scholarly journals Clinical effectiveness and cost effectiveness of individual mental health workers colocated within primary care practices: a systematic literature review

BMJ Open ◽  
2020 ◽  
Vol 10 (12) ◽  
pp. e042052
Author(s):  
Jean-Baptiste Woods ◽  
Geva Greenfield ◽  
Azeem Majeed ◽  
Benedict Hayhoe
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Cost Effectiveness ◽  
Health Worker ◽  
Health Workers ◽  
Risk Of Bias ◽  
Mental Health Workers ◽  
Mental Health Worker ◽  
Care Practices ◽  
Primary Care Practices

ObjectivesMental health disorders contribute significantly to the global burden of disease and lead to extensive strain on health systems. The integration of mental health workers into primary care has been proposed as one possible solution, but evidence of clinical and cost effectiveness of this approach is unclear. We reviewed the clinical and cost effectiveness of mental health workers colocated within primary care practices.DesignSystematic literature review.Data sourcesWe searched the Medline, Embase, PsycINFO, Healthcare Management Information Consortium (HMIC) and Global Health databases.Eligibility criteriaAll quantitative studies published before July 2019 were eligible for the review; participants of any age and gender were included. Studies did not need to report a certain outcome measure or comparator in order to be eligible.Data extraction and synthesisData were extracted using a standardised table; however, pooled analysis proved unfeasible. Studies were assessed for risk of bias using the Risk Of Bias In Non-randomised Studies - of Interventions (ROBINS-I) tool and the Cochrane collaboration’s tool for assessing risk of bias in randomised trials.ResultsFifteen studies from four countries were included. Mental health worker integration was associated with mental health benefits to varied populations, including minority groups and those with comorbid chronic diseases. Furthermore, the interventions were correlated with high patient satisfaction and increases in specialist mental health referrals among minority populations. However, there was insufficient evidence to suggest clinical outcomes were significantly different from usual general practitioner care.ConclusionsWhile there appear to be some benefits associated with mental health worker integration in primary care practices, we found insufficient evidence to conclude that an onsite primary care mental health worker is significantly more clinically or cost effective when compared with usual general practitioner care. There should therefore be an increased emphasis on generating new evidence from clinical trials to better understand the benefits and effectiveness of mental health workers colocated within primary care practices.

The Indigenous Mental Health Worker

2003 ◽  
Vol 11 (3) ◽  
pp. 295-297 ◽  
Author(s):  
Robert Parker
Keyword(s):  
Mental Health ◽  
New Zealand ◽  
Health Worker ◽  
Health Workers ◽  
National Association ◽  
Mental Health Workers ◽  
Mental Health Worker ◽  
One Step ◽  
Zealand College ◽  
Indigenous Mental Health

Objective: To provide background and context for the recent Royal Australian and New Zealand College of Psychiatrists (RANZCP) statement on indigenous mental health workers. Conclusions: There are a number of difficulties facing indigenous mental health workers in Australia today. The RANZCP statement is one step in a move to increase recognition of these workers. National registration of Aboriginal mental health workers or the formation of a national association may further promote their identity.

scholarly journals Community-based participatory research to improve primary mental health services

2017 ◽  
Vol 5 (6) ◽  
pp. 2524
Author(s):  
Abi Muhlisin ◽  
Arum Pratiwi
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Health Worker ◽  
Health Workers ◽  
Skill Training ◽  
Mental Health Workers ◽  
P Value ◽  
Mental Health Worker ◽  
Remarkable Improvement ◽  
Periodic Analysis

Background: Global statistics show that mental illness is among the three most common diseases globally: about 12% to 15% of the global population suffer from mental illness, this is a rate higher than heart disease and disability and twice as high as cancer. The objective of this study was to improve public health conditions through community involvement and social action that is mental health worker knowledge and skill.Methods: A purposive sampling of communities was undertaken in a village of Indonesia. The numbers of participants were trained about knowledge and skill as a mental health workers, then selected 15 people who have the best score and the most capable. Level of knowledge and skill were measured sequent for three times using multiple choice test questions. Periodic analysis used repeated measure ANOVA.Results: There were differences of mental health worker knowledge of each period. The differences between the mental health workers’ knowledge in each period is shown by a test of between-subjects effect to have an F score of 189.476 with a P value of 0.00; and the most remarkable improvement in knowledge as after given skill training in Wilk lambda of 248.71 by P value 0.00.Conclusions: There were differences of mental health worker knowledge of each period. The differences between the mental health workers’ knowledge in each period is shown by a test of between-subjects effect to have an F score of 189.476 with a P value of 0.00; and the most remarkable improvement in knowledge as after given skill training in Wilk lambda of 248.71 by P value 0.00.

