Young service users from refugee backgrounds: their perspectives on barriers to accessing Australian mental health services

2017 ◽  
Vol 10 (1) ◽  
pp. 68-80 ◽  
Author(s):  
Madeleine Claire Valibhoy ◽  
Josef Szwarc ◽  
Ida Kaplan
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Young People ◽  
Health Services ◽  
Health Professionals ◽  
Mental Health Problems ◽  
Health Problems ◽  
Explanatory Models ◽  
Service Users ◽  
Content Type

Purpose The purpose of this paper is to examine barriers to accessing mental health services, from the perspective of young people of refugee background who have been service users, and to suggest strategies to improve access to mental health services. Design/methodology/approach A qualitative study was conducted with 16 young people (aged 18-25), who had been refugees and who had attended mental health professionals in Australia. Interview transcripts were analysed thematically to examine participants’ perspectives on what hinders initial access to mental health services. Findings Stigma about mental health problems was particularly prominent. Many believed a high level of disturbance was the threshold for entering services, and for some there was no knowledge of such services’ existence. Options for assistance other than mental health services were often preferred, according to young people’s explanatory models. Apprehension was expressed that sessions would be uncomfortable, distressing or ineffective. The desire to be self-reliant functioned as a further barrier. Finally, structural obstacles and social exclusion deterred some young refugees from accessing services. Practical implications Implications include the need for service providers to be equipped to provide culturally sensitive, responsive services that ideally offer both practical and psychological assistance. Potential referrers, including health professionals and community leaders, could facilitate increased access if trained to recognise and address barriers. Finally, findings indicate potential content for awareness-raising initiatives for young refugees about mental health problems and services. Originality/value This paper is original in its sample, method, topic and findings; being drawn from the first known qualitative research exploring views of young mental health service users who have been refugees about barriers to accessing mental health services.

“Walking wounded or wounded healer?” Does personal experience of mental health problems help or hinder mental health practice? A review of the literature

2014 ◽  
Vol 18 (1) ◽  
pp. 35-44 ◽  
Author(s):  
Catherine Conchar ◽  
Julie Repper
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Peer Support ◽  
Personal Experience ◽  
Mental Health Problems ◽  
Health Problems ◽  
Review Of The Literature ◽  
Wounded Healer ◽  
Content Type

Purpose – A systematic review of the literature on “wounded healers” was undertaken to identify, define and interpret the term and its application within the mental health environment. The paper aims to discuss these issues. Design/methodology/approach – Eight key medical/social sciences databases were interrogated. In total, 835 papers were identified in the systematic database search and abstracts were obtained for each to determine whether they met the inclusion criteria. In total, 237 sources were retrieved for critical reading, to assess relevance and value to the review, and 125 documents were subsequently included. Through thematic analysis a number of themes and sub themes were identified Findings – The archetypal image of the wounded healer originates in ancient mythology and crosses many cultures. There are many interpretations and applications of the belief that having healed their own wounds a person is in a better position to heal others, however, the evidence to support this is not so robust. Of more direct relevance to contemporary practice are reports of supporting staff with mental health problems to make a contribution to mental health services, most recently through the employment of peer support workers. Originality/value – As peer support workers are increasingly being employed in mental health services, it is helpful to consider the many existing staff who bring personal experience of mental health problems. This paper explores the evidence that their lived experience makes a difference to the way that they work and considers their employment support needs.

“When other people try to understand”: exploring the experiences of people with intellectual disabilities, who also have mental health problems

2020 ◽  
Vol 14 (3) ◽  
pp. 91-101
Author(s):  
Sasha Martine Mattock ◽  
Kieron Beard ◽  
Amy Baddeley
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Focus Group ◽  
Health Services ◽  
Intellectual Disabilities ◽  
Mental Health Problems ◽  
Health Problems ◽  
Content Type ◽  
The People ◽  
People With Intellectual Disabilities

