scholarly journals Remote mental health services: a mixed-methods survey and interview study on the use, value, benefits and challenges of a national video consulting service in NHS Wales, UK

BMJ Open ◽  
2021 ◽  
Vol 11 (9) ◽  
pp. e053014
Author(s):  
Gemma Johns ◽  
Anna Burhouse ◽  
Jacinta Tan ◽  
Oliver John ◽  
Sara Khalil ◽  
...  
Keyword(s):  
Mental Health ◽  
Mixed Methods ◽  
Mental Health Services ◽  
Health Service ◽  
Health Services ◽  
Health Service Delivery ◽  
Government Support ◽  
Use Value ◽  
Specific Data ◽  
Mental Health Service Delivery

Social distancing laws during the first year of the pandemic, and its unprecedented changes to the National Health Service (NHS) forced a large majority of services, especially mental health teams to deliver patient care remotely. For many, this approach was adopted out of necessity, rather than choice, thus presenting a true ‘testing ground’ for remote healthcare and a robust evaluation on a national and representative level.ObjectiveTo extract and analyse mental health specific data from a national dataset for 1 year (March 2020–March 2021).DesignA mixed-methods study using surveys and interviews.SettingIn NHS mental health services in Wales, UK.ParticipantsWith NHS patients and clinicians across child and adolescent, adult and older adult mental health services.Outcome measuresMixed methods data captured measures on use, value, benefits and challenges of video consulting (VC).ResultsA total of 3561 participants provided mental health specific data. These data and its findings demonstrate that remote mental health service delivery, via the method of VC is highly satisfactory, well-accepted and clinically suitable for many patients, and provides a range of benefits to NHS patients and clinicians. Interestingly, clinicians working from ‘home’ rated VC more positively compared with those at their ‘clinical base’.ConclusionsPost 1-year adoption, remote mental health services in Wales UK have demonstrated that VC is possible from both a technical and behavioural standpoint. Moving forward, we suggest clinical leaders and government support to sustain this approach ‘by default’ as an option for NHS appointments.

Examining Models of Mental Health Service Delivery in the Emergency Department

2007 ◽  
Vol 41 (10) ◽  
pp. 784-791 ◽  
Author(s):  
Timothy Wand ◽  
Kathryn White
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Emergency Department ◽  
Mental Health Service ◽  
Mental Health Services ◽  
Health Service ◽  
Health Services ◽  
Service Delivery ◽  
Health Service Delivery ◽  
Mental Health Service Delivery

The purpose of the present paper was to review the current models of mental health service delivery used in the emergency department (ED) setting. A search was conducted of the nursing and medical literature from 1990 to 2007 for relevant articles and reports. Consideration was also given to the global and local context influencing contemporary mental health services. Wider sociopolitical and socioeconomic influences and systemic changes in health-care delivery have dictated a considerable shift in attention for mental health services worldwide. The ED is a topical location that has attracted interest and necessitated a response. The mental health liaison nurse (MHLN) role embedded within the ED structure has demonstrated the most positive outcomes to date. This model aims to raise mental health awareness and address concerns over patient-focused outcomes such as reduced waiting times, therapeutic intervention and more efficient coordination of care and follow up for individuals presenting to the ED in psychological distress. Further research is required into all methods of mental health service delivery to the ED. The MHLN role is a cost-effective approach that has gained widespread approval from ED staff and mental health patients and is consistent with national and international expectations for mental health services to become fully integrated within general health care. The mental health nurse practitioner role situated within the ED represents a potentially promising alternative for enhanced public access to specialized mental health care.

scholarly journals Community mental health services in Pakistan: Review study from Muslim world 2000-2015

2018 ◽  
Vol 7 (1) ◽  
pp. 57-71 ◽  
Author(s):  
Tahir Mahmood Ali ◽  
Sana Gul
Keyword(s):  
Mental Health ◽  
Mental Health Service ◽  
Mental Health Services ◽  
Health Service ◽  
Health Services ◽  
Service Delivery ◽  
Health Workers ◽  
Religious Faith ◽  
Health Service Delivery ◽  
Mental Health Service Delivery

