scholarly journals Beyond the barriers: South Asian women’s experience of accessing and receiving psychological therapy in primary care

2020 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Saimah Yasmin-Qureshi ◽  
Susan Ledwith
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Mental Health Services ◽  
Health Services ◽  
South Asian ◽  
Psychological Therapy ◽  
Easy Access ◽  
Asian Women ◽  
South Asian Women ◽  
Content Type

Purpose A number of initiatives have been developed to ensure easy access to mental health services for Black and Asian Minority Ethnic (BAME) communities. Improving Access to Psychological Therapies (IAPT) is a service that delivers first line interventions for South Asian women; however, little is known about what makes IAPT accessible for this population. This paper aims to explore South Asian women’s experiences of accessing psychological therapy and whether therapy within IAPT helps individuals to re-frame their experiences within their own cultural context. Design/methodology/approach A qualitative approach was used. Semi-structured interviews were carried out with South Asian women who accessed an IAPT service. Ten participants took part in the study and interviews were analysed using thematic analysis. Findings Six themes were identified; access, experience, cultural framework, therapist characteristics, expectations and “sticking with it”. Having a good therapeutic relationship with the therapist was key. While cognitive behavioural therapy (CBT) enabled clients to manage their symptoms, manualised CBT led to a sense of dissatisfaction for some. Clients spoke of having to make a forced choice to either deny their culture or leave their culture at the door to access therapy. Cultural and religious exclusion had a negative impact on therapy particularly for those whose difficulties were related to their cultural or religious context. Practical implications Culture and religion continues to be excluded from psychological therapy for South Asian Women. A cultural shift is required from within IAPT services to maintain engagement for this group. Further clinical implications are discussed. Originality/value While the experiences of Black and Asian ethnic minority groups accessing secondary mental health services has been explored, this study explores and highlights the experiences of South Asian Women accessing therapy in primary care, and uniquely identifies the processes that enable women to engage in therapy.

Measuring parent satisfaction in youth mental health services

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Aileen O’Reilly ◽  
Alanna Donnelly ◽  
Jennifer Rogers ◽  
Olive Maloney ◽  
Gillian O’Brien ◽  
...  
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Mental Health Services ◽  
Young People ◽  
Health Services ◽  
Parent Satisfaction ◽  
Youth Mental Health ◽  
Service Development ◽  
Content Type ◽  
Growth And Change

Purpose Measuring parent satisfaction is regarded as essential but there is a paucity of research reporting on parental satisfaction with community youth mental health services. This study aims to examine parent satisfaction with Jigsaw – a primary care youth mental health service. Design/methodology/approach A measure of parent satisfaction was developed and administered to parents in 12 Jigsaw services over a two-year period (n = 510, age range: 28 to 70 years) when young people and parents were ending their engagement with these services. Findings Overall, parents had high levels of satisfaction with Jigsaw and their level of satisfaction did not vary depending on the parent or young person’s age and/or gender. Examination of qualitative feedback revealed three overarching themes relating to growth and change in young people, parents and their families; strengths of the service and; suggestions for future service development. Analysis of the psychometric properties of the measure provided evidence for a two-factor structure examining satisfaction with the intervention and outcomes and service accessibility and facilities. Originality/value This study represents one of the first efforts to measure parent satisfaction with primary care youth mental health services. It has resulted in the development of a brief measure that can be more widely administered to parents engaging with primary care youth mental health services.

scholarly journals A social construction of remission for people with a diagnosis of schizophrenia

2018 ◽  
Vol 22 (2) ◽  
pp. 94-107
Author(s):  
Keith Ford
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Clinical Practice ◽  
Mental Health Services ◽  
Health Services ◽  
Social Construction ◽  
Service Users ◽  
Content Type ◽  
Professional Groups ◽  
Practical Implications

