scholarly journals Innovating in CMHT's: mental health wellbeing group visits

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S205-S206
Author(s):  
Samuel Mammolotti Parkinson ◽  
Ismail Laher ◽  
Shola Johnson
Keyword(s):  
Mental Health ◽  
Peer Support ◽  
Care Delivery ◽  
Cost Effective ◽  
Lifestyle Changes ◽  
Patient Choice ◽  
Positive Health ◽  
Health And Wellbeing ◽  
Group Visits ◽  
Wide Range

Aims‘Group consultations/visits’ are described as providing shared medical appointments delivering a range of care options and education by clinicians while providing elements of patient choice, empowerment and peer support.This innovative and cost effective model of care delivery was first conceived in the US and has been gaining a strong foothold in the UK since 2016, mainly limited to GP settings.The project goal was to attempt to transfer the model into a mental health setting by developing and delivering a novel intervention, to improve health and wellbeing options in a CMHT population.MethodA four session course was developed focussing on stress, sleep and nutrition. These chosen topics covered common significant challenges to patient health in psychiatry. Sessions were delivered to proactively address these important health related issues in a group visit setting.Baseline and post intervention feedback including telephone interviews were conducted to evaluate the effectiveness of the intervention.ResultThe qualitative data and the positive feedback obtained from participants indicate the intervention was highly valued and deemed effective in promoting positive health and lifestyle changes. Participants valued the educational and co-production aspects as well as the social and peer support elements of the groups. They appreciated the level of access they had with the clinicians involved, to explore their health and wellbeing in more detail without being limited by the usual 30 minute clinic follow-up sessions.The clinicians involved found the sessions rewarding and more engaging than most of routine 1:1 clinic sessions as they were able to spend quality time exploring important issues and not just educate the patients but also be educated by their questions and feedback about their lived experiences.ConclusionThe project aim was met and we believe this intervention can be successfully incorporated into the identified service provision gap within the CMH T model. There is potential to build on and embed this innovation with roll-out to a wide range of service users in different settings.In line with existing literature from GP settings, the consensus was that the amalgamated group visits/consultations model could be successfully modified to meet the needs of patients in the Mental Health arena who have a range of physical health and lifestyle concerns.We planned to obtain more information about improvement in patient self-management but this was affected by the pandemic. However, we believe it is a cost effective and helpful innovation which warrants further promotion and evaluation.

scholarly journals Rationale and methods for a cross-sectional study of mental health and wellbeing following river flooding in rural Australia, using a community-academic partnership approach

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
J. M. Longman ◽  
J. Bennett-Levy ◽  
V. Matthews ◽  
H. L. Berry ◽  
M. E. Passey ◽  
...  
Keyword(s):  
Climate Change ◽  
Mental Health ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
River Flooding ◽  
Health And Wellbeing ◽  
Wide Range ◽  
Flood Exposure ◽  
Partnership Approach ◽  
Rural Australia

Abstract Background Climate change is associated with greater frequency, duration, intensity and unpredictability of certain weather-related events, including floods. Floods harm mental health. There is limited understanding of the mental health and well-being effects from river flooding, particularly over the longer term and in rural contexts. This paper describes the rationale, aims, objectives, study design and socio-demographic characteristics of the sample for a study measuring associations between flood experience and mental health and wellbeing of residents (particularly those most likely to be negatively impacted and hard to reach) in rural NSW Australia 6 months following a devastating flood in 2017. To our knowledge, the study is the first of its kind within Australia in a rural community and is an important initiative given the likelihood of an increasing frequency of severe flooding in Australia given climate change. Methods A conceptual framework (The Flood Impact Framework) drawing on social ecological approaches was developed by the research team. It was based on the literature and feedback from the community. The Framework describes putative relationships between flood exposure and mental health and wellbeing outcomes. Within a community-academic partnership approach, a cross-sectional survey was then undertaken to quantify and further explore these relationships. Results The cross-sectional survey was conducted online (including on mobile phone) and on paper between September and November 2017 and recruited 2530 respondents. Of those, 2180 provided complete demographic data, among whom 69% were women, 91% were aged 25–74, 4% identified as Aboriginal and/or Torres Strait Islander, 9% were farmers and 33% were business owners. Conclusions The study recruited a wide range of respondents and the partnership facilitated the community’s engagement with the design and implementation of the study. The study will provide a basis for a follow-up study, that will aim to improve the understanding of mental health and wellbeing effects over the longer term. It will provide an important and original contribution to understanding river flooding and mental health in rural Australia, a topic that will grow in importance in the context of human-induced climate change, and identify critical opportunities to strengthen services, emergency planning and resilience to future flooding.

