scholarly journals Challenges in measuring outcomes for caregivers of people with mental health problems

2014 ◽  
Vol 16 (2) ◽  
pp. 159-169 ◽  

Patient-reported outcomes (PROs) are increasingly important in health care and mental health research. Furthermore, caregivers become partners in care for patients with mental disorders, and health workers are more attentive to the expectations and needs of caregivers. A number of outcomes for caregivers are measured and used in daily practice in order to promote actions to improve health care systems and progress in research on the impact of mental disorders on their caregivers. This paper proposes an inventory of the different outcomes and different measurement tools used to assess the impact of disorders, raising a number of methodological and conceptual issues that limit the relevance of measurement tools and complicate their use. Finally, we propose some recommendations promoting the development of relevant outcome measures for caregivers and their integration into current systems of care.

2009 ◽  
Vol 24 (S1) ◽  
pp. 1-1
Author(s):  
V. Kovess ◽  
R. de Graaf ◽  
J.M. Haro ◽  
R. Bruffaerts ◽  
F. Gilbert ◽  
...  

Objective:To complete missing information on the influence of spiritual and religious advisors as informal providers for mental health problems in Europe.Methods:Recourse to religious practice or belief when coping with mental health problems was evaluated using data from the ESEMED survey. This was a stratified, multistage, clustered-area probability sample survey of mental health carried out in six European countries which included 8796 subjects. Between countries differences in sociodemographic characteristics, religious affiliation, and prevalence of mental disorders and management of mental disorders were evaluated.Results:Religion appears to play a limited role in coping with mental health problems in Europe. Only 7.9% of individuals seeking help for such problems turned to a religious advisor. This proportion differed between countries from 13% in Italy, 12.5% in Germany, 10.5% in the Netherlands, 5.8% in France, 4.7% in Belgium to 4% in Spain. In addition, seeking help exclusively from religion was reported by only 1.3% of subjects. Practicing religion at least once a week and considering religion as important in daily life were predictors of using religion versus conventional health care only. Use of religion was not influenced by gender and age. Non-Christian respondents and individuals with alcohol disorders were more likely to use religion. In Spain, the use of religion is much lower than average.Conclusions:Unlike the situation in the United States, organised religion does not provide alternative informal mental health care in Europe. At best, it could be considered as an adjunct to conventional care.


2020 ◽  
Author(s):  
Steven Gillard ◽  
Ceri Dare ◽  
Jackie Hardy ◽  
Patrick Nyikavaranda ◽  
Rachel Rowan Olive ◽  
...  

AbstractPurposeResearch is beginning to quantify the impact of COVID-19 on people with pre-existing mental health conditions. Our paper addresses a lack of in-depth qualitative research exploring their experiences and perceptions of how life has changed at this time.MethodsWe used qualitative interviews (N=49) to explore experiences of the pandemic for people with pre-existing mental health conditions. In a participatory, coproduced approach, researchers with lived experiences of mental health conditions conducted interviews and analysed data as part of a multi-disciplinary research team.ResultsExisting mental health difficulties were exacerbated for many people. People experienced specific psychological impacts of the pandemic, struggles with social connectedness, and inadequate access to mental health services, while some found new ways to cope and connect to community. New remote ways to access mental health care, including digital solutions, provided continuity of care for some but presented substantial barriers for others. People from black and ethnic minority (BAME) communities experienced heightened anxiety, stigma and racism associated with the pandemic, further impacting their mental health.ConclusionThere is a need for evidence-based solutions to achieve accessible and effective mental health care in response to the pandemic, especially remote approaches to care. Further research should explore the long-term impacts of COVID-19 on people with pre-existing mental health conditions. Particular attention should be paid to understanding inequalities of impact on mental health, especially for people from BAME communities.


Expert public psychiatrists use case studies to share best practice strategies in this clinically oriented introduction to community mental health. Today, the majority of psychiatrists work with people who suffer not only from mental illness but also from poverty, trauma, social isolation, and discrimination. Psychiatrists cannot do this work alone but, instead, are part of teams of behavioral health workers navigating larger health care and social service systems. In an increasingly complex health care environment, mental health clinicians need to master systems-based practice in order to provide optimal care to their patients. The rapid development of public psychiatry training programs is a response to the learning needs of psychiatrists in an evolving system. This book begins with seven foundational principles of public psychiatry—recovery, trauma-informed care, integrated care, cultural humility, harm reduction, systems of care, and financing care—using cases to bring these concepts to life. Then, using a population health framework, cases are used to explore the typical needs of different age groups or vulnerable populations and to illustrate evidence-based/best practices that have been employed to meet these needs. Common to all of the chapters is a focus on the potential of each person, regardless of illness, to achieve personal goals, supported by a clinician who is also an advocate, activist, and leader.


