Debt and mental health: the role of psychiatrists

2007 ◽  
Vol 13 (3) ◽  
pp. 194-202 ◽  
Author(s):  
Chris Fitch ◽  
Robert Chaplin ◽  
Colin Trend ◽  
Sharon Collard

One in four people with mental health problems in Britain report debt or arrears, which is nearly three times the rate among individuals without similar conditions. Although health professionals commonly encounter debt among patients, some report that they lack basic knowledge to effectively intervene and that patient debt is often not acted on until a crisis emerges. Our aim in this article is to improve psychiatrists' knowledge and confidence in dealing with patient debt. We provide basic definitions of debt and problem debt; outline the impact that debt can have on patients' health, social and financial well-being; identify the stages and signs that a patient may be accruing problem debt; describe how psychiatrists should respond; and review the instruments available to assess patients' mental capacity to make financial decisions. We do not expect psychiatrists to become ‘debt experts’, but provide working knowledge for engaging more effectively with this problem.

2010 ◽  
Vol 3 (1) ◽  
pp. 1-17 ◽  
Author(s):  
Anne Joice ◽  
Stewart W. Mercer

AbstractLarge psycho-education groups are being increasingly used in mental-health promotion and the treatment of common mental-health problems. In individual therapy there is a well-established link between therapist empathy, therapeutic relationship and patient outcome but the role of empathy within large psycho-educational groups is unknown. This service evaluation investigated the impact of a 6-week large psycho-education group on patient outcome and the role of perceived therapist empathy on outcome. Within a before–after experimental design, 66 participants completed baseline and endpoint measures; Clinical Outcome Routine Evaluation (CORE), Patient Enablement Instrument (PEI), and the modified Consultation and Relational Empathy (CARE) measure. The results showed that the intervention had a positive impact on patient outcome; the CORE score reduced significantly over the 6 weeks by 0.63 (95% CI 0.82–1.14) (t= 9.18, d.f. = 55,p= <0.001) and attendees felt highly enabled. Attendees perceived the course leader as highly empathetic. However, the relationship between perceived empathy and attendee outcome was less clear; no significant relationship was found with the main outcome measure (the change in CORE score). Factors that influenced the main outcome included age, symptom severity at baseline, having a long-term illness or disability, and whether attendees tried the techniques at home (homework). These findings suggest that large group psycho-education is an effective treatment for mild to moderate mental-health problems, at least in the short term. The role of therapist empathy remains ambiguous but may be important for some patient outcomes.


2020 ◽  
Vol 42 (5) ◽  
pp. 421-427 ◽  
Author(s):  
Viswa Chaitanya Chandu ◽  
Yamuna Marella ◽  
Gnana Sarita Panga ◽  
Srinivas Pachava ◽  
Viswanath Vadapalli

Background: The coronavirus disease (COVID-19) pandemic, associated with the economic consequences of non-pharmaceutical interventions such as lockdown, has led to mental health consequences among people worldwide. Protecting the mental well-being of populations is an imperative component of fighting the COVID-19 pandemic. This scoping review attempts to present an overview of the existing tools to measure COVID-19-related mental health problems. Methods: Literature search was conducted in the PubMed electronic database using developed key search terms. Reference lists of the identified eligible articles were reviewed to locate relevant articles missed from the electronic database search. Fifteen scales measuring COVID-19-associated mental health problems, validated among diverse populations across the world, were included in this review. Results: The majority of these scales were validated among middle-aged adults in Turkey. Only a few validated scales encompass the negative socioeconomic consequences of COVID-19. None of the available scales focused on the aspects of suicidal ideation or behavioral responses/coping strategies, neither were they inclusive of participants from diverse age, geographic, and COVID-19 exposure groups. Conclusion: This scoping review highlights the need for future research to develop and validate comprehensive psychometric tools to assess COVID-19-associated mental health problems. Also, in view of the vulnerable nature of healthcare professionals for developing mental health concerns in the course of providing services for COVID-19-affected individuals, future psychometric research needs to concentrate on the development of measures specific for these professionals.


