scholarly journals Towards community care: Qatar's rapidly evolving mental health landscape

2021 ◽  
pp. 1-3
Author(s):  
Barry Solaiman ◽  
Suhaila Ghuloum
Keyword(s):  
Mental Health ◽  
Community Care ◽  
Social Stigma ◽  
Mental Healthcare ◽  
Community Services ◽  
The Past ◽  
Significant Attention

An undercurrent of change is occurring in Qatar's approach towards mental healthcare. In the past 5 years, significant attention has been given to community care initiatives. There is much progress to be made, but the provision of psychiatric support outside of hospitals, the launch of several community services and the tackling of the associated social stigma represent a marked step away from the norm that has usually pervaded in the region. This article analyses these changes and identifies the challenges that remain.

scholarly journals Changes in daily mental health service use and mortality at the commencement and lifting of COVID-19 ‘lockdown’ policy in 10 UK sites: a regression discontinuity in time design

BMJ Open ◽  
2021 ◽  
Vol 11 (5) ◽  
pp. e049721
Author(s):  
Ioannis Bakolis ◽  
Robert Stewart ◽  
David Baldwin ◽  
Jane Beenstock ◽  
Paul Bibby ◽  
...  
Keyword(s):  
Mental Health ◽  
Inpatient Care ◽  
Service Use ◽  
Regression Discontinuity ◽  
Mental Healthcare ◽  
Service Level ◽  
Community Services ◽  
Mental Health Service Use ◽  
Healthcare Data ◽  
Early Intervention In Psychosis

ObjectivesTo investigate changes in daily mental health (MH) service use and mortality in response to the introduction and the lifting of the COVID-19 ‘lockdown’ policy in Spring 2020.DesignA regression discontinuity in time (RDiT) analysis of daily service-level activity.Setting and participantsMental healthcare data were extracted from 10 UK providers.Outcome measuresDaily (weekly for one site) deaths from all causes, referrals and discharges, inpatient care (admissions, discharges, caseloads) and community services (face-to-face (f2f)/non-f2f contacts, caseloads): Adult, older adult and child/adolescent mental health; early intervention in psychosis; home treatment teams and liaison/Accident and Emergency (A&E). Data were extracted from 1 Jan 2019 to 31 May 2020 for all sites, supplemented to 31 July 2020 for four sites. Changes around the commencement and lifting of COVID-19 ‘lockdown’ policy (23 March and 10 May, respectively) were estimated using a RDiT design with a difference-in-difference approach generating incidence rate ratios (IRRs), meta-analysed across sites.ResultsPooled estimates for the lockdown transition showed increased daily deaths (IRR 2.31, 95% CI 1.86 to 2.87), reduced referrals (IRR 0.62, 95% CI 0.55 to 0.70) and reduced inpatient admissions (IRR 0.75, 95% CI 0.67 to 0.83) and caseloads (IRR 0.85, 95% CI 0.79 to 0.91) compared with the pre lockdown period. All community services saw shifts from f2f to non-f2f contacts, but varied in caseload changes. Lift of lockdown was associated with reduced deaths (IRR 0.42, 95% CI 0.27 to 0.66), increased referrals (IRR 1.36, 95% CI 1.15 to 1.60) and increased inpatient admissions (IRR 1.21, 95% CI 1.04 to 1.42) and caseloads (IRR 1.06, 95% CI 1.00 to 1.12) compared with the lockdown period. Site-wide activity, inpatient care and community services did not return to pre lockdown levels after lift of lockdown, while number of deaths did. Between-site heterogeneity most often indicated variation in size rather than direction of effect.ConclusionsMH service delivery underwent sizeable changes during the first national lockdown, with as-yet unknown and unevaluated consequences.

scholarly journals Delivering race equality in mental health services

2008 ◽  
Vol 14 (5) ◽  
pp. 326-329 ◽  
Author(s):  
Annie Lau
Keyword(s):  
Mental Health ◽  
Care Pathway ◽  
Action Plan ◽  
Good Practice ◽  
Mental Healthcare ◽  
Policy Initiatives ◽  
Pilot Survey ◽  
The Past ◽  
Department Of Health ◽  
Clinical Engagement

‘Delivering race equality’ is a 5-year action plan for tackling race inequalities in mental healthcare in England and Wales, based on the main themes of improved services, better community engagement and better information. The perception is that clinical teams have not been sufficiently engaged with the plan and progress is slow. This article shares insights from the author's work across government departments over the past 2 years and explores the potential for linking up different initiatives across the patient care pathway in support of the plan's delivery. A summary of conclusions from a pilot survey of consultant psychiatrists, commissioned by the Department of Health in June 2007, addresses the main controversial areas in the action plan, with suggestions for improvement. Areas for clinical engagement are identified that exploit new funding, investment and policy initiatives. Examples of good practice are offered.

scholarly journals Provision of mental health services in Nigeria

2008 ◽  
Vol 5 (2) ◽  
pp. 32-34 ◽  
Author(s):  
Olufemi Olugbile ◽  
M. P. Zachariah ◽  
O. Coker ◽  
O. Kuyinu ◽  
B. Isichei
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Service Delivery ◽  
Urban Areas ◽  
Mental Healthcare ◽  
African Countries ◽  
Grass Roots ◽  
The Past ◽  
Trained Personnel