2021 ◽  
Author(s):  
Esther O Okogbenin ◽  
Omonefe J Seb-Akahomen ◽  
Osahogie I. Edeawe ◽  
Mary Ehimigbai ◽  
Helen Eboreime ◽  
...  

Objective The Coronavirus Disease 2019 (COVID-19) has had devastating effects globally. These effects are likely to result in mental health problems at different levels. Although studies have reported the mental health burden of the pandemic on the general population and frontline health workers, the impact of the disease on the mental health of patients in COVID-19 treatment and isolation centres have been understudied in Africa. We estimated the prevalence of depression and anxiety and associated risk factors in hospitalized persons with COVID-19. Methods A cross-sectional survey was conducted among 489 patients with COVID-19 at the three government-designated treatment and isolation centres in Edo State, Nigeria. The 9-item Patient Health Questionnaire (PHQ-9) and the Generalized Anxiety Disorder-7 (GAD-7) tool were used to assess depression and anxiety respectively. Binary logistic regression was applied to determine risk factors of depression and anxiety. Results Of the 489 participants, 49.1% and 38.0% had depressive and anxiety symptoms respectively. The prevalence of depression, anxiety, and combination of both were 16.2%, 12.9% and 9.0% respectively. Moderate-severe symptoms of COVID-19, ≥14 days in isolation, worrying about the outcome of infection and stigma increased the risk of having depression and anxiety. Additionally, being separated/divorced increased the risk of having depression and having comorbidity increased the risk of having anxiety. Conclusion A substantial proportion of our participants experienced depression, anxiety and a combination of both especially in those who had the risk factors we identified. The findings underscore the need to address these risk factors early in the course of the disease and integrate mental health interventions into COVID-19 management guidelines.


2021 ◽  
Vol 5 (1) ◽  
pp. 433
Author(s):  
Yeni Elviani ◽  
A. Gani ◽  
Wahyu Dwi Ari Wibowo

ABSTRAKTerbentuknya kader kesehatan jiwa di masyarakat merupakan angin segar bagi pelayanan kesehatan jiwa. Hal ini harus didukung oleh tingkat pengetahuan, kemampuan, dan pengalaman kader dalam menangani penderita gangguan jiwa, sehingga perlu diadakan pendidikan bagi kader kesehatan jiwa dalam penanganan gangguan jiwa dan deteksi gangguan jiwa di masyarakat. Kader kesehatan jiwa berperan sebagai penghubung antara tenaga kesehatan di fasilitas kesehatan dengan masyarakat. Metode dilakukan dengan cara berkoordinasi dengan ketua kader kesehatan dan petugas kesehatan di Puskesmas Bandar Jaya untuk membentuk kader kesehatan jiwa dan memberikan edukasi kader terkait penanganan dan pendeteksian gangguan jiwa.Tingkat pengetahuan kader tentang penanganan dan pendeteksian gangguan jiwa sebelum dibentuknya kader kesehatan jiwa dan pendidikan kesehatan pada kategori kurang (75%) dan cukup (25%), dan semua kader tidak dapat mendeteksi gangguan jiwa. Setelah mendapatkan penyuluhan terjadi peningkatan pengetahuan kader pada kategori baik menjadi 60%, kategori baik 40%, dan tidak ada kader dalam kategori tingkat pengetahuan kurang, untuk deteksi gangguan jiwa 75% kader mampu mendeteksi gangguan jiwa. Setelah terciptanya kader kesehatan jiwa dan kegiatan ini diharapkan dapat menciptakan kader kesehatan jiwa di masyarakat yang dapat meningkatkan efektivitas pencegahan, kuratif, dan pemulihan masalah kesehatan jiwa khususnya dalam penanganan dan pendeteksian gangguan jiwa di masyarakat. Kata kunci: kader kesehatan jiwa; dekteksi gangguan jiwa; gangguan jiwa; komunitas.  ABSTRACTThe establishment of mental health cadres in the community is good news for mental health services. It must be supported by the cadre’s level of knowledge, ability, and experience in handling people with mental disorders. It is necessary to educate mental health cadres on handling mental disorders and detecting mental disorders in the community. Mental health cadres serve as a communicator between health workers in health facilities and the community. The method is used by coordinating with cadre’s leader and health workers in the Bandar Jaya Public health center to educate cadres about handling and detecting mental disorders. The level of knowledge of cadres before education and training was 74% of respondents lacking knowledge, 25% of respondents had sufficient knowledge, and no one of respondents had good knowledge of handling and detecting mental disorders. The level of knowledge obtained after education was carried out, and there was an increase in knowledge where 60% of respondents obtained good knowledge scores, 40% of respondents had sufficient knowledge. There were no respondents who found that their level of knowledge was lacking. This activity is expected to create mental health cadres in the community to increase the effectiveness of preventive, curative, and recovery mental health problems, especially in handling and detecting mental disorders in the community. Keywords:  mental health cadre; mental disorder detection; mental disorders; community.  