Purpose The purpose of this paper is to provide a social construction of remission in relation to schizophrenia by the people affected most. The qualitative perspective utilised is a contrast to the majority of papers around, which have been quantitative when addressing the concept of remission for people with a diagnosis of schizophrenia. This paper acknowledges and demonstrates evidence of listening to the stakeholder groups affected by the issues associated with remission and recovery, and delivers clarity around the phenomena of remission in relation to recovery. Design/methodology/approach A constructivist grounded theory approach was employed, exploring participants’ interpretation of the concept of remission in schizophrenia. A purposive sample, of nine professionals, ten service users and seven carers, was recruited from two community mental health teams in the UK. Semi-structured interviews were employed to yield the data and all interview transcripts were analysed utilising “qualitative codes” thereby defining what is seen in the data. Diagramming and concept mapping was employed. Theoretical sensitivity was applied to demonstrate remission in abstract terms and to illustrate the openness, transparency and intention of the study. Findings The findings resulted in a conceptual map of the themes generated from the data. From this map four possible trajectories were developed, each highlighting a route which could be taken and the issues faced along the way. Positive and negative aspects of the trajectories offer discussion points for service users and practitioners alike to consider in their professional relationship. In addition a representation of the current interplay between recovery and remission is highlighted to offer clarity in relation to present service provision. Research limitations/implications The perspective and opinion from practitioners in Primary Care services was not proposed or included within this study. To gain an improved and realistic insight into this perspective a range of practitioners from primary care could provide valuable data for any future study as this would prove to be a valuable enhancement. This study offered a broad overview of professional groups with the ability to discuss mental health services, although it did not allow for a concentration from specific professional groups and therefore they were not able to fully represent their professional group. Practical implications This paper has illuminated the area of remission for people with schizophrenia and will therefore have practical implications in respect of on-going service development. In particular the interface between primary and secondary services which have struggled to employ consistent terminology serving only to confuse service users and service providers alike. The trajectories illustrated in this study offer clarity and understanding and direction for improved practice to facilitate recovery for people with a diagnosis of schizophrenia. Shared understanding of concepts between service users and providers could be a large move in a positive direction. Social implications The movement of people formerly diagnosed with schizophrenia from secondary mental health services back to primary care may have huge social implications. Resistance, stigma and ignorance play a large part in services “having to” retain people within secondary mental health services. Misunderstandings around diagnosis, and terms such as remission and recovery fuel such confusion resulting in a risk averse position for most. This study clarifies some of the issues in relation to the transition back to society and citizenship for people and offers scope for further research of a qualitative nature too. Originality/value Previous studies around the concept of remission for people with a diagnosis of schizophrenia have centred on medication efficacy, utilising remission criteria to determine changes in symptomolotolgy. These quantitative papers have not addressed service users, carers or practitioners in healthcare in relation to their understanding of the term remission, in relation to recovery; or whether they feel it would be of use in clinical practice. This study addressed those issues gaining valuable in-depth data from participants, deriving the social construction of remission and the impact it may have in clinical practice in a non-pathologising perspective.

Clinicians’ perceptions of telephone-delivered mental health services

2019 ◽  
Vol 15 (2) ◽  
pp. 104-113
Author(s):  
Micaela Mercado ◽  
Virna Little
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Mental Health Services ◽  
Health Services ◽  
Behavioral Health ◽  
Collaborative Care ◽  
Small Sample ◽  
Care Practice ◽  
Main Theme ◽  
Content Type

Purpose The adoption of telephone-delivered mental health services (TDMHS) for scaling collaborative care or addressing access to mental health services in routine primary care practice is gradual despite the needs of the population. Although there are multi-level factors associated with efficient implementation of collaborative care, there is limited understanding of clinicians’ perceptions, experiences and acceptability providing mental health treatment exclusively over the telephone. The purpose of this paper is to explore behavioral health clinicians’ delivery of mental health services over the telephone within primary care settings. Design/methodology/approach This qualitative study explored behavioral health professionals’ perceptions and experiences providing remote, TDMHS. Convenience sampling was used to recruit 11 clinicians in New York, California and Arizona who provided collaborative care services to patients exclusively over the telephone. Semi-structured interviews were conducted, and analyzed using qualitative content analysis methods. Findings Three main themes and associated subthemes emerged from the analyses. The first theme was participants’ perceptions of TDMHS prior to implementation relating to patient characteristics, patient engagement and comparison to in-person therapy. The second main theme identified was participants’ experiences implementing TDMHS with subthemes relating to benefits, quality of care, gaps in care and concerns implementing TDMHS. The final theme that emerged from the analysis was participants’ perceived acceptability of TDMHS by patients. Research limitations/implications The small sample size limits the generalizability of these findings. Practical implications Mental health services delivered over the telephone are perceived as feasible and acceptable by behavioral health clinicians. Originality/value This study contributes to gaps in research about behavioral health clinicians’ beliefs, uptake and acceptability toward mental health services delivered exclusively over the telephone.

