scholarly journals Taking steps towards deinstitutionalizing mental health care within a low and middle-income country: A cross-sectional study of service user needs in the Republic of Moldova

2019 ◽  
Vol 66 (1) ◽  
pp. 49-57
Author(s):  
Jona J Frasch ◽  
Ionela Petrea ◽  
Jana Chihai ◽  
Filip Smit ◽  
Matthijs Oud ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Unmet Needs ◽  
Service Users ◽  
Republic Of Moldova ◽  
Level Of Functioning ◽  
The Republic

Aim: The current research was conducted in the context of an ongoing reform of mental health services in the Republic of Moldova since 2014, where efforts have been devoted to creating community-based mental health services. This article presents a snapshot of the needs of mental health service users in the Republic of Moldova and helps to understand how and with which services their needs can be addressed. Methods: This cross-sectional study compared the levels of needs (CANSAS scale), quality of life (EQ-5D 3L), mental health status (MINI for psychotic disorders) and functioning (WHO-DAS) among mental health service users in the psychiatric hospital in Chisinau, Moldova. All service users resided in districts where community mental health services were being developed. Correlations between quality of life, functioning and unmet need were explored. Results: Of 83 participants, one third had a psychotic or a mood disorder. On average, participants reported needs in 9.41 domains ( SD = 4.41), of which 4.29 were unmet ( SD = 3.63). Most unmet needs related to intimacy and relation to others. The level of functioning and quality of life were reported. We found strong, negative associations between the number of unmet needs and level of functioning, as well as the quality of life. We also found that higher functioning levels were positively associated with higher quality of life. Conclusion: There were a high number of unmet needs among this inpatient population, particularly social needs and service-related needs. A continuum of inpatient and outpatient care and individual treatment plans can help address the different needs of different patients. Individual treatment plans for patients and the choice of the appropriate treatment for patients could be guided by an assessment of service users’ (unmet) needs of care and level of functioning.

Psychotic Disorders in Urban Areas: An Overview of the Study on Low Prevalence Disorders

2000 ◽  
Vol 34 (2) ◽  
pp. 221-236 ◽  
Author(s):  
Assen Jablensky ◽  
John McGrath ◽  
Helen Herrman ◽  
David Castle ◽  
Oye Gureje ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Urban Areas ◽  
Psychotic Disorders ◽  
Functional Impairments ◽  
Personal Functioning ◽  
Low Prevalence

Objective: This paper reports on a study designed within the framework of the National Survey of Mental Health and Wellbeing to: estimate the prevalence of psychoses in urban areas of Australia; identify profiles of symptomatology, impairments and disabilities; collect information on services received and needed; and explore quality of life issues in a broadly representative sample of people with psychotic illnesses. Method: The study was conducted over four areas in the Australian Capital Territory, Queensland, Victoria and Western Australia, as a two-phase survey: (i) a census and screening for psychosis of all individuals who made contacts with mental health services during a period of 1 month in 1997; and (ii) interviews with a stratified random sample (n = 980) of the screen-positive individuals (n = 3800) using a standardised instrument. Results: The point prevalence (1 month) of psychotic disorders in the urban population aged 18–64 is in the range of 4–7 per 1000 with a weighted mean of 4.7 per 1000. People with psychotic disorders experience high rates of functional impairments and disability, decreased quality of life, persistent symptoms, substance-use comorbidity and frequent side effects of medication. Although the utilisation of hospital-based and community mental health services, as well as of public and non-governmental helping agencies, is high, the majority live in extreme social isolation and adverse socioeconomic circumstances. Among the many unmet needs, the limited availability of community-based rehabilitation, supported accommodation and employment opportunities is particularly prominent. Conclusions: The so-called ‘low-prevalence’ psychotic disorders represent a major and complex public health problem, associated with heavy personal and social costs. There is a need for a broad programmatic approach, involving various sectors of the community, to tackle the multiple dimensions of clinical disorder, personal functioning and socioeconomic environment that influence the course and outcome of psychosis and ultimately determine the effectiveness of service-based intervention.

