scholarly journals Implementing Psychological Interventions Through Nonspecialist Providers and Telemedicine in High-Income Countries: Qualitative Study from a Multistakeholder Perspective

10.2196/19271 ◽  
2020 ◽  
Vol 7 (8) ◽  
pp. e19271
Author(s):  
Daisy Radha Singla ◽  
Sasha Lemberg-Pelly ◽  
Andrea Lawson ◽  
Nika Zahedi ◽  
Tyla Thomas-Jacques ◽  
...  
Keyword(s):  
Mental Health ◽  
Lived Experience ◽  
Mental Health Professionals ◽  
Psychological Treatment ◽  
Primary Objective ◽  
Anxiety Symptoms ◽  
High Income ◽  
Barriers And Facilitators ◽  
Psychological Treatments ◽  
Stakeholder Groups

Background Task sharing has been used worldwide to improve access to mental health care, where nonspecialist providers—individuals with no formal training in mental health—have been trained to effectively treat perinatal depressive and anxiety symptoms. Little formative research has been conducted to examine relevant barriers and facilitators of nonspecialist providers and the use of telemedicine in treatment service delivery. Objective The primary objective of this study was to examine the main barriers and facilitators of nonspecialist provider–delivered psychological treatments for perinatal populations with common mental health disorders, such as depression and anxiety, from a multistakeholder perspective. Methods This study took place in Toronto, Canada. In total, 33 in-depth interviews were conducted with multiple stakeholder groups (women with lived experience and their significant others, as well as health and mental health professionals). Qualitative data were quantified to estimate commonly endorsed themes within and across stakeholder groups. Results Psychological treatments delivered by nonspecialist providers were considered acceptable by the vast majority of participants (30/33, 90%). Across all stakeholder groups, nurses (20/33, 61%) and midwives (14/33, 42%) were the most commonly endorsed cadre of nonspecialist providers. The majority of stakeholders (32/33, 97%) were amenable to nonspecialist providers delivering psychological treatment via telemedicine (27/33, 82%), although concerns were raised about the ability to establish a therapeutic alliance via telemedicine (16/33, 48%). Empathy was the most desired characteristic of a nonspecialist provider (61%). Patient and patient advocate stakeholders were more likely to emphasize stigma as an important barrier to accessing psychological treatments (7/12, 58%), compared to clinicians (2/9, 22%) and spouses (1/5, 20%). Clinician stakeholders were more likely to emphasize the importance of ensuring nonspecialist providers were trained to deliver psychological treatments (3/9, 33%), compared to other stakeholder groups. Conclusions These results can inform the design, implementation, and integration of nonspecialist-delivered interventions via telemedicine for women with perinatal depressive and anxiety symptoms in high-income country contexts.

scholarly journals Implementing Psychological Interventions Through Nonspecialist Providers and Telemedicine in High-Income Countries: Qualitative Study from a Multistakeholder Perspective (Preprint)

2020 ◽  
Author(s):  
Daisy Radha Singla ◽  
Sasha Lemberg-Pelly ◽  
Andrea Lawson ◽  
Nika Zahedi ◽  
Tyla Thomas-Jacques ◽  
...  
Keyword(s):  
Mental Health ◽  
Lived Experience ◽  
Mental Health Professionals ◽  
Psychological Treatment ◽  
Primary Objective ◽  
Anxiety Symptoms ◽  
High Income ◽  
Barriers And Facilitators ◽  
Psychological Treatments ◽  
Stakeholder Groups

