scholarly journals The Effect of Expanded Access to Mental Health Care on Economic Status of Households with a Person with a Mental Disorder in Rural Ethiopia: A Controlled Before-After Study

2021 ◽  
Author(s):  
Yohannes Hailemichael ◽  
Damen Hailemariam ◽  
Kebede Tirfessa ◽  
Sumaiyah Docrat ◽  
Atalay Alem ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Economic Status ◽  
Mental Healthcare ◽  
Secular Trends ◽  
Community Control ◽  
Consumption Expenditure ◽  
Community Based ◽  
Expanded Access

Abstract BackgroundPoverty and mental illness are strongly associated. The aim of this study was to investigate the economic impact of implementing a district level integrated mental healthcare plan for people with severe mental disorders (SMD) and depression compared to secular trends in the general population in a rural Ethiopian setting.MethodsA community-based, controlled before-after study design was used to assess changes in household economic status and catastrophic out-of-pocket (OOP) payments in relation to expanded access to mental health care. Two household samples were recruited, each with a community control group: (1) SMD sub-study and (2) depression sub-study. In the SMD sub-study, 290 households containing a member with SMD and 289 comparison households without a person with SMD participated. In the depression sub-study, 129 households with a person with depression and 129 comparison households. The case and comparison cohorts were followed up over 12 months. Propensity score matching and multivariable regression analyses were conducted. ResultsProvision of mental healthcare in the district was associated with a greater increase in income (Birr 919.53, 95% CI: 34.49, 4573.56) but no significant changes in consumption expenditure (Birr 176.25, 95% CI: -1338.19, 1690.70) in households of people with SMD compared to secular trends in comparison households. In households of people with depression, there was no significant change in income (Birr 227.78, 95% CI: -1361.21, 1816.79) or consumption expenditure (Birr -81.20, 95% CI: -2572.57, 2410.15). The proportion of households incurring catastrophic OOP payments at the ≥10% and ≥40% thresholds were significantly reduced after the intervention in the SMD (from 20.3% to 9.0%, p=0.002, and 31.9% to 14.9%, p< 0.001) and in the depression intervention (from 19.6% to 5.3%, p=0.003, and 25.2% to 11.8%, p= 0.015). Nonetheless, households of persons with SMD or depression remained impoverished relative to comparison groups at follow-up. Households of people with SMD and depression were significantly less likely to be enrolled in community-based health insurance (CBHI) than comparison households. ConclusionsOur findings support global initiatives to scale up mental healthcare as part of universal health coverage initiatives, alongside interventions to support social inclusion and targeted financial protection for vulnerable households.

scholarly journals Integrating eHealth within a Transforming Mental Healthcare Setting: A Qualitative Study into Values, Challenges, and Prerequisites

2021 ◽  
Vol 18 (19) ◽  
pp. 10287
Author(s):  
Karin Lorenz-Artz ◽  
Joyce Bierbooms ◽  
Inge Bongers
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Mental Healthcare ◽  
Healthcare Setting ◽  
High Impact ◽  
Future Research ◽  
Community Based ◽  
Main Challenge ◽  
Care Models

Mental health care is shifting towards more person-centered and community-based health care. Although integrating eHealth within a transforming healthcare setting may help accomplishing the shift, research studying this is lacking. This study aims to improve our understanding of the value of eHealth within a transforming mental healthcare setting and to define the challenges and prerequisites for implementing eHealth in particular within this transforming context. In this article, we present the results of 29 interviews with clients, social network members, and professionals of an ambulatory team in transition within a Dutch mental health care institute. The main finding is that eHealth can support a transforming practice shifting towards more recovery-oriented, person-centered, and community-based service in which shared-decision making is self-evident. The main challenge revealed is how to deal with clients’ voices, when professionals see the value of eHealth but clients do not want to start using eHealth. The shift towards client-centered and network-oriented care models and towards blended care models are both high-impact changes in themselves. Acknowledging the complexity of combining these high-impact changes might be the first step towards creating blended client-centered and network-oriented care. Future research should examine whether and how these substantial shifts could be mutually supportive.

scholarly journals The Quality Mental Health Care Network: A roadmap to improving quality mental healthcare in Canada

2021 ◽  
Vol 34 (2) ◽  
pp. 100-106
Author(s):  
Emily J. Follwell ◽  
Siri Chunduri ◽  
Claire Samuelson-Kiraly ◽  
Nicholas Watters ◽  
Jonathan I. Mitchell
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Focus Groups ◽  
Lived Experiences ◽  
Mental Healthcare ◽  
Care Network ◽  
Key Informant ◽  
Health Care Network

