scholarly journals Opening the Psychiatric Hospital and Bringing the City Inside. Contradiction and Reflexivity in a Case of Urban Innovation

2021 ◽  
Author(s):  
Tommaso Vitale
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Psychiatric Hospital ◽  
Social Innovation ◽  
Participant Observation ◽  
Care Service ◽  
Structured Interviews ◽  
Personalized Care ◽  
Long Run

The objective of the paper is to explain a case of social innovation in mental health services, moving from a psychiatric hospital, classically a total institution, to a healthier, diversified, and personalized care service. The research was conducted by a participant observation method, on the long run, from 1996 to 2006 in Milan (Italy): more than 25 meeting and 40 semi structured interviews were conducted. It looks at a case of ‘social entrepreneurship’ in Milan which contributes to the transformation of a large, closed psychiatric hospital into a more open and therapeutic environment for mental health services users, as well as for ordinary citizens of the whole metropolitan area. Most of the literature correctly emphasize governance and administrative capability as crucial variable for satisfaction of needs, recognition of capability and sustainability of projects. The paper shows the relevance of exogenous resources, non-local mobilisations, and loosely connected social movement networks to enact communicative spaces and challenge closed and inertial policy communities.

Persisting Auditory Hallucinations: Prospects for Non-medication Interventions in a Hospital Population

1996 ◽  
Vol 13 (2) ◽  
pp. 112-123 ◽  
Author(s):  
John Farhall ◽  
Nicholas Voudouris
Keyword(s):  
Mental Health ◽  
Pilot Study ◽  
Mental Health Services ◽  
Health Services ◽  
Coping Strategies ◽  
Psychiatric Hospital ◽  
Auditory Hallucinations ◽  
Structured Interviews ◽  
Potential Efficacy ◽  
Hospital Population

The potential efficacy of recently developed cognitive and behavioural treatments (CBT) for residual hallucinations raises practical questions about the extent of applicability of such treatments and the possible need for programmatic responses by mental health services. This pilot study, conducted in a 355-bed acute and rehabilitation psychiatric hospital, explored the prevalence of persisting auditory hallucinations, patients' coping strategies, and indicators for cognitive and behavioural treatments. A census identified 123 patients with persisting hallucinations. Information about practical impediments to CBT was obtained from structured interviews with staff. Detailed interviews with a subsample of 35 hallucinators identified natural coping strategies and indicators for treatment. High rates of natural coping strategies were reported by this very disabled sample. Fifty-three per cent of hallucinators were considered “potential” candidates, and 20% “good” candidates for CBT for voices.

The transition between mental health services in Scotland

2018 ◽  
Vol 23 (1) ◽  
pp. 12-24 ◽  
Author(s):  
Juliette van der Kamp
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Mental Health Professionals ◽  
Health Professionals ◽  
Transition Period ◽  
Organisational Development ◽  
Structured Interviews ◽  
Content Type ◽  
Experience Difficulty

Purpose The purpose of this paper is to describe the barriers and facilitators to an effective transition from Child and Adolescent Mental Health Services (CAMHS) to Adult Mental Health Services (AMHS). It also presents a new entry into considering how the transition can be improved. Design/methodology/approach Insights into the transition from CAMHS to AMHS were gathered through eight semi-structured interviews with mental health professionals. Two methods of data analysis were employed to explore the emerging themes in the data and the observed deficit approach to organisational development. Findings The findings identified a vast volume of barriers in comparison to facilitators to the transition. Adolescents who transition from CAMHS to AMHS initially experience difficulty adapting to the differences in the services due to the short duration of the transition period. However, despite the established barriers to the transition, adolescents tend to adapt to the differences between the services. Findings also showed a negative framing towards the transition amongst the mental health professionals which resembles a deficit approach to organisational development. Originality/value This paper explores mental health professionals’ perspectives regarding the transition in Dumfries and Galloway, Scotland. The transition is increasingly recognised as an area in health care that requires improvement. This research provides a new way to consider the transition by exploring the perceived deficit approach to organisational development in the services.

scholarly journals Influences on participation in a programme addressing loneliness among people with depression and anxiety: findings from the Community Navigator Study

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Johanna Frerichs ◽  
Jo Billings ◽  
Nick Barber ◽  
Anjie Chhapia ◽  
Beverley Chipp ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Thematic Analysis ◽  
Narrative Analysis ◽  
Mental Health Problems ◽  
Severe Depression ◽  
Feasibility Trial ◽  
Structural Level ◽  
Structured Interviews

