scholarly journals Mobile Health for All: Public-Private Partnerships Can Create a New Mental Health Landscape

2016 ◽  
Vol 3 (2) ◽  
pp. e26 ◽  
Author(s):  
Dror Ben-Zeev
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Severe Mental Illness ◽  
Mobile Phone ◽  
Mobile Phones ◽  
Mobile Technology ◽  
Low Income ◽  
Mental Health Problems ◽  
Assistance Program ◽  
The U.S

Research has already demonstrated that different mHealth approaches are feasible, acceptable, and clinically promising for people with mental health problems. With a robust evidence base just over the horizon, now is the time for policy makers, researchers, and the private sector to partner in preparation for the near future. The Lifeline Assistance Program is a useful model to draw from. Created in 1985 by the U.S. Federal Communications Commission (FCC), Lifeline is a nationwide program designed to help eligible low-income individuals obtain home phone and landline services so they can pursue employment, reach help in case of emergency, and access social services and healthcare. In 2005, recognizing the broad shift towards mobile technology and mobile-cellular infrastructure, the FCC expanded the program to include mobile phones and data plans. The FCC provides a base level of federal support, but individual states are responsible for regional implementation, including engagement of commercial mobile phone carriers. Given the high rates of disability and poverty among people with severe mental illness, many are eligible to benefit from Lifeline and research has shown that a large proportion does in fact use this program to obtain a mobile phone and data plan. In the singular area of mobile phone use, the gap between people with severe mental illness and the general population in the U.S. is vanishing. Strategic multi-partner programs will be able to grant access to mHealth for mental health programs to those who will not be able to afford them—arguably, the people who need them the most. Mobile technology manufacturing costs are dropping. Soon all mobile phones in the marketplace, including the more inexpensive devices that are made available through subsidy programs, will have “smart” capabilities (ie, internet connectivity and the capacity to host apps). Programs like Lifeline could be expanded to include mHealth resources that capitalize on “smart” functions, such as secure/encrypted clinical texting programs and mental health monitoring and illness-management apps. Mobile phone hardware and software development companies could be engaged to add mHealth programs as a standard component in the suite of tools that come installed on their mobile phones; thus, in addition to navigation apps, media players, and games, the new Android or iPhone could come with guided relaxation videos, medication reminder systems, and evidence-based self-monitoring and self-management tools. Telecommunication companies could be encouraged to offer mHealth options with their data plans. Operating system updates pushed out by the mobile carrier companies could come with optional mHealth applications for those who elect to download them. In the same manner in which the Lifeline Assistance Program has helped increase access to fundamental opportunities to so many low-income individuals, innovative multi-partner programs have the potential to put mHealth for mental health resources in the hands of millions in the years ahead.

Supporting partners of mothers with severe mental illness through text – a feasibility study

2020 ◽  
Vol 28 (5) ◽  
pp. 548-551
Author(s):  
Richard Fletcher ◽  
Jennifer M StGeorge ◽  
Cate Rawlinson ◽  
Andrea Baldwin ◽  
Paul Lanning ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Severe Mental Illness ◽  
Mobile Phone ◽  
Mobile Phones ◽  
Perinatal Period ◽  
Infant Care ◽  
Perceived Usefulness ◽  
Partner Support ◽  
New Mothers

Objective: During the perinatal period, partners of mothers with severe mental illness (SMI) play an important role in managing the new baby and supporting the mothers’ wellbeing. Providing information via mobile phone on infant care, partner support and self-care may assist partners in their support role. Method: Partners (n = 23) of mothers with SMI were enrolled in a partner-focused SMS service sending brief texts 14 times per month for a maximum of 10 months. Partners (n = 16) were interviewed on exit and their responses analysed for acceptability and perceived usefulness of the texts. Results: Partners remained with the programme and expressed high acceptability of the texts. Participants identified effects such as increased knowledge of and interaction with their baby; effective support for their partner; and reassurance that ‘things were normal’. Few partners sought support for their own mental health. Conclusions: Texts supplied to mobile phones of partners of new mothers with SMI may increase partners’ support. The texts in this study were acceptable to partners and were reported to enhance a partner’s focus on the mother’s needs, raise the partner’s awareness of the infant’s needs, and support the partner’s confidence and competence in infant care.

scholarly journals Pathways Into and Out of Homelessness Among People with Severe Mental Illness in Rural Ethiopia: A Qualitative Study