Purpose Recent guidelines from the National Institute of Health and Care Excellence highlight that service users (SUs) with intellectual disabilities and co-occurring mental health problems rarely get the opportunity to share their experiences of mental health services. Over the past 20 years, policy documents have stated that these individuals (SUs) must be included in decisions about their care. Research suggests that often this is not the case. Therefore, this paper aims to create a space for SUs to share their experiences of mental health services, and what they found helpful. Design/methodology/approach A focus group was held with five SUs, two psychologists and two researchers. The audio recording of the discussion was transcribed and analysed using thematic analysis. Findings Three main themes were identified, namely, “relationships with others”, “inclusion and communication” and “challenges”. This focus group highlighted that although some SUs felt supported, they reported having little control in their lives and wanted to be listened to. Research limitations/implications Including a SU in the planning and facilitation of the focus group would have made this research more inclusive. Practical implications The implications of this research suggest that by listening to and involving SUs and developing more person-centred services, recovery rates may increase as the services provided would be more targeted. Originality/value Very little research has previously been conducted to explore SUs’ experiences. This paper highlights the value of being heard and the knowledge that is often lost if the authors do not take the time to listen to the people for whom a service is designed.

Barriers and Supports Experienced by Pacific Peoples in Aotearoa New Zealand’s Mental Health Services

2021 ◽  
pp. 002202212110398
Author(s):  
Christina Fa’alogo-Lilo ◽  
Claire Cartwright
Keyword(s):  
Mental Health ◽  
New Zealand ◽  
Mental Health Services ◽  
Health Services ◽  
Cultural Values ◽  
Mental Health Problems ◽  
Service Providers ◽  
Health Problems ◽  
Service Users ◽  
The Family

As with minority groups internationally, Pacific peoples in New Zealand (Pasifika) experience higher rates of mental health problems than the general population, and are less likely to access mental health services. This study investigated the barriers and supports for Pasifika accessing and using mental health services with participation of 25 Pasifika (10 service-providers, 11 ex-service-users, and 4 ex-service-users/providers) in order to gain their key informant perspectives. A Pasifika-appropriate Talanoa approach was used to guide the data-collection process and the qualitative data were analyzed using thematic analysis. Barriers included stigma among Pasifika regarding mental health problems, commitment to finding solutions within the family, and both mistrust and lack of knowledge of services. Within the services, non-Pasifika providers often lacked understanding of the collectivist cultural values and practices of Pasifika, including spiritual beliefs. They were more likely to use services if the providers were respectful of Pasifika practices and paid attention to developing relationships in a culturally appropriate way. This included involvement of the Pasifika family, when possible. Service-users often benefited from contact with Pasifika providers within mainstream services. These results support previous cross-cultural research that indicates the importance of offering evaluation and intervention services grounded in an understanding and respect for the cultural significance and meaning of mental health problems for the person, the family, and their community. While efforts are made to address these issues in New Zealand, change is slow and ongoing cultural training for service-providers along with psychoeducation for Pasifika about mental health services is strongly desirable.

Mental Health of Adolescents in Custody: The Use of the ‘Adolescent Psychopathology Scale’ in a Tasmanian Context

2002 ◽  
Vol 36 (5) ◽  
pp. 603-609 ◽  
Author(s):  
Rosie Bickel ◽  
Alistair Campbell
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Young People ◽  
Health Services ◽  
Mental Health Problems ◽  
Adolescent Psychopathology ◽  
Structured Interview ◽  
Health Problems ◽  
Individual Therapy ◽  
Interview Format

Objective: To investigate the incidence of mental health problems based on the DSM-IV [ 1 ] among adolescents in custody in Tasmania, using the Adolescent Psychopathology Scale (APS) [ 2 ]. Methods: The APS was administered to 50 adolescents admitted consecutively to a youth detention centre in Tasmania, Australia, using a structured interview format. Results: In this sample 46% scored positively for a mood disorder, 36% for posttraumatic stress disorder (PTSD), and 32% for an anxiety disorder excluding PTSD. Conclusions: Tasmania is no exception to the rule that adolescents in custody have a high proportion of mental health problems. This study confirmed findings of previous studies that detained adolescents had a roughly equivalent level of mental health problems as young people referred to mental health services and five times more than adolescents in the community. Therefore, all detained adolescents should be assessed for mental health problems as their risk is equivalent to that of young people referred to mental health services in the community. Youth detention centres are able to provide significant opportunities for individual therapy and group programmes for young people with mental health problems. However, to achieve a realization of this potential, detention facilities need to develop philosophies and procedures, which facilitate the development of therapeutic, as opposed to ‘punishing’, environments.

