scholarly journals Intersectoral collaboration for people-centred mental health care in Timor-Leste: a mixed-methods study using qualitative and social network analysis

2019 ◽  
Vol 13 (1) ◽  
Author(s):  
Teresa Hall ◽  
Ritsuko Kakuma ◽  
Lisa Palmer ◽  
Harry Minas ◽  
João Martins ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Social Network ◽  
Network Analysis ◽  
Mental Health Care ◽  
Health Systems ◽  
Resource Sharing ◽  
Intersectoral Collaboration ◽  
Mental Health Systems ◽  
Timor Leste

Abstract Background Intersectoral collaboration is fundamental to the provision of people-centred mental health care, yet there is a dearth of research about how this strategy operates within mental health systems in low- and middle-income countries. This is problematic given the known attitudinal, structural and resource barriers to intersectoral collaboration in high-income country mental health systems. This study was conducted to investigate intersectoral collaboration for people-centred mental health care in Timor-Leste, a South-East Asian country in the process of strengthening its mental health system. Methods This study employed a mixed-methods convergent design. Qualitative data elicited from in-depth interviews with 85 key stakeholders and document review were complemented with quantitative social network analysis to assess understandings of, the strength and structure of intersectoral collaboration in the Timorese mental health system. Results There was consensus among stakeholder groups that intersectoral collaboration for mental health is important in Timor-Leste. Despite resource restrictions discussed by participants, interview data and social network analysis revealed evidence of information and resource sharing among organisations working within the health and social (disability and violence support) sectors in Timor-Leste (network density = 0.55 and 0.30 for information and resource sharing, respectively). Contrary to the assumption that mental health services and system strengthening are led by the Ministry of Health, the mixed-methods data sources identified a split in stewardship for mental health between subnetworks in the health and social sectors (network degree centralisation = 0.28 and 0.47 for information and resource sharing, respectively). Conclusions Overall, the findings suggest that there may be opportunities for intersectoral collaborations in mental health systems in LMICs which do not exist in settings with more formalised mental health systems such as HICs. Holistic understandings of health and wellbeing, and a commitment to working together in the face of resource restrictions suggest that intersectoral collaboration can be employed to achieve people-centred mental health care in Timor-Leste.

scholarly journals Nature-Based Interventions for Mental Health Care: Social Network Analysis as a Tool to Map Social Farms and their Response to Social Inclusion and Community Engagement

2019 ◽  
Vol 16 (18) ◽  
pp. 3501 ◽  
Author(s):  
Marta Borgi ◽  
Mario Marcolin ◽  
Paolo Tomasin ◽  
Cinzia Correale ◽  
Aldina Venerosi ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Social Network ◽  
Social Network Analysis ◽  
Network Analysis ◽  
Mental Health Care ◽  
Rural Areas ◽  
Social Inclusion ◽  
Local Communities ◽  
Social Farming

Social farming represents a hybrid governance model in which public bodies, local communities, and economic actors act together to promote health and social inclusion in rural areas. Although relational variables are crucial to foster social farm performance, the relational system in which farms are embedded has still not been fully described. Using social network analysis, here we map the nature of the links of a selected sample of social farms operating in Northern Italy. We also explore possible network variations following specific actions taken to potentiate local social farming initiatives. The results show a certain degree of variability in terms of the extension and features of the examined networks. Overall, the actions taken appear to be significant to enlarge and diversify farms’ networks. Social farming has the potential to provide important benefits to society and the environment and to contrast vulnerability in rural areas. Being able to create social and economic networks of local communities, social farming may also represent an innovative way to respond to the cultural shift from institutional psychiatry to community-based mental health care. This study emphasizes the critical role played by network facilitation in diversifying actors, promoting heterogeneous relationships, and, in turn, system complexity.

scholarly journals The balance of adult mental health care: provision of core health versus other types of care in eight European countries

2018 ◽  
Vol 29 ◽  
Author(s):  
G. Cetrano ◽  
L. Salvador-Carulla ◽  
F. Tedeschi ◽  
L. Rabbi ◽  
M. R. Gutiérrez-Colosía ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Services ◽  
Health Services ◽  
Mental Health Care ◽  
Health Systems ◽  
European Countries ◽  
Mental Health Systems ◽  
Term Care ◽  
Care Services

