Design of a Decision Support Application to Support Individuals in Mental Health Crisis

Author(s):  
Amanda J. Johnson ◽  
Ann M. Bisantz ◽  
Amy L. Reynolds ◽  
Scott T. Meier

Mental health and suicide are two substantial issues facing our society. They have far reaching impacts on the healthcare and public safety systems, the economy, and human life. Despite their impact and importance, the amount of research is disproportionate to the magnitude of the problem. The current study sought to determine decision requirements of those in mental health crisis and to translate them into a user-friendly mobile application. Individuals who had been in mental health crises and mental health professionals were interviewed. Results showed that both the availability of resources and the impact of anxiety and overwhelm on decision making are areas in which individuals in crisis can be better supported. Outcome of research included design of a prototype mobile application designed to support decision making during mental health crisis.

Author(s):  
Amanda J. Johnson ◽  
Ann M. Bisantz ◽  
Amy L. Reynolds ◽  
Scott T. Meier

Extended Abstract Previous research has shown that mental health diagnoses can impact cognitive functioning and decision-making abilities (Bosaipo et al 2017; Stergiopoulos et al 2015; Bora and Pantelis 2015; Rock et al 2014). Decision making difficulties can be particularly problematic when individuals in mental health crises are faced with decisions about their safety and wellbeing. Despite research establishing cognitive and decision-making difficulties for this population, there is an absence in the literature concerning decision support needs of those individuals. Human factors professionals possess a unique set of methods and skills to address these needs and support individuals to make healthier, safer decisions using the latest technologies. This research was part of a larger project aimed at design of a decision support based mobile application that would support individuals during mental health crises. Other phases of the research will include additional user requirements gathering, iterative prototyping, heuristic evaluation, and user testing.


2020 ◽  
Vol 27 (1) ◽  
pp. 72-76
Author(s):  
Marsha Lesley

OBJECTIVE: To raise awareness of the potential for moral injury in nurses working on the frontlines of COVID-19 patient care and to present aspects of mental functioning that may increase the likelihood of psychological distress. Approaches that draw on psychoanalytic thinking to support frontline nurses’ mental health are explained. METHOD: This article draws on recent work that is available from multiple sources, including published journal articles on moral injury, recent reports from news services highlighting the crisis state of the pandemic and effects on nurses, established literature on the structural model of the mind, and recent webinars and online lectures addressing mental health crisis interventions. The author draws on expertise from years of training in the Adult Psychoanalytic Training Program at the Michigan Psychoanalytic Institute and graduation as an academic analyst. RESULTS: How nurses navigate moral hazards inherent in the current state of frontline health care may depend on their existing ego strengths and levels of self-blame and guilt from a harsh superego. CONCLUSIONS: Mental health professionals need to be aware of the mental minefields that frontline nurses must navigate when providing care that, due to circumstances beyond their control, may be morally ambiguous. Educating nurses about the meaning of their own emotional and psychic responses amid the realities in the field may help to decrease the damaging effects of moral injury.


Subject India's efforts to address a mental health crisis. Significance The Indian government is aiming to convert 150,000 primary health centres into health and wellness centres (HWCs) providing comprehensive care, including management of mental disorders. Its plans for secondary and tertiary healthcare include medical insurance for poorer families that will cover treatment of mental illness. According to a 2016 study conducted by India’s National Institute of Mental Health and Neurosciences (NIMHANS), 150 million out of the country’s 1.3 billion people urgently need mental healthcare. Impacts Expanding mental healthcare infrastructure could lead to an overemphasis on a biomedical model of treatment for mental health disorders. The government will come under pressure to increase funding for mental health professionals as well as technological resources. Future budgets will be key indicators of the government’s commitment to its National Mental Health Programme.


2021 ◽  
Vol 10 (1) ◽  
pp. 17-26
Author(s):  
M.I. Rozenova ◽  
V.I. Ekimova ◽  
A.S. Ognev ◽  
E.V. Likhacheva

The paper presents the analysis of the results of international and national research in the field of studying the impact of global crises and pandemic situations (including COVID-19) on the state of mental health of people. Traditionally, the fear that accompanies emergency events and situations is considered as a source of mental and psychological traumatology of various kinds, however, the authors consider fear in a period of global risks and changes, from the point of view of not the cause, but an indicator of a decrease in the integrity of a person's mental health. The initial theoretical model that allows us to differentiate and diagnose different qualities of fear was the "I-structural" concept of G. Amon, which allows us to describe and understand the specific phenomenology of fears in the pandemic period. The qualities of fear, manifested in its constructive, destructive and deficient form, according to the authors, reflect the resource reserve of a person's mental health and the level of his psychological stability.


