scholarly journals Mental healthcare in Saint Lucia

2018 ◽  
Vol 15 (1) ◽  
pp. 14-16 ◽  
Author(s):  
Karen A. Francis ◽  
Andrew Molodynski ◽  
Giselle Emmanuel
Keyword(s):  
Mental Health ◽  
Mental Health Problems ◽  
Mental Healthcare ◽  
Small Island ◽  
Community Based ◽  
Middle Income ◽  
The Government ◽  
Mental Wellness ◽  
Community Based Services ◽  
Significant Shortage

St Lucia is a small island in the eastern Caribbean with a population of approximately 200 000 people. Although St Lucia is formally ranked as a high middle-income country, there are pockets of deprivation and relatively low living standards. Mental health services in St Lucia have increased considerably and advanced over recent years because of a coalition between the government of the island and South East Asian partners. The National Mental Wellness Centre opened several years ago and has much improved facilities. There remains a significant shortage of community-based services, no mental health law, and a pervasive community stigma and apprehension regarding those with mental health problems.

scholarly journals Mental health reforms in the Czech Republic

2018 ◽  
Vol 16 (1) ◽  
pp. 4-6 ◽  
Author(s):  
Ondrej Pec
Keyword(s):  
Mental Health ◽  
Czech Republic ◽  
Health Reform ◽  
Mental Healthcare ◽  
Rehabilitation Services ◽  
Community Based ◽  
The Czech Republic ◽  
Mental Health Reform ◽  
Mental Health Reforms ◽  
Community Based Services

This paper describes the history and current provision of mental healthcare in the Czech Republic. After the political changes in 1989, there was an expansion of out-patient care and several non-governmental organisations began to provide social rehabilitation services, but the main focus of care still rested on mental hospitals. In recent years, mental health reform has been in progress, which has involved expanding community-based services and psychiatric wards of general hospitals, simultaneously with educational and destigmatisation programmes.

scholarly journals Choice in mental health: myths and possibilities

2007 ◽  
Vol 13 (1) ◽  
pp. 60-67 ◽  
Author(s):  
Koravangattu Menon Valsraj ◽  
Nichola Gardner
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Social Inclusion ◽  
Mental Health Problems ◽  
National Policy ◽  
Mental Healthcare ◽  
Policy Makers ◽  
Healthcare Model ◽  
The Government

The government in England and Wales is promoting policies and initiatives to offer patients choice across all healthcare specialties. This has raised concerns in mental healthcare, particularly if the physical healthcare model of implementation is imposed. However, the ‘choice agenda’ is an opportunity for mental health services to be innovative and act as beacons to other disciplines in healthcare. The south-east London programme introducing choice in mental health services is offered as an example here. There already exists an ‘ethos of choice’ within mental health services, but current practices may require a focused approach and structuring to fit in with national policy. This also might be necessary to influence policy makers to take a different perspective on choice in mental health. The principle of choice goes hand in hand with the drive towards greater social inclusion for people with mental health problems.

Occupational Science and Community Mental Health: Using Occupational Risk Factors as a Framework for Exploring Chronicity

2000 ◽  
Vol 63 (5) ◽  
pp. 211-217 ◽  
Author(s):  
Jon Fieldhouse
Keyword(s):  
Mental Health ◽  
Risk Factors ◽  
Mental Health Problems ◽  
Occupational Risk ◽  
Community Based ◽  
Occupational Science ◽  
Occupational Risk Factors ◽  
Service Configuration ◽  
Adaptive Nature ◽  
Community Based Services

This article offers an overview of Wilcock's theories, from the field of occupational science, and relates them to the community care of people with severe mental health problems. Wilcock's occupational risk factors — imbalance, deprivation and alienation — are described and are seen to be reinforced both by the adaptive nature of this client group's problems and by the difficulties experienced by community-based services as they evolve to address the unfolding complexity of clients' needs. The potential for chronicity to be compounded and deepened in this way is highlighted, with particular reference to vocational and social disability, and the possible implications of a wider acknowledgement of occupational risk factors are discussed in relation to day-to-day practice and service configuration.