Abstract Background Loneliness is associated with negative outcomes, including increased mortality and is common among people with mental health problems. This qualitative study, which was carried out as part of a feasibility trial, aimed to understand what enables and hinders people with severe depression and/or anxiety under the care of secondary mental health services in the United Kingdom to participate in the Community Navigator programme, and make progress with feelings of depression, anxiety and loneliness. The programme consisted of up to ten meetings with a Community Navigator and three optional group sessions. Methods Semi-structured interviews were carried out with participants (n = 19) shortly after programme completion. A co-produced two-stage qualitative approach, involving narrative and reflexive thematic analysis, was undertaken by members of the study’s working group, which included experts by experience, clinicians and researchers. Results The narrative analysis showed that individuals have varied goals, hold mixed feelings about meeting other people and define progress differently. From the thematic analysis, six themes were identified that explained facilitators and challenges to participating in the programme: desire to connect with others; individual social confidence; finding something meaningful to do; the accessibility of resources locally; the timing of the programme; and the participant’s relationship with the Community Navigator. Conclusions We found that people with severe depression and/or anxiety supported by secondary mental health services may want to address feelings of loneliness but find it emotionally effortful to do so and a major personal challenge. This emotional effort, which manifests in individuals differently, can make it hard for participants to engage with a loneliness programme, though it was through facing personal challenges that a significant sense of achievement was felt. Factors at the individual, interpersonal and structural level, that enable or hinder an individual’s participation should be identified early, so that people are able to make the best use out of the Community Navigator or other similar programmes.

A systematic review of current approaches to managing demand and waitlists for mental health services

2020 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Kerry A. Thomas ◽  
Annelise M. Schroder ◽  
Debra J. Rickwood
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Service Delivery ◽  
Care Service ◽  
Health Care Service ◽  
Clinical Effectiveness ◽  
Research Literature ◽  
Inclusion Criteria ◽  
Content Type

Purpose Timely access to effective treatment is a primary goal for mental health services; however, when demand exceeds available resources, services may place clients on a waitlist or restrict services. This paper aims to identify approaches used by mental health services to manage service demand and waitlists. Design/methodology/approach A review of research literature between 2009 and 2019 was conducted using the Medline, PsycINFO, CINAHL, Embase and Cochrane databases. Articles were screened and assessed against inclusion criteria and the methodological quality of included studies was assessed using the Mixed Methods Appraisal Tool. Findings In total, 20 articles were located that met the inclusion criteria. Five demand management approaches were identified, namely, walk-in models, triage processes, multi-disciplinary care, patient-led approaches and service delivery changes. Research limitations/implications This review identifies effective approaches that services can consider adapting to their local setting; however, further research is needed to demonstrate the clinical effectiveness of services provided under these models. Originality/value This review makes a valuable contribution to mental health care service delivery by detailing the strategies that services have adopted to manage demand and, where available, comparative outcomes with traditional service delivery models.

Wellbeing and experiences of Chinese and Vietnamese carers of people with mental illness in Australia

2020 ◽  
pp. 136346152095262
Author(s):  
Abner Weng Cheong Poon ◽  
Maria Cassaniti ◽  
Michele Sapucci ◽  
Rosaleen Ow
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Mental Health Services ◽  
Health Services ◽  
Support Groups ◽  
Negative Impact ◽  
Cultural Safety ◽  
Structured Interviews ◽  
People With Mental Illness ◽  
Qualitative Thematic Analysis

Many studies show that carers of people with mental illness experience a negative impact on their wellbeing. Given the growing number of people relocating to Australia every year, there are limited studies examining the experience of carers of people with mental illness from culturally and linguistically diverse communities in Australia. Using cultural safety as a conceptual framework, this exploratory study recruited 14 carers of Chinese and Vietnamese heritage who were attending culturally and linguistically oriented support groups in Sydney, Australia. Standardised, validated scales were administered to measure carers’ wellbeing and knowledge of recovery. Structured interviews were conducted to understand carers’ perceived needs. Descriptive statistical and qualitative thematic analysis were used. Findings show that carers experienced social isolation and psychological distress, had multiple diverse needs and had a reasonably good understanding of recovery. Six themes were identified: i) obtaining information in own language; ii) attaining emotional support from support groups; iii) needing respite services to cope with caregiving responsibilities; iv) involvement in planning of treatment and care; v) migration process influencing caregiving, and; vi) cultural and transcultural factors influencing caregiving experience. Findings indicate that some carers might be experiencing some level of culturally unsafe practices in mainstream mental health services. Implications for support groups and mental health services are discussed.

