scholarly journals “I Am Not My Illness!”: Navigating the Mental Healthcare System in New Orleans

2019 ◽  
Author(s):  
◽  
Saira Mehmood ◽  
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Critical Race Theory ◽  
Mental Health Services ◽  
Health Services ◽  
New Orleans ◽  
Healthcare System ◽  
Mental Health Professionals ◽  
Mental Healthcare ◽  
Mental Illnesses

This research examines the experiences of individuals diagnosed with chronic mental illnesses and how they navigated the mental healthcare system in New Orleans, Louisiana. To realize the main research objective, I analyzed how individuals with chronic mental illnesses perceive mental illness and stigma; the services individuals use to address their mental health needs and the barriers they face in this process; who individuals disclose their mental illness to and under what contexts; and how individuals diagnosed with mental illness and their caregivers understand and embody recovery. Situated between medical anthropology and urban anthropology, it examines the challenges individuals diagnosed with chronic mental illness and caregivers encounter in utilizing mental health services. Using critical race theory and studies on whiteness, I analyze the intersectional identities of individuals to understand how various axes of identities such as race, gender, age, and religion affect how people utilize mental health services, conceptualize stigma, how this is related to disclosure, and what recovery means to them. While I use stigma scales to measure various types of stigma, I triangulate this data with observations from participant-observation and interviews to reconceptualize stigma in what Tyler and Slater (2018) argue for approaching the social and political dynamics of stigma and acknowledging history. I do this through the use of stigma syndemics. Central to this is the role of mental health professionals and other key stakeholders, and how they interact with individuals utilizing community mental health services. I examine how past experiences such as trauma and incarceration limit access to housing programs, employment, and how this affects recovery. Lastly, I argue that for effective advocacy on mental health to occur, synergistic activism through coalition building needs to transpire between all the entities that affect individuals who have mental illnesses.

scholarly journals Understanding barriers to accessing mental health services for newcomers to Canada using Peterborough, Ontario, as an illustrative example

2021 ◽  
Author(s):  
Nurun Layla Chowdhury
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Help Seeking ◽  
Mental Healthcare ◽  
Healthcare Services ◽  
Mental Illnesses ◽  
Cultural Barriers ◽  
Accurate Information

The quality of an individual’s mental health has a significant impact on their quality of life, as well as on the cost to society. Regular access to mental health services can help mitigate the risk factors of developing mental illnesses. This paper examines barriers to accessing mental health services, using the community of Peterborough, Ontario, as an example. Social, economic, and cultural barriers impact help-seeking amongst immigrants, putting them at a higher risk of developing mental disorders. The social determinants of mental health can be useful when developing policies aimed at improving utilization of mental healthcare services. Policy makers need to first focus on collecting accurate information on the population, and then developing targeted solutions to eliminate barriers such as language and employment that prevent help-seeking in immigrants.

scholarly journals EPA guidance on the quality of mental health services: A systematic meta-review and update of recommendations focusing on care coordination

2020 ◽  
Vol 63 (1) ◽  
Author(s):  
W. Gaebel ◽  
A. Kerst ◽  
B. Janssen ◽  
T. Becker ◽  
M. Musalek ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Mental Health Services ◽  
Health Services ◽  
Care Coordination ◽  
Mental Healthcare ◽  
Advantages And Disadvantages ◽  
Meta Review ◽  
Effectiveness And Efficiency

Abstract Background. The quality of mental health services is crucial for the effectiveness and efficiency of mental healthcare systems, symptom reduction, and quality of life improvements in persons with mental illness. In recent years, particularly care coordination (i.e., the integration of care across different providers and treatment settings) has received increased attention and has been put into practice. Thus, we focused on care coordination in this update of a previous European Psychiatric Association (EPA) guidance on the quality of mental health services. Methods. We conducted a systematic meta-review of systematic reviews, meta-analyses, and evidence-based clinical guidelines focusing on care coordination for persons with mental illness in three literature databases. Results. We identified 23 relevant documents covering the following topics: case management, integrated care, home treatment, crisis intervention services, transition from inpatient to outpatient care and vice versa, integrating general and mental healthcare, technology in care coordination and self-management, quality indicators, and economic evaluation. Based on the available evidence, we developed 15 recommendations for care coordination in European mental healthcare. Conclusions. Although evidence is limited, some concepts of care coordination seem to improve the effectiveness and efficiency of mental health services and outcomes on patient level. Further evidence is needed to better understand the advantages and disadvantages of different care coordination models.