2020 ◽  
Vol 2 (6) ◽  
pp. 94-100
Author(s):  
Saba Khurshid ◽  
Sidra Mumtaz ◽  
Hafsa Khalil Toor ◽  
Rubina Hanif

The outbreak of COVID-19 pandemic is constantly posing warning and creating mental health crisis among people without any discrimination. Therefore, the current study purpose is to explore mental health upheaval and transition in future perspectives due to COVID-19. Using exploratory study design, semi structure interviews were conducted. Interviews were recorded, transcribed and analyzed by using Thematic Content Analysis. The major themes which were identified showed that COVID-19 is constantly eliciting panic and mental health issues such as anxiety, stress, and depression, fears of death, xenophobia, OCD and uncertainty about future among general population. Results also indicated the major transition in public future perspectives and perception. Concern related to adjustability in life after pandemic is major emerging future concern among Pakistani People. During pandemic outbreak, people are becoming vulnerable to different mental health problems. To overcome these issues successfully, role of mental health professionals cannot be denied. There is strong need to devise activities and strategies which help people to increase resilience and build strong relationships during the period of social distancing. This paper gives a deep insight into mental health problems among general population due to COVID-19 and it also implicates need of psychological services to overcome these issues.


Author(s):  
James P Pandarakalam

The COVID-19 pandemic has resulted in an increased burden on all medical services and healthcare professionals are applying new strategies to cope with the added demands. During the pandemic mental healthcare services in many parts of the world have been reorganised to incorporate modern technology and maintain efficient service delivery. Mental health professionals are playing a major role in alleviating the suffering resulting from this pandemic. A selective survey of the literature, including narrative reviews, was carried out to study the implications of digital psychiatry. Historically, epidemics have had a substantial effect on mental health and general health services. Telehealth appears to be the right solution to the present mental health crisis, but technology cannot substitute for human presence and proximity in mental health services, so the newer interventions have advantages and disadvantages. Remote methods of therapy are likely to continue to be used and proper assessment of these new ways of working in psychiatry is required. In the post-pandemic period, the challenge will be to combine digital and in-person therapies. Discussions about digital revolution in the field of psychiatry should be modified to digital evolution.


1987 ◽  
Vol 6 (1) ◽  
pp. 27-47 ◽  
Author(s):  
Françoise Boudreau

This paper examines the current socio-political language in the formulation of mental health policy in Ontario and Quebec. “Before long,” coherent and rational policy has been promised in each province to “solve” today's mental health crisis—often identified as that of “deinstitutionaliztion.” However, there is not just one view. Here, we examine the arguments presented in the form of briefs, reports, and working documents on the part of mental health professionals, governments and unions, patient groups, and volunteer organizations in both provinces. We analyze the areas of convergence and divergence and attempt to make sense of this mass of material so important in the formulation of a sensible and sensitive government policy of action.