BACKGROUND Task sharing has been used worldwide to improve access to mental health care, where nonspecialist providers—individuals with no formal training in mental health—have been trained to effectively treat perinatal depressive and anxiety symptoms. Little formative research has been conducted to examine relevant barriers and facilitators of nonspecialist providers and the use of telemedicine in treatment service delivery. OBJECTIVE The primary objective of this study was to examine the main barriers and facilitators of nonspecialist provider–delivered psychological treatments for perinatal populations with common mental health disorders, such as depression and anxiety, from a multistakeholder perspective. METHODS This study took place in Toronto, Canada. In total, 33 in-depth interviews were conducted with multiple stakeholder groups (women with lived experience and their significant others, as well as health and mental health professionals). Qualitative data were quantified to estimate commonly endorsed themes within and across stakeholder groups. RESULTS Psychological treatments delivered by nonspecialist providers were considered acceptable by the vast majority of participants (30/33, 90%). Across all stakeholder groups, nurses (20/33, 61%) and midwives (14/33, 42%) were the most commonly endorsed cadre of nonspecialist providers. The majority of stakeholders (32/33, 97%) were amenable to nonspecialist providers delivering psychological treatment via telemedicine (27/33, 82%), although concerns were raised about the ability to establish a therapeutic alliance via telemedicine (16/33, 48%). Empathy was the most desired characteristic of a nonspecialist provider (61%). Patient and patient advocate stakeholders were more likely to emphasize stigma as an important barrier to accessing psychological treatments (7/12, 58%), compared to clinicians (2/9, 22%) and spouses (1/5, 20%). Clinician stakeholders were more likely to emphasize the importance of ensuring nonspecialist providers were trained to deliver psychological treatments (3/9, 33%), compared to other stakeholder groups. CONCLUSIONS These results can inform the design, implementation, and integration of nonspecialist-delivered interventions via telemedicine for women with perinatal depressive and anxiety symptoms in high-income country contexts.

An engagement-facilitation intervention (EFI) for increasing uptake and engagement for self-guided online mental health interventions: Consumer-guided development (Preprint)

2019 ◽  
Author(s):  
Amelia Gulliver ◽  
Alison L Calear ◽  
Matthew Sunderland ◽  
Frances Kay-Lambkin ◽  
Louise M Farrer ◽  
...  
Keyword(s):  
Mental Health ◽  
Lived Experience ◽  
Health Program ◽  
Mental Health Program ◽  
Health Interventions ◽  
Barriers And Facilitators ◽  
Health Programs ◽  
Current Evidence ◽  
Mental Health Interventions ◽  
Mental Health Programs

BACKGROUND Self-guided online mental health programs are effective in treating and preventing mental health problems. However, both the uptake and engagement with these programs in the community is suboptimal, and there is limited current evidence indicating how to increase the use of existing evidence-based programs. OBJECTIVE The current study aims to investigate the views of people with lived experience of depression and anxiety on the barriers and facilitators to using e-mental health interventions and to use these perspectives to help develop an engagement-facilitation intervention (EFI) to increase uptake and engagement with self-guided online mental health programs. METHODS A total of 24 community members (female = 21; male = 3) with lived experience of depression and/or anxiety participated in four focus groups that discussed: 1) barriers and facilitators to self-guided e-mental health programs, 2) specific details needed to help them decide to use an online program, and 3) the appearance, delivery mode, and functionality of content for the proposed EFI. A total of 14 of the focus group attendees participated in a subsequent follow-up survey to evaluate the resultant draft EFI. Data were thematically analysed using both inductive and deductive methods. RESULTS Participants suggested that the critical component of an EFI was information that would challenge personal barriers to engagement with psychosocial interventions. These were providing personalised feedback about symptoms, information about the content and effectiveness of the e-mental health program, normalisation of participation in e-mental health programs including testimonials, and brief information on data security. Reminders, rewards, feedback about their progress, and coaching were all mentioned as being useful in assisting people to continue to engage with a program once they had started. Feedback on the developed EFI was positive; with participants reporting satisfaction with the content of the EFI and that it would likely positively affect their use of an e-mental health program. CONCLUSIONS EFIs have the potential to improve the uptake of e-mental health programs in the community and should focus on providing information on the content and effectiveness of e-mental health programs, as well as normalising their use. There is strong value in involving people with a lived experience in the design and development of EFIs to maximise their effectiveness.

scholarly journals Delivering and implementing child and adolescent mental health training for mental health and allied professionals: a systematic review and qualitative meta-aggregation

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Emily Banwell ◽  
Neil Humphrey ◽  
Pamela Qualter
Keyword(s):  
Mental Health ◽  
Systematic Review ◽  
Qualitative Research ◽  
Mental Health Professionals ◽  
Synthesis Method ◽  
Barriers And Facilitators ◽  
Youth Workers ◽  
Mental Health Training ◽  
Health Training ◽  
Starting Point