Aim This study attempted to analyse the potential of two primary sources of mental health service delivery at a grassroots level, religious/faith healers and community/lady health workers, and how they can be effectively used to deliver mental health services in a resource-scarce country like Pakistan. Method A literature review was carried out for relevant studies conducted in Muslim countries between 2000 to 2015 reporting empirical results. Using the inclusion criteria, thirteen studies were selected for the review. Results The presented studies suggest that the main proportion of mental health patients in countries with major Muslim population including Pakistan, visit religious/faith healers first for treatment, however all studies are silent about the outcomes through these healers. The only potential visible outcome of contacting religious/faith healers is the identification of mental health cases. However, community/lady health workers with minimal training appeared to be a beneficial source of mental health service delivery in communities. Conclusion In a resource scarce country like Pakistan, networking with religious/faith healers can be established for effective identification and referral of mental health cases whereas strong and already existing community/lady health workers system can be used as a first level to deliver mental health service at the doorstep.

scholarly journals Requirements of Mental Health Services During the COVID-19 Outbreak: A Systematic Review

2020 ◽  
Vol 26 (3 Special Issue on COVID-19) ◽  
pp. 264-279
Author(s):  
Mehrdad Kazemzadeh Atoofi ◽  
◽  
Nazila Rezaei ◽  
Farzad Kompani ◽  
Fatemeh Shirzad ◽  
...  
Keyword(s):  
Mental Health ◽  
Systematic Review ◽  
Mental Health Service ◽  
Mental Health Services ◽  
Health Service ◽  
Health Services ◽  
Service Delivery ◽  
Scientific Information ◽  
Health Service Delivery ◽  
Mental Health Service Delivery

Objectives: After the outbreak of a new viral disease in Wuhan, China, in late December 2019, COVID-19 in a very short time and rapidly became a global pandemic. Through a systematic review, the present paper investigated the requirements of Mental Health Services during the COVID-19 outbreak. Methods: A comprehensive search was conducted through PubMed and NLM Gateway (for MEDLINE), Institute of Scientific Information (ISI), and Scopus. PsychINFO and CINAHL data banks were also searched. The primary roots for the development of the search strategy developed based on the keywords of “Covid”, “mental health”, “care”, “services”. All relevant studies were included without any limitation of publication time or the papers’ language as it was not possible to conduct a formal systematic review given the nature of the publications. Instead, it was decided to conduct a mixed systematic and complementary narrative review covering different interested domains. Results: Out of 80 papers, after excluding duplications, 58 articles were selected for the refinement process. Three refining steps based on the titles, abstracts, and full texts led to data extraction from 4 eligible papers. Considering the importance of the problem, related findings, key points, and research findings were summarized and presented in terms of critical components of infrastructure and resources, including policy for at-risk groups, different approaches to mental health service delivery, indirect contexts for mental health service delivery, follow-up attitudes, and complementary research. The results of the study indicate that many studies considered the consequences of physical aspects and diagnostic symptoms. Thus, aspects of mental health have been either less focused or even neglected. In mental health consequences, immediate attention and intensive programs to assess mental health, preparation for support and treatment, and prevention services are emphasized. Conclusion: During the implementation of mental health interventions, to improve services and to consider the limitations and challenges of implementing programs, it is necessary to pay attention to the attitudes of target groups and their preference

scholarly journals What is the current level of mental health service delivery and expenditure on infants, children, adolescents, and young people in Australia?

2017 ◽  
Vol 52 (2) ◽  
pp. 163-172 ◽  
Author(s):  
Leonie Segal ◽  
Sophie Guy ◽  
Gareth Furber
Keyword(s):  
Mental Health ◽  
Mental Health Service ◽  
Mental Health Services ◽  
Young People ◽  
Health Service ◽  
Health Services ◽  
Government Expenditure ◽  
Health Service Delivery ◽  
Current Level ◽  
Mental Health Service Delivery

