scholarly journals PARTNER-MH, a Peer-Led Patient Navigation Intervention for Racial and Ethnic Minority Veterans in Veterans Health Administration (VHA) Mental Health Services: A Mixed-Methods Randomized Controlled Feasibility Trial Study Protocol

2021 ◽  
Author(s):  
Johanne Eliacin ◽  
Diana J. Burgess ◽  
Angela L. Rollins ◽  
Scott Patterson ◽  
Teresa Damush ◽  
...  
Keyword(s):  
Mental Health ◽  
Patient Engagement ◽  
Mental Health Treatment ◽  
Healthcare Disparities ◽  
Patient Navigation ◽  
Minority Groups ◽  
Mental Healthcare ◽  
Randomized Controlled ◽  
Patient Provider Communication ◽  
Racial And Ethnic Minority

Abstract Background: Mental healthcare disparities are persistent and have increased in recent years. Compared to their White counterparts, racial and ethnic minority groups have less access to mental healthcare. Minority groups also have lower engagement in mental health treatment and are more likely to experience ineffective patient-provider communication, which contribute to negative mental healthcare experiences and poor mental health outcomes. Interventions that embrace recovery-oriented practices to support patient engagement and empower patients to participate in their mental healthcare and treatment decisions may help to reduce mental healthcare disparities. Designed to achieve this goal, PARTNER-MH is a peer-led, patient navigation intervention that aims to engage minority patients in mental health treatment, support them to take a greater role in their care, and facilitate their participation in treatment shared decision-making. Methods: This pilot study evaluates the feasibility and acceptability of PARTNER-MH in a VHA mental health setting using a mixed-methods, randomized controlled trial study design. PARTNER-MH is tested under real-world conditions, using certified VHA peer support specialists (peers), selected via usual VHA hiring practices and assigned to the mental health service. The peers provide PARTNER-MH and usual peer support services. The study compares the impact of PARTNER-MH versus a wait-list control group on patient activation, patient engagement, and shared decision-making, as well as other patient-level outcomes. PARTNER-MH also examines organizational factors that could impact its future implementation in VHA settings. Results: Participants (N=50) were veterans who were mostly male (62%), self-identified as non-Hispanic Black (70%), with a median age in the 45-54 group. Most had at least some college education, and 32% completed 4 or more years of college. Randomization produced comparable groups in terms of characteristics and outcome measures at baseline, except for gender. Discussion and Conclusion: Rather than simply documenting health disparities among vulnerable populations, PARTNER-MH offers opportunities to evaluate a tailored, culturally-sensitive system-based intervention to improve patient engagement and patient-provider communication in mental healthcare for racial and ethnic minorities. IRB Protocol #1708628270Trial registration: ClinicalTrials.gov, NCT04515771. Registered 14 August 2020, https://clinicaltrials.gov/ct2/show/NCT04515771

scholarly journals Embodied Ethical Decision-Making: A Clinical Case Study of Respect for Culturally Based Meaning Making in Mental Healthcare

2021 ◽  
Author(s):  
Megz Roberts
Keyword(s):  
Mental Health ◽  
Decision Making ◽  
Mental Health Treatment ◽  
Ethical Decision ◽  
Ethical Decision Making ◽  
Meaning Making ◽  
Hospital Setting ◽  
Mental Healthcare ◽  
Clinical Case Study ◽  
Culturally Based

AbstractHow does embodied ethical decision-making influence treatment in a clinical setting when cultural differences conflict? Ethical decision-making is usually a disembodied and rationalized procedure based on ethical codes (American Counseling Association, 2014; American Dance Therapy Association, 2015; American Mental Health Counseling Association, 2015) and a collective understanding of right and wrong. However, these codes and collective styles of meaning making were shaped mostly by White theorists and clinicians. These mono-cultural lenses lead to ineffective mental health treatment for persons of color. Hervey’s (2007) EEDM steps encourage therapists to return to their bodies when navigating ethical dilemmas as it is an impetus for bridging cultural differences in healthcare. Hervey’s (2007) nonverbal approach to Welfel’s (2001) ethical decision steps was explored in a unique case that involved the ethical decision-making process of an African-American dance/movement therapy intern, while providing treatment in a westernized hospital setting to a spiritual Mexican–American patient diagnosed with PTSD and generalized anxiety disorder. This patient had formed a relationship with a spirit attached to his body that he could see, feel, and talk to, but refused to share this experience with his White identifying psychiatric nurse due to different cultural beliefs. Information gathered throughout the clinical case study by way of chronological loose and semi-structured journaling, uncovered an ethical dilemma of respect for culturally based meanings in treatment and how we identify pathology in hospital settings. The application of the EEDM steps in this article is focused on race/ethnicity and spiritual associations during mental health treatment at an outpatient hospital setting. Readers are encouraged to explore ways in which this article can influence them to apply EEDM in other forms of cultural considerations (i.e. age) and mental health facilities. The discussion section of this thesis includes a proposed model for progressing towards active multicultural diversity in mental healthcare settings by way of the three M’s from the relational-cultural theory: movement towards mutuality, mutual empathy, and mutual empowerment (Hartling & Miller, 2004).

