Bridging the ocean: Kiribati Australia alliance in mental health

2017 ◽  
Vol 25 (5) ◽  
pp. 474-477
Author(s):  
Brigid Ryan ◽  
Manrenga Viane ◽  
Fran Timmins ◽  
Alex Smith ◽  
Claire Anstey
Keyword(s):  
Mental Health ◽  
Psychiatric Treatment ◽  
Service Planning ◽  
International Exchange ◽  
Service Development ◽  
Community Based ◽  
Custodial Care ◽  
General Training ◽  
Short Time ◽  
Acute Psychiatric Treatment

Objective: The objective of this study was to demonstrate the benefits of collaboration between Australia and Kiribati, a Pacific island nation, to enhance Kiribati’s mental health system. Method: The collaboration involved a training program for a Kiribati senior mental health leader in Melbourne, Australia, and service planning including prioritisation of key areas for development. Results: As well as receiving general training in community-based mental health, the Kiribati mental health leader gained skills in modification of the inpatient environment, with plans for implementation in Kiribati within the current limited resources. Future planning will focus on shifting from an emphasis on acute psychiatric treatment and custodial care to a recovery-oriented approach. Conclusion: The international exchange was a positive experience for both the Kiribati participants and their Australian colleagues. Knowledge transfer was achieved in a short time, and service development appropriate and realistic for the Kiribati environment was planned.

Improving Community-Based Services for Older Patients with Depression: The Benefits of an Educational and Service Initiative

2001 ◽  
Vol 35 (4) ◽  
pp. 449-454 ◽  
Author(s):  
Carolyn Mutch ◽  
Margaret Tobin ◽  
Ian Hickie ◽  
Carolyn Mutch ◽  
Margaret Tobin ◽  
...  
Keyword(s):  
Mental Health ◽  
General Practitioners ◽  
Older Patients ◽  
Community Mental Health Services ◽  
Service Development ◽  
Health Staff ◽  
Mental Health Staff ◽  
Community Based ◽  
Educational Initiative ◽  
Improvement Project

Objective: The objective of this study was to report a quality improvement project for older patients with depression. The initiative focused on both clinical practice changes (improvement of medical, neurocognitive and behavioural assessment) and service development (greater continuity of care). Method: After initial identification of key deficits, implementation of a service and educational initiative took place within a district mental health service. The service consisted of an inpatient unit, a specialized psychogeriatric service and two adult community mental health services. Mental health staff received education regarding the specific needs of older patients with depression and were provided with assessment materials, patient education and treatment aids. General practitioners participated in shared long-term management. Results: Following graded implementation, the management of 44 subjects (mean age = 65.4 years, 91% female) recruited over an 8-month period was reviewed. Compared with 99 subjects (mean age = 68.9 years, 69% female) from the earlier 12-month assessment phase, there were significant improvements in medical (43% to 92%), neurocognitive (37% to 84%) and behavioural (e.g. suicidal ideation: 78% to 100%) assessments. Similarly, relevant laboratory investigations (neuroimaging: 21% to 67%) and communication with general practitioners (73% to 97%) improved. The most change occurred in the adult community-based treatment services. Conclusions: A coordinated management and educational initiative resulted in marked improvement in basic medical and psychiatric assessment and more integrated care. These changes did not require expansion of specialist services.

scholarly journals Clinical Holistic Medicine: Psychodynamic Short-Time Therapy Complemented with Bodywork. A Clinical Follow-Up Study of 109 Patients

2006 ◽  
Vol 6 ◽  
pp. 2220-2238 ◽  
Author(s):  
Søren Ventegodt ◽  
Suzette Thegler ◽  
Tove Andreasen ◽  
Flemming Struve ◽  
Lars Enevoldsen ◽  
...  
Keyword(s):  
Mental Health ◽  
Psychiatric Treatment ◽  
Psychological Treatment ◽  
Holistic Medicine ◽  
Initial Contact ◽  
Initial Condition ◽  
Ability To Work ◽  
Follow Up Study ◽  
Short Time

This is a study of 109 patients who attended the Research Clinic for Holistic Medicine in Copenhagen during the 2004–2006 period, grouped according to the symptoms they presented with. Every new patient was asked to answer a 10-question composite questionnaire containing QOL1, QOL5, and four questions on ability to function socially, ability to function sexually, ability to love, and ability to work, rated on a 5-point Likert scale, on initial contact and after 1–3 months, when the patient had received about five treatments, the patient was asked to complete the questionnaire again, and finally again after 1 year. All had been to their general practitioner first with their problems and 30% had been in psychological/psychiatric treatment before. The patients were treated with short-time psychodynamic therapy (less than 40 sessions) including bodywork when necessary. More than half the patients had a bad or very bad self-assessed mental health before treatment, but after treatment only 15% reported a bad or very bad mental health (p < 0.001). Most had a complex of mental, somatic, existential, and sexual problems. Of the patients, 69.72% did the retest after treatment. We conclude that clinical holistic medicine was able to help the majority of these patients, even when patients had not been sufficiently helped by drugs, psychiatry, or psychology before. We found that outcome of therapy was not connected with severity of initial condition, but probably with the former experience of treatment. If psychiatric or psychological treatment had already failed, the patients were more difficult to help. The Square Curve Paradigm was used to document a large, immediate and lasting effect of the therapy.

