scholarly journals Examining Access to Psychiatric Care in Michigan’s Upper Peninsula

PRiMER ◽  
2021 ◽  
Vol 5 ◽  
Author(s):  
Jenna Bernson ◽  
Peter Hedderich ◽  
Andrea L. Wendling
Keyword(s):  
Mental Health ◽  
Bipolar Disorder ◽  
Substance Use ◽  
High Risk ◽  
Mental Health Services ◽  
Health Services ◽  
Health Resources ◽  
Care Physician ◽  
Upper Peninsula ◽  
Health Service Provision

Introduction: There is a shortage of mental health services in rural America, and little research is focused on rural underserved communities. Our aim was to identify and map clinical mental health services located in the Upper Peninsula of Michigan (UP) and explore primary care physician (PCP) mental health service provision and barriers to access experienced by this population. Methods: We mapped clinically active psychiatrists and inpatient psychiatric units in the UP, and identified high-risk regions based on >30 mile distance to ambulatory services or low inpatient bed to population ratio. We surveyed PCPs in identified high-risk areas regarding provision of mental health services, comfort with providing services, and perceived barriers to care. Results: Half of UP counties had no psychiatrists, and only two counties had inpatient psychiatric beds. PCPs are attempting to fill gaps in care, and report comfort with treating depression and anxiety, but less comfort with treating with bipolar disorder and substance use. Nearly all PCPs report barriers to accessing mental health resources; 70% report no psychiatrists to whom they can readily refer. Conclusion: Michigan’s UP has a shortage of mental health resources. Proposed strategies to confront this shortage include additional training of PCPs for substance use and bipolar disorder, bolstering the mental health workforce, and improving access to consultative services.

School Settings

2018 ◽  
Author(s):  
Melissa K. Holt ◽  
Jennifer Greif Green ◽  
Javier Guzman
Keyword(s):  
Mental Health ◽  
Mental Health Service ◽  
Mental Health Services ◽  
Health Service ◽  
Health Services ◽  
Service Provision ◽  
Community Mental Health Service ◽  
Health Service Provision ◽  
School Settings ◽  
Mental Health Service Provision

Schools are a primary setting for mental health service provision to youth and are also main sources of referral to community mental health service providers. This chapter examines the school context and its key role in the child and adolescent mental health services system. The chapter first provides information about the association of emotional and behavioral disorders with school experiences, including academic performance. Next, the chapter presents a framework for mental health service provision and assessment in schools, including describing methods for identifying students who might need mental health services and tracking their progress. Further, several evidence-based interventions are highlighted as examples of effective practices in schools. The chapter concludes with recommendations for clinical practice in school settings.

scholarly journals Implementing a digital health model of care in Australian youth mental health services: protocol for impact evaluation

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Sarah Piper ◽  
Tracey A. Davenport ◽  
Haley LaMonica ◽  
Antonia Ottavio ◽  
Frank Iorfino ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Impact Evaluation ◽  
Digital Health ◽  
Youth Mental Health ◽  
Model Of Care ◽  
Health Service Provision ◽  
Industrial Grade ◽  
The Impact

Abstract Background The World Economic Forum has recently highlighted substantial problems in mental health service provision and called for the rapid deployment of smarter, digitally-enhanced health services as a means to facilitate effective care coordination and address issues of demand. In mental health, the biggest enabler of digital solutions is the implementation of an effective model of care that is facilitated by integrated health information technologies (HITs); the latter ensuring the solution is easily accessible, scalable and sustainable. The University of Sydney’s Brain and Mind Centre (BMC) has developed an innovative digital health solution – delivered through the Youth Mental Health and Technology Program – which incorporates two components: 1) a highly personalised and measurement-based (data-driven) model of youth mental health care; and 2) an industrial grade HIT registered on the Australian Register of Therapeutic Goods. This paper describes a research protocol to evaluate the impact of implementing the BMC’s digital health solution into youth mental health services (i.e. headspace - a highly accessible, youth-friendly integrated service that responds to the mental health, physical health, alcohol or other substance use, and vocational concerns of young people aged 12 to 25 years) within urban and regional areas of Australia. Methods The digital health solution will be implemented into participating headspace centres using a naturalistic research design. Quantitative and qualitative data will be collected from headspace health professionals, service managers and administrators, as well as from lead agency and local Primary Health Network (PHN) staff, via service audits, Implementation Officer logs, online surveys, and semi-structured interviews, at baseline and then three-monthly intervals over the course of 12 months. Discussion At the time of publication, six headspace centres had been recruited to this study and had commenced implementation and impact evaluation. The first results are expected to be submitted for publication in 2021. This study will focus on the impact of implementing a digital health solution at both a service and staff level, and will evaluate digital readiness of service and staff adoption; quality, usability and acceptability of the solution by staff; staff self-reported clinical competency; overall impact on headspace centres as well as their lead agencies and local PHNs; and social return on investment.