2020 ◽  
Author(s):  
Caroline Smartt ◽  
Kaleab Ketema ◽  
Souci Frissa ◽  
Bethlehem Tekola ◽  
Rahel Birhane ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Illness ◽  
Mental Health Care ◽  
Severe Mental Illness ◽  
Low Income ◽  
Community Intervention ◽  
Social Needs ◽  
Rural Setting ◽  
Study Participants

Abstract Background: Little is known about the pathways followed into and out of homelessness among people with severe mental illness (SMI) living in rural, low-income country settings. Understanding these pathways is essential for the development of effective interventions to address homelessness and promote recovery. The aim of this study was to explore pathways into and out of homelessness in people with SMI in rural Ethiopia.Methods: In-depth interviews were conducted with 15 people with SMI who had experienced homelessness and 11 caregivers. Study participants were identified through a larger project implementing a multi-component district level plan to improve access to mental health care in primary care (PRIME). Thematic analysis was conducted using an inductive approach.Results: Study participants reported different patterns of homelessness, with some having experienced chronic and others an intermittent course. Periods of homelessness occurred when family resources were overwhelmed or not meeting the needs of the person with SMI. The most important pathways into homelessness were reported to result from family conflict and the worsening of mental ill health, interplaying with substance use in many cases. Participants also mentioned escape and/or wanting a change in environment, financial problems, and discrimination from the community as contributing to them leaving the home. Pathways out of homelessness included contact with (mental and physical) health care as a catalyst to the mobilization of other supports, family and community intervention, and self-initiated return.Conclusions: Homelessness in people with SMI in this rural setting reflected complex health and social needs that were not matched by adequate care and support. Interventions to prevent and tackle homelessness need to focus on increasing family support, and ensuring access to housing, mental health care and social support.

The rediscovery of recovery: open to all

2004 ◽  
Vol 10 (1) ◽  
pp. 37-48 ◽  
Author(s):  
Glenn Roberts ◽  
Paul Wolfson
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Severe Mental Illness ◽  
Mental Health Problems ◽  
Health Problems ◽  
Psychiatric Practice ◽  
Recovery Movement

‘Recovery’ is usually taken as broadly equivalent to ‘getting back to normal’ or ‘cure’, and by these standards few people with severe mental illness recover. At the heart of the growing interest in recovery is a radical redefinition of what recovery means to those with severe mental health problems. Redefinition of recovery as a process of personal discovery, of how to live (and to live well) with enduring symptoms and vulnerabilities opens the possibility of recovery to all. The ‘recovery movement’ argues that this reconceptualisation is personally empowering, raising realistic hope for a better life alongside whatever remains of illness and vulnerability. This paper explores the background and defining features of the international recovery movement, its influence and impact on contemporary psychiatric practice, and steps towards developing recovery-based practice and services.

scholarly journals Physical health assessment quality improvement project

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S203-S203
Author(s):  
Maggie Lambert
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Physical Health ◽  
Severe Mental Illness ◽  
Mental Health Problems ◽  
Health Assessment ◽  
Premature Mortality ◽  
Care Coordinator ◽  
Improvement Project ◽  
Physical Assessment

AimsMy aim was to ensure at least 60% of clients in the Acute Day Unit have a ‘physical screening tool’ entry.BackgroundAs a GP starting training in psychiatry I am very aware of the importance of physical health and the overlap between physical health and mental health. It has been found that there is a 20 year mortality gap for men and 15 year mortality gap for women in people with mental health problems. Thorncroft described this as ‘the scandal of premature mortality’.Nice Guidelines state: ‘Reducing premature mortality by improving physical healthcare for people with severe mental illness remains an NHS England priority. Funding has been made available to ensure that at least 60% of people who have severe mental illness receive NICE-recommended physical assessments and follow up from 2018/19 onwards.’The Acute Day Unit seemed to be the ideal situation to try to address this problem as clients are with us for 6-8 weeks during which time their physical health as well as their mental health can be optimised.MethodI emailed the whole team to invite ideas and questions regarding the QI project and discussed it further at the MDT meeting. It was important at the start to get the whole team on board. Having discussed it we decided to put six blocks of thirty minute slots weekly into the timetable for physical assessments. These were to be booked in by the client's care coordinator. I also added a column onto our team spreadsheet to input whether or not the physical assessment had been done. Frequent encouragements and reminders were sent round the team of which clients still needed a physical assessment.ResultBefore the changes were made 25% of clients were having their physical assessments done. After the changes were made 63% of clients had their physical assessment done, three of the twenty seven clients having only started at the day unit that week.ConclusionHaving made a change to the system of scheduling six regular slots for physical assessments there has been a dramatic rise in the number of clients having their physical assessment done. As this change has been to the system and will be continued automatically on the team calendar the improvement has been more easily sustained. We are keen to keep improving on this change with an ideal level of over 75% of clients having a physical health assessment.