scholarly journals Service user experience of the Norfolk youth service

2020 ◽  
Vol 25 (1) ◽  
pp. 85-98
Author(s):  
David Heavens ◽  
Joanne Hodgekins ◽  
Rebecca Lower ◽  
Joanne Spauls ◽  
Benjamin Carroll ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Young People ◽  
Health Services ◽  
Qualitative Data ◽  
Youth Mental Health ◽  
Service Users ◽  
Content Type ◽  
Youth Service ◽  
Service User Experience

Purpose There is an international drive to improve mental health services for young people. This study aims to investigate service user experience of a youth mental health service in Norfolk, UK. In addition to suggesting improvements to this service, recommendations are made for the development of youth mental health services in general. Design/methodology/approach A mixed-methods approach was used. Quantitative data from satisfaction questionnaires were analysed using descriptive statistics and compared between two time points. A semi-structured interview was used to generate qualitative data. Thematic analysis was used to identify themes in the interview transcripts and triangulation was used to synthesise quantitative and qualitative data. Findings Service users appeared satisfied with the service. Significant improvements in satisfaction were found between two time points. Qualitative analysis identified three main themes that were important to service users, including support, information and personhood. Practical implications Recommendations for the development of youth mental health services are provided. Although these are based on findings from the Norfolk youth service, they are likely to apply to other mental health services for young people. Originality/value Mental health care for young people requires significant improvement. The Norfolk youth service is one of the first services of its kind in the UK. The findings from this study might be helpful to consider in the development of youth mental health services across the world.

The “constant tug-of-war” in mental health care in Greece

2018 ◽  
Vol 23 (3) ◽  
pp. 121-130 ◽  
Author(s):  
Niki Kyriakidou ◽  
Sofia Triliva
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Mental Health Professionals ◽  
Health Professionals ◽  
Public Mental Health ◽  
Service Users ◽  
Content Type ◽  
Therapeutic Services ◽  
The Impact

Purpose The purpose of this paper is to focus on how mental health professionals involved in the therapeutic treatment of children in public mental health facilities in Greece experience and talk about the impact of the socioeconomic crises on the psychotherapeutic process. Design/methodology/approach In all, 21 semi-structured interviews were conducted and phenomenologically informed thematic analysis was used in analysing the data. Findings The results coalesced into two all-encompassing thematic structures articulating the following: first, the socioeconomic crises have permeated society and therapeutic praxis like a torrential and chronic rain storm. This has resulted in a deluge in demand for therapeutic services within the public mental health sector; second, mental health professionals describe their positioning and work as “a constant tug-of-war” where they are inundated and often overwhelmed with work, find themselves identifying with service users and taking on several roles simultaneously, and being challenged to find solutions often in dire and complex situations. They describe how creativity and flexibility are in demand in their day-to-day interactions and if they are to intervene in place of a health and welfare system that is faltering. Doing therapeutic work under such circumstances appears to be both emotionally onerous and stimulating with regard to conceptualising new ways of intervening in such complex psychosocial situations. Research limitations/implications The study is limited in that only mental health professionals presented their experiences and service users were not included. The findings do highlight how severe austerity policies impact mental health services and peoples’ lives. Practical implications The study has implications for policy regarding the provision and organisation of mental health services in contexts where crises and economic turmoil prevail. Social implications The results associate severe austerity with major changes in family and community life. Originality/value The paper provides insights and implications on how mental health services are impacted by socioeconomic conditions.

scholarly journals Mental health services for young people: matching the service to the need

