scholarly journals Influences on participation in a programme addressing loneliness among people with depression and anxiety: findings from the Community Navigator Study

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Johanna Frerichs ◽  
Jo Billings ◽  
Nick Barber ◽  
Anjie Chhapia ◽  
Beverley Chipp ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Thematic Analysis ◽  
Narrative Analysis ◽  
Mental Health Problems ◽  
Severe Depression ◽  
Feasibility Trial ◽  
Structural Level ◽  
Structured Interviews

Abstract Background Loneliness is associated with negative outcomes, including increased mortality and is common among people with mental health problems. This qualitative study, which was carried out as part of a feasibility trial, aimed to understand what enables and hinders people with severe depression and/or anxiety under the care of secondary mental health services in the United Kingdom to participate in the Community Navigator programme, and make progress with feelings of depression, anxiety and loneliness. The programme consisted of up to ten meetings with a Community Navigator and three optional group sessions. Methods Semi-structured interviews were carried out with participants (n = 19) shortly after programme completion. A co-produced two-stage qualitative approach, involving narrative and reflexive thematic analysis, was undertaken by members of the study’s working group, which included experts by experience, clinicians and researchers. Results The narrative analysis showed that individuals have varied goals, hold mixed feelings about meeting other people and define progress differently. From the thematic analysis, six themes were identified that explained facilitators and challenges to participating in the programme: desire to connect with others; individual social confidence; finding something meaningful to do; the accessibility of resources locally; the timing of the programme; and the participant’s relationship with the Community Navigator. Conclusions We found that people with severe depression and/or anxiety supported by secondary mental health services may want to address feelings of loneliness but find it emotionally effortful to do so and a major personal challenge. This emotional effort, which manifests in individuals differently, can make it hard for participants to engage with a loneliness programme, though it was through facing personal challenges that a significant sense of achievement was felt. Factors at the individual, interpersonal and structural level, that enable or hinder an individual’s participation should be identified early, so that people are able to make the best use out of the Community Navigator or other similar programmes.

scholarly journals Influences on participation in a programme addressing loneliness among people with depression and anxiety: findings from the Community Navigator Study

2020 ◽  
Author(s):  
Johanna Frerichs ◽  
Jo Billings ◽  
Nick Barber ◽  
Anjie Chhapia ◽  
Beverley Chipp ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Thematic Analysis ◽  
Mental Health Problems ◽  
Severe Depression ◽  
Feasibility Trial ◽  
Structural Factors ◽  
Depression And Anxiety ◽  
Structured Interviews

Abstract Background Loneliness is common among people with mental health problems and is associated with depression, anxiety and poorer recovery. In the absence of an existing evidence-based intervention, the Community Navigator programme was developed to help reduce loneliness among people with severe depression and/or anxiety using secondary mental health services. This paper presents a co-produced qualitative analysis of the factors that appear to influence participation in this programme. Methods The programme consisted of up to ten meetings with a Community Navigator and three optional group sessions. It was assessed using a feasibility trial. Semi-structured interviews were carried out with participants (N = 19) shortly after programme completion, by a researcher with experience of depression and anxiety. A two-stage qualitative approach to analysis was undertaken by members of the study’s co-production working group, which included service users, clinicians and researchers, using both a narrative analysis of three interviews to produce case studies as well as a thematic analysis of all nineteen interviews. Results From our case study analysis, it was clear how hard it was for participants to work with their feelings of loneliness. Six themes from the thematic analysis were identified to explain both motivation to and barriers towards participation in the programme, which relate to individual and structural factors: desire to connect with others or not; finding meaningful things to do; individual’s social confidence, particularly in group settings; accessibility of resources locally both in terms of practical considerations and financial cost; timing of the programme including in relation to people’s mental health; and, relationship with the Community Navigator. Conclusions We found that people with severe depression and/or anxiety supported by secondary mental health services may want to address feelings of loneliness but are aware of the emotional effort this entails. Interventions to address loneliness should be developed that consider the factors that enable and hinder participation and seek to build into their programmes the necessary support structures to address what may be a major personal challenge.

scholarly journals Barriers and facilitators of child and guardian attendance in task-shifted mental health services in schools in western Kenya

2020 ◽  
Vol 7 ◽  
Author(s):  
Rosemary D. Meza ◽  
Sharon Kiche ◽  
Caroline Soi ◽  
Alya N. Khairuzzaman ◽  
Cristian J. Rivera Nales ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Mental Health Problems ◽  
Behavioral Therapy ◽  
Health Impact ◽  
Barriers And Facilitators ◽  
Structured Interviews ◽  
Lay Counselors ◽  
Treatment Attendance