scholarly journals Technological and Digital Interventions for Mental Health and Wellbeing: An Overview of Systematic Reviews

2021 ◽  
Vol 3 ◽  
Author(s):  
Nele A. J. De Witte ◽  
Steven Joris ◽  
Eva Van Assche ◽  
Tom Van Daele
Keyword(s):  
Mental Health ◽  
User Involvement ◽  
Evidence Base ◽  
Overview Of Reviews ◽  
Health And Wellbeing ◽  
Use Of Technology ◽  
Active User ◽  
Wide Range ◽  
Technological Interventions ◽  
Overview Of Systematic Reviews

Background: Research increasingly shows how selective and targeted use of technology within care and welfare can have several advantages including improved quality of care and active user involvement.Purpose: The current overview of reviews aims to summarize the research on the effectiveness of technology for mental health and wellbeing. The goal is to highlight and structure the diverse combinations of technologies and interventions used so far, rather than to summarize the effectiveness of singular approaches.Methods: The current overview includes reviews published in the past five years with a focus on effectiveness of digital and technological interventions targeting mental health and wellbeing.Results: A total of 246 reviews could be included. All reviews examined the effectiveness of digital and technological interventions in the context of care and welfare. A combination of two taxonomies was created through qualitative analysis, based on the retrieved interventions and technologies in the reviews. Review classification shows a predominance of reviews on psychotherapeutic interventions using computers and smartphones. It is furthermore shown that when smartphone applications as stand-alone technology are researched, the primary focus is on self-help, and that extended reality is the most researched emerging technology to date.Conclusion: This overview of reviews shows that a wide range of interventions and technologies, with varying focus and target populations, have been studied in the field of care and wellbeing. The current overview of reviews is a first step to add structure to this rapidly changing field and may guide both researchers and clinicians in further exploring the evidence-base of particular approaches.

scholarly journals How recommender systems could support and enhance computer-tailored digital health programs: A scoping review

2019 ◽  
Vol 5 ◽  
pp. 205520761882472 ◽  
Author(s):  
Kei Long Cheung ◽  
Dilara Durusu ◽  
Xincheng Sui ◽  
Hein de Vries
Keyword(s):  
Recommender Systems ◽  
Scoping Review ◽  
Digital Health ◽  
Data Extraction ◽  
Cost Effective ◽  
Theoretical Models ◽  
Lifestyle Changes ◽  
Health Programs ◽  
Positive Health ◽  
Health Related

Objective Tailored digital health programs can promote positive health-related lifestyle changes and have been shown to be (cost) effective in trials. However, such programs are used suboptimally. New approaches are needed to optimise the use of these programs. This paper illustrates the potential of recommender systems to support and enhance computer-tailored digital health interventions. The aim is threefold, to explore: (1) how recommender systems provide health recommendations, (2) to what extent recommender systems incorporate theoretical models and (3) how the use of recommender systems may enhance the usage of computer-tailored interventions. Methods A scoping review was conducted, using MEDLINE and ScienceDirect, to identify health recommender systems reported in studies between January 2007 and December 2017. Information was subsequently extracted to understand the potential benefits of recommender systems for computer-tailored digital health programs. Titles and abstracts of 1184 studies were screened for the full-text screening, in which two reviewers independently selected articles and systematically extracted data using a predefined extraction form. Results A total of 26 articles were included for data extraction. General characteristics were reported, with eight studies reporting hybrid filtering. A description of how each recommender system provides a recommendation is described; the majority of recommender systems used messages as recommendation. We identified the potential effects of recommender systems on efficiency, effectiveness, trustworthiness and enjoyment of the digital health program. Conclusions Incorporating a collaborative method with demographic filtering as a second step to knowledge-based filtering could potentially add value to traditional tailoring with regard to enhancing the user experience. This study illustrates how recommender systems, especially hybrid programs, may have the potential to bring tailored digital health forward.

