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 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 Obsessive–compulsive symptoms and information seeking during the Covid-19 pandemic

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Alisa M. Loosen ◽  
Vasilisa Skvortsova ◽  
Tobias U. Hauser
Keyword(s):  
Mental Health ◽  
Information Seeking ◽  
Large Scale ◽  
Psychiatric Symptoms ◽  
Longitudinal Change ◽  
Depression Symptoms ◽  
Obsessive Compulsive ◽  
Related Information ◽  
Pandemic Wave

AbstractIncreased mental-health symptoms as a reaction to stressful life events, such as the Covid-19 pandemic, are common. Critically, successful adaptation helps to reduce such symptoms to baseline, preventing long-term psychiatric disorders. It is thus important to understand whether and which psychiatric symptoms show transient elevations, and which persist long-term and become chronically heightened. At particular risk for the latter trajectory are symptom dimensions directly affected by the pandemic, such as obsessive–compulsive (OC) symptoms. In this longitudinal large-scale study (N = 406), we assessed how OC, anxiety and depression symptoms changed throughout the first pandemic wave in a sample of the general UK public. We further examined how these symptoms affected pandemic-related information seeking and adherence to governmental guidelines. We show that scores in all psychiatric domains were initially elevated, but showed distinct longitudinal change patterns. Depression scores decreased, and anxiety plateaued during the first pandemic wave, while OC symptoms further increased, even after the ease of Covid-19 restrictions. These OC symptoms were directly linked to Covid-related information seeking, which gave rise to higher adherence to government guidelines. This increase of OC symptoms in this non-clinical sample shows that the domain is disproportionately affected by the pandemic. We discuss the long-term impact of the Covid-19 pandemic on public mental health, which calls for continued close observation of symptom development.

scholarly journals Mental health reforms in the Czech Republic

2018 ◽  
Vol 16 (1) ◽  
pp. 4-6 ◽  
Author(s):  
Ondrej Pec
Keyword(s):  
Mental Health ◽  
Czech Republic ◽  
Health Reform ◽  
Mental Healthcare ◽  
Rehabilitation Services ◽  
Community Based ◽  
The Czech Republic ◽  
Mental Health Reform ◽  
Mental Health Reforms ◽  
Community Based Services

This paper describes the history and current provision of mental healthcare in the Czech Republic. After the political changes in 1989, there was an expansion of out-patient care and several non-governmental organisations began to provide social rehabilitation services, but the main focus of care still rested on mental hospitals. In recent years, mental health reform has been in progress, which has involved expanding community-based services and psychiatric wards of general hospitals, simultaneously with educational and destigmatisation programmes.

scholarly journals “We Thought We Were Prepared, but We Were Not”: Experiences from the Management of the Psychosocial Support Response during the COVID-19 Pandemic in Sweden. A Mixed-Methods Study

2021 ◽  
Vol 18 (17) ◽  
pp. 9079
Author(s):  
Karin Hugelius ◽  
Sara Johansson ◽  
Helena Sjölin
Keyword(s):  
Health Care ◽  
Large Scale ◽  
Psychosocial Support ◽  
Care Staff ◽  
Mental Wellbeing ◽  
Health Care Staff ◽  
Line Managers ◽  
Major Incidents ◽  
Pandemic Response

This study aimed to describe experiences of managing mental health and psychosocial activities during the first six months of the COVID-19 pandemic in Sweden. A national survey was answered by a non-probability sample of 340 involved in the psychosocial response. The psychosocial response operations met several challenges, mainly related to the diverse actors involved, lack of competence, and lack of preparations. Less than 80% of the participants had received specific training in the provision of psychosocial support during major incidents. The interventions used varied, and no large-scale interventions were used. The psychosocial response organizations were overwhelmed by the needs of health care staff and failed to meet the needs of patients and family members. An efficient and durable psychosocial response in a long-term crisis requires to be structured, planned and well-integrated into the overall pandemic response. All personnel involved need adequate and specific competence in evidence-based individual and large-scale interventions to provide psychosocial support in significant incidents. By increasing general awareness of mental wellbeing and psychosocial support amongst health professionals and their first-line managers, a more resilient health care system, both in everyday life and during major incidents and disasters, could be facilitated.

