Mental health interventions in an Italian prison: the Parma integrated approach

2020 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Lorenzo Pelizza ◽  
Ursula Zambelli ◽  
Enrico Rossi ◽  
Germana Verdoliva ◽  
Davide Maestri ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Health Intervention ◽  
Health Interventions ◽  
Mental Health Intervention ◽  
Intervention Model ◽  
Content Type ◽  
Mental Health Interventions ◽  
Integrated Mental Health

Purpose Mental health interventions for Italian prisoners with mental disorders remain a problematic issue, despite radical changes in general psychiatric care and a 2008 major government reform transferring mental health care in prison to the National Health Service. The aim of this study is to describe the mental health intervention model implemented since January 2020 for prisoners allocated in the Parma Penitentiary Institutes (PPI). This approach is specifically based on specialized, “person-centered” and “person-tailored” therapeutic-rehabilitation plans in line with psychiatric treatments usually provided in community mental health-care centers of the Parma Department of Mental Health. Design/methodology/approach All the processes and procedures included in the PPI intervention model were first carefully illustrated, paying special attention to the service for newly admitted prisoners and each typology of specialized therapeutic-rehabilitation treatment potentially provided. Additionally, a preliminary descriptive process analysis of the first six months of clinical activity was also performed. Findings Since January 2020, 178 individuals entered the PPI service for newly admitted prisoners. In total, 83 (46.7%) of them were engaged in the services of the PPI mental health-care team (35 with pathological addiction and 48 with mental disorders): 56 prisoners were offered an integrated mental health intervention and 27 exclusively an individual psychological or psychiatric treatment. Originality/value The results support the potential applicability of an integrated mental health intervention in prison, planning a person-tailored rehabilitation in close collaboration with the prisoners, their families and the local mental health/social services.

scholarly journals Incorporating digital self-services into integrated mental health care: a physician’s perspective

2018 ◽  
Vol 52 (11) ◽  
pp. 2234-2250 ◽  
Author(s):  
Heini Sisko Maarit Taiminen ◽  
Saila Saraniemi ◽  
Joy Parkinson
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Health Care Delivery ◽  
Value Creation ◽  
Care Delivery ◽  
Service Marketing ◽  
Content Type ◽  
Integrated Mental Health ◽  
Physician’S Perspective

Purpose This paper aims to enhance the current understanding of digital self-services (computerized cognitive behavioral therapy [cCBT]) and how they could be better incorporated into integrated mental health care from the physician’s perspective. Service marketing and information systems literature are combined in the context of mental health-care delivery. Design/methodology/approach An online survey of 412 Finnish physicians was undertaken to understand physicians’ acceptance of cCBT. The study applies thematic analysis and structural equation modeling to answer its research questions. Findings Adopting a service marketing perspective helps understand how digital self-services can be incorporated in health-care delivery. The findings suggest that value creation within this context should be seen as an intertwined process where value co-creation and self-creation should occur seamlessly at different stages. Furthermore, the usefulness of having a value self-creation supervisor was identified. These value creation logic changes should be understood and enabled to incorporate digital self-services into integrated mental health-care delivery. Research limitations/implications Because health-care systems vary across countries, strengthening understanding through exploring different contexts is crucial. Practical implications Assistance should be provided to physicians to enable better understanding of the application and suitability of digital self-service as a treatment option (such as cCBT) within their profession. Additionally, supportive facilitating conditions should be created to incorporate them as part of integrated care chain. Social implications Digital self-services have the potential to serve goals beyond routine activities in a health-care setting. Originality/value This study demonstrates the relevance of service theories within the health-care context and improves understanding of value creation in digital self-services. It also offers a profound depiction of the barriers to acceptance.

scholarly journals Employees’ Perspectives on the Facilitators and Barriers to Engaging With Digital Mental Health Interventions in the Workplace: Qualitative Study

