scholarly journals A qualitative study of evidence-based therapeutic process in mental health services in Ghana– context-mechanisms-outcomes

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Eric Badu ◽  
Anthony Paul O’Brien ◽  
Rebecca Mitchell ◽  
Akwasi Osei

Abstract Background Evidence-based clinical practice is an inherent component of mental health professional practice in developed countries. However, little is known about professional perspectives of evidence-based practice in mental in developing countries such as Ghana. This paper describes the processes involved in the delivery of best practice in Ghana. The paper reports on a realistic evaluation of mental health nurses and allied health professionals’ views on the evidence-based therapeutic process in Ghana. 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 program theory of Context + Mechanism = Outcome (CMO) configuration was developed from the analysis. Results The thematic analysis identified two contexts, mechanism and outcome configurations (themes): 1) technical competency stimulates evidence-based mental health services, and 2) therapeutic relationship building ensures effective interaction. The study demonstrates that contextual factors (technical competencies and therapeutic relationship building) together with mechanisms (intentional and unintentional) help to promote quality in mental health service provision. However, contextual factors such as a lack of sign language interpreters yielded unintended outcomes including barriers to communication with providers for consumers with hearing impairment and those from linguistic minority backgrounds. Conclusion Government stakeholders and policymakers should prioritise policies, periodic monitoring and adequate financial incentives to support the mechanisms that promote technical competence in MHPs and the building of therapeutic relationship.

2020 ◽  
Author(s):  
Eric Badu ◽  
Anthony Paul O’Brien ◽  
Rebecca Mitchell ◽  
Akwasi Osei

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.


2021 ◽  
pp. 107780122110145
Author(s):  
Belinda Nixon ◽  
Elly Quinlan

The literature on sexual abuse indicates low rates of inquiry by mental health professionals. This study explores early career psychologists’ experiences of inquiry into their clients’ sexual abuse histories. Twelve Australian psychologists participated in semi-structured interviews with transcripts analyzed using thematic analysis. The vast majority of participants reported that they did not routinely inquire about sexual abuse with barriers including not knowing what to do, discomfort, stigma, and fear of negative outcomes. Participants asserted that their university training in sexual abuse inquiry was inadequate. Findings emphasize the need for the development of an evidence-based framework for sexual abuse training.


2018 ◽  
Vol 23 (1) ◽  
pp. 12-24 ◽  
Author(s):  
Juliette van der Kamp

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.


2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Johanna Frerichs ◽  
Jo Billings ◽  
Nick Barber ◽  
Anjie Chhapia ◽  
Beverley Chipp ◽  
...  

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.


2010 ◽  
Vol 34 (1) ◽  
pp. 20-23 ◽  
Author(s):  
Peter Simmons ◽  
Chris J. Hawley ◽  
Tim M. Gale ◽  
Thanusha Sivakumaran

Aims and methodTo determine which terms receivers of mental health services wish to be known by (service user, patient, client, user, survivor) according to the professional consulted (psychiatrist, nurse, psychologist, social worker, occupational therapist). We conducted a questionnaire study to assess terms by like or dislike and by rank order. There were 336 participants from local catchment area secondary care community and in-patient settings in east Hertfordshire.ResultsPatient is the preferred term when consulted by psychiatrists and nurses, but it is equally preferable to client for social workers and occupational therapists. Service user is disliked more than liked overall, particularly by those who consulted a health professional, but not by those who consulted a social worker. A significant minority wish to be regarded as a survivor or user.Clinical implicationsNational and local mental health services should adopt evidence-based terminology in referring to ‘patient’ or, in some groups, ‘patient or client’ in preference to ‘service user’.


Author(s):  
Eric G. Mart

This chapter provides information designed to assist mental health professionals in effectively marketing their services to courts, attorneys, and the legal system in general. Suggestions are offered to help mental health professionals decide whether they will be comfortable working in an adversarial environment. Methods for developing the skillsets necessary for performing forensic consultations in a competent, ethical manner are provided. Information regarding how to effectively market mental health services to legal professionals are reviewed. Various areas of subspecialty practice are described.


1997 ◽  
Vol 2 (6) ◽  
pp. 398-399
Author(s):  
Ian G Manion ◽  
Simon Davidson ◽  
Christina Norris ◽  
Sarah Brandon

Abstract Today's youth are at a disturbingly high risk for mental health and illness problems and are largely dissatisfied with the existing mental health services. Youth Net/Réseau Ado (YN/RA), supported by input from mental health professionals, is a bilingual mental health promotion program that seeks out the opinions and attitudes of youth regarding mental health and illness issues, while connecting them with appropriate resources and mental health services. This paper describes the Youth Net/Réseau Ado program and provides some guidelines for the identification of mental health and illness problems, including indicators of the risk of suicide.


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