scholarly journals Living with Psychosis without Mental Health Services: A Narrative Interview Study

BMJ Open ◽  
2021 ◽  
Vol 11 (7) ◽  
pp. e045661
Author(s):  
Rose McGranahan ◽  
Zivile Jakaite ◽  
Alice Edwards ◽  
Stefan Rennick-Egglestone ◽  
Mike Slade ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Interview Study ◽  
Future Research ◽  
Psychotic Experiences ◽  
Making Sense ◽  
Narrative Interview ◽  
External Sources ◽  
Past Experiences

ObjectivesLittle research has looked at how people who do not use mental health services experience psychosis. Thus, the present study aimed to explore the experiences and views of people with psychosis who have neither sought nor received support from mental health services for at least 5 years.DesignA narrative interview study. Thematic analysis was used to analyse the data.SettingEngland.ParticipantsTwenty-eight participants with self-defined psychotic experiences were asked to provide a free narrative about their experiences.ResultsFive themes were identified: (1) Perceiving psychosis as positive; (2) Making sense of psychotic experiences as a more active psychological process to find explanations and meaning; (3) Finding sources of strength, mainly in relationships and the environment, but outside of services; (4) Negative past experiences of mental health services, leading to disengagement and (5) Positive past experiences with individual clinicians, as an appreciation of individuals despite negative views of services as a whole.ConclusionsPerceiving psychosis as something positive, a process of making sense of psychotic experiences and the ability to find external sources of strength all underpin—in addition to negative experiences with services—a choice to live with psychosis outside of services. Future research may explore to what extent these perceptions, psychological processes and abilities can be facilitated and strengthened, in order to support those people with psychosis who do not seek treatment and possibly also some of those who are in treatment.

Making sense of child and adolescent mental health services (CAMHS): An audit of the referral journey and the use of routine outcome measures (ROMS)

2021 ◽  
pp. 135910452199970
Author(s):  
Naomi Gibbons ◽  
Emma Harrison ◽  
Paul Stallard
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Outcome Measures ◽  
Adolescent Mental Health ◽  
Child And Adolescent ◽  
Completion Rates ◽  
Making Sense ◽  
North East ◽  
Over Time

Background: There is increased emphasis on the national reporting of Routine Outcome Measures (ROMS) as a way of improving Child and Adolescent Mental Health Services (CAMHS). This data needs to be viewed in context so that reasons for outcome completion rates are understood and monitored over time. Method: We undertook an in-depth prospective audit of consecutive referrals accepted into the Bath and North East Somerset, Swindon and Wiltshire (BSW) CAMHS service from November 2017 to January 2018 ( n = 1074) and April to September 2019 ( n = 1172). Results: Across both audits 90% of those offered an appointment were seen with three quarters completing baseline ROMS. One in three were not seen again with around 30% still being open to the service at the end of each audit. Of those closed to the service, paired ROMS were obtained for 46% to 60% of cases. There were few changes in referral problems or complexity factors over time. Conclusion: Understanding the referral journey and the reasons for attrition will help to put nationally collected data in context and can inform and monitor service transformation over time.

Nonmental Healthcare Professionals’ Attitudes Toward Mental Health Services in Asir Region, KSA

2021 ◽  
Vol 6 (4) ◽  
Author(s):  
Alsubaie SS ◽  
◽  
Al-Hufayyan RS ◽  
Mohammed MS ◽  
Alsufyani AH ◽  
...  
Keyword(s):  
Mental Health ◽  
Saudi Arabia ◽  
Mental Health Services ◽  
Health Services ◽  
Work Experience ◽  
Future Research ◽  
P Value ◽  
Kingdom Of Saudi Arabia ◽  
Cross Sectional ◽  
Asir Region

Objectives: Most patients who visit other clinics are surprised when they referred to psychiatric clinics, which may be related to the social stigma of mental illness or nonmental health professionals’ (NMHPs) negative attitude toward psychiatric illness. The study aimed to assess attitudes toward mental health services among NMHPs in Asir region, Kingdom of Saudi Arabia (KSA), and to correlate the results with different variables. Methods: We conducted a cross-sectional study among NMHPs (n=358) in Asir region of the kingdom of Saudi Arabia by using an electronic questionnaire through WhatsApp application. Results: Young age, female gender, single marital status, did not ever had known or shared in giving care to a mentally ill person, work experience less than 10 years, nursing specialty, and holding diploma degree represented the significant statistical correlation with negative attitudes toward mental health services scale (p-value = <0.001; 0.01; 0.003; 0.02; <0.001; 0.02 and <0.001, respectively). Conclusion: This study demonstrates positive attitude toward mental health services among NMHPs. There is need for better educational measures and more training courses at the undergraduate level of NMHPs in order to improve such attitude. Future research could investigate the outcomes of these measures and courses.