Abstract Background Globally, nearly 140 million children have experienced the death of one or both parents, and as a result many experience higher rates of mental health problems. Trauma-focused cognitive behavioral therapy (TF-CBT) delivered by lay counselors has been shown to improve mental health outcomes for children experiencing traumatic grief due to parental loss; however, challenges with treatment attendance limit the public health impact of mental health services. This study used qualitative methods to assess barriers and facilitators of child and guardian attendance of school-based lay counselor delivered TF-CBT. Methods Semi-structured interviews were conducted with 36 lay counselors (18 teachers; 18 community health volunteers) who delivered TF-CBT to explore their perceptions of barriers of facilitators of child and guardian attendance of group-based sessions delivered in schools. Results Counselors identified attendance barriers and facilitators related to the delivery setting, resources, participant characteristics, intervention characteristics and counselor behaviors. The findings revealed a greater number of facilitators than barriers. Common facilitators included participant and counselor resources, counselor commitment behaviors and communication efforts to encourage attendance. Barriers were less frequently endorsed, with participant resources, child or guardian illness and communication challenges most commonly mentioned. Conclusions Attention to barriers and facilitators of attendance in the context in which mental health interventions are delivered allows for identification of ways to improve attendance and treatment engagement and achieve the potential promise of providing accessible mental health services.

Recovery Star: validating user recovery

2012 ◽  
Vol 36 (2) ◽  
pp. 45-50 ◽  
Author(s):  
Geoff Dickens ◽  
Judy Weleminsky ◽  
Yetunde Onifade ◽  
Philip Sugarman
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Internal Consistency ◽  
Mental Health Problems ◽  
Service Providers ◽  
Mental Health Recovery ◽  
Addictive Behaviour ◽  
Health Service Providers ◽  
The Uk

Aims and methodMental Health Recovery Star is a multifaceted 10-item outcomes measure and key-working tool that has been widely adopted by service providers in the UK. We aimed to explore its factorial validity, internal consistency and responsiveness. Recovery Star readings were conducted twice with 203 working-age adults with moderate to severe mental health problems attending a range of mental health services, and a third time with 113 of these individuals.ResultsMental Health Recovery Star had high internal consistency and appeared to measure an underlying recovery-oriented construct. Results supported a valid two-factor structure which explained 48% of variance in Recovery Star ratings data. Two Recovery Star items (‘relationships’ and ‘addictive behaviour’) did not load onto either factor. There was good statistically significant item responsiveness, and no obvious item redundancy. Data for a small number of variables were not normally distributed and the implications of this are discussed.Clinical implicationsRecovery Star has been received enthusiastically by both mental health service providers and service users. This study provides further evidence for its adoption in recovery-focused mental health services and indicates that items relating to addictive behaviour, responsibilities and work could be further developed in future.

The transition between mental health services in Scotland

2018 ◽  
Vol 23 (1) ◽  
pp. 12-24 ◽  
Author(s):  
Juliette van der Kamp
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Mental Health Professionals ◽  
Health Professionals ◽  
Transition Period ◽  
Organisational Development ◽  
Structured Interviews ◽  
Content Type ◽  
Experience Difficulty

Purpose The purpose of this paper is to describe the barriers and facilitators to an effective transition from Child and Adolescent Mental Health Services (CAMHS) to Adult Mental Health Services (AMHS). It also presents a new entry into considering how the transition can be improved. Design/methodology/approach Insights into the transition from CAMHS to AMHS were gathered through eight semi-structured interviews with mental health professionals. Two methods of data analysis were employed to explore the emerging themes in the data and the observed deficit approach to organisational development. Findings The findings identified a vast volume of barriers in comparison to facilitators to the transition. Adolescents who transition from CAMHS to AMHS initially experience difficulty adapting to the differences in the services due to the short duration of the transition period. However, despite the established barriers to the transition, adolescents tend to adapt to the differences between the services. Findings also showed a negative framing towards the transition amongst the mental health professionals which resembles a deficit approach to organisational development. Originality/value This paper explores mental health professionals’ perspectives regarding the transition in Dumfries and Galloway, Scotland. The transition is increasingly recognised as an area in health care that requires improvement. This research provides a new way to consider the transition by exploring the perceived deficit approach to organisational development in the services.

