scholarly journals Implementation of a medical education programme for addictions MDT members to improve knowledge and confidence in managing substance users with complex comorbidities

2020 ◽  
Vol 9 (4) ◽  
pp. e001112
Author(s):  
Marie Alexandra Edison ◽  
Bridget Browne ◽  
Jeffrey Fehler
Keyword(s):  
Mental Health ◽  
Early Detection ◽  
Workforce Development ◽  
Substance Misuse ◽  
Cost Effective ◽  
Education Programme ◽  
Holistic Care ◽  
Physical And Mental Health ◽  
Treatment Needs ◽  
Complex Needs

BackgroundPublic Health England (PHE) has highlighted a rising number of deaths due to addiction, and notable changes in patient profiles. Management is now frequently intertwined with medical comorbidities and polypharmacy, as the patient group presents with more complex needs. Early detection is vital to minimise harm. Mental health frequently needs treating in tandem, but ‘cross-referral’ services can fail to recognise or meet these needs. A cohesive, confident multidisciplinary team (MDT) is vital for holistic care and accelerating recovery in cost-effective ways. Furthermore, MDTs are uniquely placed to effectively broker communications between multiple care inputs.MethodsMDT members of an addictions centre participated in a three-and-a-half-months education programme, encompassing eight PHE-recommended topics. These related to physical and mental health substance misuse sequelae, and specific population treatment needs.ResultsThere was a statistically significant improvement in all areas including: recognising early physical and/or mental health deterioration signs, providing basic health advice and appropriate escalation. Regarding PHE topics, biggest mean improvements were in managing substance misuse with physical comorbidities and pregnancy (38.2% and 35.9% respectively, p<0.0001). Additionally, biological mechanisms increased 26.0%, physical health consequences 24.2%, hepatic disorders 31.7%, older people 31.3%, homeless populations 31.8% and coexisting mental health 24.6% (all p≦0.002). Confidence communicating concerns to internal and external clinicians also increased (14% and 21%, respectively, p≦0.001).ConclusionA teaching programme improved MDT knowledge and confidence in early detection, escalation and communication of physical and mental comorbidities associated with substance misuse. This intervention should support harm reduction strategies on individual and wider-community levels. Introducing an education programme ensures a sustainable approach to workforce development and helps facilitate holistic care cost-effectively. Clear communication between multiple ‘cross-referral’ services involved with complex needs is essential for comprehensive integrated care.

scholarly journals Guided Self-help Teletherapy for Behavioural Difficulties in Children with Epilepsy

2021 ◽  
Author(s):  
Sophie Bennett ◽  
Isobel Heyman ◽  
Sophia Varadkar ◽  
Anna Coughtrey ◽  
Fahreen Walji ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Mental Health ◽  
Unmet Need ◽  
Hospital Setting ◽  
Physical And Mental Health ◽  
Paediatric Hospital ◽  
Complex Needs ◽  
Self Help ◽  
Behavioural Difficulties

AbstractBehavioural difficulties impact greatly upon quality of life for children with chronic illness and their families but are often not identified or adequately treated, possibly due to the separation of physical and mental health services. This case study describes the content and outcomes of guided self-help teletherapy for behavioural difficulties in a child with epilepsy and complex needs using an evidence-based behavioural parenting protocol delivered within a paediatric hospital setting. Behavioural difficulties and progress towards the family’s self-identified goals were monitored at each session. Validated measures of mental health and quality of life in children were completed before and after intervention and satisfaction was measured at the end of treatment. Measures demonstrated clear progress towards the family’s goals and reduction in weekly ratings of behavioural difficulties. This case demonstrates that a guided self-help teletherapy approach delivered from within the paediatric setting may be one way of meeting unmet need.

scholarly journals A capability framework to develop leadership for evidence-informed therapies in publicly-funded mental health services

