scholarly journals Mitigating COVID-19 impact on the Portuguese population mental health: the opportunity that lies in Digital Mental Health (Preprint)

2020 ◽  
Author(s):  
Cristina Mendes-Santos ◽  
Gerhard Andersson ◽  
Elisabete Weiderpass ◽  
Rui Santana
Keyword(s):  
Mental Health ◽  
Healthcare Delivery ◽  
Mental Healthcare ◽  
Intervention Strategies ◽  
Mitigation Measures ◽  
Equitable Access ◽  
Portuguese Population ◽  
Research Education ◽  
Health Strategy ◽  
Population Mental Health

UNSTRUCTURED COVID-19 mitigation measures present unprecedent challenges in mental healthcare delivery, posing high risk to the mental health of populations. Ensuring safe and equitable access to mental healthcare requires resorting to innovative psychosocial intervention strategies such as, Digital Mental Health. In this perspective piece, we discuss how timely implementation of a comprehensive Digital Mental Health strategy, coupling research, education, implementation and quality assessment initiatives, might strengthen the Portuguese mental healthcare system and, therefore, buffer COVID-19´s impact on the Portuguese society.

scholarly journals Psychosocial Risk Factors and Other Than Honorable Military Discharge: Providing Healthcare to Previously Ineligible Veterans

2018 ◽  
Vol 183 (9-10) ◽  
pp. e532-e538 ◽  
Author(s):  
Eric B Elbogen ◽  
H Ryan Wagner ◽  
Mira Brancu ◽  
Nathan A Kimbrel ◽  
Jennifer C Naylor ◽  
...  
Keyword(s):  
Risk Factors ◽  
Sleep Problems ◽  
Healthcare Delivery ◽  
Mental Healthcare ◽  
Drug Misuse ◽  
Social Characteristics ◽  
Research Education ◽  
Military Discharge ◽  
History Of ◽  
Potential Factors

Abstract Introduction In response to a strong focus on suicide prevention for all veterans, the Department of Veterans Affairs (VA) recently revised policy to provide emergency mental healthcare for veterans who received Other Than Honorable (OTH) discharges from the military. This current study takes a preliminary step toward identifying demographic, historic, military, clinical, and social characteristics of veterans with OTH discharges. Materials and Methods N = 1,172 Iraq/Afghanistan-era veterans were evaluated between 2005 and 2016 in the multi-site VA Mid-Atlantic Mental Illness, Research, Education and Clinical Center (MIRECC) Study of Post-Deployment Mental Health (PDMH Study). Results Veterans with OTH discharges constituted 2.7% of our sample, approximating the estimated rate in the overall U.S. veteran population. Compared to veterans discharged under honorable conditions, veterans with OTH discharges were more likely to be younger and have greater odds of reporting family history of drug abuse and depression. Further, veterans with OTH discharges reported a lower level of social support and were more likely to be single, endorse more sleep problems, score higher on measures of drug misuse, have a history of incarceration, and meet diagnostic criteria for major depressive disorder. A subsequent matching analysis provided further evidence of the association between OTH discharge and two risk factors: drug misuse and incarceration. Conclusion These findings elucidate potential factors associated with veterans with OTH discharges, particularly substance abuse and criminal justice involvement. Results also indicate higher incidence of risk factors that often accompany suicidal ideation and should be a highlighted component of healthcare delivery to this vulnerable cohort of veterans.

scholarly journals Efforts and Challenges to Ensure Continuity of Mental Healthcare Service Delivery in a Low Resource Settings During COVID-19 Pandemic—A Case of a Kenyan Referral Hospital

2021 ◽  
Vol 11 ◽  
Author(s):  
Edith Kwobah ◽  
Florence Jaguga ◽  
Kiptoo Robert ◽  
Elias Ndolo ◽  
Jane Kariuki
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Health Care ◽  
Service Delivery ◽  
Mental Health Care ◽  
Healthcare Service ◽  
Healthcare Delivery ◽  
Mental Healthcare ◽  
Referral Hospital ◽  
Number Of Patients

