scholarly journals Treatment dropout at a secondary mental health service

2012 ◽  
Vol 34 (4) ◽  
pp. 207-214
Author(s):  
Mário Sérgio Ribeiro ◽  
José Cândido Caldeira Xavier Júnior ◽  
Tiago Rodrigues Mascarenhas ◽  
Priscila Matthiesen Silva ◽  
Eveline Maria de Melo Vieira ◽  
...  

OBJECTIVE: To investigate mental health dropout rates in secondary care and to identify possible associations between this variable and social, demographic, psychopathologic, and health care process-related variables. METHOD: This prospective, observational study included 994 patients referred to a secondary service by four primary care units and evaluated by a specialist mental health team between 2004 and 2008. The dependent variable was treatment dropout. Bivariate analyses investigated possible associations between treatment dropout and 57 independent variables. RESULTS: The overall dropout rate from specialist mental health treatment was relatively low (mean = 25.6%). Only four independent variables were associated with dropout: one socioeconomic, two psychopathological, and one health care process variable. All associations were marginally significant (p < 0.1). CONCLUSION: Our findings suggest that family members, patients, and health care professionals are well engaged in this mental health care system based on a model of primary care. The use of this mental health model of care should be extended to other regions of our country.

2017 ◽  
Vol 1 (1) ◽  
Author(s):  
Yvonne Larrier ◽  
Monica D. Allen ◽  
Irwin M.H. Larrier

Global mental health research is continuing to unearth the multiple systemic barriers that over 80% of the world’s population experiences in their search for cultural, contextual, and efficient mental health treatment and services. The widespread gaps and shortages in treatment, research, interventions, financial resources, and mental health care specialists are enduring and expansive thus leaving behind many communities and societies in low and middle income countries and high income countries. Whereas there are numerous approaches to these gaps, this article proposes a re-conceptualized approach to the promotion, practice, and intervention of mental health services locally and globally, with the Cultivating SEEDS System (CSS™) framework. This framework addresses two of the most prevalent barriers – the stigma associated with accessing mental health care resources, and the lack of mental health care professionals.


2014 ◽  
Vol 36 (2) ◽  
pp. 173-188 ◽  
Author(s):  
Laura Kohn-Wood ◽  
Lisa Hooper

Racial and ethnic minorities in the United States are less likely to receive treatment for psychiatric disorders than are White Americans. For two decades, clinicians and researchers have worked to reduce health and health care disparities, with at best minimal success. In 2001 the Surgeon General issued a seminal report that described the magnitude of the problem (U. S. Department of Health and Human Services, 2001). Nevertheless, the vexing problem of unequal treatment persists. This review provides preliminary evidence for reducing racial and ethnic disparities in mental health treatment in primary care settings by giving priority to culturally competent practices and cultural tailoring in assessment, diagnosis, and treatment.


2020 ◽  
Vol 26 (4) ◽  
pp. e102-e109
Author(s):  
Mary Icenogle ◽  
Cara A. Busenhart ◽  
Carol Buller ◽  
JoAnn M. Peterson ◽  
Lori Schwartz ◽  
...  

Primary care settings have many opportunities to support patients who have anxiety and/or depression, but resources are often scarce. Our faculty team developed an education tool to support mental health awareness and provide suggested wellness activities. Health-care professionals from various disciplines and settings have demonstrated eagerness to use this tool with patients and with health-care students to improve resilience and mental wellness.


2021 ◽  

Mental Health, Diabetes and Endocrinology examines the main areas of clinical overlap between endocrinology and mental health to address key clinical conundrums. Drawing on the most recent developments from literature and clinical practice, this book gives specific attention to the main areas where clinical conundrums and treatment challenges arise across endocrinology, psychiatry, psychology and primary care. Common challenges in this area include depression which can impact on the person's ability to self-care and to adhere to treatment with consequences for their morbidity and mortality; 'diabulaemia' associated with high mortality rates; obesity and associated mental disorders; cognitive impairment and mental capacity; anti-psychotic medications and their endocrine sequelae; and specific setting-related considerations. Mental Health, Diabetes and Endocrinology is a useful resource for the overlapping conditions across these specialities, and provides clinically-focussed evidence-based resources for all health care professionals who encounter these issues.


SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A294-A294
Author(s):  
Ivan Vargas ◽  
Alexandria Muench ◽  
Mark Seewald ◽  
Cecilia Livesey ◽  
Matthew Press ◽  
...  

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 &lt; 8], subthreshold-insomnia [ISI 8–14], and clinically-significant-insomnia [ISI&gt;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


2021 ◽  
Vol 36 (3) ◽  
pp. 362-369
Author(s):  
Katie A. Willson ◽  
Gerard J. FitzGerald ◽  
David Lim

AbstractObjective:This scoping review aims to map the roles of rural and remote primary health care professionals (PHCPs) during disasters.Introduction:Disasters can have catastrophic impacts on society and are broadly classified into natural events, man-made incidents, or a mixture of both. The PHCPs working in rural and remote communities face additional challenges when dealing with disasters and have significant roles during the Prevention, Preparedness, Response, and Recovery (PPRR) stages of disaster management.Methods:A Johanna Briggs Institute (JBI) scoping review methodology was utilized, and the search was conducted over seven electronic databases according to a priori protocol.Results:Forty-one papers were included and sixty-one roles were identified across the four stages of disaster management. The majority of disasters described within the literature were natural events and pandemics. Before a disaster occurs, PHCPs can build individual resilience through education. As recognized and respected leaders within their community, PHCPs are invaluable in assisting with disaster preparedness through being involved in organizations’ planning policies and contributing to natural disaster and pandemic surveillance. Key roles during the response stage include accommodating patient surge, triage, maintaining the health of the remaining population, instituting infection control, and ensuring a team-based approach to mental health care during the disaster. In the aftermath and recovery stage, rural and remote PHCPs provide long-term follow up, assisting patients in accessing post-disaster support including delivery of mental health care.Conclusion:Rural and remote PHCPs play significant roles within their community throughout the continuum of disaster management. As a consequence of their flexible scope of practice, PHCPs are well-placed to be involved during all stages of disaster, from building of community resilience and contributing to early alert of pandemics, to participating in the direct response when a disaster occurs and leading the way to recovery.


Sign in / Sign up

Export Citation Format

Share Document