Leadership, training, and educational opportunities

2015 ◽  
Author(s):  
Raymond F. Patterson
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Services ◽  
Health Services ◽  
Mental Health Professionals ◽  
Health Care Professionals ◽  
Criminal Responsibility ◽  
Systems Of Care ◽  
Care Delivery ◽  
Forensic Practice

Correctional settings hold a range of opportunities for Psychiatrists to assume leadership roles. The increase in the number of detainees and inmates who require mental health services has created numerous administrative and clinical opportunities for psychiatrists. The ‘front end’ of arrest and pretrial determinations has been a longstanding component of forensic practice, related to competence, criminal responsibility, and probation. Following incarceration, assessment of mental health needs, access to care, and provision of treatment as well as quality improvement partially constitute the jail and prison components of mental health services. The ‘aftercare’ aspect of mental health services in correctional psychiatry involves individuals released on parole with need and/or requirement for mental health treatment. The leadership role for psychiatrists working in correctional environments is distinctly different from typical psychiatric venues where the psychiatrist and other mental health professionals are ‘in control;’ in correctional environments, the dynamics are different and require collaboration and advocacy. Within correctional systems it is essential that ‘correctional culture’ be understood by the psychiatric/mental health leadership. With effective psychiatric leadership, mental health care delivery and its coordination with correctional management of prisoners both stand to be improved. The need for dedicated and qualified leadership for mental health services and appropriate education and training in correctional mental health practices provide remarkable opportunities for psychiatrists. Psychiatrists and other health care professionals must be educated and trained to provide the necessary leadership for these extraordinarily complex systems of care and confinement.

scholarly journals Mental health professionals’ experiences transitioning patients with anorexia nervosa from child/adolescent to adult mental health services: a qualitative study

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Veronica Lockertsen ◽  
Liv Nilsen ◽  
Lill Ann Wellhaven Holm ◽  
Øyvind Rø ◽  
Linn May Burger ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Anorexia Nervosa ◽  
Mental Health Services ◽  
Health Services ◽  
Mental Health Professionals ◽  
Transition Period ◽  
Critical Time ◽  
Transition Process ◽  
Adult Mental Health

Abstract Background The transition period between child and adolescent mental health services (CAMHS) and adult mental health services (AMHS) has been identified as an especially critical time for patients with anorexia nervosa. In the present study, to better facilitate patients’ recovery process, we explored the experiences of professionals concerning the transition from CAMHS to AMHS. Method A qualitative explorative study was carried out based on recorded interviews from one multi-step focus group and two individual interviews with eight experienced health care professionals. Together they had experience with treating patients with AN and the transition from CAMHS to AMHS, both from specialized eating disorder units, specialized mental health care units, and from a school nurse context. Service users with parents` perspectives and patients’ perspectives were involved in all steps of the research process. Results Barriers experienced during the transition process were classified into four categories: (1) different treatment cultures that describe differences in how parents are included in CAMHS and AMHS; (2) mistrust between CAMHS and AMHS that can create a lack of collaboration and predictability for the patients’ transition; (3) Clinicians` factors such as lack of professional self-confidence can influence continuity of care for patients; and (4) lack of trust between services and not enough focus on building a new alliance in AMHS negatively influences the transition. Conclusions The present study revealed four important categories that professionals needs to consider when participating in the transition for patients with AN from CAMHS to AMHS. Awareness of these challenges might improve the transition process for patients with AN.

Experiences of Young Offenders and Health-care Professionals Involved in Transitions from Forensic Adolescent Mental Health Services: A Qualitative Study

2017 ◽  
Vol 41 (S1) ◽  
pp. S153-S153
Author(s):  
M. Livanou ◽  
V. Furtado ◽  
S. Singh
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Services ◽  
Young People ◽  
Health Services ◽  
Health Care Professionals ◽  
Adolescent Mental Health ◽  
Child And Adolescent ◽  
Young Offenders ◽  
Adult Services

IntroductionTransitions from child and adolescent mental health services to adult mental health services have been quite troublesome for young people in the UK. There is strong evidence throughout the literature that long waiting lists and rigid adult services criteria hamper dramatically transitions across services. Little knowledge exists about transitions from forensic adolescent services to adult services.ObjectivesTo interview health-care professionals and young offenders in transition of care from forensic child and adolescent mental health services in England.AimsThis study aimed to bridge the current literature gap in regards to transitions across forensic services and the complexities resulting from disruptive care.MethodsThis study adopted a prospective design to identify young offenders referred to adult services over a six-month period. We utilized semi-structured interviews. Health-care professionals were interviewed about their transition views and perspectives. Young offenders were followed-up within a month of their transition and were interviewed.ResultsThe numbers of transitions within forensic settings are much lower compared to those of general transitions across mental health services in England. Transition delays were a repetitive theme across interviews due to lack of bed availability, especially in medium secure hospitals, and poor multi-agency communication. Commissioning determines age boundaries along with transfer destination for each service.ConclusionsIneffective liaison among different sectors might impact adversely young people and hallmark their long-stay in the system. Therefore, continuity of care within forensic services should be looked warily along with the role of policy shaped by commissioning. Multiple transitions can repeatedly traumatize young people moving across services.