2018 ◽  
Vol 5 (1) ◽  
pp. e8 ◽  
Author(s):  
Stephany Carolan ◽  
Richard O de Visser
Keyword(s):  
Mental Health ◽  
Controlled Trial ◽  
Health Intervention ◽  
Health Interventions ◽  
Mental Health Intervention ◽  
Depression And Anxiety ◽  
Occupational Setting ◽  
Mental Health Interventions ◽  
Facilitators And Barriers ◽  
Workplace Setting

Background Prevalence rates of work-related stress, depression, and anxiety are high, resulting in reduced productivity and increased absenteeism. There is evidence that these conditions can be successfully treated in the workplace, but take-up of psychological treatments among workers is low. Digital mental health interventions delivered in the workplace may be one way to address this imbalance, but although there is evidence that digital mental health is effective at treating stress, depression, and anxiety in the workplace, uptake of and engagement with these interventions remains a concern. Additionally, there is little research on the appropriateness of the workplace for delivering these interventions or on what the facilitators and barriers to engagement with digital mental health interventions in an occupational setting might be. Objective The aim of this research was to get a better understanding of the facilitators and barriers to engaging with digital mental health interventions in the workplace. Methods Semistructured interviews were held with 18 participants who had access to an occupational digital mental health intervention as part of a randomized controlled trial. The interviews were transcribed, and thematic analysis was used to develop an understanding of the data. Results Digital mental health interventions were described by interviewees as convenient, flexible, and anonymous; these attributes were seen as being both facilitators and barriers to engagement in a workplace setting. Convenience and flexibility could increase the opportunities to engage with digital mental health, but in a workplace setting they could also result in difficulty in prioritizing time and ensuring a temporal and spatial separation between work and therapy. The anonymity of the Internet could encourage use, but that benefit may be lost for people who work in open-plan offices. Other facilitators to engagement included interactive and interesting content and design features such as progress trackers and reminders to log in. The main barrier to engagement was the lack of time. The perfect digital mental health intervention was described as a website that combined a short interactive course that was accessed alongside time-unlimited information and advice that was regularly updated and could be dipped in and out of. Participants also wanted access to e-coaching support. Conclusions Occupational digital mental health interventions may have an important role in delivering health care support to employees. Although the advantages of digital mental health interventions are clear, they do not always fully translate to interventions delivered in an occupational setting and further work is required to identify ways of minimizing potential barriers to access and engagement. Trial Registration ClinicalTrials.gov: NCT02729987; https://clinicaltrials.gov/ct2/show/NCT02729987?term=NCT02729987& rank=1 (Archived at WebCite at http://www.webcitation.org/6wZJge9rt)

scholarly journals Employees� Perspectives on the Facilitators and Barriers to Engaging With Digital Mental Health Interventions in the Workplace: Qualitative Study (Preprint)

2017 ◽  
Author(s):  
Stephany Carolan ◽  
Richard O de Visser
Keyword(s):  
Mental Health ◽  
Controlled Trial ◽  
Health Intervention ◽  
Health Interventions ◽  
Mental Health Intervention ◽  
Depression And Anxiety ◽  
Occupational Setting ◽  
Mental Health Interventions ◽  
Facilitators And Barriers ◽  
Workplace Setting