Male secondary school student's attitudes towards using mental health services

2008 ◽  
Vol 25 (2) ◽  
pp. 52-56 ◽  
Author(s):  
Shane Burke ◽  
Robert Kerr ◽  
Patrick McKeon
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Mental Health Services ◽  
Health Services ◽  
Mental Health Professionals ◽  
Young Men ◽  
Psychiatric Hospitals ◽  
Barriers To Access ◽  
Student's Attitudes ◽  
Willingness To Use

AbstractObjectives: The rate of suicide among young men is rising. However, young men are reluctant to use mental health services. In this study we explored young men's attitudes towards mental illness and mental health services, as well as their willingness to use these services.Methods: Four focus groups were conducted in two Dublin schools. A total of 18 students participated in the study.Results: Students held negative views towards mental health services, particularly in respect to psychiatric hospitals and medication. Students were not well informed about whom to contact if they had depression and were very conscious about the stigma of going to see a ‘professional’. Many students did not recognise depression as being a mental illness and could not differentiate between depression and feeling sad.Conclusions: This study shows that a lack of knowledge and understanding about mental illness, combined with prejudice against mental health professionals and fear of stigma, are important barriers to access of mental health services for young men.

scholarly journals Mental health in post-earthquake Nepal

2015 ◽  
Vol 5 (4) ◽  
pp. 520-521 ◽  
Author(s):  
Kiran Thapa
Keyword(s):  
Mental Health ◽  
Community Mental Health ◽  
Health Services ◽  
Mental Health Professionals ◽  
Health Professionals ◽  
Mental Healthcare ◽  
Healthcare Services ◽  
Mental Illnesses ◽  
Children And Families ◽  
Long Run

For two decades, Government of Nepal has made efforts to develop and maintain mental health professionals in all areas; however, much has to be done. This could be an opportunity for Nepal to redesign mental healthcare services at the community level. Primary mental health services integrated with community mental health could help children and families cope with and recover from mental illnesses in the long run.

scholarly journals Carers and co-production: enabling expertise through experience?

2015 ◽  
Vol 20 (4) ◽  
pp. 232-241 ◽  
Author(s):  
Eleanor Bradley
Keyword(s):  
Mental Health ◽  
Decision Making ◽  
Mental Health Services ◽  
Health Services ◽  
Mental Health Professionals ◽  
Family Members ◽  
Mental Healthcare ◽  
Service Users ◽  
Content Type ◽  
The Impact

Purpose – The purpose of this paper is to provide a brief overview of the literature to date which has focused on co-production within mental healthcare in the UK, including service user and carer involvement and collaboration. Design/methodology/approach – The paper presents key outcomes from studies which have explicitly attempted to introduce co-produced care in addition to specific tools designed to encourage co-production within mental health services. The paper debates the cultural and ideological shift required for staff, service users and family members to undertake co-produced care and outlines challenges ahead with respect to service redesign and new roles in practice. Findings – Informal carers (family and friends) are recognised as a fundamental resource for mental health service provision, as well as a rich source of expertise through experience, yet their views are rarely solicited by mental health professionals or taken into account during decision making. This issue is considered alongside new policy recommendations which advocate the development of co-produced services and care. Research limitations/implications – Despite the launch of a number of initiatives designed to build on peer experience and support, there has been a lack of attention on the differing dynamic which remains evident between healthcare professionals and people using mental health services. Co-production sheds a light on the blurring of roles, trust and shared endeavour (Slay and Stephens, 2013) but, despite an increase in peer recovery workers across England, there has been little research or service development designed to focus explicitly on this particular dynamic. Practical implications – Despite these challenges, coproduction in mental healthcare represents a real opportunity for the skills and experience of family members to be taken into account and could provide a mechanism to achieve the “triangle of care” with input, recognition and respect given to all (service users, carers, professionals) whose lives are touched by mental distress. However, lack of attention in relation to carer perspectives, expertise and potential involvement could undermine the potential for coproduction to act as a vehicle to encourage person-centred care which accounts for social in addition to clinical factors. Social implications – The families of people with severe and enduring mental illness assume a major responsibility for the provision of care and support to their relatives over extended time periods (Rose et al., 2004). Involving carers in discussions about care planning could help to provide a wider picture about the impact of mental health difficulties, beyond symptom reduction. The “co-production of care” reflects a desire to work meaningfully and fully with service users and carers. However, to date, little work has been undertaken in order to coproduce services through the “triangle of care” with carers bringing their own skills, resources and expertise. Originality/value – This paper debates the current involvement of carers across mental healthcare and debates whether co-production could be a vehicle to utilise carer expertise, enhance quality and satisfaction with mental healthcare. The critique of current work highlights the danger of increasing expectations on service providers to undertake work aligned to key initiatives (shared decision-making, person-centred care, co-production), that have common underpinning principles but, in the absence of practical guidance, could be addressed in isolation rather than as an integrated approach within a “triangle of care”.

