scholarly journals Mental Health Stigma at Primary Health Care Centres in Lebanon: Qualitative Study

2021 ◽  
Author(s):  
Racha Abi Hana ◽  
Maguy Arnous ◽  
Eva Heim ◽  
Anaïs Aeschlimann ◽  
Mirja Koschorke ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Primary Health Care ◽  
Mental Disorders ◽  
Qualitative Study ◽  
Mental Health Professionals ◽  
System Level ◽  
Health Concern ◽  
Service Users ◽  
Primary Health

Abstract Background Mental health related stigma is a global public health concern and is considered a major barrier to seeking care. In this study, we explored the role of stigma as a barrier to scaling up mental health services in primary health care (PHC) centres in Lebanon. We focused on the experiences of PHC workers, while providing services to patients with mental disorders, and the perceptions of stigma or discrimination among individuals with mental illness and their families. This study was part of a larger multinational stigma reduction programme, called INDIGO-PRIMARY.Method Semi-structured qualitative interviews (n=46) were carried out, with policy makers (n=3), PHC management (n=4), PHC staff (n=24), service users and family members (n=15). The topic guides explored knowledge, implicit and explicit attitudes of staff, challenges of providing treatment, and patient outcomes including experiences of stigma. All interviews were coded using NVivo and analysed using a thematic coding framework.Results Results were analysed at five stigma-related layers: from structural stigma at the system level, down to provider-based stigma at PHC level, community level stigma, family stigma and self-stigma. Interestingly at the PHC level, stigma reporting differed among staff according to a power gradient. Service users described positive experiences in PHC. Nurses and social workers did not explicitly report incidents of stigma or discrimination but describing patients with mental health disorders as violent or uncooperative, underscored internalized negative views on mental health. GPs and directors were more outspoken than nurses regarding the challenges faced when dealing with mental health patients. Nevertheless, mental health professionals reported that things have been getting increasingly better over recent years.Conclusions This qualitative study revealed that stigma was still a major concern that affects patients with mental disorders and provided a deeper understanding on what should be done to decrease stigma at PHC centres; first addressing structural stigma by revising laws, second shaping interpersonal stigma, third commitment of PHC management to deliver high quality mental health integrated services, and fourth addressing intrapersonal stigma by building public empathy.

scholarly journals Mental Health Services in Rural China: A Qualitative Study of Primary Health Care Providers

2015 ◽  
Vol 2015 ◽  
pp. 1-6 ◽  
Author(s):  
Zhenyu Ma ◽  
Hui Huang ◽  
Qiang Chen ◽  
Faqin Chen ◽  
Abu S. Abdullah ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Primary Health Care ◽  
Mental Disorders ◽  
Qualitative Study ◽  
Health Care Providers ◽  
Mental Healthcare ◽  
Care Providers ◽  
Primary Health ◽  
Primary Health Care Providers

This study aimed to understand the challenges that primary health care providers faced in the process of delivering mental healthcare and assess their attitudes towards patients with mental health problems. In-depth interviews were conducted among 42 primary health care providers in two counties of Guangxi province, China. All interviews were audio-recorded and analyzed thematically. Primary health care providers in both counties faced the same difficulties: lack of professional knowledge, fear of patients’ attack, more extra work, and less subsidies. However, most of primary health care providers (30/42) were still willing to do mental healthcare management. All the interviewees considered that communication skills with patients and their family members, proper attitude (without discrimination), and the professional knowledge of mental health are required. There are still several participants (15/42) who showed negative attitude toward mental disorders. Nearly all the respondents (39/42) emphasized the importance of increasing their income or subsidies by the government. This qualitative study provides insights into mental health services in rural communities of Guangxi and identified issues that could be considered in engaging primary health care providers in the management of mental disorders.

scholarly journals Perceptions of Ghanaian traditional health practitioners, primary health care workers, service users and caregivers regarding collaboration for mental health care

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Solomon Nyame ◽  
Edward Adiibokah ◽  
Yasmin Mohammed ◽  
Victor C. Doku ◽  
Caleb Othieno ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Human Rights ◽  
Primary Health Care ◽  
Service Users ◽  
Traditional Health ◽  
Healthcare Needs ◽  
Primary Health ◽  
Traditional Health Practitioners ◽  
Health Practitioners

