Advancing Mental Health and Primary Care collaboration in the Public Sector

1999 ◽  
Vol 50 (7) ◽  
pp. 979c-979
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Public Sector ◽  
The Public

scholarly journals Long-term effectiveness of elderly health care voucher scheme strategies: a system dynamics simulation analysis

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Ka Chun Chong ◽  
Hong Fung ◽  
Carrie Ho Kwan Yam ◽  
Patsy Yuen Kwan Chau ◽  
Tsz Yu Chow ◽  
...  
Keyword(s):  
Primary Care ◽  
Chronic Disease ◽  
Public Sector ◽  
System Dynamics ◽  
The Elderly ◽  
Healthcare Services ◽  
Dynamics Simulation ◽  
Public And Private ◽  
The Public ◽  
The Impact

Abstract Background The elderly healthcare voucher (EHCV) scheme is expected to lead to an increase in the number of elderly people selecting private primary healthcare services and reduce reliance on the public sector in Hong Kong. However, studies thus far have reported that this scheme has not received satisfactory responses. In this study, we examined changes in the ratio of visits between public and private doctors in primary care (to measure reliance on the public sector) for different strategic scenarios in the EHCV scheme. Methods Based on comments from an expert panel, a system dynamics model was formulated to simulate the impact of various enhanced strategies in the scheme: increasing voucher amounts, lowering the age eligibility, and designating vouchers for chronic conditions follow-up. Data and statistics for the model calibration were collected from various sources. Results The simulation results show that the current EHCV scheme is unable to reduce the utilization of public healthcare services, as well as the ratio of visits between public and private primary care among the local aging population. When comparing three different tested scenarios, even if the increase in the annual voucher amount could be maintained at the current pace or the age eligibility can be lowered to include those aged 60 years, the impact on shifts from public-to-private utilization were insignificant. The public-to-private ratio could only be marginally reduced from 0.74 to 0.64 in the first several years. Nevertheless, introducing a chronic disease-oriented voucher could result in a significant drop of 0.50 in the public-to-private ratio during the early implementation phase. However, the effect could not be maintained for an extended period. Conclusions Our findings will assist officials in improving the design of the EHCV scheme, within the wider context of promoting primary care among the elderly. We suggest that an additional chronic disease-oriented voucher can serve as an alternative strategy. The scheme must be redesigned to address more specific objectives or provide a separate voucher that promotes under-utilized healthcare services (e.g., preventive care), instead of services designed for unspecified reasons, which may lead to concerns regarding exploitation.

scholarly journals Burden of mental health disability in Kerala: A secondary time trend analysis from 2002 to 2018

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
J Joseph ◽  
H Sankar ◽  
D Nambiar
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Mental Retardation ◽  
Public Sector ◽  
Human Resources ◽  
Mental Health Disorders ◽  
The State ◽  
The Public ◽  
Health Infrastructure ◽  
Health Disorders

Abstract The fourth target of Sustainable Development Goal (SDG) 3 advocates for the promotion of mental health and wellbeing. The Indian state of Kerala is recognized for its gains in health and development but has substantial burden of mental health ailments. Historical analysis is vital to understand the pattern of mental health morbidity. The current study focusses on comparable estimates available from three largescale population-based surveys in India to explore trends in prevalence of mental health disorders over the years and map resources and infrastructure available for mental health care in Kerala. We undertook a secondary analysis of national demographic surveys from 2002 to 2018 which reported information on mental health and availability of health infrastructure and human resources. Data were collated and descriptive analyses were conducted. We compared the national and state level estimates over the years to study the trend in the prevalence of mental health disability. The prevalence of mental retardation and intellectual disability in Kerala increased from 194 per hundred thousand persons in 2002 to 300 per hundred thousand persons in 2018, two times higher to the national average. The prevalence of mental illness increased from 272 per hundred thousand people to 400 per hundred thousand people in sixteen years. The prevalence was higher among males (statistical significance was not indicated) in mental illness and mental retardation. 2018 data showed that the public sector had 0.01 hospitals and 5.53 beds per hundred thousand persons available for mental health treatment. Results showed a substantial increase in mental health illness over the 16-year study period that has affected males and females, as well as all social classes of the state. The current health infrastructure and human resources in the public sector of the state are inadequate to meet the current burden of the problem and to ensure universal access to care for its population. Key messages The trend in prevalence of mental health disorders in the state is increasing across the years. There is a mismatch between the extend of the problem and resources available in public sector.

