generally, high levels of interprofessionalism were reported, though some drawbacks and individual differences were noted. The PTC was described as a valuable training experience. The importance of supervision and specific interprofessional and FHT training was highlighted. Findings from these studies represent a worthwhile contribution to the FHT and primary care psychology literature. Furthermore, the inclusion of Psychology and student trainees into a FHT appears to be a successful, viable option to improve access to effective mental health services.

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Examining interprofessional collaboration, patient care, student training, and the effectiveness of individual cognitive behavioural therapy provided at an urban family health team

10.32920/ryerson.14664459.v1 ◽

2021 ◽

Author(s):

Jennifer R. Rouse

Keyword(s):

Mental Health ◽

Health Care ◽

Graduate Students ◽

Mental Health Services ◽

Health Services ◽

Patient Care ◽

Family Health ◽

Treatment Delivery ◽

Student Training ◽

Improve Access

Mental illness is highly prevalent in Canada and costs the Canadian economy and health care system billions each year. Yet, Canadians generally do not have access to evidence-based psychotherapy that is considered a frontline treatment in countries such as the United Kingdom and Australia. Family health teams (FHTs) have been proposed as a way to improve access to mental health treatment. Yet, limited research has been conducted on the inclusion of Psychology into FHTs or the training of graduate students in this emerging field. To address this research gap, the novel treatment delivery and student training model at the Ryerson University Psychology Training Clinic (PTC) and St. Michael’s Hospital’s FHTs was examined in two studies. First, a pilot study examined the effectiveness of individual CBT provided by graduate students to patients with a primary anxiety or depressive disorder. Eighty percent of participants either no longer met diagnostic criteria for their primary mental disorder or were in partial remission. They experienced a significant reduction in symptoms of overall mental health, depression, and anxiety. As well, participants expressed a high level of satisfaction with the services received and reported having a positive working alliance with their student psychotherapist. Results indicate that student-delivered psychotherapy in a FHT setting is an effective treatment delivery model. Second, a two-part mixed methods study was conducted evaluating perspectives on patient care, interprofessionalism, and student training through an online study and individual interviews with health care providers, clinical supervisors, graduate students, and patients. Results from this study indicate that the PTC was a positive addition to the FHTs that improved access and provided patients with high quality mental health services. Generally, high levels of interprofessionalism were reported, though some drawbacks and individual differences were noted. The PTC was described as a valuable training experience. The importance of supervision and specific interprofessional and FHT training was highlighted. Findings from these studies represent a worthwhile contribution to the FHT and primary care psychology literature. Furthermore, the inclusion of Psychology and student trainees into a FHT appears to be a successful, viable option to improve access to effective mental health services.

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A Tribute to the Late William J. Curran

The Journal of Law Medicine & Ethics ◽

10.1017/s1073110500004058 ◽

1996 ◽

Vol 24 (3) ◽

pp. 274-275

Author(s):

O. Lawrence ◽

J.D. Gostin

Keyword(s):

Mental Health ◽

Health Care ◽

Mental Illness ◽

United Nations ◽

Mental Health Care ◽

Harvard University ◽

Legal Medicine ◽

General Assembly ◽

International Institute ◽

University Professor

In the summer of 1979, a group of experts on law, medicine, and ethics assembled in Siracusa, Sicily, under the auspices of the International Commission of Jurists and the International Institute of Higher Studies in Criminal Science, to draft guidelines on the rights of persons with mental illness. Sitting across the table from me was a quiet, proud man of distinctive intelligence, William J. Curran, Frances Glessner Lee Professor of Legal Medicine at Harvard University. Professor Curran was one of the principal drafters of those guidelines. Many years later in 1991, after several subsequent re-drafts by United Nations (U.N.) Rapporteur Erica-Irene Daes, the text was adopted by the U.N. General Assembly as the Principles for the Protection of Persons with Mental Illness and for the Improvement of Mental Health Care. This was the kind of remarkable achievement in the field of law and medicine that Professor Curran repeated throughout his distinguished career.

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Using Technology to Improve Access to Health Care for Culturally and Linguistically Diverse Populations

Perspectives on Communication Disorders and Sciences in Culturally and Linguistically Diverse Populations ◽

10.1044/cds19.3.71 ◽

2012 ◽

Vol 19 (3) ◽

pp. 71-76 ◽

Cited By ~ 1

Author(s):

Pauline A. Mashima

Keyword(s):

Health Care ◽

Health Care Providers ◽

Access To Health Care ◽

Underserved Populations ◽

Linguistically Diverse ◽

Care Providers ◽

Department Of Health ◽

Use Of Technology ◽

Access To Health ◽

Improve Access

Important initiatives in health care include (a) improving access to services for disadvantaged populations, (b) providing equal access for individuals with limited or non-English proficiency, and (c) ensuring cultural competence of health-care providers to facilitate effective services for individuals from diverse racial and ethnic backgrounds (U.S. Department of Health and Human Services, Office of Minority Health, 2001). This article provides a brief overview of the use of technology by speech-language pathologists and audiologists to extend their services to underserved populations who live in remote geographic areas, or when cultural and linguistic differences impact service delivery.

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