scholarly journals What is the prevalence, and what are the clinical correlates, of insulin resistance in young people presenting for mental health care? A cross-sectional study

BMJ Open ◽  
2019 ◽  
Vol 9 (5) ◽  
pp. e025674 ◽  
Author(s):  
Elizabeth M Scott ◽  
Joanne S Carpenter ◽  
Frank Iorfino ◽  
Shane P M Cross ◽  
Daniel F Hermens ◽  
...  
Keyword(s):  
Mental Health ◽  
Insulin Resistance ◽  
Primary Care ◽  
Mental Health Services ◽  
Young People ◽  
Health Services ◽  
Self Report ◽  
Model Assessment ◽  
Cross Sectional ◽  
Younger Age

ObjectivesTo report the distribution and predictors of insulin resistance (IR) in young people presenting to primary care-based mental health services.DesignCross-sectional.SettingHeadspace-linked clinics operated by the Brain and Mind Centre of the University of Sydney.Participants768 young people (66% female, mean age 19.7±3.5, range 12–30 years).Main outcome measuresIR was estimated using the updated homeostatic model assessment (HOMA2-IR). Height and weight were collected from direct measurement or self-report for body mass index (BMI).ResultsFor BMI, 20.6% of the cohort were overweight and 10.2% were obese. However, <1% had an abnormally high fasting blood glucose (>6.9 mmol/L). By contrast, 9.9% had a HOMA2-IR score >2.0 (suggesting development of IR) and 11.7% (n=90) had a score between 1.5 and 2. Further, there was a positive correlation between BMI and HOMA2-IR (r=0.44, p<0.001). Participants in the upper third of HOMA2-IR scores are characterised by younger age, higher BMIs and depression as a primary diagnosis. HOMA2-IR was predicted by younger age (β=0.19, p<0.001) and higher BMI (β=0.49, p<0.001), together explaining 22% of the variance (F(2,361)=52.1, p<0.001).ConclusionsEmerging IR is evident in a significant subgroup of young people presenting to primary care-based mental health services. While the major modifiable risk factor is BMI, a large proportion of the variance is not accounted for by other demographic, clinical or treatment factors. Given the early emergence of IR, secondary prevention interventions may need to commence prior to the development of full-threshold or major mood or psychotic disorders.

scholarly journals Child and adolescent mental health problems in primary care

2000 ◽  
Vol 6 (4) ◽  
pp. 287-294 ◽  
Author(s):  
Tami Kramer ◽  
M. Elena Garralda
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
General Practitioner ◽  
Mental Health Services ◽  
Young People ◽  
Health Services ◽  
Psychiatric Disorder ◽  
Children And Adolescents ◽  
Mental Health Problems

Epidemiological research has revealed that psychiatric disorders in children and adolescents are common, persistent and handicapping. Only 1 in 10 of those with a disorder is seen in specialist mental health services. However, the majority of children and adolescents see their general practitioner (GP) every year. Although the majority present with physical complaints, there are indications that rates of psychiatric disorder in those attending are increased and that psychiatric disorder is associated with increased consulting. These findings raise questions about the role of primary care in the promotion and management of mental health in young people.

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 Regional analysis of UK primary care prescribing and adult service referrals for young people with attention-deficit hyperactivity disorder: from little to very little

BJPsych Open ◽  
2020 ◽  
Vol 6 (3) ◽  
Author(s):  
Samuele Cortese
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Attention Deficit Hyperactivity Disorder ◽  
Mental Health Services ◽  
Young People ◽  
Health Services ◽  
Mental Health Professionals ◽  
Attention Deficit ◽  
Hyperactivity Disorder ◽  
The Uk

Summary Drawing on data from the Clinical Practice Research Datalink, Price et al reported UK regional variations in primary care prescribing and referral rates to adult mental health services for young people with attention-deficit hyperactivity disorder (ADHD) in transition from child and adolescent mental health services. Overall, considering that around 65% of young adults with childhood ADHD present with impairing ADHD symptoms and up to 90% of individuals with ADHD may benefit from ADHD medications, the study by Price et al shows that the rate of appropriate treatment for youngsters in the transition period varies from low to very low across the UK. As such, there is a continuous need for education and training for patients, their families, mental health professionals and commissioners, to eradicate the misconception that, in the majority of the cases, ADHD remits during adolescence and to support the devolvement of appropriate services for the evidence-based management of adult ADHD across the UK.

scholarly journals Problem severity and waiting times for young people accessing mental health services