Uninsured Children With Psychosocial Problems: Primary Care Management

PEDIATRICS ◽  
2000 ◽  
Vol 106 (Supplement_3) ◽  
pp. 930-936 ◽  
Author(s):  
Thomas K. McInerny ◽  
Peter G. Szilagyi ◽  
George E. Childs ◽  
Richard C. Wasserman ◽  
Kelly J. Kelleher
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Mental Health Professionals ◽  
Mental Health Problems ◽  
Psychosocial Problems ◽  
The United States ◽  
Behavior Study ◽  
Care Practices ◽  
Uninsured Children ◽  
Primary Care Practices

Objective. Nearly 14% of children in the United States are uninsured. We compared the prevalence of psychosocial problems and mental health services received by insured and uninsured children in primary care practices. Methods. The Child Behavior Study was a cohort study conducted by Pediatric Research in Office Settings and the Ambulatory Sentinel Practice Network. Four hundred one primary care clinicians enrolled an average sample of 55 consecutive children (4–15 years old) per clinician. Results. Of the 13 401 visits to clinicians with 3 or more uninsured patients, 12 518 were by insured children (93.4%) and 883 were by uninsured children (6.6%). A higher percentage of adolescents, Hispanic children, those with unmarried parents, and those with less educated parents were uninsured. According to clinicians, uninsured children and insured children had similar rates of psychosocial problems (19%) and severe psychosocial problems (2%). For children with a clinician-identified psychosocial problem, we found no differences in clinician-reported counseling, medication use, or referral to mental health professionals. Conclusions. Among children served in primary care practices, uninsured children have similar prevalence of clinician-identified psychosocial and mental health problems compared with insured children. Within their practices, clinicians managed uninsured children much the same way as insured children.psychosocial problems, uninsured children, pediatrics, family medicine, primary care.

scholarly journals Graduate mental health worker case management of depression in UK primary care: a pilot study

2007 ◽  
Vol 57 (544) ◽  
pp. 880-885 ◽  
Author(s):  
Lindsay McMahon ◽  
Karin M Foran ◽  
Stephen D Forrest ◽  
Michelle L Taylor ◽  
Graham Ingram ◽  
...  
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Pilot Study ◽  
Case Management ◽  
Health Worker ◽  
Mental Health Worker

Addressing the Implementation Challenge: Introducing Primary Care Graduate Mental Health Workers

2005 ◽  
Vol 10 (1) ◽  
pp. 16-21
Author(s):  
Karen Newbigging ◽  
Debbie Nixon ◽  
John Playle ◽  
Christina Lyons ◽  
Nigel Harrison
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Health Workers ◽  
Mental Health Workers ◽  
Implementation Challenge

scholarly journals Effectiveness and Safety of Using Chatbots to Improve Mental Health: Systematic Review and Meta-Analysis

10.2196/16021 ◽  
2020 ◽  
Vol 22 (7) ◽  
pp. e16021 ◽  
Author(s):  
Alaa Ali Abd-Alrazaq ◽  
Asma Rababeh ◽  
Mohannad Alajlani ◽  
Bridgette M Bewick ◽  
Mowafa Househ
Keyword(s):  
Mental Health ◽  
Systematic Review ◽  
Health Workers ◽  
Meta Analysis ◽  
Visual Language ◽  
Risk Of Bias ◽  
Mental Health Workers ◽  
Bibliographic Databases ◽  
Reference List ◽  
Weak Evidence

Background The global shortage of mental health workers has prompted the utilization of technological advancements, such as chatbots, to meet the needs of people with mental health conditions. Chatbots are systems that are able to converse and interact with human users using spoken, written, and visual language. While numerous studies have assessed the effectiveness and safety of using chatbots in mental health, no reviews have pooled the results of those studies. Objective This study aimed to assess the effectiveness and safety of using chatbots to improve mental health through summarizing and pooling the results of previous studies. Methods A systematic review was carried out to achieve this objective. The search sources were 7 bibliographic databases (eg, MEDLINE, EMBASE, PsycINFO), the search engine “Google Scholar,” and backward and forward reference list checking of the included studies and relevant reviews. Two reviewers independently selected the studies, extracted data from the included studies, and assessed the risk of bias. Data extracted from studies were synthesized using narrative and statistical methods, as appropriate. Results Of 1048 citations retrieved, we identified 12 studies examining the effect of using chatbots on 8 outcomes. Weak evidence demonstrated that chatbots were effective in improving depression, distress, stress, and acrophobia. In contrast, according to similar evidence, there was no statistically significant effect of using chatbots on subjective psychological wellbeing. Results were conflicting regarding the effect of chatbots on the severity of anxiety and positive and negative affect. Only two studies assessed the safety of chatbots and concluded that they are safe in mental health, as no adverse events or harms were reported. Conclusions Chatbots have the potential to improve mental health. However, the evidence in this review was not sufficient to definitely conclude this due to lack of evidence that their effect is clinically important, a lack of studies assessing each outcome, high risk of bias in those studies, and conflicting results for some outcomes. Further studies are required to draw solid conclusions about the effectiveness and safety of chatbots. Trial Registration PROSPERO International Prospective Register of Systematic Reviews CRD42019141219; https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42019141219

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