Mental Health Services for Syrian Refugees in Lebanon: Perceptions and Experiences of Professionals and Refugees

2020 ◽  
Vol 30 (6) ◽  
pp. 849-864
Author(s):  
Hala Kerbage ◽  
Filippo Marranconi ◽  
Yara Chamoun ◽  
Alain Brunet ◽  
Sami Richa ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Health Conditions ◽  
Adaptive Mechanism ◽  
Syrian Refugees ◽  
Health Practice ◽  
Short Term ◽  
Mental Health Practice ◽  
Depth Interviews

We applied semi-structured and in-depth interviews to explore the perceptions and experiences of 60 practitioners/policymakers and 25 Syrian participants involved in mental health services for refugees in Lebanon. Refugees were found to view their distress as a normal shared reaction to adversity while professionals perceived it as symptomatic of mental illness. Practitioners viewed Syrian culture as an obstacle to providing care and prioritized educating refugees about mental health conditions. Policymakers invoked the state of crisis to justify short-term interventions, while Syrian refugees requested community interventions and considered resettlement in a third country the only solution to their adverse living conditions. The therapeutic relationship seems threatened by mistrust, since refugees change their narratives as an adaptive mechanism in response to the humanitarian system, which professionals consider manipulative. We discuss the implications of our findings for mental health practice in humanitarian settings.

scholarly journals Key issues in the process of implementing shared decision making (DM) in mental health practice

2017 ◽  
Vol 22 (3) ◽  
pp. 257-274 ◽  
Author(s):  
Shulamit Ramon ◽  
Helen Brooks ◽  
Sarah Rae ◽  
Mary-Jane O’Sullivan
Keyword(s):  
Mental Health ◽  
Decision Making ◽  
Mental Health Services ◽  
Health Services ◽  
Shared Decision Making ◽  
Shared Decision ◽  
Health Practice ◽  
Mental Health Practice ◽  
Content Type ◽  
Key Issues

Purpose This review paper will look at internationally existing publications in the English language on mental health shared decision making (SDM) implementation of a variety of interventions, including different methodologies and research methods, age groups and countries. The purpose of this paper is to provide an overview of: process, degree and outcomes of implementation; barriers and facilitators; perspectives on implementation by different stakeholders; analysis of the process of implementation in mental health services through the lenses of the normalisation process theory (NPT). Design/methodology/approach Following a targeted literature search the data were analysed in order to provide an overview of methodologies and methods applied in the articles, as well as of the variables listed above. Three different types of information were included: a content analysis of key issues, reflective understanding coming out of participating in implementation of an SDM project in the form of two narratives written by two key participants in an SDM pilot project and an NPT analysis of the process of implementation. Findings Only a minority of mental health SDM research focuses on implementation in everyday practice. It is possible and often desirable to achieve SDM in mental health services; it requires a low level of technology, it can save time once routinized, and it is based on enhancing therapeutic alliance, as well as service users’ motivation. Implementation requires an explicit policy decision, a clear procedure, and regular adherence to the aims and methods of implementation by all participants. These necessary and sufficient conditions are rarely met, due to the different levels of commitment to SDM and its process by the different key stakeholders, as well as due to competing providers’ objectives and the time allocated to achieving them. Originality/value The review indicates both the need to take into account the complexity of SDM, as well as future strategies for enhancing its implementation in everyday mental health practice. Perhaps because applying SDM reflects a major cultural change in mental health practice, current value attached to SDM among clinicians and service managers would need to be more positive, prominent and enduring to enable a greater degree of implementation.

Distress and impaired functioning, coping mechanisms and barriers to access mental health services among Syrian refugees and Jordanian adults after eight years of Syrian crisis: a cross-sectional study (Preprint)

2021 ◽  
Author(s):  
Yousef Khader ◽  
Ahmad Bawaneh ◽  
Zaid Al-Hamdan
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Significant Proportion ◽  
Cross Sectional Study ◽  
Coping Mechanisms ◽  
Syrian Refugees ◽  
Sectional Study ◽  
Cross Sectional ◽  
Barriers To Access

BACKGROUND The Syrian conflict started in 2011 and resulted ever since in a large displacement of Syrians. Conflict-related violence coupled with displacement related stressors such as poverty, poor access to health services, loss of family support and discrimination had a significant impact on the mental health and psychosocial wellbeing of Syrian refugee OBJECTIVE This study aimed to identify the perceived symptoms of severe distress and impaired functioning, identify coping mechanisms and identify the barriers to access mental health services among Syrian refugees and Jordanian adults. METHODS This cross-sectional study study took place in 14 randomly selected sites in Jordan where Syrian refugees are concentered and from Za’tari refugee camp. A toolkit for humanitarian settings was used for data collection. RESULTS Of the 1424 participants, 43.4% had distress; 38.9% among host population, 57.0% among refugees in urban communities, and 23.0% among refugees in camp (p <0.005). Overall, finding comfort in faith and spiritual beliefs was the most common coping mechanism reported by those who perceived to be experiencing distress. CONCLUSIONS A significant proportion of Syrian refugees had distress symptoms. It is recommended to incorporate mental health services into broad-based community settings, such as schools, primary prevention or case management programs.