scholarly journals Status of primary and secondary mental healthcare of people with severe mental illness: an epidemiological study from the UK PARTNERS2 programme

BJPsych Open ◽  
2021 ◽  
Vol 7 (2) ◽  
Author(s):  
Siobhan Reilly ◽  
Catherine McCabe ◽  
Natalie Marchevsky ◽  
Maria Green ◽  
Linda Davies ◽  
...  
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Mental Illness ◽  
Mental Health Services ◽  
Health Services ◽  
Severe Mental Illness ◽  
Medical Records ◽  
Secondary Care ◽  
Mental Healthcare ◽  
The Uk

Background There is global interest in the reconfiguration of community mental health services, including primary care, to improve clinical and cost effectiveness. Aims This study seeks to describe patterns of service use, continuity of care, health risks, physical healthcare monitoring and the balance between primary and secondary mental healthcare for people with severe mental illness in receipt of secondary mental healthcare in the UK. Method We conducted an epidemiological medical records review in three UK sites. We identified 297 cases randomly selected from the three participating mental health services. Data were manually extracted from electronic patient medical records from both secondary and primary care, for a 2-year period (2012–2014). Continuous data were summarised by mean and s.d. or median and interquartile range (IQR). Categorical data were summarised as percentages. Results The majority of care was from secondary care practitioners: of the 18 210 direct contacts recorded, 76% were from secondary care (median, 36.5; IQR, 14–68) and 24% were from primary care (median, 10; IQR, 5–20). There was evidence of poor longitudinal continuity: in primary care, 31% of people had poor longitudinal continuity (Modified Modified Continuity Index ≤0.5), and 43% had a single named care coordinator in secondary care services over the 2 years. Conclusions The study indicates scope for improvement in supporting mental health service delivery in primary care. Greater knowledge of how care is organised presents an opportunity to ensure some rebalancing of the care that all people with severe mental illness receive, when they need it. A future publication will examine differences between the three sites that participated in this study.

scholarly journals Organizing as negotiation: the construction of a pathway in Norwegian mental health services

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Tine Nesboe Toerseth
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Illness ◽  
Mental Health Services ◽  
Health Services ◽  
Mental Health Care ◽  
Mental Health Professionals ◽  
Health Professionals ◽  
Clinical Pathway ◽  
The Political

Abstract Background In 2015, a decision was made to implement clinical pathways in Norwegian mental health services. The idea was to construct pathways similar to those used in cancer treatment. These pathways are based on diagnosis and evidence-based medicine and have strict timeframes for the different procedures. The purpose of this article is to provide a thorough examination of the formulation of the pathway “mental illness, adults” in Norwegian mental health services. In recent decades, much research has examined the implementations and outcomes of different mental health sector reforms and services in Western societies. However, there has been a lack of research on the process and creation of these reforms and/or services, particularly how they emerge as constructs in the contexts of policy, profession and practice. Methods A qualitative single case study design was employed. A text and document analysis was performed in which 52 articles and opinion pieces, 30 public hearing responses and 8 political documents and texts were analysed to identify the main actors in the discourse of mental health services and to enable a replication of their affiliated institutional logics and their views concerning the clinical pathway. Additionally, ten qualitative interviews were performed with members of the work group responsible for designating the pathway “mental illness, adults”. Results This article shows how the two main actor groups, “Mental health professionals” and “Politicians”, are guided by values associated with a specific logic when understanding the concept of a clinical pathway (CP). The findings show that actors within the political field believe in control and efficiency, in contrast to actors in mental health services, who are guided by values of discretion and autonomy. This leads to a debate on the concept of CPs and mental health services. The discussion becomes polarized between concern for patients and concern for efficiency. The making of the pathway is led by the Directorate of Health, with health professionals operating in the political domain and who have knowledge of the values of both logics, which were taken into consideration when formulating the pathways, and explains how the pathway became a complex negotiation process between the two logics and where actors on both sides were able to retain their core values. Ultimately, the number of pathways was reduced from 22 to 9. The final “Pathway for mental illness, adults” was a general pathway involving several groups of patients. The pathway explains the process from diagnosis through treatment and finalizing treatment. The different steps involve time frames that need to be coded, requiring more rigid administrative work for compliance, but without stating specific diagnostic tools or preferred treatment strategies. Conclusions This article shows that there is also a downside of having sense making guided by strong values associated with a specific institutional logic when constructing new, and hopefully better, mental health care services. This article demonstrates how retaining values sometimes becomes more crucial than engaging in constructive debates about how to solve issues of importance within the field of mental health care.

