Collaborative Mental Health Care for the Homeless: The Role of Psychiatry in Positive Housing and Mental Health Outcomes

Abstract Aims Mental disorders in children are a significant and growing cause of morbidity worldwide. Although interventions to help overcome barriers along the pathway to accessing health care for children with mental disorders exist, there is no overview of randomised controlled trials (RCTs) on these interventions as yet. This study aimed to systematically identify RCTs of interventions to improve access to mental health care for children and synthesise them using a conceptual framework of access to health care. Methods This systematic review was performed following a predefined protocol registered with PROSPERO (ID: CRD42018081714). We searched the databases MEDLINE, EMBASE, PsycINFO and CENTRAL for RCTs up to 15 May 2019 using terms related to the concepts ‘young people,’ ‘mental disorders’ and ‘help-seeking interventions’ and scanned reference lists from relevant studies. Two reviewers independently screened all identified articles in a two-stage process, extracted results on outcomes of interest (knowledge, attitudes, intentions, help-seeking, accessing care, mental health outcomes and satisfaction), assessed the risk of bias and conducted meta-analyses where deemed appropriate. Results After screening 5641 identified articles, 34 RCTs were eligible for inclusion. Eighty per cent of universal school-based interventions measuring knowledge (n = 5) and 67% measuring attitudes (n = 6) reported significantly better results compared with controls on those outcomes, whereas 20% measuring access to care (n = 5) and none measuring mental health outcomes (n = 7) did. In contrast, 71% of interventions targeting at-risk individuals (n = 21) reported better access to care compared with controls, while just 33% (n = 6) did for mental health outcomes. For satisfaction with care, this proportion was 80% (n = 5). Meta-analyses of interventions measuring initial appointment attendance yielded combined odds ratios of 3.11 (2.07–4.67) for appointment reminder interventions and 3.51 (2.02–6.11) for treatment engagement interventions. The outcomes for universal school-based interventions were heterogeneous and could not be summarised quantitatively through meta-analysis. Conclusions To have a population-level effect on improving children's access to mental health care, two-stage interventions that identify those in need and then engage them in the health-care system may be necessary. We need more evidence on interventions to target contextual factors such as affordability and infrastructural barriers.

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Dysfunctional coping mediates the relationship between stress and mental health in health care staff working amid COVID-19 pandemic.

Medical Principles and Practice ◽

10.1159/000516181 ◽

2021 ◽

Author(s):

Katarzyna Warchoł-Biedermann ◽

Przmysław Daroszewski ◽

Grażyna Bączyk ◽

Krzysztof Greberski ◽

Paweł Bugajski ◽

...

Keyword(s):

Mental Health ◽

Health Care ◽

Health Outcomes ◽

Coping Strategies ◽

Mental Health Outcomes ◽

Care Staff ◽

Health Care Staff ◽

Cross Sectional ◽

The Relationship

Objective: The cross-sectional study aimed to assess the stress outcomes in health care staff working during the Covid-19 pandemic and to explore the role of coping in the relationship between stress outcomes and mental health dimensions with Preacher & Hayes's mediation analysis. Subjects and methods: 170 participants including physicians (n=41; 24.1%), nurses (n=114, 67.1%) and paramedics (n = 15, 8.8%) with a mean age of 37.69 ± 12,23 years and an average seniority of 14.40 ±12.32 years. were administered The Toronto Alexithymia Scale– 20 (TAS – 20), Cohen's Perceived Stress Scale (PSS-10), the Emotional Processing Scale (EPS) and Positive and Negative Affect Schedule (PANAS). The data were analyzed by estimation of simple correlation coefficients and a Preacher and Hayes's mediation procedure. Results: Participants reported elevated levels of stress (7-8 sten on the sten scale developed for the PSS-10 questionnaire). Statistically significant differences in the stress levels between nurses, paramedics and physicians could not determined. In contrast, significant association between mental health outcomes and occupational category could not be found. Coping mediated the relationship between coping strategies and mental health outcomes. A positive and significant relationship was observed between stress, dysfunctional coping strategies and mental health. Conclusion: Our observations support the assumption about a controlling role of coping in the relationship between work-related stress and mental health outcomes in the medical staff working amid pandemic.

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Mental Health Inequities and Disparities among African American Adults in the United States: The Role of Race

Research in Health Science ◽

10.22158/rhs.v5n3p23 ◽

2020 ◽

Vol 5 (3) ◽

pp. p23

Author(s):

Elizabeth Armstrong-Mensah ◽

Harshita Patel ◽

Priyanka Parekh ◽

Crystal Lee

Keyword(s):

Mental Health ◽

United States ◽

Health Care ◽

African Americans ◽

Mental Health Care ◽

Health Outcomes ◽

Economic Status ◽

The United States ◽

Poor Quality ◽

Mental Health Outcomes

Although the rate of mental illness among African Americans and Whites in the United Sates are similar, African Americans tend to have the worst mental health outcomes in the country. This is due to several inequities, particularly those associated with race such as discrimination, provider bias, stereotyping, weak socio-economic status, limited access to health insurance, poor quality mental health care, treatment gaps, culture, and stigma related to mental health care. Recognizing that the differences in mental health outcomes among minority populations in the United States is also driven by race and not just by brain chemistry, or environmental exposures, and developing strategies that target the issue of race, will not only lead to increased access to mental health services among African Americans, but will generally improve upon their mental health status. This article discusses mental health disparities among African Americans, the inequities that cause them, and strategies for addressing the disparities with a focus on race.