scholarly journals Samhällsvårdens Svarte Petter

2019 ◽  
Vol 26 (1) ◽  
Author(s):  
Ulrika Levander ◽  
Lina Sturfelt
Keyword(s):  
Mental Health ◽  
Residential Care ◽  
Mental Healthcare ◽  
Preventive Actions ◽  
Child Psychiatric ◽  
History Of ◽  
Mental Health Interventions ◽  
Public Responsibility ◽  
Open Question ◽  
Children In Care

Drawing the short straw. Contemporary and historical categorizations of children in foster and residential care with mental health disordersAbout 67 per cent of children placed in residential care in Sweden suffer from mental health disorders. Although the problem has been recognized for decades, the group’s access to sufficient mental healthcare is still lagging. In this article we examine contemporary and historical categorizations of mental health issues among children in foster and residential care. The study examines Swedish commission reports, government bills, and Children’s Acts published between 1902 and 2016 where the issue is discussed. Hereby, ”the history of the present”, and its implications for the targeted group, is analysed and problematized. Our findings show that continuous talk of preventive actions in the name of the all-embracing welfare state repeatedly has downplayed the group’s access to mental health interventions. Ever since the establishment of the child psychiatric field in the 1940s, a discursive battle about the public responsibility for the group is also raging. In the 1970s, coordination is articulated as the grand solution, but the problem still persists. Neither the contemporary child rights perspective nor the latest law regulations of forced coordination for children in care have changed the group’s underprivileged position. Whether the legal turn will finally lead to recognition of the group’s right to adequate mental health care remains an open question.

School and Community - based Youth Mental Health Intervention Studies in India: A Scoping Review

2019 ◽  
Vol 2 (02) ◽  
pp. 14-22
Author(s):  
Ragaviveka Gopalan ◽  
C Sangeetha ◽  
P Ramakrishnan ◽  
Vijaya Raghavan
Keyword(s):  
Mental Health ◽  
Young People ◽  
Mental Disorders ◽  
Youth Mental Health ◽  
Health Interventions ◽  
Community Based Interventions ◽  
Community Based ◽  
School Based ◽  
School And Community ◽  
Mental Health Interventions

BACKGROUND About 70% of mental disorders emerge in late childhood and young peo-ple bear the burden of these disorders throughout life. Yet, to date there has been com-paratively little research on mental health interventions for young people in India and not many attempts have been made to collate the existing literature. This systematic review aims to synthesize the available evidence on school- and community-based mental health interventions for young people in India. METHODS A range of major electronic databases were searched systematically, and the abstracts of relevant papers were independently examined for possible inclusion. Selected papers were read in full text and a standardized set of data items were extracted. RESULTS Four papers met inclusion criteria for the analysis; two studies of school-based interventions for adolescents and two studies evaluating out-of-school community interventions for youth were reviewed. The quality of evidence from the interventions in Indian school and community settings were poor. While two studies evidence the effectiveness of a school-based life skills programme and a community based multicomponent intervention designed to promote youth health, two other studies do not offer sufficient data. CONCLUSION The review findings indicate that the number of interventional studies conducted in India to address youth mental health issues are very limited. Hence, it is extremely difficult to ensure the feasibility and effectiveness of school and community-based interventions in India. Further research is warranted to establish whether interventions promoting youth mental health people can be implemented effectively in Indian settings with positive mental health outcomes. Given the possibility of a huge population of young people at-risk or experiencing mental disorders, evidence for the efficacy of youth mental health interventions is crucial.

The effects of non-clinician guidance on effectiveness and process outcomes of digital mental health interventions: A systematic review and meta-analysis. (Preprint)

2021 ◽  
Author(s):  
Calista Leung ◽  
Julia Pei ◽  
Kristen Hudec ◽  
Farhud Shams ◽  
Richard Munthali ◽  
...  
Keyword(s):  
Mental Health ◽  
Systematic Review ◽  
Psychosocial Support ◽  
Meta Analysis ◽  
Grey Literature ◽  
Risk Of Bias ◽  
Health Interventions ◽  
Cochrane Central Register ◽  
Process Outcomes ◽  
Mental Health Interventions

