scholarly journals Implementing Web-Based Therapy in Routine Mental Health Care: Systematic Review of Health Professionals’ Perspectives (Preprint)

2019 ◽  
Author(s):  
Fiona Davies ◽  
Heather L Shepherd ◽  
Lisa Beatty ◽  
Brodie Clark ◽  
Phyllis Butow ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mixed Methods ◽  
Mental Health Care ◽  
Organizational Support ◽  
Health Professionals ◽  
Psychological Treatment ◽  
Cochrane Library ◽  
Great Promise ◽  
Web Based

BACKGROUND Web-based therapies hold great promise to increase accessibility and reduce costs of delivering mental health care; however, uptake in routine settings has been low. OBJECTIVE Our objective in this review was to summarize what is known about health care professionals’ perceptions of the barriers to and facilitators of the implementation of web-based psychological treatments in routine care of adults in health care settings. METHODS We searched 5 major databases (MEDLINE, EMBASE, PsycINFO, CINAHL, and the Cochrane Library) for qualitative, quantitative, or mixed-methods studies exploring health professionals’ views on computer- or internet-based psychological treatment programs. We coded included articles for risk of bias and extracted data using a prepiloted extraction sheet. RESULTS We identified 29 eligible articles: 14 qualitative, 11 quantitative, and 4 mixed methods. We identified the following themes: patient factors, health professional factors, the therapeutic relationship, therapy factors, organizational and system factors, and models of care. Health professionals supported web-based therapies only for patients with relatively straightforward, low-risk diagnoses, strong motivation and engagement, high computer literacy and access, and low need for tailored content. They perceived flexibility with timing and location as advantages of web-based therapy, but preferred blended therapy to facilitate rapport and allow active monitoring and follow-up of patients. They emphasized the need for targeted training and organizational support to manage changed workflows. Health professionals were concerned about the confidentiality and security of client data for web-based programs, suggesting that clear and transparent protocols need to be in place to reassure health professionals before they will be willing to refer. CONCLUSIONS Without health professionals’ support, many people will not access web-based therapies. To increase uptake, it is important to ensure that health professionals receive education, familiarization, and training to support them in incorporating web-based therapies into their practice, and to design systems that support health professionals in this new way of working with patients and addressing their concerns. CLINICALTRIAL PROSPERO CRD42018100869; https://tinyurl.com/y5vaoqsk

scholarly journals Implementing Web-Based Therapy in Routine Mental Health Care: Systematic Review of Health Professionals’ Perspectives

10.2196/17362 ◽  
2020 ◽  
Vol 22 (7) ◽  
pp. e17362
Author(s):  
Fiona Davies ◽  
Heather L Shepherd ◽  
Lisa Beatty ◽  
Brodie Clark ◽  
Phyllis Butow ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mixed Methods ◽  
Mental Health Care ◽  
Organizational Support ◽  
Health Professionals ◽  
Psychological Treatment ◽  
Cochrane Library ◽  
Great Promise ◽  
Web Based

Background Web-based therapies hold great promise to increase accessibility and reduce costs of delivering mental health care; however, uptake in routine settings has been low. Objective Our objective in this review was to summarize what is known about health care professionals’ perceptions of the barriers to and facilitators of the implementation of web-based psychological treatments in routine care of adults in health care settings. Methods We searched 5 major databases (MEDLINE, EMBASE, PsycINFO, CINAHL, and the Cochrane Library) for qualitative, quantitative, or mixed-methods studies exploring health professionals’ views on computer- or internet-based psychological treatment programs. We coded included articles for risk of bias and extracted data using a prepiloted extraction sheet. Results We identified 29 eligible articles: 14 qualitative, 11 quantitative, and 4 mixed methods. We identified the following themes: patient factors, health professional factors, the therapeutic relationship, therapy factors, organizational and system factors, and models of care. Health professionals supported web-based therapies only for patients with relatively straightforward, low-risk diagnoses, strong motivation and engagement, high computer literacy and access, and low need for tailored content. They perceived flexibility with timing and location as advantages of web-based therapy, but preferred blended therapy to facilitate rapport and allow active monitoring and follow-up of patients. They emphasized the need for targeted training and organizational support to manage changed workflows. Health professionals were concerned about the confidentiality and security of client data for web-based programs, suggesting that clear and transparent protocols need to be in place to reassure health professionals before they will be willing to refer. Conclusions Without health professionals’ support, many people will not access web-based therapies. To increase uptake, it is important to ensure that health professionals receive education, familiarization, and training to support them in incorporating web-based therapies into their practice, and to design systems that support health professionals in this new way of working with patients and addressing their concerns. Trial Registration PROSPERO CRD42018100869; https://tinyurl.com/y5vaoqsk