scholarly journals Whose responsibility is it to address the needs of persons with mental health problems? Development of a scale to assess how stakeholders distribute responsibilities across geo-cultural contexts

2021 ◽  
Author(s):  
Srividya Iyer ◽  
Megan Pope ◽  
Aarati Taksal ◽  
Greeshma Mohan ◽  
Thara Rangaswamy ◽  
...  
Keyword(s):  
Mental Health ◽  
Internal Consistency ◽  
Mental Health Problems ◽  
Mental Healthcare ◽  
Health Problems ◽  
Ease Of Use ◽  
Retest Reliability ◽  
Cultural Contexts ◽  
The Government ◽  
Test Retest Reliability

Abstract Background Individuals with mental health problems have multiple, often inadequately met needs. Responsibility for meeting these needs frequently falls to patients, their families/caregivers, and governments. Little is known about stakeholders' views of who should be responsible for these needs and there are no measures to assess this construct. This study’s objectives were to present the newly designed Whose Responsibility Scale (WRS), which assesses how stakeholders apportion responsibility to persons with mental health problems, their families, and the government for addressing various needs of persons with mental health problems, and to report its psychometric properties. Methods The 22-item WRS asks respondents to assign relative responsibility to the government vis-à-vis persons with mental health problems, government vis-à-vis families, and families vis-à-vis persons with mental health problems for seven support needs. The items were modelled on a World Values Survey item comparing the government’s and people’s responsibility for ensuring that everyone is provided for. We administered English, Tamil, and French versions to 57 patients, 60 family members, and 27 clinicians at two early psychosis programs in Chennai, India, and Montreal, Canada, evaluating test-retest reliability, internal consistency, and ease of use. Results Test-retest reliability (intra-class correlation coefficients) ranged from excellent to good across stakeholders (patients, families, and clinicians); settings (Montreal and Chennai), and languages (English, French, and Tamil). Internal consistency estimates (Cronbach’s alphas) ranged from acceptable to excellent. The WRS scored average on ease of comprehension and completion. Scores were spread across the 1–10 range, suggesting that the scale captured variations in views on how responsibility for meeting needs should be distributed. On select items, scores at one end of the scale were never endorsed, but these reflected expected views about specific needs (e.g., Chennai patients never endorsed patients as being substantially more responsible for housing needs than families). Conclusions The WRS is a promising measure for use across geo-cultural contexts to inform mental health policies, and to foster dialogue and accountability among stakeholders about roles and responsibilities. It can help researchers study stakeholders’ views about responsibilities, and how these are shaped by and shape sociocultural contexts and mental healthcare systems.

scholarly journals Whose responsibility? Part 1 of 2: A scale to assess how stakeholders apportion responsibilities for addressing the needs of persons with mental health problems

2022 ◽  
Vol 16 (1) ◽  
Author(s):  
Srividya N. Iyer ◽  
Megan Pope ◽  
Aarati Taksal ◽  
Greeshma Mohan ◽  
Thara Rangaswamy ◽  
...  
Keyword(s):  
Mental Health ◽  
Internal Consistency ◽  
Mental Health Problems ◽  
Mental Healthcare ◽  
Correlation Coefficients ◽  
Health Problems ◽  
Ease Of Use ◽  
Retest Reliability ◽  
The Government ◽  
Test Retest Reliability