Abstract Aims Although many mental health care systems provide care interventions that are not related to direct health care, little is known about the interfaces between the latter and core health care. ‘Core health care’ refers to services whose explicit aim is direct clinical treatment which is usually provided by health professionals, i.e., physicians, nurses, psychologists. ‘Other care’ is typically provided by other staff and includes accommodation, training, promotion of independence, employment support and social skills. In such a definition, ‘other care’ does not necessarily mean being funded or governed differently. The aims of the study were: (1) using a standard classification system (Description and Evaluation of Services and Directories in Europe for Long Term Care, DESDE-LTC) to identify ‘core health’ and ‘other care’ services provided to adults with mental health problems; and (2) to investigate the balance of care by analysing the types and characteristics of core health and other care services. Methods The study was conducted in eight selected local areas in eight European countries with different mental health systems. All publicly funded mental health services, regardless of the funding agency, for people over 18 years old were identified and coded. The availability, capacity and the workforce of the local mental health services were described using their functional main activity or ‘Main Types of Care’ (MTC) as the standard for international comparison, following the DESDE-LTC system. Results In these European study areas, 822 MTCs were identified as providing core health care and 448 provided other types of care. Even though one-third of mental health services in the selected study areas provided interventions that were coded as ‘other care’, significant variation was found in the typology and characteristics of these services across the eight study areas. Conclusions The functional distinction between core health and other care overcomes the traditional division between ‘health’ and ‘social’ sectors based on governance and funding. The overall balance between core health and other care services varied significantly across the European sites. Mental health systems cannot be understood or planned without taking into account the availability and capacity of all services specifically available for this target population, including those outside the health sector.

scholarly journals European comparisons between mental health services

2011 ◽  
Vol 20 (1) ◽  
pp. 15-18 ◽  
Author(s):  
K. Wahlbeck
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Services ◽  
Data Collection ◽  
Health Services ◽  
Mental Health Care ◽  
Health Systems ◽  
Health Data ◽  
World Health ◽  
Mental Health Systems

When developing accessible, affordable and effective mental health systems, exchange of data between countries is an important moving force towards better mental health care. Unfortunately, health information systems in most countries are weak in the field of mental health, and comparability of data is low.Special international data collection exercises, such as the World Health Organization (WHO) Atlas Project and the WHO Baseline Project have provided valuable insights in the state of mental health systems in countries, but such single-standing data collections are not sustainable solutions. Improvements in routine data collection are urgently needed. The European Commission has initiated major improvements to ensure harmonized and comprehensive health data collection, by introducing the European Community Health Indicators set and the European Health Interview Survey. However, both of these initiatives lack strength in the field of mental health. The neglect of the need for relevant and valid comparable data on mental health systems is in conflict with the importance of mental health for European countries and the objectives of the ‘Europe 2020’ strategy.The need for valid and comparable mental health services data is today addressed only by single initiatives, such as the Organisation for Economic Co-operation and Development work to establish quality indicators for mental health care. Real leadership in developing harmonized mental health data across Europe is lacking. A European Mental Health Observatory is urgently needed to lead development and implementation of monitoring of mental health and mental health service provision in Europe.

scholarly journals Meeting Boundaries: Exploring the Faces of Social Inclusion beyond Mental Health Systems

2020 ◽  
Vol 8 (1) ◽  
pp. 214-224 ◽  
Author(s):  
Carole Heather Walker ◽  
Sophie Thunus
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Health Systems ◽  
Social Inclusion ◽  
Mental Health Problems ◽  
Service Users ◽  
Mental Health Systems ◽  
Subjective Experiences ◽  
Complex Processes

This article examines social inclusion in the context of the deinstitutionalisation of mental health care. It draws on a scientific evaluation of the Belgian reform of mental health care (2010), designed to assess the influence of organisational mechanisms on the social and care trajectories of service users. The findings highlight the ongoing challenge for mental health systems to support the inclusion of service users within the community, and the increasingly difficult access to mental health care for people with complex and chronic mental health problems. Drawing from Systems Theory (Luhmann, 2013) and the analysis of subjective experiences, this article delves into the complex processes of social inclusion using the empirically-grounded concepts of the patient role and the impatient role. By acknowledging the relational dimensions of social inclusion, this article argues that complementarities between two faces of the mental health system are key to achieving inclusion beyond the walls of institutions and within society at large.

The Legal and Social Significance of Aftercare Systems: A Review and Analysis

1977 ◽  
Vol 5 (2) ◽  
pp. 229-291 ◽  
Author(s):  
John J. Ensminger ◽  
Patrick Reilly
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Community Mental Health ◽  
Mental Health Care ◽  
Health Care Delivery ◽  
Care Delivery ◽  
Community Mental Health Care ◽  
Mental Health Systems ◽  
Social Significance ◽  
Mental Health Care Delivery

There have been a number of findings in the research on aftercare which have significance for courts and legislatures faced with choices involving planning and implementation of mental health systems. Both the older and newer methods of community mental health care delivery are analyzed. There appear to be cogent reasons for emphasizing the provision of aftercare facilities to poverty communities. Certain reasons for failures in aftercare treatment are identified. An analysis of the literature on aftercare indicates that there are certain elements important for the effective functioning of an aftercare system.

Epidemiology and Public Policy

2017 ◽  
Author(s):  
Carlos E. Molina
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Public Policy ◽  
Health Systems ◽  
Research Design ◽  
Evidence Based Practice ◽  
Evidence Based ◽  
Health Care Economics ◽  
Mental Health Systems

This chapter reviews topics on epidemiology, biostatistics and research design. In addition, topics on mental health systems, evidence-based practice and health care economics will be reviewed. Topics on public policy and law and psychiatry will be reviewed in this chapter

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