scholarly journals The ongoing need for local services for people with complex mental health problems

2014 ◽  
Vol 38 (6) ◽  
pp. 257-259 ◽  
Author(s):  
Helen Killaspy
Keyword(s):  
Mental Health ◽  
Mental Health Problems ◽  
Care Pathway ◽  
Mental Healthcare ◽  
Rehabilitation Care ◽  
Complex Needs ◽  
Lengths Of Stay ◽  
The Social ◽  
Health Rehabilitation ◽  
Mental Health Rehabilitation

SummaryDespite developments in mental healthcare over recent decades, there remains a group of people with very complex needs who require lengthy admissions and high levels of support in the community on discharge. This is the group that mental health rehabilitation services focus on. In the context of contemporary mental health services that minimise in-patient lengths of stay, the needs of this group must not be overlooked. Providing a local, ‘whole system, integrated rehabilitation care pathway’ requires intelligent commissioning in order to avoid the social exclusion of this group to the ‘virtual asylum’ of out-of-area placements.

scholarly journals Tensions and Paradoxes of Stigma: Discussing Stigma in Mental Health Rehabilitation

2020 ◽  
Vol 17 (16) ◽  
pp. 5943
Author(s):  
Jenny Paananen ◽  
Camilla Lindholm ◽  
Melisa Stevanovic ◽  
Elina Weiste
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Mental Health Professionals ◽  
Mentally Ill ◽  
Media Coverage ◽  
Mental Health Problems ◽  
Mental Illnesses ◽  
Rehabilitation Centers ◽  
Health Rehabilitation ◽  
Mental Health Rehabilitation

Mental illness remains as one of the most stigmatizing conditions in contemporary western societies. This study sheds light on how mental health professionals and rehabilitants perceive stigmatization. The qualitative study is based on stimulated focus group interviews conducted in five Finnish mental health rehabilitation centers that follow the Clubhouse model. The findings were analyzed through inductive content analysis. Both the mental health rehabilitants and the professionals perceived stigmatization as a phenomenon that concerns the majority of rehabilitants. However, whereas the professionals viewed stigma as something that is inflicted upon the mentally ill from the outside, the rehabilitants perceived stigma as something that the mentally ill themselves can influence by advancing their own confidence, shame management, and recovery. Improvements in treatment, along with media coverage, were seen as the factors that reduce stigmatization, but the same conceptualization did not hold for serious mental illnesses. As the average Clubhouse client was thought to be a person with serious mental illness, the rehabilitation context designed to normalize attitudes toward mental health problems was paradoxically perceived to enforce the concept of inevitable stigma. Therefore, it is important for professionals in rehabilitation communities to be reflexively aware of these tensions when supporting the rehabilitants.

Pro-Motion: A Positive Way Forward for Clients with Severe and Enduring Mental Health Problems Living in the Community, Part 1

2002 ◽  
Vol 65 (12) ◽  
pp. 551-558 ◽  
Author(s):  
Frances Heather
Keyword(s):  
Mental Health ◽  
Antipsychotic Medication ◽  
Mental Health Problems ◽  
Health Problems ◽  
Mental Health Nursing ◽  
Case Vignettes ◽  
Health Rehabilitation ◽  
Mental Health Rehabilitation ◽  
Health Nursing

This is the first part of a two-part article describing a clinical therapeutic intervention planned and organised by a senior occupational therapist and mental health nursing staff for clients with diagnoses of severe and enduring mental health problems. The six participants had a diagnosis of schizophrenia or schizoaffective disorder or bipolar illness. Four were receiving the atypical antipsychotic medication, Clozapine. One was receiving Olanzapine, also atypical, and the last was receiving traditional antipsychotic medication. These clients were all receiving long-term support from the mental health rehabilitation unit. Participation was voluntary and each client gave written consent to participation and publication later. The aims and objectives of the initial group, the selection criteria and the content and process of the group over a period of 6 weeks are described. The subsequent group, also held for 6 weeks, will be described in part 2, together with a brief overview of the further groups that have taken place since. The evaluation methods of the first group were the Beck Anxiety Inventory (BAI) and the State-Trait Anxiety Inventory (STAI) together with verbal and written evaluation. The BAI and the STAI were not repeated in the second group and the rationale for this is explained. The perceived benefits to clients are illustrated with two brief case vignettes. The benefits to other clients are also mentioned, together with the perceived drawbacks. The article concludes with the plans for the second group.