The rising number of patients with Covid-19 as well as the infection control measures have affected healthcare service delivery, including mental healthcare. Mental healthcare delivery in low and middle income countries where resources were already limited are likely to be affected more during this pandemic. This paper describes the efforts of ensuring mental healthcare delivery is continued in a referral hospital in Kenya, Moi Teaching and Referral hospital, as well as the challenges faced. These efforts are guided by the interim guidelines developed by the Kenyan ministry of health. Some of the adjustments described includes reducing number of patients admitted, shortening the stay in the inpatient setting, using outdoors for therapy to promote physical distancing, utilization of electronic platforms for family therapy sessions, strengthening outpatient services, and supporting primary care workers to deliver mental health care services. Some of the challenges include limited ability to move about, declining ability for patients to pay out of pocket due to the economic challenges brought about by measures to control Covid-19, limited drug supplies in primary care facilities, inability to fully implement telehealth due to connectivity issues and stigma for mental health which results in poor social support for the mentally ill patients. It is clear that current pandemic has jeopardized the continuity of usual mental healthcare in many settings. This has brought to sharp focus the need to decentralize mental health care and promote community based services. Meanwhile, there is need to explore feasible alternatives to ensure continuity of care.

scholarly journals Mental health services in Cambodia: an overview

2019 ◽  
Vol 17 (2) ◽  
pp. 29-31
Author(s):  
Sarah J. Parry ◽  
Ewan Wilkinson
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Rapid Growth ◽  
Urban Areas ◽  
Mental Healthcare ◽  
Mental Health Training ◽  
Health Strategy ◽  
Professional Mental Health ◽  
National Mental Health

Mental health services in Cambodia required rebuilding in their entirety after their destruction during conflict in the 1970s. During the late 1990s there was rapid growth and development of professional mental health training and education. Currently, basic mental healthcare is available primarily in urban areas and is provided by a mixture of government, non-government and private services. Despite the initial rapid growth of services and the development of a national mental health strategy in 2010, significant challenges remain in achieving an acceptable, standardised level of mental healthcare nationally.

scholarly journals The global impact on mental health almost 2 years into the COVID-19 pandemic

2021 ◽  
Vol 38 (4) ◽  
pp. 243-246
Author(s):  
Blanaid Gavin ◽  
John Lyne ◽  
Fiona McNicholas
Keyword(s):  
Mental Health ◽  
Health Research ◽  
Mental Healthcare ◽  
Mental Health Research ◽  
Health Needs ◽  
Mental Health Needs ◽  
Global Impact ◽  
Global Pandemic ◽  
Population Mental Health ◽  
Global Population

AbstractApproaching 2 years into a global pandemic, it is timely to reflect on how COVID-19 has impacted the mental health of the global population. With research continuing apace, a clearer picture should crystallise in time. COVID-19 has undoubtedly had some impact on population mental health, although the severity and duration of this impact remain less clear. The exceptional period of COVID-19 has provided a unique prism through which we can observe and consider societal mental health. This is a momentous time to be involved in mental health research as we strive to understand the mental health needs of the population and advocate for adequate resourcing to deliver quality mental healthcare in the post-pandemic period.

scholarly journals ‘Fair Horizons’: a person-centred, non-discriminatory model of mental healthcare delivery

2012 ◽  
Vol 36 (1) ◽  
pp. 25-30 ◽  
Author(s):  
Chris Fear ◽  
Mark Scheepers ◽  
Martin Ansell ◽  
Rosemary Richards ◽  
Paul Winterbottom
Keyword(s):  
Mental Health ◽  
Healthcare Delivery ◽  
Mental Healthcare ◽  
Major Change ◽  
Access Point ◽  
Clinical Implications ◽  
Service Access ◽  
Similar Model ◽  
Intellectual Function ◽  
Local Politicians

Aims and methodService access is currently determined primarily by age and intellectual function and, unwittingly, is discriminatory. Our aim is to develop a novel, person-centred, non-discriminatory model of mental healthcare delivery. We sought the views of people who use services, carers, commissioners and local politicians.ResultsThe model represents a major change programme that commenced in September 2011.Clinical implicationsBy integrating specialist mental health services, with a single access point, and mapping of care to the person's needs, rather than their circumstances we hope to have developed a greatly improved and fairer service. A similar model could be adopted in other locations nationally.

