scholarly journals Reform of psychiatric services in Germany: hospital staffing directive and commissioning of community care

2004 ◽  
Vol 28 (6) ◽  
pp. 218-221 ◽  
Author(s):  
Heinrich Kunze ◽  
Thomas Becker ◽  
Stefan Priebe
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Social Services ◽  
Access To Health Care ◽  
Insurance Coverage ◽  
Legal Framework ◽  
Free Access ◽  
The Government ◽  
The Uk

The German mental health care system differs significantly from the system in the UK. There is no central organisation with overall responsibility as in the National Health Service (NHS), and the government is not entitled to prescribe details of policy or set specific targets. It can only determine the legal framework, define general goals and, with difficulties, influence the spending level. Responsibilities for mental health care, as for other fields of health care, are shared between federal authorities, the 16 states (Lander), local authorities, and semi-statutory organisations, which govern out-patient health care provided by psychiatrists in office-based practices. Virtually every citizen is health-insured and there is free access to health care for those who have no insurance coverage, in which case social services usually cover the costs. Social services also directly fund various services in the community. The fragmented system can be difficult to comprehend. However, many of the challenges are similar to those in other countries, and policy makers and practitioners elsewhere might be interested to know some of the lessons learnt in the German system.

scholarly journals Community-Based Mental Health Care in Britain

2020 ◽  
Vol 1 (2) ◽  
pp. 14-20
Author(s):  
T. Burns
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Social Services ◽  
Multidisciplinary Teams ◽  
Outpatient Psychotherapy ◽  
Family Doctors ◽  
Assertive Outreach ◽  
Admission Rates ◽  
The Uk

Community mental health care in the UK was established by two influential mental health acts (MHAs). The 1930 MHA legislated for voluntary admissions and outpatient clinics. The 1959 MHA required hospitals to provide local follow- up after discharge, required them to work closely with local social services and obliged social services to help with accommodation and support. An effect of this was to establish highly sectorized services for populations of about 50,000. These were served by multidisciplinary teams (generic CMHTs), which accepted all local referrals from family doctors. Sector CMHTs evolved a pragmatic approach with an emphasis on skill-sharing and outreach, depending heavily on community psychiatric nurses. The NHS is funded by central taxation, with no distortion of clinical practice by per-item service fees. It is highly centrally regulated, with a strong emphasis on evidence-based treatments.Since 2000, generic sector teams have gradually been replaced or enhanced by Crisis Resolution Home Treatment teams, Assertive Outreach Teams and Early Intervention Teams. Assertive Outreach Teams were resorbed into CMHTs, based on outcome evidence. The last decade has seen a major expansion in outpatient psychotherapy (Improving Access to Psychological Treatments (IAPT) services) and in specialist teams for personality disorders and perinatal psychiatry. The traditional continuity of care across the inpatient-outpatient divide has recently been broken. During the last decade of austerity, day care services have been decimated, and (along with the reduction in availability of beds) compulsory admission rates have risen sharply. Mental health care is still disadvantaged, receiving 11% of the NHS spend while accounting for 23% of the burden of disease.

Mental health care in London

2005 ◽  
Vol 20 (S2) ◽  
pp. s274-s278 ◽  
Author(s):  
P. De Ponte ◽  
G. Hughes
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Services ◽  
Health Services ◽  
Mental Health Care ◽  
National Policy ◽  
Health Staff ◽  
Mental Health Staff ◽  
The Uk ◽  
Occupancy Rates

AbstractAimTo describe principles and characteristics of mental health care in London.MethodBased on existing data, service provision, number of professionals working in services, funding arrangements, pathways intocare, user/carer involvement and specific issues are reported.ResultsLondon experiences high levels of need and use of mental health services compared to England as a whole. Inpatient andcompulsory admissions are considerably higher than the national average. Despite having more psychiatric beds and mental health staff, London has higher bed occupancy rates and staffing shortages. At the same time there is a trend away from institutionalised care to care in the community.ConclusionMental health services in the UK are undergoing considerable reform. These changes will not remove the greater need formental health services in the capital, but national policy and funding lends support to cross-agency and pan-London work to tackle some of the problems characteristic of mental health in London. Whilst various issues of mental health care in London overlap with those in other European capitals, there also are some specific problems and features.

scholarly journals Media coverage of mental health care in the UK, USA and Australia

2003 ◽  
Vol 27 (9) ◽  
pp. 331-333 ◽  
Author(s):  
Beatrice Huang ◽  
Stefan Priebe
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Media Coverage ◽  
Mental Illnesses ◽  
The Public ◽  
The Usa ◽  
Research Findings ◽  
The Media ◽  
The Uk

Aims and MethodWe aimed to assess the contents and tone of articles on mental health care in the UK print media by comparing them with reporting in the USA and Australia. Two broadsheets from each country were analysed using the Internet for a random 4 months over a 1-year period. The number of articles, their content and the views expressed in them were identified and compared.ResultsA total of 118 articles on mental health care issues were found. The predominant tone of the articles in all three countries was negative, though there were slightly more positive articles in the USA and Australian media. Positive articles highlighted in the UK media covered mostly medical conferences and research findings.Clinical ImplicationsEfforts to achieve a more positive attitude towards people with mental illnesses in the public, such as anti-stigma campaigns, operate against a background of predominantly negative coverage of mental health care issues in broadsheets. The coverage in the UK may tend to be even less positive than in the USA and Australia. Medical conferences and research findings can, however, be used to promote positive views of mental health care in the media.

scholarly journals Characterizing Emotional State Transitions During Prolonged Use of a Mindfulness and Meditation App: An Observational Study (Preprint)

