scholarly journals Youth Mental Health Services Utilization Rates After a Large-Scale Social Media Campaign: Population-Based Interrupted Time-Series Analysis

2018 ◽  
Vol 5 (2) ◽  
pp. e27 ◽  
Author(s):  
Richard G Booth ◽  
Britney N Allen ◽  
Krista M Bray Jenkyn ◽  
Lihua Li ◽  
Salimah Z Shariff
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Primary Health Care ◽  
Large Scale ◽  
Interrupted Time Series ◽  
Female Adolescents ◽  
Outpatient Mental Health ◽  
Primary Health ◽  
Slope Change ◽  
The Impact

Background Despite the uptake of mass media campaigns, their overall impact remains unclear. Since 2011, a Canadian telecommunications company has operated an annual, large-scale mental health advocacy campaign (Bell Let’s Talk) focused on mental health awareness and stigma reduction. In February 2012, the campaign began to explicitly leverage the social media platform Twitter and incented participation from the public by promising donations of Can $0.05 for each interaction with a campaign-specific username (@Bell_LetsTalk). Objective The intent of the study was to examine the impact of this 2012 campaign on youth outpatient mental health services in the province of Ontario, Canada. Methods Monthly outpatient mental health visits (primary health care and psychiatric services) were obtained for the Ontario youth aged 10 to 24 years (approximately 5.66 million visits) from January 1, 2006 to December 31, 2015. Interrupted time series, autoregressive integrated moving average modeling was implemented to evaluate the impact of the campaign on rates of monthly outpatient mental health visits. A lagged intervention date of April 1, 2012 was selected to account for the delay required for a patient to schedule and attend a mental health–related physician visit. Results The inclusion of Twitter into the 2012 Bell Let’s Talk campaign was temporally associated with an increase in outpatient mental health utilization for both males and females. Within primary health care environments, female adolescents aged 10 to 17 years experienced a monthly increase in the mental health visit rate from 10.2/1000 in April 2006 to 14.1/1000 in April 2015 (slope change of 0.094 following campaign, P<.001), whereas males of the same age cohort experienced a monthly increase from 9.7/1000 to 9.8/1000 (slope change of 0.052 following campaign, P<.001). Outpatient psychiatric services visit rates also increased for both male and female adolescents aged 10 to 17 years post campaign (slope change of 0.005, P=.02; slope change of 0.003, P=.005, respectively). For young adults aged 18 to 24 years, females who used primary health care experienced the most significant increases in mental health visit rates from 26.5/1000 in April 2006 to 29.2/1000 in April 2015 (slope change of 0.17 following campaign, P<.001). Conclusions The 2012 Bell Let’s Talk campaign was temporally associated with an increase in the rate of mental health visits among Ontarian youth. Furthermore, there appears to be an upward trend of youth mental health utilization in the province of Ontario, especially noticeable in females who accessed primary health care services.

Interventions in the Health and Non-health Sectors Aimed at Promoting Mental Health

2017 ◽  
Vol 41 (S1) ◽  
pp. S8-S8
Author(s):  
H. Herrman
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Human Rights ◽  
Primary Health Care ◽  
Early Intervention ◽  
Mental Disorders ◽  
Women’S Mental Health ◽  
Women's Mental Health ◽  
Primary Health ◽  
The Impact

The impact of social determinants on women's mental health is becoming clearer worldwide. Poverty, violence and communal insecurity are among the main challenges to women's mental health and the health of their families. Depression is one of the most common mental disorders experienced by women. It typically has an early onset in life and is more frequently found in women made vulnerable by trauma.Improving mental health for women and girls requires early intervention for depression and other mental disorders; with gender sensitive clinical care and support for recovery in primary health care, and mother, child and reproductive health settings. Early intervention in primary health care and collaboration with patients and family carers encourage integration of mental health with the health care system, in turn protective of human rights.In addition, gender equity and observance of human rights need to be embedded in policy and practice in health and non-health sectors to ensure that women's mental health is promoted and mental illnesses adequately prevented and treated. Effective promotion of mental health and prevention of mental disorders is possible in countries of all income levels.Disclosure of interestThe author has not supplied his declaration of competing interest.

scholarly journals Assessing the impact of the 2008 health reform in Ecuador on the performance of primary health care services: an interrupted time series analysis

