Depressions Plural

2017 ◽  
Author(s):  
K W M (Bill) Fulford ◽  
David Crepaz-Keay ◽  
Giovanni Stanghellini
Keyword(s):  
Quality Of Life ◽  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Personal Values ◽  
The Political ◽  
Medical Law ◽  
Isaiah Berlin ◽  
Political Philosopher

This chapter examines how values influence the heterogeneity of depression. The plurality of values is increasingly significant for contemporary person-centred mental health care with its emphasis on quality of life and development of self-manvnagement skills. Values-based practice is a partner with medical law invn working with the plurality of personal values. The chapter explains what values are, shows how the plurality of values influences the heterogeneity of depression at several levels, and provides an overview of values-based practice. It looks at the resources available for combining values-based practice with medical law in contemporary person-centred care and indicates some of the challenges this raises. It concludes with a brief reflection on these challenges understood as an instance of what the political philosopher Isaiah Berlin called the challenge of pluralism.

scholarly journals Challenges in Investigating the Effective Components of Feedback from Routine Outcome Monitoring (ROM) in Youth Mental Health Care

2020 ◽  
Author(s):  
Maartje A. M. S. van Sonsbeek ◽  
Giel J. M. Hutschemaekers ◽  
Jan W. Veerman ◽  
Ad Vermulst ◽  
Marloes Kleinjan ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Symptom Severity ◽  
Youth Mental Health ◽  
Routine Outcome Monitoring ◽  
Effective Components ◽  
Outcome Monitoring

Abstract BackGround Studies on feedback in youth mental health care are scarce and implementation of feedback into clinical practice is problematic. Objective To investigate potentially effective components of feedback from Routine Outcome Monitoring (ROM) in youth mental health care in the Netherlands through a three-arm, parallel-group, randomized controlled trial in which a literature-based, multi-faceted implementation strategy was used. Method Participants were randomly allocated to three conditions (basic feedback about symptoms and quality of life; basic feedback supplemented with clinical support tools; discussion of the feedback of the second condition with a colleague while following a standardized format for case consultation) using a block randomization procedure, stratified by location and participants’ age. The youth sample consisted of 225 participants (mean age = 15.08 years; 61.8% female) and the parent sample of 234 mothers and 54 fathers (mean age of children = 12.50 years; 47.2% female). Primary outcome was symptom severity. Secondary outcomes were quality of life and end-of-treatment variables. Additionally, we evaluated whether being Not On Track (NOT) moderated the association between condition and changes in symptom severity. Results No significant differences between conditions and no moderating effect of being NOT were found. This outcome can probably be attributed to limited power and implementation difficulties, such as infrequent ROM, unknown levels of viewing and sharing of feedback, and clinicians’ poor adherence to feedback conditions. Conclusions The study contributes to our limited knowledge about feedback from ROM and underscores the complexity of research on and implementation of ROM within youth mental health care. Trial registration Dutch Trial Register NTR4234 .

scholarly journals The impact of routine outcome measurement on treatment processes in community mental health care: approach and methods of the MECCA study

2002 ◽  
Vol 11 (3) ◽  
pp. 198-205 ◽  
Author(s):  
Stefan Priebe ◽  
Rosemarie McCabe ◽  
Jens Bullenkamp ◽  
Lars Hansson ◽  
Wulf Rössler ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Mental Health ◽  
Health Care ◽  
Community Mental Health ◽  
Mental Health Care ◽  
Psychotic Disorders ◽  
Outcome Measurement ◽  
Treatment Decisions ◽  
Community Mental Health Care

SUMMARYThree issues characterise the background to the MECCA study: A) Throughout Europe, most patients with severe forms of psychotic disorders are cared for in the community. The challenge now is to make processes in community mental health care more effective. B) There are widespread calls to implement regular outcome measurement in routine settings. This, however, is more likely to happen, if it provides a direct benefit to clinicians and patients. C) Whilst user involvement is relatively ?" easy to achieve on a political level, new mechanisms may have to be established to make the views of patients feed into individual treatment decisions. The MECCA study is a cluster randomised controlled trial following the same protocol in community mental health teams in six European countries. In the experimental group, patients' subjective quality of life, treatment satisfaction and wishes for different or additional help are assessed in key worker-patient meetings every two months and intended to inform the therapeutic dialogue and treatment decisions. The trial tests the hypothesis that the intervention – as compared to current best standard practice – will lead to a better outcome in terms of quality of life and other criteria in patients with psychotic disorders over a one year period. This more favourable outcome is assumed to be mediated through different treatment input based on more appropriate joint decisions or a more positive therapeutic relationship in line with a partnership model of care or both. Moreover, the study will hopefully reveal new insights into how therapeutic processes in community mental health care work and how they can be optimised.