scholarly journals Preventing unnecessary referrals into specialist mental health services: an interrupted time-series evaluation of a new primary care-linked mental health service

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Andrew Healey ◽  
Alexandra Melaugh ◽  
Len Demetriou ◽  
Tracey Power ◽  
Nick Sevdalis ◽  
...  
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Mental Health Service ◽  
Mental Health Services ◽  
Health Service ◽  
Health Services ◽  
Secondary Care ◽  
Interrupted Time Series ◽  
Content Type ◽  
Care Assessment

Purpose Many patients referred by their GP for an assessment by secondary mental health services are unlikely to ever meet eligibility thresholds for specialist treatment and support. A new service was developed to support people in primary care. “the authors evaluate” whether the phased introduction of the Lambeth Living Well Network (LWN) Hub to a population in south London led to: a reduction in the overall volume of patients referred from primary care for a secondary mental health care assessment; and an increase in the proportion of patients referred who met specialist service eligibility criteria, as indicated by the likelihood of being accepted in secondary care. Design/methodology/approach The evaluation applied a quasi-experimental interrupted time series design using electronic patient records data for a National Health Service (NHS) provider of secondary mental health services in south London. Findings Scale-up of the Hub to the whole of the population of Lambeth led to an average of 98 fewer secondary care assessments per month (95% CI −118 to −78) compared to an average of 203 assessments per month estimated in the absence of the Hub; and an absolute incremental increase in the probability of acceptance for specialist intervention of 0.20 (95% CI; 0.14 to 0.27) above an average probability of acceptance of 0.57 in the absence of the Hub. Research limitations/implications Mental health outcomes for people using the service and system wide-service impacts were not evaluated preventing a more holistic evaluation of the effectiveness and cost-effectiveness of the LWN Hub. Practical implications Providing general practitioners with access to service infrastructure designed to help people whose needs cannot be managed within specialist mental health services can prevent unnecessary referrals into secondary care assessment teams. Social implications Reducing unnecessary referrals through provision of a primary-care linked mental health service will reduce delay in access to professional support that can address specific mental-health related needs that could not be offered within the secondary care services and could prevent the escalation of problems. Originality/value The authors use NHS data to facilitate the novel application of a quasi-experimental methodology to deliver new evidence on whether an innovative primary care linked mental health service was effective in delivering on one of its key aims.

scholarly journals Impact of COVID-19 on Primary Care Mental Health Services: A Descriptive, Cross-Sectional Timeseries of Electronic Healthcare Records

2020 ◽  
Author(s):  
Clarissa M. M. Bauer-Staeb ◽  
Alice Davis ◽  
Theresa R Smith ◽  
David Betts ◽  
Wendy Wilsher ◽  
...  
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Mental Health Services ◽  
Health Services ◽  
Service Providers ◽  
Mental Healthcare ◽  
Psychological Therapy ◽  
Cross Sectional ◽  
Number Of Patients ◽  
The Impact