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Sergio E Flores Jimenez ◽  
Miguel San Sebastián
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Health Reform ◽  
Health Care Services ◽  
Interrupted Time Series ◽  
Interrupted Time Series Analysis ◽  
Care Services ◽  
Primary Health ◽  
Primary Health Care Services ◽  
The Impact

Abstract Background In 2008, Ecuador started a national health reform based on the principles of Alma Ata to achieve Universal Health Coverage. While coverage indicators have increased, a systematic assessment of the impact of the reform on the delivery of health services at primary level is lacking. The aim of this study was to assess the impact of the 2008 health reform on the performance of primary health care services in Ecuador. Methods Ambulatory Care Sensitive Conditions (ACSC) are a subset of diseases where hospital admission is potentially avoidable by high quality well-functioning primary care. Thus, observing the behaviour of ACSC hospitalizations can serve as an indicator of how the primary health care level is performing. Crude and adjusted rates, stratified by sex, were calculated from ten selected ACSC hospitalization discharges during 22 years of data representing 11 years before and after the health reform. An interrupted time series analysis was then conducted by applying a negative binomial regression and adjusting for overdispersion and autocorrelation. Results Overall higher crude and adjusted rates for ACSC hospitalizations were observed in women compared to men; both increased gradually since the start of the observation, reaching a peak around 2010, and then started a downwards trend. In men, the incidence rate ratio increased significantly by 3 % per year during the period before the intervention. During the first year after intervention, an increase (13 %) was detected, and then a statistically significant 1 % decrease (IRR = 0.99; 95 % CI: 0.98, 0.99) was observed in the ACSC rate ratio per year in the period after the intervention. Similar trends and effect sizes were found for women. Conclusions The study revealed significant decreasing trends of the ACSC hospitalization rates in both sexes, indicating an improvement of the performance of the primary health care services following the 2008 national health reform. A continuous strengthening of the primary care model as well as a regular monitoring of ACSC hospitalization rates in the country is recommended. A health economic evaluation considering hospitalizations avoided and associated costs is also advisable.

The impact of the economic crisis on mental health in Portugal: A qualitative approach

2017 ◽  
Vol 41 (S1) ◽  
pp. S567-S567
Author(s):  
A. Antunes ◽  
D. Frasquilho ◽  
M. Silva ◽  
G. Cardoso ◽  
J. Ferrão ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Primary Health Care ◽  
Health Professionals ◽  
Economic Recession ◽  
Qualitative Approach ◽  
System Level ◽  
Health Priorities ◽  
Primary Health ◽  
The Impact

IntroductionPortugal is among the European countries with higher prevalence of mental disorders, associated with substantial unmet needs for treatment. Literature on the impact of the economic recession shows that an increased risk of mental health problems is likely to occur. Despite possible growing needs, the budget cuts at the health system level may have decreased the adequacy of care response. Understanding the impacts of the recession in psychological distress and in access and quality of care is imperative to set public health priorities.ObjectivesResorting to a qualitative approach, this study aims to explore the perceptions and experiences of primary health care users and professionals during the recession in the Lisbon Metropolitan Area.AimsProvide in depth information regarding the specific contexts and subjective experiences of key informants during the economic recession that started in 2008.MethodsThis study design resorts to focus groups with primary health care users and semi-structured interviews with health professionals. All interviews were recorded and transcribed verbatim. Inductive approach and thematic analysis were performed, using NVivo 10.ResultsThis study explores the views and insights of users and health professionals regarding their socio-economic context, mental health needs, changes in health services and possible solutions to alleviate the impact of the economic recession.ConclusionsBeing based on the perspectives of users and health professionals, this approach will complement epidemiological evidence for policy-making.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals Does mental health needs vary as we grow from pediatrics to adults to elderly? Results from a study in Dubai

2017 ◽  
Vol 1 (1) ◽  
pp. 1
Author(s):  
Kadhim Alabady
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Primary Health Care ◽  
Psychiatric Morbidity ◽  
Mental Illnesses ◽  
Health Needs ◽  
Service Development ◽  
Mental Health Needs ◽  
Primary Health ◽  
The Impact

