scholarly journals Situational analysis to inform development of primary care and community-based mental health services for severe mental disorders in Nepal

2017 ◽  
Vol 11 (1) ◽  
Author(s):  
Mangesh Angdembe ◽  
Brandon A. Kohrt ◽  
Mark Jordans ◽  
Damodar Rimal ◽  
Nagendra P. Luitel
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Mental Health Services ◽  
Mental Disorders ◽  
Health Services ◽  
Situational Analysis ◽  
Severe Mental Disorders ◽  
Community Based

scholarly journals Discrepancy between experience and importance of recovery components in the symptomatic and recovery perceptions of people with severe mental disorders

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Patricia Penas ◽  
Jose-Juan Uriarte ◽  
Susana Gorbeña ◽  
Mike Slade ◽  
María-Concepción Moreno-Calvete ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Mental Disorders ◽  
Health Services ◽  
Recovery Process ◽  
Internalized Stigma ◽  
Personal Recovery ◽  
Severe Mental Disorders ◽  
Clinical Recovery ◽  
The Relationship

Abstract Background Personal recovery has become an increasingly important approach in the care of people with severe mental disorders and consequently in the orientation of mental health services. The objective of this study was to assess the personal recovery process in people using mental health services, and to clarify the role of variables such as symptomatology, self-stigma, sociodemographic and treatment. Methods Standardised measures of personal recovery process, clinical recovery, and internalized stigma were completed by a sample of 312 participants in a Severe Mental Disorder program. Results Users valued most the recovery elements of: improving general health and wellness; having professionals who care; hope; and sense of meaning in life. Significant discrepancies between perceived experience and relative importance assigned to each of the components of the REE were observed. Regression modeling (χ2 = 6.72, p = .394; GFI = .99, SRMR = .03) identified how positive discrepancies were associated with a higher presence of recovery markers (β = .12, p = .05), which in turn were negatively related to the derived symptomatology index (β = −.33, p < .001). Furthermore, the relationship between clinical and personal recovery was mediated by internalized stigma. Conclusions An improvement in psychiatric services should be focused on recovery aspects that have the greatest discrepancy between importance and experience, in particular social roles, basic needs and hope. Personal and clinical recovery are correlated, but the relationship between them is mediated by internalized stigma, indicating the need for clinical interventions to target self-stigma.

scholarly journals Improving referrals from primary care to secondary mental health services through an educational intervention: experience from Qatar

2021 ◽  
pp. 1-4
Author(s):  
Ovais Wadoo ◽  
Sami Ouanes ◽  
Mohamed Ali Siddig Ahmed ◽  
Iman Saeed Ahmed Saeid ◽  
Samya Ahmad AlAbdulla ◽  
...  
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Mental Health Services ◽  
Mental Disorders ◽  
Health Services ◽  
Educational Intervention ◽  
Common Mental Disorders ◽  
Clinical Information ◽  
Health Clinic

Primary care is geared to manage patients with mild to moderate presentations of common mental disorders and to refer patients with more severe mental disorders to specialist mental health services. With growing demand for specialty care, the quality of the referral is increasingly important to ensure efficient patient flow across the primary/secondary care interface and appropriate use of secondary services. We report on an initiative in a Qatari mental health clinic to improve the quality of referrals from primary care to specialist mental health services through an educational intervention for family physicians. We highlight the problem, the intervention and the outcome of our initiative, which was the first of its kind in the region. The number of inappropriate referrals fell by 93%, and the number of referrals with inadequate clinical information declined from 15 (January 2019) to 1 (September 2019). Feedback was very positive; respondents reported feeling supported, with better understanding of care pathways, the scope of primary care and mental health services.

