A community-based approach to evaluation of health outcomes and costs for telepsychiatry in a rural population: Preliminary results

2000 ◽  
Vol 6 (1_suppl) ◽  
pp. 155-157 ◽  
Author(s):  
Craig Kennedy ◽  
Peter Yellowlees
Keyword(s):  
Mental Health ◽  
Health Outcomes ◽  
Rural Areas ◽  
Pilot Trial ◽  
Public Mental Health ◽  
Cost Effective ◽  
Community Based ◽  
Public And Private ◽  
Preliminary Results ◽  
The People

A pilot trial was established to support visiting psychiatric services and local public and private practitioners through the use of videoconferencing. The purpose of the trial was to determine whether people in the community received better health-care with telemedicine. A community-based approach was used to evaluate health outcomes, costs, utilization, accessibility, quality and needs for such services in a rural community in Queensland. Over a two-year period data were collected from 124 subjects who met the criteria of having a mental health problem or mental disorder. Nine further subjects refused to participate in the study. Only 32 subjects used videoconferencing to receive mental health services. Preliminary results did not show any significant improvements in wellbeing or quality of life, although the time span was relatively short. However, the results confirmed that the people were no worse off from a consumer or a practitioner perspective from using videoconferencing. Most consumers found that videoconferencing with a psychiatrist moderately or greatly helped them in managing their treatment, with 98% of them preferring to be offered videoconferencing in combination with local services. Overall, videoconferencing is a crucial part of enhancing psychiatry services in rural areas. However, it is not necessarily cost-effective for all consumers, general practitioners, psychiatrists, or the public mental health service.

scholarly journals A Peer-Led Electronic Mental Health Recovery App in a Community-Based Public Mental Health Service: Pilot Trial

10.2196/12550 ◽  
2019 ◽  
Vol 3 (2) ◽  
pp. e12550 ◽  
Author(s):  
Amelia Gulliver ◽  
Michelle Banfield ◽  
Alyssa R Morse ◽  
Julia Reynolds ◽  
Sarah Miller ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Health Service ◽  
Health Service ◽  
Pilot Trial ◽  
Public Mental Health ◽  
Mental Health Recovery ◽  
Community Based ◽  
Public Mental Health Service

Evaluation of a Philippine Community Based Rehabilitation Programme

2000 ◽  
Vol 12 (2) ◽  
pp. 85-89 ◽  
Author(s):  
Juan M. Lopez ◽  
Janice A. Lewis ◽  
Duncan P. Boldy
Keyword(s):  
Rural Areas ◽  
Cost Effective ◽  
Rehabilitation Programme ◽  
World Health ◽  
Community Based ◽  
Department Of Health ◽  
The People ◽  
Community Based Rehabilitation ◽  
Cost Effective Approach ◽  
Record Review

In 1991, the Philippine Department of Health implemented a Philippine Model of the World Health Organisation's Community Based Rehabilitation Programme initiative in pilot areas. The objective of this study was to explore whether, after seven years of operation, the Programme had actually been implemented as planned. The study was conducted in one pilot area in Rosario, La Union, a rural district of Luzon. The research used audit methodology to compare planned services with actual services. The main audit techniques used were record review, in-depth personal interview and focus group discussions. The study showed that such a programme, if properly organised and managed, can meet the needs of the people with disabilities who need rehabilitation. The Community Based Rehabilitation Programme represents a simple cost-effective approach for the delivery of disability prevention and rehabilitation services, particularly in rural areas that have little access to such services. Asia Pac J Public Health 2000;12(2): 85-89

scholarly journals Effectiveness of a Community-based Group Mindfulness Program tailored for Arabic and Bangla-speaking Migrants

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Ilse Blignault ◽  
Hend Saab ◽  
Lisa Woodland ◽  
Haider Mannan ◽  
Arshdeep Kaur
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Health Outcomes ◽  
Mental Health Outcomes ◽  
Home Practice ◽  
Community Based ◽  
Mindfulness Skills ◽  
Arabic Speakers ◽  
Language Groups