2013 ◽  
Vol 202 (s54) ◽  
pp. s1-s2 ◽  
Author(s):  
Max Birchwood ◽  
Swaran P. Singh
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Young People ◽  
Health Services ◽  
Mental Health Problems ◽  
Public Mental Health ◽  
Health Problems ◽  
Adult Services ◽  
Service Engagement ◽  
Policy Frameworks

SummaryIt is now known that the onset of severe and recurring mental health problems begins for the most part before the age of 25: this provides a clear focus for preventive strategies and public mental health that are a feature of many health policy frameworks. The present distinction between child and adolescent mental health services and adult services at 16 or 18 does not fit easily with these data and the now well-documented problems of transition suggest that a fundamental review of services for young people is overdue. This supplement provides an overview of the epidemiological, conceptual and service structures for young people with emergent and existing mental health problems, and asks the question, ‘How should we design services for young people to promote prevention and service engagement, and to improve outcomes?’

scholarly journals How included are mental health service users in decisions about their medication?

2016 ◽  
Vol 20 (3) ◽  
pp. 141-148 ◽  
Author(s):  
Sue Holttum
Keyword(s):  
Mental Health ◽  
Decision Making ◽  
Mental Health Services ◽  
Young People ◽  
Health Services ◽  
Service Users ◽  
Shared Decision ◽  
Content Type ◽  
The Third ◽  
Medication Decisions

Purpose – The purpose of this paper is to consider four recent articles relating to how included service users are in decision making about their medication in mental health services. Design/methodology/approach – One article describes conversations between a psychiatrist and service users about medication. The second paper describes a study in which young people were supported with the aim of developing their confidence to challenge medication decisions. The third paper reports on interviews with both professionals and service users about medication decisions. The fourth paper presents a theory of how the wider context can affect medication decision making in mental health. Findings – The first paper shows how a psychiatrist can persuade service users to accept medication decisions. The second paper shows how some young people can challenge medication decisions if they have the right support. The third paper illustrates how both professionals and service users may doubt service users’ ability to decide about medication, and pessimistically suggests that shared decision making may be unrealistic. In contrast to this, the fourth paper offers hope of changing how mental health services are organised in order to enable service users to be more empowered about medication decisions. Originality/value – A model of shared decision making is being imported into mental health from physical health. These four papers illustrate problems with a simple transfer from physical to mental health. The present paper points to differences in apparent awareness of different clinical researchers of the need to tackle service users’ disempowerment in mental health care, showing how some researchers are tackling this.

The transition between mental health services in Scotland

2018 ◽  
Vol 23 (1) ◽  
pp. 12-24 ◽  
Author(s):  
Juliette van der Kamp
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Mental Health Professionals ◽  
Health Professionals ◽  
Transition Period ◽  
Organisational Development ◽  
Structured Interviews ◽  
Content Type ◽  
Experience Difficulty

Purpose The purpose of this paper is to describe the barriers and facilitators to an effective transition from Child and Adolescent Mental Health Services (CAMHS) to Adult Mental Health Services (AMHS). It also presents a new entry into considering how the transition can be improved. Design/methodology/approach Insights into the transition from CAMHS to AMHS were gathered through eight semi-structured interviews with mental health professionals. Two methods of data analysis were employed to explore the emerging themes in the data and the observed deficit approach to organisational development. Findings The findings identified a vast volume of barriers in comparison to facilitators to the transition. Adolescents who transition from CAMHS to AMHS initially experience difficulty adapting to the differences in the services due to the short duration of the transition period. However, despite the established barriers to the transition, adolescents tend to adapt to the differences between the services. Findings also showed a negative framing towards the transition amongst the mental health professionals which resembles a deficit approach to organisational development. Originality/value This paper explores mental health professionals’ perspectives regarding the transition in Dumfries and Galloway, Scotland. The transition is increasingly recognised as an area in health care that requires improvement. This research provides a new way to consider the transition by exploring the perceived deficit approach to organisational development in the services.

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