UK health policy in relation to mentally disordered offenders in the community

2017 ◽  
Author(s):  
Jane Senior ◽  
Adrian Hayes ◽  
Jenny Shaw
Keyword(s):  
Mental Health ◽  
Criminal Justice ◽  
Criminal Justice System ◽  
Mental Health Treatment ◽  
Justice System ◽  
Healthcare Delivery ◽  
Mental Healthcare ◽  
Mentally Disordered Offenders ◽  
Mentally Disordered ◽  
Point Of Entry

The majority of mentally disordered offenders are never treated within forensic mental health services. Instead, they remain within the criminal justice system, where care and treatment for complex and co-morbid mental health, substance-misuse, and personality disorder issues remain secondary to justice and punishment. In this chapter, we explore the policy, practice, and legislative drivers influencing healthcare delivery throughout the criminal justice pathway. Firstly, we consider the current liaison and diversion programme in England, which aims to identify people with mental health issues at the point of entry into the criminal justice system. Secondly, we review the state of mental healthcare in prisons, a quarter of a century after the clinical improvement partnership between the National Health Service and HM Prison Service. Thirdly, we discuss issues around court mandated mental health treatment in the community. Finally, we consider initiatives designed to meet the discrete needs of offenders with personality disorders.

scholarly journals Building the digital mental health ecosystem: opportunities and challenges for innovators (Preprint)

2021 ◽  
Author(s):  
Benedetta Spadaro ◽  
Nayra Anna Martin-Key ◽  
Sabine Bahn
Keyword(s):  
Mental Health ◽  
Clinical Practice ◽  
Care Pathway ◽  
Digital Health ◽  
Healthcare Delivery ◽  
Mental Healthcare ◽  
Digital Tools ◽  
Middle Income ◽  
Digital Ecosystem ◽  
Regulatory Flexibility

UNSTRUCTURED Digital mental health holds promise in tackling the growing demand for psychotherapeutic services. However, existing digital approaches are rarely integrated in clinical practice and rely on patients’ ability to self-diagnose and seek support. Digital health innovators are presented with opportunities and challenges to create an integrated digital ecosystem for mental healthcare. The uptake of digital tools depends on efficacy and engagement of end-users. To this aim, behavior theories offer the opportunity to identify behavioral drivers and address barriers to uptake. The agenda for innovators also includes building strong evidence-based cases for digital mental health, moving away from a one-size-fits-all wellbeing approach, to embrace the development of comprehensive digital diagnostics and validated digital tools. Innovators have the opportunity to make their clinical evaluation more insightful by assessing effectiveness and feasibility in the intended context of use with hybrid pragmatic trials. The COVID-19 pandemic has prompted regulatory flexibility and increased implementation of digital mental health, however equitable access remains a challenge, particularly in low- and middle-income countries, and the mental health gap is still present and increasing. A joint effort by digital health developers and providers is required to enable individuals to access care through digital technologies in communities where mental health services may be otherwise scarce. Shifting from the practice of designing for to designing with users will enhance traditional healthcare delivery and connect more patients to the appropriate care pathway. By laying these foundations, digital services can become integrated in clinical practice and set the scene for deeper technology-enabled changes.

scholarly journals Lifestyle coaching for mental health difficulties: scoping review

2018 ◽  
Vol 17 (1) ◽  
pp. 29-44 ◽  
Author(s):  
Lauren Bishop ◽  
Ann Hemingway ◽  
Sara Ashencaen Crabtree
Keyword(s):  
Mental Health ◽  
Scoping Review ◽  
Mental Healthcare ◽  
Cost Effective ◽  
Evidence Base ◽  
Research Literature ◽  
Self Management ◽  
Content Type ◽  
Psychological Therapies ◽  
Health Strategy

Purpose UK mental health strategy calls for interventions that empower people to self-manage their condition. In lifestyle coaching, coach and client work collaboratively on positive behaviour change to improve client health. There is debate about the appropriateness of coaching for mental health, yet claims have not been supported with evidence. Therefore, the purpose of this paper is to explore the nature and scope of the existing research literature in this field. Design/methodology/approach Scoping review. Findings The growing evidence base shows positive outcomes of coaching; for instance, symptom reduction, enhanced self-management and achievement of personal goals. Research limitations/implications The evidence base is small and of variable quality, offering insights that warrant further exploration. Practical implications Coaching not only supports better self-management but also addresses further mental health strategy priorities (such as improved physical health and social functioning). Coaches need not be mental health experts; therefore coaching may be a cost-effective intervention. Social implications As mental ill-health prevalence continues to rise despite widespread use of Improving Access to Psychological Therapies and medication, there is a need to explore how novel approaches such as coaching might be integrated into mental healthcare. Originality/value This is the first study to collate the evidence on mental health coaching, highlighting its extensive potential, which should be further explored in research and practice.

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