scholarly journals Prescribing of unlicensed medicines or licensed medicines for unlicensed applications in child and adolescent psychiatry

2001 ◽  
Vol 25 (12) ◽  
pp. 465-466 ◽  
Author(s):  
Joanne Johnson ◽  
Andrew F. Clark
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Child And Adolescent ◽  
Child And Adolescent Psychiatry ◽  
Health Practice ◽  
North West ◽  
Child Mental Health Services ◽  
Paediatric Practice ◽  
Product Licence

Aims and MethodChild and adolescent mental health services in north-west England (n=21) participated in a prospective collection of information regarding all instances of new prescribing of medication over the 6–month period September 1999 to February 2000.ResultsA total of 478 new prescriptions were issued to 411 individuals. Eight prescriptions (2%) were for an unlicensed drug and a further 188 (39%) were of licensed drugs but used in a manner outside of their product licence.Clinical ImplicationsThis level of unlicensed and outside-licence prescribing is similar to levels previously found in studies both within paediatric practice and in adult mental health practice. Anxiety about excessive beyond-licence prescribing by child mental health services is unlikely to be justified.

Our Biggest Hurdle Yet: Caregivers' Encounters with Structural Stigma in Child and Youth Mental Health

2017 ◽  
Vol 98 (4) ◽  
pp. 300-309 ◽  
Author(s):  
Maria Liegghio
Keyword(s):  
Mental Health ◽  
Criminal Justice ◽  
Focus Group ◽  
Health Services ◽  
Child Protection ◽  
Youth Mental Health ◽  
Service Systems ◽  
Service Delivery System ◽  
Health Practice ◽  
Mental Health Practice

The aim of this article explores structural stigma in child and youth mental health. The focus is on the experiences of caregivers with children between 12 and 22 years old in their encounters with the systems involved with their families for their children's mental health. The outcomes are presented of a study based on analysis of 10 transcripts—two focus group and eight interview transcripts—with 15 caregivers with children involved with mental health services. Two main themes emerged: (a) structural stigma as denigrating encounters within and across service systems (i.e., child and youth mental health, education, child protection, and criminal justice) and (b) fragmentation of the service delivery system as a significant factor exacerbating stigmatizing encounters. The implications for mental health practice with families are considered.

scholarly journals Digital Game Interventions for Youth Mental Health Services (Gaming My Way to Recovery): Protocol for a Scoping Review

10.2196/13834 ◽  
2020 ◽  
Vol 9 (6) ◽  
pp. e13834
Author(s):  
Manuela Ferrari ◽  
Sarah V McIlwaine ◽  
Jennifer Ann Reynolds ◽  
Suzanne Archie ◽  
Katherine Boydell ◽  
...  
Keyword(s):  
Mental Health ◽  
Video Games ◽  
Mental Health Services ◽  
Health Services ◽  
Scoping Review ◽  
Video Game ◽  
Digital Games ◽  
Youth Mental Health ◽  
Health Conditions ◽  
Digital Game

Background Digital or video games are played by millions of adolescents and young adults around the world and are one of the technologies used by youths to access mental health services. Youths with mental health problems strongly endorse the use of technologies, including mobile and online platforms, to receive information, support their treatment journeys (eg, decision-making tools), and facilitate recovery. A growing body of literature explores the advantages of playing digital games for improving attention span and memory, managing emotions, promoting behavior change, and supporting treatment for mental illness (eg, anxiety, depression, or posttraumatic stress disorder). The research field has also focused on the negative impact of video games, describing potential harms related to aggression, addiction, and depression. To promote clarity on this matter, there is a great need for knowledge synthesis offering recommendations on how video games can be safely and effectively adopted and integrated into youth mental health services. Objective The Gaming My Way to Recovery scoping review project assesses existing evidence on the use of digital game interventions within the context of mental health services for youths (aged 11-29 years) using the stepped care model as the conceptual framework. The research question is as follows: For which youth mental health conditions have digital games been used and what broad objectives (eg, prevention, treatment) have they addressed? Methods Using the methodology proposed by Arksey and O’Malley, this scoping review will map the available evidence on the use of digital games for youths between 11 and 29 years old with mental health or substance use problems, or both. Results The review will bring together evidence-based knowledge to assist mental health providers and policymakers in evaluating the potential benefits and risks of these interventions. Following funding of the project in September 2018, we completed the search in November 2018, and carried out data screening and stakeholder engagement activities during preparation of the protocol. We will conduct a knowledge synthesis based on specific disorders, treatment level and modality, type of service, population, settings, ethical practices, and user engagement and offer recommendations concerning the integration of video game technologies and programs, future research and practice, and knowledge dissemination. Conclusions Digital game interventions employ unique, experiential, and interactive features that potentially improve skills and facilitate learning among players. Digital games may also provide a new treatment platform for youths with mental health conditions. Assessing current knowledge on video game technology and interventions may potentially improve the range of interventions offered by youth mental health services while supporting prevention, intervention, and treatment. International Registered Report Identifier (IRRID) PRR1-10.2196/13834