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Borderline personality disorder and mental health care utilization: The role of self-harm.

Personality Disorders Theory Research and Treatment ◽

10.1037/per0000245 ◽

2018 ◽

Vol 9 (2) ◽

pp. 188-191 ◽

Cited By ~ 4

Author(s):

Randy A. Sansone ◽

Martin Sellbom ◽

Douglas A. Songer

Keyword(s):

Mental Health ◽

Health Care ◽

Borderline Personality Disorder ◽

Personality Disorder ◽

Mental Health Care ◽

Borderline Personality ◽

Care Utilization ◽

Self Harm ◽

Mental Health Care Utilization

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The Role of Coping in the Relationship Between Endorsement of the Strong Black Woman Schema and Depressive Symptoms Among Black Women

Journal of Black Psychology ◽

10.1177/00957984211021229 ◽

2021 ◽

pp. 009579842110212

Author(s):

Martinque K. Jones ◽

Tanisha G. Hill-Jarrett ◽

Kyjeila Latimer ◽

Akilah Reynolds ◽

Nekya Garrett ◽

...

Keyword(s):

Mental Health ◽

Depressive Symptoms ◽

Black Women ◽

Health Outcomes ◽

Black Woman ◽

Coping Styles ◽

Mental Health Outcomes ◽

Multiple Mediation ◽

Strong Black Woman

The Strong Black Woman (SBW) schema has been consistently linked to negative mental health outcomes among Black women. However, few have begun to explicate the mechanisms by which the endorsement of the SBW schema may influence mental health outcomes. Accordingly, the current study examined coping styles (social support, disengagement, spirituality, and problem-oriented/engagement) as mediators in the association between endorsement of the SBW schema and depressive symptoms in a sample of Black women. Data from 240 Black women ( Mage = 22.0, SD = 4.0 years) were collected assessing SBW schema endorsement, coping styles, and depressive symptoms. Parallel multiple mediation analysis was conducted using PROCESS Macro. Of the four coping styles examined, disengagement coping partially mediated the association between greater endorsement of the SBW schema and greater depressive symptoms. Study findings add depth to our understanding of the association between the SBW schema and mental health outcomes and lend themselves to research and clinical implications.

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Racial Discrimination Predicts Mental Health Outcomes Beyond the Role of Personality Traits in a Community Sample of African Americans

Clinical Psychological Science ◽

10.1177/2167702620957318 ◽

2021 ◽

pp. 216770262095731

Author(s):

Yara Mekawi ◽

Courtland S. Hyatt ◽

Jessica Maples-Keller ◽

Sierra Carter ◽

Vasiliki Michopoulos ◽

...

Keyword(s):

Mental Health ◽

African Americans ◽

Health Outcomes ◽

Personality Traits ◽

Posttraumatic Stress ◽

Racial Discrimination ◽

Community Sample ◽

Mental Health Outcomes ◽

Hierarchical Regression

Despite a consistent body of work documenting associations between racial discrimination and negative mental health outcomes, the utility and validity of these findings have recently been questioned because some authors have posited that personality traits may account for these associations. To test this hypothesis in a community sample of African Americans ( n = 419, age: M = 43.96 years), we used bivariate relations and hierarchical regression analyses to determine whether racial discrimination accounted for additional variance in depression, anxiety, and posttraumatic stress symptoms beyond the role of personality. Bivariate relations between personality traits and racial discrimination were small and positive (i.e., rs ≈ .10). Regression results demonstrated that racial discrimination accounted for variance in depression, anxiety, and posttraumatic stress independent of personality traits ( ps < .01). These results suggest that personality traits do not fully explain associations between racial discrimination and negative mental health outcomes, further supporting the detrimental impact of racial discrimination on the mental health of African Americans.

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Understanding the occupational identity of care-givers for people with mental health problems

British Journal of Occupational Therapy ◽

10.1177/03080226211018153 ◽

2021 ◽

pp. 030802262110181

Author(s):

Megan L Howes ◽

Diane Ellison

Keyword(s):

Mental Health ◽

Health Care ◽

Mental Health Care ◽

Occupational Therapists ◽

Occupational Identity ◽

Care Giver ◽

Care Givers ◽

Care Giving ◽

Occupational Participation

Introduction There is recognition within the literature that the role of care-giving can have a negative impact on care-givers’ general well-being. Less is understood about the role of care-giving on an individual’s occupational participation and in turn occupational identity. Occupational therapists have a unique understanding of the interplay between occupational participation and health, though this is an area that has been under researched in relation to mental health care-givers. Therefore, the current research aims to understand how the role of care-giving for an individual with a mental illness impacts on occupational participation and identity. Method A qualitative semi-structured interview the Occupational Performance and History Interview–Version 2 was utilised to understand life experiences. Six mental health care-givers were interviewed, and these interviews were transcribed for thematic analysis. Findings Three main themes were identified: being me, roles and responsibilities associated with care-giving and services. Conclusion The findings suggest being a mental health care-giver does have a detrimental impact on occupational participation and therefore occupational identity. As care-givers gained more experience in their role, they used occupational adaption as a positive coping mechanism that helped them achieve occupational balance. Using their unique understanding of occupational participation and occupational identity, occupational therapists are well placed to utilise their knowledge and skills to work in a systemic way supporting both the person with mental illness and their care-giver.

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