Pro-Motion: A Positive Way Forward for Clients with Severe and Enduring Mental Health Problems Living in the Community, Part 2

2003 ◽  
Vol 66 (1) ◽  
pp. 25-30 ◽  
Author(s):  
Frances Heather
Keyword(s):  
Mental Health ◽  
Antipsychotic Medication ◽  
Mental Health Problems ◽  
Health Problems ◽  
Mental Health Nursing ◽  
Case Vignettes ◽  
Health Rehabilitation ◽  
Mental Health Rehabilitation ◽  
Health Nursing

This is the second part of a two-part article describing a clinical therapeutic intervention, planned and organised by a senior occupational therapist and mental health nursing staff for clients with severe and enduring mental health problems living in the community. The six participants had a diagnosis of schizophrenia or schizoaffective disorder or bipolar illness. Four were receiving the atypical antipsychotic medication, Clozapine. One was receiving Olanzapine, also atypical, and the last was receiving traditional antipsychotic medication, a phenothiazine. These clients were all receiving long-term support from the mental health rehabilitation unit. Participation was voluntary and each client gave written consent to participate and for the findings to be published later. Part 1 described the aims and objectives of the initial group, the selection criteria, and the content and process of the group over a period of 6 weeks. Part 2 describes a subsequent group held with the same clients for another 6 weeks. The outcome measures used in part 1 were the Beck Anxiety Inventory (BAI) (Beck and Steer 1993) and the State-Trait Anxiety Inventory (STAI) (Speilberger 1983) together with verbal and written evaluation. In the second group, it was decided not to repeat the use of the BAI and STAI; instead, a more detailed qualitative questionnaire was issued. The reasons for this are explained. Part 2 goes on to describe the progress of the subsequent group and gives a brief overview of what has happened in further groups since. Client evaluations are illustrated by two case vignettes. The benefits to the other clients are highlighted, together with the possible drawbacks. There is discussion about the possible potential for such groups in the future.

scholarly journals The Effectiveness of Mental Health Rehabilitation Services: A Systematic Review and Narrative Synthesis

2021 ◽  
Vol 11 ◽  
Author(s):  
Christian Dalton-Locke ◽  
Louise Marston ◽  
Peter McPherson ◽  
Helen Killaspy
Keyword(s):  
Mental Health ◽  
Service Use ◽  
Mental Health Problems ◽  
Homeless People ◽  
Rehabilitation Services ◽  
Inpatient Service ◽  
Supported Accommodation ◽  
Community Rehabilitation ◽  
Health Rehabilitation ◽  
Mental Health Rehabilitation

Introduction: Mental health rehabilitation services provide essential support to people with complex and longer term mental health problems. They include inpatient services and community teams providing clinical input to people living in supported accommodation services. This systematic review included international studies evaluating the effectiveness of inpatient and community rehabilitation services.Methods: We searched six online databases for quantitative studies evaluating mental health rehabilitation services that reported on one or both of two outcomes: move-on to a more independent setting (i.e. discharge from an inpatient unit to the community or from a higher to lower level of supported accommodation); inpatient service use. The search was further expanded by screening references and citations of included studies. Heterogeneity between studies was too great to allow meta-analysis and therefore a narrative synthesis was carried out.Results: We included a total of 65 studies, grouped as: contemporary mental health rehabilitation services (n = 34); services for homeless people with severe mental health problems (n = 13); deinstitutionalization programmes (n = 18). The strongest evidence was for services for homeless people. Access to inpatient rehabilitation services was associated with a reduction in acute inpatient service use post discharge. Fewer than one half of people moved on from higher to lower levels of supported accommodation within expected timeframes.Conclusions: Inpatient and community rehabilitation services may reduce the need for inpatient service use over the long term but more high quality research of contemporary rehabilitation services with comparison groups is required.Review registration: This review was prospectively registered on PROSPERO (ID: CRD42019133579).

scholarly journals Tavoitteet nuorten mielenterveyskuntoutuksessa

Kuntoutus ◽  
2021 ◽  
Vol 44 (2) ◽  
pp. 36-47
Author(s):  
Jonna Tolonen ◽  
Katja Kokkinen ◽  
Erika Jääskeläinen ◽  
Sanna Sihvonen ◽  
Liisa Kiviniemi ◽  
...  
Keyword(s):  
Mental Health ◽  
Goal Setting ◽  
Social Inclusion ◽  
Mental Health Disorders ◽  
Developmental Tasks ◽  
Collaborative Relationship ◽  
The Social ◽  
Health Rehabilitation ◽  
Health Disorders ◽  
Mental Health Rehabilitation

