scholarly journals A mixed methods evaluation of an integrated adult mental health service model

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Diana Beere ◽  
Imogen S. Page ◽  
Sandra Diminic ◽  
Meredith Harris
Keyword(s):  
Mental Health ◽  
Mental Health Service ◽  
Mental Health Services ◽  
Health Service ◽  
Health Services ◽  
Public Mental Health ◽  
Client Outcomes ◽  
Service Model ◽  
Public Mental Health Services

Abstract Background The Floresco integrated service model was designed to address the fragmentation of community mental health treatment and support services. Floresco was established in Queensland, Australia, by a consortium of non-government organisations that sought to partner with general practitioners (GPs), private mental health providers and public mental health services to operate a ‘one-stop’ mental health service hub. Methods We conducted an independent mixed-methods evaluation of client outcomes following engagement with Floresco (outcome evaluation) and factors influencing service integration (process evaluation). The main data sources were: (1) routinely-collected Recovery Assessment Scale — Domains and Stages (RAS–DS) scores at intake and review (n = 108); (2) RAS–DS scores, mental health inpatient admissions and emergency department (ED) presentations among clients prospectively assessed at intake and six-month follow-up (n = 37); (3) semi-structured interviews with staff from Floresco, consortium partners, private practitioners and the local public mental health service (n = 20); and (4) program documentation. Results Interviews identified staff commitment, co-location of services, flexibility in problem-solving, and anecdotal evidence of positive client outcomes as important enablers of service integration. Barriers to integration included different organisational practices, difficulties in information-sharing and in attracting and retaining GPs and private practitioners, and systemic constraints on integration with public mental health services. Of 1129 client records, 108 (9.6%) included two RAS–DS measurements, averaging 5 months apart. RAS–DS ‘total recovery’ scores improved significantly (M = 63.3%, SD = 15.6 vs. M = 69.2%, SD = 16.1; p < 0.001), as did scores on three of the four RAS–DS domains (‘Looking forward’, p < 0.001; ‘Mastering my illness’, p < 0.001; and ‘Connecting and belonging’, p = 0.001). Corresponding improvements, except in ‘Connecting and belonging’, were seen in the 37 follow-up study participants. Decreases in inpatient admissions (20.9% vs. 7.0%), median length of inpatient stay (8 vs. 3 days), ED presentations (34.8% vs. 6.3%) and median duration of ED visits (187 vs. 147 min) were not statistically significant. Conclusions Despite the lack of a control group and small follow-up sample size, Floresco’s integrated service model showed potential to improve client outcomes and reduce burden on the public mental health system. Horizontal integration of non-government and private services was achieved, and meaningful progress made towards integration with public mental health services.

Attaining the age threshold for adolescent mental health services: factors associated with transition of care in the independent sector in Ireland

2019 ◽  
Vol 36 (3) ◽  
pp. 187-193 ◽  
Author(s):  
L. Bond ◽  
A. Feeney ◽  
R. Collins ◽  
I. Khurshid ◽  
S. Healy ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Health Service ◽  
Young Adult ◽  
Mental Health Services ◽  
Health Service ◽  
Health Services ◽  
Public Mental Health ◽  
Adolescent Mental Health ◽  
Descriptive Study ◽  
Adult Service

ObjectivesThe transition from adolescent to adult mental health services (AMHS) is associated with disengagement, poor continuity of care and patient dissatisfaction. The aim of this retrospective and descriptive study was to describe the ‘care pathways’ in an independent mental health service when adolescents reach age 18 and to investigate the level of engagement of those who transitioned to independent AMHS.MethodsThis is a retrospective, naturalistic and descriptive study in design. All patients discharged from the St Patrick’s Adolescent Mental Health Service aged 17 years and 6 months and older, during a 3-year period between January 2014 and December 2016, were included. Electronic records were used to collect socio-demographic and clinical details and to determine engagement rates in adolescents who transferred to independent adult services.ResultsA total of 180 patients aged over 17 years and 6 months were discharged from the adolescent service. Of these, 45.6% were discharged to their GP, 28.9% to public mental health services and 25.6% to independent mental health services. The majority who transitioned to independent AMHS went to a Young Adult Service, which had high engagement rates at 3 and 12 months post-transition.ConclusionsIn this independent mental health service, less than half of adolescents who reach the transition age are referred onto AMHS. Engagement rates were found to be high among those referred on to a specialised young adult service.