scholarly journals Culturally adapted mental healthcare: evidence, problems and recommendations

2015 ◽  
Vol 39 (4) ◽  
pp. 153-155 ◽  
Author(s):  
Sokratis Dinos
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Mental Health Professionals ◽  
Minority Groups ◽  
Mental Health Problems ◽  
Mental Healthcare ◽  
Health Problems ◽  
Cultural Adaptations ◽  
Culturally Adapted

SummaryEvidence suggests disparities in the prevalence of mental health problems and access to mental healthcare for a number of minority groups. The main response from mental health services falls into two related categories: (a) cultural adaptations of existing evidence-based interventions (EBIs) and/or (b) cultural competence of mental health professionals. This editorial looks at the evidence on culturally adapted EBIs and argues that although such interventions can be effective, they also carry the risk of alienating members of the groups they are aimed at. Recommendations focus on identifying issues that pertain to being from a racial minority and/or possessing other stigmatised identities that can have an impact on mental health problems, which may be overlooked by mental health services by assuming an overarching predominant cultural identity.

scholarly journals Lived Experience, Transparency, Help, and Humility: Four Characteristics of Clergy Responding to Mental and Emotional Problems

2020 ◽  
Vol 74 (1) ◽  
pp. 4-11
Author(s):  
Krystal Hays ◽  
Jennifer Shepard Payne
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Lived Experience ◽  
Mental Health Professionals ◽  
Help Seeking ◽  
Emotional Problems ◽  
Individual Characteristics ◽  
Mental Illnesses ◽  
The Individual

Many individuals who experience mental and emotional problems prefer support from clergy instead of formal mental health services. Because clergy are often sought out by those with mental illnesses, it is essential to understand their perspectives about mental and emotional problems and identify the individual characteristics that influence these perspectives. This study utilized qualitative data from a conversation among pastors in an online social networking group to examine the characteristics of clergy who held affirming attitudes toward professional mental health services. Thirty-five pastors participated in the discussion, generating more than 140 comments over 13 days in response to the question: “If the church is where we are to come for healing, how do we handle people who are depressed, suicidal, suffering from PTSD or anxiety?” Thematic analysis was conducted, and results suggest four characteristics common among clergy: personal experiences with mental and emotional problems, transparency in sharing their stories, personal help-seeking, and humility. These four characteristics may influence clergy members’ present-day understanding and responses to mental and emotional problems. Implications for spiritual care professionals and mental health professionals are presented.

scholarly journals Przez kwasową psychiatrię do kwasowego komunizmu. Renesans psychodeliczny w psychiatrii jako szansa na zmianę paradygmatu

2021 ◽  
Vol 40 (2) ◽  
pp. 123-176
Author(s):  
Radosław Stupak
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Mental Health Services ◽  
Health Services ◽  
Status Quo ◽  
Mental Illnesses ◽  
The Road ◽  
The Status

Mark Fisher wrote „the task of repoliticizing mental illness is an urgent one if the left wants to challenge capitalist realism.” This paper attempts to develop this thought and show how the repoliticization of issues defined as mental illnesses that could have an emancipatory potential and undermine capitalist realism could look like and how it could be related to the contemporary phenomenon of „psychedelic renaissance”. This repoliticization could constitute the first step towards acid communism – a step that would enable a comprehensive formulation of the project, the imagining of both acid communism itself as well as the road towards it. Even though psychedelics could provide an impulse for the change of the dominant psychiatric paradigm and the reorganization of mental health services, the process of the interception of these substances by the alienating and commodificating orders of psychiatry and capitalism can already be observed, so that both of the intertwined and mutually supporting orders can in fact be strengthened. From this perspective the institution of psychiatry becomes a key element preserving the status quo, which makes the imagining of the end of capitalism impossible. Politicization of mental health, that could question capitalist realism, needs to be connected with the deconstruction of the ideology of psychiatry.

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