Nigeria, like other African countries, is short of personnel trained in mental healthcare. Efforts to tackle the problem have often focused on increasing the numbers of psychiatrists and nurses in the field. These efforts, over the past 20 years, have not appeared to have greatly improved service delivery at the grass roots. Most of the specialist centres where such highly trained personnel work are in urban areas and for a large part of the population access to them is limited by distance and cost.

scholarly journals Mental health law in Colombia

2015 ◽  
Vol 12 (4) ◽  
pp. 92-94 ◽  
Author(s):  
Roberto Chaskel ◽  
James M. Shultz ◽  
Silvia L. Gaviria ◽  
Eliana Taborda ◽  
Roland Vanegas ◽  
...  
Keyword(s):  
Mental Health ◽  
Policy Development ◽  
Mental Healthcare ◽  
Epidemiological Data ◽  
Health Law ◽  
Mental Health Law ◽  
The Past ◽  
Law And Policy ◽  
Laws And Policies ◽  
Health Laws

Mental health law in Colombia has evolved over the past 50 years, in concert with worldwide recognition and prioritisation of mental healthcare. Laws and policies have become increasingly sophisticated to accommodate the ongoing transformations throughout Colombia's healthcare system and improvements in mental health screening, treatment and supportive care. Mental health law and policy development have been informed by epidemiological data on patterns of mental disorders in Colombia. Colombia is distinguished by the fact that its mental health laws and policies have been formulated during a 60-year period of continuous armed conflict. The mental health of Colombian citizens has been affected by population-wide exposure to violence and, accordingly, the mental health laws that have been enacted reflect this feature of the Colombian experience.

Coercion in Community Mental Health Care

2016 ◽  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Mentally Ill ◽  
Community Care ◽  
Current Knowledge ◽  
Community Services ◽  
Community Treatment ◽  
Community Treatment Orders ◽  
Improved Outcome

The use of coercion is one of the defining issues of mental health care and has been intensely controversial since the very earliest attempts to contain and treat the mentally ill. The balance between respecting autonomy and ensuring that those who most need treatment and support are provided with it has never been finer, with the ‘move into the community’ in many high-income countries over the last 50 years and the development of community services. The vast majority of patients worldwide now receive mental health care outside hospital, and this trend is increasing. New models of community care, such as assertive community treatment (ACT), have evolved as a result and there are widespread provisions for compulsory treatment in the community in the form of community treatment orders. These legal mechanisms now exist in over 75 jurisdictions worldwide. Many people using community services feel coerced, but at the same time intensive forms of treatment such as ACT, which arguably add pressure to patients to engage in treatment, have been associated with improved outcome. This volume draws together current knowledge about coercive practices worldwide, both those founded in law and those ‘informal’ processes whose coerciveness remains contested. It does so from a variety of perspectives, drawing on diverse disciplines such as history, law, sociology, anthropology, and medicine and for is explored

Paradigm 8: Community Care Is Destigmatizing

2013 ◽  
Author(s):  
Heather Stuart ◽  
Julio Arboleda-Flórez ◽  
Norman Sartorius
Keyword(s):  
Mental Illness ◽  
Community Care ◽  
Social Stigma ◽  
Safety Net ◽  
Poor Quality ◽  
Community Services ◽  
Negative Consequences ◽  
Health Movement ◽  
Community Mental Health Movement

Chapter 9 addresses how there have been many negative consequences for people with a mental illness as a result of the rapid deinstitutionalization of mental hospitals without appropriate community services to provide a safety net. These have included criminalization, increased stigmatization, social exclusion, poor quality of care, and poorer health outcomes. It covers how these problems challenge the notion that the community mental health movement has been a destigmatizing force leading to greater social participation for people with a mental illness. Because they are now more visible, and often less supported by treatment systems, people with a mental illness living in the community may be at greater risk of experiencing social stigma.

scholarly journals Reconfiguring in-patient services for adults with mental health problems: changing the balance of care

BJPsych Open ◽  
2018 ◽  
Vol 4 (6) ◽  
pp. 420-426 ◽  
Author(s):  
Sue Tucker ◽  
Jane Hughes ◽  
David Jolley ◽  
Deborah Buck ◽  
Claire Hargreaves ◽  
...  
Keyword(s):  
Mental Health ◽  
Community Care ◽  
Mental Health Problems ◽  
Cost Savings ◽  
Community Services ◽  
Nominal Group ◽  
Strategic Issues ◽  
Patient Groups ◽  
Balance Of Care ◽  
Alternative Settings