Introduction. There are growing concerns about the impact of the COVID-19 pandemic on mental health. With government-imposed restrictions as well as a general burden on healthcare systems, the pandemic has the potential to disrupt the access to, and delivery of, mental healthcare. Ultimately, this could potentially lead to unmet needs of individuals requiring mental health support. Methods. Electronic healthcare records from primary care psychological therapy services (Improving Access to Psychological Therapy) in England were used to examine changes in access to mental health services and service delivery during early stages of the COVID-19 pandemic. A cross-sectional, descriptive timeseries was conducted using data from 1st January 2019 to 24th May 2020 across five NHS trusts to examine patterns in referrals to services (n = 171,823) and appointments taking place (n = 865,902). Results. The number of patients accessing mental health services dropped by an average of 55% in the 9 weeks after lockdown was announced, reaching a maximum reduction of 74% in the initial 3 weeks after lockdown in the UK. As referrals began to increase again, there was a relatively faster increase in referrals from Black, Asian, and ethnic minority groups as well an increase in referrals from more densely populated areas. Despite a reduction in access, service providers adapted to infection control guidance by rapidly shifting to remote delivery of care. Interpretation. Services were able to rapidly adapt to provide continuity of care in mental healthcare. However, patients accessing services reduced dramatically, potentially placing a future burden on service providers to treat a likely backlog of patients in addition to a possible excess of patients as the long-term consequences of the pandemic become more apparent. Despite the observational nature of the data, which should be noted, the present study can inform the planning of service provision and policy.

The Bridge Program: A Model for Delivering Mental Health Services to Asian Americans through Primary Care

2005 ◽  
Vol 3 (1) ◽  
pp. 13-29 ◽  
Author(s):  
Hongtu Chen ◽  
Elizabeth Kramer ◽  
Teddy Chen ◽  
Jianping Chen ◽  
Henry Chung
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Mental Health Services ◽  
Health Services ◽  
Asian Americans ◽  
Mental Health Professionals ◽  
Primary Care Providers ◽  
Care Providers ◽  
Bridge Program ◽  
Community Awareness

Compared to all other racial and ethnic groups, Asian Americans have the lowest utilization of mental health services. Contributing factors include extremely low community awareness about mental health, a lack of culturally competent Asian American mental health professionals, and severe stigma associated with mental illness. This manuscript describes an innovative program that bridges the gap between primary care and mental health services. The Bridge Program, cited in the supplement to the Surgeon’s General’s Report on Mental Health: Culture, Race, and Ethnicity as a model for delivery of mental health services through primary care; (2) to improve capacity by enhancing the skills of primary care providers to identify and treat mental disorders commonly seen in primary care; and (3) to raise community awareness by providing health education on mental health and illness. Results are presented and the potential for replication is addressed.

scholarly journals Teaching Family Nurse Practitioner Students to Provide Mental Health Care to Older Adults

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 10-11
Author(s):  
Victoria Grando ◽  
Roy Grando
Keyword(s):  
Mental Health ◽  
Older Adults ◽  
Primary Care ◽  
Mental Health Services ◽  
Health Services ◽  
Treatment Plan ◽  
Primary Care Providers ◽  
Neurocognitive Disorders ◽  
Mental Condition ◽  
Care Providers

Abstract In recent years, FNPs have been challenged to deliver mental health services in the primary care setting. Over half of mental health services are provided in primary care, and one-quarter of all primary care patients have a mental disorder. Moreover, 20% of older adults have a mental or neurological disorder often not diagnosed. Nationally, it is estimated that 17% of older adults commit suicide, 15% have a mental condition, 11% have dementia, and 5% have a serious mental condition. There is a paucity of adequately prepared primary care providers trained in geropsychiatric treatment. A didactic course was developed to instruct FNP students in the skills needed to provide mental health treatment in primary care. We discuss mental illness in the context of culture to ensure that treatment is congruent with a patient’s unique cultural background and experiences. This shapes the patients’ beliefs and behaviors that influence the way they view their condition and what they perceive as acceptable solutions. We then go into detail about the common mental conditions that older adults exhibit. Through the case study method, students learn to identify the presenting problem, protocols for analyzing the case, which includes making differential diagnoses and a treatment plan including initial medications, non-medical treatments, and referral. Students are introduced to the DMS-5 to learn the criteria for mental health diagnosis with an emphasis on suicide, depressive disorders, anxiety disorders, bipolar disorders, substance use disorders, and neurocognitive disorders. We have found that students most often misdiagnose neurocognitive disorders.

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