2017 ◽  
Vol 13 (3) ◽  
pp. 151-165 ◽  
Author(s):  
Geoffrey Lau ◽  
Pamela Meredith ◽  
Sally Bennett ◽  
David Crompton ◽  
Frances Dark
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Workforce Development ◽  
Cost Effective ◽  
Publicly Funded ◽  
Standard Case ◽  
Content Type ◽  
Management Roles ◽  
Standard Case Management

Purpose It is difficult to replicate evidence-informed models of psychosocial and assertive care interventions in non-research settings, and means to determine workforce capability for psychosocial therapies have not been readily available. The purpose of this paper is to describe and provide a rationale for the Therapy Capability Framework (TCF) which aims to enhance access to, and quality of, evidence-informed practice for consumers of mental health services (MHSs) by strengthening workforce capabilities and leadership for psychosocial therapies. Design/methodology/approach Guided by literature regarding the inadequacies and inconsistencies of evidence-informed practice provided by publicly-funded MHSs, this descriptive paper details the TCF and its application to enhance leadership and provision of evidence-informed psychosocial therapies within multi-disciplinary teams. Findings The TCF affords both individual and strategic workforce development opportunities. Applying the TCF as a service-wide workforce strategy may assist publicly-funded mental health leaders, and other speciality health services, establish a culture that values leadership, efficiency, and evidence-informed practice. Originality/value This paper introduces the TCF as an innovation to assist publicly-funded mental health leaders to transform standard case management roles to provide more evidence-informed psychosocial therapies. This may have clinical and cost-effective outcomes for public MHSs, the consumers, carers, and family members.

What can be done to improve outcomes for prisoners with a dual diagnosis?

2016 ◽  
Vol 9 (1) ◽  
pp. 14-25 ◽  
Author(s):  
Hattie Catherine Ann Moyes ◽  
Joshua James Heath ◽  
Lucy Victoria Dean
Keyword(s):  
Mental Health ◽  
Dual Diagnosis ◽  
Substance Misuse ◽  
Service Providers ◽  
Female Gender ◽  
Integrated Treatment ◽  
International Studies ◽  
Treatment Needs ◽  
Content Type ◽  
Practical Implications

Purpose – The purpose of this paper is to review the literature on offenders with a dual diagnosis and discuss how prison-based services can improve to better meet the needs of prisoners with co-occurring substance misuse and mental health disorders. Design/methodology/approach – A comprehensive literature search of PsycINFO, JSTOR, PubMed and Google Scholar, reviewing international studies on dual diagnosis amongst offender and community samples spanning the last three decades, supplemented by international policy, guidance papers and reports was conducted to explore how services can be improved. Findings – It was found that research into dual diagnosis amongst prisoners internationally was scarce. However, from the evidence available, several consistent factors emerged that led to the following recommendations: integrated treatment needs to be coordinated and holistic, staged and gender-responsive; increased availability of “low level”, flexible interventions; transitional support and continuity of care upon release with the utilisation of peer mentors; comprehensive assessments in conducive settings; mandatory dual diagnosis training for staff; and increased funding for female/gender-responsive services. Practical implications – The recommendations can inform commissioners, funders and service providers of areas where support must be improved to address the needs of prisoners with a dual diagnosis. Social implications – Improved outcomes for prisoners with a dual diagnosis would likely have a positive effect on society, with improvements in mental health and substance misuse treatment impacting on rates of reoffending. Originality/value – This paper brings originality and value to the sector because it reviews relevant research on dual diagnosis and translates it into practical implications for policy makers.

scholarly journals Quantitative Study of Individual Creative Caregiving Sessions on Well-Being of Caregivers and Care Recipients

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 74-75
Author(s):  
Felicia Wheaton ◽  
Safiyyah Cole ◽  
Sai Raj Kappari ◽  
Matilda Johnson
Keyword(s):  
Mental Health ◽  
Mental Health Problems ◽  
Cost Effective ◽  
Well Being ◽  
The United States ◽  
Physical And Mental Health ◽  
Paired Samples ◽  
The Arts ◽  
Care Partners ◽  
Arts Programs