Johdanto: Tavoitteiden asettaminen on tärkeä osa mielenterveyskuntoutusta. Nuorilla mielenterveyshäiriöt voivat vaikeuttaa kehitystehtävien saavuttamista, joten kuntoutuksen tavoitteiden tulee mukailla niitä. Aiemmat tutkimukset korostavat, että kuntoutuksessa on tärkeää huomioida kuntoutujan henkilökohtaiset tavoitteet yhteiskunnallisten resurssien lisäksi. Tavoite ja menetelmä: Tämän tutkimuksen tavoitteena oli kuvailla nuorten mielenterveyskuntoutuksen tavoitteita ja tämän myötä lisätä ymmärrystä tavoitteiden merkityksestä ja kehittää tavoitteiden asettelua. Tutkimuksen aineistona olivat 18–29-vuotiaiden nuorten (n = 16) asumiskuntoutuksessa laaditut kuntoutustiedotteet. Aineisto analysoitiin laadullisella sisällön analyysillä. Tulokset: Mielenterveyskuntoutuksen tavoitteiden pääkategoriat olivat: ikätasoiset toiminnalliset roolit, sosiaalinen osallisuus sekä sisäinen resilienssi. Yksilön toimiessa ikätasoisten toiminnallisten rooliensa mukaisesti yksilö kykenee suuntautumaan kehitystehtäviinsä. Sosiaalinen osallisuus on mahdollisuutta osallistua sosiaalisiin ympäristöihin. Sisäinen resilienssi tarkoittaa yksilön kykyä vaikeissa tilanteissa käyttää vahvuuksiaan. Aineistosta nousi esille myös nuoren ja ammattilaisen välinen vuorovaikutussuhde kuntoutusprosessin aikana. Pohdinta: Tässä tutkimuksessa löydetyt pääkategoriat ovat aiemman tutkimustiedon perusteella yhteydessä valtaistumiseen, kuntoutumiseen ja toipumiseen. Tulosten perusteella ammattilaisen ja nuoren välinen vuorovaikutussuhde on tärkeä osa kuntoutusta ja kuntoutujan osallisuutta tavoitteiden asettelussa tulee vahvistaa. Toipumisorientaation laajempi käyttö mielenterveyspalveluissa voisi mahdollistaa tätä kehitystä. Abstract Goals in Adolescents` Mental Health Rehabilitation Introduction: Goal setting is a central part of mental health rehabilitation. Especially among young people mental health disorders may delay achieving developmental tasks. Goals of rehabilitation should be in concordance with developmental tasks. According to rehabilitation impact studies, it is important to consider the rehabilitees’ goals in addition to the social and financial perspectives. Purpose and method: The purpose of this study was to increase the understanding of goals set in adolescents’ mental health rehabilitation and develop goal setting. The aim of the study was to describe the goals set in adolescent’s mental health rehabilitation. The study participants were rehabilitees between 18 - 29 years in residential rehabilitation (n=16) and the data was register information. The analyze method was content analysis. Results: The main categories of goals were: age-level occupational roles, social inclusion and inner resilience. When acting according to the age-level occupational roles, people are pursuing their developmental tasks. Social inclusion is the possibility to participate in the social environment. Inner resilience is a psychological process which helps the individual to cope with difficult situations by using their personal skills. The data shows also the importance of collaborative relationship between the professional and the young person during the process of recovery. Discussion: Prior research shows that the main categories are connected to empowerment, rehabilitation and recovery. It is important to support the collaborative relationship between the professional and the adolescent by increasing methods that supports adolescent`s participation in the process of goal setting. Wider use of recovery orientation in mental health services could support this development. Keywords: youth, young adults, adolescent`s, mental health disorders, metal health rehabilitation, goals, register information, qualitative study, retrospective study

scholarly journals Exploring pathways to mental healthcare for urban Aboriginal young people: a qualitative interview study

BMJ Open ◽  
2019 ◽  
Vol 9 (7) ◽  
pp. e025670
Author(s):  
Deanna Kalucy ◽  
Janice Nixon ◽  
Michael Parvizian ◽  
Peter Fernando ◽  
Simone Sherriff ◽  
...  
Keyword(s):  
Mental Health ◽  
Young People ◽  
Mental Health Problems ◽  
Health Workers ◽  
Care Pathway ◽  
Mental Healthcare ◽  
Qualitative Interview ◽  
Interview Study ◽  
Screening Tools ◽  
Qualitative Interview Study