BJPsych Open ◽  
2020 ◽  
Vol 6 (6) ◽  
Author(s):  
Julian Edbrooke-Childs ◽  
Jessica Deighton
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Mental Health Services ◽  
Young People ◽  
Health Services ◽  
Waiting Times ◽  
Adolescent Mental Health ◽  
Child And Adolescent ◽  
Area Deprivation ◽  
Multinomial Regression

Background Access to timely care is a quality standard underpinning many international healthcare models, and long waiting times for child and adolescent mental health services are often reported as a barrier to help-seeking. Aims The aim of this study was to examine whether young people with more severe problems have shorter waiting times for mental health services. Method Multilevel multinomial regression analysis controlling for service-area deprivation, age, gender, ethnicity, referral source and contextual factors was conducted on N = 21 419 episodes of care (mean age 12.37 years (s.d. = 3.71), 11 712 (55%) female) using data from child and adolescent mental health services. Results There was high variation in waiting times, which ranged from 0 days to 1629 days (mean 50.65 days (s.d. = 78.03), median 32 days). Compared with young people with less severe problems young people with severe problems, self-harm, psychosis or eating disorders were less likely to experience longer waiting times. Moreover, referrals from sources other than primary care were generally less likely to have longer waiting times than referrals from primary care sources, especially referral from accident and emergency services. Conclusions The findings suggest that young people with more severe problems had shorter waiting times. Intermediary information and resources for support before access to services is needed to prevent escalation of problems and to support individuals and families while waiting for care. Interventions to reduce waiting times should be considered without compromising on the quality and experience of care that young people and families deserve when seeking help.

scholarly journals Consumer Reported Care Deferrals Due to the COVID-19 Pandemic, and the Role and Potential of Telemedicine: Cross-Sectional Analysis (Preprint)

2020 ◽  
Author(s):  
Adam Atherly ◽  
Eline Van Den Broek-Altenburg ◽  
Victoria Hart ◽  
Kelsey Gleason ◽  
Jan Carney
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Mental Health Services ◽  
Health Services ◽  
Health Effects ◽  
Care Delivery ◽  
Preventive Services ◽  
Cross Sectional ◽  
Cross Sectional Analysis ◽  
Sectional Analysis

BACKGROUND The COVID-19 pandemic forced many health systems to proactively reduce care delivery to prepare for an expected surge in hospitalizations. There have been concerns that care deferral may have negative health effects, but it is hoped that telemedicine can provide a viable alternative. OBJECTIVE This study aimed to understand what type of health care services were being deferred during the COVID-19 pandemic lockdown, the role played by telemedicine to fill in care gaps, and changes in attitudes toward telemedicine. METHODS We conducted a cross-sectional analysis of survey responses from 1694 primary care patients in a mid-sized northeastern city. Our main outcomes were use of telemedicine and reports of care deferral during the shutdown. RESULTS Deferred care was widespread—48% (n=812) of respondents deferred care—but it was largely for preventive services, particularly dental and primary care, and did not cause concerns about negative health effects. In total, 30.2% (n=242) of those who delayed care were concerned about health effects, with needs centered around orthopedics and surgery. Telemedicine was viewed more positively than prior to the pandemic; it was seen as a viable option to deliver deferred care, particularly by respondents who were over 65 years of age, female, and college educated. Mental health services stood out for having high levels of deferred care. CONCLUSIONS Temporary health system shutdowns will give rise to deferred care. However, much of the deferrals will be for preventive services. The effect of this on patient health can be moderated by prioritizing surgical and orthopedic services and delivering other services through telemedicine. Having telemedicine as an option is particularly crucial for mental health services.

scholarly journals Investigating geographical variation in the use of mental health services by area of England: a cross-sectional ecological study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Lucy Maconick ◽  
Luke Sheridan Rains ◽  
Rebecca Jones ◽  
Brynmor Lloyd-Evans ◽  
Sonia Johnson
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Mental Illness ◽  
Mental Health Services ◽  
Health Services ◽  
Geographical Variation ◽  
Ecological Study ◽  
Cross Sectional ◽  
Psychological Therapies ◽  
Access To Primary Care