Abstract Background The increasing prevalence of mental health difficulties among children and young people (CYP) suggests that early intervention is vital. A comprehensive system of care and support requires the involvement of mental health professionals, including psychologists and psychiatrists, and allied professionals, including teachers, police, and youth workers. A critical starting point is the provision of effective training, in order that these professionals can better support the mental health needs of the CYP that they encounter. Objectives Given the primacy of training in the CYP mental health support system, understanding the factors that maximise potential gains and facilitate uptake is pertinent. The current review therefore located and explored qualitative research evidence, to identify the barriers and facilitators underpinning successful delivery and implementation of training focussed on the mental health of CYP, for both mental health and allied professionals. Methods A systematic review and qualitative meta-aggregation were conducted. Systematic searches were carried out using ASSIA, EMBASE, MEDLINE, NICE Evidence, PsycINFO, and Scopus databases, for papers published between 2000 and 2020. Twelve thousand four hundred forty-eight records were identified, of which 39 were eligible for review. The records were appraised for quality using the Joanna Briggs Institute Critical Appraisal Checklist for Qualitative Research, and synthesised using the qualitative meta-aggregation method. Results One hundred eighty-two raw findings were extracted from the 39 papers, which were condensed into 47 sub-categories, 19 categories, and finally 5 synthesis statements. These synthesis statements reflected the barriers and facilitators influencing the training delivery process (“support”; “content, design, and planning”), and the implementation of training into the workplace (“context”; “perceived value”; “organisational factors”). Conclusions The synthesis statements and underlying categories provide practical recommendations for those designing, delivering, or implementing CYP mental health training. Recommendations ranged from facilitating peer support during training, to the idea that training will be better implemented when perceived need is high. The review provides a robust evidence-based foundation to “common-sense” principles, drawing them into a coherent and organised framework using a synthesis method grounded in pragmatism. Protocol registration number PROSPERO reference ID: CRD42020162876.

scholarly journals The Debt and Mental Health Evidence Form

2010 ◽  
Vol 34 (3) ◽  
pp. 95-100 ◽  
Author(s):  
Chris Fitch ◽  
Robert Chaplin ◽  
Simon Tulloch
Keyword(s):  
Mental Health ◽  
Mental Health Professionals ◽  
Health Professionals ◽  
Qualitative Data ◽  
Mental Health Problems ◽  
Clinical Information ◽  
Relevant Information ◽  
Clinical Implications ◽  
Stakeholder Groups ◽  
Question Form

Aims and methodTo develop a standardised clinical information form which helps health professionals provide clear and relevant information about individuals who believe mental disorders affect their ability to repay debt and have consented to creditor organisations or money advisors approaching professionals for evidence. The six-question form was evaluated by three stakeholder groups.ResultsOverall, 35 responses were received from creditors/money advisors, 28 from mental health professionals and 29 from service users/carers. All questions scored acceptable levels of clarity and three questions scored acceptable relevance levels. Qualitative data were used to revise questions on the basis of concerns expressed by stakeholders about sharing diagnostic data, providing prognoses, and the risk of creditor misunderstanding.Clinical implicationsThe form is likely to be an acceptable standardised means by which health professionals can elicit information on debt from individuals with mental health problems, for use by creditor organisations or money advisors. The results of a pilot study are awaited.

scholarly journals To disclose or not to disclose? Peer workers impact on a culture of safe disclosure for mental health professionals with lived experience.

2021 ◽  
Author(s):  
Louise Byrne ◽  
Helena Roennfeldt ◽  
Larry Davidson ◽  
Rebecca Miller ◽  
Chyrell Bellamy
Keyword(s):  
Mental Health ◽  
Lived Experience ◽  
Mental Health Professionals ◽  
Health Professionals

scholarly journals Making Lived-Experience Research Accessible: A Design Thinking Approach to Co-Creating Knowledge Translation Resources Based on Evidence