Author(s):  
M. Silva ◽  
D. M. Resurrección ◽  
A. Antunes ◽  
D. Frasquilho ◽  
G. Cardoso

Abstract Aims Unmet needs for mental health treatment are large and widespread, and periods of economic crisis may increase the need for care and the treatment gap, with serious consequences for individuals and society. The aim of this systematic review was to summarise the empirical evidence on the association between periods of economic crisis and the use of mental health care. Methods Following the PRISMA statement, MEDLINE, Embase, Scopus, Open Grey and Cochrane Database were searched for relevant publications, published between 1990 and 2018, from inception to June 2018. Search terms included (1) economic crisis, (2) use of mental health services and (3) mental health problems. Study selection, data extraction and the assessment of study quality were performed in duplicate. Results Seventeen studies from different countries met the inclusion criteria. The results from the included articles suggest that periods of economic crisis might be linked to an increase of general help sought for mental health problems, with conflicting results regarding the changes in the use of specialised psychiatric care. The evidence on the use of mental health care specifically due to suicide behaviour is mixed. The results also suggest that economic crises might be associated with a higher use of prescription drugs and an increase in hospital admissions for mental disorders. Conclusions Research on the impact of economic crises on the use of mental health care is scarce, and methodologies of the included papers are prone to substantial bias. More empirical and long-term studies on this topic are needed, in order to adapt mental health care systems to the specific needs of the population in times of economic crisis.


2004 ◽  
Vol 15 ◽  
pp. 29-42 ◽  
Author(s):  
Betty E. Koka ◽  
Frank P. Deane ◽  
Gordon Lambert

Confidence in identifying different diagnostic categories of mental disorders by general health workers who provide the bulk of Papua New Guinea's (PNG) mental health care is vital for the country's provision of mental health care. Making a psychiatric diagnosis is complicated by PNG's diverse culture and estimated 800 distinct languages. These cultural-linguistic factors influence help-seeking behaviour and continued use of traditional treatment despite the introduction of western approaches to mental health care. The aim of this study was to determine the confidence of health workers in identifying and diagnosing different categories of mental health problems in this complex environment. A sample of 209 Papua New Guinea health workers from four geographic regions completed a questionnaire that assessed background levels of training and confidence in diagnosing a range of modern and culture specific diagnoses. Overall, respondents reported relatively little prior mental health training. Consistent with this were the relatively low levels of confidence for culture specific diagnoses (e.g. sorcery), but significantly higher levels of confidence with modern diagnoses (e.g. depression). The implications of the findings for training and provision of mental health care are discussed.


Author(s):  
J. E. M. Nakku ◽  
S. D. Rathod ◽  
E. C. Garman ◽  
J. Ssebunnya ◽  
S. Kangere ◽  
...  

Abstract Background The burden of mental disorders in low- and middle-income countries is large. Yet there is a major treatment gap for these disorders which can be reduced by integrating the care of mental disorders in primary care. Aim We aimed to evaluate the impact of a district mental health care plan (MHCP) on contact coverage for and detection of mental disorders, as well as impact on mental health symptom severity and individual functioning in rural Uganda. Results For adults who attended primary care facilities, there was an immediate positive effect of the MHCP on clinical detection at 3 months although this was not sustained at 12 months. Those who were treated in primary care experienced significant reductions in symptom severity and functional impairment over 12 months. There was negligible change in population-level contact coverage for depression and alcohol use disorder. Conclusion The study found that it is possible to integrate mental health care into primary care in rural Uganda. Treatment by trained primary care workers improves clinical and functioning outcomes for depression, psychosis and epilepsy. Challenges remain in accessing the men for care, sustaining the improvement in detection over time, and creating demand for services among those with presumed need.


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