Purpose: To Provide a baseline of the current picture of major mental health challenges among men and women of different ages in Dubai. which can then be used to measure the impact of interventions or service development. Method: In order to carry out the mental health needs assessment we applied qualitative and quantitative methodology. Results: * The prevalence of people who suffer from different types of mental disorders remains largely unknown, many men and are unwilling to seek professional help because of lack of awareness or the stigma attached to it. * According to the Dubai Household Health Survey DHHS (2009) 14.5% of respondents reported moderate to severe depressive symptoms over a 2-week period. * It was predicted in 2014 that there would be 37,933 people suffering from psychotic disorders of which 29,747 were males. * It is estimated there would be 19,117 adults between the ages of 20 and 64 years with ASD in Dubai for 2014. *It was estimated around 548 residents in Dubai aged 60 years or more in 2014 had dementia (of which 338 were men). Recommendations: * Work is required with primary health care in order to identify men with undiagnosed mental illnesses. Further work is undertaken within primary health care to assess disease registries with the aim of helping GP practices to improve their disease registers. * It is important to conduct local psychiatric morbidity surveys in Dubai to obtain data and assess the prevalence of essential mental health symptoms and conditions. * Continuum of care - a significant gap in the services for adults once they diagnosed with mental disorder.)

The Roots of Global Health Inequity

2017 ◽  
Author(s):  
Joia S. Mukherjee
Keyword(s):  
Health Care ◽  
World War Ii ◽  
Primary Health Care ◽  
Economic Policies ◽  
World War ◽  
The Public ◽  
The World Bank ◽  
Primary Health ◽  
The Cold War ◽  
The Impact

This chapter outlines the historical roots of health inequities. It focuses on the African continent, where life expectancy is the shortest and health systems are weakest. The chapter describes the impoverishment of countries by colonial powers, the development of the global human rights framework in the post-World War II era, the impact of the Cold War on African liberation struggles, and the challenges faced by newly liberated African governments to deliver health care through the public sector. The influence of the World Bank and the International Monetary Fund’s neoliberal economic policies is also discussed. The chapter highlights the shift from the aspiration of “health for all” voiced at the Alma Ata Conference on Primary Health Care in 1978, to the more narrowly defined “selective primary health care.” Finally, the chapter explains the challenges inherent in financing health in impoverished countries and how user fees became standard practice.

Disaster Management in Rural and Remote Primary Health Care: A Scoping Review

2021 ◽  
Vol 36 (3) ◽  
pp. 362-369
Author(s):  
Katie A. Willson ◽  
Gerard J. FitzGerald ◽  
David Lim
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Primary Health Care ◽  
Mental Health Care ◽  
Disaster Management ◽  
Scoping Review ◽  
Health Care Professionals ◽  
Disaster Preparedness ◽  
Rural And Remote ◽  
Primary Health

AbstractObjective:This scoping review aims to map the roles of rural and remote primary health care professionals (PHCPs) during disasters.Introduction:Disasters can have catastrophic impacts on society and are broadly classified into natural events, man-made incidents, or a mixture of both. The PHCPs working in rural and remote communities face additional challenges when dealing with disasters and have significant roles during the Prevention, Preparedness, Response, and Recovery (PPRR) stages of disaster management.Methods:A Johanna Briggs Institute (JBI) scoping review methodology was utilized, and the search was conducted over seven electronic databases according to a priori protocol.Results:Forty-one papers were included and sixty-one roles were identified across the four stages of disaster management. The majority of disasters described within the literature were natural events and pandemics. Before a disaster occurs, PHCPs can build individual resilience through education. As recognized and respected leaders within their community, PHCPs are invaluable in assisting with disaster preparedness through being involved in organizations’ planning policies and contributing to natural disaster and pandemic surveillance. Key roles during the response stage include accommodating patient surge, triage, maintaining the health of the remaining population, instituting infection control, and ensuring a team-based approach to mental health care during the disaster. In the aftermath and recovery stage, rural and remote PHCPs provide long-term follow up, assisting patients in accessing post-disaster support including delivery of mental health care.Conclusion:Rural and remote PHCPs play significant roles within their community throughout the continuum of disaster management. As a consequence of their flexible scope of practice, PHCPs are well-placed to be involved during all stages of disaster, from building of community resilience and contributing to early alert of pandemics, to participating in the direct response when a disaster occurs and leading the way to recovery.

