scholarly journals Mental health and human rights: Challenges for health services and communities

2021 ◽  
Vol 17 ◽  
pp. e3488
Author(s):  
Rosana Onocko-Campos ◽  
Larry Davidson ◽  
Manuel Desviat

The care of people with mental health problems requires health system and service reforms to build up proper mental health care. The challenges of the present moment continue to be immense. The viral pandemic that we are experiencing has exposed the fragility of our health and social services and certified the inequality and precariousness of the living conditions of many people. The collection of articles published in the journal Salud Colectiva as part of the open call for papers “Mental health and human rights: challenges for health services and communities,” includes articles from Spain, Brazil, Mexico, and Chile. These papers present conceptual experiences and reflections on community action plans and programs, contributing toward better knowledge and development of mental health in the region.

2020 ◽  
Vol 3 (1) ◽  
Author(s):  
Tatiana Varela Madureira ◽  
Maria Cristina Quintas Antunes

Background: The integration of mental health in primary health care, throughout its various functional units and with effective articulation between primary health care and mental health services, has been considered an essential objective of the legislative documents produced in the last three decades in Portugal, among them the National Health Plan 2011-2016.Goals: This study aimed to inquire health professionals’ perceptions about mental health care provided by public primary health care units, namely their perceptions about the mental health of their patients. It also intended to explore the difficulties perceived by the health professionals in their daily activity about the mental health problems of their patients and about the need of clinical psychologists’ activity in the public primary health care.Methods: This is an observational cross-sectional study with two non-probabilistic samples: health professionals (doctors, nurses and psychologists) and patients from two public health care units. Health professionals were interviewed (individual structured face-to-face interviews) about their perceptions of needs for improving their capacity to provide mental healthcare and about patients’ mental health conditions. Patients responded (by self-administration) to the Depression, Anxiety and Stress Scale (DASS-21), providing a characterization of patients’ stress, anxiety and symptoms of depression.Results: Health professionals in their daily practice often identify in their patients symptoms of stress, anxiety and depression (most particularly in adults),. Several issues were identified as problematic, such as: poor access of the referral system for psychiatric and clinical psychological specialized care, insufficient number of health professionals, particularly of psychologists, and lack of appropriate mental health care specialization. The results also revealed relevant levels of stress, anxiety and depression in primary health care patients (both genders), which seem to increase with age. Discussion: Difficulties identified by health professionals may relate to the centralisation of resources, resistance to change from human resources management, lack of consensus among the various decision groups linked to mental health and, at institutional level, insufficient and inadequate funding. These factors may contribute to a failure in early diagnosis of symptoms of depression, anxiety and stress. It is expected that articulation between primary health services and differentiated health services will improve, with improvement in teamwork among professionals and increase of the quality of life of users, satisfaction with work, from health professionals,  and reduction of health costs.


2020 ◽  
Vol 30 (6) ◽  
pp. 1127-1133
Author(s):  
Pierre-André Michaud ◽  
Annemieke Visser ◽  
Johanna P M Vervoort ◽  
Paul Kocken ◽  
Sijmen A Reijneveld ◽  
...  

Abstract Background Mental health problems in adolescence can profoundly jeopardize adolescent current and future health and functioning. We aimed to describe existing recommendations and services regarding the delivery of primary mental health care for adolescents in 31 European countries. Methods Data on the availability and accessibility of primary mental health services were collected, as part of the Horizon 2020-funded project Models of Child Health Appraised. One expert from each country answered a closed items questionnaire during years 2017–18. Results All 31 participating countries had some policy or recommendations regarding the availability and accessibility of primary mental health services for adolescents, but their focus and implementation varied largely between and within countries. Only half of the participating countries had recommendations on screening adolescents for mental health issues and burdens. Merely a quarter of the countries had ambulatory facilities targeting specifically adolescents throughout the whole country. Just over half had some kind of suicide prevention programs. Same-day access to primary care in case of -health emergencies was possible in 21 countries, but often not throughout the whole country. Nineteen countries had strategies securing accessible mental health care for vulnerable adolescents. Conclusions Overall, around half of European countries had strategies securing access to various primary mental health care for adolescents. They frequently did not guarantee care over the whole country and often tackled a limited number of situations. EU countries should widen the range of policies and recommendations governing the delivery of mental health care to adolescents and monitor their implementation.