scholarly journals What do we know about different models of providing palliative care? Findings from a systematic review of reviews

2017 ◽  
Vol 31 (9) ◽  
pp. 781-797 ◽  
Author(s):  
Louise Brereton ◽  
Joseph Clark ◽  
Christine Ingleton ◽  
Clare Gardiner ◽  
Louise Preston ◽  
...  
Keyword(s):  
Palliative Care ◽  
Care Delivery ◽  
Grey Literature ◽  
Cost Effective ◽  
Patient Characteristics ◽  
Cochrane Library ◽  
Measurement Tool ◽  
Home Based ◽  
Wide Range ◽  
Effective Models

Background: A wide range of organisational models of palliative care exist. However, decision makers need more information about which models are likely to be most effective in different settings and for different patient groups. Aim: To identify the existing range of models of palliative care that have been evaluated, what is already known and what further information is essential if the most effective and cost-effective models are to be identified and replicated more widely. Design: A review of systematic and narrative reviews according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Study quality was assessed using the AMSTAR (A MeaSurement Tool to Assess Reviews) tool. Data sources: MEDLINE, EMBASE, PsycINFO, CINAHL, Cochrane Library, Web of Science and ASSIA were searched for reviews about models of service provision from 2000 to 2014 and supplemented with Google searches of the grey literature. Results: Much of the evidence relates to home-based palliative care, although some models are delivered across care settings. Reviews report several potential advantages and few disadvantages of models of palliative care delivery. However, under-reporting of the components of intervention and comparator models are major barriers to the evaluation and implementation of models of palliative care. Conclusion: Irrespective of setting or patient characteristics, models of palliative care appear to show benefits and some models of palliative care may reduce total healthcare costs. However, much more detailed and systematic reporting of components and agreement about outcome measures is essential in order to understand the key components and successfully replicate effective organisational models.

scholarly journals Our Healthy Clarence: A Community-Driven Wellbeing Initiative

2019 ◽  
Vol 16 (19) ◽  
pp. 3691 ◽  
Author(s):  
Powell ◽  
Dalton ◽  
Perkins ◽  
Considine ◽  
Hughes ◽  
...  
Keyword(s):  
Mental Health ◽  
Help Seeking ◽  
Successful Implementation ◽  
Positive Health ◽  
Care Community ◽  
Health And Wellbeing ◽  
South Wales ◽  
Leadership Support ◽  
Key Stakeholders ◽  
Collective Commitment

In 2015–2016, the Clarence Valley in Northern New South Wales, Australia, experienced an unexpectedly high number of deaths by suicide, and the resulting distress was exacerbated by unhelpful press coverage. The local response was to adopt a community-wide positive mental health and wellbeing initiative. This paper describes the process and achievements of the initiative called ‘Our Healthy Clarence’. Key stakeholders were interviewed at year two and relevant documents reviewed. Data were analysed using document and thematic analysis. Our Healthy Clarence was established following community consultation, including forums, interviews, surveys and workshops. It adopted a strengths-based approach to suicide prevention, encompassing positive health promotion, primary and secondary prevention activities, advocacy, and cross-sectoral collaboration. A stakeholder group formed to develop and enact a community mental health and wellbeing plan. Factors contributing to its successful implementation included a collective commitment to mental health and wellbeing, clarity of purpose, leadership support from key local partners, a paid independent coordinator, and inclusive and transparent governance. Stakeholders reported increased community agency, collaboration, optimism and willingness to discuss mental health, suicide and help-seeking. Our Healthy Clarence draws ideas from mental health care, community development and public health. This initiative could serve as a model for other communities to address suicide, self-harm and improve wellbeing on a whole-of-community scale.