ObjectivesTo explore the perceptions of Aboriginal Community Controlled Health Service (ACCHS) staff involved in providing mental healthcare to Aboriginal young people of the current and ideal pathways to mental healthcare for urban Aboriginal young people attending ACCHSs, and to identify what additional supports staff may need to provide optimal mental healthcare to Aboriginal young people.DesignQualitative interview study conducted during May 2016–2017.SettingPrimary care, at two ACCHSs participating in the Study of Environment on Aboriginal Resilience and Child Health in New South Wales.ParticipantsPurposive sampling of staff involved in mental healthcare pathways of Aboriginal young people, including general practitioners (GPs), nurses and Aboriginal Health Workers (AHWs).ResultsAll individuals approached for interview (n=21) participated in the study. Four overarching themes and seven sub-themes were identified: availability and use of tools in practice (valuing training and desire for tools and established pathways), targeting the ideal care pathway (initiating care and guiding young people through care), influencing the care pathway (adversities affecting access to care and adapting the care pathway) and assessing future need (appraising service availability).ConclusionsParticipants desired screening tools, flexible guidelines and training for healthcare providers to support pathways to mental healthcare for Aboriginal young people. Both GPs and AHWs were considered key in identifying children at risk and putting young people onto a pathway to receive appropriate mental healthcare. AHWs were deemed important in keeping young people on the care pathway, and participants felt care pathways could be improved with the addition of dedicated child and adolescent AHWs. The ACCHSs were highlighted as essential to providing culturally appropriate care for Aboriginal young people experiencing mental health problems, and funding for mental health specialists to be based at the ACCHSs was considered a priority.

scholarly journals The experiences of veterans with mental health problems participating in an occupational therapy and resilience workshop intervention: an exploratory study

2020 ◽  
pp. 030802262097781
Author(s):  
Hannah Vaughan-Horrocks ◽  
Carly Reagon ◽  
Alison Seymour
Keyword(s):  
Mental Health ◽  
Occupational Therapy ◽  
Mental Health Treatment ◽  
Exploratory Study ◽  
Mental Health Problems ◽  
Mental Healthcare ◽  
Lifestyle Changes ◽  
Complex Needs ◽  
Workshop Intervention ◽  
The Impact

Introduction Occupational therapy has long had a strong presence in military mental healthcare. Today’s veterans have complex needs and can face challenges reintegrating into civilian life. This exploratory study investigated whether veterans receiving mental health treatment who participated in a bespoke occupational therapy and resilience workshop intervention improved their perceived participation in everyday life. Method An interpretivist hermeneutic phenomenological approach was used to explore veterans’ perspectives. Ten participants took part in two semistructured focus groups. Thematic analysis was used to identify and analyse patterns within the data. Findings Most participants developed occupational goals and started to make lifestyle changes; participants developed an appreciation of the value of occupation; participants developed insight into their recovery journeys; and value was placed on the ‘healing power’ of the group. Conclusion This exploratory study provides preliminary evidence to suggest occupational therapy was influential in helping participants understand the impact of occupation on health and start making lifestyle changes. Participants also reflected on their recovery journeys. The benefits of doing this within a group environment appear to have been particularly therapeutic. Original occupational therapy research in this specialism is sparse. This novel study provides insight that can further discussion and enhance understanding about what the profession can offer this client group.

scholarly journals Contemporary approaches in mental health rehabilitation

2018 ◽  
Vol 28 (1) ◽  
pp. 9-14 ◽  
Author(s):  
L. van der Meer ◽  
C. Wunderink
Keyword(s):  
Mental Health ◽  
Mental Health Problems ◽  
Community Integration ◽  
Health Problems ◽  
Knowledge And Skills ◽  
Inpatient Settings ◽  
Health Rehabilitation ◽  
Comprehensive Manner ◽  
Mental Health Rehabilitation ◽  
Levels Of Support

AbstractIn many European countries, deinstitutionalisation has been an ongoing process over the last few decades. Mental health organisations were transformed to provide support in a more integrated and comprehensive manner, preferably in their own homes in the community. Yet, despite the welcome aspiration of community integration for all, people with complex mental health problems (also termed severe mental illness) have continued to require high levels of support, in inpatient settings and in the community. This group's needs make them highly dependent on their caregivers. The attitudes, knowledge and skills of the staff providing treatment and support is crucial to their recovery. Rehabilitation programmes provide a much-needed framework to guide practitioners and help them organise and focus their recovery-oriented approach. In this editorial, we will provide a non-exhaustive overview of such rehabilitation programmes and interventions to illuminate the wide scope and practical usability of these interventions for this group of people with complex mental health problems.

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