Yoga and mindfulness for anxiety and depression and the role of mental health professionals: a literature review

2017 ◽  
Vol 12 (1) ◽  
pp. 44-54 ◽  
Author(s):  
Nicole Butterfield ◽  
Tim Schultz ◽  
Philippa Rasmussen ◽  
Michael Proeve
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Mental Health Professionals ◽  
Health Professionals ◽  
Nursing Practice ◽  
Cochrane Library ◽  
Anxiety And Depression ◽  
Content Type

Purpose The purpose of this paper is to examine the role of yoga in the management of anxiety and depression, development of mindfulness and self-compassion and implications for mental health care delivery and mental health professionals, with a specific focus on nursing practice. Design/methodology/approach A search of electronic databases Scopus, CINAHL, EMBASE, Medline and Cochrane Library was undertaken. Findings There is growing research evidence supporting the use of yoga as an adjunct or combination therapy for the management of stress, anxiety and depression. Mindfulness has been indicated as a potential mechanism of change but needs further research. Health care professionals may play an important role in supporting consumers to engage in yoga as part of their mental health care. Research limitations/implications Yoga research to date has been limited by methodological weaknesses including wide variation of yoga practices, styles and teaching methods; difficulties in double-blinding, suitable placebo-control; lack of randomised controlled trials and small sample sizes. The literature highlights that more high-quality yoga and mental health research is needed. Practical implications The paper introduces the potential role of yoga for anxiety and depression in the health care system and the role of mental health professionals in implementing and promoting holistic yoga-based therapies. Originality/value This paper proposes a yoga model for mental health and provides insight into a proposed new direction for future mental health care and the role of nursing practice and other mental health professionals.

scholarly journals Health professionals' views of services for schizophrenia – fragmentation and inequality

2000 ◽  
Vol 24 (2) ◽  
pp. 47-50 ◽  
Author(s):  
Peter Haddad ◽  
Martin Knapp
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Great Britain ◽  
Mental Health Care ◽  
Inner City ◽  
Health Professionals ◽  
Psychiatric Nurses ◽  
Mental Health Care System ◽  
Educational Grant ◽  
Community Psychiatric

There has been much debate about effective treatments, service configurations and costs within Britain's mental health care system, but it has largely taken place in academic and management circles. We were interested in the views of those providing care. We organised a meeting of community psychiatric nurses, general practitioners and consultant psychiatrists (funded with an educational grant from Zeneca Pharmaceuticals). Participants worked in various parts of Great Britain, including rural and inner city areas. The authors facilitated the discussion, the emphasis of which was on participants' clinical experience.

scholarly journals Shaping Blended Care: Adapting an Instrument to Support Therapists in Using eMental Health

10.2196/24245 ◽  
2020 ◽  
Vol 7 (11) ◽  
pp. e24245
Author(s):  
Hanneke Kip ◽  
Jobke Wentzel ◽  
Saskia M Kelders
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Focus Groups ◽  
Phase 1 ◽  
Participatory Development ◽  
Project Team ◽  
Related Factors ◽  
Web Based ◽  
Blended Care