E-health responses to common mental disorders in primary care: experiences with Ębeyondblue‘ and ĘSPHERE’

2002 ◽  
Vol 10 (3) ◽  
pp. 253-258 ◽  
Author(s):  
Ian Hickie ◽  
Tracey Davenport ◽  
Elizabeth Scott ◽  
Hugh Morgan
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Mental Health Services ◽  
Mental Disorders ◽  
Health Services ◽  
Health Systems ◽  
General Practitioners ◽  
Support System ◽  
Common Mental Disorders ◽  
Web Based

Objective: To highlight opportunities for enhancing mental health services in primary care through utilisation of e-health systems. Specifically, an information-based website (provided by ‘beyondblue: the national depression initiative’) and a web-based support system for general practitioners (provided by ‘SPHERE: a national depression project’) are described. Conclusions: Recommendations regarding potential roles for e-health systems in association with Australian primary care are outlined.

scholarly journals A Multi-Site Study of Mental Disorders in the Mozambican Health Care System

2020 ◽  
Author(s):  
Lidia Gouveia ◽  
Kathryn Lovero ◽  
Wilza Fumo ◽  
Afonso Mazine Tiago Fumo ◽  
Palmira Dos Santos ◽  
...  
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Mental Health Services ◽  
Mental Disorders ◽  
Health Services ◽  
Mental Disorder ◽  
Suicide Risk ◽  
Common Mental Disorders ◽  
Tertiary Care ◽  
Public Mental Health

Abstract BackgroundIn Mozambique, human and financial resources for public mental health services are extremely limited. Understanding the mental health needs of those seeking healthcare can inform efficient targeting of mental health services. We examined if the frequency of mental disorders in a health facility varied based on the level of specialization of such facility, from primary care without mental health specialists (PrCMH-), to those with mental health specialists (PrCMH+) and tertiary care (TerC), where both inpatient and outpatient mental health services are available.MethodsParticipants were adults seeking health or mental health services at six facilities (2 PrCMH+, 3 PrCMH-, and 1 TerC) in the cities of Maputo and Nampula in Mozambique. Mental disorders were assessed by the MINI International Neuropsychiatric Interview (MINI) 4.0.0. We compared the sociodemographic characteristics and MINI diagnoses across the three types of health facilities. Multiple logistic regression models determined the likelihood that a person seeking services at each type of facility would have any mental disorder, common mental disorders (CMD), severe mental disorders (SMD), substance use disorders (SUD), and moderate-to-high suicide risk, adjusting for sociodemographic factors. ResultsOf the 612 total participants, 52.6% (n=322) were positive for at least one mental disorder: 37.1% were positive for CMD, 28.9% for SMD, 13.2% for SUD, and 10.5% had suicide risk. Presence of any mental disorder was highest in TerC (62.5%) and lowest in PrCMH- (48.4%). Adjusting for sociodemographic covariates, participants in PrCMH+ were significantly more likely to have SMD (OR: 1.85, 95%CI: 1.10-3.11) and SUD (OR: 2.79, 95%CI: 1.31-5.94) than participants in PrCMH-; participants in TerC were more likely to have CMD (OR: 1.70, 95%CI: 1.01-2.87) and SUD (OR: 2.57, 95%CI: 1.14-5.79) than in PrCMH-. Suicide risk was the only condition that did not differ across facility types.ConclusionsAs anticipated, people with mental disorders were more likely to be cared for at facilities with mental health specialists. However, our study suggests there is a remarkably high frequency of mental disorders across different types of facilities within the Mozambican healthcare system. These results suggest a need to increase mental health services at the primary care level.

Outcomes of promotion, prevention, treatment and care

2016 ◽  
Vol 33 (S1) ◽  
pp. S3-S3
Author(s):  
M. Muijen
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Health Promotion ◽  
Mental Health Services ◽  
Mental Disorders ◽  
Health Services ◽  
Low Income ◽  
Action Plan ◽  
Vulnerable Groups ◽  
Populations At Risk

The WHO European Mental Health Action Plan encompasses promotion, prevention, treatment and recovery, within the context of a model of mental health that proposes a set of socio-economic and biological determinants that predispose to vulnerabilities and increase the risk of disorders. These determinants also negatively affect access to and quality of care. Such risk factors are shared with common non-communicable disorders, increasing the risk of morbidity and early mortality for people with mental disorders.Mental health promotion and prevention actions should therefore be addressing determinants such as alcohol and smoking. However, such determinants are not equally distributed in the population, but cluster among vulnerable groups, such as those with a low income, the unemployed and minority groups. These groups overlap with the populations services struggle to reach. In addition, both primary care and specialist mental health services struggle to identify and treat people with co-morbidities. This suggests that connections need to be established between public health, primary care and specialist mental health services.WHO is focussing on the strengthening of primary care and the interface with mental health services. In particular, there is an urgent need to screen people who present with symptoms of NCDs or mental disorders for common determinants and co-morbidities. Effective health promotion activities need to be offered to populations at risk, in addition to universal health promotion interventions such as taxation or advertising bans. Some examples will be presented.Disclosure of interestThe author has not supplied his declaration of competing interest.