Abstract Background There is evidence of geographical variation in the use of mental health services in the UK and in international settings. It is important to understand whether this variation reflects differences in the prevalence of mental disorders, or if there is evidence of variation related to other factors, such as population socioeconomic status and access to primary care services. Methods This is a cross-sectional ecological study using Public Health England data. The unit of analysis was the population served by clinical commissioning groups (CCGs), National Health Service (NHS) catchment areas. The analysis explored associations between area characteristics and the number of people in contact with mental health services using regression modelling. Explanatory variables included age, gender, prevalence of severe mental illness (SMI), prevalence of common mental disorder (CMD), index of multiple deprivation (IMD), unemployment, proportion of the population who are Black and Minority Ethnic (BAME), population density, access to and recovery in primary care psychological therapies. Unadjusted results are reported, as well as estimates adjusted for age, prevalence of CMD and prevalence of SMI. Results The populations of 194 CCGs were included, clustered within 62 trusts (NHS providers of mental health services). The number of people in contact with mental health services showed wide variation by area (range from 1131 to 5205 per 100,000 population). Unemployment (adjusted IRR 1.11; 95% CI 1.05 to 1.17; p < 0.001) and deprivation (adjusted IRR 1.02 95% CI 1.01 to 1.04; p < 0.001) were associated with more people being in contact with mental health services. Areas with a higher proportion of the population who are BAME (IRR 0.95 95% CI 0.92 to 0.99 p = 0.007) had lower service use per 100,000 population. There was no evidence for association with access to primary care psychological therapies. Conclusions There is substantial variation in the use of mental health services by area of England. Social factors including deprivation, unemployment and population ethnicity continued to be associated with the outcome after controlling for the prevalence of mental illness. This suggests that there are factors that influence the local population use of mental health services in addition to the prevalence of mental disorder.

scholarly journals Determinants of timely access to Specialized Mental Health Services and maintenance of a link with Primary Care: A cross-sectional study.

2021 ◽  
Author(s):  
Carlos Alberto dos Santos Treichel ◽  
Ioannis Bakolis ◽  
Rosana Teresa Onocko-Campos
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Mental Health Services ◽  
Health Services ◽  
Waiting Times ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Timely Access ◽  
Specialized Mental Health

Abstract Background: Although it is known that several factors may influence the access to specialized care, the factors related to the maintenance of a link with Primary Care by patients who accessed Specialized Mental Health Services (SMHS) remain unknown. The aim of this study was to evaluate the determinants of timely access to SMHS and maintenance of a link with Primary Care. Methods: This is a cross-sectional study, conducted with 341 users of SMHS at outpatient and community level in a medium-sized city in Brazil. Associations between the outcomes and the other variables were explored with the use of Poisson regression models with robust variance estimators. Results: Among the factors associated with the study outcomes, those related to the organization of services and the movement between them were noteworthy. Patients referred by Primary Care were less likely to access specialized services in a timely manner (RR: 0.61; 95% CI: 0.40, 0.93). However, the referral of cases by Primary Care (RR: 1.38; 95% CI: 1.06, 1.79) and follow-up with visits by Community Health Agents (RR: 1.26; 95% CI: 1.04, 1.53) appeared to favor maintenance of the patient-Primary Care link. Conclusion: This study reinforces the idea that integration between Primary Care and SMHS should be strengthened, both to reduce waiting times for between-service referrals and benefit continuity of care.

scholarly journals Determinants of timely access to Specialized Mental Health Services and maintenance of a link with primary care: a cross-sectional study

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Carlos Alberto dos Santos Treichel ◽  
Ioannis Bakolis ◽  
Rosana Teresa Onocko-Campos
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Mental Health Services ◽  
Health Services ◽  
Substance Misuse ◽  
Cross Sectional Study ◽  
Psychoactive Substance ◽  
Cross Sectional ◽  
Timely Access ◽  
Specialized Mental Health

Abstract Background Although access to specialized services is one of the main components of the study of paths to mental health care worldwide, the factors related to the continuity of the patient’s link with Primary Care after admission to a Specialized Mental Health Services still need to be explored in greater depth. Thus, this study aimed to evaluate the determinants of timely access to Specialized Mental Health Services (outcome 1) and maintenance of a link with Primary Care after patients’ admission (outcome 2). Methods This is a cross-sectional study, conducted with 341 users of Specialized Mental Health Services at outpatient and community level in a medium-sized city in Brazil between August and November 2019. Associations between the outcomes and the other variables were explored with the use of Poisson regression models with robust variance estimators. Results Factors positively associated with timely access were the diagnosis of psychosis or psychoactive substance misuse. The inversely associated factors with this outcome were higher income, having their need for mental health care identified in an appointment for general complaints, having been referred to the current service by Primary Care, having attended the current service for up to 3 years and delay until the first appointment (in a previous service). Regarding the maintenance of a link with Primary Care, factors positively associated were being referred to the current service by Primary Care or private service and receiving visits from Community Health Agents. The inversely associated factors with this outcome were male sex, being employed, having a diagnosis of psychosis or psychoactive substance misuse, and a greater perception of social support. Conclusions In addition to individual factors, factors related to the organization of services and the referral between them stood out in influencing both the access and maintenance of the patients’ link with Primary Care. Thus, this study reinforces the idea that integration between Primary Care and Specialized Mental Health Services should be strengthened, both to reduce waiting times for between-service referrals and benefit of care continuity.

