scholarly journals Engaging primary care professionals in suicide prevention: A qualitative study

PLoS ONE ◽  
2020 ◽  
Vol 15 (11) ◽  
pp. e0242540
Author(s):  
Elke Elzinga ◽  
Anja J. T. C. M. de Kruif ◽  
Derek P. de Beurs ◽  
Aartjan T. F. Beekman ◽  
Gerdien Franx ◽  
...  
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Health Care ◽  
The Netherlands ◽  
Mental Health Care ◽  
Suicide Prevention ◽  
Implementation Process ◽  
Theory Approach ◽  
Structured Interviews ◽  
Primary Care Professionals

In health systems with strongly developed primary care, such as in the Netherlands, effectively engaging primary care professionals (PCPs) in suicide prevention is a key strategy. As part of the national Suicide Prevention Action Network (SUPRANET), a program was offered to PCPs in six regions in the Netherlands in 2017–2018 to more effectively engage them in suicide prevention. This implementation study aimed to evaluate to what extent SUPRANET was helpful in supporting PCPs to apply suicide prevention practices. From March to May 2018, 21 semi-structured interviews have been carried out with PCPs and other non-clinical professionals from SUPRANET regions in the Netherlands. Verbatim transcripts were analysed using the grounded theory approach. Data was structured using the Consolidated Framework for Implementation Research, which enabled identifying facilitating and challenging factors for PCPs to carry out suicide prevention practices. An important challenge included difficulties in assessing suicide risk (intervention characteristics) due to PCPs’ self-perceived incompetence, burdensomeness of suicide and limited time and heavy workload of PCPs. Another important limitation was collaboration with mental health care (outer setting), whereas mental health nurses (inner setting) and SUPRANET (implementation process) were facilitating factors for applying suicide prevention practices. With regard to SUPRANET, especially the training was positively evaluated by PCPs. PCPs expressed a strong need for improving collaboration with specialized mental health care, which was not provided by SUPRANET. Educating PCPs on suicide prevention seems beneficial, but is not sufficient to improve care for suicidal patients. Effective suicide prevention also requires improved liaison between mental health services and primary care, and should therefore be the focus of future suicide prevention strategies aimed at primary care.

scholarly journals The provision of mental health care by primary health organisations in the northern region: Barriers and enablers

2009 ◽  
Vol 1 (2) ◽  
pp. 120 ◽  
Author(s):  
Anthony O'Brien ◽  
Fiona Moir ◽  
Katey Thom
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Health Care ◽  
Mental Health Care ◽  
Northern Region ◽  
Structured Interviews ◽  
District Health ◽  
Good Communication ◽  
Barriers And Enablers ◽  
Primary Health

AIM: To identify barriers and enablers to the provision of mental health care by Primary Health Organisations (PHOs) in the northern region. METHODS: Information was generated from structured interviews with 22 of the 25 PHOs and the four District Health Boards (DHBs) in the northern region. RESULTS: Of the 22 PHOs who participated in the study, 17 had at least one specific mental health initiative; others had up to five initiatives. PHOs that were funded to provide one of the 41 Ministry of Health mental health pilot projects had more mental health initiatives in place. Barriers and enablers to providing mental health care occurred in areas such as workforce capacity, funding, infrastructure, and limited interest in transfer of care from secondary to primary care. CONCLUSIONS: Barriers to providing mental health care within the primary sector include stigma, lack of training, communication between sectors, funding and perceptions of sector roles. Factors which enable provision of mental health care are availability of training, good communication between sectors, use of available and new funding mechanisms and community involvement. Further research at the practice and practitioner level is necessary to fully understand development of mental health care within the primary care sector. KEYWORDS: Mental health, primary care, Primary Health Organisations, health policy

scholarly journals Tips for permanent education in mental health in primary care guided by the Institutional Socio-clinic

2019 ◽  
Vol 27 ◽  
Author(s):  
Larissa de Almeida Rézio ◽  
Cinira Magali Fortuna ◽  
Flávio Adriano Borges
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Health Care ◽  
Mental Health Care ◽  
Health Effects ◽  
Family Health ◽  
Structured Interviews ◽  
The Family ◽  
Service Training ◽  
Collective Construction

Objective: to analyze a process of Permanent Education in Health about mental health with Family Health teams. Method: research-intervention performed with 20 workers from two teams of the Family Health Strategies. Semi-structured interviews and 12 reflection meetings were carried out with each team. The principles of Institutional Socio-clinic were used to guide the meetings and the analysis of the data. Results: seven beaconing tips were identified for the Process of Permanent Education in Health: effects produced from the choices of inclusion of the management in the planning of the meetings, revealing established ways of working; attention to non-control in training movements; use of restitution at meetings, reducing stiffness and tensions; attention to the institutions that cross us; analysis of the facilitator’s involvement in the training, redirecting behaviors and attitudes; problematization about the object, instrument and purpose, which favored the reflection about the mental health care and to learn to facilitate and experience the Permanent Education in Health in the act of making. Conclusions: socio-clinic assisted the experience of facilitating in-service training, pointing out tips for the collective construction of contextualized, reflexive and problematizing knowledge.