Psychotic experiences in a mental health clinic sample: implications for suicidality, multimorbidity and functioning

2013 ◽  
Vol 44 (8) ◽  
pp. 1615-1624 ◽  
Author(s):  
I. Kelleher ◽  
N. Devlin ◽  
J. T. W. Wigman ◽  
A. Kehoe ◽  
A. Murtagh ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Young People ◽  
Health Services ◽  
Suicidal Behaviour ◽  
Health Clinic ◽  
Psychotic Experiences ◽  
Global Functioning ◽  
Community Based Research ◽  
Wide Range

BackgroundRecent community-based research has suggested that psychotic experiences act as markers of severity of psychopathology. There has, however, been a lack of clinic-based research. We wished to investigate, in a clinical sample of adolescents referred to a state-funded mental health service, the prevalence of (attenuated or frank) psychotic experiences and the relationship with (i) affective, anxiety and behavioural disorders, (ii) multimorbid psychopathology, (iii) global functioning, and (iv) suicidal behaviour.MethodThe investigation was a clinical case–clinical control study using semi-structured research diagnostic psychiatric assessments in 108 patients newly referred to state adolescent mental health services.ResultsPsychotic experiences were prevalent in a wide range of (non-psychotic) disorders but were strong markers of risk in particular for multimorbid psychopathology (Z = 3.44, p = 0.001). Young people with psychopathology who reported psychotic experiences demonstrated significantly poorer socio-occupational functioning than young people with psychopathology who did not report psychotic experiences, which was not explained by multimorbidity. Psychotic experiences were strong markers of risk for suicidal behaviour. Stratified analyses showed that there was a greatly increased odds of suicide attempts in patients with a major depressive disorder [odds ratio (OR) 8.89, 95% confidence interval (CI) 1.59–49.83], anxiety disorder (OR 15.4, 95% CI 1.85–127.94) or behavioural disorder (OR 3.13, 95% CI 1.11–8.79) who also had psychotic experiences compared with patients who did not report psychotic experiences.ConclusionsPsychotic experiences (attenuated or frank) are an important but under-recognized marker of risk for severe psychopathology, including multimorbidity, poor functioning and suicidal behaviour in young people who present to mental health services.

scholarly journals Adversity Over the Life Course: A Comparison Between Women and Men Who Died by Suicide

2021 ◽  
Vol 12 ◽  
Author(s):  
Monique Séguin ◽  
Guy Beauchamp ◽  
Charles-Édouard Notredame
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Adverse Events ◽  
Life Course ◽  
Mental Health Problems ◽  
Future Research ◽  
Public Health Perspective ◽  
Significant Difference ◽  
The Life Course

Purpose: This study sets out to compare the presence of life events across different domains throughout the life course which may contribute to the burden of adversity experienced differently among men and women who died by suicide.Method: In a sample of 303 individuals (213 men and 90 women), data was derived from extensive clinical interviews conducted with informants. Models allowed the identification of patterns of life trajectories.Results: Overall, the burden of adversity was similar across the life course except for the 5–9, 25–29, and 30–34 age ranges, where a significant difference appeared between genders [t-test = 2.13 (p &lt; 0.05), 2.16 (p &lt; 0.05) and 3.08 (p &lt; 0.005), respectively] that seems to disadvantage women. The early adversities of violence and neglect, between 0 and 19 years old, are important for both groups. During the life course, women were more exposed to interpersonal adverse events such as being victims of negligence and violence, relational difficulties or abuse from their spouse, as well as tension with their own children. Men encountered more academic difficulties, legal entanglements and financial difficulties, and were more than three times more likely to develop an alcohol/drug abuse problem than women.Conclusions: The data suggests some gender differences in exposure to longstanding and severe life problems contributing to suicide vulnerability. For women, the continuing burden emerges from chronic interpersonal adversities, whereas, for men, the adverse events are to a larger degree socially exposed, compounded with alcohol misuse. The adversities, especially those of a public or social nature, may be witnessed by others, which should favor the detection of vulnerability over the life course, and psychosocial or mental health services should be offered and provided earlier during the life course. Yet more men die by suicide than women. Resiliency and protective factors may benefit women to a greater degree. Future research should tackle the challenge of investigating these important elements. Meanwhile, from a public health perspective, access to psychosocial and mental health services and social acceptability of seeking services should be part of an ongoing effort in all institutional structures as a way of decreasing downstream mental health problems and vulnerability to suicide.