Introduction

2020 ◽  
pp. 1-2
Keyword(s):  
Mental Health ◽  
Public Sector ◽  
Medical Humanities ◽  
Well Being ◽  
Early Career ◽  
Mental Health Clinics ◽  
Occupational Outcomes ◽  
The Public ◽  
Healthcare Settings ◽  
The Many

Physicians who choose to serve in public sector mental healthcare settings and physicians-in-training assigned to public sector mental health clinics may not be fully prepared for the many roles of the public and community psychiatrist. This primer offers practical information and guidance to the psychiatrist called upon to serve in the roles of public-sector clinician, team member, advocate, administrator, and academician. Each chapter includes a concise description of these various roles and responsibilities and offers engaging examples of the public psychiatrist at work. The chapters also ask readers to thoughtfully consider case-based problems typical of those faced by the public psychiatrist. Each chapter also features works of art and literature, usually from the public domain. Medical humanities help physicians keep sight of the lived experiences of public-sector patients; this includes not only the pain and suffering endured by them due to both the medical disorders with which they live and the disparities they endure in health, educational and occupational outcomes, but also their resilience while facing so many challenges. Medical humanities also serve to reinforce the physician’s individual and collective will to address the disparities endured by our patients. There are several very comprehensive textbooks available that examine community psychiatry broadly. By contrast, this work is a concise guide for the resident and early-career psychiatrist to the many roles he or she might be asked to provide in a public-sector mental health setting. Our hope is that the primer provides a level of support to psychiatrists that fosters their desire, individually and collectively, to serve the poor and the marginalized with grit and determination, and to broadly consider their potential to improve not only patient well-being but also these patients’ incorporation into their communities.

Public and Community Psychiatry

2020 ◽  
Keyword(s):  
Mental Health ◽  
Public Sector ◽  
Medical Humanities ◽  
Community Psychiatry ◽  
Well Being ◽  
Early Career ◽  
The Public ◽  
Medical Disorders ◽  
The Many ◽  
Concise Guide

Physicians who choose to serve in public sector mental healthcare settings and physicians-in-training assigned to public sector mental health clinics may not be fully prepared for the many roles of the public and community psychiatrist. This primer offers practical information and guidance to the psychiatrist called upon to serve in the roles of public-sector clinician, team member, advocate, administrator, and academician. Each chapter includes a concise description of these various roles and responsibilities and offers engaging examples of the public psychiatrist at work. The chapters also ask readers to thoughtfully consider case-based problems typical of those faced by the public psychiatrist. Each chapter also features works of art and literature, usually from the public domain. Medical humanities help physicians keep sight of the lived experiences of public-sector patients; this includes not only the pain and suffering endured by them due to both the medical disorders with which they live and the disparities they endure in health, educational and occupational outcomes, but also their resilience while facing so many challenges. Medical humanities also serve to reinforce the physician’s individual and collective will to address the disparities endured by our patients. There are several very comprehensive textbooks available that examine community psychiatry broadly. By contrast, this work is a concise guide for the resident and early-career psychiatrist to the many roles he or she might be asked to provide in a public-sector mental health setting. Our hope is that the primer provides a level of support to psychiatrists that fosters their desire, individually and collectively, to serve the poor and the marginalized with grit and determination, and to broadly consider their potential to improve not only patient well-being but also these patients’ incorporation into their communities.

Managed Mental Health Care in the Public Sector: A Survival Manual

1998 ◽  
Vol 49 (6) ◽  
pp. 836-836
Author(s):  
Steven S. Sharfstein
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Public Sector ◽  
Mental Health Care ◽  
The Public

Managed mental health care in the public sector

1993 ◽  
Vol 1993 (59) ◽  
pp. 67-80 ◽  
Author(s):  
David Dangerfield ◽  
Rod L. Betit
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Public Sector ◽  
Mental Health Care ◽  
The Public

scholarly journals Trust local knowledge

2020 ◽  
Vol 16 (2) ◽  
Author(s):  
Sally Hett
Keyword(s):  
Mental Health ◽  
Public Sector ◽  
Young People ◽  
Local Knowledge ◽  
Social Impact ◽  
Risk Averse ◽  
The Public ◽  
The Social ◽  
The Government

