scholarly journals Modelling Target Workforce Estimates For Community-Based Mental Health Services In Lebanon

2021 ◽  
Author(s):  
Wissam Kheir ◽  
Edwina Zoghbi ◽  
Rachel Bteich ◽  
Alissar Rady ◽  
Rabih El Chammay
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Human Resources ◽  
Health System ◽  
Service Use ◽  
Psychosocial Care ◽  
Full Time ◽  
Care Providers ◽  
Community Based

Abstract Background: Mental health services in Lebanon are weakly integrated in the health system due to a huge political unrest, cultural and societal stigma, and more importantly, due to the inappropriate planning of human resources. A shift of the mental health services in Lebanon from hospital-based care into community-based care and efficient planning of human resources became a priority given the increasing burden of mental health disorders as a consequence of socio-political and economic crises: the bordering Syrian war, the massive influx of refugees, the huge inflation rate and above all the Beirut explosion. Methods: The WHO-ATLAS was conducted in 2019 as well as the WHO-AIMS in 2015 to map mental health services in Lebanon. Data from those two reports was plugged into the service needs calculator; an economic tool including epidemiology of eight priority mental health packages and target population, outpatient service use/needs and inpatient service use/needs. Total full-time equivalents (FTE) were calculated for psychiatrists, nurses and psychosocial care providers. All formulas were extracted from the WHO “Planning and Budgeting to deliver mental health services” module of the Mental Health Policy and Service Guidance Package. Results: For an effective community-based mental health system in Lebanon, there is additional need for 182 (+16%) psychiatrists, 762 (+68%) nurses and 184 (+16%) psychosocial care providers; a total increase of 1,128 mental health workforce. Conclusions: A proper workforce skill mix for an optimal utilization of the existing staff is recommended. New models will need to account for task shifting to attempt to close the gap between what is needed and what is available.

scholarly journals Readiness to Deliver Person-Focused Care in A Fragile Situation: The Case of Mental Health Services in Lebanon

2020 ◽  
Author(s):  
Aya Noubani ◽  
Karin Diaconu ◽  
Giulia Loffreda ◽  
Shadi Saleh
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Health Care ◽  
Mental Health Services ◽  
Health Services ◽  
Health System ◽  
Health Care Providers ◽  
Mental Healthcare ◽  
Care Providers ◽  
Health Seeking

Abstract Background: Evidence suggests wide variability in the provision of mental healthcare across countries. Countries experiencing fragility related risks suffer from a high burden of mental-ill health and additionally have limited capacity to scale up mental health services given financial and human resource shortages. Integration of mental health services into routine primary care is one potential strategy for enhancing service availability, however little is known about the experiences of currently active health care providers involved in mental health and psychosocial support (MHPSS) service provision at primary care level. This study aims to determine how healthcare providers offering MHPSS services at primary care levels in Lebanon perceive mental health and the health system’s ability to address the rising mental ill-health burden with a view to identify opportunities for strengthening MHPSS service implementation geared towards integrated person focused care model.Methods: A qualitative study design was adopted including 15 semi-structured interviews and 2 participatory group model-building workshops with health care providers (HCPs) involved in mental healthcare delivery at primary care level. Participants were recruited from two contrasting fragility contexts (Beirut and Beqaa). During workshops, causal loop diagrams depicting shared understandings of factors leading to stress and mental ill health, associated health seeking behaviors, and challenges and barriers within the health system were elicited. This research is part of a larger study focused on understanding the dynamics shaping mental health perceptions and health seeking behaviours among community members residing in Lebanon. Results: Findings are organized around a causal loop diagram depicting three central dynamics as described by workshop participants. First, participants linked financial constraints at household levels and the inability to secure one’s livelihood with contextual socio-political stressors, principally referring to integration challenges between host communities and Syrian refugees. In a second dynamic, participants linked exposure to war, conflict and displacement to the occurrence of traumatic events and high levels of distress as well as tense family and community relations. Finally, participants described a third dynamic linking cultural norms and patriarchal systems to exposure to violence and intergenerational trauma among Lebanon’s populations. When describing help-seeking pathways, participants noted the strong influence of social stigma within both the community and among health professionals; the latter was noted to negatively affect patient-provider relationships. Participants additionally spoke of difficulties in the delivery of mental health services and linked this to the design of the health system itself, noting the current system being geared towards patient centered care, which focuses on the patient’s experiences with a disease only, rather than person focused care where providers and patients acknowledge broader structural and social influences on health and work together to reach appropriate decisions for tackling health and other social needs. Barriers to delivery of person focused care include the lack of coherent mental health information systems, limited human capacity to deliver MHPSS services among primary health care staff and inadequate service integration and coordination among the many providers of mental health services in our study contexts. Critically however, provider accounts demonstrate readiness and willingness of health professionals to engage with integrated person focused care models of care.Conclusion: Mental ill health is a major public health problem with implications for individual health and wellbeing; in a fragile context such as Lebanon, the burden of mental ill health is expected to rise and this presents substantive challenges for the existing health system. Concrete multi-sectoral efforts and investments are required to 1) reduce stigma and improve public perceptions surrounding mental ill health and associated needs for care seeking and 2) promote the implementation of integrated person focused care for addressing mental health.