Objectives: The study aim was to estimate the current level of ambulatory mental health service delivery to young people aged 0–24 years in Australia and associated government expenditure. Recognising the importance of the early years for the development of mental illness and socioeconomic outcomes, we were particularly interested in service access by infants and young children. Methods: We extracted information from government administrative datasets on the number of people who received mental health services, number of services and expenditure through the health sector for 2014–2015. Results are primarily reported by age groups 0–4, 5–11, 12–17 and 18–24 years. Results: Less than 1% of 0- to 4-year-olds received a mental health service in any one service setting, whereas nearly 11% of 18- to 24-year-olds received a mental health service through the Medicare Benefits Schedule Better Access programme alone. Many more services were delivered to 12- to 24-year-olds (>4 million) than to 0- to 11-year-olds (552,000). Medicare Benefits Schedule Better Access delivers services to more children and youth than do state/territory community mental health services, although the latter provide more services per client. In 2013–2014, Australian Government expenditure on ambulatory mental health services for 0- to 24-year-olds was AUD428 million, similar to the AUD491 million spent by state/territory governments. Conclusion: The study provides a benchmark for data-driven service planning to ensure that the mental health needs of infants, children and young people are met. Our results indicate that the youngest age group are underserviced relative to need, even noting infants and children may receive services for behavioural/mental health issues from providers not captured in our study (such as paediatricians). The developmental origins of mental illness underlies the urgency of adequate provision by governments of perinatal, infant and child mental health services to avoid loss of life potential and reduce the pressures on the justice, child protection and welfare systems.

Mental Health Service Delivery to Older People in New South Wales: Perceptions of Aged Care, Adult Mental Health and Mental Health Services for Older People

2003 ◽  
Vol 37 (6) ◽  
pp. 735-740 ◽  
Author(s):  
Brian Draper ◽  
Tanya Jochelson ◽  
David Kitching ◽  
John Snowdon ◽  
Henry Brodaty ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Service Delivery ◽  
Older People ◽  
Health Service Delivery ◽  
Aged Care ◽  
Mental Health Service Delivery ◽  
Adult Mental Health ◽  
Care Services

Objective: To compare the perceptions of aged care services, adult mental health services and mental health services for older people regarding aspects of mental health service delivery for older people in New South Wales, Australia. Method: The NSW Branch of the Faculty of Psychiatry of Old Age in association with the NSW Centre for Mental Health, sent a postal survey to all aged care services, adult mental health services and mental health services for older people in NSW. The survey canvassed issues ranging across service profiles, regional variations, availability of resources, processes of care, views on working relationships between services, difficulties and gaps experienced, and ways to improve co-ordination and service delivery. Clinical issues such as the management and practice of psychiatric disorders of old age, educational/training requirements and skill and experience in working with older people were explored. Results: An overall response rate of 86% was achieved, including 95% from aged care services (n = 58), 74% from adult mental health services (n = 62) and 90% from mental health services for older people (n = 20). Only 59% of aged care services and adult mental health services considered that their local mental health services for older people provided an adequate service; resource and budget limitations were portrayed as the main constraint. Mental health services for older people varied widely in structure, settings and activities undertaken. Access to mental health beds for older people was also variable, and alongside staffing levels was considered problematic. Lack of staff training and/or inexperience in psychogeriatrics posed a challenge for aged care services and adult mental health services. Conclusion: Relationships between aged care services, adult mental health services and mental health services for older people are affected by lack of access to psychogeriatric staff, resource limitations of mental health services for older people, and inadequate liaison and support between the service types. Joint case conferences, education, increased funding of mental health services for older people, and cross referrals were considered ways to address these issues.

‘Maybe a Maverick, Maybe a Parent, but Definitely Not an Honorary Nurse’: Social Worker Perspectives on the Role and Nature of Social Work in Mental Health Care

2020 ◽  
Author(s):  
Laura Tucker ◽  
Martin Webber
Keyword(s):  
Mental Health ◽  
Social Work ◽  
Mental Health Services ◽  
Health Service ◽  
Health Services ◽  
Social Workers ◽  
Geographical Area ◽  
Health Service Delivery ◽  
Structured Interviews ◽  
The Uk

