scholarly journals Perceptions of Facilitators and Barriers to Mental Health Treatment Engagement Among Decision-making Competent Adolescents in Greece

2021 ◽  
Author(s):  
Eftychia Tsamadou ◽  
Polychronis Voultsos ◽  
Anastasios Emmanouilidis ◽  
Grigorios Ampatzoglou
Keyword(s):  
Mental Health ◽  
Decision Making ◽  
Mental Disorders ◽  
Hospital Setting ◽  
Treatment Engagement ◽  
Well Being ◽  
Perceived Usefulness ◽  
Attrition Rate ◽  
Self Image ◽  
Supportive Role

Abstract Background: A subset of adolescents with mental disorders are likely to be (share) decision making competent and hence can make their treatment engagement more effective. Treatment engagement is decisive in achieving successful outcomes. However, there are high rates of drop-out in mental health settings.Aim: This study aims at identifying barriers to or facilitators of mental health care engagement among adolescents with decision-making competence in Greece. Methods: Participants were adolescents in therapy for mental disorders recruited from an outpatient tertiary hospital setting. First, potential participants with decision making competence were identified. Second, 50 participants were interviewed about their perceptions of treatment. The interviews were auto-recorded. A transcription verbatim and data analysis were conducted. All the requirements of a qualitative research and ethical considerations were observed.Results: All the participants highlighted their experience with facilitators rather than barriers to their treatment engagement. Facilitators included: a) positive treatment outcomes and adolescent's perceived usefulness of treatment, b) a meaningful adolescent-therapist relationship, c) family’s supportive role, d) symptoms and negative self-image, and e) developing social relationships and acceptance by peers. The participants equally highlighted the importance of getting rid of their symptoms and improve their socialization skills. Other facilitators included: achieving professional and personal goals in life, enhancing their independence and self-esteem / self-image, or even just confessing to another trustworthy person. Friends were reported as having a neutral or mild supportive role. The barriers included ineffective and unhelpful treatment, negative experiences with their therapist, relief from symptoms and mental health therapy-related stigma. Conclusion: For the most part, the findings enhance prior studies. Participants highlighted facilitators rather than barriers to treatment engagement. For the most part, the findings enhance prior studies. However, we identified some nuances which might be used by therapists to enhance the adolescents’ treatment engagement. For instance, bearing in their mind that by the subsiding of symptoms adolescents are most likely to terminate the treatment prematurely and highlighting the achievement of adolescents’ future goals as well as the potential family’s enhanced well-being because of the improvement of adolescents’ mental health may contribute to reducing the attrition rate.

scholarly journals Perceptions of Facilitators and Barriers to Mental Health Treatment Engagement Among Decision-making Competent Adolescents in Greece

2021 ◽  
Author(s):  
Eftychia Tsamadou ◽  
Polychronis Voultsos ◽  
Anastasios Emmanouilidis ◽  
Grigorios Ampatzoglou
Keyword(s):  
Mental Health ◽  
Decision Making ◽  
Mental Disorders ◽  
Hospital Setting ◽  
Treatment Engagement ◽  
Well Being ◽  
Perceived Usefulness ◽  
Attrition Rate ◽  
Self Image ◽  
Supportive Role

Abstract Background: A subset of adolescents with mental disorders are likely to be (share) decision making competent and hence can make their treatment engagement more effective. Treatment engagement is decisive in achieving successful outcomes. However, there are high rates of drop-out in mental health settings.Aim: This study aims at identifying barriers to or facilitators of mental health care engagement among adolescents with decision-making competence in Greece. Methods: Participants were adolescents in therapy for mental disorders recruited from an outpatient tertiary hospital setting. First, potential participants with decision making competence were identified. Second, 50 participants were interviewed about their perceptions of treatment. The interviews were auto-recorded. A transcription verbatim and data analysis were conducted. All the requirements of a qualitative research and ethical considerations were observed.Results: All the participants highlighted their experience with facilitators rather than barriers to their treatment engagement. Facilitators included: a) positive treatment outcomes and adolescent's perceived usefulness of treatment, b) a meaningful adolescent-therapist relationship, c) family’s supportive role, d) symptoms and negative self-image, and e) developing social relationships and acceptance by peers. The participants equally highlighted the importance of getting rid of their symptoms and improve their socialization skills. Other facilitators included: achieving professional and personal goals in life, enhancing their independence and self-esteem / self-image, or even just confessing to another trustworthy person. Friends were reported as having a neutral or mild supportive role. The barriers included ineffective and unhelpful treatment, negative experiences with their therapist, relief from symptoms and mental health therapy-related stigma. Conclusion: For the most part, the findings enhance prior studies. Participants highlighted facilitators rather than barriers to treatment engagement. For the most part, the findings enhance prior studies. However, we identified some nuances which might be used by therapists to enhance the adolescents’ treatment engagement. For instance, bearing in their mind that by the subsiding of symptoms adolescents are most likely to terminate the treatment prematurely and highlighting the achievement of adolescents’ future goals as well as the potential family’s enhanced well-being because of the improvement of adolescents’ mental health may contribute to reducing the attrition rate.