Background Although eMental health interventions, especially when delivered in a blended way, have great potential to improve the quality and efficiency of mental health care, their use in practice lags behind expectations. The Fit for Blended Care (FfBC) instrument was developed to support therapists and clients in shaping blended care in a way that optimally fits their needs. However, this existing version cannot be directly applied to specific branches of mental health care as it is too broad and generic. Objective The goal of this study is to adapt the existing FfBC instrument to fit a specific, complex setting—forensic mental health care—by means of participatory development with therapists. Methods The participatory process was divided into 4 phases and was executed by a project team consisting of 1 manager, 3-5 therapists, and 1 researcher. In phase 1, general requirements for the adaptation of the existing instrument were discussed in 2 focus groups with the project team. In phase 2, patient-related factors that influence the use of an existing web-based intervention were elicited through semistructured interviews with all 18 therapists working at an outpatient clinic. In phase 3, multiple focus groups with the project teams were held to create the first version of the adapted FfBC instrument. In phase 4, a digital prototype of the instrument was used with 8 patients, and the experiences of the 4 therapists were discussed in a focus group. Results In phase 1, it became clear that the therapists’ main requirement was to develop a much shorter instrument with a few items, in which the content was specifically tailored to the characteristics of forensic psychiatric outpatients. The interviews showed a broad range of patient-related factors, of which 5 were used in the instrument: motivation for blended treatment; writing about thoughts, feelings, and behavior; conscientiousness; psychosocial problems; and social support. In addition, a part of the instrument was focused on the practical necessary preconditions that patients should fill by themselves before the treatment was developed. The use of the web-based prototype of the instrument in treatment resulted in overall positive experiences with the content; however, therapists indicated that the items should be formulated in a more patient-centered way to encourage their involvement in discussing the factors. Conclusions The participatory, iterative process of this study resulted in an adapted version of the FfBC instrument that fits the specific forensic context and supports shared decision making. In general, the adaptiveness of the instrument is important: its content and implementation should fit the type of care, the organization, and eHealth intervention. To adapt the instrument to other contexts, the guidelines described in this paper can be followed.

scholarly journals Mental health in primary health care: professionals’ perceptions and patients’ levels of depression, anxiety and stress

2020 ◽  
Vol 3 (1) ◽  
Author(s):  
Tatiana Varela Madureira ◽  
Maria Cristina Quintas Antunes
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Primary Health Care ◽  
Health Services ◽  
Mental Health Care ◽  
Health Professionals ◽  
Mental Health Problems ◽  
Anxiety And Depression ◽  
Self Administration ◽  
Primary Health

Background: The integration of mental health in primary health care, throughout its various functional units and with effective articulation between primary health care and mental health services, has been considered an essential objective of the legislative documents produced in the last three decades in Portugal, among them the National Health Plan 2011-2016.Goals: This study aimed to inquire health professionals’ perceptions about mental health care provided by public primary health care units, namely their perceptions about the mental health of their patients. It also intended to explore the difficulties perceived by the health professionals in their daily activity about the mental health problems of their patients and about the need of clinical psychologists’ activity in the public primary health care.Methods: This is an observational cross-sectional study with two non-probabilistic samples: health professionals (doctors, nurses and psychologists) and patients from two public health care units. Health professionals were interviewed (individual structured face-to-face interviews) about their perceptions of needs for improving their capacity to provide mental healthcare and about patients’ mental health conditions. Patients responded (by self-administration) to the Depression, Anxiety and Stress Scale (DASS-21), providing a characterization of patients’ stress, anxiety and symptoms of depression.Results: Health professionals in their daily practice often identify in their patients symptoms of stress, anxiety and depression (most particularly in adults),. Several issues were identified as problematic, such as: poor access of the referral system for psychiatric and clinical psychological specialized care, insufficient number of health professionals, particularly of psychologists, and lack of appropriate mental health care specialization. The results also revealed relevant levels of stress, anxiety and depression in primary health care patients (both genders), which seem to increase with age. Discussion: Difficulties identified by health professionals may relate to the centralisation of resources, resistance to change from human resources management, lack of consensus among the various decision groups linked to mental health and, at institutional level, insufficient and inadequate funding. These factors may contribute to a failure in early diagnosis of symptoms of depression, anxiety and stress. It is expected that articulation between primary health services and differentiated health services will improve, with improvement in teamwork among professionals and increase of the quality of life of users, satisfaction with work, from health professionals,  and reduction of health costs.