Abstract In many places in the UK, social work is integral to mental health service delivery. Significant role erosion, however, has left the profession unclear about where it fits within modern mental health services. The 2016 Social Work for Better Mental Health initiative outlines five key mental health roles and has been adopted into national policy in England to combat this uncertainty, but the influence of this has not been explored. This study aimed to develop an understanding of how mental health social workers perceive and explain their role. Semi-structured interviews were undertaken with seven social workers based within one English National Health Service mental health trust covering a large geographical area and their responses analysed using Ritchie, Spencer and O’Connor’s Framework thematic model. Findings indicated that social workers only superficially engaged with the aspirational policy roles, instead presenting their own framework for what makes mental health social work distinctive. This was constructed around the context and intentions of practice, rather than around proscribed tasks and responsibilities. This study has significance for individual social workers and for organisations providing and planning mental health services in the UK and beyond, given the influence that practitioner perceptions can have on how they undertake their roles.

scholarly journals Stakeholder perspectives on integration of mental health services into primary care: a mixed methods study in Northern Iraq

2019 ◽  
Vol 13 (1) ◽  
Author(s):  
Amanda J. Nguyen ◽  
Natalie Rykiel ◽  
Laura Murray ◽  
Ahmed Amin ◽  
Emily Haroz ◽  
...  
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Mixed Methods ◽  
Mental Health Services ◽  
Health Services ◽  
Mixed Methods Study ◽  
Working Environment ◽  
Government Support ◽  
Northern Iraq ◽  
Stakeholder Perspectives

Abstract Background Integrating evidence-based mental health services into primary care has been identified as one strategy for overcoming the treatment gap in low and middle-income countries, yet their uptake into standard practice remains poor. The purpose of this study was to understand stakeholder perspectives regarding barriers and facilitators to integration of mental health services into primary care settings in Northern Iraq. Methods Using a convergent mixed methods study design, quantitative and qualitative questionnaires assessed respondent perceptions of implementation factors under the domains of Autonomy, Acceptability, Appropriateness, Feasibility, Penetration/Accessibility, Sustainability, and Organizational Climate. We interviewed four types of stakeholders: clients, providers of mental health services, non-mental health (MH) staff working at the centers, and center directors. Interviews were conducted with clients at the completion of services, and with all other stakeholder groups in the latter half of the first year of program implementation, by Kurdish-speaking interviewer pairs. Qualitative and quantitative data were analyzed separately and merged using qualitative data transformation to quantify frequency of theme and integrate with quantitative findings through woven narrative. Results 123 clients, 26 providers, 40 non-MH staff, and 12 directors provided data. Positive perceptions of the program’s acceptability, appropriateness, feasibility, and positive impacts were reported across all stakeholder levels. Providers reported that the program length (8–12 sessions) was a challenge. Clients described logistical challenges (e.g.: transportation, childcare, home duties); support from family and friends appeared to be critical. Lack of private space, insufficient staffing, and need for greater government support were also important issues. Conclusions This mixed methods study is unique in its inclusion of non-MH staff and director perspectives on integration of mental health services in primary care clinics. Their inclusion proved vital since they included critical human resource barriers to feasibility. Providers reported generally positive integration experiences but that some colleagues (clinic staff not involved in mental health services) were unsupportive. Most non-MH staff were supportive, but some did report negative impacts on their working environment. Future studies of integration of mental health services into other service platforms should include the perspectives of stakeholders not involved in provision of mental health services.

"Are We There Yet?" - Consumer Participation in Mental Health Services

2006 ◽  
Vol 12 (1) ◽  
pp. 8 ◽  
Author(s):  
Graeme Browne ◽  
Mary Courtney
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Service Delivery ◽  
Mental Health Professionals ◽  
Health Professionals ◽  
Health Service Delivery ◽  
Consumer Participation ◽  
Mental Health Service Delivery ◽  
Community Attitudes

Public policy in Australia recommends that the relationship between consumers and mental health professionals should be one of equals and that consumers be encouraged to have input into service delivery at every level. This approach requires a significant change in attitude for mental health professionals and within services. Although consumer input into mental health service delivery has improved, there is still a long way to go. Unfortunately, consumers consider many of the efforts by mental health services to be tokenistic. This paper considers some of the issues regarding consumer participation, including the changing community attitudes towards people with a mental illness, the concept of recovery, challenges for health professionals and the impediments to consumer participation.