2015 ◽  
Vol 20 (4) ◽  
pp. 232-241 ◽  
Author(s):  
Eleanor Bradley

Purpose – The purpose of this paper is to provide a brief overview of the literature to date which has focused on co-production within mental healthcare in the UK, including service user and carer involvement and collaboration. Design/methodology/approach – The paper presents key outcomes from studies which have explicitly attempted to introduce co-produced care in addition to specific tools designed to encourage co-production within mental health services. The paper debates the cultural and ideological shift required for staff, service users and family members to undertake co-produced care and outlines challenges ahead with respect to service redesign and new roles in practice. Findings – Informal carers (family and friends) are recognised as a fundamental resource for mental health service provision, as well as a rich source of expertise through experience, yet their views are rarely solicited by mental health professionals or taken into account during decision making. This issue is considered alongside new policy recommendations which advocate the development of co-produced services and care. Research limitations/implications – Despite the launch of a number of initiatives designed to build on peer experience and support, there has been a lack of attention on the differing dynamic which remains evident between healthcare professionals and people using mental health services. Co-production sheds a light on the blurring of roles, trust and shared endeavour (Slay and Stephens, 2013) but, despite an increase in peer recovery workers across England, there has been little research or service development designed to focus explicitly on this particular dynamic. Practical implications – Despite these challenges, coproduction in mental healthcare represents a real opportunity for the skills and experience of family members to be taken into account and could provide a mechanism to achieve the “triangle of care” with input, recognition and respect given to all (service users, carers, professionals) whose lives are touched by mental distress. However, lack of attention in relation to carer perspectives, expertise and potential involvement could undermine the potential for coproduction to act as a vehicle to encourage person-centred care which accounts for social in addition to clinical factors. Social implications – The families of people with severe and enduring mental illness assume a major responsibility for the provision of care and support to their relatives over extended time periods (Rose et al., 2004). Involving carers in discussions about care planning could help to provide a wider picture about the impact of mental health difficulties, beyond symptom reduction. The “co-production of care” reflects a desire to work meaningfully and fully with service users and carers. However, to date, little work has been undertaken in order to coproduce services through the “triangle of care” with carers bringing their own skills, resources and expertise. Originality/value – This paper debates the current involvement of carers across mental healthcare and debates whether co-production could be a vehicle to utilise carer expertise, enhance quality and satisfaction with mental healthcare. The critique of current work highlights the danger of increasing expectations on service providers to undertake work aligned to key initiatives (shared decision-making, person-centred care, co-production), that have common underpinning principles but, in the absence of practical guidance, could be addressed in isolation rather than as an integrated approach within a “triangle of care”.


2017 ◽  
Vol 41 (S1) ◽  
pp. s895-s895
Author(s):  
M. Fernando ◽  
M. Bhat

IntroductionAbout one in 20 attendances at emergency departments (EDs) in the UK relate to mental health, yet recent work has shown that a majority of people presenting with mental health crises do not report positive experiences (Care Quality Commission, 2015). Although there are many reasons for this, one may be a lack of mental health training for staff working in EDs. In response to this, a new training module for multi-professional ED staff was developed.Objectives and methodsWe aimed to assess the impact of this new module on clinicians’ confidence in managing mental health presentations. Thirty-eight ED doctors and nurses across two centers were asked to complete surveys before and after receiving training.ResultsFollowing training, we found improvements in confidence in each of five domains explored: assessing self-harm; managing someone with personality difficulties; assessing psychotic symptoms; distinguishing between physical and psychotic symptoms; and, managing psychotic symptoms. These improvements were seen for clinicians across both centers.ConclusionsThe results show that training can help to improve confidence around mental health. This is particularly important given that before the training was developed a survey of local ED doctors had shown that 31% felt under-confident in managing mental health conditions. Since developing the training, it has been further enhanced at the request of local EDs to include video-based scenarios. We continue to assess its impact in improving the confidence of ED clinicians (as well as their knowledge, skills and attitudes towards mental health), and ultimately the benefit to patients experiencing mental health crises.Disclosure of interestThe authors have not supplied their declaration of competing interest.


2020 ◽  
Author(s):  
Fabrice Kämpfen ◽  
Iliana V. Kohler ◽  
Alberto Ciancio ◽  
Wändi Bruine de Bruin ◽  
Jürgen Maurer ◽  
...  

ObjectiveTo assess mental health in the US adult population in the Covid-19 pandemic and explore the roles of economic concerns, health worries and social distancing in shaping mental health outcomes.MethodsWe analyze online survey data from the “Understanding America Study” (UAS) that is representative of the US adult population and covers the period of March 10-31st 2020 (sample size: 6436).ResultsAbout 29% (CI:27.4-.30.4%) of the US adult population reported some depression/anxiety symptoms osver the study period, with symptoms deteriorating over the month of March. Worsening mental health was most strongly associated with concerns about the economic consequences of the pandemic, while concerns about the potential impact of the virus on respondents’ own health and the practice of social distancing also predicted the presence of depression and anxiety symptoms, albeit less strongly.ConclusionsOur findings point towards a major mental health crisis unfolding simultaneously with the pandemic in the US. They also highlight the importance of economic countermeasures and social policy for mitigating the impact of Covid-19 on adult mental health in the US over and above an effective public health response.


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