BACKGROUND Prevalence rates of work-related stress, depression, and anxiety are high, resulting in reduced productivity and increased absenteeism. There is evidence that these conditions can be successfully treated in the workplace, but take-up of psychological treatments among workers is low. Digital mental health interventions delivered in the workplace may be one way to address this imbalance, but although there is evidence that digital mental health is effective at treating stress, depression, and anxiety in the workplace, uptake of and engagement with these interventions remains a concern. Additionally, there is little research on the appropriateness of the workplace for delivering these interventions or on what the facilitators and barriers to engagement with digital mental health interventions in an occupational setting might be. OBJECTIVE The aim of this research was to get a better understanding of the facilitators and barriers to engaging with digital mental health interventions in the workplace. METHODS Semistructured interviews were held with 18 participants who had access to an occupational digital mental health intervention as part of a randomized controlled trial. The interviews were transcribed, and thematic analysis was used to develop an understanding of the data. RESULTS Digital mental health interventions were described by interviewees as convenient, flexible, and anonymous; these attributes were seen as being both facilitators and barriers to engagement in a workplace setting. Convenience and flexibility could increase the opportunities to engage with digital mental health, but in a workplace setting they could also result in difficulty in prioritizing time and ensuring a temporal and spatial separation between work and therapy. The anonymity of the Internet could encourage use, but that benefit may be lost for people who work in open-plan offices. Other facilitators to engagement included interactive and interesting content and design features such as progress trackers and reminders to log in. The main barrier to engagement was the lack of time. The perfect digital mental health intervention was described as a website that combined a short interactive course that was accessed alongside time-unlimited information and advice that was regularly updated and could be dipped in and out of. Participants also wanted access to e-coaching support. CONCLUSIONS Occupational digital mental health interventions may have an important role in delivering health care support to employees. Although the advantages of digital mental health interventions are clear, they do not always fully translate to interventions delivered in an occupational setting and further work is required to identify ways of minimizing potential barriers to access and engagement. CLINICALTRIAL ClinicalTrials.gov: NCT02729987; https://clinicaltrials.gov/ct2/show/NCT02729987?term=NCT02729987& rank=1 (Archived at WebCite at http://www.webcitation.org/6wZJge9rt)

scholarly journals Improving mental health among people living with HIV: a review of intervention trials in low- and middle-income countries

2015 ◽  
Vol 2 ◽  
Author(s):  
K. J. Sikkema ◽  
A. C. Dennis ◽  
M. H. Watt ◽  
K. W. Choi ◽  
T. T. Yemeke ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Intervention ◽  
Health Interventions ◽  
People Living With Hiv ◽  
Mental Health Intervention ◽  
Middle Income ◽  
Middle Income Countries ◽  
Mental Health Interventions ◽  
Intervention Trials ◽  
Living With Hiv

People living with HIV (PLWH) experience greater psychological distress than the general population. Evidence from high-incomes countries suggests that psychological interventions for PLWH can improve mental health symptoms, quality of life, and HIV care engagement. However, little is known about the effectiveness of mental health interventions for PLWH in low- and middle-income countries (LMICs), where the large majority of PLWH reside. This systematized review aims to synthesize findings from mental health intervention trials with PLWH in LMICs to inform the delivery of mental health services in these settings. A systematic search strategy was undertaken to identify peer-reviewed published papers of intervention trials addressing negative psychological states or disorders (e.g. depression, anxiety) among PLWH in LMIC settings. Search results were assessed against pre-established inclusion and exclusion criteria. Data from papers meeting criteria were extracted for synthesis. Twenty-six papers, published between 2000 and 2014, describing 22 unique interventions were identified. Trials were implemented in sub-Saharan Africa (n = 13), Asia (n = 7), and the Middle East (n = 2), and addressed mental health using a variety of approaches, including cognitive-behavioral (n = 18), family-level (n = 2), and pharmacological (n = 2) treatments. Four randomized controlled trials reported significant intervention effects in mental health outcomes, and 11 preliminary studies demonstrated promising findings. Among the limited mental health intervention trials with PLWH in LMICs, few demonstrated efficacy. Mental health interventions for PLWH in LMICs must be further developed and adapted for resource-limited settings to improve effectiveness.

scholarly journals Mental disorder and mental health interventions for children and youth: the cases of non-suicidal self-harm and unruly behaviour A philosophical inquiry

2021 ◽  
Author(s):  
Snita Ahir-Knight
Keyword(s):  
Mental Health ◽  
Mental Disorder ◽  
Interesting Case ◽  
Health Intervention ◽  
Health Interventions ◽  
Children And Youth ◽  
Mental Health Intervention ◽  
Mental Health Interventions ◽  
Self Harm ◽  
Outcomes For Children