“We need to slowly break down this barrier”: understanding the barriers and facilitators that Afro-Caribbean undergraduates perceive towards accessing mental health services in the UK

2020 ◽  
Vol 19 (1) ◽  
pp. 63-81
Author(s):  
Tamara Nadine Sancho ◽  
Michael Larkin
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Critical Incident ◽  
Structural Changes ◽  
Barriers And Facilitators ◽  
Future Research ◽  
Sociocultural Factors ◽  
Content Type ◽  
The Uk

Purpose Undergraduates are highly susceptible to the development of mental health difficulties. Afro-Caribbean students are particularly vulnerable to the pressures of university yet are less likely than other ethnic groups to receive early intervention. This paper aims to understand the barriers and facilitators that Afro-Caribbean undergraduates perceive towards accessing mental health services in the UK. Design/methodology/approach Critical Incident Technique was used as the qualitative method because it explores the critical factors that contribute to or detract from a specific experience. Seventeen Afro-Caribbean undergraduates participated in five focus groups. This involved engaging in a novel psychosocial activity that incorporated vignettes to encourage the identification of barriers and facilitators to service access. The data were analysed thematically to generate categories of critical incidents and wish-list items. Findings Analysis revealed rich data from a sub-group rarely researched within UK literature. Fifteen barriers, eleven facilitators and five wish-list items were identified. The importance of mental health literacy, social networks, cultural sensitivity and concerns surrounding services underpinned many categories. Originality/value Findings provide a new perspective on barriers reported in previous literature. Novel facilitators were highlighted where, although psychological and sociocultural factors were deemed valuable, structural changes were most desired. Recommended changes illustrate innovative interventions that could make services accessible for young adult Afro-Caribbean populations. Future research should explore the barriers and facilitators identified by Afro-Caribbean undergraduates across various universities who have successfully accessed and engaged with services. This could provide a holistic perspective on viable facilitators enabling access despite the presence of barriers.

Sähköiset mielenterveyspalvelut toipumisen näkökulmasta. Integroiva kirjallisuuskatsaus

Kuntoutus ◽  
2020 ◽  
Vol 43 (3) ◽  
pp. 34-50
Author(s):  
Mari Kivistö
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Literature Review ◽  
Future Research ◽  
Service Users ◽  
Personal Recovery ◽  
Recovery Orientation ◽  
Digital Services ◽  
Mental Health Practices

Mielenterveyden häiriöiden merkityksen kasvaminen sekä haasteet mielenterveyspalveluiden järjestämisessä ovat tehneet sähköisten mielenterveyspalveluiden kehittämisestä ja tutkimuksesta ajankohtaista. Nyt COVID-19-pandemia on lisännyt sähköisten mielenterveyspalveluiden tarvetta mutta tuonut samalla näkyviksi organisaatioiden eriytyvät lähtökohdat sähköisten mielenterveyspalveluiden järjestämisessä. Tämän tutkimuksen tavoitteena oli kuvata sähköisten mielenterveyspalveluiden vaikutuksia palvelunkäyttäjien näkökulmasta sekä tunnistaa positiivisesti vaikuttavien sähköisten mielenterveyspalveluiden edellytyksiä. Tutkimus toteutettiin kansainvälisistä tutkimusartikkeleista (n = 27) tietoa kokoavana integroivana kirjallisuuskatsauksena. Analyysimenetelmänä sovellettiin teemoittelua ja tulkintakehyksenä toipumisorientaation (recovery) viitekehystä. Kirjallisuuskatsauksen perusteella sähköiset mielenterveyspalvelut tarjoavat mahdollisuuksia toipumiseen ja sen tukemiseen, mutta toipuminen ehdollistuu sähköisiin mielenterveyspalveluihin liittyvissä toimintakäytännöissä. Tulokset jäsennettiin yksilön laaja-alaista toipumista ja toipumista kokonaisvaltaisesti tukevia sähköisiä mielenterveyspalveluja ilmentävinä yläteemoina, joista edelliseen sisällytettiin alateemat kliininen toipuminen, henkilökohtainen toipuminen ja osallisuuden vahvistuminen ja jälkimmäiseen tietoperusteisuus, tilannekohtaisuus, tuen tarjoaminen, vuorovaikutteisuus, henkilökohtaisuus ja asiakaslähtöisyys. Kirjallisuuskatsaus osoittaa, että tutkimustarpeista huolimatta tiedämme jo paljon tekijöistä, jotka mahdollistavat toipumista edistävien sähköisten mielenterveyspalveluiden toteuttamista. Tätä tietoa on tarpeen hyödyntää myös COVID-19-pandemian muuttamassa toimintaympäristössä. Tulosten sovellettavuutta rajoittaa tutkimustiedon pirstaleisuus sekä se, että tutkimukset kohdistuivat vain henkilöihin, joilla oli pääsy, kyky ja halu sähköisten mielenterveyspalveluiden käyttöön.Abstract Digital mental health services and recovery. An Integrative literature review The increase of mental health disorders and the challenges of delivering mental health services have made the development and research of digital mental health services topical. Currently, the COVID-19 pandemic has increased the need for digital mental health services, but at the same time it has made visible the various potential of organizations for providing digital services. The aim of this study is to describe the effects of digital mental health services from the service users’ perspective and to identify the features of the services that make an impact. The study was conducted as an integrative literature review of international research articles (n = 27). The method used was thematic analysis and a recovery orientation was applied as the interpretation framework. Based on the review, digital mental health services offer opportunities for and support the recovery of service users, but the recovery is conditioned on digital mental health practices. The results were presented as two main-themes: a person’s extensive recovery and digital mental health services that support recovery holistically. The former includes the sub-themes of clinical recovery, personal recovery and participation, and the latter the sub-themes of knowledge orientation, situationality, provision of support, interactivity, personality and client orientation. The integrative literature review shows that despite the need for future research, we already know a great deal about the factors that enable the implementation of digital mental health services that promote recovery. This knowledge needs to be utilized in the operating environment of mental health services, which is currently changing because of the COVID-19 pandemic. The review has some limitations, because research on the subject is fragmentary and the studies involved in the review were only targeted at persons with access to digital mental health services and the ability and motivation to use them. Keywords: mental health, digital services, recovery, integrative literature review