The Mental Illness Needs Index

1997 ◽  
Vol 6 (S1) ◽  
pp. 13-20 ◽  
Author(s):  
Gyles Glover
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Mental Health Services ◽  
Health Service ◽  
Health Services ◽  
Public Mental Health ◽  
Public Mental Health Services

It is well known that the prevalence of mental illness is not uniformly distributed. This has practical consequences for the planning, financing and evaluation of public mental health services. Areas likely to have greater morbidity are likely to require more resources. The question is by how much? This essay describes a method devised in the context of the English health service to provide practical help to mental health planners faced with this type of question.

scholarly journals The effect of a youth mental health service model on access to secondary mental healthcare for young people aged 14–25 years

2018 ◽  
Vol 43 (1) ◽  
pp. 27-31 ◽  
Author(s):  
Sarah Maxwell ◽  
Obianuju Ugochukwu ◽  
Tim Clarke ◽  
Brioney Gee ◽  
Emmet Clarke ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Health Service ◽  
Mental Health Services ◽  
Young People ◽  
Health Service ◽  
Health Services ◽  
Mental Healthcare ◽  
Youth Mental Health ◽  
Service Model ◽  
Youth Service

Aims and methodThe Norfolk Youth Service was created in 2012 in response to calls to redesign mental health services to better meet the needs of young people. The new service model transcends traditional boundaries by creating a single, ‘youth friendly’ service for young people aged 14–25 years. The aim of this study was to investigate the effect of the transition to this new model on patterns of referral, acceptance and service use. We analysed routinely collected data on young people aged 14–25 years referred for secondary mental healthcare in Norfolk before and after implementation of the youth mental health service. The number of referrals, their age and gender, proportion of referrals accepted and average number of service contacts per referral by age pre- and post-implementation were compared.ResultsReferrals increased by 68% following implementation of the new service model, but the proportion of referrals accepted fell by 27 percentage points. Before implementation of the youth service, there was a clear discrepancy between the peak age of referral and the age of those seen by services. Following implementation, service contacts were more equitable across ages, with no marked discontinuity at age 18 years.Clinical implicationsOur findings suggest that the transformation of services may have succeeded in reducing the ‘cliff edge’ in access to mental health services at the transition to adulthood. However, the sharp rise in referrals and reduction in the proportion of referrals accepted highlights the importance of considering possible unintended consequences of new service models.Declaration of interestsNone.

Capitation of Public Mental Health Services in Colorado: A Five-Year Follow-Up of System-Level Effects

2011 ◽  
Vol 62 (2) ◽  
pp. 179-185 ◽  
Author(s):  
Joan R. Bloom ◽  
Huihui Wang ◽  
Soo Hyang Kang ◽  
Neal T. Wallace ◽  
Jenny K. Hyun ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Public Mental Health ◽  
System Level ◽  
Public Mental Health Services

School Settings

2018 ◽  
Author(s):  
Melissa K. Holt ◽  
Jennifer Greif Green ◽  
Javier Guzman
Keyword(s):  
Mental Health ◽  
Mental Health Service ◽  
Mental Health Services ◽  
Health Service ◽  
Health Services ◽  
Service Provision ◽  
Community Mental Health Service ◽  
Health Service Provision ◽  
School Settings ◽  
Mental Health Service Provision

Schools are a primary setting for mental health service provision to youth and are also main sources of referral to community mental health service providers. This chapter examines the school context and its key role in the child and adolescent mental health services system. The chapter first provides information about the association of emotional and behavioral disorders with school experiences, including academic performance. Next, the chapter presents a framework for mental health service provision and assessment in schools, including describing methods for identifying students who might need mental health services and tracking their progress. Further, several evidence-based interventions are highlighted as examples of effective practices in schools. The chapter concludes with recommendations for clinical practice in school settings.

scholarly journals Higher Rates of Untreated Distress in Older Versus Younger Adults With Indolent Lymphoma

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 466-466
Author(s):  
Kelly Trevino ◽  
Peter Martin ◽  
John Leonard
Keyword(s):  
Mental Health ◽  
Older Adults ◽  
Mental Health Service ◽  
Mental Health Services ◽  
Health Service ◽  
Health Services ◽  
Service Use ◽  
Mental Health Service Use ◽  
Health Service Use ◽  
Younger Adults

Abstract Indolent lymphomas are incurable but slow-growing cancers, resulting in a large number of older adults living with these diseases. Patients typically live with their illness for years with the knowledge that disease progression is likely. Yet, little is known about psychological distress in this population. This study examined rates of and the relationship between distress and mental health service use in older and younger adults with indolent lymphomas. Adult patients diagnosed with an indolent lymphoma (e.g., follicular lymphoma, marginal zone lymphoma) within the past six months completed self-report surveys of distress (Hospital Anxiety and Depression Scale; HADS) and mental health service use since the cancer diagnosis (yes/no). Descriptive statistics, t-tests, and chi-square analyses were used to examine study questions. The sample (n=84) included 35 patients 65 years or older. Across the entire sample, 21.4% screened positive for distress on the HADS; 58.8% of these patients did not receive mental health services. Older adults reported lower distress levels than younger adults (17.1% v. 24.5%; p=.038). Among younger adults, 50% of distressed patients received mental health services; only 20% of distressed older adults received mental health services. Distress was associated with mental health service use in younger adults (p=.004) but not in older adults (p=.17). Older adults with indolent lymphomas have higher levels of untreated distress than younger adults. Research on the mechanisms underlying these age differences (e.g., stigma toward mental health services, ageism) would inform interventions to increase rates of mental health service use and reduce care disparities due to age.

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