scholarly journals Access to mental health for Black youths in Alberta

2021 ◽  
Vol 41 (9) ◽  
pp. 245-253
Author(s):  
Bukola Salami ◽  
Benjamin Denga ◽  
Robyn Taylor ◽  
Nife Ajayi ◽  
Margot Jackson ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Health Service ◽  
Mental Health Services ◽  
Health Service ◽  
Health Services ◽  
Advisory Committee ◽  
Access To Health Care ◽  
Black Youth ◽  
Health Service Delivery ◽  
The Impact

Introduction The objective of this study was to examine the barriers that influence access to and use of mental health services by Black youths in Alberta. Methods We used a youth-led participatory action research (PAR) methodology within a youth empowerment model situated within intersectionality theory to understand access to health care for both Canadian-born and immigrant Black youth in Alberta. The research project was co-led by an advisory committee consisting of 10 youths who provided advice and tangible support to the research. Seven members of the advisory committee also collected data, co-facilitated conversation cafés, analyzed data and helped in the dissemination activities. We conducted in-depth individual interviews and held four conversation café-style focus groups with a total of 129 youth. During the conversation cafés, the youths took the lead in identifying issues of concern and in explaining the impact of these issues on their lives. Through rigorous data coding and thematic analysis as well as reflexivity and member checking we ensured our empirical findings were trustworthy. Results Our findings highlight key barriers that can limit access to and utilization of mental health services by Black youth, including a lack of cultural inclusion and safety, a lack of knowledge/information on mental health services, the cost of mental health services, geographical barriers, stigma and judgmentalism, and limits of resilience. Conclusion Findings confirm diverse/intersecting barriers that collectively perpetuate disproportional access to and uptake of mental health services by Black youths. The results of this study suggest health policy and practice stakeholders should consider the following recommendations to break down barriers: diversify the mental health service workforce; increase the availability and quality of mental health services in Black-dominated neighbourhoods; and embed anti-racist practices and intercultural competencies in mental health service delivery.

Inquiries Into Homicides and Serious Violence Perpetrated by Psychiatric Patients in New Zealand: Need for Consistency of Method and Result Analysis

2001 ◽  
Vol 35 (3) ◽  
pp. 364-369 ◽  
Author(s):  
Alexander I.F. Simpson ◽  
Stephen Allnutt ◽  
David Chaplow
Keyword(s):  
Mental Health ◽  
New Zealand ◽  
Mental Health Services ◽  
Health Services ◽  
Psychiatric Patients ◽  
Health Service Delivery ◽  
England And Wales ◽  
Mental Health Service Delivery ◽  
Violent Action ◽  
Result Analysis

Background: The violent action of mentally ill people is a source of considerable public and professional concern. At times such incidents are subject to inquiry. In England and Wales, homicides by people suffering from mental illness are subject to mandatory external inquiry. Further, the Royal College of Psychiatrists coordinates a confidential research study into homicide and suicide by people in contact with mental health services. Inquiries have raised concern regarding widespread problems in mental health service delivery. Within New Zealand, similar concerns have been raised, but inquiries have been irregular and not of consistent methodology. The paper aims to review 10 years of inquiries into violent incidents to describe their methods, structure and findings. Method: All inquiries into violent actions perpetrated by patients in contact with mental health services between 1988 and 1998 and held by the Ministry of Health were reviewed. The nature of the inquiry, the incident, findings and recommendations were summarized. For each inquiry, an assessment was made as to whether the incident was predictable or preventable. Results: There were 11 incidents leading to 13 inquiries, six of homicide, two of rape, one of the release of a dangerous patient and two in which a patient was shot by police. Two internal inquiries were followed by external inquiries. All inquiries found deficiencies of varying severity, the degree of deficiency being greater with external inquiries. Consistent criticisms related to skill, resource, coordination and communication failures. Two of the 11 inquiries found the incident to be ‘predictable’, and eight to have been ‘preventable’. Conclusions: The problems in New Zealand are similar to those noted in England and Wales. Small numbers of inquiries make firm conclusions difficult, but the authors feel that a mandatory process of independent review of serious incidents is wise.

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