scholarly journals Perceptions of facilitators and barriers to mental health treatment engagement among decision-making competent adolescents in Greece

2021 ◽  
Author(s):  
E. Tsamadou ◽  
Polychronis Voultsos ◽  
A. Emmanouilidis ◽  
G. Ampatzoglou
Keyword(s):  
Mental Health ◽  
Decision Making ◽  
Mental Disorders ◽  
Hospital Setting ◽  
Treatment Engagement ◽  
Well Being ◽  
Perceived Usefulness ◽  
Attrition Rate ◽  
Self Image ◽  
Supportive Role

Abstract Background A subset of adolescents with mental disorders are likely to be (share) decision making competent and hence can make their treatment engagement more effective. Treatment engagement is decisive in achieving successful outcomes. However, there are high rates of drop-out in mental health settings. Aim This study aims at identifying barriers to or facilitators of mental health care engagement among adolescents with decision-making competence in Greece. Methods Participants were adolescents in therapy for mental disorders recruited from an outpatient tertiary hospital setting. First, potential participants with decision making competence were identified. Second, 50 participants were interviewed about their perceptions of treatment. The interviews were auto-recorded. A transcription verbatim and data analysis were conducted. All the requirements of a qualitative research and ethical considerations were observed. Results All the participants highlighted their experience with facilitators rather than barriers to their treatment engagement. Facilitators included: a) positive treatment outcomes and adolescent's perceived usefulness of treatment, b) a meaningful adolescent-therapist relationship, c) family’s supportive role, d) symptoms and negative self-image, and e) developing social relationships and acceptance by peers. The participants equally highlighted the importance of getting rid of their symptoms and improve their socialization skills. Other facilitators included: achieving professional and personal goals in life, enhancing their independence and self-esteem / self-image, or even just confessing to another trustworthy person. Friends were reported as having a neutral or mild supportive role. The barriers included ineffective and unhelpful treatment, negative experiences with their therapist, relief from symptoms and mental health therapy-related stigma. Conclusion For the most part, the findings enhance prior studies. Participants highlighted facilitators rather than barriers to treatment engagement. For the most part, the findings enhance prior studies. However, we identified some nuances which might be used by therapists to enhance the adolescents’ treatment engagement. For instance, bearing in their mind that by the subsiding of symptoms adolescents are most likely to terminate the treatment prematurely and highlighting the achievement of adolescents’ future goals as well as the potential family’s enhanced well-being because of the improvement of adolescents’ mental health may contribute to reducing the attrition rate.

scholarly journals Perceived facilitators of and barriers to mental health treatment engagement among decision-making competent adolescents in Greece

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
E. Tsamadou ◽  
P. Voultsos ◽  
A. Emmanouilidis ◽  
G. Ampatzoglou
Keyword(s):  
Mental Health ◽  
Decision Making ◽  
Mental Disorders ◽  
Mental Health Problems ◽  
Well Being ◽  
Drop Out ◽  
Attrition Rate ◽  
Negative Experiences ◽  
Wide Range