Making sense of child and adolescent mental health services

1999 ◽  
Vol 23 (4) ◽  
pp. 217-221 ◽  
Author(s):  
Paul Stallard ◽  
Robert Potter
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Adolescent Mental Health ◽  
Child And Adolescent ◽  
Service Development ◽  
Resource Reallocation ◽  
Appointment Attendance ◽  
Making Sense ◽  
Adolescent Mental Health Service

Aims and methodA prospective audit of the 425 referrals made to a community child and adolescent mental health service over a three month period was undertaken. Standardised data were collected about the referrer, reason for referral problem chronicity and complexity, service response and first appointment attendance.ResultsThe service is currently seeing less than one in five of the children conservatively estimated to require specialist mental health services. The majority of those referred were appropriate, identifying multiple problems of longer than six months' duration presenting within a complex context.Clinical implicationsThe results have provided commissioning authorities with a clear specification of the current service. This can inform decisions about resource reallocation, prioritisation and future service development. Clinicians feel that the complexity of their work is now understood and various audit projects and initiatives have been established in order to explore alternative ways of responding to referrer demands.

Lesbian, gay and bisexual individuals experience of mental health services - a systematic review

2020 ◽  
Vol 15 (2) ◽  
pp. 59-70 ◽  
Author(s):  
Geraldine McNamara ◽  
Charlotte Wilson
Keyword(s):  
Mental Health ◽  
Systematic Review ◽  
Mental Health Services ◽  
Health Services ◽  
Minority Group ◽  
Future Research ◽  
Ethical Practice ◽  
Content Type ◽  
Mental Health Difficulties ◽  
And Bisexual

Purpose Lesbian, gay and bisexual (LGB) individuals experience higher rates of mental health difficulties in comparison to their heterosexual counterparts (Meyer, 2003; Plöderl and Tremblay, 2015). This is in part due to the experience of homophobia and stigmatisation within society. This discrimination has also been perpetuated within the mental health field, where LGB individual’s sexuality has been pathologised. In response to this historical stigmatisation a number of policies have been created to develop ethical practice while working with this minority group (APA, 2012; BPS, 2019; HSE, 2009; PSI, 2015). The purpose of this paper is to capture the experience of LGB individuals within mental health services and examine if these guidelines are being adhered to. Design/methodology/approach This study is a meta-narrative synthesis of 13 empirical papers, published between 1999 and 2019. Findings This study has found both negative and positive experiences of service users. The paper discusses major themes, implications for practice and directions for future research. Originality/value This is the first systematic review to look at the experiences of clients who have attended mental health services.

Inter-agency collaboration between mental health services and police in Queensland

2017 ◽  
Vol 25 (4) ◽  
pp. 399-402 ◽  
Author(s):  
Russ Scott ◽  
Tom Meehan
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Mental Health Services ◽  
Health Services ◽  
Future Research

Objective: The objective of this study was to consider the collaboration between mental health services and police in Queensland. Conclusion: Queensland has developed a number of initiatives for intervention and response to incidents involving police and persons with mental illness. Future research should focus on identifying interventions that promote effective resolution of incidents involving police.

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