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

Author(s):  
Steven Gillard ◽  
Ceri Dare ◽  
Jackie Hardy ◽  
Patrick Nyikavaranda ◽  
Rachel Rowan Olive ◽  
...  

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.

Author(s):  
Steven Gillard ◽  
◽  
Ceri Dare ◽  
Jackie Hardy ◽  
Patrick Nyikavaranda ◽  
...  

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.


2021 ◽  
Vol 21 (7) ◽  
pp. 361-372
Author(s):  
Jesse Kokaua ◽  
Seini Jensen ◽  
Reremoana Theodore ◽  
Nicholas Bowden ◽  
Russell Blakelock ◽  
...  

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.


2021 ◽  
Author(s):  
Stephanie Sutherland ◽  
Dahn Jeong ◽  
Michael Cheng ◽  
Mireille St-Jean ◽  
Alireza Jalali

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


2020 ◽  
Vol 16 (1) ◽  
Author(s):  
Richard Mpango ◽  
Jasmine Kalha ◽  
Donat Shamba ◽  
Mary Ramesh ◽  
Fileuka Ngakongwa ◽  
...  

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.


2017 ◽  
Vol 7 (3) ◽  
pp. 131-136 ◽  
Author(s):  
Christina Herbert ◽  
Holly Winkler ◽  
Troy A. Moore

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.


2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Dung Ezekiel Jidong ◽  
Di Bailey ◽  
Tholene Sodi ◽  
Linda Gibson ◽  
Natéwindé Sawadogo ◽  
...  

Purpose This study aims to explore how cultural beliefs and traditions are integral to understanding indigenous mental health conditions (MHCs) and traditional healing (TH). However, Nigerian cultural beliefs about MHCs and TH are under-researched. Design/methodology/approach This study adopted a qualitative design using critical realist and social constructionist perspectives to explore Nigerian mental health-care practitioners (MHCPs) and lay participants’ (LPs) views regarding MHCs and TH. Purposive and snowball sampling techniques were used to select 53 participants (MHCPs = 26; LPs = 27; male = 32; female = 21) in four Nigerian cities (Ado-Ekiti, Enugu, Jos and Zaria). Data were collected using semi-structured interviews and analysed through thematic analyses. Findings The data sets revealed three overarching themes, namely, existing cultural beliefs about MHCs as spiritual curse; description of TH as the first treatment modality for MHCs; and perceived stigma associated with MHCs and help-seeking behaviours. Originality/value A study on Nigerian cultural beliefs and TH contributes meaningfully to mental health systems. Future research and policy initiatives could explore ways of optimising TH practices and community awareness programmes to increase access to mental health care in Nigeria.


Author(s):  
M. Silva ◽  
D. M. Resurrección ◽  
A. Antunes ◽  
D. Frasquilho ◽  
G. Cardoso

Abstract Aims Unmet needs for mental health treatment are large and widespread, and periods of economic crisis may increase the need for care and the treatment gap, with serious consequences for individuals and society. The aim of this systematic review was to summarise the empirical evidence on the association between periods of economic crisis and the use of mental health care. Methods Following the PRISMA statement, MEDLINE, Embase, Scopus, Open Grey and Cochrane Database were searched for relevant publications, published between 1990 and 2018, from inception to June 2018. Search terms included (1) economic crisis, (2) use of mental health services and (3) mental health problems. Study selection, data extraction and the assessment of study quality were performed in duplicate. Results Seventeen studies from different countries met the inclusion criteria. The results from the included articles suggest that periods of economic crisis might be linked to an increase of general help sought for mental health problems, with conflicting results regarding the changes in the use of specialised psychiatric care. The evidence on the use of mental health care specifically due to suicide behaviour is mixed. The results also suggest that economic crises might be associated with a higher use of prescription drugs and an increase in hospital admissions for mental disorders. Conclusions Research on the impact of economic crises on the use of mental health care is scarce, and methodologies of the included papers are prone to substantial bias. More empirical and long-term studies on this topic are needed, in order to adapt mental health care systems to the specific needs of the population in times of economic crisis.


