The Impact of Comorbid Mental Health Conditions on Health Care for Children with ADHD

AbstractPurposeResearch is beginning to quantify the impact of COVID-19 on people with pre-existing mental health conditions. Our paper addresses a lack of in-depth qualitative research exploring their experiences and perceptions of how life has changed at this time.MethodsWe used qualitative interviews (N=49) to explore experiences of the pandemic for people with pre-existing mental health conditions. In a participatory, coproduced approach, researchers with lived experiences of mental health conditions conducted interviews and analysed data as part of a multi-disciplinary research team.ResultsExisting mental health difficulties were exacerbated for many people. People experienced specific psychological impacts of the pandemic, struggles with social connectedness, and inadequate access to mental health services, while some found new ways to cope and connect to community. New remote ways to access mental health care, including digital solutions, provided continuity of care for some but presented substantial barriers for others. People from black and ethnic minority (BAME) communities experienced heightened anxiety, stigma and racism associated with the pandemic, further impacting their mental health.ConclusionThere is a need for evidence-based solutions to achieve accessible and effective mental health care in response to the pandemic, especially remote approaches to care. Further research should explore the long-term impacts of COVID-19 on people with pre-existing mental health conditions. Particular attention should be paid to understanding inequalities of impact on mental health, especially for people from BAME communities.

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Outcomes of mental health pharmacist-managed electronic consults at a Veterans Affairs health care system

Mental Health Clinician ◽

10.9740/mhc.2017.05.131 ◽

2017 ◽

Vol 7 (3) ◽

pp. 131-136 ◽

Cited By ~ 2

Author(s):

Christina Herbert ◽

Holly Winkler ◽

Troy A. Moore

Keyword(s):

Mental Health ◽

Primary Care ◽

Health Care ◽

Health Care System ◽

Health Conditions ◽

Veterans Health ◽

Improvement Project ◽

Mental Health Conditions ◽

The Impact ◽

Care System

Abstract Introduction: The demand for mental health services has increased as more veterans have been diagnosed with—and sought care for—one or more mental health conditions. Within the South Texas Veterans Health Care System (STVHCS), providers may submit electronic consults (e-consults) to mental health clinical pharmacy specialists for medication review and recommendations. These consults aim to manage veterans with uncomplicated mental health conditions in primary care, making specialty mental health providers more available for those who need such services. Pharmacists have improved outcomes and access to care for conditions such as diabetes and hypertension, but currently, there is limited evidence demonstrating the impact of pharmacists in mental health. Methods: This quality improvement project assessed the effectiveness of the e-consult service. Information was collected through a retrospective chart review of STVHCS veterans with the corresponding consult note placed in their chart from May 2014 through December 2015. Numbers of recommendations implemented and veterans maintained in primary care were analyzed as markers of effectiveness. Time and cost savings were secondarily explored. Results: A total of 361 consults were submitted for 353 unique patients. Of the 322 patients included in analyses, a total of 301 unique patients (93.5%) were maintained in primary care for at least 3 months. Of the 21 not maintained in primary care, 15 recommendations were implemented; of those maintained in primary care, 271 recommendations were implemented. Discussion: This service improves mental health care—and patient access—by promoting successful management and maintenance of less complicated patients in primary care.

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Experiences of living with mental health problems during the COVID-19 pandemic in the UK: a coproduced, participatory qualitative interview study

Social Psychiatry and Psychiatric Epidemiology ◽

10.1007/s00127-021-02051-7 ◽

2021 ◽

Author(s):

Steven Gillard ◽

◽

Ceri Dare ◽

Jackie Hardy ◽

Patrick Nyikavaranda ◽

...