2019 ◽  
Vol 16 (1) ◽  
Author(s):  
Minh X. Nguyen ◽  
Vivian F. Go ◽  
Quynh X. Bui ◽  
Bradley N. Gaynes ◽  
Brian W. Pence

Abstract Background The HIV epidemic in Vietnam has been primarily driven by injection drug use. HIV-infected people who inject drugs (PWID) in Vietnam have very high rates of mental health problems, which can accelerate progression to AIDS and increase mortality rates. No research has explored the barriers and facilitators of mental health care for HIV-infected PWID in Vietnam. Methods We conducted 28 in-depth interviews among HIV-infected PWID (n = 16), HIV and MMT (methadone maintenance treatment) providers (n = 8), and health officials (n = 4) in Hanoi. We explored participants’ perceptions of mental health disorders, and barriers and facilitators to seeking and receiving mental health care. Results HIV-infected PWID were perceived by both PWID, HIV/MMT providers, and health officials to be vulnerable to mental health problems and to have great need for mental health care. Perceived social, physical, and economical barriers included stigma towards HIV, injection drug use, and mental illnesses; lack of awareness around mental health issues; lack of human resources, facilities and information on mental health services; and limited affordability of mental health services. Social support from family and healthcare providers was a perceived facilitator of mental health care. Conclusions Interventions should raise self-awareness of HIV-infected PWID about common mental health problems; address social, physical, economic barriers to seeking mental health services; and increase social support for patients.


2017 ◽  
Vol 41 (S1) ◽  
pp. S568-S568
Author(s):  
C. Aroui ◽  
A. Khoubila ◽  
K. Mchichi Alami ◽  
M. Agoub ◽  
O. Battas ◽  
...  

IntroductionAll over the world, there is global emergency when it comes to respecting human rights in providing good mental health services. Morocco as an African and a developing country has always had a mental health policy defined by several glitches and failures, which had not helped him improve its mental health services quality. Nevertheless, huge improvements were achieved through time.ObjectivesThis report, aims to draw attention on how compulsory it is to think and act all together to promote mental health and provide patients with better health services in Morocco.MethodsThe National Human Rights Council conducted an information and investigation mission in Morocco's main mental health hospitals and facilities between March 27 and July 6, 2012.ResultsStructures are insufficient and inadequate in terms of geographical distribution, architecture and equipment. There is a big shortage of medical and paramedical staff and little interest is given to vulnerable groups. Nevertheless, huge improvements have also been achieved through time with mental health issues becoming a cornerstone of the ministerial program, the involvement of the NGOs, the construction of newer facilities, the implementation of an information gathering system and the presence of a substance use policy.ConclusionPsychiatry in Morocco has come a long way since it was firstly implemented in the country as a medical specialty. Undoubtedly, a lot has been done but much more remains to be achieved. The current situation requires relevant actions and that clearly includes the implementation of a new mental health policy and the update of the legal framework.Disclosure of interestThe authors have not supplied their declaration of competing interest.


2012 ◽  
Vol 49 (2) ◽  
pp. 261-282 ◽  
Author(s):  
Simon Corneau ◽  
Vicky Stergiopoulos

Anti-racism and anti-oppression frameworks of practice are being increasingly advocated for in efforts to address racism and oppression embedded in mental health and social services, and to help reduce their impact on mental health and clinical outcomes. This literature review summarizes how these two philosophies of practice are conceptualized and the strategies used within these frameworks as they are applied to service provision toward racialized groups. The strategies identified can be grouped in seven main categories: empowerment, education, alliance building, language, alternative healing strategies, advocacy, social justice/activism, and fostering reflexivity. Although anti-racism and anti-oppression frameworks have limitations, they may offer useful approaches to service delivery and would benefit from further study.


2008 ◽  
Vol 123 (6) ◽  
pp. 768-780 ◽  
Author(s):  
Jeff J. Guo ◽  
Terrance J. Wade ◽  
Kathryn N. Keller

Objectives. School-based health centers (SBHCs) play an increasingly major role in providing mental health services for students. This study evaluated the impact of SBHCs on mental health-care services and psychosocial health-related quality of life (HRQOL). Methods. Four SBHC intervention and two matched non-SBHC school districts were examined from 1997 to 2003. The SBHC intervention began in 2000. Data included child and parent pediatric HRQOL and Ohio Medicaid claims. A longitudinal quasi-experimental time-series repeated measures design was used for this study, involving analysis of covariance to assess health costs and regression analyses for HRQOL scores. Results. After the SBHC program, proportions of students accessing mental health-care services for urban and rural SBHC intervention schools increased 5.6% (χ2=39.361, p<0.0001) and 5.9% (χ2=5.545, p<0.0001), respectively, compared with increases of 2.6% (χ2=2.670, p=0.1023) and 0.2% (χ2=0.006, p=0.9361) for urban and rural non-SBHC schools, respectively. Using data from 109 students with mental health problems based on Medicaid claims, the study found SBHC students had significantly lower total health-care costs (F=5.524, p=0.005) and lower costs of mental health services (F=4.820, p=0.010) compared with non-SBHC students. While improvements over time in HRQOL for SBHC students compared with non-SBHC students and students from non-SBHC schools were observed, only some were statistically significant. Conclusions. SBHC programs increase the proportion of students who receive mental health services and may improve pediatric HRQOL. SBHC students with mental health problems had lower total Medicaid reimbursements compared with non-SBHC students.