scholarly journals Diary of a Mental Health Peer Worker: Findings From a Diary Study Into the Role of Peer Work in a Clinical Mental Health Setting

2020 ◽  
Vol 11 ◽  
Author(s):  
Marianne Wyder ◽  
Helena Roennfeldt ◽  
Stephen Parker ◽  
Gabrielle Vilic ◽  
Karen McCann ◽  
...  
Keyword(s):  
Mental Health ◽  
Peer Support ◽  
Personal Growth ◽  
Care Delivery ◽  
Mental Health Policy ◽  
Family Members ◽  
Mental Health Disorder ◽  
Rehabilitation Service ◽  
Clinical Diagnoses ◽  
Residential Rehabilitation

Introduction: The importance of peer support workers in mental health care delivery has been extensively advocated for in mental health policy frameworks. However, there has been limited research examining the implementation of paid peer workers in clinical settings. This study explores the experience of paid peer support workers integrated within a clinically-operated community-based residential rehabilitation service for people diagnosed with a mental health disorder experiencing challenges living independently in the community.Methods: A general inductive approach was taken in the analysis of diaries completed by a newly employed peer workforce. These diaries focussed on what they viewed as significant interactions in fulfilling their role. Composite vignettes were generated to illustrate key themes.Findings: Thirty-six diaries were provided; these reported unplanned and spontaneously occurring interactions. Peer workers emphasized the importance of connecting with people while they were engaging in everyday activities as an opportunity for personal growth of the residents. The diaries also focussed on the peer workers' ability to connect and establish trust by sharing similar experiences with residents or family members. Peer workers also believed that they brought a different perspective than clinical staff and were able to refocus attention from clinical diagnoses and symptoms to other aspects of the resident's lives.Discussion: Peer support workers described their work as flexible, responsive, and adaptable to the resident's needs. They believed that their roles brought a different lens to interactions on the unit and fostered a more inclusive and personal way of working for the team.Conclusion: To ensure that peer workers can engage authentically with residents and family members, it is critical that the role and principles of peer work are valued and understood by all.

scholarly journals Disordered eating and self-harm as risk factors for poorer mental health during the COVID-19 pandemic: a UK-based birth cohort study

2021 ◽  
Vol 9 (1) ◽  
Author(s):  
Naomi Warne ◽  
Jon Heron ◽  
Becky Mars ◽  
Alex S. F. Kwong ◽  
Francesca Solmi ◽  
...  
Keyword(s):  
Mental Health ◽  
Young Adults ◽  
Disordered Eating ◽  
Lifestyle Changes ◽  
Mental Wellbeing ◽  
Health And Wellbeing ◽  
Symptoms Of Depression ◽  
Increased Risk ◽  
Self Harm ◽  
The Relationship