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.

scholarly journals Social determinants of depression: association with age, gender and primary health care model

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
J China
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Primary Health Care ◽  
Social Determinants ◽  
Care Physician ◽  
Health Policies ◽  
Age And Gender ◽  
Primary Health ◽  
And Gender ◽  
Primary Health Care Physician

Abstract Background Depression is one of the most common mental disorders worldwide and is a major contributor to the overall global burden of disease. The social determinants of age, gender and access to a primary health care physician have been identified as significant determinants of variability in the prevalence of depression. This research evaluates the association between depression and these social determinants in the city of Almada, in Portugal. Methods This cross-sectional study reports the one-month prevalence (December, 2015) of depression and its association with age, gender and access to a primary health care doctor in Almada's primary health care population. Data was collected from the 'Information System of the Regional Health Administration' (SIARS) database. The diagnostic tools used for the identification of cases were the ICPC-2 codes 'P76: Depressive Disorder' and 'P03: Feeling Depressed'. An odds ratio was applied as an association measure. Results Regarding gender and age: women are more likely to develop depression than men (OR 3.21) and the age group of 40-64 years is more likely to develop depression compared with other age groups (OR 2.21). The odds of being affected by depression for patients with a permanent primary health care physician, compared with users without a permanent primary health care physician, are higher (OR 2.24). Conclusions The patterns of association of age and gender, uncovered in this dataset, are consistent with previously reported findings for other Western countries. The association between depression and the assignment of a permanent primary health care doctor is highly significant. This finding suggests the existence of a higher detection rate of depression in patients with a permanent doctor and adds weight to the need to implement health policies that guarantee a primary health care physician for each patient. Key messages The age and gender gap in depression calls for stronger public health and intersectoral strategies to promote and protect mental health, in community-based settings. Reducing barriers and enhancing access to high-quality primary medical care must be a cornerstone of mental health policies.

scholarly journals Cohort study of ageing from Bagé (SIGa-Bagé), Brazil: profile and methodology

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Elaine Thumé ◽  
Marciane Kessler ◽  
Karla P. Machado ◽  
Bruno P. Nunes ◽  
Pamela M. Volz ◽  
...  
Keyword(s):  
Older Adults ◽  
Health Care ◽  
Cohort Study ◽  
Primary Health Care ◽  
Rio Grande ◽  
Cognitive Testing ◽  
Rio Grande Do Sul ◽  
Primary Health ◽  
The Impact

Abstract Background The Bagé Cohort Study of Ageing is a population-based cohort study that has recently completed the first follow-up of a representative sample of older adults from Bagé, a city with more than 100,000 inhabitants located in the state of Rio Grande do Sul, Brazil. This is one of the first longitudinal studies to assess the impact of primary health care coverage on health conditions and inequalities. Our aim is to investigate the prevalence, incidence and trends of risk factors, health behaviours, social relationships, non-communicable diseases, geriatric diseases and disorders, hospitalisation, self-perceived health, and all-cause and specific-cause mortality. In addition, we aim to evaluate socioeconomic and health inequalities and the impact of primary health care on the outcomes under study. Methods/design The study covers participants aged 60 or over, selected by probabilistic (representative) sampling of the urban area of the city of Bagé, which is covered by Primary Health Care Services. The baseline examination included 1593 older adults and was conducted from July 2008 to November 2008. After eight to nine years (2016/2017), the first follow-up was conducted from September 2016 to August 2017. All participants underwent an extensive core assessment programme including structured interviews, questionnaires, cognitive testing (baseline and follow-up), physical examinations and anthropometric measurements (follow-up). Results Of the original participants, 1395 (87.6%) were located for follow-up: 757 elderly individuals (47.5%) were re-interviewed, but losses in data transfer occurred for 22. The remaining 638 (40.1%) had died. In addition, we had 81 (5.1%) refusals and 117 (7.3%) losses. Among the 1373 older adults who were followed down, there was a higher proportion of female interviewees (p=0.042) and a higher proportion of male deaths (p=0.001) in 2016/2017. There were no differences in losses and refusals according to gender (p=0.102). There was a difference in average age between the interviewees (68.8 years; SD ±6.5) and non-interviewees (73.2 years; SD ±9.0) (p<0.001). Data are available at the Department of Social Medicine in Federal University of Pelotas, Rio Grande do Sul, Brazil, for any collaboration.

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