Abstract Background A subset of adolescents with mental disorders are likely to have decision-making capacity that facilitates their therapy engagement. However, there are high rates of drop-out in mental health settings. Aim This study aims to identify perceived barriers to or facilitators of mental health care engagement among adolescents with decision-making competence in Greece. Methods A qualitative study was conducted using semi-structured interviews of adolescents with a wide range of mental health problems. In addition, two psychometric assessment measures were used to define who to include or exclude from the study sample. Results Positive attitudes and experiences with therapy were reported as strong (“major”) facilitators of therapy engagement for adolescents with mental disorders, whereas negative experiences with therapy were reported as strong barriers to it. Furthermore, and most importantly, a “good” adolescent-therapist relationship was reported as a strong facilitator, whereas negative experiences of participants with their therapist were reported as strong barriers. Moreover, goals such as getting rid of symptoms, improving personal well-being, and improving social skills and relationships (especially with peers) emerged as strong facilitators of therapy engagement. Importantly, the early remission of symptoms emerged from the study as a strong barrier to therapy engagement for participants. Among the weaker (“minor”) perceived facilitators were goals such as confessing to a trustworthy person, becoming able to achieve personal expectations and life goals, enhancing independence and self-esteem, and developing a positive self-image. The (active or supportive) role of family emerged as a facilitator. The stigma related to mental health emerged as both a (“minor”) facilitator of and barrier to therapy engagement for participants. Friends were reported as having a role ranging from neutral to mildly supportive. Conclusion A number of more or less strong barriers and facilitators were identified that, for the most part, were consistent with prior literature. However, the authors identified some nuances that are of clinical importance. For instance, adolescents are most likely to terminate the treatment prematurely if they experience early symptom remission. Highlighting the role of therapy in achieving their goals or improving their families’ well-being might be used by therapists to reduce the attrition rate.

Framing School Mental Health Services Within a Dual-Factor Model of Mental Health

2020 ◽  
pp. 40-60
Author(s):  
Beth Doll ◽  
Evan H. Dart ◽  
Prerna G. Arora ◽  
Tai A. Collins
Keyword(s):  
Mental Health ◽  
Decision Making ◽  
Mental Disorders ◽  
Field Test ◽  
Universal Screening ◽  
Progress Monitoring ◽  
Factor Model ◽  
School Mental Health ◽  
Well Being ◽  
Complete Mental Health

This chapter proposes a reimagined dual-factor, multitiered system of support (MTSS) that targets students’ complete mental health by simultaneously diminishing symptoms of mental disorders and enhancing attributes of well-being. Examples of assessments and interventions are cited to show that our existing knowledge base includes examples of universal screening, progress monitoring, and interventions that address complete mental health. An argument is made for more research to build a broader base of assessments of well-being for progress monitoring and universal screening and to develop and field test decision-making protocols to identify students’ complete mental health needs and align services with these needs. The chapter concludes that important first steps toward dual-factor MTSS have already been taken.

scholarly journals Epidemiological Profile of Decision Making Competent Adolescents Engaged in Mental Health Therapy

2021 ◽  
Author(s):  
E. Tsamadou ◽  
Polychronis Voultsos ◽  
A. Emmanouilidis ◽  
E. Demertzi ◽  
G. Ampatzoglou
Keyword(s):  
Mental Health ◽  
Decision Making ◽  
Mental Disorders ◽  
Sleep Disorders ◽  
Clinical Decision Making ◽  
Treatment Engagement ◽  
Self Report ◽  
Decision Making Process ◽  
Icd 10 ◽  
Epidemiological Profile

Abstract Background: A subset of adolescents with mental disorders maintain their ability to be fully engaged in shared clinical decision making process in the context of their psychiatric treatment engagement, thereby promoting an effective therapeutic process. Aim: This paper aims at exploring the epidemiological profile of adolescents who are already engaged in mental health treatment while maintaining their ability to be fully engaged in shared decision making process.Method: A single-center cross-sectional cohort survey was conducted. A sample of fifty participants recruited from Child and Adolescent Psychiatry outpatient setting of a tertiary hospital of Thessaloniki, the second largest city in Greece. An intelligence test (Wechsler Intelligence Scale for Children, WISC III) and a self-report measure of depression (Beck Depression Inventory, BDI II), in combination with a clinical assessment of participants’ practical wisdom. The mental disorders were defined and diagnosed using the ICD-10 (1992) (International Classification of Diseases), which is under a process of revision and the new edition of IDC-11 is expected to be put in effect in January 2022. At present, the last edition of ICD-10 is in use since 1992. Results: The largest percentage of adolescents (44,9%) were found to suffer from mood (affective) disorders, while 20,4% suffered from neurotic disorders. We also found pessimism (32,7%), reduction of energy (28,6%) and difficulty in concentration (32,7%) in high frequency. 22,4% of adolescents complained of sleep disorders. For the most part, the findings of our study were consistent with prior studies. However, a limited interest in sex was noted, a fact coming in contrast with international and Greek data, where interest and experimentation around sex seems to preoccupy an essential percentage of adolescents. Furthermore, sleep disorders, either as a symptom of an underlying disease, or as an independent clinical condition, seem to preoccupy adolescents and this may be a motive for their treatment engagement.Conclusion: For the most part, the findings enhanced prior studies which, however, did not exclusively include decision competent adolescents with mental disorders who were engaged in psychotherapy (for at least two months). Interestingly, however, we identified some nuances related to interest in sex and sleep disorders. Further research is recommended for the investigation of possible correlations between the lack of interest in sex or sleep disorders and the fact that the adolescents of our sample were decision making competent and engaged in psychotherapy.