2021 ◽  
Author(s):  
Tristan J Philippe ◽  
Naureen Sikder ◽  
Anna Jackson ◽  
Maya E Koblanski ◽  
Eric Liow ◽  
...  

BACKGROUND The COVID-19 pandemic has shifted mental health care delivery to digital platforms, video conferencing, and other mobile communications. However, existing reviews of digital health interventions are narrow in scope and focus on a limited number of mental health conditions. OBJECTIVE To address this gap, we conducted a rapid review of the literature to assess the state of digital health interventions for the treatment of several mental health conditions. METHODS We searched MEDLINE for secondary literature published between 2010-2021 on the use, efficacy, and appropriateness of digital health interventions for the delivery of mental health care. RESULTS Sixty percent (60%) of research involved the treatment of substance use disorders, 25% focused on mood, anxiety and traumatic stress disorders and 5% or less on other mental health conditions. Synchronous and asynchronous communication, computerized therapy, and cognitive training appear to be effective, but require further examination in understudied mental health conditions. Similarly, virtual reality, mobile apps, social media platforms, and online forums are novel technologies that have the potential to improve mental health but require higher quality evidence. CONCLUSIONS Digital health interventions offer promise in the treatment of mental health conditions. In the context of the COVID-19 pandemic, digital health interventions provide a safer alternative to face-to-face treatment. However, further research on the applications of digital interventions in understudied mental health conditions is needed. Additionally, evidence is needed on the effectiveness and appropriateness of digital health tools for patients, who are marginalized, and may lack access to digital health interventions.


2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Emily C. Baron ◽  
Sujit D. Rathod ◽  
Charlotte Hanlon ◽  
Martin Prince ◽  
Abebaw Fedaku ◽  
...  

An amendment to this paper has been published and can be accessed via the original article.


BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S137-S138
Author(s):  
George Gillett ◽  
Owen Davis ◽  
Amarit Gill ◽  
Clare van Hamel

AimsPrevious research suggests the prevalence of mental health conditions among medical inpatients may be as high as 38%. Anecdotally, junior doctors report lacking the confidence, knowledge and skills to assess and treat patients with psychiatric conditions. Identifying this unmet need offers potential to improve standards of care and achieve parity of esteem between psychiatric and medical conditions within the general hospital. Aims:To assess self-reported preparedness of newly-qualified Foundation Doctors to care for patients with acute or chronic psychiatric symptoms in comparison to physical health conditions.MethodIn September of each year (2017, 2018, 2019), a survey was cascaded to all incoming Foundation Year 1 Doctors. For each respective year there were 1673, 961 & 1301 respondents. Respondents were asked to rate their agreement with statements on a Likert scale. Statements pertaining to mental health included “a) I am competent in acute mental health care provision, b) I am competent in chronic mental health care provision” and “I feel confident in prescribing the following drugs; c) drugs for mental health problems”. Comparison statements assessed confidence caring for medically unwell patients, performing practical procedures and prescribing drugs for physical health conditions.ResultPreparedness for acute and chronic mental health were lower than both physical health comparison items; preparedness to care for patients with critical illness (acute: r = 0.794, p < 0.001, chronic: r = 0.556, p < 0.001) and preparedness to perform practical procedures (acute: r = 0.724, p < 0.001, chronic: r = 0.433, p < 0.001).Confidence prescribing mental health drugs was lower than all other comparison items (simple analgesia: r = 0.854, bronchodilators: r = 0.789, antimicrobials: r = 0.772, inhaled steroids: r = 0.720, intravenous fluids: r = 0.702, oral anti-diabetics: r = 0.611, anticoagulants: r = 0.515, narcotics: r = 0.514, insulin: r = 0.206; p < 0.001)ConclusionThese results identify a disparity in foundation doctors’ self-reported preparedness to treat acute and chronic mental health conditions and prescribe psychotropic medications, compared to a variety of physical health domains. To our knowledge this is the first large-scale study to empirically test a potential discrepancy between newly-qualified doctors’ preparedness to treat patients’ mental and physical health needs. Medical school education and foundation training may therefore present a fruitful opportunity to improve care for patients with psychiatric conditions within general hospital settings.


Sign in / Sign up

Export Citation Format

Share Document