Keyword(s):

Mental Health ◽

Health Care ◽

Mental Health Care ◽

Social Connectedness ◽

Mental Health Problems ◽

Qualitative Interviews ◽

Health Conditions ◽

Mental Health Conditions ◽

Qualitative Interview Study ◽

The Impact

Abstract Purpose Research is beginning to quantify the impact of COVID-19 on people with pre-existing mental health conditions. Our paper addresses a lack of in-depth qualitative research exploring their experiences and perceptions of how life has changed at this time. Methods We used qualitative interviews (N = 49) to explore experiences of the pandemic for people with pre-existing mental health conditions. In a participatory, coproduced approach, researchers with lived experiences of mental health conditions conducted interviews and analysed data as part of a multi-disciplinary research team. Results Existing mental health difficulties were exacerbated for many people. People experienced specific psychological impacts of the pandemic, struggles with social connectedness, and inadequate access to mental health services, while some found new ways to cope and connect to the community. New remote ways to access mental health care, including digital solutions, provided continuity of care for some but presented substantial barriers for others. People from black and ethnic minority (BAME) communities experienced heightened anxiety, stigma and racism associated with the pandemic, further impacting their mental health. Conclusion There is a need for evidence-based solutions to achieve accessible and effective mental health care in response to the pandemic, especially remote approaches to care. Further research should explore the long-term impacts of COVID-19 on people with pre-existing mental health conditions. Particular attention should be paid to understanding inequalities of impact on mental health, especially for people from BAME communities.

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Is parent education protective of mental wellbeing in Pacific young people? A cohort study of mental health and census data in Aotearoa/New Zealand’s integrated data infrastructure.

Pacific Health Dialog ◽

10.26635/phd.2021.112 ◽

2021 ◽

Vol 21 (7) ◽

pp. 361-372

Author(s):

Jesse Kokaua ◽

Seini Jensen ◽

Reremoana Theodore ◽

Nicholas Bowden ◽

Russell Blakelock ◽

...

Keyword(s):

Mental Health ◽

Health Care ◽

Young People ◽

Mental Health Care ◽

Parent Education ◽

Parental Education ◽

Health Conditions ◽

Data Infrastructure ◽

Mental Health Conditions ◽

The Impact

Aim: The aims of this paper are to quantify the impact of parental education on the five-year incidence of mental health conditions (MHC) in Pacific young people and to investigate the influence of other factors. Method: The analyses in this paper used data extracted from Aotearoa/New Zealand’s Integrated Data Infrastructure (IDI). Data relating to 383,595 young people (48,768 Pacific), identified in the 2013 Census, aged 12-24 years, and their parents’ were used. Logistic regression models were used to investigate the incidence of children with MHC from 2013-2018. Results: Mental health conditions were identified in one of five Pacific young people. Irrespective of ethincity, increased parental education was associated with decreased MHC. However, the association was only significant for those in specialist mental health care (OR=0. 897, 95%CI:0.881-0.913) but not for those seen in other health settings (OR=0. 989, 95%CI:0.974-1.004). The association, for specialist settings, was not mediated by the contribution of other factors (OR=0.941, 95%CI:0.926-0.958). However, increased parents education with the addition of social, cultural and economic advantages the number of Pacific children seen in the specialist mental health setting could be nearly halved. Conclusion: The findings show that a parental educational advantage exists for children who access specialist mental health care. However, there are more complex but far greater opportunities for the health of Pacific families if a coordinated education, housing, employment and health solution were possible. The gains from a multi-disciplinary Pacific solution exist in terms of reduced severity for and level of care to Pacific children with MHC.

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Parental mental health conditions and use of healthcare services in children the first year of life– a register-based, nationwide study

BMC Public Health ◽

10.1186/s12889-021-10625-y ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Signe Heuckendorff ◽

Martin Nygård Johansen ◽

Søren Paaske Johnsen ◽

Charlotte Overgaard ◽

Kirsten Fonager

Keyword(s):