Issues in the development of statistical and epidemiological data for mental health services research

1976 ◽  
Vol 6 (2) ◽  
pp. 185-215 ◽  
Author(s):  
Morton Kramer
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Mental Disorders ◽  
Health Services Research ◽  
Health Services ◽  
Living Arrangements ◽  
The United States ◽  
Situational Analysis ◽  
Services Research ◽  
Mental Health Services Research

SynopsisThe planning of health services consists of a process that generally involves the following steps: (a) situational analysis, or the description, definition and statement of the problem, its characteristics and dimensions in relation to population and time; (b) the formulation of alternative tactical approaches to the handling and solution of the problem; (c) decision analysis or the selection of a plan; (d) discussion and implementation of the plan selected; (e) evaluation of the results achieved in relation to the problem, situations or populations concerned. This paper discusses the content of a programme of mental health services research for collecting and analysing the information needed to apply these processes to the planning of mental health services, monitoring the manner in which the plan is being implemented, and assessing its effectiveness in achieving short-term and intermediate objectives and long-term goals.Statistical and epidemiological information play an important role in these processes, particularly in the situational analysis and the evaluation processes. Illustrations have been provided of types of data that are produced in the national mental health statistics programme in the United States. Difficulties in using such data to answer questions concerning the needs for mental health services, and manpower requirements for delivering services to meet these needs are discussed. In many instances, currently available data are quite inadequate for answering key issues such as these, plus others related to living arrangements of the population, the effect of services on the persons who receive them, their families and the communities in which they live. Thus, much still remains to be done to develop systematic, comparative morbidity statistics on the incidence, duration and prevalence of mental disorders in the general population, on the needs for mental health services, and on the effectiveness of our efforts to prevent disorders that can be prevented, and to reduce the amount of disability and distress caused by those that cannot be prevented or terminated.A series of problems have been identified, the solutions to which would assist materially in providing data that would narrow gaps between available knowledge and that which is needed. The importance of establishing well-staffed research units at the catchment area level with stable funding to accomplish this is underscored. It is a matter of the greatest urgency that adequate resources - financial, manpower, scientific and administrative - be made available to solve these problems. If this is not done, then efforts to document quantitatively the effectiveness of programmes to prevent and control mental disorders will continue to suffer from many of the same shortcomings that have impeded our past and continue to impede current efforts to accomplish this.

scholarly journals Significance of mental health legislation for successful primary care for mental health and community mental health services: A review

2018 ◽  
Vol 10 (1) ◽  
Author(s):  
Getinet Ayano
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Health Care ◽  
Mental Health Services ◽  
Community Mental Health ◽  
Mental Disorders ◽  
Health Services ◽  
Mental Health Care ◽  
Mental Health Legislation ◽  
Health Legislation

Background: Mental health legislation (MHL) is required to ensure a regulatory framework for mental health services and other providers of treatment and care, and to ensure that the public and people with a mental illness are afforded protection from the often-devastating consequences of mental illness.Aims: To provide an overview of evidence on the significance of MHL for successful primary care for mental health and community mental health servicesMethod: A qualitative review of the literature on the significance of MHL for successful primary care for mental health and community mental health services was conducted.Results: In many countries, especially in those who have no MHL, people do not have access to basic mental health care and treatment they require. One of the major aims of MHL is that all people with mental disorders should be provided with treatment based on the integration of mental health care services into the primary healthcare (PHC). In addition, MHL plays a crucial role in community integration of persons with mental disorders, the provision of care of high quality, the improvement of access to care at community level. Community-based mental health care further improves access to mental healthcare within the city, to have better health and mental health outcomes, and better quality of life, increase acceptability, reduce associated social stigma and human rights abuse, prevent chronicity and physical health comorbidity will likely to be detected early and managed.Conclusion: Mental health legislation plays a crucial role in community integration of persons with mental disorders, integration of mental health at primary health care, the provision of care of high quality and the improvement of access to care at community level. It is vital and essential to have MHL for every country.

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