scholarly journals Protocol of a Multi-centric Randomized Controlled Trial to Evaluate Efficacy of Telephone-Based Psychosocial Interventions on Future Suicide Risk in Suicide Attempters

2020 ◽  
Vol 42 (6_suppl) ◽  
pp. S39-S45
Author(s):  
Ram Pratap Beniwal ◽  
Priya Sreedaran ◽  
Uttara Chari ◽  
Ashok MV ◽  
Triptish Bhatia
Keyword(s):  
Mental Health ◽  
Randomized Controlled Trial ◽  
Mental Health Treatment ◽  
Suicide Attempts ◽  
Controlled Trial ◽  
Psychosocial Interventions ◽  
Health Treatment ◽  
Risk Of Death ◽  
Randomized Controlled ◽  
Telephone Reminders

Background: Persons with previous history of a suicide attempt are at increased future risk of death by suicide. These vulnerable individuals, however, do not seek receive or seek help from mental health services. Telephone-based psychosocial interventions are potential strategies in augmenting mental health care in such persons. Methods: We aim to compare the efficacy of telephone-based psychosocial interventions (TBPI) with routine telephone reminders in persons with recent suicide attempts using a multi-site, parallel group, rater-blind, two-arm randomized controlled trial design in 362 participants. In the first group, participants will receive three sessions of TBPI comprising of brief supportive interventions, problem-solving strategies, and reminders for adherence to prescribed mental health treatment at weekly intervals. In the second group, participants will receive three telephone reminders for adherence to prescribed mental health treatment at weekly intervals. We will follow up participants for 6 months. Primary outcomes are suicidal ideation scores on Beck’s Scale for Suicide Ideation and number of repeat suicide attempts. Secondary outcomes are scores on Beck’s Hopelessness Scale, Beck’s Depression Inventory, Connor–Davidson Resilience Scale and Visual Analogue Rating Scales for acceptability of interventions. Outcomes will be assessed at 1, 3, and 6 months after receiving telephone interventions or reminders. Results: The trial is currently underway after prospective registration under Clinical Trials Registry of India and has recruited 260 participants till August 15, 2020. Conclusion: This study has potential to generate evidence on additional strategies for use along with standard mental health treatments in management of high-risk suicide behaviors.

scholarly journals Interventions to promote psychiatric patients’ compliance to mental health treatment: A systematic review

2014 ◽  
Vol 19 (1) ◽  
Author(s):  
Mosidi B. Serobatse ◽  
Emmerentia Du Plessis ◽  
Magdalena P. Koen
Keyword(s):  
Mental Health ◽  
Systematic Review ◽  
Mental Health Professionals ◽  
Mental Health Treatment ◽  
Psychiatric Patients ◽  
Research Question ◽  
Mental Healthcare ◽  
Healthcare Services ◽  
Current Evidence ◽  
Health Treatment