Mental Health ◽

Healthcare Services ◽

Health Condition ◽

Health Conditions ◽

Mental Health Condition ◽

Parental Mental Health ◽

Mental Health Conditions ◽

First Year Of Life ◽

Paternal Mental Health ◽

The Impact

Abstract Background Parental mental health conditions have been associated with increased morbidity and use of healthcare services in offspring. Existing studies have not examined different severities of parental mental health conditions, and the impact of paternal mental health has been overlooked. We examined the association between two severities of parental mental health conditions and use of healthcare services for children during the first year of life and explored the impact of both maternal and paternal mental health conditions. Methods This register-based cohort study included all live-born children born in Denmark from 2000 to 2016. Information on socioeconomics, diagnoses, drug prescriptions, and healthcare contacts was extracted from nationwide public registries. Parents were grouped according to severity of mental condition based on the place of treatment of the mental health condition. Negative binominal regression analyses were performed to estimate the incidence rate ratio (IRR) of contacts to general practice (GP), out-of-hour medical service, emergency room (ER), and out- and inpatient hospital contacts during the first 12 months of the child’s life. Results The analyses included 964,395 children. Twenty percent of the mothers and 12 % of the fathers were identified with mental health conditions. Paternal mental health conditions were independently associated with increased risk of infant healthcare contacts (GP IRR 1.05 (CI95% 1.04–1.06) and out-of-hour IRR 1.20 (CI95% 1.18–1.22)). Risks were higher for maternal mental health conditions (GP IRR 1.18 (CI95% 1.17–1.19) and out-of-hour IRR 1.39 (CI95% 1.37–1.41)). The risks were even higher if both parents were classified with a mental health condition (GP IRR 1.25 (CI95% 1.23–1.27) and out-of-hour contacts IRR 1.49 (CI95% 1.45–1.54)), including minor mental health condition (GP IRR 1.22 (CI95% 1.21–1.24) and out-of-hour IRR 1.37 (CI95% 1.34–1.41)). This pattern was the same for all types of healthcare contacts. Conclusions Both maternal and paternal mental health conditions, including minor mental health conditions, were associated with increased utilization of healthcare services. Focus on both parents’ mental health conditions (even if minor) may be warranted in service planning.

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Higher Education Completion Rates for Domestic Undergraduate Students Who Access Mental Health Services Using A Multi-Agency Matched Population Cohort

International Journal for Population Data Science ◽

10.23889/ijpds.v5i5.1502 ◽

2020 ◽

Vol 5 (5) ◽

Author(s):

Lewis Cowie ◽

Luke Hendrickson

Keyword(s):

Mental Health ◽

Health Condition ◽

Health Conditions ◽

Mental Health Service Use ◽

Randomised Control Trial ◽

Completion Rates ◽

Mental Health Condition ◽

Mental Health Conditions ◽

Wide Range ◽

The Impact

By linking Education, Health, and Welfare data in the Multi-Agency Data Integration Project (MADIP), our analysis looked at the impact of poor mental health on the likelihood of completing an undergraduate degree in Australia. IntroductionCompletion of a bachelor degree is important to both the student and the government, as it provides lifelong benefits and prevents investment loss. Previous research has reported conflicting findings regarding whether students with mental ill health are less likely to complete a degree, with an estimated 25 per cent of young adult university students experiencing mental ill-health each year. Objectives and ApproachOur research analysed national mental health service use and related pharmaceutical prescriptions linked with education data to determine the extent and effect of known mental health conditions on undergraduate student six-year completion rates. We followed a de-identified cohort of 120,000 students who commenced an undergraduate degree for the first time in 2011 for six years. Summary statistics and a binomial logit was used on a matched sample to confirm significance. ResultsWe found that students with a known mental health condition had a significantly lower six-year completion rate (58 per cent) than those students with no known mental health condition (71 per cent). By simulating a randomised control trial controlling for a wide range of demographics, we showed that these results held and that completion rates worsened with increasing severity of mental health conditions, as measured by usage of psychiatric services. ConclusionIntegrated data assets such as MADIP help us better understand the interaction between student success and mental health conditions which in turn will help us improve policy and better evaluate programs.

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On the same page or in a different book? A pilot project on the perceptions of educational needs in an era of shifting mental health care to primary care (Preprint)

10.2196/preprints.32422 ◽

2021 ◽

Author(s):

Stephanie Sutherland ◽

Dahn Jeong ◽

Michael Cheng ◽

Mireille St-Jean ◽

Alireza Jalali

Keyword(s):