2020 ◽  
Author(s):  
Argus Athanas ◽  
Jamison McCorrison ◽  
Julie Campiston ◽  
Nick Bender ◽  
Jamie Price ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Access To Health Care ◽  
Emotional State ◽  
Favorable Effect ◽  
State Transitions ◽  
Emotional States ◽  
Digital Device ◽  
Mixed Effect

BACKGROUND The increasing demand for mental health care, shortages in mental healthcare providers, and unequal access to health care generally has created a need for innovative approaches to mental health care. Digital device apps – including ‘digital therapeutics’ – that provide recommendations and feedback for dealing with stress, depression, and other mental health issues, can be used to adjust mood and show promise for helping meet this demand. In addition, the recommendations delivered through such apps can also be tailored to an individual’s needs (i.e., personalized) and thereby potentially provide greater benefits than traditional ‘one-size-fits-all’ recommendations. OBJECTIVE We sought to characterize individual transitions from one emotional state to another during the prolonged use of a digital app designed to provide a user with guided meditations based on their initial, potentially negative, emotional state. Understanding the factors that mediate such transitions can lead to improved recommendations for specific mindfulness and meditation interventions or activities (MMAs) provided in a mental health app. METHODS We analyzed data collected during the use of the Stop, Breathe and Think (SBT) mindfulness app. The SBT app prompts users to input their emotional state prior to, and immediately after, engaging with MMAs recommended by the app. Data were collected on more than 650,000 SBT users engaging in nearly 5 million MMAs. We limited the scope of our analysis to users with 10 or more MMA sessions that included at least 6 basal emotional state evaluations. Using clustering techniques, we grouped emotions recorded by individual users and then applied longitudinal mixed effect models to assess the effects that individual recommended MMAs had on transitions from one group of emotions to another. RESULTS We found that basal emotional states have a strong influence on transitions from one emotional state to another after MMA engagements. We also found that different MMAs impact these transitions, and many were effective in eliciting a healthy transition but only under certain conditions. In addition, we also observed gender and age effects on these transitions. CONCLUSIONS We find that the initial emotional state of an SBT app user has an impact on which SBT MMAs will have a favorable effect on their transition from one emotional state to another. Our results have implications for the design and use of guided mental health recommendations for digital device apps. CLINICALTRIAL

scholarly journals Mental Health Service in Ghana: A Review of the Case

2017 ◽  
Vol 6 (4) ◽  
pp. 299 ◽  
Author(s):  
Samuel Adu-Gyamfi
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Service ◽  
Mental Health Services ◽  
Health Service ◽  
Health Services ◽  
Service Delivery ◽  
Mental Health Care ◽  
Psychiatric Hospitals ◽  
The Government

Mental health care in Ghana has been fraught with several challenges leading to stagnant growth in mental health service delivery and in some cases a severe depreciation in the nature of care. The Government of Ghana pays little or no attention to mental health care in the country, a situation that has led to poor service delivery in the three major psychiatric hospitals in Ghana. The implementation of the Ghana Mental Act of 2012 has also been faced with major challenges with no significant progress being made. This studytherefore sought to review and document the development of mental health care services in Ghana. Specifically, the study examined the various legislations on mental health that have been enacted  in Ghana since 1900; investigated the implementation of the current Mental Health Act of Ghana; found out whether the Ghanaian government has prioritise mental health services in the country and assessed the challenges and problems that confronted mental health services in Ghana since 1900.The study concludes that, since 1888 efforts have been made by various governments to legislate the provision of mental services in Ghana. However, these legislations have not always protected the rights and interest of the mentally ill.

scholarly journals Mental health implications of COVID-19 pandemic and its response in India

2020 ◽  
pp. 002076402095076 ◽  
Author(s):  
Adrija Roy ◽  
Arvind Kumar Singh ◽  
Shree Mishra ◽  
Aravinda Chinnadurai ◽  
Arun Mitra ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Social Media ◽  
Mental Health Care ◽  
Intervention Strategies ◽  
Health Issues ◽  
Mental Health Issues ◽  
The Government ◽  
Novel Coronavirus ◽  
Anxiety Depression

Introduction: Mental health concerns and treatment usually take a backseat when the limited resources are geared for pandemic containment. In this global humanitarian crisis of the COVID-19 pandemic, mental health issues have been reported from all over the world. Objectives: In this study, we attempt to review the prevailing mental health issues during the COVID-19 pandemic through global experiences, and reactive strategies established in mental health care with special reference to the Indian context. By performing a rapid synthesis of available evidence, we aim to propose a conceptual and recommendation framework for mental health issues during the COVID-19 pandemic. Methods: A search of the PubMed electronic database and google scholar were undertaken using the search terms ‘novel coronavirus’, ‘COVID-19’, ‘nCoV’, SARS-CoV-2, ‘mental health’, ‘psychiatry’, ‘psychology’, ‘anxiety’, ‘depression’ and ‘stress’ in various permutations and combinations. Published journals, magazines and newspaper articles, official webpages and independent websites of various institutions and non-government organizations, verified social media portals were compiled. Results: The major mental health issues reported were stress, anxiety, depression, insomnia, denial, anger and fear. Children and older people, frontline workers, people with existing mental health illnesses were among the vulnerable in this context. COVID-19 related suicides have also been increasingly common. Globally, measures have been taken to address mental health issues through the use of guidelines and intervention strategies. The role of social media has also been immense in this context. State-specific intervention strategies, telepsychiatry consultations, toll free number specific for psychological and behavioral issues have been issued by the Government of India. Conclusion: Keeping a positive approach, developing vulnerable-group-specific need-based interventions with proper risk communication strategies and keeping at par with the evolving epidemiology of COVID-19 would be instrumental in guiding the planning and prioritization of mental health care resources to serve the most vulnerable.

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