BackgroundResearch suggests that a significant minority of hospital in-patients could be more appropriately supported in the community if enhanced services were available. However, little is known about these individuals or the services they require.AimsTo identify which individuals require what services, at what cost.MethodA ‘balance of care’ (BoC) study was undertaken in northern England. Drawing on routine electronic data about 315 admissions categorised into patient groups, frontline practitioners identified patients whose needs could be met in alternative settings and specified the services they required, using a modified nominal group approach. Costing employed a public-sector approach.ResultsCommunity care was deemed appropriate for approximately a quarter of admissions including people with mild-moderate depression, an eating disorder or personality disorder, and some people with schizophrenia. Proposed community alternatives drew heavily on carer support services, community mental health teams and consultants, and there was widespread consensus on the need to increase out-of-hours community services. The costs of the proposed community care were relatively modest compared with hospital admission. On average social care costs increased by approximately £60 per week, but total costs fell by £1626 per week.ConclusionsThe findings raise strategic issues for both national policymakers and local service planners. Patients who could be managed at home can be characterised by diagnosis. Although potential financial savings were identified, the reported cost differences do not directly equate to cost savings. It is not clear whether in-patient beds could be reduced. However, existing beds could be more efficiently used.Declaration of interestNone.

scholarly journals Access to community-based mental healthcare and psychosocial support within a disaster context

2015 ◽  
Vol 12 (2) ◽  
pp. 44-47 ◽  
Author(s):  
Katherine P O'Hanlon ◽  
Boris Budosan
Keyword(s):  
Mental Health ◽  
Large Scale ◽  
Psychosocial Support ◽  
Mental Healthcare ◽  
Community Services ◽  
Community Based ◽  
Clear Vision ◽  
Mental Health Interventions ◽  
Mental Health Effects

After a large-scale humanitarian disaster, 30–50% of victims develop moderate or severe psychological distress. Rates of mild and moderate mental disorders increase by 5–10% and severe disorders by 1–2%. Those with such disorders need access to mental healthcare. Primary care clinics are appropriate due to their easy accessibility and the non-stigmatising environment. There is a consensus among experts that the mental health effects of disaster are best addressed by existing services, that is, through capacity building rather than by establishing parallel systems. Mental health interventions in emergencies should begin with a clear vision for the long-term advancement of community services.

scholarly journals Optimizing turn-taking in interpreter-mediated therapy: on the importance of the interpreter’s speaking space

2021 ◽  
Vol 13 (1) ◽  
Author(s):  
Jelena Vranjes ◽  
Hanneke Bot
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Conversation Analysis ◽  
Nonverbal Behavior ◽  
Mental Healthcare ◽  
The Past ◽  
Turn Taking ◽  
The Moment ◽  
Therapeutic Counseling ◽  
Scholarly Attention

This paper highlights two types of turn-taking problems that can occur in dialogue interpreting within the context of mental healthcare. Although interpreting in mental health care has received some scholarly attention over the past two decades, the multimodal dimension of such encounters has not been investigated in detail so far.Based on a dataset of video recorded psychotherapeutic sessions with refugees, the study aims to show how interpreters deal with turn-taking issues during the conversation and how this affectsboth their ownrolein the encounter and the interaction itself. Both verbal and nonverbal behavior (gaze orientation and gestures) were taken into account. The data were analyzed qualitatively by drawing on the insights from Conversation Analysis (CA). The analysis suggests that problems may arise when the interpreter is not able to negotiate the moment of turn transfer or his/her turn space during the talk.Such problems in the coordination of turn-taking with the interpreter can even result in loss of information. We argue that turn-taking in therapeutic counseling with an onsite interpreter is a collaborative achievement between both speakers and the interpreter, and that acknowledging the interpreter as a co-participant with rights for speaking space supports the interpreting process.

Telepsychiatry -another window to escape from poverty (Preprint)

2020 ◽  
Author(s):  
Tanjir Rashid Soron ◽  
Lamia Shams
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Mental Health Professionals ◽  
Social Stigma ◽  
Mental Healthcare ◽  
Health Issues ◽  
Socioeconomic Condition ◽  
Mental Health Issues ◽  
Resource Limited

UNSTRUCTURED People living in poverty are in greater risk of developing mental health issues due to its association with various stressors such as decreased productivity, loss of employment, reduced social support, stigma etc. Low socioeconomic status can hinder one’s access to mental health care and can lead him to devastating consequences. Even though Bangladesh has made a significant progress in eradicating poverty, the recent pandemic of COVID-19 has overburdened its resource limited healthcare settings. However, during lockdown a large number of people are experiencing a deterioration in their socioeconomic condition and this can negatively impact their mental health. Like many other developing countries, Bangladesh do not have equitable distribution of mental healthcare facilities in urban and rural areas. Distance to mental health care canter along with social stigma discourage people to get professional help. The psychological sufferings of the people can be mitigated by ensuring remote consultation through telepsychiatry services where the patients can maintain anonymity and escape the social stigma. Moreover, with the recent progress in using mobile phone and related technologies, telepsychiatry services will not only help the patients to reduce their access to service gap in an affordable way but also the mental health professionals will be able to help more patients. Telepsychiatry interventions can contribute to early diagnosis of mental health issues in population and this can reduce the chances of suicide and other morbidities. In resource limited settings, mental healthcare services aided with technology can overcome the barriers to access to care. In an addition to that, the mental well-being of individuals will enable them to lead an economically productive life with active contribution at workplaces.

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