scholarly journals Demographic Equality of Access to Cognitive Behavioural Treatment for Early Psychosis in Community Mental Healthcare in Greater London

2021 ◽  
Vol 8 (3) ◽  
pp. 149-170
Author(s):  
Pawel D. Mankiewicz ◽  
Jordan Reid ◽  
Eleonore Ann Hughes
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Equal Access ◽  
Empirical Literature ◽  
Behavioural Treatment ◽  
Cognitive Behavioural Treatment ◽  
Cognitive Behavioural ◽  
Treatment Provision ◽  
Equality Of Access

Individuals experiencing psychosis have been described as one of the most stigmatised, disadvantaged and socially excluded groups in modern societies. Despite the development of evidence-based psychological treatments for psychosis, the access to such intervention remains debateable. In metropolitan areas, where clinical caseloads of mental health services should reflect the ethnic diversity of local populations, equal provision of recommended therapies might be further confounded, while empirical literature investigating this appears limited. The present study inspects equality of access to cognitive behavioural therapy for psychosis across four specialist healthcare teams located in Greater London. Subsequent acceptance and participation in treatment are also examined. A retrospective analysis of electronic medical records of 244 patients was conducted using binary logistic regression and multiple linear regression. Participants were shown to have received treatment offers equally across demographic variables. Likewise, once the treatment commenced, engagement was equally distributed. However, despite having equal access to the offered treatment, patients of Black ethnic group seemed less likely to accept such offer, hence appeared disadvantaged in terms of treatment provision. This study demonstrates that, in multicultural communities, equal access to core interventions for psychosis is achievable, however does not on its own merits ensure equitable treatment provision. Thus mental health services need to proactively focus on specific ethnic groups requiring further efforts to increase treatment uptake. Keywords: mental health, psychosis, cognitive behavioural treatment, diversity, equal access to healthcare

scholarly journals Developing and Using Vignettes to Explore the Relationship Between Risk Management Practice and Recovery-Oriented Care in Mental Health Services

2017 ◽  
Vol 28 (3) ◽  
pp. 371-380 ◽  
Author(s):  
Jessica Holley ◽  
Steven Gillard
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Services ◽  
Health Services ◽  
Focus Groups ◽  
Health Workers ◽  
Management Practice ◽  
Health Care Research ◽  
Empirical Literature ◽  
Care Research

There is a lack of literature evaluating the development and use of vignettes to explore contested constructs in qualitative health care research where a conventional interview schedule might impose assumptions on the data collected. We describe the development and validation of vignettes in a study exploring mental health worker and service user understandings of risk and recovery in U.K. mental health services. Focus groups with mental health workers and service users explored study questions from experiential perspectives. Themes identified in the groups were combined with existing empirical literature to develop a set of vignettes. Feedback focus groups were conducted to validate and amend the vignettes. Following use in research interviews, results suggested that the vignettes had successfully elicited data on issues of risk and recovery in mental health services. Further research using creative, comparative methods is needed to fully understand how vignettes can best be used in qualitative health care research.

scholarly journals Nature: the cure we've been looking for

2021 ◽  
Author(s):  
◽  
Sarah Knowles
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Group Therapy ◽  
Health Services ◽  
Effective Treatment ◽  
Behavioural Therapy ◽  
Context Information ◽  
Ethical Concerns ◽  
Cognitive Behavioural ◽  
Western Psychology

Nature-based therapy is a therapeutic lens that utilizes nature as a co-therapist. This approach addresses the disconnect between land and people, a disconnect that negatively impacts the mental health of many of those seeking mental health services. Consequently, this approach is now considered an effective treatment for youth and is used as a standalone approach or integrated with cognitive behavioural therapy, gestalt, or group therapy. In either case, this nature-based lens provides a bridge between traditional Indigenous practices and Western psychology. My project highlights various activities and ideas in order to incorporate nature into one’s practice as a therapist, specifically within a northern context. Information regarding benefits, ethical concerns and various types of nature-based therapy will be discussed and guide the development of the manual. The guidebook will assist those interested in nature therapy by creating a place where tangible and realistic ideas for how to incorporate it into practice are located.