BACKGROUND Digital mental health interventions are increasingly prevalent in the current context of rapidly evolving technology, and research indicates that they yield effectiveness outcomes comparable to in-person treatment. Integrating professionals (i.e. psychologists, physicians) into digital mental health interventions has been common, and the inclusion of guidance within programs can increase adherence to interventions. However, employing professionals to enhance mental health programs may undermine the scalability of digital interventions. Therefore, delegating guidance tasks to paraprofessionals (peer supporters, technicians, lay counsellors, or other non-clinicians) can help reduce costs and increase accessibility. OBJECTIVE This systematic review and meta-analysis evaluates the effectiveness, adherence, and other process outcomes of non-clinician guided digital mental health interventions. METHODS Four databases (MEDLINE, EMBASE, CINAHL, and PSYCInfo) were searched for randomized controlled trials published between 2010 and 2020 examining digital mental health interventions. Three journals focused on digital intervention were also hand searched and grey literature was searched using ProQuest and the Cochrane Central Register of Control Trials (CENTRAL). Two researchers independently assessed risk of bias using the Cochrane Risk of Bias Tool 2. Data were collected on effectiveness, adherence, and other process outcomes, and meta-analyses were conducted for effectiveness and adherence outcomes. Non-clinician guided interventions were compared with treatment as usual, clinician-guided interventions, and unguided interventions. RESULTS Thirteen studies qualified for inclusion. Results indicate that non-clinician guided interventions yielded higher post-treatment effectiveness outcomes when compared to conditions involving control programs (e.g. online psychoeducation, monitored attention control) or waitlist controls (k=7, Hedges g=-0.73 (95% CI -1.08 to -0.38)). There are significant differences between non-clinician guided interventions and unguided interventions as well (k=6, Hedges g=-0.17 (95% CI -0.23 to -0.11)). In addition, non-clinician guided interventions did not differ in effectiveness from clinician-guided interventions (k=3, Hedges g=0.08 (95% CI -0.01 to 0.17)). These results suggest that guided digital mental health interventions are helpful to improve mental health outcomes regardless of the qualification, and that the presence of a non-clinician guide improves effectiveness outcomes more than no guidance. Non-clinician guided interventions did not yield significantly different effects on adherence outcomes when compared with unguided interventions (k=3, OR 1.58 (95% CI 0.51 to 4.92)), although a general trend of improved adherence was observed within non-clinician guided interventions. CONCLUSIONS Integrating paraprofessionals and non-clinicians appear to improve outcomes of digital mental health interventions, and may also enhance adherence outcomes (though the trend was nonsignificant). Further research should focus on the specific types of tasks these paraprofessionals can successfully provide (i.e. psychosocial support, therapeutic alliance, technical augmentation) and their associated outcomes. CLINICALTRIAL The protocol is preregistered on PROSPERO (CRD42020191226).

scholarly journals Implementation of stepped care for patients with chronic fatigue syndrome in community-based mental health care: outcomes at post-treatment and long-term follow-up

2019 ◽  
Vol 47 (5) ◽  
pp. 548-558 ◽  
Author(s):  
Anthonie Janse ◽  
Arno van Dam ◽  
Coby Pijpers ◽  
Jan F. Wiborg ◽  
Gijs Bleijenberg ◽  
...  
Keyword(s):  
Mental Health ◽  
Chronic Fatigue ◽  
Post Treatment ◽  
Stepped Care ◽  
Community Based ◽  
Fatigue Syndrome ◽  
Specialist Centre ◽  
Long Term Follow Up

AbstractBackground:Cognitive behavioural therapy (CBT) is an evidence-based treatment for chronic fatigue syndrome (CFS). Stepped care for CFS, consisting of a minimal intervention followed by face-to-face CBT, was found efficacious when tested in a CFS specialist centre. Stepped care implemented in a community-based mental health centre (MHC) has not yet been evaluated.Aims:(1) To test the effectiveness of stepped care for CFS implemented in a MHC at post-treatment and at long-term follow-up; and (2) compare post-treatment outcomes of implemented stepped care with treatment outcomes of a CFS specialist centre.Method:An uncontrolled study was used to test effectiveness of stepped care implemented in a MHC (n = 123). The outcomes of implemented care were compared with the outcomes of specialist care reported in previous studies (n = 583). Data on outcomes from implemented stepped care were gathered at post-treatment and at long-term follow-up. Mixed models were used as method of analysis.Results:Fatigue decreased and physical functioning increased significantly following implemented stepped care (both p < .001). The follow-up was completed by 94 patients (78%) within 1–6 years after treatment. Treatment effects were sustained to follow-up. Patients in the MHC showed less improvement directly following stepped care compared with patients in a CFS specialist centre (p < .01).Conclusion:Implemented stepped care for CFS is effective with sustained treatment gains at long-term follow-up. There is room for improvement when compared with outcomes of a CFS specialist centre. Some suggestions are made on how to improve stepped care.

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