Telemental Health in Africa

2017 ◽  
Author(s):  
Sinclair Wynchank ◽  
Dora Wynchank
Keyword(s):  
Mental Illness ◽  
Severe Mental Illness ◽  
Mental Healthcare ◽  
Cross Cultural ◽  
Healthcare Personnel ◽  
Telemental Health ◽  
African Countries ◽  
Broadcast Media ◽  
Equipment Costs

Although telemental health (TMH) in Africa shares much with TMH in well-resourced nations, significant differences exist. These mainly result from relatively small funds available for all forms of healthcare, inadequate infrastructure, lack of mental healthcare personnel, and cross-cultural difficulties. The majority of individuals with severe mental illness receive no treatment in most African countries. This lack has been alleviated in part by some “North–South” and “South–South” TMH programs, in addition to other locally initiated programs. African TMH has emphasized provision of a wide variety of TMH—education, managing psychotrauma in regions of violent upheavals, and the provision of other TMH services. Novel African telecommunications techniques and means of providing TMH, for example using broadcast media and diasporic mental healthcare personnel, are outlined. So, future African TMH will surely grow because of decreasing equipment costs, but principally because of proven effectiveness and the power of such interventions.

scholarly journals Methodological challenges in the use of focus groups with people with severe mental illness

2017 ◽  
Vol 33 (6) ◽  
Author(s):  
Rosana Teresa Onocko-Campos ◽  
Alberto Rodolfo Giovanello Díaz ◽  
Catarina Magalhães Dahl ◽  
Erotildes Maria Leal ◽  
Octavio Domont de Serpa Junior
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Community Mental Health ◽  
Focus Groups ◽  
Severe Mental Illness ◽  
Ethical Issues ◽  
Collaborative Work ◽  
Mental Healthcare ◽  
Community Mental Health Services ◽  
Ethical Challenges

Abstract: This study addresses the practical, methodological and ethical challenges that were found in three studies that used focus groups with people with severe mental illness, in the context of community mental health services in Brazil. Focus groups are a powerful tool in health research that need to be better discussed in research with people with severe mental illness, in the context of community mental health facilities. This study is based on the authors’ experience of conducting and analyzing focus groups in three different cities - Campinas, Rio de Janeiro and Salvador - between 2006-2010. The implementation of focus groups with people with severe mental illness is discussed in the following categories; planning, group design, sampling, recruitment, group interview guides, and conduction. The importance of connecting mental healthcare providers as part of the research context is emphasized. Ethical issues and challenges are highlighted, as well as the establishment of a sensitive and empathic group atmosphere, wherein mutual respect can facilitate interpersonal relations and enable people diagnosed with severe mental illness to make sense of the experience. We emphasize the relevance of the interaction between clinical and research teams in order to create collaborative work, achieve inquiry aims, and elicit narratives of mental health users and professionals.

scholarly journals Mental healthcare for psychiatric inpatients during the COVID-19 epidemic

2020 ◽  
Vol 33 (2) ◽  
pp. e100216 ◽  
Author(s):  
Shen Li ◽  
Yong Zhang
Keyword(s):  
Mental Illness ◽  
Severe Mental Illness ◽  
Psychiatric Patients ◽  
Reverse Current ◽  
Mental Healthcare ◽  
Hospitalized Patients ◽  
Vulnerable Group ◽  
Population Groups ◽  
Hospitalised Patients ◽  
Different Types

During this 2019 coronavirus disease (COVID-19) pneumonia epidemic, some experts have expressed concern for the mental healthcare of different types of population groups. However, hospitalised patients with severe mental illness are seemingly overlooked. Psychiatric patients are still a vulnerable group who need to obtain more attention and respect, particularly during the COVID-19 outbreak in China. In this commentary, we briefly introduce the situation of hospitalized patients with severe mental illness and suggest some effective measures that should be rapidly undertaken to reverse current challenges.