scholarly journals Organizing as negotiation: the construction of a pathway in Norwegian mental health services

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Tine Nesboe Toerseth
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Illness ◽  
Mental Health Services ◽  
Health Services ◽  
Mental Health Care ◽  
Mental Health Professionals ◽  
Health Professionals ◽  
Clinical Pathway ◽  
The Political

Abstract Background In 2015, a decision was made to implement clinical pathways in Norwegian mental health services. The idea was to construct pathways similar to those used in cancer treatment. These pathways are based on diagnosis and evidence-based medicine and have strict timeframes for the different procedures. The purpose of this article is to provide a thorough examination of the formulation of the pathway “mental illness, adults” in Norwegian mental health services. In recent decades, much research has examined the implementations and outcomes of different mental health sector reforms and services in Western societies. However, there has been a lack of research on the process and creation of these reforms and/or services, particularly how they emerge as constructs in the contexts of policy, profession and practice. Methods A qualitative single case study design was employed. A text and document analysis was performed in which 52 articles and opinion pieces, 30 public hearing responses and 8 political documents and texts were analysed to identify the main actors in the discourse of mental health services and to enable a replication of their affiliated institutional logics and their views concerning the clinical pathway. Additionally, ten qualitative interviews were performed with members of the work group responsible for designating the pathway “mental illness, adults”. Results This article shows how the two main actor groups, “Mental health professionals” and “Politicians”, are guided by values associated with a specific logic when understanding the concept of a clinical pathway (CP). The findings show that actors within the political field believe in control and efficiency, in contrast to actors in mental health services, who are guided by values of discretion and autonomy. This leads to a debate on the concept of CPs and mental health services. The discussion becomes polarized between concern for patients and concern for efficiency. The making of the pathway is led by the Directorate of Health, with health professionals operating in the political domain and who have knowledge of the values of both logics, which were taken into consideration when formulating the pathways, and explains how the pathway became a complex negotiation process between the two logics and where actors on both sides were able to retain their core values. Ultimately, the number of pathways was reduced from 22 to 9. The final “Pathway for mental illness, adults” was a general pathway involving several groups of patients. The pathway explains the process from diagnosis through treatment and finalizing treatment. The different steps involve time frames that need to be coded, requiring more rigid administrative work for compliance, but without stating specific diagnostic tools or preferred treatment strategies. Conclusions This article shows that there is also a downside of having sense making guided by strong values associated with a specific institutional logic when constructing new, and hopefully better, mental health care services. This article demonstrates how retaining values sometimes becomes more crucial than engaging in constructive debates about how to solve issues of importance within the field of mental health care.

scholarly journals Changes in community mental health services availability and suicide mortality in the US: A retrospective study

2020 ◽  
Author(s):  
Peiyin Hung ◽  
Susan Busch ◽  
Yi-Wen Shih ◽  
Alecia McGregor ◽  
Shi-Yi Wang
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Services ◽  
Community Mental Health ◽  
Health Services ◽  
Mental Health Care ◽  
Mental Health Professionals ◽  
The United States ◽  
Suicide Mortality ◽  
Per Capita

Abstract Background: Despite the fact that the overwhelming majority of mental health services are delivered in outpatient settings, the effect of changes in non-hospital-based mental health care on increased suicide rates is largely unknown. This study examines the association between changes in community mental health center (CMHC) supply and suicide mortality in the United States. Methods: Retrospective analysis was performed using data from National Mental Health Services Survey (N-MHSS) and the Centers for Disease Control and Prevention (CDC) Wide-Ranging Online Data for Epidemiologic Research (WONDER) (2014-2017). Population-weighted multiple linear regressions were used to examine within-state associations between CMHCs per capita and suicide mortality. Models controlled for state-level characteristics (i.e., number of hospital psychiatric units per capita, number of mental health professionals per capita, age, race, and percent low-income), year and state. Results: From 2014 to 2017, the number of CMHCs decreased by 14% nationally (from 3,406 to 2,920). Suicide increased by 9.7% (from 15.4 to 16.9 per 100,000) in the same time period. We find a small but negative association between the number of CMHCs and suicide deaths (-0.52, 95% CI -1.08 to 0.03; p=0.066). Declines in the number of CMHCs from 2014 to 2017 may be associated with approximately 6% of the national increase in suicide, representing 263 additional suicide deaths. Conclusions: State governments should avoid the declining number of CMHCs and the services these facilities provide, which may be an important component of suicide prevention efforts. Keywords: Suicide, Deinstitutionalization, Access to mental health care, Community mental health

Options and Directions for Psychology within a Framework for Mental Health Services in South Africa

1993 ◽  
Vol 23 (2) ◽  
pp. 64-70 ◽  
Author(s):  
Susan Kriegler
Keyword(s):  
Mental Health ◽  
South Africa ◽  
Health Care ◽  
Mental Health Services ◽  
Health Services ◽  
Mental Health Care ◽  
Care Delivery ◽  
Cultural Issues ◽  
Potential Cost ◽  
Structural Problems

