scholarly journals Implementation of guidelines on family involvement for persons with psychotic disorders in community mental health centres (IFIP): protocol for a cluster randomised controlled trial

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Lars Hestmark ◽  
Maria Romøren ◽  
Kristin Sverdvik Heiervang ◽  
Bente Weimand ◽  
Torleif Ruud ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Community Mental Health ◽  
Family Involvement ◽  
Psychotic Disorders ◽  
Psychosocial Health ◽  
Health Care Personnel ◽  
National Guidelines ◽  
Cluster Randomised ◽  
Health Centres

Abstract Background Family involvement for persons with psychotic disorders is under-implemented in mental health care, despite its firm scientific, economic, legal and moral basis. This appears to be the case in Norway, despite the presence of national guidelines providing both general recommendations on family involvement and support in the health- and care services, and specific guidance on family interventions for patients with psychotic disorders. The aim of this project is to improve mental health services and the psychosocial health of persons with psychotic disorders and their relatives, by implementing selected recommendations from the national guidelines in community mental health centres, and to evaluate this process. Methods The trial is cluster randomised, where 14 outpatient clusters from community mental health centres undergo stratified randomisation with an allocation ratio of 1:1. The seven intervention clusters will receive implementation support for 18 months, whereas the control clusters will receive the same support after this implementation period. The intervention consists of: 1. A basic level of family involvement and support. 2. Family psychoeducation in single-family groups. 3. Training and guidance of health care personnel. 4. A family coordinator and 5. Other implementation measures. Fidelity to the intervention will be measured four times in the intervention arm and two times in the control arm, and the differences in fidelity changes between the arms constitute the primary outcomes. In each arm, we aim to include 161 patients with psychotic disorders and their closest relative to fill in questionnaires at inclusion, 6 months and 12 months, measuring psychosocial health and satisfaction with services. Clinicians will contribute clinical data about patients at inclusion and 12 months. Use of health and welfare services and work participation, for both patients and relatives, will be retrieved from national registries. We will also perform qualitative interviews with patients, relatives, health care personnel and leaders. Finally, we will conduct a cost-effectiveness analysis and a political economy analysis. Discussion This project, with its multilevel and mixed methods approach, may contribute valuable knowledge to the fields of family involvement, mental health service research and implementation science. Trial registration ClinicalTrials.gov Identifier NCT03869177. Registered 11.03.19.

scholarly journals Consumer satisfaction with community mental health care in Durban

2004 ◽  
Vol 9 (1) ◽  
Author(s):  
Renée Almeida ◽  
Oluyinka Adejumo
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Quality Assurance ◽  
Community Mental Health ◽  
Mental Health Care ◽  
Full Text ◽  
Consumer Satisfaction ◽  
Community Mental Health Care ◽  
Consumer Evaluation ◽  
Health Centres

This study presents a consumer evaluation of the delivery and aspects of services provided at three community run mental health centres with the aim of using this information to improve the services in future for quality assurance. Opsomming Hierdie studie handel oor 'n verbruikersevaluering van die lewering van dienste en aspekte daarvan wat aan die drie gemeenskapsonder-houdende geestesgesondheidsentra gelewer is met die doel om hierdie inligting te gebruik om die dienste in die toekoms vir kwaliteits-versekering te verbeter. *Please note: This is a reduced version of the abstract. Please refer to PDF for full text.

Descriptive study of patients with intellectual disability attended in a community mental health care center

2017 ◽  
Vol 41 (S1) ◽  
pp. S599-S600
Author(s):  
S. Oller Canet ◽  
E. Pérez Sánchez ◽  
L. Alba Pale ◽  
E. Mur Mila ◽  
B. Samsó Buixareu ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Intellectual Disability ◽  
Community Mental Health ◽  
Mental Health Care ◽  
Aggressive Behavior ◽  
Psychotic Disorders ◽  
Care Center ◽  
Community Mental Health Care ◽  
Health Care Center