scholarly journals Readiness to deliver person‐focused care in a fragile situation: the case of Mental Health Services in Lebanon

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Aya Noubani ◽  
Karin Diaconu ◽  
Giulia Loffreda ◽  
Shadi Saleh
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Health Care ◽  
Mental Health Services ◽  
Health Services ◽  
Health System ◽  
Health Care Providers ◽  
Mental Healthcare ◽  
Care Providers ◽  
Health Seeking

Abstract Background Evidence suggests wide variability in the provision of mental healthcare across countries. Countries experiencing fragility related risks suffer from a high burden of mental-ill health and additionally have limited capacity to scale up mental health services given financial and human resource shortages. Integration of mental health services into routine primary care is one potential strategy for enhancing service availability, however little is known about the experiences of currently active health care providers involved in mental health and psychosocial support service (MHPSS) provision at primary care level. This study aims to determine how healthcare providers offering MHPSS services at primary care levels in Lebanon perceive mental health and the health system’s ability to address the rising mental ill-health burden with a view to identify opportunities for strengthening MHPSS service implementation geared towards integrated person focused care model. Methods A qualitative study design was adopted including 15 semi-structured interviews and 2 participatory group model-building workshops with health care providers (HCPs) involved in mental healthcare delivery at primary care level. Participants were recruited from two contrasting fragility contexts (Beirut and Beqaa). During workshops, causal loop diagrams depicting shared understandings of factors leading to stress and mental ill health, associated health seeking behaviors, and challenges and barriers within the health system were elicited. This research is part of a larger study focused on understanding the dynamics shaping mental health perceptions and health seeking behaviours among community members residing in Lebanon. Results Findings are organized around a causal loop diagram depicting three central dynamics as described by workshop participants. First, participants linked financial constraints at household levels and the inability to secure one’s livelihood with contextual socio-political stressors, principally referring to integration challenges between host communities and Syrian refugees. In a second dynamic, participants linked exposure to war, conflict and displacement to the occurrence of traumatic events and high levels of distress as well as tense family and community relations. Finally, participants described a third dynamic linking cultural norms and patriarchal systems to exposure to violence and intergenerational trauma among Lebanon’s populations. When describing help-seeking pathways, participants noted the strong influence of social stigma within both the community and among health professionals; the latter was noted to negatively affect patient-provider relationships. Participants additionally spoke of difficulties in the delivery of mental health services and linked this to the design of the health system itself, noting the current system being geared towards patient centered care, which focuses on the patient’s experiences with a disease only, rather than person focused care where providers and patients acknowledge broader structural and social influences on health and work together to reach appropriate decisions for tackling health and other social needs. Barriers to delivery of person focused care include the lack of coherent mental health information systems, limited human capacity to deliver MHPSS services among primary health care staff and inadequate service integration and coordination among the many providers of mental health services in our study contexts. Critically however, provider accounts demonstrate readiness and willingness of health professionals to engage with integrated person focused care models of care. Conclusions Mental ill health is a major public health problem with implications for individual health and wellbeing; in a fragile context such as Lebanon, the burden of mental ill health is expected to rise and this presents substantive challenges for the existing health system. Concrete multi-sectoral efforts and investments are required to (1) reduce stigma and improve public perceptions surrounding mental ill health and associated needs for care seeking and (2) promote the implementation of integrated person focused care for addressing mental health.