scholarly journals Experiences of men with psychosis participating in a community-based football programme

2017 ◽  
Vol 45 (2) ◽  
pp. 100-111 ◽  
Author(s):  
Laura Moloney ◽  
Daniela Rohde
Keyword(s):  
Mental Health ◽  
Physical Activity ◽  
Mental Health Services ◽  
Health Services ◽  
Occupational Therapy ◽  
Positive Impact ◽  
Physical And Mental Health ◽  
Community Based ◽  
Health Service Provision ◽  
Content Type

Purpose Physical activity is associated with both physical and mental health benefits for people with psychosis. However, mental health services have been criticised for failing to adequately promote physical activities. Occupational Therapy, with its focus on meaningful everyday occupations, is well placed to incorporate physical activity interventions. The purpose of this study was to explore the experiences of men with psychosis participating in an Irish community-based football programme. Design/methodology/approach Six men with psychosis participated in qualitative interviews. The interviews were audio-recorded and transcribed verbatim. Interview data were analysed thematically. Findings Participants identified many benefits of engaging in the programme. Football became a valued part of weekly routines and fostered re-engagement with previously valued roles. Participants identified improvements in social confidence and motor and process skills, as well as a positive impact on their mental and physical health. Originality/value This study highlights the value and meaning of participation in football for men with psychosis, as well as demonstrating the longer-term feasibility of football as a therapeutic medium in Occupational Therapy mental health service provision. Findings could help to promote the routine use of sports interventions to mental health services.

scholarly journals Demystifying the pathway of assessment and treatment for bipolar disorder – utilising co-production and algorithms to personalise the approach

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S150-S150
Author(s):  
Jessica Nicholls-Mindlin ◽  
Digby Quested ◽  
Matthew Taylor ◽  
Lauren Fuzi ◽  
David Gee
Keyword(s):  
Mental Health ◽  
Bipolar Disorder ◽  
Mental Health Services ◽  
Health Services ◽  
Public Involvement ◽  
Psychological Intervention ◽  
Patient And Public Involvement ◽  
Service Development ◽  
Post Discharge ◽  
Nice Guideline

AimsTo develop an evidence based, patient centred treatment pathway for people experiencing symptoms of bipolar disorder (BD), modifiable to include local resources.MethodThis project was developed in line with current approaches to service development such as coproduction, with patient and public involvement (PPI) and enhancing personalisation of treatment in medicine. As part of a local initiative, a multi-disciplinary team was brought together to understand and analyse the current local pathway for those affected by BD. It was found that the approach to assessment and management was not consistent between locality teams. Two experts by experience who have a diagnosis of BD were invited to become involved with the development of the pathway. Meetings were set up to enable coproduction and elicit information from those with the diagnosis. The responses provided insight into the effectiveness of different approaches used nationally to inform the methods and resources that are most helpful and appropriate to comprehensively support those with the illness.NICE guideline evidence was used to create two algorithms to streamline the care of those with BD in both primary and secondary care. These algorithms include pharmacological, psychological and social approaches. It also considers the junctions at which referrals should be made and the criteria on which decisions are based.ResultOne algorithm was designed for use in primary care and will be distributed to local GPs to clarify the initial steps for assessment and management of BD and the criteria for referral. A second decision tree will be made available to all doctors working in mental health services with detailed medication options, when they are appropriate and whether additional psychological intervention should be considered e.g. post-discharge groups. Other specialist options such as Early Intervention for Psychosis and Perinatal Mental Health Services were also included. An information pack was created to be offered to all those with a diagnosis or possible diagnosis of BD. This contains useful resources such as skills and exercises that patients may find of benefit, external resources and websites regarding additional support and further information on BD, its nature and management.ConclusionThe approach and resources collated here will help to streamline the management of those with bipolar disorder whilst also ensuring a more consistent approach. The involvement of experts by experience and the incorporation of NICE guidelines ensures a well-rounded and comprehensive set of documents that will be helpful to both clinicians and patients.

