scholarly journals Changes in community mental health services availability and suicide mortality in the US: A retrospective study

2020 ◽  
Author(s):  
Peiyin Hung ◽  
Susan Busch ◽  
Yi-Wen Shih ◽  
Alecia McGregor ◽  
Shi-Yi Wang
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Services ◽  
Community Mental Health ◽  
Health Services ◽  
Mental Health Care ◽  
Mental Health Professionals ◽  
The United States ◽  
Suicide Mortality ◽  
Per Capita

Abstract Background: Despite the fact that the overwhelming majority of mental health services are delivered in outpatient settings, the effect of changes in non-hospital-based mental health care on increased suicide rates is largely unknown. This study examines the association between changes in community mental health center (CMHC) supply and suicide mortality in the United States. Methods: Retrospective analysis was performed using data from National Mental Health Services Survey (N-MHSS) and the Centers for Disease Control and Prevention (CDC) Wide-Ranging Online Data for Epidemiologic Research (WONDER) (2014-2017). Population-weighted multiple linear regressions were used to examine within-state associations between CMHCs per capita and suicide mortality. Models controlled for state-level characteristics (i.e., number of hospital psychiatric units per capita, number of mental health professionals per capita, age, race, and percent low-income), year and state. Results: From 2014 to 2017, the number of CMHCs decreased by 14% nationally (from 3,406 to 2,920). Suicide increased by 9.7% (from 15.4 to 16.9 per 100,000) in the same time period. We find a small but negative association between the number of CMHCs and suicide deaths (-0.52, 95% CI -1.08 to 0.03; p=0.066). Declines in the number of CMHCs from 2014 to 2017 may be associated with approximately 6% of the national increase in suicide, representing 263 additional suicide deaths. Conclusions: State governments should avoid the declining number of CMHCs and the services these facilities provide, which may be an important component of suicide prevention efforts. Keywords: Suicide, Deinstitutionalization, Access to mental health care, Community mental health

scholarly journals Changes in community mental health services availability and suicide mortality in the US: A retrospective study

2020 ◽  
Author(s):  
Peiyin Hung ◽  
Susan Busch ◽  
Yi-Wen Shih ◽  
Alecia McGregor ◽  
Shi-Yi Wang
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Community Mental Health ◽  
Health Services ◽  
Mental Health Professionals ◽  
Low Income ◽  
Mental Health Center ◽  
The United States ◽  
Suicide Mortality ◽  
Per Capita

Abstract Background: Despite the fact that the overwhelming majority of mental health services are delivered in outpatient settings, the effect of changes in non-hospital-based mental health care on increased suicide rates is largely unknown. This study examines the association between changes in community mental health center (CMHC) supply and suicide mortality in the United States.Methods: Retrospective analysis was performed using data from National Mental Health Services Survey (N-MHSS) and the Centers for Disease Control and Prevention (CDC) Wide-Ranging Online Data for Epidemiologic Research (WONDER) (2014-2017). Population-weighted multiple linear regressions were used to examine within-state associations between CMHCs per capita and suicide mortality. Models controlled for state-level characteristics (i.e., number of hospital psychiatric units per capita, number of mental health professionals per capita, age, race, and percent low-income), year and state.Results: From 2014 to 2017, the number of CMHCs decreased by 14% nationally (from 3,406 to 2,920). Suicide increased by 9.7% (from 15.4 to 16.9 per 100,000) in the same time period. We find a small but negative association between the number of CMHCs and suicide deaths (-0.52, 95% CI -1.08 to 0.03; p=0.066). Declines in the number of CMHCs from 2014 to 2017 may be associated with approximately 6% of the national increase in suicide, representing 263 additional suicide deaths. Conclusions: State governments should avoid the declining number of CMHCs and the services these facilities provide, which may be an important component of suicide prevention efforts.

scholarly journals Changes in community mental health services availability and suicide mortality in the US: A retrospective study

2020 ◽  
Author(s):  
Peiyin Hung ◽  
Susan Busch ◽  
Yi-Wen Shih ◽  
Alecia McGregor ◽  
Shi-Yi Wang
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Community Mental Health ◽  
Health Services ◽  
Mental Health Professionals ◽  
Low Income ◽  
Mental Health Center ◽  
The United States ◽  
Suicide Mortality ◽  
Per Capita