scholarly journals Status of primary and secondary mental healthcare of people with severe mental illness: an epidemiological study from the UK PARTNERS2 programme

BJPsych Open ◽  
2021 ◽  
Vol 7 (2) ◽  
Author(s):  
Siobhan Reilly ◽  
Catherine McCabe ◽  
Natalie Marchevsky ◽  
Maria Green ◽  
Linda Davies ◽  
...  
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Mental Illness ◽  
Mental Health Services ◽  
Health Services ◽  
Severe Mental Illness ◽  
Medical Records ◽  
Secondary Care ◽  
Mental Healthcare ◽  
The Uk

Background There is global interest in the reconfiguration of community mental health services, including primary care, to improve clinical and cost effectiveness. Aims This study seeks to describe patterns of service use, continuity of care, health risks, physical healthcare monitoring and the balance between primary and secondary mental healthcare for people with severe mental illness in receipt of secondary mental healthcare in the UK. Method We conducted an epidemiological medical records review in three UK sites. We identified 297 cases randomly selected from the three participating mental health services. Data were manually extracted from electronic patient medical records from both secondary and primary care, for a 2-year period (2012–2014). Continuous data were summarised by mean and s.d. or median and interquartile range (IQR). Categorical data were summarised as percentages. Results The majority of care was from secondary care practitioners: of the 18 210 direct contacts recorded, 76% were from secondary care (median, 36.5; IQR, 14–68) and 24% were from primary care (median, 10; IQR, 5–20). There was evidence of poor longitudinal continuity: in primary care, 31% of people had poor longitudinal continuity (Modified Modified Continuity Index ≤0.5), and 43% had a single named care coordinator in secondary care services over the 2 years. Conclusions The study indicates scope for improvement in supporting mental health service delivery in primary care. Greater knowledge of how care is organised presents an opportunity to ensure some rebalancing of the care that all people with severe mental illness receive, when they need it. A future publication will examine differences between the three sites that participated in this study.

scholarly journals An evaluation of symptom domains in the 2 years before pregnancy as predictors of relapse in the perinatal period in women with severe mental illness

2021 ◽  
Vol 64 (1) ◽  
Author(s):  
Sharvari Khapre ◽  
Robert Stewart ◽  
Clare Taylor
Keyword(s):  
Mental Illness ◽  
Severe Mental Illness ◽  
Language Processing ◽  
Mental Healthcare ◽  
Positive Association ◽  
Perinatal Period ◽  
Health Records ◽  
Increased Risk ◽  
Pregnancy And Postpartum ◽  
Symptom Domains

Abstract Background Symptoms may be more useful prognostic markers for mental illness than diagnoses. We sought to investigate symptom domains in women with pre-existing severe mental illness (SMI; psychotic and bipolar disorder) as predictors of relapse risk during the perinatal period. Methods Data were obtained from electronic health records of 399 pregnant women with SMI diagnoses from a large south London mental healthcare provider. Symptoms within six domains characteristically associated with SMI (positive, negative, disorganization, mania, depression, and catatonia) recorded in clinical notes 2 years before pregnancy were identified with natural language processing algorithms to extract data from text, and associations investigated with hospitalization during pregnancy and 3 months postpartum. Results Seventy-six women (19%) relapsed during pregnancy and 107 (27%) relapsed postpartum. After adjusting for covariates, disorganization symptoms showed a positive association at borderline significance with relapse during pregnancy (adjusted odds ratio [aOR] = 1.36; 95% confidence interval [CI] = 0.99–1.87 per unit increase in number of symptoms) and depressive symptoms negatively with relapse postpartum (0.78; 0.62–0.98). Restricting the sample to women with at least one recorded symptom in any given domain, higher disorganization (1.84; 1.22–2.76), positive (1.50; 1.07–2.11), and manic (1.48; 1.03–2.11) symptoms were associated with relapse during pregnancy, and disorganization (1.54; 1.08–2.20) symptom domains were associated with relapse postpartum. Conclusions Positive, disorganization, and manic symptoms recorded in the 2 years before pregnancy were associated with increased risk of relapse during pregnancy and postpartum. The characterization of routine health records from text fields is relatively transferrable and could help inform predictive risk modelling.