Structural problems in mental health services conjoined with attitudinal barriers are the cause of inadequate mental health care in South Africa. However, the major reason for the failure of psychology to address the needs of the majority lies in training deficiencies. In spite of the potential cost benefits of psychotherapy and prevention by way of counselling and educative interventions, psychologists are not perceived or employed as primary members of mental health teams. In schools they are rapidly losing ground. The profession is disempowered to position itself strategically to become a significant roleplayer in the ‘new’ South Africa. Affirmative action for psychology is needed. Ways in which the state may help are suggested, including the creation of more posts and training opportunities in health care settings, as well as use of the school as a locus for health and mental health care delivery. The author concludes with a call to the profession to get its own house in order by way of self-regenerating actions in the areas of training, addressing political and cross-cultural issues, and service delivery.

scholarly journals The Pathways to the First Contact with Mental Health Services among Patients with Schizophrenia in Lagos, Nigeria

2013 ◽  
Vol 2013 ◽  
pp. 1-8 ◽  
Author(s):  
Increase Ibukun Adeosun ◽  
Abosede Adekeji Adegbohun ◽  
Tomilola Adejoke Adewumi ◽  
Oyetayo O. Jeje
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Services ◽  
Health Services ◽  
Mental Health Care ◽  
Mental Health Professionals ◽  
Point Of Care ◽  
Public Mental Health ◽  
Duration Of Untreated Psychosis ◽  
First Contact

There is increasing evidence that delay in the commencement of treatment, following the onset of schizophrenia, may be related to the pathways patients navigate before accessing mental health care. Therefore, insight into the pattern and correlates of pathways to mental care of patients with schizophrenia may inform interventions that could fast track their contact with mental health professionals and reduce the duration of untreated psychosis. This study assessed the pathways to mental health care among patients with schizophrenia (n=138), at their first contact with mental health services at the Federal Neuro-Psychiatric Hospital Yaba Lagos, Nigeria. Traditional and religious healers were the first contact for the majority (69%) of the patients. Service users who first contacted nonorthodox healers made a greater number of contacts in the course of seeking help, eventuating in a longer duration of untreated psychosis (P<0.001). However, the delay between the onset of psychosis and contact with the first point of care was shorter in patients who patronized nonorthodox practitioners. The findings suggest that collaboration between orthodox and nonorthodox health services could facilitate the contact of patients with schizophrenia with appropriate treatment, thereby reducing the duration of untreated psychosis. The need for public mental health education is also indicated.

scholarly journals Advancing E-Mental Health in Canada: Report From a Multistakeholder Meeting (Preprint)

2020 ◽  
Author(s):  
Gillian Strudwick ◽  
Danielle Impey ◽  
John Torous ◽  
Reinhard Michael Krausz ◽  
David Wiljer
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Services ◽  
Health Services ◽  
Mental Health Care ◽  
Care Delivery ◽  
Current Form ◽  
Health Technologies ◽  
Important Solution ◽  
Mental Health Workforce

UNSTRUCTURED The need for e-mental health (electronic mental health) services in Canada is significant. The current mental health care delivery models primarily require people to access services in person with a health professional. Given the large number of people requiring mental health care in Canada, this model of care delivery is not sufficient in its current form. E-mental health technologies may offer an important solution to the problem. This topic was discussed in greater depth at the 9th Annual Canadian E-Mental Health Conference held in Toronto, Canada. Themes that emerged from the discussions at the conference include (1) the importance of trust, transparency, human centeredness, and compassion in the development and delivery of digital mental health technologies; (2) an emphasis on equity, diversity, inclusion, and access when implementing e-mental health services; (3) the need to ensure that the mental health workforce is able to engage in a digital way of working; and (4) co-production of e-mental health services among a diverse stakeholder group becoming the standard way of working.

scholarly journals Mental Health Care Delivery for Older Adults in Rural Greece: Unmet Needs

2019 ◽  
Vol 10 (04) ◽  
pp. 721-724
Author(s):  
Vaios Peritogiannis ◽  
Charalampos Lixouriotis
Keyword(s):  
Mental Health ◽  
Older Adults ◽  
Health Care ◽  
Mental Health Services ◽  
Health Services ◽  
Mental Health Care ◽  
Rural Areas ◽  
Primary Care Physicians ◽  
Care Delivery ◽  
The Elderly

AbstractMental disorders may go unrecognized and undertreated in older adults. This is the rationale for the launch of specialized mental health services for the elderly in high resourced settings. Rural areas, however, do not receive adequate mental health care owing to socioeconomic and geographical reasons, and this is the case of rural Greece, where research on mental health of the elderly is scarce. This article discusses the challenges of providing mental health care for older adults in rural Greece and the available options. Care can be delivered through the existing rural mental health services that are the mobile mental health units and through the primary care physicians. Training in psychogeriatrics for the personnel of the former and in mental health for the latter is warranted.

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