scholarly journals Using administrative data to examine mental health service use among post-secondary students in Alberta, Canada

2018 ◽  
Vol 3 (4) ◽  
Author(s):  
Navjot Lamba ◽  
Robert Jagodzinski
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Service ◽  
Health Services ◽  
Secondary Students ◽  
Service Use ◽  
Full Time ◽  
Post Secondary ◽  
Part Time ◽  
Post Secondary Students

IntroductionPoor mental health among post-secondary students has been on the rise, and as such, has become a growing concern for the Alberta government. Alberta’s major post-secondary institutions have emphasized the need for evidence that would improve mental health supports for students troubled by mental health issues. Objectives and ApproachResponding to the need for evidence, the Child and Youth Data Laboratory profiled the socio-demographic characteristics (sex, socio-economic status, etc) of students who used mental health services between 2005/06 and 2010/11. In addition, using linked administrative data from a range of government programs, the profiles provide new data on the program involvement of post-secondary students who used mental health services, including educational achievement in high school, high cost health service use, the presence of chronic conditions, injury diagnoses, disability status, justice system involvement, income support, and type of mental health condition. ResultsOver the study period, 7% (~6,000) of post-secondary students received mental health services. Of those, between 11 and 13% were high cost health service users, ~20% received an injury diagnosis, and ~15% had a chronic condition. These proportions were higher compared to the proportions among students who did not receive mental health services. Rates of income support service use, corrections involvement, and students with disabilities were higher compared to students not receiving mental health services. A greater proportion of Canadian students (between 6.5% and 7.1%) compared to non-Canadian students (between 3.4% and 4.1%) received mental health services. In 2010/11, a greater proportion of part-time compared to full-time students were diagnosed with an anxiety disorder (3.4%, part-time; 2.3% full-time) or depression (4.0% part-time; 2.3% full-time). Conclusion/ImplicationsEvidence produced from linked administrative data offers a unique understanding of students who use mental health services, particularly in terms of their government program involvement. This new evidence can be used, for example, to determine if mental health service needs are different for Canadian versus non-Canadian students, or for full-time versus part-time students.

Case Study of an Ethnic Community-Based Organization in the United States

2016 ◽  
Vol 46 (1) ◽  
pp. 199-217 ◽  
Author(s):  
Catherine M. Vu ◽  
Duy Nguyen ◽  
Daniel B. Tanh ◽  
Jessica Chun
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Service Use ◽  
The United States ◽  
Mental Health Service Use ◽  
Community Based ◽  
Study Approach ◽  
Korean Adults

Ethnic nonprofit community-based organizations (CBOs) have played a crucial role in the social fabric of ethnic communities. Despite the importance of ethnic CBOs, limited empirical knowledge exists about these types of organizations. This study seeks to fill this gap by exploring how ethnic CBOs engage their target populations in stigma-associated services using a multidimensional cultural competence framework. A case study approach is used to explore how a Korean ethnic organization engages older adults in mental health services. The study provides an in-depth examination of the organization’s responses to the increasing need for mental health services for older Korean adults by providing culturally grounded services in a nonstigmatized environment. The study contributes to current literature by (a) using a multidimensional approach to examine community, organizational, and individual factors that influence mental health service use and (b) exploring how ethnic organizations consider these domains to serve older Korean adults.