Listening to patients' needs to improve their subjective quality of life

2005 ◽  
Vol 35 (11) ◽  
pp. 1655-1665 ◽  
Author(s):  
ANTONIO LASALVIA ◽  
CHIARA BONETTO ◽  
FRANCESCA MALCHIODI ◽  
GIOVANNI SALVI ◽  
ALBERTO PARABIAGHI ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Mental Health Professionals ◽  
Subjective Quality ◽  
Subjective Quality Of Life ◽  
Community Based ◽  
Prospective Longitudinal

Background. Subjective quality of life has gained a crucial role as a global measure of outcome in mental health care. This study aimed to investigate the impact of meeting needs for care, as assessed by both patients and mental health professionals, to improve the subjective quality of life in a sample of patients receiving community-based psychiatric care.Method. The study was conducted using a 4-year prospective longitudinal design. A cohort of patients from the South-Verona Community-based Mental Health Service (CMHS) was assessed at baseline and follow-up using, among other social and clinical measures, the Camberwell Assessment of Need (both staff and patient versions) and the Lancashire Quality of Life Profile. Predictors of changes of subjective quality of life were explored using block-stratified multiple regression procedures.Results. Improvement in patients' clinical conditions as well as the reduction in patient-rated unmet needs in the social domain predicted an increase in subjective quality of life over 4 years; changes in staff-rated needs did not show any association with changes in subjective quality of life.Conclusions. Meeting self-perceived social needs, beyond symptoms reduction, seems to be of particular importance for ensuring a better quality of life for people with mental disorders. If the main goal of mental health care is to improve the quality of life of users, a policy of actively addressing patient-rated needs should be implemented.

scholarly journals Integration of mental health care into primary care

2000 ◽  
Vol 176 (6) ◽  
pp. 581-588 ◽  
Author(s):  
D. Chisholm ◽  
S. James ◽  
K. Sekar ◽  
K. Kishore Kumar ◽  
R. Srinivasa Murthy ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Mental Health ◽  
Primary Care ◽  
Health Care ◽  
Mental Disorder ◽  
Mental Health Care ◽  
Low Income ◽  
Common Mental Disorder ◽  
Low Income Countries

BackgroundTargeting resources on cost-effective care strategies is important for the global mental health burden.AimsTo demonstrate cost–outcome methods in the evaluation of mental health care programmes in low-income countries.MethodFour rural populations were screened for psychiatric morbidity. Individuals with a diagnosed common mental disorder were invited to seek treatment, and assessed prospectively on symptoms, disability, quality of life and resource use.ResultsBetween 12% and 39% of the four screened populations had a diagnosable common mental disorder. In three of the four localities there were improvements over time in symptoms, disability and quality of life, while total economic costs were reduced.ConclusionEconomic analysis of mental health care in low-income countries is feasible and practicable. Our assessment of the cost-effectiveness of integrating mental health into primary care was confounded by the naturalistic study design and the low proportion of subjects using government primary health care services.

scholarly journals The Importance of Self-Mastery in Enhancing Quality of Life and Social Participation of Individuals Experiencing Homelessness: Results of a Mixed-Method Study

2019 ◽  
Vol 148 (2) ◽  
pp. 491-515 ◽  
Author(s):  
Miranda Rutenfrans-Stupar ◽  
Naomi Hanique ◽  
Tine Van Regenmortel ◽  
René Schalk
Keyword(s):  
Quality Of Life ◽  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Social Participation ◽  
Mixed Method ◽  
Education Level ◽  
Equation Modeling ◽  
Mixed Method Study

Abstract Self-mastery plays a basic role in strength-based and recovery-oriented approaches applied by (mental) health-care institutions and social services. However, no research has been conducted on a comprehensive model that could provide insight into enhancing self-mastery and outcomes, such as social participation and quality of life, for individuals experiencing homelessness. The current mixed-method study investigated associations between person-related variables (optimism, age, education level) and care-related variables (experiences with care, duration of support) as predictors of both social participation and quality of life through the mediator of self-mastery among clients of a Dutch shelter facility. Quantitative analysis (Structural Equation Modeling; n = 97) showed that: (1) Self-mastery is related to social participation and quality of life; (2) Optimism predicts social participation and quality of life through self-mastery; (3) Age squared predicts social participation through self-mastery, but is not related to quality of life; (4) The variable, clients’ experiences with care, is not related to self-mastery, but directly to social participation and quality of life; (5) Education level and duration of support do not predict self-mastery, social participation and quality of life. Qualitative analysis (semi-structured interviews; n = 36) revealed: (1) Contrary to the results of the quantitative study qualitative data indicated that there is a positive association between experiences with care and self-mastery; (2) Social participation and health are associated with self-mastery; (3) The absence of external locus of control should also be included as an aspect of self-mastery; (4) Additional promoting and impeding factors for self-mastery (e.g., a daily structure, privacy, house rules). Based on these results we formulated guidelines for social and mental health-care workers to enhance their clients’ self-mastery.

Quality of Life: A New Dimension in Mental Health Care

2003 ◽  
pp. 171-192 ◽  
Author(s):  
Heinz Katschnig ◽  
Monika Krautgartner
Keyword(s):  
Quality Of Life ◽  
Mental Health ◽  
Health Care ◽  
Mental Health Care
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