Who should be responsible for supporting individuals with mental health problems? A critical literature review

2018 ◽  
Vol 64 (3) ◽  
pp. 293-302 ◽  
Author(s):  
Megan A Pope ◽  
Ashok K Malla ◽  
Srividya N Iyer

Background: Individuals with mental health problems have many support needs that are often inadequately met; however, perceptions of who should be responsible for meeting these needs have been largely unexplored. Varying perceptions may influence whether, how, and to what extent relevant stakeholders support individuals with mental health problems. Aims: To critically evaluate the literature to determine who different stakeholders believe should be responsible for supporting individuals with mental health problems, what factors shape these perceptions, and how they relate to one another. Method: A critical literature review was undertaken. Following an extensive literature search, the conceptual contributions of relevant works were critically evaluated. A concept map was created to build a conceptual framework of the topic. Results: Views of individual versus societal responsibility for need provision and health; the morality of caring; and attributions of responsibility for mental illness offered valuable understandings of the review questions. Creating a concept map revealed that various interrelated factors may influence perceptions of responsibility. Conclusions: Varying perceptions of who should be responsible for supporting individuals with mental health problems may contribute to unmet support needs among this group. Our critical review helps build a much-needed conceptual framework of factors influencing perceptions of responsibility. Such a framework is essential as these views iteratively shape and reflect the complex divisions of mental healthcare roles and responsibilities. Understanding these perceptions can help define relevant stakeholders’ roles more clearly, which can improve mental health services and strengthen stakeholder accountability.

Author(s):  
Srividya N. Iyer ◽  
Ashok Malla ◽  
Megan Pope ◽  
Sally Mustafa ◽  
Greeshma Mohan ◽  
...  

Abstract Background Individuals with mental health problems have many insufficiently met support needs. Across sociocultural contexts, various parties (e.g., governments, families, persons with mental health problems) assume responsibility for meeting these needs. However, key stakeholders' opinions of the relative responsibilities of these parties for meeting support needs remain largely unexplored. This is a critical knowledge gap, as these perceptions may influence policy and caregiving decisions. Methods Patients with first-episode psychosis (n = 250), their family members (n = 228), and clinicians (n = 50) at two early intervention services in Chennai, India and Montreal, Canada were asked how much responsibility they thought the government versus persons with mental health problems; the government versus families; and families versus persons with mental health problems should bear for meeting seven support needs of persons with mental health problems (e.g., housing; help covering costs of substance use treatment; etc.). Two-way analyses of variance were conducted to examine differences in ratings of responsibility between sites (Chennai, Montreal); raters (patients, families, clinicians); and support needs. Results Across sites and raters, governments were held most responsible for meeting each support need and all needs together. Montreal raters assigned more responsibility to the government than did Chennai raters. Compared to those in Montreal, Chennai raters assigned more responsibility to families versus persons with mental health problems, except for the costs of substance use treatment. Family raters across sites assigned more responsibility to governments than did patient raters, and more responsibility to families versus persons with mental health problems than did patient and clinician raters. At both sites, governments were assigned less responsibility for addressing housing- and school/work reintegration-related needs compared to other needs. In Chennai, the government was seen as most responsible for stigma reduction and least for covering substance use services. Conclusions All stakeholders thought that governments should have substantial responsibility for meeting the needs of individuals with mental health problems, reinforcing calls for greater government investment in mental healthcare across contexts. The greater perceived responsibility of the government in Montreal and of families in Chennai may both reflect and influence differences in cultural norms and healthcare systems in India and Canada.


2020 ◽  
Author(s):  
Matthias Schützwohl

Background: People with an intellectual disability (ID) show a great number and complex constellation of support needs. With respect to the planning of services, it is important to assess needs at the population level. ID services need to know to what extent support needs of clients with mental health problems differ from support needs of clients without any mental health problem.Aims: The aim of this study was to compare the prevalence rates of needs in relevant study groups. Methods: Data was generated from the MEMENTA-Study (“Mental health care for adults with intellectual disability and a mental disorder”). The Camberwell Assessment of Need for Adults with Intellectual Disabilities (CANDID) was used to assess met und unmet support needs. Data was available for n=248 adults with mild to moderate ID.Results: Mean total number of needs and unmet needs was associated with mental health status. However, in most particular areas under study, individuals without significant psychiatric symptoms or any behaviour problem needed as much as often help as individuals with such mental health problems. A higher rate of need for care among study participants with significant psychiatric symptoms or any behaviour problem was mainly found with regard to these specific areas (“minor mental health problems”, “major mental health problems”, “inappropriate behaviour”) or with regard to closely related areas (“safety of others”).Conclusions: Differences in prevalence rates mainly occurred in such areas of need that rather fall under the responsibility of mental health services than under the responsibility of ID services. This has implications for service planning.