IntroductionThe rate of mental illness among people with intellectual disability is at least 2.5 times higher than in the general population [1].ObjectiveTo describe the clinical and sociodemographic characteristics of all patients with intellectual disability treated in a community mental health care center (CMH) located in a city of 120,000 inhabitants on the outskirts of Barcelona with a high poverty index.MethodsDocuments and patient records were reviewed. Clinical, sociodemographic and other treatment data of patients with intellectual disability treated at the CMH were collected.ResultsThe sample consisted of 118 patients. Mean age: 39.5 (SD: 15), 54% men. 92% single and 23.7% legally incapacitated. 46.6% never completed basic education and 44.1% completed primary school. Employment status: 14.4% unemployed, 14.4% currently active, and 50% pensioned. Patients living mainly with their family (parents:) 86%. 68.6% of patients showed aggressive behavior, but the rate of hospital psychiatric admissions was low (mean: 1.1 (SD: 2.3)). Organic comorbidity: 44.9%. Functionality measured with GAF mean: 45 (SD: 12). Level of intellectual disability was mostly mild (62%). Psychiatric diagnoses were: psychotic disorders: 49.25%, affective disorders: 6.8%, personality disorder: 3.4%, Obsessive-compulsive disorder: 3.4%, autism: 11.9% and other diagnoses: 37.3%. Patients treated with anti-psychotics: 78.8%, anti-depressants: 40.7%, and mood stabilizers: 70.5%.ConclusionsIntellectually disabled patients from our sample showed high comorbidity with psychotic disorders, were highly medicated and often exhibited aggressive behavior.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals The impact of routine outcome measurement on treatment processes in community mental health care: approach and methods of the MECCA study

2002 ◽  
Vol 11 (3) ◽  
pp. 198-205 ◽  
Author(s):  
Stefan Priebe ◽  
Rosemarie McCabe ◽  
Jens Bullenkamp ◽  
Lars Hansson ◽  
Wulf Rössler ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Mental Health ◽  
Health Care ◽  
Community Mental Health ◽  
Mental Health Care ◽  
Psychotic Disorders ◽  
Outcome Measurement ◽  
Treatment Decisions ◽  
Community Mental Health Care

SUMMARYThree issues characterise the background to the MECCA study: A) Throughout Europe, most patients with severe forms of psychotic disorders are cared for in the community. The challenge now is to make processes in community mental health care more effective. B) There are widespread calls to implement regular outcome measurement in routine settings. This, however, is more likely to happen, if it provides a direct benefit to clinicians and patients. C) Whilst user involvement is relatively ?" easy to achieve on a political level, new mechanisms may have to be established to make the views of patients feed into individual treatment decisions. The MECCA study is a cluster randomised controlled trial following the same protocol in community mental health teams in six European countries. In the experimental group, patients' subjective quality of life, treatment satisfaction and wishes for different or additional help are assessed in key worker-patient meetings every two months and intended to inform the therapeutic dialogue and treatment decisions. The trial tests the hypothesis that the intervention – as compared to current best standard practice – will lead to a better outcome in terms of quality of life and other criteria in patients with psychotic disorders over a one year period. This more favourable outcome is assumed to be mediated through different treatment input based on more appropriate joint decisions or a more positive therapeutic relationship in line with a partnership model of care or both. Moreover, the study will hopefully reveal new insights into how therapeutic processes in community mental health care work and how they can be optimised.

scholarly journals Reshaping Community Mental Health Services during the COVID-19 Epidemic - Report from the 59G21 Service in Lille, France

2020 ◽  
Vol 13 ◽  
pp. 117863292095487
Author(s):  
Baleige Antoine ◽  
Daumerie Nicolas ◽  
Defromont Laurent
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Services ◽  
Community Mental Health ◽  
Health Services ◽  
Community Mental Health Services ◽  
Severe Form ◽  
Physical And Mental Health ◽  
National Guidelines ◽  
International Crisis