Cross-Cultural Considerations for Social Work Practice:

1998 ◽  
Vol 4 (1) ◽  
pp. 75-85
Author(s):  
Paula T. Tanemura Morelli
Keyword(s):  
Mental Illness ◽  
Social Work ◽  
Severe Mental Illness ◽  
Large Scale ◽  
Work Practice ◽  
Well Being ◽  
The United States ◽  
Social Work Practice ◽  
Cross Cultural ◽  
Mental Illnesses

In the United States, our increasing populations of ethnic and racial minorities suffering with severe mental illnesses require culturally sensitive and culturally appropriate mental health services. The multiple facets of work involving culturally diverse individuals with severe mental illness challenge social work faculty to prepare students with salient, useful knowledge and skills. This teaching module, which utilizes the International Pilot Study of Schizophrenia: Five-year follow-up findings (Leff et al., 1992) is applicable to practice, human behavior in the social environment, and policy courses. The module examines the findings of a large scale, longitudinal study of individuals diagnosed with schizophrenia in nine countries. The learning process encourages students to think critically about the cross-cultural applicability of western diagnosis, treatment, and service provision models, to learn more about cultural constructions of illness and well-being, and to explore the nature of systemic and other barriers that prevent individuals with severe mental illness from obtaining services.

scholarly journals Providers’ competencies positively affect personal recovery of involuntarily admitted patients with severe mental illness: A prospective observational study

2017 ◽  
Vol 64 (2) ◽  
pp. 145-155 ◽  
Author(s):  
Ellen Jas ◽  
Martijn Wieling
Keyword(s):  
Mental Illness ◽  
Severe Mental Illness ◽  
Psychiatric Patients ◽  
Linear Regression Analysis ◽  
Healthcare Providers ◽  
Mental Healthcare ◽  
Alcohol Problems ◽  
Treatment Motivation ◽  
Personal Recovery ◽  
Inpatient Settings

Objective: There is limited research on the patient–provider relationship in inpatient settings. The purpose of this study was to measure the effect of mental healthcare providers’ recovery-promoting competencies on personal recovery in involuntarily admitted psychiatric patients with severe mental illness. Methods: In all, 127 Dutch patients suffering from a severe mental illness residing in a high-secure psychiatric hospital reported the degree of their personal recovery (translated Questionnaire about Processes of Recovery questionnaire (QPR)) and the degree of mental healthcare providers’ recovery-promoting competence (Recovery Promoting Relationship Scale (RPRS)) at two measurement points, 6 months apart. Analyses: (Mixed-effects) linear regression analysis was used to test the effect of providers’ recovery-promoting competence on personal recovery, while controlling for the following confounding variables: age, gender drug/alcohol problems, social relationships, activities of daily living, treatment motivation and medication adherence. Results: Analyses revealed a significant positive effect of providers’ recovery-promoting competencies on the degree of personal recovery ( t = 8.4, p < .001) and on the degree of change in personal recovery over time ( ts > 4, p < .001). Conclusion: This study shows that recovery-promoting competencies of mental healthcare providers are positively associated with (a change in) personal recovery of involuntarily admitted patients. Further research is necessary on how to organize recovery-oriented care in inpatient settings and how to enhance providers’ competencies in a sustainable way.

scholarly journals Rates of mental disorder in people convicted of homicide

2006 ◽  
Vol 188 (2) ◽  
pp. 143-147 ◽  
Author(s):  
Jenny Shaw ◽  
Isabelle M. Hunt ◽  
Sandra Flynn ◽  
Janet Meehan ◽  
Jo Robinson ◽  
...  
Keyword(s):  
Mental Illness ◽  
Mental Disorder ◽  
Severe Mental Illness ◽  
Mental Healthcare ◽  
Psychiatric Services ◽  
England And Wales ◽  
History Of ◽  
Clinical Survey ◽  
The Relationship ◽  
Diminished Responsibility