2021 ◽  
Vol 28 (1) ◽  
pp. 3
Author(s):  
Daniel Rogoža ◽  
Robertas Strumila ◽  
Eglė Klivickaitė ◽  
Edgaras Diržius ◽  
Neringa Čėnaitė

Background: Previous research suggests that healthcare professionals (HCPs) experience high levels of work-related psychological distress, including depressive symptoms. Due to the stigma of mental health problems and other barriers, HCPs are likely to be hesitant to seek appropriate mental healthcare. We aimed to explore these phenomena among HCPs in Lithuania.Methods: A web survey inquiring about depressive symptoms, help-seeking, and barriers to mental healthcare was conducted. Depressive symptoms were measured using the Patient Health Questionnaire-9 (PHQ-9). 601 complete questionnaires were included in the analyses. The barriers to help-seeking were identified using the inductive content analysis approach. Descriptive, non-parametric, and robust statistical analysis was performed using SPSS software.Results: Most of the respondents have reported depression-like symptoms over the lifetime, although only about a third of them sought professional help. Of those, roughly half preferred a private specialist. The stigma and neglect of mental health problems were the most common barriers to help-seeking. Around half of the HCPs believed that seeking mental healthcare can imperil their occupational license. About a quarter of the HCPs screened positive for clinically relevant depressive symptoms. Statistically significant differences in the PHQ-9 score were found between categories of healthcare specialty, marital status, religious beliefs, workplace, and years of work as a HCP. Fewer years of work and younger age were associated with the higher PHQ-9 score.Conclusions: Our findings suggest that HCPs in Lithuania may be inclined not to seek appropriate mental healthcare and experience poor mental health, although stronger evidence is needed to verify these findings. 


2020 ◽  
Vol 284 ◽  
pp. 112702
Author(s):  
Harriet Mills ◽  
Nadine Mulfinger ◽  
Sophie Raeder ◽  
Nicolas Rüsch ◽  
Henry Clements ◽  
...  

2018 ◽  
Vol 9 ◽  
pp. 110-133
Author(s):  
Anne Mari Steigen ◽  
Bengt Eriksson ◽  
Ragnfrid Eline Kogstad ◽  
Helge Prytz Toft ◽  
Daniel Bergh

Young adults with mental health problems who do not attend school or work constitute a significant welfare challenge in Norway. The welfare services available to these individuals include nature-based services, which are primarily located on farms and integrate the natural and agricultural environment into their daily activities. The aim of this study is to examine young adults (16–30 years old) not attending school or work who participated in nature-based services in Norway. In particular, the study analyses mental health problems among the participants and in-group variations regarding their symptoms of mental health problems using the Hopkins Symptoms Checklist (HSCL-10). This paper compares symptoms of mental health problems among participants in nature-based services with those of a sample from the general population and a sample of those receiving clinical in-patient mental healthcare. A questionnaire was developed for the study and was completed by 93 participants in nature-based services. The majority of these participants were recruited from the Norwegian Labour and Welfare Administration (NAV), local mental health services, and school authorities. Results indicate that just more than half of the respondents exhibited symptoms of mental health problems based on their HSCL-10 scores. In general, they reported fewer symptoms than the clinical in-patient sample (18–30 years old) and more symptoms than the general population sample (18–19 years old). Among the participants in nature-based services, those recruited through NAV and local mental health services exhibited no differences in symptoms. Half of the participants older than 23 years in nature-based services had not completed upper secondary school. The participants, including those with symptoms of mental health problems and low expectations at the outset of their participation, generally expressed high satisfaction with the services.


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