Abstract Background Migrant communities are often underserved by mainstream mental health services resulting in high rates of untreated psychological distress. This collaborative study built on evidence that mindfulness-based interventions delivered in-language and culturally tailored were acceptable and clinically effective for Arabic speakers in Australia. It aimed to establish whether a group mindfulness program produced expected outcomes under normal operational conditions, and to test its scalability and its transferability to Bangla speakers. Methods A 5-week mindfulness program was delivered to 15 Arabic-speaking and 8 Bangla-speaking groups in community settings. The mixed-methods evaluation incorporated a pre-post study. Descriptive statistics were used to summarise the socio-demographic data, group attendance and home practice. Differences in DASS 21 and K10 scores from pre to post-intervention were tested using the nonparametric sign test for paired samples (two-sided). Multiple linear regression analysis was performed to determine the effects of selected sociodemographic variables, group attendance and home practice on clinical outcomes, based on intention to treat. Content analysis was used to examine the qualitative data. Results The program attracted 168 Arabic speakers and 103 Bangla speakers aged 16 years and over, mostly women. Cultural acceptability was evident in the overall 80% completion rate, with 78% of Arabic speakers and 84% of Bangla speakers retained. Both language groups showed clinically and statistically significant improvements in mental health outcomes on the DASS21 and K10. Thirty new referrals were made to mental health services. Participant feedback emphasised the benefits for their everyday lives. All but one participant reported sharing the mindfulness skills with others. Conclusions Across multiple and diverse groups of Arabic and Bangla speakers in Sydney, the community-based group mindfulness program was shown to have high levels of cultural acceptability and relevance. It resulted in clinically and statistically significant improvements in mental health outcomes, facilitated access to mental health care and boosted mental health literacy. This innovative, low-intensity, in-language mental health intervention that was originally developed for Arabic speakers is scalable. It is also transferable—with cultural tailoring—to Bangla speakers.

scholarly journals Testing a community-based distribution approach to reproductive health service delivery in Senegal (a study of community agents in Kébémer)

2004 ◽  
Keyword(s):  
Rural Communities ◽  
Reproductive Health ◽  
Service Delivery ◽  
Social Action ◽  
Rural Areas ◽  
Cost Effective ◽  
Health Service Delivery ◽  
Reproductive Health Services ◽  
Community Based ◽  
Integrated Cost

The Division of Reproductive Health (DSR) of the Senegal Ministry of Health and Social Action, in partnership with the Population Council’s FRONTIERS in Reproductive Health program and Management Sciences for Health (MSH), conducted a study to test and compare three ways of providing reproductive health services to rural communities in the Kébémer district of Senegal in terms of their effectiveness, cost, and cost-effectiveness. FRONTIERS and MSH collaborated with the DSR to design the interventions, MSH supported the DSR in implementing the interventions, and FRONTIERS undertook the evaluation. This study, funded by USAID, responded to the recommendations of a 1999 workshop, organized by FRONTIERS and the DSR, on the community-based distribution (CBD) approach, which defined alternative CBD models appropriate for Senegal. The DSR sees the development of community-based service delivery models as essential for the future of health care in Senegal. As noted in this report, the general objective of the study was to contribute to the development of an integrated cost-effective program to increase the accessibility and availability of reproductive health information and services in rural areas of Senegal.

scholarly journals A Peer-Led Electronic Mental Health Recovery App in a Community-Based Public Mental Health Service: Pilot Trial (Preprint)

2018 ◽  
Author(s):  
Amelia Gulliver ◽  
Michelle Banfield ◽  
Alyssa R Morse ◽  
Julia Reynolds ◽  
Sarah Miller ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Service ◽  
Health Service ◽  
Public Mental Health ◽  
Care Staff ◽  
Mental Health Recovery ◽  
Proof Of Concept ◽  
Community Based ◽  
Public Mental Health Service