2021 ◽  
Vol 8 (1) ◽  
pp. 205510292110121
Author(s):  
Dung Ezekiel Jidong ◽  
Nusrat Husain ◽  
Tarela J Ike ◽  
Maisha Murshed ◽  
Juliet Y Pwajok ◽  
...  

Maternal mental health distress has a disease burden of severe adverse effects for both mother and child. This review identified maternal mental health concerns, their impact on child growth and the current practice of maternal healthcare for both mothers and their children in Nigeria. The Population, phenomenon of Interest and Context (PICo) model was adopted to formulate the review strategy, and five databases were searched for published articles between 1999 and 2019. Databases include Scopus, PubMed, ProQuest, Applied Social Science Index and Abstracts and Web of Science. Boolean operators (AND/OR/NOT) helped to ensure rigorous use of search terms which include ‘maternal’, ‘pre/peri/postnatal’, ‘mental health’, ‘mental illness’, ‘disorders’, ‘intervention,’ ‘Nigeria’, ‘child’, ‘infant growth’, and ‘wellbeing’. Thirty-four studies met the inclusion criteria, and extracted data were qualitatively synthesised and analysed thematically. Five themes emerged. These include (i) marital difficulties, (ii) relationship status of the mother, (iii) child’s gender, (iv) mode of child delivery and (v) child growth and development. The review showed a significant paucity of literature on the impact of specific maternal mental health problems on child physical growth and cognitive development. We concluded that culturally appropriate and evidence-based psychological interventions for maternal mental health problems would benefit Nigerian indigenous mothers. Therefore, the study recommends randomised controlled trials that are culturally appropriate and cost-effective for distressed mothers with children.


2018 ◽  
Vol 75 (6) ◽  
pp. 462-470 ◽  
Author(s):  
Aimée Gayed ◽  
Josie S Milligan-Saville ◽  
Jennifer Nicholas ◽  
Bridget T Bryan ◽  
Anthony D LaMontagne ◽  
...  

Managers are in an influential position to make decisions that can impact on the mental health and well-being of their employees. As a result, there is an increasing trend for organisations to provide managers with training in how to reduce work-based mental health risk factors for their employees. A systematic search of the literature was conducted to identify workplace interventions for managers with an emphasis on the mental health of employees reporting directing to them. A meta-analysis was performed to calculate pooled effect sizes using the random effects model for both manager and employee outcomes. Ten controlled trials were identified as relevant for this review. Outcomes evaluating managers’ mental health knowledge (standardised mean difference (SMD)=0.73; 95% CI 0.43 to 1.03; p<0.001), non-stigmatising attitudes towards mental health (SMD=0.36; 95% CI 0.18 to 0.53; p<0.001) and improving behaviour in supporting employees experiencing mental health problems (SMD=0.59; 95% CI 0.14 to 1.03; p=0.01) were found to have significant pooled effect sizes favouring the intervention. A significant pooled effect was not found for the small number of studies evaluating psychological symptoms in employees (p=0.28). Our meta-analysis indicates that training managers in workplace mental health can improve their knowledge, attitudes and self-reported behaviour in supporting employees experiencing mental health problems. At present, any findings regarding the impact of manager training on levels of psychological distress among employees remain preliminary as only a very limited amount of research evaluating employee outcomes is available. Our review suggests that in order to understand the effectiveness of manager training on employees, an increase in collection of employee level data is required.


FACETS ◽  
2020 ◽  
Vol 5 (1) ◽  
pp. 1071-1098
Author(s):  
Gordon J.G. Asmundson ◽  
Cindy Blackstock ◽  
Marie Claire Bourque ◽  
Glenn Brimacombe ◽  
Allison Crawford ◽  
...  