754 Insomnia and Depression Symptoms in Primary Care Patients Referred for Mental Health Care

SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A294-A294
Author(s):  
Ivan Vargas ◽  
Alexandria Muench ◽  
Mark Seewald ◽  
Cecilia Livesey ◽  
Matthew Press ◽  
...  
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Health Care ◽  
Mental Health Care ◽  
Primary Care Providers ◽  
Depression Symptoms ◽  
Care Providers ◽  
Mild Depression ◽  
Significant Depression ◽  
Clinically Significant

Abstract Introduction Past epidemiological research indicates that insomnia and depression are both highly prevalent and tend to co-occur in the general population. The present study further assesses this association by estimating: (1) the concurrence rates of insomnia and depression in outpatients referred by their primary care providers for mental health care; and (2) whether the association between depression and insomnia varies by insomnia subtype (initial, middle, and late). Methods Data were collected from 3,174 patients (mean age=42.7; 74% women; 50% Black) who were referred to the integrated care program for assessment of mental health symptoms (2018–2020). All patients completed an Insomnia Severity Index (ISI) and a Patient Health Questionnaire (PHQ-9) during their evaluations. Total scores for the ISI and PHQ-9 were computed. These scores were used to categorize patients into diagnostic groups for insomnia (no-insomnia [ISI < 8], subthreshold-insomnia [ISI 8–14], and clinically-significant-insomnia [ISI>14]) and depression (no-depression [PHQ-914]). Items 1–3 of the ISI were also used to assess the association between depression and subtypes of insomnia. Results Rates of insomnia were as follows: 34.6% for subthreshold-insomnia, 35.5% for clinically-significant insomnia, and 28.9% for mild-depression and 26.9% for clinically-significant-depression. 92% of patients with clinically significant depression reported at least subthreshold levels of insomnia. While the majority of patients with clinical depression reported having insomnia, the proportion of patients that endorsed these symptoms were comparable across insomnia subtypes (percent by subtype: initial insomnia 63%; middle insomnia 61%; late insomnia 59%). Conclusion According to these data, the proportion of outpatients referred for mental health evaluations that endorse treatable levels of insomnia is very high (approximately 70%). This naturally gives rise to at least two questions: how will such symptomatology be addressed (within primary or specialty care) and what affect might targeted treatment for insomnia have on health were it a focus of treatment in general? Support (if any) Vargas: K23HL141581; Perlis: K24AG055602

Suicidal ideation in an ethnically mixed, highland Guatemalan community

2021 ◽  
pp. 136346152097693
Author(s):  
Carla Pezzia ◽  
Luisa M. Hernandez
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Ethnic Identity ◽  
Suicidal Ideation ◽  
Mental Health Care ◽  
Protective Factor ◽  
Indigenous Populations ◽  
Structured Interviews ◽  
And Gender ◽  
Survey Responses

Reported suicide rates in Latin America remain low, but there is evidence to suggest they may be increasing, particularly among indigenous populations. To better understand who may be at risk for suicide, we examined the prevalence of suicidal ideation and explored factors contributing to suicidal thoughts in an ethnically mixed, highland Guatemalan community. The data presented in this article are from a mixed methods ethnographic field project conducted over 15 months from 2010 to 2011 in Panajachel, Guatemala. We surveyed a random sample of 350 community members. Survey questions included standardized modules from the Mini-International Neuropsychiatric Interview, as well as questions on experiences of violence and mental health care. We also conducted semi-structured interviews with 13 self-selected survey participants with current suicidal ideation. These interviews included questions regarding survey responses, experiences of mental illness, and access to mental health care. A total of 55 survey participants (N = 350; 15.7%) scored positive for suicidality. Ethnic identity, gender, psychiatric illness, and experiences of violence were all correlated to suicidal ideation. Qualitative interview data highlight distinctions between genders within prominent themes of religion, family, experiences of violence, and seeking resources. Three key findings emerged from our research that are relevant to the literature: 1) ethnic identity may be both a critical risk and a protective factor for suicide in some indigenous people; 2) intersections between violence and gender highlight different patterns in suicidal ideation; and 3) high rates of suicidal ideation and other psychiatric comorbidities underscore the need for greater access to mental health services.

Identification and Management of Depression in Australian Primary Care and Access to Specialist Mental Health Care

2012 ◽  
Vol 63 (12) ◽  
pp. 1247-1251 ◽  
Author(s):  
Nicholas Glozier ◽  
Tracey Davenport ◽  
Ian B. Hickie
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Health Care ◽  
Mental Health Care
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