The Needs of Women Users of Mental Health Services and their Families

2017 ◽  
Vol 41 (S1) ◽  
pp. S8-S9
Author(s):  
M. Amering
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Interpersonal Violence ◽  
Health Resources ◽  
Perinatal Period ◽  
Mental Health Stigma ◽  
Persons With Disabilities ◽  
Women And Girls ◽  
Gender Specific

AimUnderstand the needs of women users of mental health services and their families and discuss consequences.MethodNon-systematic review of concepts and data regarding the needs of women users of mental health services and their families.Resultsnequity and inefficiency of mental health resources affect men and women all around the globe. Some important mental health needs as well as barriers to care are gender-specific. Women have specific needs in specific phases of life, e.g. the perinatal period, as well as specific risk factors, e.g. interpersonal violence and sexual abuse. Developments of women only services as well as the implementation of gender-specific approaches in routine care are underway and need to be evaluated, amended and expanded. Training as well as research requirements are numerous and urgent. Family carers are an essential mental health resource. A majority is female with significant unmet needs. Family advocacy in mental health is prominently supported by female activists as is the psychiatric user movement. Because of the cumulation and the interaction of gender-based and other forms of discrimination, legislations such as those following the UN-Convention on the rights of persons with disabilities include specific provisions for women and girls with psychosocial disabilities.ConclusionsMental health stigma and discrimination interact with gender inequality and the discrimination of women and girls to their mental health detriment. Clinical and scientific responsibilities in mental health essentially include gender-specific attention to the needs of women and girls and their families.Disclosure of interestThe author has not supplied his declaration of competing interest.

scholarly journals Are Mental Health Services for Children Distributed According to Needs?

2003 ◽  
Vol 48 (3) ◽  
pp. 176-186 ◽  
Author(s):  
Régis Blais ◽  
Jean-Jacques Breton ◽  
Mylène Fournier ◽  
Marie St-Georges ◽  
Claude Berthiaume
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Regional Differences ◽  
Mental Health Policy ◽  
Health Resources ◽  
Administrative Databases ◽  
Epidemiologic Survey ◽  
Service Data ◽  
Professional Resources

Objectives: The purpose of this study was twofold: 1) to determine whether publicly funded mental health services and resources available in 4 large regions in the province of Quebec were distributed according to the mental health needs of children aged 6 to 14 years and 2) to assess whether the variations in mental health services and resources across the 4 regions had changed over a 5-year period. Methods: Indicators of need according to the child's parent (presence of mental disorder, measure of adaptation, and perception of need for help) from an epidemiologic survey of 2400 noninstitutionalized children were compared with both in-school and community professional resources and with physician and hospital services in 1992–1993. Resource and service data were also collected for 1997–1998. Resource and service data came from professional colleges and government administrative databases. Results: No significant regional differences were found for need indicators, but there were large discrepancies in mental health resources and services in 1992–1993. Differences in professional resources were largest for special education teachers in the school system and for psychiatrists in the community. The regional differences in resources and services were as large in 1997–1998 as they were in 1992–1993. Conclusions: Despite universal health care in Quebec and a government mental health policy stressing equity of access, the available mental health resources for children aged 6 to 14 years are not distributed across regions according to needs. More evidence-based planning is required, specifically using epidemiologic survey data, to match resources to needs and to monitor changes over time.