2021 ◽  
Vol 18 (17) ◽  
pp. 9250
Author(s):  
Katherine M. Boydell ◽  
Anne Honey ◽  
Helen Glover ◽  
Katherine Gill ◽  
Barbara Tooth ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Lived Experience ◽  
Mental Health Professionals ◽  
Participatory Design ◽  
Design Thinking ◽  
Evidence Based ◽  
Journal Articles ◽  
Translation Strategy ◽  
User Friendly

Mental health lived-experience research illuminates the perspectives and experiences of people who live with mental illness. However, little is known about how useful people with lived experience of mental illness/distress might find lived-experience research, nor what the best formats are to bring it to their attention. This paper describes the STELLER study (Supporting the Translation into Everyday Life of Lived-Experience Research), which explores the translation of lived-experience research in the lives of people living with mental illness. Our aim was to use a design thinking approach to develop a range of user-friendly formats to disseminate lived-experience research. A staged design thinking approach was used to develop a translation strategy for lived-experience research. We explored empathy via consumer consultation to understand their perspectives on lived-experience research, refined the design aim, research questions and generated ideas with consumers and mental health professionals, identified the evidence based on lived experience-authored journal articles, worked with design students and peer workers to create a suite of resources and developed prototypes tailored to individual settings and clients. Participatory design thinking strategies are essential to identify the best ways to translate evidence-based lived-experience research via accessible, lay-friendly resources targeted to individuals impacted by mental illness. This study is the first to investigate the feasibility and usefulness of bringing the findings of lived-experience research to individuals impacted by mental illness/distress. It provides evidence about a potentially important source of information that can be used to facilitate their recovery.

scholarly journals Attitude of Non-Mental Health Professionals Towards Mental Illness in a Tertiary Care Center

2019 ◽  
Vol 2 (02) ◽  
pp. 23-28
Author(s):  
Nishad P. M. A. ◽  
Dilshana N. B. ◽  
Anil Kakunje ◽  
Ravichandra K. ◽  
Kamran Chisty
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Mental Health Professionals ◽  
Health Professionals ◽  
Health Care Professionals ◽  
Psychiatric Illness ◽  
Positive Attitude ◽  
Care Center ◽  
Tertiary Care ◽  
Primary Objective

BACKGROUND Mental and behavioral disorders are major health problems. Stigma can prevent the care and treatment of the mentally ill. There is a gross underestimation of psychiatric comorbidities among patients by non-mental health professionals. A positive attitude of these health professionals has a crucial role in the treatment of patients suffering from psychiatric illness. The primary objective of the study is to study the attitude of various nonmental health professionals towards mental illness. METHODS It is a crosssectional descriptive study, conducted in a private medical college in Mangalore, Karnataka in India. The study had 76 participants consisting of doctors and nurses. Instruments used were a semi-structured demographic proforma and Mental illness: Clinicians Attitude Scale - Version 4 (MICA-4). MICA-4 is a 16- item scale used for assessing attitude towards mental illness. RESULTS The total number of subjects included was 76 among which doctors constituted 57 and nurses 19. As the experience and age of the participants increased, a shift to the positive attitude towards psychiatric illness was noted. Specialist doctors had a higher positive attitude compared to non-specialist medical graduates and nurses. CONCLUSIONS It is essential to have structured training in psychiatry for all health care professionals.

scholarly journals Mental Health Apps in Psychiatric Treatment: A Patient Perspective on Real World Technology Usage (Preprint)

2018 ◽  
Author(s):  
Emil Chiauzzi ◽  
Amy Newell
Keyword(s):  
Mental Health ◽  
Lived Experience ◽  
Patient Perspective ◽  
Psychiatric Treatment ◽  
Mobile Apps ◽  
Psychiatric Patients ◽  
Primary Objective ◽  
Health Apps ◽  
The Difference ◽  
Mobile Mental Health