scholarly journals Digital Game Interventions for Youth Mental Health Services (Gaming My Way to Recovery): Protocol for a Scoping Review (Preprint)

2019 ◽  
Author(s):  
Manuela Ferrari ◽  
Sarah V McIlwaine ◽  
Jennifer Ann Reynolds ◽  
Suzanne Archie ◽  
Katherine Boydell ◽  
...  
Keyword(s):  
Mental Health ◽  
Video Games ◽  
Mental Health Services ◽  
Health Services ◽  
Scoping Review ◽  
Video Game ◽  
Digital Games ◽  
Youth Mental Health ◽  
Health Conditions ◽  
Digital Game

BACKGROUND Digital or video games are played by millions of adolescents and young adults around the world and are one of the technologies used by youths to access mental health services. Youths with mental health problems strongly endorse the use of technologies, including mobile and online platforms, to receive information, support their treatment journeys (eg, decision-making tools), and facilitate recovery. A growing body of literature explores the advantages of playing digital games for improving attention span and memory, managing emotions, promoting behavior change, and supporting treatment for mental illness (eg, anxiety, depression, or posttraumatic stress disorder). The research field has also focused on the negative impact of video games, describing potential harms related to aggression, addiction, and depression. To promote clarity on this matter, there is a great need for knowledge synthesis offering recommendations on how video games can be safely and effectively adopted and integrated into youth mental health services. OBJECTIVE The Gaming My Way to Recovery scoping review project assesses existing evidence on the use of digital game interventions within the context of mental health services for youths (aged 11-29 years) using the stepped care model as the conceptual framework. The research question is as follows: For which youth mental health conditions have digital games been used and what broad objectives (eg, prevention, treatment) have they addressed? METHODS Using the methodology proposed by Arksey and O’Malley, this scoping review will map the available evidence on the use of digital games for youths between 11 and 29 years old with mental health or substance use problems, or both. RESULTS The review will bring together evidence-based knowledge to assist mental health providers and policymakers in evaluating the potential benefits and risks of these interventions. Following funding of the project in September 2018, we completed the search in November 2018, and carried out data screening and stakeholder engagement activities during preparation of the protocol. We will conduct a knowledge synthesis based on specific disorders, treatment level and modality, type of service, population, settings, ethical practices, and user engagement and offer recommendations concerning the integration of video game technologies and programs, future research and practice, and knowledge dissemination. CONCLUSIONS Digital game interventions employ unique, experiential, and interactive features that potentially improve skills and facilitate learning among players. Digital games may also provide a new treatment platform for youths with mental health conditions. Assessing current knowledge on video game technology and interventions may potentially improve the range of interventions offered by youth mental health services while supporting prevention, intervention, and treatment. INTERNATIONAL REGISTERED REPORT PRR1-10.2196/13834

scholarly journals Mental health services: results of a survey of English district plans

1989 ◽  
Vol 13 (2) ◽  
pp. 77-78 ◽  
Author(s):  
D. Kingdon
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Strategic Plan ◽  
Substantial Proportion ◽  
Short Term ◽  
Health Authorities ◽  
Comprehensive Service ◽  
Initial Reading

In November 1987, I wrote to the ‘Planning Officer (Mental Health)’ of the 192 English Health Authorities requesting a copy of the section of their 1984 Strategic Plan dealing with mental health and any recent update. A checklist of information to be analysed was drawn up on the basis of an initial reading of the plans. This contained a substantial proportion of the elements for a comprehensive service listed by Hirsch (1988) and by MIND (1983). Replies were received from 137 (71%) of the health authorities. Of these, 127 (67%) sent planning documents, ten wrote saying that their plans were under review and therefore unavailable, or “meaningless”. Strategies were sent dated 1983 (2), 1984/5 (63), 1986 (11) and 1987/8 (45). Planning reports and Short Term Programmes were also sent which meant that four (3%) provided information updated to 1988, 74 (58%) to 1987, 16 (13%) to 1986, 17 (13%) to 1985, 15 (12%) to 1984, with one giving details relating to 1983 only.

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