Mental Health ◽

Primary Care ◽

Health Care ◽

Mental Health Care ◽

Medical Management ◽

Family Physicians ◽

Educational Needs ◽

Health Conditions ◽

Care Providers ◽

Mental Health Conditions

BACKGROUND There is an unmet need for mental health care in Canada. Seventy-five percent of visits for mental health services are related to mood and anxiety disorder, which occur most frequently in the primary care setting. Primary care providers such as general practitioners and family physicians are essential part of mental health care services. However, it is currently not well known what is needed to increase care providers’ willingness, comfort and skills to adequately provide care. OBJECTIVE The aim of this study was to understand the caregiver and family physician needs regarding the care and medical management of individuals with mental health conditions. METHODS A needs assessment was designed to understand the educational needs of caregivers and family physicians with regard to the provision of mental health care, specifically, to seek advice of the format and delivery mode for an educational curriculum to be accessed by both stakeholder groups. Exploratory qualitative interviews were conducted and data was collected and analysed iteratively until thematic saturation was achieved. RESULTS Caregivers of individuals with mental health conditions (n=24) and family physicians (n=10) were interviewed. Both caregivers and family physicians expressed dissatisfaction with the status quo regarding the provision of mental health care at the family physician’s office. They stated that there was a need for more educational materials as well as additional supports. Caregivers expressed a general lack of confidence in family physicians to manage their son/daughter’s mental health condition, while family physicians sought more networking opportunities to improve and facilitate provision of mental health care. CONCLUSIONS Robust qualitative studies are necessary to identify the educational and medical management needs of caregivers and family physicians. Understanding each other’s perspectives is an essential first step to collaboratively designing, implementing, and the subsequent evaluation of community-based mental health care. Fortunately, there are initiatives underway already to address these need areas (e.g. websites such as eMentalHealth.ca/PrimaryCare as well as mentorship and collaborative care network) and information from this study can help inform the gaps in those existing initiatives. CLINICALTRIAL NA

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Challenges to peer support in low- and middle-income countries during COVID-19

Globalization and Health ◽

10.1186/s12992-020-00622-y ◽

2020 ◽

Vol 16 (1) ◽

Author(s):

Richard Mpango ◽

Jasmine Kalha ◽

Donat Shamba ◽

Mary Ramesh ◽

Fileuka Ngakongwa ◽

...

Keyword(s):

Mental Health ◽

Health Care ◽

Mental Health Care ◽

Peer Support ◽

Global Mental Health ◽

Health Conditions ◽

Middle Income ◽

Low Resource Settings ◽

Mental Health Conditions ◽

Middle Income Countries

Abstract Background A recent editorial urged those working in global mental health to “change the conversation” on coronavirus disease (Covid-19) by putting more focus on the needs of people with severe mental health conditions. UPSIDES (Using Peer Support In Developing Empowering mental health Services) is a six-country consortium carrying out implementation research on peer support for people with severe mental health conditions in high- (Germany, Israel), lower middle- (India) and low-income (Tanzania, Uganda) settings. This commentary briefly outlines some of the key challenges faced by UPSIDES sites in low- and middle-income countries as a result of Covid-19, sharing early lessons that may also apply to other services seeking to address the needs of people with severe mental health conditions in similar contexts. Challenges and lessons learned The key take-away from experiences in India, Tanzania and Uganda is that inequalities in terms of access to mobile technologies, as well as to secure employment and benefits, put peer support workers in particularly vulnerable situations precisely when they and their peers are also at their most isolated. Establishing more resilient peer support services requires attention to the already precarious situation of people with severe mental health conditions in low-resource settings, even before a crisis like Covid-19 occurs. While it is essential to maintain contact with peer support workers and peers to whatever extent is possible remotely, alternatives to face-to-face delivery of psychosocial interventions are not always straightforward to implement and can make it more difficult to observe individuals’ reactions, talk about emotional issues and offer appropriate support. Conclusions In environments where mental health care was already heavily medicalized and mostly limited to medications issued by psychiatric institutions, Covid-19 threatens burgeoning efforts to pursue a more holistic and person-centered model of care for people with severe mental health conditions. As countries emerge from lockdown, those working in global mental health will need to redouble their efforts not only to make up for lost time and help individuals cope with the added stressors of Covid-19 in their communities, but also to regain lost ground in mental health care reform and in broader conversations about mental health in low-resource settings.

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