scholarly journals Indian Medical Students with Depression, Anxiety, and Suicidal Behavior: Why Do They Not Seek Treatment?

2021 ◽  
pp. 025371762098232
Author(s):  
Praveen Arun ◽  
Parthasarathy Ramamurthy ◽  
Pradeep Thilakan
Keyword(s):  
Mental Health ◽  
Anxiety Disorder ◽  
Medical Students ◽  
Mental Health Services ◽  
Health Services ◽  
Anxiety Disorders ◽  
Suicidal Behavior ◽  
Mental Healthcare ◽  
Suicidal Risk ◽  
Healthcare Seeking

Background: Identification of barriers to mental healthcare seeking among medical students will help organize student mental health services in medical colleges across India. This study was conducted to estimate the prevalence of depression, anxiety disorders, and suicidal behavior among medical students and to identify the potential barriers to mental healthcare seeking among them. Methods: In this cross-sectional observational study, the medical students from a medical college in South India were asked to complete a structured pro forma for sociodemographic details, Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder Questionnaire (GAD-7),and Suicide Behaviors Questionnaire-Revised (SBQ-R). The barriers to mental healthcare seeking were assessed using the mental health subscale of Barriers to Healthcare Seeking Questionnaire for medical students. A cut-off of 15 was used for determining the presence of depression on PHQ-9. A cut-off of 10 on GAD-7 indicated the presence of anxiety disorder, and a cut-off of 7 on SBQ-R indicated suicidal risk. Results: Out of the 425 participants, 59 (13.9%) were found to have depression (moderately severe or severe) and 86 (20.2%) were found to have anxiety disorders (moderate or severe). A total of 126 (29.6%) students were found to have a suicidal risk. Preference for informal consultations, concerns about confidentiality, and preference for self-diagnosis were the most commonly reported barriers to mental healthcare seeking. Students with psychiatric disorders perceived more barriers to mental healthcare seeking than students without psychiatric disorders. Conclusions: One-fourth of the medical students were detected to have depression and/or anxiety disorders. Establishing student mental health services, taking into account the perceived barriers, will go a long way in improving medical students’ mental well-being.

scholarly journals An exploratory analysis of the association between moral injury and mental healthcare-seeking attitudes and behaviors in returning veterans of the Iraq and Afghanistan wars

2020 ◽  
Author(s):  
Chad York Lewis
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Mental Health Treatment ◽  
Mental Healthcare ◽  
Moral Injury ◽  
Health Treatment ◽  
Healthcare Seeking ◽  
Attitudes And Behaviors ◽  
And Behaviors

Abstract Objectives: This study examines the degree to which veterans who have experienced more "moral injury" are less likely to seek the mental healthcare services they may urgently need. Methods: The sampling frame for this study included American veterans of the Iraq and/or Afghanistan wars aged 25-44. Participants were recruited into the study by posting a call for participants to social media platforms such as Facebook and LinkedIn. A web link was provided to direct them to an anonymous online survey. We then collected data assessing veterans' combat experiences, healthcare-seeking attitudes and behaviors, and various sociodemographic data. No identifying information was collected, and an Institutional Review Board exemption was granted under DHHS Regulatory Category II by the George Washington University's Office of Human Research Study. Results: The results from the Inventory of Attitudes toward Seeking Mental Health Services (IASMHS) clearly showed that moral injury was associated with more negative mental health services-seeking attitudes in all measurable areas. Those respondents scoring higher on the Moral Injury Events Scale (MIES) were presumably less likely to acknowledge their psychological problems, more likely to have fear of anticipated stigma from loved ones if they were to seek mental health treatment, and less willing and able to seek out mental health treatment when needed. Conclusions: It is probable that we will not be able to reach a significant number of veterans suffering from moral injury unless we dedicate further research in the area of developing effective techniques to recruit veterans suffering from moral injury into mental health treatment programs by taking their specific symptoms (independent of PTSD) into consideration.

The EPA Guidance Project: Guidance for Mental Healthcare in Europe

2015 ◽  
Vol 12 (01) ◽  
pp. 5-11
Author(s):  
I. Großimlinghaus ◽  
J. Zielasek ◽  
W. Gaebel
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Graduate Training ◽  
Action Plan ◽  
Stakeholder Involvement ◽  
Mental Healthcare ◽  
World Health ◽  
Post Graduate Training ◽  
Health Organization

Summary Background: The development of guidelines is an important and common method to assure and improve quality in mental healthcare in European countries. While guidelines have to fulfill predefined criteria such as methodological accuracy of evidence retrieval and assessment, and stakeholder involvement, the development of guidance was not standardized yet. Aim: In 2008, the European Psychiatric Association (EPA) initiated the EPA Guidance project in order to provide guidance in the field of European psychiatry and related fields for topics that are not dealt with by guideline developers – for instance due to lack of evidence or lack of funding. The first three series of EPA Guidance deal with diverse topics that are relevant to European mental healthcare, such as quality assurance for mental health services, post-graduate training in mental healthcare, trust in mental health services and mental health promotion. Results: EPA Guidance recommendations address current and future challenges for European psychiatry. They are developed in accordance with the World Health Organization (WHO) European Mental Health Action Plan.