Abstract Background: Despite the fact that the overwhelming majority of mental health services are delivered in outpatient settings, the effect of changes in non-hospital-based mental health care on increased suicide rates is largely unknown. This study examines the association between changes in community mental health center (CMHC) supply and suicide mortality in the United States.Methods: Retrospective analysis was performed using data from National Mental Health Services Survey (N-MHSS) and the Centers for Disease Control and Prevention (CDC) Wide-Ranging Online Data for Epidemiologic Research (WONDER) (2014-2017). Population-weighted multiple linear regressions were used to examine within-state associations between CMHCs per capita and suicide mortality. Models controlled for state-level characteristics (i.e., number of hospital psychiatric units per capita, number of mental health professionals per capita, age, race, and percent low-income), year and state.Results: From 2014 to 2017, the number of CMHCs decreased by 14% nationally (from 3,406 to 2,920). Suicide increased by 9.7% (from 15.4 to 16.9 per 100,000) in the same time period. We find a small but negative association between the number of CMHCs and suicide deaths (-0.52, 95% CI -1.08 to 0.03; p=0.066). Declines in the number of CMHCs from 2014 to 2017 may be associated with approximately 6% of the national increase in suicide, representing 263 additional suicide deaths. Conclusions: State governments should avoid the declining number of CMHCs and the services these facilities provide, which may be an important component of suicide prevention efforts.

Compulsory community mental health care: Oceania

2016 ◽  
Author(s):  
Anthony J. O’Brien
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Developing Countries ◽  
Mental Health Services ◽  
Community Mental Health ◽  
Health Services ◽  
Mental Health Care ◽  
Developed Countries ◽  
Community Treatment ◽  
Community Mental Health Care

Oceania is characterized by the diversity of countries and by highly variable provision of mental health services and community mental health care. Countries such as Australian and New Zealand have well-developed mental health services with a high level of provision, but many less developed countries lack mental health infrastructure. Some developing countries such as Samoa and Tonga have passed mental health legislation with provision for community treatment orders, but this legal measure is probably not a useful mechanism for advancing mental health care in developing countries. Instead, efforts to improve provision of care seem best directed to the primary care sector, and to the general health workforce, rather than to specialists. The UN CRPD offer extensions of human rights to people with mental illness and most countries in Oceania have signed it. However, the absence of a regional rights tribunal potentially limits the realization of those rights.

scholarly journals Insurance Status, Use of Mental Health Services, and Unmet Need for Mental Health Care in the United States

2015 ◽  
Vol 66 (6) ◽  
pp. 578-584 ◽  
Author(s):  
Elizabeth Reisinger Walker ◽  
Janet R. Cummings ◽  
Jason M. Hockenberry ◽  
Benjamin G. Druss
Keyword(s):  
Mental Health ◽  
United States ◽  
Health Care ◽  
Mental Health Services ◽  
Health Services ◽  
Mental Health Care ◽  
Unmet Need ◽  
The United States ◽  
Insurance Status

scholarly journals The Role of Non-Governmental Organisations (NGOs) in Community-based Mental Health Services in Northern Nigeria: Prospects and Challenges

2021 ◽  
Vol 9 (4) ◽  
pp. 24-37
Author(s):  
Emmanuel Ejembi Anyebe
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Services ◽  
Community Mental Health ◽  
Health Services ◽  
Mental Health Care ◽  
Northern Nigeria ◽  
Health Issues ◽  
Community Based

Despite the role of non-governmental organisations (NGOs) in many health issues, their role in community mental health services in parts of northern Nigeria is unknown. This study explored the availability and role of NGOs in community-mental health care services, with a view to identifying the prospects and challenges. Using the convergent mixed methods approach, a self-constructed questionnaire and in-depth interviews were used to collect data from 205 conveniently and purposively selected study participants. Descriptive and thematic analyses were done and then triangulated to meet research objectives. There is a scarcity of mental health-related NGOs in the study areas; only one NGO engaged in the mental health activities was identified (13.4%). Surprisingly attempts by the only available NGO at providing the needed community-based mental health care were “frustrated” by certain government policy directions, which appear to paralyse activities and intentions of the only existing one. NGOs for mental health care are lacking. There is a dire need for NGO activities in mental health care. Efforts should be made to attract NGOs to the study areas in view of the increasing burden of mental health issues in the communities in the setting. Governments at all levels, community-based organisations and traditional institutions can be instrumental to this. NGOs within and outside the study areas focusing on community health in general and mental health care, in particular, may also interrogate this situation further for urgent intervention.

scholarly journals Organizing as negotiation: the construction of a pathway in Norwegian mental health services

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Tine Nesboe Toerseth
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Illness ◽  
Mental Health Services ◽  
Health Services ◽  
Mental Health Care ◽  
Mental Health Professionals ◽  
Health Professionals ◽  
Clinical Pathway ◽  
The Political