A descriptive study of the prevalence of psychological distress and mental disorders in the Canadian population: comparison between low-income and non-low-income populations

2010 ◽  
Vol 30 (3) ◽  
pp. 148-149 ◽  
Author(s):  
J. Caron ◽  
A. Liu
Keyword(s):  
Mental Health ◽  
Substance Abuse ◽  
Psychological Distress ◽  
Mental Disorders ◽  
Low Income ◽  
Well Being ◽  
Descriptive Study ◽  
Canadian Community Health Survey ◽  
Vulnerable Groups ◽  
High Psychological Distress

Objective This descriptive study compares rates of high psychological distress and mental disorders between low-income and non-low-income populations in Canada. Methods Data were collected through the Canadian Community Health Survey – Mental Health and Well-being (CCHS 1.2), which surveyed 36 984 Canadians aged 15 or over; 17.9% (n = 6620) was classified within the low-income population using the Low Income Measure. The K-10 was used to measure psychological distress and the CIDI for assessing mental disorders. Results One out of 5 Canadians reported high psychological distress, and 1 out of 10 reported at least one of the five mental disorders surveyed or substance abuse. Women, single, separated or divorced respondents, non-immigrants and Aboriginal Canadians were more likely to report suffering from psychological distress or from mental disorders and substance abuse. Rates of reported psychological distress and of mental disorders and substance abuse were much higher in low-income populations, and these differences were statistically consistent in most of the sociodemographic strata. Conclusion This study helps determine the vulnerable groups in mental health for which prevention and promotion programs could be designed.

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 Do carers care for themselves? A population-based study

2019 ◽  
Vol 4 (3) ◽  
Author(s):  
Foteini Tseliou ◽  
Mark Atkinson ◽  
Shantini Paranjothy ◽  
Pauline Ashfield-Watt
Keyword(s):  
Mental Health ◽  
Mental Disorders ◽  
Health Behaviour ◽  
Dietary Habits ◽  
Common Mental Disorders ◽  
Smoking Status ◽  
Health Behaviours ◽  
Well Being ◽  
Self Report ◽  
Informal Carer

Background Informal caregiving has become an integral part of many societies, however there is increasing concern about the well-being of carers and how they manage their care-related responsibilities in conjunction with their health and mental health. Previous studies have reported mixed results with some proposing that carers are intrinsically healthier. Aims To explore the association between different levels of caregiving and health behaviours and mental health status. Methods Data were collected through HealthWise Wales (HWW) and linked to healthcare records (N=27,455). These included self-reported data on level of caring responsibilities (0;1-19;20-49;50+ hours per week), whether or not they left employment due to their caring role, mental health using the short Mental Health Inventory (MHI-5) and health behaviour data on smoking status, physical activity and dietary habits. Data on current diagnosis of Anxiety and Depression were drawn from linked healthcare records. Separate logistic regression models adjusted for age, gender and socio-economic status were fitted to assess the association between intensity of caring responsibility and each mental health and health behaviour outcome. Results Of the 14,451 HWW participants who had complete records, 3,856 (26.7%) reported being an informal carer. Intense carers (20-49 hours per week) were more likely to be physically inactive (OR:1.27, 95%CI:1.04-1.56), smoke cigarettes (OR:1.49, 95%CI:1.11-2.00) and eat unhealthily (OR:1.48, 95%CI:1.13-1.93). They were more also likely to self-report (OR:1.87, 95%CI:1.51-2.32) or have a diagnosis of depression or anxiety (OR:1.57, 95%CI:1.26-1.97). Other levels of caregiving intensity also demonstrated the above associations. Carers who had given up work to care were more likely to be smokers and have common mental disorders. Conclusion Being an informal carer is associated with unhealthy behaviours and common mental disorders, with a gradient effect dependent on the level of caregiving activity. New interventions that can support carers to improve their health and wellbeing are urgently needed.