scholarly journals Remote care for mental health: qualitative study with service users, carers and staff during the COVID-19 pandemic

BMJ Open ◽  
2021 ◽  
Vol 11 (4) ◽  
pp. e049210
Author(s):  
Elisa Liberati ◽  
Natalie Richards ◽  
Jennie Parker ◽  
Janet Willars ◽  
David Scott ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Service ◽  
Health Services ◽  
Mental Healthcare ◽  
Well Being ◽  
Comparison Method ◽  
Service Users ◽  
Qualitative Interview Study ◽  
Remote Care

ObjectivesTo explore the experiences of service users, carers and staff seeking or providing secondary mental health services during the COVID-19 pandemic.DesignQualitative interview study, codesigned with mental health service users and carers.MethodsWe conducted semistructured, telephone or online interviews with a purposively constructed sample; a lived experience researcher conducted and analysed interviews with service users. Analysis was based on the constant comparison method.SettingNational Health Service (NHS) secondary mental health services in England between June and August 2020.ParticipantsOf 65 participants, 20 had either accessed or needed to access English secondary mental healthcare during the pandemic; 10 were carers of people with mental health difficulties; 35 were members of staff working in NHS secondary mental health services during the pandemic.ResultsExperiences of remote care were mixed. Some service users valued the convenience of remote methods in the context of maintaining contact with familiar clinicians. Most participants commented that a lack of non-verbal cues and the loss of a therapeutic ‘safe space’ challenged therapeutic relationship building, assessments and identification of deteriorating mental well-being. Some carers felt excluded from remote meetings and concerned that assessments were incomplete without their input. Like service users, remote methods posed challenges for clinicians who reported uncertainty about technical options and a lack of training. All groups expressed concern about intersectionality exacerbating inequalities and the exclusion of some service user groups if alternatives to remote care are lost.ConclusionsThough remote mental healthcare is likely to become increasingly widespread in secondary mental health services, our findings highlight the continued importance of a tailored, personal approach to decision making in this area. Further research should focus on which types of consultations best suit face-to-face interaction, and for whom and why, and which can be provided remotely and by which medium.

scholarly journals Understanding barriers to accessing mental health services for newcomers to Canada using Peterborough, Ontario, as an illustrative example

2021 ◽  
Author(s):  
Nurun Layla Chowdhury
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Help Seeking ◽  
Mental Healthcare ◽  
Healthcare Services ◽  
Mental Illnesses ◽  
Cultural Barriers ◽  
Accurate Information

The quality of an individual’s mental health has a significant impact on their quality of life, as well as on the cost to society. Regular access to mental health services can help mitigate the risk factors of developing mental illnesses. This paper examines barriers to accessing mental health services, using the community of Peterborough, Ontario, as an example. Social, economic, and cultural barriers impact help-seeking amongst immigrants, putting them at a higher risk of developing mental disorders. The social determinants of mental health can be useful when developing policies aimed at improving utilization of mental healthcare services. Policy makers need to first focus on collecting accurate information on the population, and then developing targeted solutions to eliminate barriers such as language and employment that prevent help-seeking in immigrants.

scholarly journals Improving access to mental healthcare for displaced Syrians: case studies from Syria, Iraq and Turkey

2016 ◽  
Vol 13 (4) ◽  
pp. 84-86 ◽  
Author(s):  
P. Hughes ◽  
Z. Hijazi ◽  
K. Saeed
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Primary Healthcare ◽  
Unmet Need ◽  
Mental Healthcare ◽  
Integrated Approach ◽  
World Health ◽  
Case Examples ◽  
Displaced People

The conflict in Syria has led to an unprecedented humanitarian crisis that extends across multiple countries in the area. Mental health services were undeveloped before and now face huge strain and unmet need. The World Health Organization and others have developed a programme to build capacity in the delivery of mental health services in an integrated healthcare package to refugees and displaced people. The tool used for this is the mhGAP Intervention Guide and complementary materials. In this paper we refer to training in Turkey, Iraq and Syria where health professionals were trained to roll out this community-based integrated approach through primary healthcare. We describe field case examples that show the complexity of situations that face refugees, displaced people and those caught in active conflict. Training improved the knowledge and skills for managing mental health disorders in primary healthcare. Further work needs to be done to demonstrate greater access to and utilisation of services, client outcomes and organisational change with this approach.

scholarly journals Provision of mental health services in Nigeria

2008 ◽  
Vol 5 (2) ◽  
pp. 32-34 ◽  
Author(s):  
Olufemi Olugbile ◽  
M. P. Zachariah ◽  
O. Coker ◽  
O. Kuyinu ◽  
B. Isichei
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Service Delivery ◽  
Urban Areas ◽  
Mental Healthcare ◽  
African Countries ◽  
Grass Roots ◽  
The Past ◽  
Trained Personnel