<p><b>Thesis abstract </b></p><p> </p><p>This dissertation is a contribution to the philosophy of mental disorder with a focus on children and youth and questions about what interventions they need. </p><p>I start by asking whether non-suicidal self-harm in youth is a mental disorder. Non-suicidal self-harm involves someone causing themselves harm with no intent to try to kill themselves. Young people cutting themselves alone and when with peers may be viewed as destructive, abnormal and irrational. Yet, I argue that non-suicidal self-harm in youth is never a mental disorder in its own right. Although non-suicidal self-harm in youth is not a disordered behaviour, that does not imply that it never merits intervention. </p><p>This leads to the question of what criteria should be applied when deciding whether to offer mental health interventions. I claim that whether one has a mental disorder should not determine whether one is offered a mental health intervention. The argument is made through considering the cases of non-suicidal self-harm in youth and unruly behaviour in children and youth. Unruly behaviour includes a wailing toddler, a child deliberately breaking items and a youth crossing police lines when protesting. </p><p>Unruly behaviour is another interesting case. In some instances, there is a high likelihood of negative outcomes for some children and youth who are behaving in an unruly way. However, unruly behaviour may also be part of a passing phase and helpful for development. Furthermore, in some cases, unruly behaviour may be praiseworthy, and encouraging unruliness may advance an individual’s welfare. The case of unruly behaviour, then, raises the question of when mental health clinicians should intervene. </p><p>The cases of non-suicidal self-harm and unruly behaviour help make my central claims. I say that behaviours and thoughts that are usually part of a passing phase and produce goods appropriate to that phase of life are not mental disorders; that managing life in the best way one can with the abilities available at a particular stage of life is not disordered; and, furthermore, that whether one has a mental disorder should not determine whether one is offered a mental health intervention. Finally, I say that, rather than depending on whether a person has a mental disorder, interventions should be offered only when they will advance the welfare of the service user. </p><p>My dissertation will appeal to philosophers. I also hope that youth, parents, teachers, clinicians, policy makers and similar will be interested in the contents. This is because important practical questions are asked that challenge common views, and that guide policies and clinical practice to improve the welfare and service outcomes for children and youth. </p>

cThe Cultural Adaptation of Step-by-Step: An intervention to address depression among Chinese young adults (Preprint)

2020 ◽  
Author(s):  
Hao Fong Sit ◽  
Rui Ling ◽  
Agnes Iok Fong Lam ◽  
Wen Chen ◽  
Brian Hall
Keyword(s):  
Mental Health ◽  
Young Adults ◽  
Cultural Adaptation ◽  
Ecological Validity ◽  
Health Intervention ◽  
Health Interventions ◽  
Content Adaptation ◽  
Mental Health Intervention ◽  
Mental Health Interventions ◽  
Chinese Young Adults

BACKGROUND Digital mental health interventions leverage digital communication technology to address the mental health needs of populations. Culturally adapting interventions can lead to a successful scalable mental health intervention implementation, and cultural adaptation of digital mental health interventions is a critical component to implementing interventions at scale within contexts where mental health services are not well supported. OBJECTIVE The study aims to describe the cultural adaptation of a digital mental health intervention Step-by-Step in order to address depression among Chinese young adults. METHODS Cultural adaptation was carried out in four phases following Ecological Validity Model: 1) Stage setting and expert consultation; 2) Preliminary content adaptation; 3) Iterative content adaptation with community members; 4) Finalized adaptation with community feedback meetings. Cognitive interviewing was applied to probe for relevance, acceptability, comprehensibility, and completeness of illustrations and text. Six mental health experts and 34 Chinese young adults were recruited for key informant interviews and focus group discussions. RESULTS We adapted the text and illustrations to fits the culture among Chinese young adults. Eight elements of the intervention were chosen as the targets of cultural adaptation (e.g., language, metaphors, content). Samples of major adaptations included: adding scenarios related to university life (relevance), changing leading characters from a physician to a peer and a cartoon (acceptability), incorporating two language versions (traditional Chinese and simplified Chinese) in the intervention (comprehensibility), and maintaining fundamental therapeutic components (completeness). CONCLUSIONS This study showed the utility of using Ecological Validity Model and a four-point procedure framework for cultural adaptation and achieved a culturally appropriate version of the Step-by-Step program for Chinese young adults.