A 'snap shot' of the health of homeless people in inner Sydney: St Vincent's Hospital

2011 ◽  
Vol 35 (1) ◽  
pp. 52 ◽  
Author(s):  
Caroline N. Chin ◽  
Kate Sullivan ◽  
Stephen F. Wilson
Keyword(s):  
Mental Health ◽  
Substance Use ◽  
Health Services ◽  
Physical Health ◽  
Homeless People ◽  
Health Resources ◽  
Poor Health ◽  
Health Profile ◽  
The Poor ◽  
Health Comorbidities

Objectives. The poor health profile of people who are homeless results in a disproportionate use of health resources by these people. An in-hospital count of demographic and health data of homeless patients was conducted on two occasions at St Vincent’s Hospital in Sydney as an indicator of health resource utilisation for the Sydney region. Methods. Two in-hospital counts were conducted of homeless patients within the boundaries of St Vincent’s Hospital to coincide with the inaugural City of Sydney homeless street counts in winter 2008 and summer 2009. Data collected included level of homelessness, principal diagnosis, triage category, bed occupancy and linkages to services post hospital discharge. Results. Homeless patients at St Vincent’s utilised over four times the number of acute ward beds when compared with the state average. This corresponds to a high burden of mental health, substance use and physical health comorbidities in homeless people. There was high utilisation of mental health and drug and alcohol services by homeless people, and high levels of linkages with these services post-discharge. There were relatively low rates of linkage with general practitioner and ambulatory care services. Conclusion. Increasing knowledge of the health needs of the homeless community will assist in future planning and allocation of health services. What is known about the topic? The poor health status of people who are homeless has been previously noted in the USA, Canada and Scotland. What does this paper add? Homeless people living in Sydney also have a poor health profile and a disproportionate use of health resources when compared to people in the general population. What are the implications for practitioners? Health services for homeless people should be equipped to deal with mental health, substance use and physical health comorbidities.

scholarly journals (A66) Integration of Psycho-Social Social Support and Mental Health Services in to National Disaster Management Guidelines

2011 ◽  
Vol 26 (S1) ◽  
pp. s18-s18
Author(s):  
J.K. Christy
Keyword(s):  
Mental Health ◽  
Social Support ◽  
High Risk ◽  
Mental Health Services ◽  
Health Services ◽  
Disaster Management ◽  
Disaster Response ◽  
Social Care ◽  
Management Guidelines ◽  
National Disaster

Integration of Psycho-social Social Support and Mental Health Services in to National Disaster Management Guidelines India is vulnerable, in varying degrees, to a large number of natural as well as man-made disasters and also a high risk country for disasters due to expanding population, urbanization and industrialisation, development within high-risk zones, environmental degradation and climate changes. The creation of National Disaster Management Authority (NDMA) in 2005, as the apex body for disaster management, has brought out a paradigm shift in the area of disaster management. One of the important mandate of NDMA is to issue National Disaster Management Guidelines (NDMG) to the ministries/ departments to assist them to formulate their respective Disaster Management (DM) plans. In this direction NDMA has issued number of NDMG on different themes to provide basis of preparation of DM plans at different levels. There are policies & guidelines on Psycho-social Support and Mental Health Services (PSSMHS) in disasters at the international level in the form of Inter Agency Standing Committee guidelines (IASC) which advocates PSSMHS in disasters. In India there was no such policy which streamlines the Psycho-social Support and Mental Health Services in Disasters. During preparation of various National Disaster Management Guidelines, one remarkable factor noticed was the need for psycho-social care, subsequently preparation of NDMG on Medical Preparedness and Mass Causality Management brought out an overwhelming consensus to formulate a separate NDMG for PSSMHS. In order to translate the critical need for psycho-social care and support into guidelines, NDMA adopted a mission-mode approach for integrating PSSMHS in disaster response by involving participatory and multi step methodology to formulate NDMG on Psycho-social Support and Mental Health Services in Disasters.

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