Nigeria, like other African countries, is short of personnel trained in mental healthcare. Efforts to tackle the problem have often focused on increasing the numbers of psychiatrists and nurses in the field. These efforts, over the past 20 years, have not appeared to have greatly improved service delivery at the grass roots. Most of the specialist centres where such highly trained personnel work are in urban areas and for a large part of the population access to them is limited by distance and cost.

scholarly journals Quality improvement in mental health services

2019 ◽  
Vol 44 (1) ◽  
pp. 30-35 ◽  
Author(s):  
Billy Boland
Keyword(s):  
Mental Health ◽  
Quality Improvement ◽  
Mental Health Services ◽  
Health Services ◽  
Manufacturing Industry ◽  
Mental Healthcare ◽  
Lean Thinking ◽  
Use Of Data ◽  
Healthcare Improvement ◽  
The Usa

Quality improvement (QI) approaches are becoming increasingly important in the delivery of mental healthcare internationally. They were originally developed in the manufacturing industry, but the principle of having a systematic approach to improvement has spread to many other industries, not least to healthcare. Quality improvement approaches in healthcare were pioneered in the USA at organisations such as Virginia Mason and the Institute for Healthcare Improvement. In recent years, they have become firmly established in mental health services in the UK's National Health Service (NHS). There are a number of different approaches to quality improvement, but two leading models have taken root: ‘lean thinking’ (also known as ‘lean methodology’ or simply ‘lean’), which arose out of Virginia Mason, and the ‘Model for Improvement’, which came out of the Institute of Healthcare Improvement. This article describes these two quality improvement approaches, critiques their philosophy and explores how they can apply in the provision of mental healthcare, particularly with reference to the use of data, evidence and metrics.

scholarly journals EPA guidance on the quality of mental health services: A systematic meta-review and update of recommendations focusing on care coordination

2020 ◽  
Vol 63 (1) ◽  
Author(s):  
W. Gaebel ◽  
A. Kerst ◽  
B. Janssen ◽  
T. Becker ◽  
M. Musalek ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Mental Health Services ◽  
Health Services ◽  
Care Coordination ◽  
Mental Healthcare ◽  
Advantages And Disadvantages ◽  
Meta Review ◽  
Effectiveness And Efficiency

Abstract Background. The quality of mental health services is crucial for the effectiveness and efficiency of mental healthcare systems, symptom reduction, and quality of life improvements in persons with mental illness. In recent years, particularly care coordination (i.e., the integration of care across different providers and treatment settings) has received increased attention and has been put into practice. Thus, we focused on care coordination in this update of a previous European Psychiatric Association (EPA) guidance on the quality of mental health services. Methods. We conducted a systematic meta-review of systematic reviews, meta-analyses, and evidence-based clinical guidelines focusing on care coordination for persons with mental illness in three literature databases. Results. We identified 23 relevant documents covering the following topics: case management, integrated care, home treatment, crisis intervention services, transition from inpatient to outpatient care and vice versa, integrating general and mental healthcare, technology in care coordination and self-management, quality indicators, and economic evaluation. Based on the available evidence, we developed 15 recommendations for care coordination in European mental healthcare. Conclusions. Although evidence is limited, some concepts of care coordination seem to improve the effectiveness and efficiency of mental health services and outcomes on patient level. Further evidence is needed to better understand the advantages and disadvantages of different care coordination models.

scholarly journals Choice in mental health: myths and possibilities

2007 ◽  
Vol 13 (1) ◽  
pp. 60-67 ◽  
Author(s):  
Koravangattu Menon Valsraj ◽  
Nichola Gardner
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Social Inclusion ◽  
Mental Health Problems ◽  
National Policy ◽  
Mental Healthcare ◽  
Policy Makers ◽  
Healthcare Model ◽  
The Government

The government in England and Wales is promoting policies and initiatives to offer patients choice across all healthcare specialties. This has raised concerns in mental healthcare, particularly if the physical healthcare model of implementation is imposed. However, the ‘choice agenda’ is an opportunity for mental health services to be innovative and act as beacons to other disciplines in healthcare. The south-east London programme introducing choice in mental health services is offered as an example here. There already exists an ‘ethos of choice’ within mental health services, but current practices may require a focused approach and structuring to fit in with national policy. This also might be necessary to influence policy makers to take a different perspective on choice in mental health. The principle of choice goes hand in hand with the drive towards greater social inclusion for people with mental health problems.

scholarly journals Mental health services in Cambodia: an overview

2019 ◽  
Vol 17 (2) ◽  
pp. 29-31
Author(s):  
Sarah J. Parry ◽  
Ewan Wilkinson
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Rapid Growth ◽  
Urban Areas ◽  
Mental Healthcare ◽  
Mental Health Training ◽  
Health Strategy ◽  
Professional Mental Health ◽  
National Mental Health

Mental health services in Cambodia required rebuilding in their entirety after their destruction during conflict in the 1970s. During the late 1990s there was rapid growth and development of professional mental health training and education. Currently, basic mental healthcare is available primarily in urban areas and is provided by a mixture of government, non-government and private services. Despite the initial rapid growth of services and the development of a national mental health strategy in 2010, significant challenges remain in achieving an acceptable, standardised level of mental healthcare nationally.

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