Quality of Life and Mental Health Services

2005 ◽  
Author(s):  
Keith Bridges ◽  
Dr Peter Huxley ◽  
Peter Huxley ◽  
Hadi Mohamad ◽  
Joseph Oliver
Keyword(s):  
Quality Of Life ◽  
Mental Health ◽  
Mental Health Services ◽  
Health Services

The Quality of Life Inventory: Its Utility as an Assessment and Treatment Planning Tool in a Psychiatric Setting

1997 ◽  
Vol 5 (4) ◽  
pp. 170-172
Author(s):  
Malcolm Hugo
Keyword(s):  
Quality Of Life ◽  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Treatment Planning ◽  
Well Being ◽  
Relevant Information ◽  
Service Evaluation ◽  
Subjective Well Being

Interest in assessing the quality of life of individuals with severe psychiatric disorders has grown within recent years [1,2,3]. The anticipation of quality of life research is that it will provide relevant information to assist in treatment planning and service evaluation. Increasingly, the goal of mental health services is to improve sufferers' quality of life as well as effecting biological interventions and ameliorating illness symptoms [4]. Subjective well-being and quality of life constitute the ultimate humanitarian goals for services to severely mentally disordered adults. Mental health services also endeavour to be reflective of the needs of sufferers and their families by eliciting information from service consumers and involving them in therapeutic decision making. Life satisfaction assessments offer a means for sufferers to express how they perceive their well-being, what they value as important and what they want.

scholarly journals Use of Mental Health Services for Patients Diagnosed with Major Depressive Disorders in Primary Care

2021 ◽  
Vol 18 (3) ◽  
pp. 885
Author(s):  
Laura González-Suñer ◽  
Cristina Carbonell-Duacastella ◽  
Ignacio Aznar-Lou ◽  
Maria Rubio-Valera ◽  
Maria Iglesias-González ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Mental Health ◽  
Primary Care ◽  
Mental Health Services ◽  
Health Services ◽  
Depressive Disorders ◽  
Mental Healthcare ◽  
Major Depressive ◽  
Use Of Services

Major depressive disorder (MDD) is one of the most disabling diseases worldwide, generating high use of health services. Previous studies have shown that Mental Health Services (MHS) use is associated with patient and Family Physician (FP) factors. The aim of this study was to investigate MHS use in a naturalistic sample of MDD outpatients and the factors influencing use of services in specialized psychiatric care, to know the natural mental healthcare pathway. Non-randomized clinical trial including newly depressed Primary Care (PC) patients (n = 263) with a 12-month follow-up (from 2013 to 2015). Patient sociodemographic variables were assessed along with clinical variables (mental disorder diagnosis, severity of depression or anxiety, quality of life, disability, beliefs about illness and medication). FP (n = 53) variables were also evaluated. A multilevel logistic regression analysis was performed to assess factors associated with public or private MHS use. Subjects were clustered by FP. Having previously used MHS was associated with the use of MHS. The use of public MHS was associated with worse perception of quality of life. No other sociodemographic, clinical, nor FP variables were associated with the use of MHS. Patient self-perception is a factor that influences the use of services, in addition to having used them before. This is in line with Value-Based Healthcare, which propose to put the focus on the patient, who is the one who must define which health outcomes are relevant to him.

scholarly journals The role of mental health symptomology and quality of life in predicting referrals to special child and adolescent mental health services

2021 ◽  
Author(s):  
Yeosun and Yoon ◽  
Jessica Deighton ◽  
Alice Wickersham ◽  
Julian Edbrooke-Childs ◽  
David Osborn ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Confidence Interval ◽  
Adolescent Mental Health ◽  
Child And Adolescent ◽  
Hazard Ratio ◽  
Adjusted Hazard Ratio

Abstract BackgroundChildren and adolescents’ mental health problems have been largely assessed with conventional symptom scales, for example, Strengths and Difficulties Questionnaire (SDQ) given that it is one of the mostly widely used measures in specialist Child and Adolescent Mental Health Services (CAMHS). However, this emphasis on symptom scales might have missed some important features of the mental health challenges that children and young people experience including day to day functioning and life satisfaction aspect (i.e. qualify of life).MethodThe study examined longitudinal association between a young person’s self-perceptions of quality of life and mental health difficulties and referral to specialist CAMHS service using a population cohort study (Targeted Mental Health in Schools service data) nested within a large-scale linkage between school (National Pupil Data base) and child mental health service administrative data (South London and Maudsley NHS Foundation Trust children and adolescent mental health services health records). Cox proportional hazard regression to estimate crude and adjusted hazard ratios (HRs) for the association between participant psychopathology, and incidence of CAMHS referral.ResultsPupils experiencing more behavioural difficulties, had an increased incidence of CAMHS referral (adjusted hazard ratio 1.1, 95% confidence interval 1.0-1.2). However, pupils who reported higher health related quality of life had a lower incidence of CAMHS referral over the follow-up period (adjusted hazard ratio 0.94, 95% confidence interval 0.9–0.98).ConclusionChildren and young people’s perception of their quality of life should be considered at the stages of a clinical needs assessment.

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