scholarly journals Mental Health Mobile Phone App Usage, Concerns, and Benefits Among Psychiatric Outpatients: Comparative Survey Study (Preprint)

2018 ◽  
Author(s):  
John Torous ◽  
Hannah Wisniewski ◽  
Gang Liu ◽  
Matcheri Keshavan
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Mobile Phone ◽  
Mobile Phones ◽  
Private Insurance ◽  
The State ◽  
Survey Study ◽  
Health Apps ◽  
Single Time Point ◽  
Time Point

BACKGROUND Despite the popularity of mental health apps, it is unknown if they are actually used by those with mental illness. This study assessed whether differences in clinic setting may influence the use of mental health apps and which factors influence patient perception of apps. OBJECTIVE The objective of this study was to gain an understanding of how individuals with mental illness use their mobile phones by exploring their access to mobile phones and their use of mental health apps. METHODS A single time point survey study was conducted over a 2-week period in February 2018 at two nearby outpatient psychiatry clinics: one serving largely mood and anxiety disorder patients with private insurance staffed by both faculty and residents and the other serving largely psychotic disorder patients in a state Department of Mental Health (DMH) setting. A total of 25 patients at the state DMH clinic also consented for a single time point observation of apps currently installed on their personal mobile phone. RESULTS A total of 113 patients at the private insurance clinic and 73 at the state DMH clinic completed the survey. Those in the private insurance clinic were more likely to download a mental health app compared to the state DMH clinic, but actual rates of reported current app usage were comparable at each clinic, approximately 10%. Verifying current apps on patients’ mobile phones at the state DMH clinic confirmed that approximately 10% had mental health apps installed. Patients at both clinics were most concerned about privacy of mental health apps, although those at the state DMH clinic viewed cost savings as the greatest benefit while those at the private clinic reported time as the greatest benefit. CONCLUSIONS High interest in mental health apps does not automatically translate into high use. Our results of low but similar rates of mental health app use at diverse clinics suggests DMH patients with largely psychotic disorders are as interested and engaged with apps as those in a private insurance clinic treating largely mood and anxiety disorders. Results from our study also highlight the importance of understanding how actual patients are using apps instead of relying on internet-based samples, which often yield higher results due to their likelihood of being selected.

scholarly journals Re-Oreintation of Nigerians Towards Mental Health: Its Counseling Implications

2017 ◽  
Vol 13 (17) ◽  
pp. 302
Author(s):  
Bukoye Roseline Olufunke
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Health Education ◽  
Low Income ◽  
Mental Health Problems ◽  
Heart Diseases ◽  
Well Being ◽  
Health Problems ◽  
Mental Health Education ◽  
The Public

Mental health is a state of well-being which allows a better realisation of one's own potentials. With good mental health, individuals are able to cope productively with life situations. According to WHO (2002), hundreds of millions of people worldwide are affected by mental health problems. This led to their defection in terms of behavioural, neurological, physical, emotional, and substance use. It was discovered that about 36 million people worldwide are HIV positive, and about 20 million people have died from AIDS, tobacco, alcohol, amongst others. The use of hard drugs are discovered as potential addictive substance that have led to major health problems like heart diseases, stroke, cancer, liver diseases, fever, amongst others. Mental illness/problem occurs due to careless attitudes towards mental health education. Most middle and low income countries devote less than 1% of their health expenditure to mental health and mental health education thereby worsening the health condition of the citizens. This paper, therefore, sees it as point of urgency to re-orientate Nigerians towards mental health and its counseling implications. For its effectiveness, the roles of counseling cannot be over- emphasised. There is need for counsellors to inculcate into the public mental health skills, self-management skills, and self-descriptive culture through seminars and workshops. The Counsellor should bring to the awareness of the public information about their lifestyles regarding sleeping procedures, eating behaviour, nutrition, exercise, and stress management through enlightenment campaigns and medical programmes. Other recommendations include; the government in collaboration with the counsellors and NGOs should embark on comprehensive mental health problems preventive programmes. Also, mental health policies, legislation, community care giver facilities, and treatments for people with mental illness should be given proper attention.

scholarly journals Family care for persons with severe mental illness: experiences and perspectives of caregivers in Uganda