The COVID-19 pandemic has had a significant impact on the mental health of the people of Canada. Most have found it challenging to cope with social distancing, isolation, anxiety about infection, financial security and the future, and balancing demands of work and home life. For some, especially those who have had to face pre-existing challenges such as structural racism, poverty, and discrimination and those with prior mental health problems, the pandemic has been a major impact. The Policy Briefing Report focuses on the current situation, how the COVID-19 pandemic has exacerbated significant long-standing weaknesses in the mental health system and makes specific recommendations to meet these challenges to improve the well-being of the people of Canada. The COVID-19 pandemic has had a detrimental effect on mental health of people in Canada but the impact has been variable, impacting those facing pre-existing structural inequities hardest. Those living in poverty, and in some socially stratified groups facing greater economic and social disadvantage, such as some racialized and some Indigenous groups and those with preexisting mental health problems, have suffered the most. Some occupational groups have been more exposed to the virus and to psychological stress with the pandemic. The mental health care system was already overextended and under resourced. The pandemic has exacerbated the problems. The care system responded by a massive move to virtual care. The future challenge is for Canada to strengthen our knowledge base in mental health, to learn from the pandemic, and to provide all in Canada the support they need to fully participate in and contribute to Canada’s recovery from the pandemic.


BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S277-S277
Author(s):  
E. Naomi Smith ◽  
Emily Finch ◽  
Colin Drummond

AimsInput from Assertive Alcohol Outreach Teams (AAOTs) reduces the ‘burden’ on already overstretched community mental health teams (CMHTs).AAOTs are specialist addictions services. This project focuses on an AAOT based in the London, which engages with people with severe alcohol and illicit substance misuse problems.Previous research has shown that input from AAOTs reduces hospital admissions. This project examined the impact of AAOT input on reducing the ‘burden’ on CMHTs.MethodThe full caseload of the Southwark-based AAOT was reviewed, including mental health records, general practitioner notes, hospital notes and discharge summaries. We collected data on diagnoses and previous hospital admissions. Patients were assessed to determine whether they met criteria to be open to a CMHT (the presence of complex or serious mental health problems, in addition to addictions).ResultThe caseload was made up of 39 patients, 85% of patients were deemed to meet criteria for being under the care of a CMHT. Only 15% of patients are currently under the care of a CMHT. 87% of patients had at least one comorbid psychiatric diagnosis. 72% of patients had had at least one emergency department or medical hospital admission due to mental health-related problems. 39% had previous admissions to mental health wards. 21% of patients has been admitted under Section of Mental Health Act.ConclusionThe majority of AAOT patients have severe mental health problems in addition to addictions. The patients are complex and often have a history of disengagement from standard mental health services. Formal diagnosis and treatment of comorbid mental health problems is challenging in the presence of protracted drug and alcohol misuse. AAOT input appears to address a serious ‘gap’ in supporting patients with complex mental health needs who are often ineligible for CMHT input or disengage from CMHT support.


2021 ◽  
Vol 31 (Supplement_3) ◽  
Author(s):  
A Belscak Colakovic

Abstract It was very clear that the COVID-19 pandemic will have an impact on mental health from the first day that it was declared.However, the scale and magnitude of the impact changed as the pandemic persisted, progressed, and transformed. After a year of social distancing, distance education, and virtual concerts, the societal fabric has changed to such an extent that it will most likely produce a long lasting impact on public mental health. The presentation will focus on the indicators of public mental health obtained from the SI-PANDA research, a bi-weekly web panel survey with a nationally representative sample of 1000 respondents per each wave of the survey. The 5-item World Health Organization Well-Being Index (WHO-5) was used to measure mental health. A cut-off score of ≤ 50 was used to screen for mental health problems, and a cut-off score ≤28 to screen for major depression. Results of the repeated cross-sectional surveys indicate continuation of trends that were present pre-pandemic. Namely, higher prevalence of mental health problems among people with lower education, adolescents and young adults, people with pre-existing chronic conditions, and people experiencing worsening financial situation during the pandemic. Trends from SI-PANDA research show that the differences (or inequities) in mental health are deepening as the pandemic progresses. People with mental health problems are at greater risk of experiencing worsening mental health during the pandemic as well as experiencing other adverse health outcomes - which are themselves a risk factor for worsening mental health. Is the downward spiral of poor mental health and COVID-19 the story of health inequities or is it a new phenomenon built on top of inequitable society?