BACKGROUND There is an increasing need for peer workers (people with lived experience of mental health problems who support others) to work alongside consumers to improve recovery and outcomes. In addition, new forms of technology (tablet or mobile apps) can deliver services in an engaging and innovative way. However, there is a need to evaluate interventions in real-world settings. OBJECTIVE This exploratory proof-of-concept study aimed to determine if a peer worker–led electronic mental health (e-mental health) recovery program is a feasible, acceptable, and effective adjunct to usual care for people with moderate-to-severe mental illness. METHODS Overall, 6 consumers and 5 health service staff participated in the evaluation of a peer-led recovery app delivered at a community-based public mental health service. The peer worker and other health professional staff invited attendees at the drop-in medication clinics to participate in the trial during June to August 2017. Following the intervention period, participants were also invited by the peer worker to complete the evaluation in a separate room with the researcher. Consumers were explicitly informed that participation in the research evaluation was entirely voluntary. Consumer evaluation measures at postintervention included recovery and views on the acceptability of the program and its delivery. Interviews with staff focused on the acceptability and feasibility of the app itself and integrating a peer worker into the health care service. RESULTS Consumer recruitment in the research component of the study (n=6) fell substantially short of the target number of participants (n=30). However, from those who participated, both staff and consumers were highly satisfied with the peer worker and somewhat satisfied with the app. Health care staff overall believed that the addition of the peer worker was highly beneficial to both the consumers and staff. CONCLUSIONS The preliminary findings from this proof-of-concept pilot study suggest that a peer-led program may be a feasible and acceptable method of working on recovery in this population. However, the e-mental health program did not appear feasible in this setting. In addition, recruitment was challenging in this particular group, and it is important to note that these study findings may not be generalizable. Despite this, ensuring familiarity of technology in the target population before implementing e-mental health interventions is likely to be of benefit.

scholarly journals Understanding Neighborhoods’ Impact on Youth Substance Use and Mental Health Outcomes in Paterson, New Jersey: Protocol for a Community-Based Participatory Research Study

10.2196/29427 ◽  
2021 ◽  
Vol 10 (5) ◽  
pp. e29427
Author(s):  
Ijeoma Opara ◽  
Noelle R Leonard ◽  
Daneele Thorpe ◽  
Trace Kershaw
Keyword(s):  
Mental Health ◽  
Substance Use ◽  
New Jersey ◽  
Health Outcomes ◽  
Participatory Research ◽  
Quantitative Methods ◽  
Urban Community ◽  
Community Based Participatory Research ◽  
Mental Health Outcomes ◽  
Community Based

Background Substance use among youth is a major public health concern. Of note, substance use among youth is increasing in prevalence, and the incidence of substance use at earlier ages is rising. Given the long-term consequences of early substance use, it is important to identify factors that increase youth vulnerability to drug use, as they may be important targets for future interventions. Objective This study aims to use innovative methods, such as venue-based sampling, to recruit youth who are disconnected from school and use community-based participatory research to gain a better understanding of the prevalence of substance use and important correlates among youth aged between 13 and 21 years in Paterson, New Jersey, a low-income, urban community. The study will use a convergent, mixed methods design involving multiple data collection components and the analysis of a ministrative data source, designed with the strengths of complex intervention frameworks in mind. The overall aims of the study are to identify the prevalence of substance use among youth who are engaged in school and not engaged in school; to understand important antecedents and correlates of substance use; and to use this information to inform social, environmental, and culturally appropriate interventions to address substance use and its correlates among youths in a lower-resourced urban community. Methods This study will use both qualitative and quantitative methods to address important questions. Specifically, semistructured interviews using focus group and interview methodologies will be used to assess youths’ lived experiences and will account for specific details that quantitative methods may not be able to attain. In addition, quantitative methods will be used to examine direct and multilevel associations between neighborhood factors and youth substance use and mental health outcomes. Results A previous analysis from a substance use initiative in Paterson, New Jersey found that youth who use substances such as marijuana and alcohol are more likely to have higher rates of depression and anxiety. On the basis of the research questions, this study will examine the association between neighborhood characteristics, substance use, and mental health symptoms among youth in Paterson by using quantitative and qualitative methods and will use these findings to inform the adaptation of a community- and evidence-based substance use prevention intervention for these youths. Conclusions The findings of this study will provide an important contribution to understanding the role of socioecological factors in predicting substance use and mental health outcomes among youth in a lower-resourced, urban community. Furthermore, these findings will serve as evidence for the development of a culturally informed, community-based prevention program to address substance use disparities for youth, including those who are truant in Paterson, New Jersey. International Registered Report Identifier (IRRID) PRR1-10.2196/29427