I was excited. When I started working I was excited about the social impact mandate inherent in the public sector – how good! Then, as my work led me into the depths of the public sector’s limitations, I was swallowed by despair. As an advisor on the Government Inquiry into Mental Health and Addiction I was a sponge to the pain of the country. I heard the pain in young people, solo mothers, whänau, refugees of not being heard, seen or supported. The reality of slow, siloed, under-resourced and overly risk-averse agencies was undeniable.

scholarly journals Videoconferencing Psychotherapy in the Public Sector: Synthesis and Model for Implementation

10.2196/14996 ◽  
2020 ◽  
Vol 7 (1) ◽  
pp. e14996 ◽  
Author(s):  
Samuel David Muir ◽  
Kathleen de Boer ◽  
Neil Thomas ◽  
Elizabeth Seabrook ◽  
Maja Nedeljkovic ◽  
...  
Keyword(s):  
Mental Health ◽  
Public Sector ◽  
Mental Health Professionals ◽  
Service Providers ◽  
Lessons Learned ◽  
Unique Challenge ◽  
Implementation Challenges ◽  
The Public ◽  
Public Sector Organizations ◽  
The Military

Background Videoconferencing psychotherapy (VCP) is a growing practice among mental health professionals. Early adopters have predominantly been in private practice settings, and more recent adoption has occurred in larger organizations, such as the military. The implementation of VCP into larger health service providers in the public sector is an important step in reaching and helping vulnerable and at-risk individuals; however, several additional implementation challenges exist for public sector organizations. Objective The aim of this study was to offer an implementation model for effectively introducing VCP into public sector organizations. This model will also provide practical guidelines for planning and executing an embedded service trial to assess the effectiveness of the VCP modality once implemented. Methods An iterative search strategy was employed, drawing on multiple fields of research across mental health, information technology, and organizational psychology. Previous VCP implementation papers were considered in detail to provide a synthesis of the barriers, facilitators, and lessons learned from the implementation attempts in the military and other public sector settings. Results A model was formulated, which draws on change management for technology integration and considers the specific needs for VCP integration in larger organizations. A total of 6 phases were formulated and were further broken down into practical and measurable steps. The model explicitly considers the barriers often encountered in large organizational settings and suggests steps to increase facilitating factors. Conclusions Although the model proposed is time and resource intensive, it draws on a comprehensive understanding of larger organizational needs and the unique challenge that the introduction of VCP presents to such organizations.

The quality of care in outpatient primary care in public and private sectors in Malaysia

2019 ◽  
Author(s):  
May Chien Chin ◽  
Sheamini Sivasampu ◽  
Nilmini Wijemunige ◽  
Ravindra P Rannan-Eliya ◽  
Rifat Atun
Keyword(s):  
Primary Care ◽  
Public Sector ◽  
Private Sector ◽  
Clinical Care ◽  
Developed Countries ◽  
Prescribing Practices ◽  
Public And Private ◽  
The Public ◽  
The Usa

Abstract In Malaysia, first-contact, primary care is provided by parallel public and private sectors, which are completely separate in organization, financing and governance. As the country considers new approaches to financing, including using public schemes to pay for private care, it is crucial to examine the quality of clinical care in the two sectors to make informed decisions on public policy. This study intends to measure and compare the quality of clinical care between public and private primary care services in Malaysia and, to the extent possible, assess quality with the developed economies that Malaysia aspires to join. We carried out a retrospective analysis of the National Medical Care Survey 2014, a nationally representative survey of doctor–patient encounters in Malaysia. We assessed clinical quality for 27 587 patient encounters using data on 66 internationally validated quality indicators. Aggregate scores were constructed, and comparisons made between the public and private sectors. Overall, patients received the recommended care just over half the time (56.5%). The public sector performed better than the private sector, especially in the treatment of acute conditions, chronic conditions and in prescribing practices. Both sectors performed poorly in the indicators that are most resource intensive, suggesting that resource constraints limit overall quality. A comparison with 2003 data from the USA, suggests that performance in Malaysia was similar to that a decade earlier in the USA for common indicators. The public sector showed better performance in clinical care than the private sector, contrary to common perceptions in Malaysia and despite providing worse consumer quality. The overall quality of outpatient clinical care in Malaysia appears comparable to other developed countries, yet there are gaps in quality, such as in the management of hypertension, which should be tackled to improve overall health outcomes.

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