scholarly journals Help-Seeking Intention During COVID-19 Pandemic: A Nationwide Web-Based Survey in Indonesia

2020 ◽  
Author(s):  
Aprezo Pardodi Maba ◽  
Mulawarman ◽  
Ma'rifatin Indah Kholili ◽  
Anugrah Intan Cahyani ◽  
kushendar ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
General Public ◽  
Help Seeking ◽  
Mental Health Problems ◽  
Self Report ◽  
Cross Sectional ◽  
Infected Area ◽  
Cross Sectional Design

Background: This study was conducted based on many studies on mental health problems during the Covid-19 pandemic and the urgency for the availability of mental health services. Unfortunately, research related to help-seeking intention for mental health in general public, particularly in Indonesia, is very limited. Meanwhile, several studies have shown that help-seeking intention is a good predictor whether someone will attend mental health services or not.Objective: The aims of this study are to determine the sources of help that are most soughtafter and the factors predicting help-seeking intention during the COVID-19 pandemic.Methods: Online instruments consist of demographical questions, 11 items of General Helpseeking Questionnaire (GHSQ) (Wilson, Deane, Ciarrochi, &amp; Rickwood, 2005), 7 items of Fear of COVID-19 Scale (FCV-19S) (Ahorsu et al., 2020), and 5 items of Coronavirus Anxiety Scale (CAS) (Lee, 2020) were distributed via email, Facebook messenger, and Whatsapp during August 11 – 21, 2020. The data were analyzed using multiple linear regression and multivariate logistic regression.Results: The results showed that parents were the most sought-after source of help during the COVID-19 pandemic. While age, education, occupation, living in infected area, and fear significantly predict help-seeking intention. Meanwhile, the factors significantly predict the level of help-seeking intention are anxiety and fear.Limitations: This research uses a cross-sectional design. Therefore, it cannot test help-seeking intention after data collection. Furthermore, data was obtained using the self-report method which depends on the participants' ability to understand the items of the questionnaire. Conclusion: The results showed that parents were the main choice of the participants if they seek for help. Therefore, it is important for parents to be equipped with skills in providing mental health help for their children or relatives. Moreover, all parties should be equipped and trained to provide mental health help. Mental health services should be provided to various demographical background of general public during of COVID-19 pandemic. The attention of mental health services should be directed to the not infected area as well rather than infected area only.

scholarly journals Consumer Reported Care Deferrals Due to the COVID-19 Pandemic, and the Role and Potential of Telemedicine: Cross-Sectional Analysis

10.2196/21607 ◽  
2020 ◽  
Vol 6 (3) ◽  
pp. e21607 ◽  
Author(s):  
Adam Atherly ◽  
Eline Van Den Broek-Altenburg ◽  
Victoria Hart ◽  
Kelsey Gleason ◽  
Jan Carney
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Mental Health Services ◽  
Health Services ◽  
Health Effects ◽  
Care Delivery ◽  
Preventive Services ◽  
Cross Sectional ◽  
Cross Sectional Analysis ◽  
Sectional Analysis

Background The COVID-19 pandemic forced many health systems to proactively reduce care delivery to prepare for an expected surge in hospitalizations. There have been concerns that care deferral may have negative health effects, but it is hoped that telemedicine can provide a viable alternative. Objective This study aimed to understand what type of health care services were being deferred during the COVID-19 pandemic lockdown, the role played by telemedicine to fill in care gaps, and changes in attitudes toward telemedicine. Methods We conducted a cross-sectional analysis of survey responses from 1694 primary care patients in a mid-sized northeastern city. Our main outcomes were use of telemedicine and reports of care deferral during the shutdown. Results Deferred care was widespread—48% (n=812) of respondents deferred care—but it was largely for preventive services, particularly dental and primary care, and did not cause concerns about negative health effects. In total, 30.2% (n=242) of those who delayed care were concerned about health effects, with needs centered around orthopedics and surgery. Telemedicine was viewed more positively than prior to the pandemic; it was seen as a viable option to deliver deferred care, particularly by respondents who were over 65 years of age, female, and college educated. Mental health services stood out for having high levels of deferred care. Conclusions Temporary health system shutdowns will give rise to deferred care. However, much of the deferrals will be for preventive services. The effect of this on patient health can be moderated by prioritizing surgical and orthopedic services and delivering other services through telemedicine. Having telemedicine as an option is particularly crucial for mental health services.

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