scholarly journals Social Determinants of Mental Health Care Systems: Intensive Community Based Care in The Veterans Health Administration

2020 ◽  
Author(s):  
Ish P Bhalla ◽  
Elina A Stefanovics ◽  
Robert A Rosenheck
Keyword(s):  
Mental Health ◽  
Social Determinants ◽  
Public Mental Health ◽  
Veterans Health Administration ◽  
Outpatient Clinics ◽  
Veterans Health ◽  
Health Administration ◽  
Community Based ◽  
Community Based Programs ◽  
Community Based Services

Abstract Background: Since deinstitutionalization in the 1950s-1970s, public mental health care has changed its focus from asylums to general hospitals, outpatient clinics and specialized community-based programs addressing both clinical and social determinants of mental health. Analysis of the place of community-based programs within a comprehensive health system such as the Veterans Health Administration (VHA) may illuminate the role of social forces in shaping contemporary public mental health systems. Methods: National VHA administrative data were used to compare veterans who exclusively received outpatient clinic care to those receiving four types of specialized community-based services, addressing: 1) functional disabilities from severe mental illness (SMI), 2) justice system involvement, 3) homelessness, and 4) vocational rehabilitation. Bivariate comparisons and multinomial logistic regression analyses compared groups on demographics, diagnoses, service use, and psychiatric prescription fills. Results: An hierarchical classification of 1,386,487 Veterans who received specialty mental health services from VHA in Fiscal Year 2012, showed 1,134,977 (81.8%) were seen exclusively in outpatient clinics; 27,931 (2.0 %) received intensive SMI-related services; 42,985 (3.1%) criminal justice services; 160,273 (11.6%) specialized homelessness services; and 20,921 (1.5%) vocational services. Compared to those seen only in clinics, veterans in the four community treatment groups were more likely to be black, diagnosed with HIV and hepatitis, had more numerous substance use diagnoses and made far more extensive use of mental health outpatient and inpatient care. Conclusions: Almost one-fifth of VHA mental health patients receive community-based services prominently addressing major social determinants of health and multimorbid substance use disorders.

Privatization and school mental health

2020 ◽  
Vol 19 (2) ◽  
pp. 99-107 ◽  
Author(s):  
Mark Weist ◽  
Kathleen Blackburn Franke ◽  
Rob Lucio ◽  
Jefferson Bass ◽  
Terry Doan ◽  
...  
Keyword(s):  
Mental Health ◽  
South Carolina ◽  
Health Systems ◽  
School Mental Health ◽  
Public Mental Health ◽  
Mental Health Systems ◽  
Public And Private ◽  
Content Type ◽  
The Usa ◽  
General Funding

Purpose The purpose of this paper is to describe the relationship between privatization and school mental health (SMH) in the USA, as well as to present a case study of the SMH system in South Carolina. Design/methodology/approach The authors reviewed data regarding states’ mental health systems (e.g. public, private and hybrid of public and private), mental health budgets and percentages of schools with mental health clinicians. Findings The results demonstrate that the majority of states have public mental health systems. There is variability between states regarding general funding, as well as funding for SMH. Further, there was variability in the percentage of schools with SMH clinicians, with South Carolina reporting the greatest percentage. South Carolina’s mental health system, which is a public–private hybrid is reviewed, along with relevant history on the development of SMH programs in the state. Originality/value This paper contributes to the general knowledge by describing the provision and funding sources for SMH services within the USA. It yields important implications for integrating public mental health services within schools.

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