Abstract There were approximately 34.2 million unpaid caregivers of adults age 50+ in the United States in the last 12 months (NAC & AARP, 2015). These individuals provide important care for older adults with physical, psychological and cognitive problems. There is a growing awareness that caregivers are also at risk for physical and mental health problems and therefore also require support to reduce stress and maintain optimal health. Research suggests that engaging in creative and artistic activities may reduce stress and improve physical and mental health among caregivers. Researchers from Bethune-Cookman University partnered with the Atlantic Center for the Arts in New Smyrna Beach, FL to evaluate their Creative Caregiving program. Approximately 10 informal caregivers and their care partners met for 2 hours each week over the course of 6 weeks from February 3-March 9, 2020. Participants learned how to connect mind, body and spirit by using the arts as a tool of self-care, social interaction, and learning. At each session, participants were asked to rate their overall wellbeing on a scale from 1-10. Pre- and post-session data was analyzed using paired samples t-tests. Results indicate that there was significant improvement in wellbeing and participants reported improvements in their stress, mood and relationship with their caregiver or care partner. These findings were observed for both caregivers and care partners, suggesting that arts programs can benefit both. Such programs are a fun and cost-effective way to improve wellbeing, at least in the short-term.

An Interpretive Phenomenological Analysis Of Physiotherapy In Mental Health: Exploring Barriers And Facilitators To Care

2019 ◽  
Vol 26 (6) ◽  
pp. 8-8
Author(s):  
Laura Hemmings
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Physical Health ◽  
Patient Activation ◽  
Case Analysis ◽  
Phenomenological Analysis ◽  
Holistic Care ◽  
Service Users ◽  
Physical And Mental Health ◽  
Physical Health Care

Background/Aims Current literature identifies decreased life expectancy and increased physical health complaints for service users with mental health diagnosis. However, research also highlights increased challenges for this population when accessing physical health care services. Physiotherapy is one such service shown to be of benefit for those with co-morbid physical and mental health needs. However, research is currently lacking on experiences and access to physiotherapy for this population. This study aimed to explore lived experiences of physiotherapeutic care for those with co-morbid physical and mental health complaint and identify barriers and facilitators for those attempting to access this service. Methods Semi-structured interviews were carried out with service users (n=8) with long-standing physiotherapeutic and severe and enduring psychiatric complaints. Focus groups were completed with physiotherapists working within the field of mental health care. Verbatim transcripts of the interviews and focus groups were analysed using Interpretive Phenomenological Analysis in order to obtain in depth insight into participant experiences. The study was designed to enhance quality through use of methodological and investigator triangulation, negative case analysis, reflexivity, secondary coding and a clear audit trail. Results Data was analysed systematically following the structure: individual case analysis, emergence of themes, cross case analysis, validation of themes and ideas. This analysis produced five master themes: (1) Communication with health care provider; (2) holistic care from physiotherapist; (3) perceived benefit of physiotherapy; (4) health care politics and interaction between services; (5) patient activation and motivation to comply with physiotherapy. These factors were seen to be of high importance for patient experience and, when lacking, were identified as barriers to quality physiotherapeutic care. Conclusions Results were found to be consistent with current literature around physical health care. This study identifies the need for greater integrated care between physical and mental health services and improved awareness of mental health and use of the biopsychosocial model within physiotherapy practice in order to promote holistic care. Results also highlight the need for positive experience of physiotherapy for those with severe mental illness in order to increase patient activation and motivation to attend and comply with services.

scholarly journals Evaluation of a Culturally Adapted Training in Indigenous Mental Health and Wellbeing for the Alcohol and Other Drug Workforce

2012 ◽  
Vol 2012 ◽  
pp. 1-6 ◽  
Author(s):  
Rachael Hinton ◽  
Tricia Nagel
Keyword(s):  
Mental Health ◽  
Substance Misuse ◽  
Indigenous Australians ◽  
Mental Health Training ◽  
Complex Needs ◽  
Health And Wellbeing ◽  
Client Group ◽  
Culturally Adapted ◽  
Health Promoting ◽  
Indigenous Mental Health