BackgroundPrevious studies of people convicted of homicide have used different definitions of mental disorder.AimsTo estimate the rate of mental disorder in people convicted of homicide; to examine the relationship between definitions, verdict and outcome in court.MethodA national clinical survey of people convicted of homicide (n=1594) in England and Wales (1996–1999). Rates of mental disorder were estimated based on: lifetime diagnosis, mental illness at the time of the offence, contact with psychiatric services, diminished responsibility verdict and hospital disposal.ResultsOf the 1594, 545 (34%) had a mental disorder: most had not attended psychiatric services; 85 (5%) had schizophrenia (lifetime); 164 (10%) had symptoms of mental illness at the time of the offence; 149 (9%) received a diminished responsibility verdict and 111 (7%) a hospital disposal – both were associated with severe mental illness and symptoms of psychosis.ConclusionsThe findings suggest an association between schizophrenia and conviction for homicide. Most perpetrators with a history of mental disorder were not acutely ill or under mental healthcare at the time of the offence. Some perpetrators receive prison sentences despite having severe mental illness.

Decriminalizing severe mental illness by reducing risk of contact with the criminal justice system, including for forensic patients

CNS Spectrums ◽  
2020 ◽  
Vol 25 (5) ◽  
pp. 687-700
Author(s):  
Kimberlie Dean ◽  
Sara Singh ◽  
Yin-Lan Soon
Keyword(s):  
Mental Illness ◽  
Criminal Justice ◽  
Severe Mental Illness ◽  
Criminal Justice System ◽  
Justice System ◽  
Mental Healthcare ◽  
Extensive Literature ◽  
Mental Health Systems ◽  
Forensic Patients ◽  
Secure Care

Risk of contact with the criminal justice system (CJS) is greater among those with mental illness, including severe mental illness—an observation that many argue reflects a process of “criminalizing” mental illness. Forensic patients represent a subgroup at one end of a spectrum of such criminalization, typically with histories of serious violence and psychotic illness. Strategies for decriminalizing mental illness in this context should consider a range of approaches, including intervening to prevent CJS contact in those with severe mental illness, particularly in the early or emerging stages of psychosis. However, it may be that even gold standard mental healthcare applied universally is insufficient to address CJS contact risks. While there is now an extensive literature documenting the relatively low rates of repeat CJS contact for forensic patients released from secure care, appropriate comparison groups are lacking and the key ingredients of any benefits of treatment are unknown. The CJS may well have something to learn from forensic mental health systems and services given the abject failure to stem rates of prison-release reoffending internationally. Understanding how to best identify risk and effectively intervene to prevent CJS contact in those with mental illness, whether early in the course of psychosis or following release from secure care, remains a priority for those seeking to address the criminalization of mentally illness in our communities.

scholarly journals Closing the mortality gap for severe mental illness: Are we going in the right direction?

2017 ◽  
Vol 211 (3) ◽  
pp. 130-131 ◽  
Author(s):  
Najma Siddiqi ◽  
Tim Doran ◽  
Stephanie L. Prady ◽  
Johanna Taylor
Keyword(s):  
Bipolar Disorder ◽  
Mental Illness ◽  
Cohort Study ◽  
Severe Mental Illness ◽  
Mental Healthcare ◽  
The Right

SummaryIn this editorial, we discuss a UK-based cohort study examining the mortality gap for people with schizophrenia and bipolar disorder from 2000 to 2014. There have been concerted efforts to improve physical and mental healthcare for this population in recent decades. Have these initiatives reduced mortality and ‘closed the gap’?

Sign in / Sign up

Export Citation Format

Share Document