scholarly journals Community-Based Mental Health Services in Mexico

10.17816/cp86 ◽  
2021 ◽  
Vol 2 (3) ◽  
pp. 53-62
Author(s):  
Martha Cordero Oropeza ◽  
Shoshana Berenzon ◽  
Rebeca Robles ◽  
Tania Real ◽  
María Elena Medina Mora
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Health System ◽  
Primary Healthcare ◽  
Psychiatric Hospitals ◽  
Community Services ◽  
Steady Increase ◽  
Community Based ◽  
Tertiary Healthcare

AIM: This article describes the general characteristics of community-based mental healthcare in Mexico. METHODS: Data from national surveys, special studies and statistics from the national information system during the period 20012017 are used. Available information on health systems, new regulations and the innovations implemented are reviewed, as well as research on psychosocial interventions conducted within the country. RESULTS: Data show a fragmented health system with services for workers and those without social security or private care. This is a treatment system essentially based on tertiary healthcare and not integrated into the general health system, with a significant treatment gap and delay in relation to the first treatment. At the same time, a slow but steady increase in the level of care provided at primary healthcare level and in specialized community services has been observed. This trend has been accompanied by an increase in the number of medical doctors, psychologists and, to a lesser extent, psychiatrists, incorporated into the primary healthcare services. At the same time, no new psychiatric hospitals have been built; there has been a proportional reduction in psychiatric beds but no increase in mental health services or beds allocated to first contact hospitals. Research initiatives have analysed the barriers to reform, and efficient interventions have been developed and tested for the community and for primary healthcare; special interventions are available for the most vulnerable but no formal efforts have been to facilitate their implementation. CONCLUSIONS: Evidence is available regarding the implementation of the transition from reliance on tertiary healthcare to reinforced primary care. At the same time, parity, financial protection, quality and continuity of care remain major challenges.

The Use of Mental Health Services in Ontario: Epidemiologic Findings

1996 ◽  
Vol 41 (9) ◽  
pp. 572-577 ◽  
Author(s):  
Elizabeth Lin ◽  
Paula Goering ◽  
David R Offord ◽  
Dugal Campbell ◽  
Michael H Boyle
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Health Care Providers ◽  
Help Seeking ◽  
Service Use ◽  
Composite International Diagnostic Interview ◽  
Marital Disruption ◽  
Mental Health Service Use ◽  
Care Providers

Objective: To describe the distribution and predictors of mental health service use for a survey of Ontario household residents aged 15 to 64 years. Method: Service use was defined as any past-year contact with formal or informal health care providers for mental health reasons. Data from the Mental Health Supplement (the Supplement) to the Ontario Mental Health Survey were used to compare the sociodemographic, geographic, and diagnostic status characteristics of service users with these characteristics among nonusers. Results: Mental health services were used by 7.8% of respondents in the past year. The majority (57.8%) had a past-year University of Michigan Composite International Diagnostic Interview (UM-CIDI) diagnosis, although 27.1% had never met diagnostic criteria. Other significant predictors were marital status, household public assistance, gender, age, and urban/rural residence. Conclusion: Although diagnosis is the strongest predictor of use, the fit between “need” and “care” in Ontario is not perfect. Help seeking differs within specific sociodemographic and geographic groups. Furthermore, the association of marital disruption and economic disadvantage with utilization indicates that prevention and intervention should address needs beyond the medical or psychological.

A comparison between two community-based mental health services, Northern Italy and Northern Norway

2011 ◽  
Vol 38 (S 01) ◽  
Author(s):  
D Pucci ◽  
F Amaddeo ◽  
A Rossi ◽  
G Rezvy ◽  
R Olstad ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Northern Italy ◽  
Community Based ◽  
Northern Norway
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