UNSTRUCTURED For many people who use mobile apps, the primary motivations are entertainment, news, gaming, social connections, or productivity. For those experiencing health problems, particularly those with chronic conditions such as psychiatric disorders, the stakes are much higher. The digital tools that they select may be the difference between improvement and decompensation or even life and death. Although there has been a wide expansion of mental health apps with promise as well as hype, the current means of researching, evaluating, and deploying effective tools have been problematic. As a means of gaining a perspective that moves beyond usability testing, surveys, and app ratings, the primary objective of this patient perspective is to question the killer app and condition-specific mentality of current mental health app development. We do this by reviewing the current mobile mental health app literature, identifying ways in which psychiatric patients use apps in their lives, and then exploring how these issues are experienced by a software engineer who has struggled with her bipolar disorder for many years. Her lived experience combined with a technology perspective offers potential avenues for using technology productively in psychiatric treatment. We believe that this responds to JMIR Publications’ call for patient perspective papers and provides encouragement for patients to share their views on mental health and technology.

scholarly journals Cultural adaptation of mental health first aid guidelines for depression for Sri Lanka: a Delphi expert consensus study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Madhawee Fernando ◽  
Amila Chandrasiri ◽  
Madhubhashinee Dayabandara ◽  
Nicola J. Reavley
Keyword(s):  
Mental Health ◽  
Sri Lanka ◽  
Lived Experience ◽  
Mental Health Professionals ◽  
Health Professionals ◽  
English Language ◽  
First Aid ◽  
Expert Consensus ◽  
Mental Health First Aid ◽  
First Aid Training

Abstract Background Family and friends can play a key role in supporting a person with depression to seek professional help. However, they may lack the knowledge to do so. English-language guidelines for high-income countries have been developed to assist with this. The aim of this study was to adapt the English mental health first aid guidelines for helping a person with depression to the Sri Lankan context. Methods A Delphi expert consensus study involving mental health professionals and people with lived experience (either their own or as carers) was conducted. Participants were recruited from inpatient, outpatient and community care settings. The English-language questionnaire was translated into Sinhala and participants were asked to rate the importance of each item for inclusion in the guidelines for Sri Lanka. Results Data were collected over two survey rounds. A total of 115 panellists (23% male) consisting of 92 mental health professionals and 23 consumers and carers completed the Round 1 questionnaire. A total of 165 items were included in the final guidelines, with 156 adopted from the guidelines for English-speaking countries and 9 generated from the comments of panellists. Conclusions The adapted guidelines were similar to the English-language guidelines. However, new items reflecting culturally relevant approaches to autonomy-granting, communication and culture-specific manifestations of depression were reflected in the adapted version. Further research should explore the use of the adapted guidelines, including their incorporation into Mental Health First Aid Training.

scholarly journals A Mobile App–Based Intervention for Depression: End-User and Expert Usability Testing Study

2018 ◽  
Vol 5 (3) ◽  
pp. e54 ◽  
Author(s):  
Matthew Fuller-Tyszkiewicz ◽  
Ben Richardson ◽  
Britt Klein ◽  
Helen Skouteris ◽  
Helen Christensen ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Health Professionals ◽  
Psychological Treatment ◽  
Treatment Compliance ◽  
End Users ◽  
Mobile App ◽  
End User ◽  
Self Monitoring ◽  
Participant Engagement ◽  
System Usability Scale

Background Despite the growing number of mental health apps available for smartphones, the perceived usability of these apps from the perspectives of end users or health care experts has rarely been reported. This information is vital, particularly for self-guided mHealth interventions, as perceptions of navigability and quality of content are likely to impact participant engagement and treatment compliance. Objective The aim of this study was to conduct a usability evaluation of a personalized, self-guided, app-based intervention for depression. Methods Participants were administered the System Usability Scale and open-ended questions as part of a semistructured interview. There were 15 participants equally divided into 3 groups: (1) individuals with clinical depression who were the target audience for the app, (2) mental health professionals, and (3) researchers who specialize in the area of eHealth interventions and/or depression research. Results The end-user group rated the app highly, both in quantitative and qualitative assessments. The 2 expert groups highlighted the self-monitoring features and range of established psychological treatment options (such as behavioral activation and cognitive restructuring) but had concerns that the amount and layout of content may be difficult for end users to navigate in a self-directed fashion. The end-user data did not confirm these concerns. Conclusions Encouraging participant engagement via self-monitoring and feedback, as well as personalized messaging, may be a viable way to maintain participation in self-guided interventions. Further evaluation is necessary to determine whether levels of engagement with these features enhance treatment effects.

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