scholarly journals An Overview of International Literature on School Interventions to Promote Mental Health and Well-being in Children and Adolescents

2015 ◽  
Vol 11 (1) ◽  
pp. 16-20 ◽  
Author(s):  
Mauro Giovanni Carta ◽  
Teresa Di Fiandra ◽  
Lorenzo Rampazzo ◽  
Paolo Contu ◽  
Antonio Preti
Keyword(s):  
Mental Health ◽  
Mental Disorders ◽  
Children And Adolescents ◽  
Mental Health Problems ◽  
Well Being ◽  
Childhood And Adolescence ◽  
International Literature ◽  
Special Issue ◽  
School Interventions ◽  
Health And Wellbeing

Introduction:Mental disorders are the largest cause of the burden of disease in the world. Most of the burden affecting adult life has its onset during childhood and adolescence. The European Pact for Mental Health and Wellbeing calls for immediate action and investments in the mental health of children and adolescents. Schools may be the ideal location for promoting health and delivering healthcare services, since schools are a location where young people usually spend their daytime and socialize, schools are easily accessible to families, can provide non-stigmatizing health actions, and form links with the community.Aims and Goals of this Special Issue:This issue is developed within the framework of the Joint Action on Mental Health promoted by the European Commission. This special issue presents a set of systematic reviews on the evidence of the international literature on school interventions for the promotion of the mental health and wellbeing of children and adolescents. It is focused on five topical main areas: promoting general health and wellbeing; programs targeting specific mental disorders and conditions and integration of adolescents with mental health problems; Bullying; Sport; Alcohol and Drugs. An additional paper on the results of the largest epidemiological study conducted in some European countries on the prevalence and relative risk factors of mental disorders in school-age completes the issue.Conclusion:These reviews are a first contribution to address future European research and interventions, in particular about the multiple ways through which European policies could support the schooling and wellbeing of children and adolescents.

The scale of the problem

Psychiatry ◽  
2019 ◽  
Author(s):  
Rebecca McKnight ◽  
Jonathan Price ◽  
John Geddes
Keyword(s):  
Mental Health ◽  
Mental Disorders ◽  
Mental Disorder ◽  
Mental Health Problems ◽  
Clinical Medicine ◽  
Well Being ◽  
World Health ◽  
The Social ◽  
Definition Of ◽  
Health Organization

One in four individuals suffer from a psychiatric disorder at some point in their life, with 15– 20 per cent fitting cri­teria for a mental disorder at any given time. The latter corresponds to around 450 million people worldwide, placing mental disorders as one of the leading causes of global morbidity. Mental health problems represent five of the ten leading causes of disability worldwide. The World Health Organization (WHO) reported in mid 2016 that ‘the global cost of mental illness is £651 billion per year’, stating that the equivalent of 50 million working years was being lost annually due to mental disorders. The financial global impact is clearly vast, but on a smaller scale, the social and psychological impacts of having a mental dis­order on yourself or your family are greater still. It is often difficult for the general public and clin­icians outside psychiatry to think of mental health dis­orders as ‘diseases’ because it is harder to pinpoint a specific pathological cause for them. When confronted with this view, it is helpful to consider that most of medicine was actually founded on this basis. For ex­ample, although medicine has been a profession for the past 2500 years, it was only in the late 1980s that Helicobacter pylori was linked to gastric/ duodenal ul­cers and gastric carcinoma, or more recently still that the BRCA genes were found to be a cause of breast cancer. Still much of clinical medicine treats a patient’s symptoms rather than objective abnormalities. The WHO has given the following definition of mental health:… Mental health is defined as a state of well- being in which every individual realizes his or her own po­tential, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to her or his community.… This is a helpful definition, because it clearly defines a mental disorder as a condition that disrupts this state in any way, and sets clear goals of treatment for the clinician. It identifies the fact that a disruption of an individual’s mental health impacts negatively not only upon their enjoyment and ability to cope with life, but also upon that of the wider community.

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