Background: Non-compliance to treatment remains one of the greatest challenges in mental healthcare services, and how to improve this remains a problem.Aim: The aim of this study was to critically synthesise the best available evidence from literature regarding interventions to promote psychiatric patients’ compliance to mental health treatment. The interventions can be made available for mental health professionals to use in clinical practice.Method: A systematic review was chosen as a design to identify primary studies that answered the following research question: What is the current evidence on interventions to promote psychiatric patients’ compliance to mental health treatment? Selected electronic databases were thoroughly searched. Studies were critically appraised and identifid as answeringthe research questions. Evidence extraction, analysis and synthesis were then conducted by means of evidence class rating and grading of strength prescribed in the American Dietetic Association’s manual.Results: The systematic review identifid several interventions that can improve patients’ compliance in mental health treatment, for example adherence therapy and motivational interviewing techniques during in-hospital stay.Conclusions: Conclusions were drawn and recommendations formulated for nursing practice, education and research.Agtergrond: Geen-samewerking met behandeling bly steeds een van die grootste uitdagings in geestesgesondheidsorgdienste, en genoegsame kennis oor hoe om dit te verbeter, is steeds ’n probleem.Doelwit: Die doel van hierdie studie was om die beskikbare bewyse vanuit literatuur aangaande intervensies ter bevordering van psigiatriese pasiënte se samewerking met geestesgesondheidsbehandeling krities te sintetiseer. Hierdie intervensies kan aan professionele gesondheidsorgpersoneel beskikbaar gestel word ter bevordering van psigiatriese pasiënte se samewerking met geestesgesondheidsbehandeling.Metode: ’n Sistematiese literatuuroorsig is gekies as die ontwerp om primêre studieste identifieer wat die volgende navorsingsvraag beantwoord: Wat is die huidige kennis ten opsigte van intervensies wat psigiatriese pasiënte se samewerking met geestesgesondheidsbehandeling bevorder?Resultate: Studies is ingesluit vir kritiese gehalte-beoordeling ten opsigte van metodologie, en is uiteindelik geïdentifieer as bronne van bewyse wat die literatuuroorsigvraag toepaslik beantwoord. Bewysonttrekking, -analise en -sintese is gedoen deur middel van die beoordeling van bewysklas en -gradering van bewyssterkte, soos voorgeskryf in die American Dietetic Association se handleiding. Die sistemiese literatuuroorsig het aangedui datdaar heelparty intervensies is wat psigiatriese pasiënte se samewerking met behandeling kan verbeter, byvoorbeeld samewerkingsterapie en motiveringsonderhoudstegnieke.Gevolgtrekking: Gevolgtrekkings is gemaak en aanbevelings is geformuleer vir die verpleegpraktyk, verpleegonderrig en navorsing in verpleging.

scholarly journals Practices and Perspectives of Mental Health in the Balkan Countries: A Narrative Review

2019 ◽  
Author(s):  
Maya E. Lee
Keyword(s):  
Mental Health ◽  
Mental Health Treatment ◽  
Mental Healthcare ◽  
Research Literature ◽  
Economic Research ◽  
Health Issues ◽  
The Balkans ◽  
Historical Perspectives ◽  
Yugoslav Republic ◽  
Balkan Region

Mental health and wellness are integral parts to person’s overall health and happiness. Globally, there has been an increased initiative to treat and support people living with mental health issues and disease; the Balkan region of southeastern Europe is no exception. A literary review researching the background of mental health treatment and how it intersects with the unique history and current administrative environment within the nations of the former Yugoslav Republic was conducted. Existing literature about mental health prevalence and practices within the region was analyzed and contextualized with historical perspectives. Significant gaps in research literature were identified, including lack of research into everyday mental disorders in the region that are not to do with the recent civil war, a need for standardized data collection about where mental health infrastructure exists within the region and how effective it is in treating patients, and finally economic research to determine how and by which governing body national healthcare systems should be funded. Filling these gaps in knowledge would greatly reduce barriers to mental healthcare and overall wellness within the Balkans.

scholarly journals Structural Correlates of Mental Health Support Access Among Sexual Minority Youth of Color During COVID-19

2021 ◽  
Author(s):  
Chantelle A Roulston ◽  
Sarah McKetta ◽  
Maggi Price ◽  
Kathryn Fox ◽  
Jessica L. Schleider
Keyword(s):  
Mental Health ◽  
Mental Health Treatment ◽  
Mental Healthcare ◽  
State Level ◽  
Structural Factors ◽  
Marginalized Youth ◽  
Treatment Access ◽  
Health Treatment ◽  
Mental Health Support ◽  
Health Support

Objective: Many youth with mental health needs cannot access treatment, with multiply-marginalized youth, such as sexual minority youth of Color (SMYoC), experiencing both structural and identity-related barriers to care. The COVID-19 pandemic threatens to exacerbate multi-level treatment access barriers facing SMYoC youth nationwide. However, little large-scale research has examined access to mental health care among SMYoC across the United States, either during or prior to the pandemic. Such work is critical to understanding and ameliorating barriers in this domain. Methods: Using data from adolescents who self-identified as SMYoC and who endorsed a desire for mental health support during the COVID-19 pandemic (N=470, ages 13-16, from 43 U.S. states), we examined associations between state-level, structural factors (income inequality; mental healthcare provider shortage; anti-Black racism; homophobia; and the interaction between anti-Black racism and homophobia) and SMYoC mental health treatment access. Results: Multinomial logistic regressions revealed state-level mental healthcare provider shortage as the only significant predictor of SMYoC reporting they never (versus always) accessed mental health support during the COVID-19 pandemic. SMYoC living in areas with both lower homophobia and lower anti-Black racism were more likely to report always (versus sometimes) accessing mental health treatment. Conclusions: Results highlight the critical importance of considering diverse structural factors and applying an intersectional lens when exploring barriers to mental health treatment among multiply-marginalized youth. In locations where provider shortages are less severe, cultural stigma—including anti-Black racism and homophobia—may still pose challenges for SMYoC in need of mental health care.