Abstract Background In 2015, a decision was made to implement clinical pathways in Norwegian mental health services. The idea was to construct pathways similar to those used in cancer treatment. These pathways are based on diagnosis and evidence-based medicine and have strict timeframes for the different procedures. The purpose of this article is to provide a thorough examination of the formulation of the pathway “mental illness, adults” in Norwegian mental health services. In recent decades, much research has examined the implementations and outcomes of different mental health sector reforms and services in Western societies. However, there has been a lack of research on the process and creation of these reforms and/or services, particularly how they emerge as constructs in the contexts of policy, profession and practice. Methods A qualitative single case study design was employed. A text and document analysis was performed in which 52 articles and opinion pieces, 30 public hearing responses and 8 political documents and texts were analysed to identify the main actors in the discourse of mental health services and to enable a replication of their affiliated institutional logics and their views concerning the clinical pathway. Additionally, ten qualitative interviews were performed with members of the work group responsible for designating the pathway “mental illness, adults”. Results This article shows how the two main actor groups, “Mental health professionals” and “Politicians”, are guided by values associated with a specific logic when understanding the concept of a clinical pathway (CP). The findings show that actors within the political field believe in control and efficiency, in contrast to actors in mental health services, who are guided by values of discretion and autonomy. This leads to a debate on the concept of CPs and mental health services. The discussion becomes polarized between concern for patients and concern for efficiency. The making of the pathway is led by the Directorate of Health, with health professionals operating in the political domain and who have knowledge of the values of both logics, which were taken into consideration when formulating the pathways, and explains how the pathway became a complex negotiation process between the two logics and where actors on both sides were able to retain their core values. Ultimately, the number of pathways was reduced from 22 to 9. The final “Pathway for mental illness, adults” was a general pathway involving several groups of patients. The pathway explains the process from diagnosis through treatment and finalizing treatment. The different steps involve time frames that need to be coded, requiring more rigid administrative work for compliance, but without stating specific diagnostic tools or preferred treatment strategies. Conclusions This article shows that there is also a downside of having sense making guided by strong values associated with a specific institutional logic when constructing new, and hopefully better, mental health care services. This article demonstrates how retaining values sometimes becomes more crucial than engaging in constructive debates about how to solve issues of importance within the field of mental health care.

scholarly journals The Pathways to the First Contact with Mental Health Services among Patients with Schizophrenia in Lagos, Nigeria

2013 ◽  
Vol 2013 ◽  
pp. 1-8 ◽  
Author(s):  
Increase Ibukun Adeosun ◽  
Abosede Adekeji Adegbohun ◽  
Tomilola Adejoke Adewumi ◽  
Oyetayo O. Jeje
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Services ◽  
Health Services ◽  
Mental Health Care ◽  
Mental Health Professionals ◽  
Point Of Care ◽  
Public Mental Health ◽  
Duration Of Untreated Psychosis ◽  
First Contact

There is increasing evidence that delay in the commencement of treatment, following the onset of schizophrenia, may be related to the pathways patients navigate before accessing mental health care. Therefore, insight into the pattern and correlates of pathways to mental care of patients with schizophrenia may inform interventions that could fast track their contact with mental health professionals and reduce the duration of untreated psychosis. This study assessed the pathways to mental health care among patients with schizophrenia (n=138), at their first contact with mental health services at the Federal Neuro-Psychiatric Hospital Yaba Lagos, Nigeria. Traditional and religious healers were the first contact for the majority (69%) of the patients. Service users who first contacted nonorthodox healers made a greater number of contacts in the course of seeking help, eventuating in a longer duration of untreated psychosis (P<0.001). However, the delay between the onset of psychosis and contact with the first point of care was shorter in patients who patronized nonorthodox practitioners. The findings suggest that collaboration between orthodox and nonorthodox health services could facilitate the contact of patients with schizophrenia with appropriate treatment, thereby reducing the duration of untreated psychosis. The need for public mental health education is also indicated.

scholarly journals Qatar Community Mental Health Care: Achievements and Challenges

10.17816/cp78 ◽  
2021 ◽  
Vol 2 (2) ◽  
pp. 76-80
Author(s):  
Mohamed Ali Ahmed ◽  
Suhaila Ali Ghuloum
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Services ◽  
Community Mental Health ◽  
Health Services ◽  
Mental Health Care ◽  
Best Practice ◽  
Community Mental Health Services ◽  
Historical Background ◽  
Community Based

Guided by international best practice and evidence-based medicine, the Qatar mental health service has undergone a major transformation in the last two decades, replacing the institution-based service with an accessible multidisciplinary community-based service. In this paper, we provide a brief historical background to mental health services in Qatar, and the progress and development towards community-based mental health-care provision. We also explore the challenges facing this new model of care in Qatar including social and cultural sensitivities, and the various solutions adopted to overcome these challenges. We outline the comprehensive plans envisaged to further develop Qatar community mental health services, including the provision of accessible, integrated and multimodal mental health care within primary care settings.

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