Approaches to Delivering Child and Adolescent Mental Health Services: The South Australian Experience

1995 ◽  
Vol 29 (2) ◽  
pp. 230-237 ◽  
Author(s):  
Michael Gifford Sawyer ◽  
Robert John Kosky
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Children And Adolescents ◽  
Mental Health Problems ◽  
South Australia ◽  
Adolescent Mental Health ◽  
Child And Adolescent ◽  
The South ◽  
Number Of Children

Approximately 10% of children and adolescents experience mental health problems, however only a small proportion receive specialised help. Identifying approaches which can provide a balanced and effective service for the large number of children and adolescents with problems is currently a major challenge for child and adolescent mental health services in Australia. In South Australia, following a review in 1983, child and adolescent services were reorganised into two separate but closely related services. This paper draws on experience in South Australia over the last decade to identify approaches which can be employed in six key areas that significantly influence the effectiveness of child and adolescent mental health services. The paper also describes the specific features which were included in the South Australian child and adolescent mental health service to address these issues.

“Walking wounded or wounded healer?” Does personal experience of mental health problems help or hinder mental health practice? A review of the literature

2014 ◽  
Vol 18 (1) ◽  
pp. 35-44 ◽  
Author(s):  
Catherine Conchar ◽  
Julie Repper
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Peer Support ◽  
Personal Experience ◽  
Mental Health Problems ◽  
Health Problems ◽  
Review Of The Literature ◽  
Wounded Healer ◽  
Content Type

Purpose – A systematic review of the literature on “wounded healers” was undertaken to identify, define and interpret the term and its application within the mental health environment. The paper aims to discuss these issues. Design/methodology/approach – Eight key medical/social sciences databases were interrogated. In total, 835 papers were identified in the systematic database search and abstracts were obtained for each to determine whether they met the inclusion criteria. In total, 237 sources were retrieved for critical reading, to assess relevance and value to the review, and 125 documents were subsequently included. Through thematic analysis a number of themes and sub themes were identified Findings – The archetypal image of the wounded healer originates in ancient mythology and crosses many cultures. There are many interpretations and applications of the belief that having healed their own wounds a person is in a better position to heal others, however, the evidence to support this is not so robust. Of more direct relevance to contemporary practice are reports of supporting staff with mental health problems to make a contribution to mental health services, most recently through the employment of peer support workers. Originality/value – As peer support workers are increasingly being employed in mental health services, it is helpful to consider the many existing staff who bring personal experience of mental health problems. This paper explores the evidence that their lived experience makes a difference to the way that they work and considers their employment support needs.

Autistic spectrum disorder without intellectual impairment in adult mental health services – fostering new perspectives and enhancing existing services

2018 ◽  
pp. 1-7
Author(s):  
N. Crowley ◽  
H. O’Connell ◽  
M. Gervin
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Autistic Spectrum Disorder ◽  
Mental Health Problems ◽  
Health Problems ◽  
Spectrum Disorder ◽  
Intellectual Impairment ◽  
Autistic Spectrum ◽  
Adult Mental Health

Autistic spectrum disorder (ASD) is a neuro-developmental disability with multi-systemic impacts. Individuals with ASD without intellectual impairment (DSM-V) or Aspergers (DSM-IV) are often particularly vulnerable to mental health problems such as anxiety disorders including social phobia and generalised anxiety disorder, depressive disorders and psychosis. Adults with ASD without intellectual impairment suffer higher rates of physical and psychiatric morbidity, display a poorer ability to engage with treatment and have a lower chance of recovery compared with the general population. It is widely acknowledged that adults with suspected ASD without intellectual impairment and co-morbid mental health problems are often not best supported through adult mental health services and often require more tailored supports. This review seeks to (a) increase awareness in the area of undiagnosed cases of ASD without intellectual impairment in adult mental health settings and (b) highlights the importance of identifying this population more efficiently by referring to best practice guidelines. The value of future research to examine the benefit of having a team of specialist staff within adult mental health teams who have received ASD training and who are supported to work with the ‘core difficulties’ of ASD is discussed and a model for the same is proposed. It is proposed that a specialist team could form a ‘hub’ for the development of expertise in ASD, which when adequately resourced and funded could reach across an entire region, offering consultancy and diagnostic assessments and interventions.

scholarly journals Digital cognitive behaviour therapy for insomnia (CBTi) for adolescents with mental health problems. Results from a feasibility open trial. (Preprint)

