scholarly journals The influence of primary care physicians’ mental health knowledge, attitudes and self-efficacy on referrals to specialised services: findings from a longitudinal pilot trial

BJPsych Open ◽  
2020 ◽  
Vol 6 (6) ◽  
Author(s):  
Jessica Spagnolo ◽  
Helen-Maria Vasiliadis ◽  
Djamal Berbiche ◽  
François Champagne ◽  
Nicole Leduc ◽  
...  
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Mental Health Services ◽  
Health Services ◽  
Self Efficacy ◽  
Primary Care Physicians ◽  
Health Knowledge ◽  
Pilot Trial ◽  
Health Attitudes ◽  
Mental Health Knowledge

Background Training based on the Mental Health Gap Action Programme (mhGAP) is being increasingly adopted by countries to enhance non-specialists’ mental health capacities. However, the influence of these enhanced capacities on referral rates to specialised mental health services remains unknown. Aims We rely on findings from a longitudinal pilot trial to assess the influence of mental health knowledge, attitudes and self-efficacy on self-reported referrals from primary to specialised mental health services before, immediately after and 18 months after primary care physicians (PCPs) participated in an mhGAP-based training in the Greater Tunis area of Tunisia. Method Participants included PCPs who completed questionnaires before (n = 112), immediately after (n = 88) and 18 months after (n = 59) training. Multivariable analyses with linear mixed models accounting for the correlation among participants were performed with the SAS version 9.4 PROC MIXED procedure. The significance level was α < 0.05. Results Data show a significant interaction between time and mental health attitudes on referrals to specialised mental health services per week. Higher scores on the attitude scale were associated with more referrals to specialised services before and 18 months after training, compared with immediately after training. Conclusion Findings indicate that, in parallel to mental health training, considering structural/organisational supports to bring about a sustainable change in the influence of PCPs’ mental health attitudes on referrals is important. Our results will inform the scale-up of an initiative to further integrate mental health into primary care settings across Tunisia, and potentially other countries with similar profiles interested in further developing task-sharing initiatives.

scholarly journals Mental health knowledge, attitudes, and self-efficacy among primary care physicians working in the Greater Tunis area of Tunisia

2018 ◽  
Vol 12 (1) ◽  
Author(s):  
Jessica Spagnolo ◽  
François Champagne ◽  
Nicole Leduc ◽  
Michèle Rivard ◽  
Myra Piat ◽  
...  
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Self Efficacy ◽  
Primary Care Physicians ◽  
Health Knowledge ◽  
Mental Health Knowledge

scholarly journals The Status Quo Survey and Countermeasure Analysis of Chinese Netizens’ Needs for E-Mental Health Services

2015 ◽  
Vol 11 (27) ◽  
pp. 281
Author(s):  
Jian Zhao
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Health Knowledge ◽  
Service Providers ◽  
Social Orientation ◽  
Professional Service ◽  
Electronic Service ◽  
The Status ◽  
Mental Health Knowledge

The<strong> </strong>e-Mental Health Service refers to the work for mental health promotion provided, following the laws of mental health, by professional institutions and professionals to netizens through the Internet. A survey of 1588 netizens shows that netizens have a need for e-Mental Health Services and higher needs for mental health knowledge; they show obvious social orientation in their choices of service providers; demographic variables have remarkable influences on netizens’ specific needs; and netizen groups, there are relatively higher needs in female, college degree holders and above, the youth and brain workers, such as students, teachers, company employees, and staff in public institutions. The results of the survey indicate that netizens’ needs for e-Mental Health Services are complex and diversified, and netizens’ understanding and demand for professional service institutions, professional service providers and electronic service modes still need to be improved.

scholarly journals Building capacity in mental health care in low- and middle-income countries by training primary care physicians using the mhGAP: a randomized controlled trial

2019 ◽  
Vol 35 (2) ◽  
pp. 186-198 ◽  
Author(s):  
Jessica Spagnolo ◽  
François Champagne ◽  
Nicole Leduc ◽  
Michèle Rivard ◽  
Wahid Melki ◽  
...  
Keyword(s):  
Mental Health ◽  
Self Efficacy ◽  
Primary Care Physicians ◽  
Health Knowledge ◽  
Control Group ◽  
Middle Income ◽  
Middle Income Countries ◽  
Group 2 ◽  
Mental Health Knowledge ◽  
Group 1