Abstract Background In low- and middle-income countries, the paucity of conventional health services means that many people with mental health problems rely on traditional health practitioners (THPs). This paper examines the possibility of forging partnerships at the Primary Health Care (PHC) level in two geopolitical regions of Ghana, to maximize the benefits to both health systems. Methods The study was a qualitative cross-sectional survey. Eight (8) focus group discussions (FGDs) were conducted between February and April 2014. The views of THPs, PHC providers, service users (i.e. patients) and their caregivers, on the perceived benefits, barriers and facilitators of forging partnerships were examined. A thematic framework approach was employed for analysis. Results The study revealed that underlying the widespread approval of forging partnerships, there were mutual undertones of suspicion. While PHC providers were mainly concerned that THPs may incur harms to service users (e.g., through delays in care pathways and human rights abuses), service users and their caregivers highlighted the failure of conventional medical care to meet their healthcare needs. There are practical challenges to these collaborations, including the lack of options to adequately deal with human rights issues such as some patients being chained and exposed to the vagaries of the weather at THPs. There is also the issue of the frequent shortage of psychotropic medication at PHCs. Conclusion Addressing these barriers could enhance partnerships. There is also a need to educate all providers, which should include sessions clarifying the potential value of such partnerships.

Expanding the Role of Primary Health Care in the Provision of Mental Health Services to the Population of the Kyrgyz Republic

2017 ◽  
Vol 41 (S1) ◽  
pp. S606-S606
Author(s):  
T. Galako
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Primary Health Care ◽  
Mental Health Services ◽  
Mental Disorders ◽  
Health Services ◽  
Mental Health Care ◽  
Kyrgyz Republic ◽  
Family Doctors ◽  
Primary Health

Providing comprehensive, integrated services in the field of mental health in primary health care (PHC) is a component of the state mental health program for the population of the Kyrgyz republic (KR) in the 2017–2030 biennium. In order to develop an action plan in this area a situational analysis of resources of psychiatric care at PHC level was carried out. There was revealed a significant deficit of specialists, such as family doctors, mental health care professionals. In spite of the need for 3,300 family doctors, only 1706 work, and 80% of them are of retirement age.The results of a research showed a low level of knowledge and skills of family physicians for the early detection of mental disorders and provision of appropriate medical care. There are also a limited number of psychiatrists, especially in rural regions (77% of the required quantity).During recent years, there have been implemented significant changes in the system of mental health services, aimed at improving its quality, the approach to the place of residence of the patient and the prevalence of psychosocial services.Since 2016 in 8 southern regions in the Kyrgyz Republic has been introduced a new model for the provision of comprehensive health care services. Piloting this model involves psychosocial rehabilitation of patients with mental disorders, the help of mobile teams at the place of patient residence, as well as psychoeducation, training, and support to family doctors. These and other measures will help to optimise mental health care at PHC level.Disclosure of interestThe author has not supplied his/her declaration of competing interest.

scholarly journals The Effect of Mental Health Training on Attitudes and Knowledge of Cadres in Early Detection of Mental Disorders in Tanjungsari Sub-district, Gunungkidul Regency

2018 ◽  
Vol 1 (3) ◽  
pp. 136
Author(s):  
Nur Alifa Istiani ◽  
Adi Heru Sutomo ◽  
Mahar Agusno
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Primary Health Care ◽  
Mental Disorders ◽  
Early Detection ◽  
Wilcoxon Test ◽  
Mental Health Training ◽  
Health Training ◽  
Primary Health ◽  
Attitudes And Knowledge

ABSTRACTBackground: In developing countries, the proportion of undetected mental disorders is still high. This is due to the lack of time and skill of primary health care providers in early detection and therapy. Community empowerment through cadres plays an important role in improving the early detection of mental disorders. Attitudes and knowledge of cadres are influenced by several factors such as the level of formal education, employment status, economic status and the level of knowledge gained through training.Objectives: This study aimed to determine the effect of mental health training on the attitude and knowledge of cadres in the early detection of mental disorders.Methods: This study was a quasi-experimental research with a pre and posttest design. The population in this research was all (posyandu) volunteer cadres in the working area of the Community and Primary Health Care Center Hargosari, Tanjungsari, amounting to 45 people. The sampling technique used in this study was total sampling. The research instrument used was the questionnaire. Data analysis used the Wilcoxon test for comparison of scores (p<0.05).Results: The results of the mean value for pretest of knowledge = 13.44 and posttest = 17.38. Wilcoxon test showed there was a significant change in knowledge with the value p=0.0000 (<0.05). The results of the average value of pretest attitude = 36.71 and posttest = 45.20. Wilcoxon test showed there was a significant change in attitude with the value p = 0.0000 (<0.05).Conclusion: In conclusion, there was a significant influence by providing health training on the attitude and knowledge of cadres in the early detection of mental disorders in Tanjungsari District, Gunungkidul Regency.