Mental health services for individuals at risk of suicide in Peru: Attitudes and perspectives of mental health professionals

2020 ◽  
pp. 002076402094678
Author(s):  
Dana Alonzo ◽  
Dafne Aida Zapata Pratto
Keyword(s):  
Mental Health ◽  
Health Care ◽  
At Risk ◽  
Mental Health Care ◽  
Health Care System ◽  
Mental Health Professionals ◽  
Health Professionals ◽  
Specialized Training ◽  
Mental Health Care System ◽  
Care System

Background: Mental Health professionals often have to deal with at-risk individuals in crises and lack specialized training on suicide risk assessment and intervention. This study examined mental health professionals’ attitudes toward at-risk individuals and their perceptions of the quality of training and treatment available for assessing and intervening with this population. Methods: A total of 32 mental health professionals (13 psychiatrists, 16 psychologists, 2 psychiatric nurses; 1 social assistant) from highly vulnerable communities in Lima, Peru discussed their perceptions in four focus groups conducted by the authors. Results: Participants reported glaring deficiencies in all areas explored including training, knowledge and skills regarding suicide assessment and management. In addition, using ground theory analysis, three domains of findings emerged representing barriers and facilitators of treatment engagement, risk and protective factors of suicide and pros and cons of the current mental health care system including micro-, mezzo- and macro-level factors. The most frequently identified barrier was the perception that suicide is illegal; facilitator was family involvement; risk factor was poor parenting; protective factor was religious beliefs; pro of mental health care system was establishment of community-based services and con of mental health care system was lack of access to psychiatrists. Conclusion: The lack of specialized training available in the institutions that are designed to prepare mental health professionals for working with at-risk individuals is notable and has a direct and known impact self-identified by helping professionals. The need and desire for targeted training is palpable and essential to address growing rates of suicide, particularly among youth, in Peru.

scholarly journals Data Handling for E-Mental Health Professionals

2020 ◽  
Vol 42 (5_suppl) ◽  
pp. 85S-91S
Author(s):  
Sandeep Grover ◽  
Siddharth Sarkar ◽  
Rahul Gupta
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Data Storage ◽  
Mental Health Professionals ◽  
Health Professionals ◽  
Fair Use ◽  
Digital Data ◽  
Data Handling ◽  
Health Care Data

Digital psychiatry and e-mental health have proliferated and permeated vastly in the current landscape of mental health care provision. The COVID-19 crisis has accelerated this digital transformation, and changes that usually take many years to translate into clinical practice have been implemented in a matter of weeks. These have outpaced the checks and balances that would typically accompany such changes, which has brought into focus a need to have a proper approach for digital data handling. Health care data is sensitive, and is prone to hacking due to the lack of stringent protocols regarding its storage and access. Mental health care data need to be more secure due to the stigma associated with having a mental health condition. Thus, there is a need to emphasize proper data handling by mental health professionals, and policies to ensure safeguarding patient’s privacy are required. The aim of useful, free, and fair use of mental health care data for clinical, business, and research purposes should be balanced with the need to ensure the data is accessible to only those who are authorized. Systems and policies should be in place to ensure that data storage, access, and disposal are systematic and conform to data safety norms.

scholarly journals Spirituality and Mental Health Care in a Religiously Homogeneous Country: Definitions, Opinions, and Practices Among Polish Mental Health Professionals

2019 ◽  
Vol 59 (1) ◽  
pp. 113-134 ◽  
Author(s):  
Edyta Charzyńska ◽  
Irena Heszen-Celińska
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Mental Health Professionals ◽  
Health Professionals ◽  
Specific Context ◽  
Spirituality In Therapy ◽  
Definition Of ◽  
Insufficient Knowledge ◽  
Human Characteristic

Abstract This qualitative study involved a sample of 121 Polish mental health professionals who were interviewed about their definitions of spirituality and their opinions and practices concerning the inclusion of clients’ spirituality in therapy. Using inductive content analysis, we identified seven categories regarding the definitions of spirituality: (1) relationship, (2) transcendence, (3) dimension of functioning, (4) a specific human characteristic, (5) searching for the meaning of life, (6) value-based lifestyle, and (7) elusiveness and indefinability. The majority of respondents claimed to include elements of spirituality in therapy. However, some participants included spirituality only under certain circumstances or conditions, or did not include it at all, citing lack of need, lack of a clear definition of spirituality, their own insufficient knowledge, lack of experience, fear, or concern over ethical inappropriateness. Implicit techniques were primarily used when working on clients’ spirituality. This article deepens the knowledge on including spirituality in mental health care, with special consideration for a specific context of a highly religious and religiously homogenous culture.

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