scholarly journals The More We Are Together, The Happier We Are: Peer Music in Mental Health Treatment in Zimbabwe

2015 ◽  
Vol 15 (3) ◽  
Author(s):  
Jeffrey Robert Angell ◽  
Ruth Verhey
Keyword(s):  
Mental Health ◽  
New York ◽  
New York City ◽  
Support Groups ◽  
Mental Health Treatment ◽  
Mental Healthcare ◽  
Clinical Psychologist ◽  
Health Treatment ◽  
Music Therapist ◽  
Empowerment Model

Ruth Verhey is a clinical psychologist involved in developing and running the Friendship Bench, a comprehensive, group based mental healthcare initiative in Harare, Zimbabwe.  In 2013, she invited Jeffrey Angell, a music therapist from New York City, to facilitate one of weekly Zeebag support groups at Harare Hospital.  The Zeebag group is comprised of eight women who suffer from depression.  The essay provides Jeffrey's first person accounts of this experience, as well as describing the music, music process, and how these intergrate into the peer empowerment model of the Frienship Bench.

scholarly journals Applying a General Systems Theory framework in Mental Health Treatment Pathways: the case of the Hellenic Center of Mental Health and Research

2020 ◽  
Author(s):  
Panagiotis Katrakazas ◽  
Aliki Grigoriadou ◽  
Dimitrios Koutrouris
Keyword(s):  
Mental Health ◽  
Systems Theory ◽  
Mental Health Treatment ◽  
Mental Healthcare ◽  
Patient Characteristics ◽  
General Systems Theory ◽  
Treatment Pathways ◽  
General Systems ◽  
Population Interactions ◽  
Theory Framework

Abstract Language, socio-emotional and cognitive development in children and adolescents with mental health issues is getting increased attention over the last years. Establishing communication patterns and addressing behavioural diversities among this population should be of priority, along with a better understanding in a large variety of patient characteristics within the operational framework of mental healthcare centers. As integrated systems’ approaches are still missing to correlate patients' characteristics and predict treatment services’ efficiency in a macroscopic scale, a General Systems Theory framework is hereby proposed. This framework is applied and tested against the operational framework of the Hellenic Center of Mental Health and Research, in order to identify the need of such an approach and the strong cooperation between medical and population interactions. Using such frameworks as a prerequisite to identify important factors can lead to evaluating their impact on the treatment outcome and depict the complexity of pathways potentially related to the children’s development.

scholarly journals Mental health disorders and utilization of mental healthcare services in United Nations personnel

2020 ◽  
Vol 7 ◽  
Author(s):  
Adam D. Brown ◽  
Katharina Schultebraucks ◽  
Meng Qian ◽  
Meng Li ◽  
Danny Horesh ◽  
...  
Keyword(s):  
Mental Health ◽  
United Nations ◽  
Mental Health Treatment ◽  
Trauma Exposure ◽  
Mental Healthcare ◽  
Healthcare Services ◽  
Mental Health Disorders ◽  
Mental Health Disorder ◽  
Diverse Range ◽  
Health Disorders

Abstract Background United Nations (UN) personnel address a diverse range of political, social, and cultural crises throughout the world. Compared with other occupations routinely exposed to traumatic stress, there remains a paucity of research on mental health disorders and access to mental healthcare in this population. To fill this gap, personnel from UN agencies were surveyed for mental health disorders and mental healthcare utilization. Methods UN personnel (N = 17 363) from 11 UN entities completed online measures of generalized anxiety disorder (GAD), major depressive disorder (MDD), posttraumatic stress disorder (PTSD), trauma exposure, mental healthcare usage, and socio-demographic information. Results Exposure to one or more traumatic events was reported by 36.2% of survey responders. Additionally, 17.9% screened positive for GAD, 22.8% for MDD, and 19.9% for PTSD. Employing multivariable logistic regressions, low job satisfaction, younger age (<35 years of age), greater length of employment, and trauma exposure on or off-duty was significantly associated with all the three disorders. Among individuals screening positive for a mental health disorder, 2.05% sought mental health treatment within and 10.01% outside the UN in the past year. Conclusions UN personnel appear to be at high risk for trauma exposure and screening positive for a mental health disorder, yet a small percentage screening positive for mental health disorders sought treatment. Despite the mental health gaps observed in this study, additional research is needed, as these data reflect a large sample of convenience and it cannot be determined if the findings are representative of the UN.

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