Mental Health Service Needs of Commercially Sexually Exploited Youth: Voices of Survivors and Stakeholders

2020 ◽  
Vol 35 (3) ◽  
pp. 354-362
Author(s):  
Rachel Robitz ◽  
Emilio C. Ulloa ◽  
Marissa Salazar ◽  
Monica D. Ulibarri
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Sexual Exploitation ◽  
Individual Therapy ◽  
Service Needs ◽  
Structured Interviews ◽  
Community Stakeholders ◽  
Self Worth ◽  
Level Of Understanding

Youth who experience commercial sexual exploitation (CSE) have complex mental health needs. This study describes what CSE survivors and stakeholders who work with them desire in mental health services. We conducted semi-structured interviews with 10 CSE survivors 16–20 years old, and 15 community experts on CSE (n = 25). Thematic analyses indicated CSE survivors value mental health services including individual therapy and coping skills, and they wanted providers who are nonjudgmental, and exhibit some level of understanding of CSE. Community stakeholders described skills important for CSE survivors to gain from mental health services including recognition of patterns of victimization, self-worth, and emotion regulation. Both stakeholders and CSE youth desired services that give survivors some control over their treatment and recovery utilizing a trauma-informed approach.

scholarly journals Screening and Referral is Not Enough: A Qualitative Exploration of Barriers to Access and Uptake of Mental Health Services in Patients With Cardiovascular Diseases

2020 ◽  
Author(s):  
Catherine M Collopy ◽  
Suzanne M Cosh ◽  
Phillip J Tully
Keyword(s):  
Mental Health ◽  
Cardiovascular Diseases ◽  
Mental Health Services ◽  
Health Services ◽  
Peer Support ◽  
Service Use ◽  
Information Provision ◽  
Cardiac Events ◽  
Structured Interviews

Abstract Background: Cardiovascular diseases (CVD) are commonly comorbid with mental health disorders, portending poorer cardiac prognosis. Despite the high prevalence of depression and anxiety, and guidelines recommending routine depression screening and referral, uptake of mental healthcare in CVD populations remains low. Reasons for the underutilisation of mental health and psychological services for this population remain largely unknown.Methods: Thirteen CVD patients with clinically significant psychological symptoms (depression, anxiety and/or stress) participated in one-on-one in-depth semi-structured interviews. Data were analysed using inductive thematic analysis.Results: Barriers to uptake included the timing of referral and screening, with patients reporting a need for longer term follow-up. A lack of information provision and understanding around mental health and services, especially following cardiac-events were further barriers. A reluctance to report mental health or engage in services was also identified, with patients indicating a preference for informal peer support networks. A range of practical barriers such as mobility, transport and cost were also reported. Conclusions: Longer term follow-up and routine mental health assessment may be beneficial to facilitate use of mental health services. Upskilling of practitioners around mental health may be a further avenue to promote information provision and enhance service use. Further focus on enhancing informal peer support may be a valuable initial approach for the CVD population. The implications for improving services and enhancing service use are discussed.

‘Maybe a Maverick, Maybe a Parent, but Definitely Not an Honorary Nurse’: Social Worker Perspectives on the Role and Nature of Social Work in Mental Health Care

2020 ◽  
Author(s):  
Laura Tucker ◽  
Martin Webber
Keyword(s):  
Mental Health ◽  
Social Work ◽  
Mental Health Services ◽  
Health Service ◽  
Health Services ◽  
Social Workers ◽  
Geographical Area ◽  
Health Service Delivery ◽  
Structured Interviews ◽  
The Uk

Abstract In many places in the UK, social work is integral to mental health service delivery. Significant role erosion, however, has left the profession unclear about where it fits within modern mental health services. The 2016 Social Work for Better Mental Health initiative outlines five key mental health roles and has been adopted into national policy in England to combat this uncertainty, but the influence of this has not been explored. This study aimed to develop an understanding of how mental health social workers perceive and explain their role. Semi-structured interviews were undertaken with seven social workers based within one English National Health Service mental health trust covering a large geographical area and their responses analysed using Ritchie, Spencer and O’Connor’s Framework thematic model. Findings indicated that social workers only superficially engaged with the aspirational policy roles, instead presenting their own framework for what makes mental health social work distinctive. This was constructed around the context and intentions of practice, rather than around proscribed tasks and responsibilities. This study has significance for individual social workers and for organisations providing and planning mental health services in the UK and beyond, given the influence that practitioner perceptions can have on how they undertake their roles.

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