The COVID-19 pandemic led to a rapid transformation of the health care system to cope with the risk of contamination and of developing a severe form of the infection. Although it is an international crisis, strategies have been decided nationally. In France, priority was given to hospital reorganization, especially intensive care units. Reorganization of primary health and mental health services took place with late and inadequate national guidelines or coordination. For mental health services, lack of visibility on the crisis impact on mental health, and difficulties in defining their place in the overall health strategy appeared as the main challenges to overcome. These rapid transformations impacted the whole organization of community mental health care. Any strategies developed must ensure that every person enjoys the highest attainable standard of physical and mental health. Using a systemic approach, it has been necessary to identify both status and risk factors of communities, and to implement appropriate and efficient health promotion and crisis resolution actions. These theoretical issues and their practical impact are discussed using the field strategy developed during the first 28 days of confinement by the 59G21 service in Lille, France.

Psychometric Properties of the German Version of the Scale to Assess the Therapeutic Relationship in Community Mental Health Care (D-STAR)

2012 ◽  
Vol 28 (4) ◽  
pp. 255-261 ◽  
Author(s):  
Sabine Loos ◽  
Reinhold Kilian ◽  
Thomas Becker ◽  
Birgit Janssen ◽  
Harald Freyberger ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Community Mental Health ◽  
Mental Health Care ◽  
Psychometric Properties ◽  
Therapeutic Relationship ◽  
Internal Consistency ◽  
Convergent Validity ◽  
Community Mental Health Care ◽  
German Version

Objective: There are presently no instruments available in German language to assess the therapeutic relationship in psychiatric care. This study validates the German version of the Scale to Assess the Therapeutic Relationship in Community Mental Health Care (D-STAR). Method: 460 persons with severe mental illness and 154 clinicians who had participated in a multicenter RCT testing a discharge planning intervention completed the D-STAR. Psychometric properties were established via item analysis, analyses of missing values, internal consistency, and confirmatory factor analysis. Furthermore, convergent validity was scrutinized via calculating correlations of the D-STAR scales with two measures of treatment satisfaction. Results: As in the original English version, fit indices of a 3-factor model of the therapeutic relationship were only moderate. However, the feasibility and internal consistency of the D-STAR was good, and correlations with other measures suggested reasonable convergent validity. Conclusions: The psychometric properties of the D-STAR are acceptable. Its use can be recommended in German-speaking countries to assess the therapeutic relationship in both routine care and research.

Costs of Schizophrenia and Other Psychoses in Urban Australia: Findings from the Low Prevalence (Psychotic) Disorders Study

2003 ◽  
Vol 37 (1) ◽  
pp. 31-40 ◽  
Author(s):  
Vaughan J. Carr ◽  
Amanda L. Neil ◽  
Sean A. Halpin ◽  
Scott Holmes ◽  
Terry J. Lewin
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Psychotic Disorders ◽  
Community Services ◽  
Societal Costs ◽  
Metropolitan Regions ◽  
Lost Productivity ◽  
Average Patient ◽  
The Government ◽  
Low Prevalence

Objective: To estimate the costs associated with the treatment and care of persons with psychosis in Australia based on data from the Low Prevalence Disorders Study (LPDS), and to identify areas where there is potential for more efficient use of existing health care resources. Method: The LPDS was a one-month census-based survey of people with psychotic disorders in contact with mental health services, which was conducted in four metropolitan regions in 1997–1998. Mental health and service utilization data from 980 interviews were used to estimate the economic costs associated with psychotic disorders. A prevalencebased, ‘bottom-up’ approach was adopted to calculate the government and societal costs associated with psychosis, including treatment and non-treatment related costs. Results: Annual societal costs for the average patient with psychosis are of the order of $46 200, comprising $27 500 in lost productivity, $13 800 in inpatient mental health care costs and $4900 in other mental health and community services costs. Psychosis costs the Australian government at least $1.45 billion per annum, while societal costs are at least $2.25 billion per annum (including $1.44 billion for schizophrenia). We also report relationships between societal costs and demographic factors, diagnosis, disability and participation in employment. Conclusions: Current expenditure on psychosis in Australia is probably inefficient. There may be substantial opportunity costs in not delivering effective treatments in sufficient volume to people with psychotic disorders, not intervening early, and not improving access to rehabilitation and supported accommodation.

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