Indigenous Australians have high rates of mental illness comorbid with substance misuse. The complex needs of this client group create challenges for the alcohol and other drug (AOD) workforce. This paper describes the outcomes of an Indigenous-specific “Yarning about Mental Health” training for the AOD workforce to strengthen knowledge and skills in mental health approaches and in their engagement with Indigenous clients. The training provides culturally adapted strategies and tools for understanding mental health, promoting wellbeing, and delivering brief interventions in the substance misuse setting. A nonexperimental evaluation which incorporated pre-post questionnaires was conducted with workshop participants attending one of four trainings. The training was perceived to be highly appropriate and helpful in participants’ work with Indigenous AOD clients. There was significant improvement in confidence and knowledge related to Indigenous mental health and wellbeing and qualitative data supported these positive outcomes. This study supports the need to blend Indigenous concepts of health and wellbeing with non-Indigenous ways of understanding and treating illness in order to develop services which are appropriate to Indigenous peoples. It also suggests research is required to understand whether self-reported increases in knowledge and confidence can translate into behavioural changes in participants' teaching and practice of culturally competent care and to improved client outcomes.

scholarly journals Health care needs among recently arrived refugees in Germany: a cross-sectional, epidemiological study

2020 ◽  
Vol 65 (6) ◽  
pp. 811-821 ◽  
Author(s):  
Yuriy Nesterko ◽  
David Jäckle ◽  
Michael Friedrich ◽  
Laura Holzapfel ◽  
Heide Glaesmer
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Physical And Mental Health ◽  
Treatment Needs ◽  
Mental Health Symptoms ◽  
Care Needs ◽  
Cross Sectional ◽  
Health Treatment ◽  
Health Symptoms ◽  
Health Related

Abstract Objectives The purpose of the present study is to investigate current needs for physical and/or mental health treatment in recently arrived refugees’ by considering socio-demographic, flight, and mental health-related characteristics as well as different social care needs based on epidemiological data. Methods The study was conducted in a reception facility for asylum-seekers in Leipzig, where 569 newly arrived adult residents participated. The questionnaire included socio-demographic and flight-related questions as well as standardized instruments for assessing mental health symptoms. Logistic regression models were conducted to predict current needs for treatment of self-rated physical and mental health status. Results Greater numbers of traumatic events, positive screening results for at least one mental disorder, and a current need for assistance navigating the health care system were found to be significant predictors for current mental and physical health treatment needs. In addition, males are more likely to report current treatment needs for mental health symptoms. Conclusions Health-related characteristics do predict newly arrived refugees’ treatment needs, and socio-demographic and flight-related characteristics do not. The results provide both academia and policy makers with first implications for improving health care for refugees in need as quickly as possible.

Substance Misuse Psychiatry

2014 ◽  
Author(s):  
Greg Lydall ◽  
Kelly Clarke
Keyword(s):  
Mental Health ◽  
Substance Use ◽  
Dual Diagnosis ◽  
Illicit Drugs ◽  
Substance Misuse ◽  
Crack Cocaine ◽  
Physical Illness ◽  
Physical And Mental Health ◽  
Risky Behaviour ◽  
Social Ability