Abstract Background Individuals with mental health problems have multiple, often inadequately met needs. Responsibility for meeting these needs frequently falls to patients, their families/caregivers, and governments. Little is known about stakeholders' views of who should be responsible for these needs and there are no measures to assess this construct. This study’s objectives were to present the newly designed Whose Responsibility Scale (WRS), which assesses how stakeholders apportion responsibility to persons with mental health problems, their families, and the government for addressing various needs of persons with mental health problems, and to report its psychometric properties. Methods The 22-item WRS asks respondents to assign relative responsibility to the government versus persons with mental health problems, government versus families, and families versus persons with mental health problems for seven support needs. The items were modelled on a World Values Survey item comparing the government’s and people’s responsibility for ensuring that everyone is provided for. We administered English, Tamil, and French versions to 57 patients, 60 family members, and 27 clinicians at two early psychosis programs in Chennai, India, and Montreal, Canada, evaluating test–retest reliability, internal consistency, and ease of use. Internal consistency estimates were also calculated for confirmatory purposes with the larger samples from the main comparative study. Results Test–retest reliability (intra-class correlation coefficients) generally ranged from excellent to fair across stakeholders (patients, families, and clinicians), settings (Montreal and Chennai), and languages (English, French, and Tamil). In the standardization and larger confirmatory samples, internal consistency estimates (Cronbach’s alphas) ranged from acceptable to excellent. The WRS scored average on ease of comprehension and completion. Scores were spread across the 1–10 range, suggesting that the scale captured variations in views on how responsibility for meeting needs should be distributed. On select items, scores at one end of the scale were never endorsed, but these reflected expected views about specific needs (e.g., Chennai patients never endorsed patients as being substantially more responsible for housing needs than families). Conclusions The WRS is a promising measure for use across geo-cultural contexts to inform mental health policies, and to foster dialogue and accountability among stakeholders about roles and responsibilities. It can help researchers study stakeholders’ views about responsibilities, and how these shape and are shaped by sociocultural contexts and mental healthcare systems.

scholarly journals The future of psychiatry

10.17816/cp63 ◽  
2021 ◽  
Vol 2 (1) ◽  
pp. 3-7
Author(s):  
Norman Sartorius
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Human Rights ◽  
Mental Disorders ◽  
Mental Health Problems ◽  
Health Workers ◽  
Mental Healthcare ◽  
Past Century ◽  
Middle Income ◽  
Adequate Treatment

Since the Second World War mental health programmes and psychiatry have made significant advances. Countries, as well as the United Nations, have recognized the magnitude and severity of mental health problems, and numerous national programmes have been launched to deal with them. Technology relating to the treatment of mental disorders has advanced and significant progress has been made in terms of knowledge regarding the functioning of the brain. The awareness of the need to protect the human rights of those with mental illness has increased. National and regional programmes against stigma and the consequent discrimination of those with mental illness, have been launched in many countries. Associations bringing together those who have experienced mental illness and their relatives, have come into existence in many countries. While these are great steps forward, more work is necessary to complete these advances. In low- and middle-income countries, the vast majority of people with mental disorders do not receive adequate treatment. Even in highly industrialized countries, a third of people with severe forms of mental illness are not receiving the appropriate therapy. Laws concerning mental health are outdated in many countries. The protection of the human rights of the mentally ill is incomplete and imperfect. The emphasis on economic gain and the digitalization of medicine in recent years has not helped. On occasions, this has even slowed down the development of mental health services, and the provision of mental healthcare. Thus, psychiatry must still deal with the challenges of the past century, while facing new demands and tasks. Among the new tasks for psychiatry are undoubtedly reforms which will allow (i) the provision of appropriate care of people with comorbid mental and physical disorders, (ii) the application of interventions leading to the primary prevention of mental and neurological disorders, and (iii) a radical reform of the education of psychiatrists and other mental health workers, dealing with mental illness. Collaboration with other stakeholders in the field of mental health and medicine, will be of crucial importance in relation to all these tasks.

scholarly journals Community-based Mental Health Services in Norway

10.17816/cp43 ◽  
2021 ◽  
Vol 2 (1) ◽  
pp. 47-54
Author(s):  
Torleif Ruud ◽  
Svein Friis
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Mental Health Problems ◽  
Service Providers ◽  
Mental Healthcare ◽  
Mental Illnesses ◽  
Community Treatment ◽  
Community Based ◽  
Catchment Areas