scholarly journals Mental disorder and mental health interventions for children and youth: the cases of non-suicidal self-harm and unruly behaviour A philosophical inquiry

2021 ◽  
Author(s):  
Snita Ahir-Knight
Keyword(s):  
Mental Health ◽  
Mental Disorder ◽  
Interesting Case ◽  
Health Intervention ◽  
Health Interventions ◽  
Children And Youth ◽  
Mental Health Intervention ◽  
Mental Health Interventions ◽  
Self Harm ◽  
Outcomes For Children

<p><b>Thesis abstract </b></p><p> </p><p>This dissertation is a contribution to the philosophy of mental disorder with a focus on children and youth and questions about what interventions they need. </p><p>I start by asking whether non-suicidal self-harm in youth is a mental disorder. Non-suicidal self-harm involves someone causing themselves harm with no intent to try to kill themselves. Young people cutting themselves alone and when with peers may be viewed as destructive, abnormal and irrational. Yet, I argue that non-suicidal self-harm in youth is never a mental disorder in its own right. Although non-suicidal self-harm in youth is not a disordered behaviour, that does not imply that it never merits intervention. </p><p>This leads to the question of what criteria should be applied when deciding whether to offer mental health interventions. I claim that whether one has a mental disorder should not determine whether one is offered a mental health intervention. The argument is made through considering the cases of non-suicidal self-harm in youth and unruly behaviour in children and youth. Unruly behaviour includes a wailing toddler, a child deliberately breaking items and a youth crossing police lines when protesting. </p><p>Unruly behaviour is another interesting case. In some instances, there is a high likelihood of negative outcomes for some children and youth who are behaving in an unruly way. However, unruly behaviour may also be part of a passing phase and helpful for development. Furthermore, in some cases, unruly behaviour may be praiseworthy, and encouraging unruliness may advance an individual’s welfare. The case of unruly behaviour, then, raises the question of when mental health clinicians should intervene. </p><p>The cases of non-suicidal self-harm and unruly behaviour help make my central claims. I say that behaviours and thoughts that are usually part of a passing phase and produce goods appropriate to that phase of life are not mental disorders; that managing life in the best way one can with the abilities available at a particular stage of life is not disordered; and, furthermore, that whether one has a mental disorder should not determine whether one is offered a mental health intervention. Finally, I say that, rather than depending on whether a person has a mental disorder, interventions should be offered only when they will advance the welfare of the service user. </p><p>My dissertation will appeal to philosophers. I also hope that youth, parents, teachers, clinicians, policy makers and similar will be interested in the contents. This is because important practical questions are asked that challenge common views, and that guide policies and clinical practice to improve the welfare and service outcomes for children and youth. </p>

scholarly journals Designing Mobile Applications to Support Mental Health Interventions

2008 ◽  
pp. 635-656 ◽  
Author(s):  
Mark Matthews ◽  
Gavin Doherty ◽  
David Coyle ◽  
John Sharry
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Health Care Professionals ◽  
Health Interventions ◽  
End User ◽  
Highly Sensitive ◽  
Wide Range ◽  
Technological Interventions ◽  
Mental Health Interventions

The advent of mobile technology has brought computing to a wide range of new contexts, some of which are highly sensitive and place new constraints on the designer. In this chapter we discuss issues related to the design and evaluation of mobile software for sensitive situations, where access to the end user is extremely restricted. We focus on the specific example of technological interventions that support adolescents in mental health care settings. We examine the practical and ethical constraints placed on access to end users and contexts of use, and how this may affect approaches to design and evaluation. General design recommendations for this area are described. We consider approaches to iterative design with mental health care professionals, and how research on technological and therapeutic aspects may proceed in tandem. We identify methods that can be used when conducting evaluation in these limited situations and describe a methodology for maximising the value of such evaluation. By way of illustration, we present the design and evaluation of a mobile phone-based “mood diary” application designed for use in clinical situations by adolescents undergoing mental health interventions.