2019 ◽  
Author(s):  
Bethany Cliffe ◽  
Abigail Croker ◽  
Megan Denne ◽  
Jacqueline Smith ◽  
Paul Stallard
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Mental Health Problems ◽  
Health Problems ◽  
Anxiety And Depression ◽  
Severity Scale ◽  
Sleep Condition ◽  
Condition Indicator ◽  
Insomnia Severity

BACKGROUND Insomnia in adolescents is common, persistent, and associated with poor mental health including anxiety and depression. Insomnia in adolescents attending child mental health services is seldom directly treated and the effects of digital CBTi on the mental health of adolescents with significant mental health problems is unknown. OBJECTIVE This paper reports an open study assessing the feasibility of adding supported online CBT for insomnia to the usual care of young people aged 14-17 years attending specialist child and adolescent mental health services. METHODS Thirty-nine adolescents aged 14-17 attending specialist child and adolescent mental health services with insomnia were assessed and offered digital CBTi. The digital intervention was Sleepio, an evidence based, self-directed, fully automated CBTi that has proven effective in multiple randomized controlled trials with adults. Self-report assessments of sleep (Sleep Condition Indicator, Insomnia Severity Scale, online sleep diaries), anxiety (Revised Child Anxiety and Depression Scale) and depression (Mood and Feelings Questionnaire) were completed at baseline and post-intervention. Post-use interviews assessed satisfaction with digital CBTi. RESULTS Average baseline sleep efficiency was very poor (52.9%) with participants spending an average of 9.6 hrs in bed but only 5.1 hrs asleep. All scored <17 on the Sleep Condition Indicator with 36/39 (92.3%) scoring ≥15 on the Insomnia Severity Scale, suggesting clinical insomnia. 36 (92.3%) scored ≥ 27 on the Mood and Feelings Questionnaire for major depression and 20 (51.3%) had clinically elevated symptoms of anxiety. The majority (76%) were not having any treatment for their insomnia, with the remaining 24% receiving medication. Sleepio was acceptable with 77% (30/39) activating their account and 67% (21/30) completing the program. Statistically significant pre-post improvements were found in weekly diaries of sleep efficiency (p=.005) and sleep quality (p=.001) and on measures of sleep (SCI; p=.001: ISI; p=.001), low mood (MFQ; p=.024) and anxiety (RCADS; p=.015). Satisfaction was high; with 89% finding Sleepio helpful, 94% would recommend it to a friend with 39% expressing a definite preference for a digital intervention. CONCLUSIONS Our study has a number of methodological limitations, particularly the small sample size, absence of a comparison group and follow-up assessment. Nonetheless, our findings are encouraging and suggest that digital CBTi for young people with mental health problems might offer an acceptable and an effective way to improve both sleep and mental health. CLINICALTRIAL N/a

scholarly journals A realistic evaluation of evidence-based therapeutic processes in mental health services– Context-Mechanisms-Outcomes

2020 ◽  
Author(s):  
Eric Badu ◽  
Anthony Paul O’Brien ◽  
Rebecca Mitchell ◽  
Akwasi Osei
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Health Professional ◽  
Therapeutic Alliance ◽  
Thematic Analysis ◽  
Mental Health Professional ◽  
Evidence Based ◽  
Realistic Evaluation ◽  
Alliance Building

Abstract Background Evidence-based clinical practice is an inherent component of developed countries mental health professional practice, however, little is known about Ghana mental health professional perspectives on evidence-based practice. This paper outlines the processes involved in the delivery of best practice in Ghana. The paper describes a realistic evaluation of mental health nurses and allied health opinions regarding the evidenced-based therapeutic process in Ghana mental health facilities. Methods A purposive sample of 30 Mental Health Professionals (MHPs) was recruited to participate in semi-structured in-depth interviews. Thematic analysis was used to analyse the data. A programme theory of Context + Mechanism = Outcome (CMO) configuration was developed from the analysis. Results The thematic analysis identified two CMO configurations: 1) technical competency stimulates evidence-based mental health services; and, 2) therapeutic alliance-building ensures effective interaction. The study demonstrated that contextual factors (technical competencies and therapeutic alliance building) together with mechanisms (intentional and unintentional) help to promote the quality of mental health services. However, contextual factor such as the lack of sign language interpreters yielded an unintended outcome such as consumer-provider communication barrier for consumers with hearing impaired and those from linguistically minority background. Conclusion We conclude that government stakeholders and policymakers should prioritize policy documents, periodic monitoring and adequate financial incentives to support the on-going mechanisms that promote mental health professional technical competence and therapeutic alliance building.

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