Abstract Background Young adults and especially those with pre-existing mental health conditions, such as disordered eating and self-harm, appear to be at greater risk of developing metal health problems during the COVID-19 pandemic. However, it is unclear whether this increased risk is affected by any changes in lockdown restrictions, and whether any lifestyle changes could moderate this increased risk. Methods In a longitudinal UK-based birth cohort (The Avon Longitudinal Study of Parents and Children, ALSPAC) we assessed the relationship between pre-pandemic measures of disordered eating and self-harm and mental health during the COVID-19 pandemic in 2657 young adults. Regression models examined the relationship between self-reported disordered eating, self-harm, and both disordered eating and self-harm at age 25 years and depressive symptoms, anxiety symptoms and mental wellbeing during a period of eased restrictions in the COVID-19 pandemic (May–July 2020) when participants were aged 27–29 years. Analyses were adjusted for sex, questionnaire completion date, pre-pandemic socioeconomic disadvantage and pre-pandemic mental health and wellbeing. We also examined whether lifestyle changes (sleep, exercise, alcohol, visiting green space, eating, talking with family/friends, hobbies, relaxation) in the initial UK lockdown (April–May 2020) moderated these associations. Results Pre-existing disordered eating, self-harm and comorbid disordered eating and self-harm were all associated with the reporting of a higher frequency of depressive symptoms and anxiety symptoms, and poorer mental wellbeing during the pandemic compared to individuals without disordered eating and self-harm. Associations remained when adjusting for pre-pandemic mental health measures. There was little evidence that interactions between disordered eating and self-harm exposures and lifestyle change moderators affected pandemic mental health and wellbeing. Conclusions Young adults with pre-pandemic disordered eating, self-harm and comorbid disordered eating and self-harm were at increased risk for developing symptoms of depression, anxiety and poor mental wellbeing during the COVID-19 pandemic, even when accounting for pre-pandemic mental health. Lifestyle changes during the pandemic do not appear to alter this risk. A greater focus on rapid and responsive service provision is essential to reduce the impact of the pandemic on the mental health of these already vulnerable individuals. Plain English summary The aim of this project was to explore the mental health of young adults with disordered eating behaviours (such as fasting, vomiting/taking laxatives, binge-eating and excessive exercise) and self-harm during the COVID-19 pandemic. We analysed data from an established study that has followed children from birth (in 1991 and 1992) up to present day, including during the pandemic when participants were 28 years old. We looked at the relationship between disordered eating and/or self-harm behaviours from before the pandemic and mental health problems (symptoms of depression and anxiety) and mental wellbeing during the pandemic. We also explored whether there were any lifestyle changes (such as changes in sleep, exercise, visiting green space) that might be linked to better mental health and wellbeing in young adults with disordered eating and self-harm. We found that young adults with prior disordered eating and/or self-harm had more symptoms of depression and anxiety, and worse mental wellbeing than individuals without prior disordered eating or self-harm. However, lifestyle changes did not appear to affect mental health and wellbeing in these young adults. Our findings suggest that people with a history of disordered eating and/or self-harm were at high risk for developing mental health problems during the pandemic, and they will need help from mental health services.

Are the early benefits of the Adoption Support Fund (therapeutic support for adoptive families) sustainable?

2019 ◽  
Vol 18 (1) ◽  
pp. 66-72
Author(s):  
Sadie King ◽  
Matt Gieve ◽  
Giorgia Iacopini ◽  
Anna Sophie Hahne ◽  
Heather Stradling
Keyword(s):  
Mental Health ◽  
Social Care ◽  
Local Authority ◽  
Adopted Children ◽  
Adoptive Families ◽  
Vulnerable Children ◽  
Content Type ◽  
Health And Wellbeing ◽  
Wide Range ◽  
Support Fund

Purpose The purpose of this paper is to explore the wider context in which the national evaluation of the Adoption Support Fund (ASF) was delivered and raise concerns about the sustainability of the early outcomes. Design/methodology/approach The paper briefly summarises the outcomes of a two-year mixed-methods evaluation. This included a two-wave postal survey (n=792) and follow-up (n=481), an online survey of adopters (n=586) and professionals (providers n=50, local authority staff n=124) and in-depth family interviews. The focus of the discussion on sustainability is drawn from the qualitative research of 10 local authority case studies based on 86 interviews with adoption teams and 33 providers and the perspectives of parents. Findings Whilst the ASF showed modest early outcomes for families in terms of improved mental health and wellbeing without the scaffolding of wider support of services able to understand the complex lifelong needs of adoptive children and their families, the sustainability of the benefits of therapeutic support is questioned. Adoption teams struggled with the increased burden of administration of the fund, their knowledge of therapeutic interventions, an evidence base and quality of provision from a market that is difficult to regulate. In a society that is failing to meet the mental health and wellbeing needs of children generally, how can a single intervention meet the needs of a very vulnerable group? Research limitations/implications Research and evaluation on interventions in children’s social care could be more systems aware and instead of narrowly focusing on outcomes pay attention to the complex network of services that interlink to support vulnerable children and their families and the restraints on resources that they are working with. Social implications To prevent adoption breakdown and increase recruitment of adopters, support for adoptive families needs to be improved beyond the current scope of the ASF. A wide range of services are required to support adopted children particularly as they grow into adolescence. While families have the right to live independently of social services, the awareness of their needs throughout public organisations should be raised particularly in schools. Originality/value This paper represents the views of the evaluators at TIHR of the ASF beyond the scope of the original evaluation. It reflects on the wider context of the role out of the Fund and raises important questions about the failure to support the mental health and wellbeing needs of the most vulnerable children in society. It is an organisation reflection drawing on early research in children’s social care from its archive.