Community-based mental healthcare in Norway consists of local community mental health centres (CMHCs) collaborating with general practitioners and primary mental healthcare in the municipalities, and with psychiatrists and psychologists working in private practices. The CMHCs were developed from the 1980s to give a broad range of comprehensive mental health services in local catchment areas. The CMHCs have outpatient clinics, mobile teams, and inpatient wards. They serve the larger group of patients needing specialized mental healthcare, and they also collaborate with the hospital-based mental health services. Both CMHCs and hospitals are operated by 19 health trusts with public funding. Increasing resources in community-based mental healthcare was a major aim in a national plan for mental health between 1999 and 2008. The number of beds has decreased in CMHCs the last decade, while there has been an increase in mobile teams including crisis resolution teams (CRTs), early intervention teams for psychosis and assertive community treatment teams (ACT teams). Team-based care for mental health problems is also part of primary care, including care for patients with severe mental illnesses. Involuntary inpatient admissions mainly take place at hospitals, but CMHCs may continue such admissions and give community treatment orders for involuntary treatment in the community. The increasing specialization of mental health services are considered to have improved services. However, this may also have resulted in more fragmented services and less continuity of care from service providers whom the patients know and trust. This can be a particular problem for patients with severe mental illnesses. As the outcomes of routine mental health services are usually not measured, the effects of community-based mental care for the patients and their families, are mostly unknown.

scholarly journals Whose responsibility? Part 2 of 2: views of patients, families, and clinicians about responsibilities for addressing the needs of persons with mental health problems in Chennai, India and Montreal, Canada

2022 ◽  
Vol 16 (1) ◽  
Author(s):  
Srividya N. Iyer ◽  
Ashok Malla ◽  
Megan Pope ◽  
Sally Mustafa ◽  
Greeshma Mohan ◽  
...  
Keyword(s):  
Mental Health ◽  
Substance Use ◽  
Mental Health Problems ◽  
Mental Healthcare ◽  
Health Problems ◽  
Substance Use Treatment ◽  
First Episode ◽  
Support Needs ◽  
School Work ◽  
The Government

Abstract Background Individuals with mental health problems have many insufficiently met support needs. Across sociocultural contexts, various parties (e.g., governments, families, persons with mental health problems) assume responsibility for meeting these needs. However, key stakeholders' opinions of the relative responsibilities of these parties for meeting support needs remain largely unexplored. This is a critical knowledge gap, as these perceptions may influence policy and caregiving decisions. Methods Patients with first-episode psychosis (n = 250), their family members (n = 228), and clinicians (n = 50) at two early intervention services in Chennai, India and Montreal, Canada were asked how much responsibility they thought the government versus persons with mental health problems; the government versus families; and families versus persons with mental health problems should bear for meeting seven support needs of persons with mental health problems (e.g., housing; help covering costs of substance use treatment; etc.). Two-way analyses of variance were conducted to examine differences in ratings of responsibility between sites (Chennai, Montreal); raters (patients, families, clinicians); and support needs. Results Across sites and raters, governments were held most responsible for meeting each support need and all needs together. Montreal raters assigned more responsibility to the government than did Chennai raters. Compared to those in Montreal, Chennai raters assigned more responsibility to families versus persons with mental health problems, except for the costs of substance use treatment. Family raters across sites assigned more responsibility to governments than did patient raters, and more responsibility to families versus persons with mental health problems than did patient and clinician raters. At both sites, governments were assigned less responsibility for addressing housing- and school/work reintegration-related needs compared to other needs. In Chennai, the government was seen as most responsible for stigma reduction and least for covering substance use services. Conclusions All stakeholders thought that governments should have substantial responsibility for meeting the needs of individuals with mental health problems, reinforcing calls for greater government investment in mental healthcare across contexts. The greater perceived responsibility of the government in Montreal and of families in Chennai may both reflect and influence differences in cultural norms and healthcare systems in India and Canada.

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