Although there are numerous quality of care frameworks, little attention has been given to the essential concepts that encompass quality mental healthcare. HealthCare CAN and the Mental Health Commission of Canada co-lead the Quality Mental Health Care Network (QMHCN), which has developed a quality mental healthcare framework, building on existing provincial, national, and international frameworks. HealthCare CAN conducted an environmental scan, key informant interviews, and focus groups with individuals with lived experiences to develop the framework. This article outlines the findings from this scan, interviews and focus groups.

scholarly journals Alternative medicine under the Mental Health Care Act, 2017: Future implications and concerns

2022 ◽  
Vol 07 (01) ◽  
pp. 37-41
Author(s):  
Ramdas Ransing ◽  
Sujita Kumar Kar ◽  
Vikas Menon
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Alternative Medicine ◽  
Mental Healthcare ◽  
Evidence Base ◽  
Evidence Based ◽  
Insufficient Evidence ◽  
Indian Government ◽  
Evidence Based Care

In recent years, the Indian government has been promoting healthcare with an insufficient evidence base, or which is non-evidence-based, alongside delivery of evidence-based care by untrained practitioners, through supportive legislation and guidelines. The Mental Health Care Act, 2017, is a unique example of a law endorsing such practices. In this paper, we aim to highlight the positive and negative implications of such practices for the delivery of good quality mental healthcare in India.

scholarly journals Efforts and Challenges to Ensure Continuity of Mental Healthcare Service Delivery in a Low Resource Settings During COVID-19 Pandemic—A Case of a Kenyan Referral Hospital

2021 ◽  
Vol 11 ◽  
Author(s):  
Edith Kwobah ◽  
Florence Jaguga ◽  
Kiptoo Robert ◽  
Elias Ndolo ◽  
Jane Kariuki
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Health Care ◽  
Service Delivery ◽  
Mental Health Care ◽  
Healthcare Service ◽  
Healthcare Delivery ◽  
Mental Healthcare ◽  
Referral Hospital ◽  
Number Of Patients

The rising number of patients with Covid-19 as well as the infection control measures have affected healthcare service delivery, including mental healthcare. Mental healthcare delivery in low and middle income countries where resources were already limited are likely to be affected more during this pandemic. This paper describes the efforts of ensuring mental healthcare delivery is continued in a referral hospital in Kenya, Moi Teaching and Referral hospital, as well as the challenges faced. These efforts are guided by the interim guidelines developed by the Kenyan ministry of health. Some of the adjustments described includes reducing number of patients admitted, shortening the stay in the inpatient setting, using outdoors for therapy to promote physical distancing, utilization of electronic platforms for family therapy sessions, strengthening outpatient services, and supporting primary care workers to deliver mental health care services. Some of the challenges include limited ability to move about, declining ability for patients to pay out of pocket due to the economic challenges brought about by measures to control Covid-19, limited drug supplies in primary care facilities, inability to fully implement telehealth due to connectivity issues and stigma for mental health which results in poor social support for the mentally ill patients. It is clear that current pandemic has jeopardized the continuity of usual mental healthcare in many settings. This has brought to sharp focus the need to decentralize mental health care and promote community based services. Meanwhile, there is need to explore feasible alternatives to ensure continuity of care.

scholarly journals Working on and with Relationships: Relational Work and Spatial Understandings of Good Care in Community Mental Healthcare in Trieste

2020 ◽  
Vol 44 (4) ◽  
pp. 544-564
Author(s):  
Christien Muusse ◽  
Hans Kroon ◽  
Cornelis L. Mulder ◽  
Jeannette Pols
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Community Mental Health ◽  
Mental Health Care ◽  
Mental Healthcare ◽  
Care Practice ◽  
Community Mental Health Care ◽  
Good Care ◽  
Daily Care ◽  
Spatial Metaphors

Abstract Deinstitutionalization is often described as an organizational shift of moving care from the psychiatric hospital towards the community. This paper analyses deinstitutionalization as a daily care practice by adopting an empirical ethics approach instead. Deinstitutionalization of mental healthcare is seen as an important way of improving the quality of lives of people suffering from severe mental illness. But how is this done in practice and which different goods are strived for by those involved? We examine these questions by giving an ethnographic description of community mental health care in Trieste, a city that underwent a radical process of deinstitutionalization in the 1970s. We show that paying attention to the spatial metaphors used in daily care direct us to different notions of good care in which relationships are central. Addressing the question of how daily care practices of mental healthcare outside the hospital may be constituted and the importance of spatial metaphors used may inform other practices that want to shape community mental health care.

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