Clinicians in all areas of medicine are likely to encounter people with substance misuse issues, so an understanding of the key issues is essen­tial. Human beings have used intoxicating substances, such as alcohol, nicotine, cannabis, and heroin, for millennia. Motivations might include experimentation, pleasure, social enhancement, or for physical or psy­chological pain management. Some people who use these legal and illegal substances experience problems related to their use, including loss of control, adverse consequences, withdrawals or cravings, damaged end organs, risky behaviour, and premature death. Substance misuse impacts not only on individual physical and mental health but also upon families and wider society by increased healthcare, criminal justice, social ser­vices, and unemployment costs. Drug and alcohol problems affect between 10% and 25% of the popu­lation each year, and up to 35% of people have ever used illicit drugs. Alcohol, an intoxicating sedative, is the most commonly used drug, with 25% of the UK population drinking above ‘low-risk’ limits. In England in 2010 there were an estimated 300 000 opiate, crack-cocaine, and inject­ing drug users, and only half were in treatment. Substance misuse is commonly associated with physical and mental health co-morbidity. The prevalence of co-existing mental health and substance use problems (termed ‘dual diagnosis’) may affect between 30% and 70% of those presenting to healthcare and social care settings. In general, four interrelationships in dual diagnosis are recognized: • substance use leading to social problems and psychological symptoms not amounting to a diagnosis • substance use leading to social dysfunction and secondary psychiatric and physical illness • substance use exacerbating an existing mental or physical health prob­lem and associated social functioning • primary psychiatric illness precipitating substance misuse which may also be associated with physical illness and affect social ability. Given the array of substance misuse problems, an individual treat­ment approach is essential and may involve psychological, pharmaco­logical, and social intervention. An empathic, non-judgemental clinical approach is essential to engage people with substance misuse problems. Motivational interviewing is an evidence-based talking therapy to help people in denial about their problems make changes for themselves and avoids imposing change prematurely.

scholarly journals CORONAVIRUS DISEASE-19: A HOLISTIC PERSPECTIVE

2021 ◽  
pp. 3-9
Author(s):  
POOJA RAJ ◽  
KIRTI BHATI ◽  
RAVINDRA PATWARDHAN
Keyword(s):  
Mental Health ◽  
Health Professionals ◽  
Antiretroviral Treatment ◽  
Dominant Role ◽  
Holistic Approach ◽  
Holistic Care ◽  
Physical And Mental Health ◽  
Traditional System ◽  
Proper Balance

Even when the predictions of effective specific antiretroviral treatment improved after 1996, many scientists and health professionals stayed committed to a dominant role of prevention over treatment and care. With the growing need for vaccines and safer drugs, greater attention is now toward the traditional system of medicine. Charak Samhita explains epidemics and its etiological factor in Janapadodhwamsa Adhyay of Vimansthan 3. Ayurveda and Yoga have immersed to have great combat with coronavirus disease (COVID-19) to maintain your overall health. The present study is aimed to get, a holistic approach that suggests a preventive approach and strengthening of Bala and Oja. Ayurveda and Yoga give importance to physical immunity and also psychological immunity as well. By following Rasayan, Sadvritta, Acharasayan, Astanga Yoga and Satvik Karma one manages a proper balance and Tridosha along with physical and mental health. There is a need to explore the holistic care modules stated in different Ayurvedic classical texts and Yoga for COVID-19.

scholarly journals Advocacy for Teaching Mindfulness Practices and World Religions in Public Schools

2021 ◽  
Vol 2 (1) ◽  
Author(s):  
Trung Huynh
Keyword(s):  
Mental Health ◽  
Public Schools ◽  
Old Testament ◽  
Cost Effective ◽  
Well Being ◽  
Physical And Mental Health ◽  
World Religions ◽  
The New Testament ◽  
Mindfulness Practices ◽  
K 12

People from various walks of life, professions, and traditions, including Christians, have been implementing mindfulness practices as cost-effective tools to deal with physical and mental health issues. Notably, numerous studies have demonstrated that mindfulness training has brought tremendous benefits to K-12 students physiologically and psychologically. As a result, this training should be implemented in public schools for the sake of our children’s well-being, behavior, mental health, and educational success. Some states, such as Texas and Kentucky, have granted the Christian Bible priority in teaching the New Testament and Old Testament while excluding other traditions and sacred texts. This precedent, however, violated the First Amendment. Instead, public schools should provide teachers proper training and knowledge to teach their students broader perspectives on world religions, including Western and Eastern traditions, in this modern globalized era.

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