Abstract To address the rise in mental health conditions in Tunisia, a training based on the Mental Health Gap Action Programme (mhGAP) Intervention Guide (IG) was offered to primary care physicians (PCPs) working in the Greater Tunis area. Non-specialists (such as PCPs)’ training is an internationally supported way to target untreated mental health symptoms. We aimed to evaluate the programme’s impact on PCPs’ mental health knowledge, attitudes, self-efficacy and self-reported practice, immediately following and 18 months after training. We conducted an exploratory trial with a combination of designs: a pretest–posttest control group design and a one-group pretest–posttest design were used to assess the training’s short-term impact; and a repeated measures design was used to assess the training’s long-term impact. The former relied on a delayed-intervention strategy: participants assigned to the control group (Group 2) received the training after the intervention group (Group 1). The intervention consisted of a weekly mhGAP-based training session (totalling 6 weeks), comprising lectures, discussions, role plays and a support session offered by trainers. Data were collected at baseline, following Group 1’s training, following Group 2’s training and 18 months after training. Descriptive, bivariate and ANOVA analyses were conducted. Overall, 112 PCPs were randomized to either Group 1 (n = 52) or Group 2 (n = 60). The training had a statistically significant short-term impact on mental health knowledge, attitudes and self-efficacy scores but not on self-reported practice. When comparing pre-training results and results 18 months after training, these changes were maintained. PCPs reported a decrease in referral rates to specialized services 18 months after training in comparison to pre-training. The mhGAP-based training might be useful to increase mental health knowledge and self-efficacy, and decrease reported referral rates and negative mental health attitudes among PCPs in Tunisia and other low- and middle-income countries. Future studies should examine relationships among these outcome variables.

Mental Health Services in Primary Care: Implications for Clinical Mental Health Counselors and Other Mental Health Providers

2014 ◽  
Vol 36 (2) ◽  
pp. 95-98 ◽  
Author(s):  
Lisa Hooper
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Mental Health Services ◽  
Health Services ◽  
Primary Care Physicians ◽  
Mental Health Counseling ◽  
Mental Health Counselors ◽  
Special Issue ◽  
Health Counseling ◽  
Primary Care Settings

I am pleased to introduce this special issue of the Journal of Mental Health Counseling dedicated to mental health in primary care. Though the idea of incorporating mental health services into primary care is not new, there is a clear need to promote the transportability of counseling theories and culturally sensitive counseling practices to primary care settings. Clinical mental health counselors who are not aware of the importance of fostering meaningful collaborations and consultation with primary care physicians can garner useful information from the articles that appear in this special issue of the Journal of Mental Health Counseling. Knowledge acquired from this special issue about the dearth of quality mental health care for some patients seen in primary care settings may engender innovative solutions, both put forward by clinical mental health counselors and co-created with primary care physicians. I also hope that the articles in this special issue may stimulate future research and produce implications for treatment and services that can be piloted and evaluated for their sustainability, patient-centeredness, and cultural responsiveness to the long-standing clinical issue of ensuring effective mental health services in primary care settings.

Mental Health Treatment in Ontario: Selected Comparisons between the Primary Care and Specialty Sectors

1997 ◽  
Vol 42 (9) ◽  
pp. 929-934 ◽  
Author(s):  
Sagar V Parikh ◽  
Elizabeth Lin ◽  
Alain D Lesage
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Mental Health Services ◽  
Health Services ◽  
General Health ◽  
Primary Care Physicians ◽  
Health Sector ◽  
Mental Illnesses ◽  
Health Treatment ◽  
Specialty Mental Health

