peacebrief-no57-mental-health-services-during-and-after-armed-conflict-the-state-of-knowledge-and-practice-sept-28-2010

2017 ◽  
Vol 25 (5) ◽  
pp. 437-439
Author(s):  
Stephen Allison ◽  
Tarun Bastiampillai ◽  
Malcolm Battersby

Objective: Psychiatry faces urgent problems requiring united action. These problems affect academic psychiatrists in the universities, and clinicians in publicly funded mental health services. Academic units are isolated and endangered, finding it difficult to recruit. They could benefit from closer relationships with public mental health services, in terms of recruitment, shared teaching and clinical research. However, mental health services are preoccupied with their own problems, particularly in relation to acute clinical demand. How can we stand together to improve academic units and clinical psychiatry? Conclusions: Clinicians and academic psychiatrists can stand together on important matters, but it takes initiatives from local leaders to overcome the structural barriers between health services and the universities. An example is given of united action by clinicians and academic psychiatrists to address a crisis within a state mental health system. First, psychiatrists undertook independent health services research that compared the state system with those in other Australian and international jurisdictions. The comparative data was used to generate solutions, which were presented at every level from ministerial offices through to service managers. Finally, psychiatrists took up joint academic and clinical leadership roles in the university and the mental health system. This united research-led approach turned around the crisis in the state mental health system.


2021 ◽  
Author(s):  
Precious Anyanwu ◽  
Tyler J Varisco ◽  
Matthew A. Wanat ◽  
Shweta Bapat ◽  
Kasey Claborn ◽  
...  

Abstract: Aims: To compare county-level differences in the number of buprenorphine prescribers listed in the publicly available Substance Abuse and Mental Health Services Administration (SAMHSA) Buprenorphine Practitioner Locator and in the Drug Enforcement Administration’s (DEA) Controlled Substance Act (CSA) database and to determine if disparities in access exist in poorer areas with more non-white residents. Design: Cross-sectional study Setting: TexasMeasurements: County-level counts of buprenorphine prescribers were calculated from both the publicly available SAMHSA buprenorphine practitioner locator list and the DEA CSA database. These were then used to estimate the number of providers per 100,000 residents in each county. Regional variation in access to buprenorphine was compared descriptively across the state using poverty data from the US Census and county-level demography from the Texas Demographic Center. Results: This study found 68.8% more X-waivered providers on the DEA CSA database (n=2,622) with at least one provider reported in 125 of 144 counties in the state (49.2%) compared to the SAMHSA Buprenorphine Practitioner Locator (n=1,553) with at least one provider reported in 103 counties (40.5%). This difference was magnified in Texas Public Health Region 11. This is the poorest region of the state (23.7% of residents below the federal poverty line) and contains the most non-white residents 87.4% vs 54.9% (SD: 13.6%). This region had the lowest number of buprenorphine prescribers with 3.8 providers per 100,000 on the DEA CSA database and 2.5 providers per 100,000 in the SAMHSA Buprenorphine Practitioner Locator.Conclusions: The lack of a complete, public registry of buprenorphine prescribers makes it difficult for patients to identify a convenient buprenorphine prescriber and for referring physicians to help their patients access care. This may be especially true in poorer and more diverse areas with fewer buprenorphine prescribers.


2002 ◽  
Vol 10 (2) ◽  
pp. 166-167 ◽  
Author(s):  
John Gleisner

Objective: To describe the state of mental health services in Zambia. Conclusions: Mental health services in Zambia are in a dreadful state, partly brought about by being afforded a low priority rating, in turn through a miscalculation. Richer countries may be in a position to help remedy Zambia's problems in this area.


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