Innovations in Mental Health Care Delivery

1992 ◽  
Vol 160 (5) ◽  
pp. 589-597 ◽  
Author(s):  
Isaac Marks
Keyword(s):  
Mental Health ◽  
Mental Health Professionals ◽  
Community Care ◽  
Clinical Audit ◽  
Care Delivery ◽  
Severe Depression ◽  
Cost Effective ◽  
Community Services ◽  
Self Help ◽  
Anxiety Depression

In serious mental illness (SMI) even good community care does not usually make a major impact on clinical or social function, but patients and relatives prefer community to hospital care, and it tends to be cheaper. Any gains are lost if the required community services are not resourced, coordinated, and maintained indefinitely. A few SMI patients continue to need asylum under one roof. CPNs see more anxiety/depression than SMI. Their patients come increasingly from GPs, and they tend to work in practices with less need. Their cost-effectiveness is uncertain, although nurse behaviour therapists are cost-effective in anxiety disorders in primary care. Such research is also needed into the work of other mental health professionals. Despite their effectiveness, there is a dearth of behaviour therapists among nurses and psychiatrists. Problem-orientated training is lacking for most professionals with most patients. Behavioural self-treatments have improved phobic disorders and non-severe depression in controlled studies. Gains were as great when self-treatment was guided by a computer or by a manual as by a clinician. Self-help can extend care delivery, with therapists acting as consultants. Computers can also aid clinical audit.

scholarly journals Telemental Health Care: A Review of Efficacy and Interventions

2020 ◽  
Author(s):  
Calvin T. Schaffer ◽  
Preeti Nakrani ◽  
Paul A. Pirraglia
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Rural Areas ◽  
Care Delivery ◽  
Quality Care ◽  
The United States ◽  
Mental Health Practitioners ◽  
Telemental Health ◽  
Wide Range ◽  
Health Practitioners

Objective: Mental illness continues to rise in the United States, burdening a healthcare system set to dive further into a shortage of mental health practitioners. The effects of this are already being felt in many rural areas, which are all too frequently understaffed to address the mental health concerns of their populations. To further compound this growing crisis, COVID-19 has led to a reduction in access to in-person care. Furthermore, COVID-19 has led to reduced access to in-person care. As a result, Telehealth has become more essential. Knowledge of the strategies and barriers to implement a successful Telehealth program is necessary to deliver a sustainable, accessible, and quality care. Design: In this review, we analyze published research on the efficacy of Telehealth for mental health, discuss how these services have been implemented, and explore how to address barriers to quality care delivery via Telehealth. Results: Telehealth, when the appropriate resources and supports are considered, is effective in a wide range of patient populations and care locations. Multiple modalities, including via video, apps, and telephone were shown to be efficacious. Interventions have been shown to increase the accessibility to care without compromising quality of care. Conclusions: Telehealth constitutes a well-researched, efficacious tool to address the issues in access to care. Telemental health programs should address the barriers to implementation, including training, access to technology, reimbursement and regulations, and adequate program oversight. Telehealth interventions should be strongly considered in areas facing shortages of mental health practitioners and long wait times for patients with mental health disorders, to reduce the burden of mental illness on healthcare.

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