2016 ◽  
Vol 26 (4) ◽  
pp. 383-394 ◽  
Author(s):  
A. Lora ◽  
A. Lesage ◽  
S. Pathare ◽  
I. Levav

Aims.Information is crucial in mental healthcare, yet it remains undervalued by stakeholders. Its absence undermines rationality in planning, makes it difficult to monitor service quality improvement, impedes accountability and human rights monitoring. For international organizations (e.g., WHO, OECD), information is indispensable for achieving better outcomes in mental health policies, services and programs. This article reviews the importance of developing system level information with reference to inputs, processes and outputs, analyzes available tools for collecting and summarizing information, highlights the various goals of information gathering, discusses implementation issues and charts the way forward.Methods.Relevant publications and research were consulted, including WHO studies that purport to promote the use of information systems to upgrade mental health care in high- and low-middle income countries.Results.Studies have shown that once information has been collected by relevant systems and analyzed through indicator schemes, it can be put to many uses. Monitoring mental health services, represents a first step in using information. In addition, studies have noted that information is a prime resource in many other areas such as evaluation of quality of care against evidence based standards of care. Services data may support health services research where it is possible to link mental health data with other health and non-health databases. Information systems are required to carefully monitor involuntary admissions, restrain and seclusion, to reduce human rights violations in care facilities. Information has been also found useful for policy makers, to monitor the implementation of policies, to evaluate their impact, to rationally allocate funding and to create new financing models.Conclusions.Despite its manifold applications, Information systems currently face many problems such as incomplete recording, poor data quality, lack of timely reporting and feedback, and limited application of information. Corrective action is needed to upgrade data collection in outpatient facilities, to improve data quality, to establish clear rules and norms, to access adequate information technology equipment and to train health care personnel in data collection. Moreover, it is necessary to shift from mere administrative data collection to analysis, dissemination and use by relevant stakeholders and to develop a “culture of information” to dismantle the culture of intuition and mere tradition. Clinical directors, mental health managers, patient and family representatives, as well as politicians should be educated to operate with information and not just intuition.


1986 ◽  
Vol 10 (10) ◽  
pp. 293
Author(s):  
Elizabeth Garrett

ESCATA, the enterprising and innovative organisation which specialises in training material for health and social services professionals, does not claim mainly to produce educational films but rather, what it terms ‘video assisted workshops’. This is an important distinction and should be borne in mind when viewing the ‘Tread Softly’ video which looks at the transition from large psychiatric hospitals to local community services and is intended for practitioners, planners, managers and members from both voluntary and statutory mental health services.


2017 ◽  
Vol 15 (15) ◽  
pp. 7
Author(s):  
Ugnė Grigaitė

During this time, in which Lithuania is going through the deinstitutionalization of its mental health services, the principles of Global Mental Health are especially relevant. This global field for study, research and practice places a priority on improving mental health outcomes as well as reducing respective inequities for all people worldwide. Scaling-up support services for persons who have mental health problems based on both scientific evidence and human rights has become one of the main focuses for action globally, and the key principles of Global Mental Health apply to the situation in Lithuania as much as they do in a number of other countries. This article explores the critical need to effectively reform the existing mental health care system in the country, which in its current form often results in human rights violations. It points to the idea, based on the global evidence base, that different Lithuanian authorities and other key stakeholders could start working together in an intersectoral way in order to reorganize mental health services from institutional to community-based models of care. It is suggested by this article that a sensible, local application of the broad key principles of Global Mental Health could be a mature and rational step taken by Lithuania. This has the potential to be a major step toward the improvement of human rights and mental health outcomes in the country.


2021 ◽  
Vol 4 (1) ◽  
pp. 442-452
Author(s):  
Patrycja Kabiesz ◽  
Joanna Bartnicka

Abstract The health care system should offer and provide a variety of services without undue delay. Due to numerous technical, financial and human resource constraints, not all services can be offered both without restrictions and in equal measure in places of different sizes of residence. As a result of qualitative and quantitative research, a map of accessibility to social and health services was drawn up, taking into consideration the division of the country into voivodeships with different population. Spatial analysis showed great diversity in terms of service availability. Voivodships with the highest accessibility of health and social services are Dolnośląskie, Opolskie and Świętokrzyskie, while the worst situation is in Wielkopolskie. Moreover, the article identifies the main problems that people with limited functionality encounter when using health and social services.


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