scholarly journals Adherence to clinical guidelines in integration of mental health services into primary health care in Mbarara, southwestern Uganda: a medical records review

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Edith K. Wakida ◽  
Moses Ocan ◽  
Godfrey Z. Rukundo ◽  
Samuel Maling ◽  
Peter Ssebutinde ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Primary Health Care ◽  
Mental Health Services ◽  
Mental Disorders ◽  
Health Services ◽  
Clinical Guidelines ◽  
Common Mental Disorders ◽  
Primary Health ◽  
Southwestern Uganda

Abstract Background The Ugandan Ministry of Health decentralized mental healthcare to the district level; developed the Uganda Clinical Guidelines (UCG); and trained primary health care (PHC) providers in identification, management, and referral of individuals with common mental disorders. This was intended to promote integration of mental health services into PHC in the country. ‘Common mental disorders’ here refers to mental, neurological and substance use conditions as indicated in the UCG. However, the extent of integration of mental health into general healthcare remains unknown. This study aimed to establish the level of adherence of PHC providers to the UCG in the identification and management of mental disorders. Methods This was a prospective medical record review of patient information collected in November and December 2018, and March and April 2019 at two health centers (III and IV) in southwestern Uganda. Data (health facility level; sex and age of the patient; and mental disorder diagnosis, management) was collected using a checklist. Continuous data was analyzed using means and standard deviation while categorical data was analyzed using Chi-square. Multivariable logistic regression analysis was performed to establish predictors of PHC provider adherence to the clinical guidelines on integration of mental health services into PHC. The analysis was conducted at a 95% level of significance. Results Of the 6093 records of patients at the study health facilities during the study period, 146 (2.4%) had a mental or neurological disorder diagnosis. The commonly diagnosed disorders were epilepsy 91 (1.5%) and bipolar 25 (0.4%). The most prescribed medications were carbamazepine 65 (44.5%), and phenobarbital 26 (17.8%). The medicines inappropriately prescribed at health center III for a mental diagnosis included chlorpromazine for epilepsy 3 (2.1%) and haloperidol for epilepsy 1 (0.7%). Female gender (aOR: 0.52, 95% CI 0.39–0.69) and age 61+ years (aOR: 3.02, 95% CI 1.40–6.49) were predictors of a mental disorder entry into the HMIS register. Conclusion There was a noticeable change of practice by PHC providers in integrating mental health services in routine care as reflected by the rise in the number of mental disorders diagnosed and treated and entered into the modified paper based HMIS registers.

scholarly journals General practitioners’ perspectives on care coordination in primary health care: A qualitative study

2018 ◽  
Vol 21 (4) ◽  
pp. 153-159 ◽  
Author(s):  
Ane Drougge Vassbotn ◽  
Hege Sjøvik ◽  
Trond Tjerbo ◽  
Jan Frich ◽  
Ivan Spehar
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Qualitative Study ◽  
General Practitioners ◽  
Care Coordination ◽  
Health Care Professionals ◽  
System Level ◽  
Financial Barriers ◽  
Financial Compensation ◽  
Primary Health

Introduction To explore Norwegian general practitioners’ experiences with care coordination in primary health care. Methods Qualitative study using data from five focus groups with 32 general practitioners in Norway. We analysed the data using systematic text condensation, a descriptive and explorative method for thematic cross-case analysis of qualitative data. Results The general practitioners had different notions of care pathways. They expressed a wish and an obligation to be involved in planning and coordination of primary health-care services, but they experienced organisational and financial barriers that limited their involvement and contribution. General practitioners reported lack of information about and few opportunities for involvement in formal coordination initiatives, and they missed informal arenas for dialogue with other primary health-care professionals. They argued that the general practitioner’s role as coordinator should be recognised by other parties and that they needed financial compensation for contributions and attendance in meetings with the municipality. Discussion General practitioners need informal arenas for dialogue with other primary health-care professionals and access to relevant information to promote coordinated care. There might be an untapped potential for improving patient care involving general practitioners more in planning and coordinating services at the system level. Financial compensation of general practitioners contribution may promote increased involvement by general practitioners.

Sign in / Sign up

Export Citation Format

Share Document