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
F. Verity ◽  
A. Turiho ◽  
B. B. Mutamba ◽  
D. Cappo
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Severe Mental Illness ◽  
Low Income ◽  
Mental Hospital ◽  
Belief Systems ◽  
Hospital Readmissions ◽  
Family Care ◽  
The Family ◽  
The Impact

Abstract Background In low-income settings with limited social protection supports, by necessity, families are a key resource for care and support. Paradoxically, the quality of family care for people living with Severe Mental Illness (PLSMI) has been linked to support for recovery, hospital overstay and preventable hospital readmissions. This study explored the care experiences of family members of PLSMI with patients at the national mental hospital in Kampala, Uganda, a low income country. This study was undertaken to inform the development of YouBelongHome (YBH), a community mental health intervention implemented by YouBelong Uganda (YBU), a registered NGO in Uganda. Methods Qualitative data was analysed from 10 focus groups with carers of ready to discharge patients on convalescent wards in Butabika National Referral Mental Hospital (BNRMH), Kampala. This is a subset of data from a mixed methods baseline study for YouBelong Uganda, undertaken in 2017 to explore hospital readmissions and community supports for PLSMI from the Wakiso and Kampala districts, Uganda. Results Three interrelated themes emerge in the qualitative analysis: a range of direct, practical care provided by the caregiver of the PLSMI, emotional family dynamics, and the social and cultural context of care. The family care giving role is multidimensional, challenging, and changing. It includes protection of the PLSMI from harm and abuse, in the context of stigma and discrimination, and challenging behaviours that may result from poor access to and use of evidence-based medicines. There is reliance on traditional healers and faith healers reflecting alternative belief systems and health seeking behaviour rather than medicalised care. Transport to attend health facilities impedes access to help outside the family care system. Underpinning these experiences is the impact of low economic resources. Conclusions Family support can be a key resource and an active agent in mental health recovery for PLSMI in Uganda. Implementing practical family-oriented mental health interventions necessitates a culturally aware practice. This should be based in understandings of dynamic family relationships, cultural understanding of severe mental illness that places it in a spiritual context, different family forms, caregiving practices and challenges as well as community attitudes. In the Ugandan context, limited (mental) health system infrastructure and access to medications and service access impediments, such as economic and transport barriers, accentuate these complexities.

scholarly journals Prevalence and Associated Factors of Metabolic Syndrome among Patients with Severe Mental Illness Attending a Tertiary Hospital in Southwest Uganda

2019 ◽  
Vol 2019 ◽  
pp. 1-8 ◽  
Author(s):  
David Collins Agaba ◽  
Richard Migisha ◽  
Rosemary Namayanja ◽  
Godfrey Katamba ◽  
Henry Mark Lugobe ◽  
...  
Keyword(s):  
Mental Health ◽  
Metabolic Syndrome ◽  
Mental Illness ◽  
Logistic Regression ◽  
Severe Mental Illness ◽  
Low Income ◽  
Associated Factors ◽  
Tertiary Hospital ◽  
Low Income Countries ◽  
Health Clinic

Globally, the prevalence of metabolic syndrome (MetS) and its components which are the major cardiovascular disease (CVD) risk factors, is higher among patients with severe mental illness (SMI) compared to the general population. This is mainly due to the deleterious lifestyles characterized by physical inactivity, excessive alcohol consumption, smoking, and unhealthy diets common among patients with SMI as well as due to cardiometabolic effects of psychotropic medications. Despite these conditions being highly prevalent among patients with SMI, little attention is given to these conditions during routine reviews in the mental health clinics in most low-income countries including Uganda. The main objective of this study was to determine the prevalence and associated factors of MetS among patients with SMI at Mbarara Regional Referral Hospital (MRRH), a tertiary hospital in southwestern Uganda. Through a cross-sectional study at the mental health clinic of the hospital, we recruited 304 patients with SMI and evaluated them for MetS using the National Cholesterol Education Programme Adult Treatment Panel III (NCEP ATP III) criteria. We defined the prevalence of MetS as the proportion of patients meeting the NCEP ATP III criteria. We used logistic regression to evaluate associations between MetS and independent variables. We included a total of 302 (44.37% male, 55.63% female) patients with a diagnosis of SMI in the analysis. The prevalence of MetS was 23.51% (95% CI 18.84–28.71). At multivariable logistic regression, age >40 years and long duration of mental illness (>10 years) were significantly associated with MetS. The prevalence of MetS is high among patients with psychiatric disorders, and thus metabolic screening, especially among the high-risk groups, is critical.

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