scholarly journals Manipulating efficacy expectancies in an ambulatory smartphone-based digital placebo mental health intervention: a randomized controlled trial (Preprint)

2020 ◽  
Author(s):  
Esther Stalujanis ◽  
Joel Neufeld ◽  
Martina Glaus Stalder ◽  
Angelo Belardi ◽  
Gunther Meinlschmidt
Keyword(s):  
Mental Health ◽  
Controlled Trial ◽  
Health Intervention ◽  
Health Interventions ◽  
Mental Health Intervention ◽  
Placebo Effects ◽  
Intention To Treat ◽  
Randomized Controlled ◽  
Mental Health Interventions ◽  
Efficacy Expectancies

BACKGROUND Smartphone-based mental health interventions provide new ways to treat mental disorders. There is certain evidence on the efficacy of such interventions. Placebo effects represent a substantial element of the mechanisms of action of face-to-face mental health interventions. OBJECTIVE We manipulated efficacy expectancies and investigated whether time trajectories of efficacy expectancies differed between conditions across a smartphone-based digital placebo mental health intervention. METHODS We conducted a randomized, controlled, single-blinded superiority trial with a multi-arm parallel design. Participants underwent a smartphone-based digital placebo mental health intervention for 20 consecutive days. We induced prospective efficacy expectancies by manipulating initial instructions on the purpose of the intervention and retrospective efficacy expectancies by manipulating feedback on the success of the intervention at days 1, 4, 7, 10, and 13. 132 healthy participants were randomized to four conditions: prospective expectancy only (n=33), retrospective expectancy only (n=33), combined expectancy (n=34), or control (n=32). Changes in efficacy expectancies were assessed with the Credibility Expectancy Questionnaire, at the introductory session and on intervention days 1, 7, 14, and 20. We performed our analyses for the intention-to-treat sample using a random effects model, with intervention day as time variable and condition as two factors: prospective expectancy (yes vs. no), and retrospective expectancy (yes vs.no), allowed to vary over participant and intervention day. RESULTS Credibility (b = -1.63, 95%confidence interval (CI) [-2.37, -0.89], P < 0.001) and expectancy (b = -0.77, 95%CI [-1.49, -0.05], P = 0.04) decreased across intervention days. For credibility and expectancy, we found significant three-way interactions intervention day*prospective expectancy*retrospective expectancy (b = 2.05, 95%CI [0.60, 3.50], P < 0.01 resp. b = 1.55, 95%CI [0.14, 2.95] P = 0.03). Efficacy expectancies decreased least in the combined expectancy and in the control condition, most in the prospective expectancy only and the retrospective expectancy only condition. CONCLUSIONS This is the first study investigating the induction of efficacy expectancies across a placebo smartphone-based mental health intervention. Efficacy expectancies decreased throughout intervention days and differed between conditions. Our findings may pave the way for diminishing and exploiting digital placebo effects and help to improve treatment efficacy of digital mental health interventions. CLINICALTRIAL ClinicalTrials.gov Identifier: NCT02365220. Registered February 18, 2015.

scholarly journals Digital Mental Health: The Answer to the Global Mental Health Crisis?

10.2196/18472 ◽  
2020 ◽  
Vol 7 (6) ◽  
pp. e18472 ◽  
Author(s):  
Brittany N Rudd ◽  
Rinad S Beidas
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Global Mental Health ◽  
Health Interventions ◽  
Health Prevention ◽  
Mental Health Crisis ◽  
Health Crisis ◽  
Prevention And Intervention ◽  
Mental Health Interventions

Digital mental health interventions are often touted as the solution to the global mental health crisis. However, moving mental health care from the hands of professionals and into digital apps may further isolate individuals who need human connection the most. In this commentary, we argue that people, our society’s greatest resource, are as ubiquitous as technology. Thus, we argue that research focused on using technology to support all people in delivering mental health prevention and intervention deserves greater attention in the coming decade.

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