Author(s):  
Hannah Wepf ◽  
Agnes Leu

AbstractAdolescent young carers have been described as a hidden group at risk of mental health problems. However, research has not yet clarified the effect of caring when considering the related family situation. We aimed to examine the impact of a caring role on adolescents’ mental health and to gain knowledge about adolescent young carers’ specific needs. We collected cross-sectional data from adolescents (15–21 years, N = 2525) recruited through educational institutions in German-speaking Switzerland. Based on self-reported answers regarding the presence or absence of a family member with health problems and youth’s caring activities, the participants were grouped into three subsamples. We compared mental health outcomes (well-being and perceived stress) in current carers and their peers, and we conducted multiple regression analyses for predicting these outcomes among all adolescents and the subsample of carers. Adolescent young carers had lower levels of well-being and higher levels of perceived stress than their peers. However, when controlling for background variables, well-being levels were lower only when carers were compared to adolescents from a healthy family background. Indicators of family instability predicted mental health outcomes independently of being a carer. More recognition for the caring role predicted better well-being and perceived stress outcomes, and more support in caring predicted better well-being but not perceived stress outcomes. The findings suggest that a caring role is not necessarily related to decreased well-being in adolescents, but it is associated with higher levels of perceived stress. The way professionals and services respond to young carers’ specific needs should be improved.


2021 ◽  
pp. 002076402110175
Author(s):  
Roberto Rusca ◽  
Ike-Foster Onwuchekwa ◽  
Catherine Kinane ◽  
Douglas MacInnes

Background: Relationships are vital to recovery however, there is uncertainty whether users have different types of social networks in different mental health settings and how these networks may impact on users’ wellbeing. Aims: To compare the social networks of people with long-term mental illness in the community with those of people in a general adult in-patient unit. Method: A sample of general adult in-patients with enduring mental health problems, aged between 18 and 65, was compared with a similar sample attending a general adult psychiatric clinic. A cross-sectional survey collected demographic data and information about participants’ social networks. Participants also completed the Short Warwick Edinburgh Mental Well-Being Scale to examine well-being and the Significant Others Scale to explore their social network support. Results: The study recruited 53 participants (25 living in the community and 28 current in-patients) with 339 named as important members of their social networks. Both groups recorded low numbers in their social networks though the community sample had a significantly greater number of social contacts (7.4 vs. 5.4), more monthly contacts with members of their network and significantly higher levels of social media use. The in-patient group reported greater levels of emotional and practical support from their network. Conclusions: People with serious and enduring mental health problems living in the community had a significantly greater number of people in their social network than those who were in-patients while the in-patient group reported greater levels of emotional and practical support from their network. Recommendations for future work have been made.


Work ◽  
2021 ◽  
pp. 1-9
Author(s):  
Annika Lexén ◽  
Maria Emmelin ◽  
Lars Hansson ◽  
Bengt Svensson ◽  
Susann Porter ◽  
...  

BACKGROUND: Lack of mental health literacy among rehabilitation professionals and employers in the return-to-work of persons with mental health problems resulted in the development of a three-day group training program, the Support to Employers from rehabilitation Actors about Mental health (SEAM) intervention. OBJECTIVE: To evaluate the impact of SEAM on rehabilitation professionals’ knowledge and beliefs, attitudes, and supporting behaviors towards people with mental health problems and employers as part of the return-to-work process. METHODS: In this longitudinal study, 94 rehabilitation professionals were included. Data were collected prior to (T1), immediately after (T2) and 6 months after SEAM training (T3) using knowledge and attitude scales and a questionnaire on supporting behaviors. SEAM includes training in Mental Health First Aid, presentations and discussions on current research on work and mental health, and strategies and communication guidelines to use when meeting service users and employers as part of the return-to-work of persons with mental health problems. SEAM also includes a homepage with targeted employer information. Data were analyzed using non-parametric statistics. RESULTS: SEAM significantly increased rehabilitation professionals’ knowledge of mental health (T1-T2: z = –2.037, p = 0.042; T2-T3: z = –5.093, p = 0.001), and improved their attitudes towards persons with mental health problems (T1-T2: z = 4.984, p = 0.001). Professionals (50–60%) also estimated that they had increased their use of supporting strategies towards service users and employers. CONCLUSIONS: The study suggests that SEAM can increase mental health literacy among rehabilitation professionals and lead to a greater focus on service users’ resources and work ability, as well as on employers’ support needs.


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