scholarly journals Mental Health Services Planning

1985 ◽  
Vol 9 (7) ◽  
pp. 138-138
Author(s):  
Greg Wilkinson
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Service Planning ◽  
Government Policies ◽  
Community Based ◽  
Health Service Planning ◽  
Department Of Health ◽  
Health Services Planning ◽  
Community Based Services

A timely conference on Mental Health Services Planning, organized jointly by the Royal College of Psychiatrists and the Department of Health and Social Security, took place in London in March 1985. The conference concentrated on difficulties associated with the implementation of government policies for mental health service planning in England and Wales. Particular emphasis was given to the problems of transition from hospital-based services to community-based services.

Development of an operational manual for a consultation–liaison psychiatry service

2018 ◽  
Vol 26 (5) ◽  
pp. 503-507 ◽  
Author(s):  
Anne PF Wand ◽  
Swapnil Sharma ◽  
Lindsay J Carpenter ◽  
Mike Gatsi
Keyword(s):  
Mental Health ◽  
General Hospital ◽  
Service Planning ◽  
Service Development ◽  
Mental Health Systems ◽  
Liaison Psychiatry ◽  
Procedural Information ◽  
Hospital Executives ◽  
Consultation Liaison Psychiatry

Objectives: Consultation–liaison psychiatry (CLP) services sit between mental health and the general hospital, and risk being poorly understood by both systems. The aim of this study was to develop an operational manual for a CLP service, which defined functions and governance. Methods: The CLP literature was reviewed with a focus on descriptions of CLP roles, organisational processes, quality measures and service development. The CLP team held service planning meetings and met with members of the mental health and hospital executives. Site visits and collaboration with other CLP services occurred in defining the roles of the CLP service and organisational governance. Results: A CLP operational document was developed, including a description of the service, its functions, staff roles and governance. Procedural information such as the CLP timetable, referral process, triage and assessment, documentation, activity recording, quality assurance and relevant policies were outlined. Conclusions: The development of a dedicated operational manual for CLP clarified the roles, functions and governance of CLP within the general hospital and mental health systems. The development process facilitated the engagement of key clinicians and administrators of these systems, the determination of quality improvement targets and greater transparency and accountability.

Modernizing mental health services for older people: a case study

2010 ◽  
Vol 23 (1) ◽  
pp. 10-19 ◽  
Author(s):  
Niall McCrae ◽  
Sube Banerjee
Keyword(s):  
Mental Health ◽  
Older People ◽  
Professional Training ◽  
Quantitative Methods ◽  
Resistance To Change ◽  
Longitudinal Design ◽  
Complex Interventions ◽  
Service Planning ◽  
Service Development

ABSTRACTBackground: This paper describes an evaluation of a redevelopment program in a mental health service for older people, stimulated by U.K. Department of Health policy. IQCOL (Improving Quality of Care for Older People in Lambeth) was a two-year program to modernize and expand an inner-city service, with objectives to improve access, embed new functions, and tune the service towards the needs of the local community. The program evaluation aimed to contribute to knowledge on service planning and methodology for evaluating complex interventions.Methods: The study evaluated the progress and outcomes of this multifaceted program. The realist model of evaluation was followed, with a dual emphasis on utility and generalizability. With an iterative approach, the pragmatic, longitudinal design comprised a combination of qualitative and quantitative methods to explain the process of change and to measure achievement of objectives.Results: A high level of participation in evaluation activities was achieved. The workforce generally responded well to the program. However, progress in one team was hindered by understaffing and resistance to change, emphasizing that while localized provision may be desirable, team viability requires adequate resources and professional support. Improved access was indicated by a 13% increase of referrals. Data suggested earlier referral of dementia cases. Carer support was implemented, but assertive outreach was impeded by professional boundary issues. Ethnicity data showed that the service was responding to demographic trends. Positive views towards the program were associated with team resources and recent professional training.Conclusions: This case study demonstrates how whole system change can be achieved if sufficient attention is given to the needs of staff implementing the program. The evaluation emphasizes the importance of context in producing generalizable evidence on service development, and contributes useful methodological insights.

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