Objective: Epidemiologic research has demonstrated that the majority of mental illness in the community is not treated. Primary care physicians and the specialty mental health sector each have an important role in the provision of mental health services. Our goal is to clarify the extent of undertreatment of selected mental illnesses in Ontario and to examine how treatment is divided between the primary care and specialty sectors. In particular, we are interested in both the relative numbers and the types—based on sociodemographic and severity indicators—of patients found in each sector, as well as in confirming the key role of primary care in the provision of mental health services. Method: Data were taken from the Mental Health Supplement to the Ontario Health Survey, a community survey of 9953 individuals. All subjects who met DSM-III-R criteria for a past year diagnosis of mood, anxiety, substance abuse, bulimic, or antisocial personality disorders were categorized by their use of mental health services in the preceding year—into nonusers, primary care only patients, specialty only patients, and both sector patients. The 3 groups utilizing services were then compared by demographic, clinical, and disability characteristics. Results: Only 20.8% of subjects with a psychiatric diagnosis reported use of mental health services, but 82.9% of these same individuals used primary care physicians for general health problems. Among those who used mental health services, 38.2% used family physicians only for psychiatric treatment, compared with 35.8% who used only specialty mental health providers, and 26.0% who used both sectors. The 3 groups of users showed only modest differences on sociodemographic characteristics. Patients in the specialty only sector reported significantly higher rates of sexual and physical abuse. On specific disability measures, all 3 groups were similar. Conclusion: The vast majority of individuals with an untreated psychiatric disorder are using the primary care sector for general health treatment, allowing an opportunity for identification and intervention. Primary care physicians also treat the majority of those seeking mental health services, and individuals seen only by these primary care physicians are probably as ill as those seen exclusively in the specialty mental health sector. From a public health perspective, future policy interventions should aim to improve collaboration between the 2 sectors and enhance the ability of primary care physicians to deliver psychiatric services.

The Bridge Program: A Model for Delivering Mental Health Services to Asian Americans through Primary Care

2005 ◽  
Vol 3 (1) ◽  
pp. 13-29 ◽  
Author(s):  
Hongtu Chen ◽  
Elizabeth Kramer ◽  
Teddy Chen ◽  
Jianping Chen ◽  
Henry Chung
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Mental Health Services ◽  
Health Services ◽  
Asian Americans ◽  
Mental Health Professionals ◽  
Primary Care Providers ◽  
Care Providers ◽  
Bridge Program ◽  
Community Awareness

Compared to all other racial and ethnic groups, Asian Americans have the lowest utilization of mental health services. Contributing factors include extremely low community awareness about mental health, a lack of culturally competent Asian American mental health professionals, and severe stigma associated with mental illness. This manuscript describes an innovative program that bridges the gap between primary care and mental health services. The Bridge Program, cited in the supplement to the Surgeon’s General’s Report on Mental Health: Culture, Race, and Ethnicity as a model for delivery of mental health services through primary care; (2) to improve capacity by enhancing the skills of primary care providers to identify and treat mental disorders commonly seen in primary care; and (3) to raise community awareness by providing health education on mental health and illness. Results are presented and the potential for replication is addressed.

scholarly journals Teaching Family Nurse Practitioner Students to Provide Mental Health Care to Older Adults

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 10-11
Author(s):  
Victoria Grando ◽  
Roy Grando
Keyword(s):  
Mental Health ◽  
Older Adults ◽  
Primary Care ◽  
Mental Health Services ◽  
Health Services ◽  
Treatment Plan ◽  
Primary Care Providers ◽  
Neurocognitive Disorders ◽  
Mental Condition ◽  
Care Providers

Abstract In recent years, FNPs have been challenged to deliver mental health services in the primary care setting. Over half of mental health services are provided in primary care, and one-quarter of all primary care patients have a mental disorder. Moreover, 20% of older adults have a mental or neurological disorder often not diagnosed. Nationally, it is estimated that 17% of older adults commit suicide, 15% have a mental condition, 11% have dementia, and 5% have a serious mental condition. There is a paucity of adequately prepared primary care providers trained in geropsychiatric treatment. A didactic course was developed to instruct FNP students in the skills needed to provide mental health treatment in primary care. We discuss mental illness in the context of culture to ensure that treatment is congruent with a patient’s unique cultural background and experiences. This shapes the patients’ beliefs and behaviors that influence the way they view their condition and what they perceive as acceptable solutions. We then go into detail about the common mental conditions that older adults exhibit. Through the case study method, students learn to identify the presenting problem, protocols for analyzing the case, which includes making differential diagnoses and a treatment plan including initial medications, non-medical treatments, and referral. Students are introduced to the DMS-5 to learn the criteria for mental health diagnosis with an emphasis on suicide, depressive disorders, anxiety disorders, bipolar disorders, substance use disorders, and neurocognitive disorders. We have found that students most often misdiagnose neurocognitive disorders.

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