Cognitive-Behavioural Assessment and Treatment of Maladaptive Help-Seeking Behaviour in a Patient with Schizophrenia

2000 ◽  
Vol 34 (4) ◽  
pp. 688-691 ◽  
Author(s):  
Gus Norris ◽  
Roy Laube
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Help Seeking ◽  
Service Providers ◽  
Public Mental Health ◽  
Chronic Schizophrenia ◽  
Cognitive Behavioural ◽  
Public Mental Health Services ◽  
Help Seeking Behaviour

Objective: Maladaptive help-seeking behaviour in psychiatric patients is a significant problem for public mental health services, yet it is not addressed in the mainstream literature. We present a report on the successful treatment of a person with schizophrenia who displayed this common dilemma for patients and clinicians. Clinical picture: A 31-year-old man with borderline intellectual functioning had a 10-year history of schizophrenia marked by negative features. He frequently presented in crisis to public mental health services, the local hospital, and his general practitioner; this resulted in excessive use of services, including admissions. Treatment: The patient was reassessed from a cognitive-behavioural perspective rather than a syndromal perspective. Specific behaviours were modified, cognitions were identified, challenged and restructured, and other service providers were provided with an alternative to admission or acute community care. Outcome: At 24 months the maladaptive behaviour remains in remission. Conclusions: Behavioural problems in persons with chronic schizophrenia may be effectively treated by reconceptualising the behaviour as distinct from the major diagnosis.

scholarly journals Mental health service discrimination against older people

2013 ◽  
Vol 37 (3) ◽  
pp. 98-103 ◽  
Author(s):  
David Anderson ◽  
Peter Connelly ◽  
Richard Meier ◽  
Cherie McCracken
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Older People ◽  
Freedom Of Information ◽  
Ageing Population ◽  
Information Request ◽  
Specialist Services ◽  
The Face ◽  
Equality Of Access

Aims and methodTo provide a picture of availability and equality of access to mental health services for older people prior to the Equality Act. In 2010, a questionnaire was sent to health commissioners in England, Scotland and Wales under a Freedom of Information request.ResultsOverall, 132 (76%) replied. Of 11 services, 7 were either unavailable or did not provide equality of access to older people in more than a third of commissioning areas. When provided by specialist older people's mental health, services were more often considered to ensure equality.Clinical implicationsIncreasing need resulting from an ageing population is unlikely to be met in the face of current inequality. Inequality on the basis of age is the result of government policy and not the existence of specialist services for older people. Single age-inclusive services may create indirect age discrimination. Availability alone is insufficient to demonstrate equality of access. Monitoring the effects of legislation must take this into account.

Are Depressed Adolescents Routinely Offered CBT? A Brief Review of Current Practice

2007 ◽  
Vol 36 (1) ◽  
pp. 113-117 ◽  
Author(s):  
Gill Ross ◽  
Chris Brannigan
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Adolescent Depression ◽  
Behavioural Therapy ◽  
Postal Questionnaire ◽  
Evidence Based ◽  
Empirically Supported ◽  
Cognitive Behavioural ◽  
Research Findings

AbstractAn increasing body of research in support of cognitive-behavioural therapy (CBT) for adolescent depression has emerged during the last two decades. However, it has been suggested that empirically supported treatments are seldom carried out in clinical practice. Although the reasons for this are likely to be diverse, it is argued that mental health services have an ethical responsibility to offer evidence-based interventions. Whether empirically supported interventions, such as CBT, are consistently offered to depressed adolescents attending Child and Adolescent Mental Health Services (CAMHS) is currently unknown. A primary aim of this study was to survey the use of CBT for depression in a number of United Kingdom (UK) CAMHS settings. A postal questionnaire was sent to 117 members of the BABCP Children, Adolescents and Families Special Interest Branch, of which 44 completed questionnaires were returned. Descriptive statistics indicate that just over half of the organizations represented routinely offered CBT to depressed adolescents. CBT practice and the transportation of evidence-based research findings to CAMHS settings are discussed.

Status of Computerized Cognitive Behavioural Therapy for Adults

2007 ◽  
Vol 41 (2) ◽  
pp. 95-114 ◽  
Author(s):  
Nickolai Titov
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Cognitive Behavioural Therapy ◽  
Cost Effective ◽  
Behavioural Therapy ◽  
Treatment Delays ◽  
Cognitive Behavioural ◽  
Key Issues ◽  
Considerable Work

A growing body of evidence supports the efficacy of computerized cognitive behavioural therapy (CCBT). This technology has the potential to increase the capacity of mental health services, and to overcome some of the barriers to accessing mental health services, including stigma, traveling time for rural patients, treatment delays, and the low availability of skilled clinicians. This review discusses key issues around the implementation of CCBT in current mental health services, and summarizes recent evidence for the efficacy of CCBT in anxiety and depression. Many CCBT systems exist, and the evidence for each varies in quality and quantity. It is concluded that CCBT, particularly guided by a therapist, represents a promising resource. However, considerable work needs to be done to develop CCBT techniques that are appropriate to Australasian populations, acceptable to patients and clinicians, easy to use, and are clinically and cost effective. Suggestions are made for further research and useful website addresses are provided to assist clinicians in familiarizing themselves with CCBT.

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