Health Care and Community-based Interventions for War-traumatized People in Croatia: Community-based Study of Service Use and Mental Health

Background: Skepticism of therapy and stigma are significant barriers for veterans with mental health issues. Therapeutic adventure shows promise in addressing veterans’ mental health needs while circumventing the stigma many veterans face in initiating treatment. Purpose: Given the small group model of therapeutic adventure programs, such programs may be ideal to provide social support for veterans and reduce mental health symptomology. The present study investigated: can a brief peer-led therapeutic adventure program modify veterans’ mental health symptoms? Methodology/Approach: The study's sample included 56 participants attending one Sierra Club Military Outdoors trip lasting at least three days and two nights and involving camping. Participants completed study measurements assessing depression, anxiety, stress, Post-Traumatic Stress Disorder symptoms, substance misuse symptoms, and suicidality at pre-trip, post-trip, one-month post trip, six-months post trip, and 12-months post trip. Six-month and 12-month post-trip data was collected during the COVID-19 pandemic. Findings/Conclusions: Results indicated significant reduction in mental health symptomology from pre-trip to post-trip, but showed few longer-term changes in mental health symptomology. Implications: The present study's findings are consistent with research suggesting improvements in overall psychological well-being immediately following a nature-based intervention and suggest the need for on-going, community-based interventions to support optimally military veterans’ mental health.

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Community interventions for people with complex emotional needs that meet the criteria for ‘personality disorder’ diagnoses: a systematic review of economic evaluations

10.1101/2020.11.03.20225078 ◽

2020 ◽

Author(s):

Joe Botham ◽

Amy Clark ◽

Thomas Steare ◽

Ruth Stuart ◽

Sian Oram ◽

...

Keyword(s):

Mental Health ◽

Cost Effectiveness ◽

Personality Disorder ◽

Economic Evaluations ◽

Economic Evidence ◽

Emotional Needs ◽

Community Based Interventions ◽

Community Based ◽

Single Intervention ◽

The Cost

AbstractBackgroundDiagnoses of “personality disorder” are prevalent among people using community secondary mental health services. Whilst the effectiveness of a range of community-based treatments have been considered, as the NHS budget is finite, it is also important to consider the cost-effectiveness of those interventions.AimsTo assess the cost-effectiveness of primary or secondary care community-based interventions for people with complex emotional needs that meet criteria for a diagnosis of “personality disorder” to inform healthcare policy making.MethodSystematic review (PRESPORO #: CRD42020134068) of five databases, supplemented by reference list screening and citation tracking of included papers. We included economic evaluations of interventions for adults with complex emotional needs associated with a diagnosis of ‘personality disorder’ in community mental health settings published between before 18 September 2019. Study quality was assessed using the CHEERS statement. Narrative synthesis was used to summarise study findings.ResultsEighteen studies were included. The studies mainly evaluated psychotherapeutic interventions. Studies were also identified which evaluated altering the setting in which care was delivered and joint crisis plans. No strong economic evidence to support a single intervention or model of community-based care was identified.ConclusionThere is no robust economic evidence to support a single intervention or model of community-based care for people with complex emotional needs. The review identified the strongest evidence for Dialectical Behavioural Therapy with all three identified studies indicating the intervention is likely to be cost-effective in community settings compared to treatment as usual. Further research is needed to provide robust evidence on the cost-effectiveness of community-based interventions upon which decision makers can confidently base guidelines or allocate resources.

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Psychological Science Into Practice During the COVID-19 Pandemic

European Psychologist ◽

10.1027/1016-9040/a000458 ◽

2021 ◽

Vol 26 (4) ◽

pp. 387-396

Author(s):

Eleni Karayianni ◽

Tom Van Daele ◽

Jasminka Despot-Lučanin ◽

Josip Lopižić ◽

Nicholas Carr

Keyword(s):

Public Health ◽

Mental Health ◽

Professional Growth ◽

European Federation ◽

Evidence Based ◽

Community Based Interventions ◽

Community Based ◽

The Public ◽

The Third ◽

Psychological Science

Abstract. The public health outbreak of the COVID-19 virus has hit all aspects of life as we know it. We found ourselves trying to solve several concurrent crises that have afflicted us. The European Federation of Psychologists’ Associations (EFPA) launched the Psychologists’ Support Hub to share resources among its members and beyond and promote the continuing adoption of psychological science to battle the pandemic. In the greater context of evidence-based practice (EBP), the best available evidence is what we turn to for help in our decision-making on how best to address different challenges. However, there are challenges in implementing EBP when the science is limited, and we are still expected to be effective and efficient as professionals. The article outlines the need for EBP during the pandemic. Three vignettes display how that can be done while identifying obstacles and recommending ways forward in the future. The first one relates to the development of e-mental health services in Belgium following the March 2020 lockdown. The second describes addressing the needs of older adults in Croatia when it was hit by two crises simultaneously – the March 2020 lockdown and a destructive earthquake. The third looks at how targeted community-based interventions in Norway directed at social change can positively impact times of crisis. Overall, the pandemic presents a unique opportunity for professional growth for researchers, trainers, practitioners, and policymakers alike. EFPA can play a pivotal role in EBP adoption.

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School and Community - based Youth Mental Health Intervention Studies in India: A Scoping Review

INDIAN JOURNAL OF MENTAL HEALTH AND NEUROSCIENCES ◽

10.32746/10.32746/ijmhns.2019.v2.i2.20 ◽

2019 ◽

Vol 2 (02) ◽

pp. 14-22

Author(s):

Ragaviveka Gopalan ◽

C Sangeetha ◽

P Ramakrishnan ◽

Vijaya Raghavan

Keyword(s):

Mental Health ◽

Young People ◽

Mental Disorders ◽

Youth Mental Health ◽

Health Interventions ◽

Community Based Interventions ◽

Community Based ◽

School Based ◽

School And Community ◽

Mental Health Interventions

BACKGROUND About 70% of mental disorders emerge in late childhood and young peo-ple bear the burden of these disorders throughout life. Yet, to date there has been com-paratively little research on mental health interventions for young people in India and not many attempts have been made to collate the existing literature. This systematic review aims to synthesize the available evidence on school- and community-based mental health interventions for young people in India. METHODS A range of major electronic databases were searched systematically, and the abstracts of relevant papers were independently examined for possible inclusion. Selected papers were read in full text and a standardized set of data items were extracted. RESULTS Four papers met inclusion criteria for the analysis; two studies of school-based interventions for adolescents and two studies evaluating out-of-school community interventions for youth were reviewed. The quality of evidence from the interventions in Indian school and community settings were poor. While two studies evidence the effectiveness of a school-based life skills programme and a community based multicomponent intervention designed to promote youth health, two other studies do not offer sufficient data. CONCLUSION The review findings indicate that the number of interventional studies conducted in India to address youth mental health issues are very limited. Hence, it is extremely difficult to ensure the feasibility and effectiveness of school and community-based interventions in India. Further research is warranted to establish whether interventions promoting youth mental health people can be implemented effectively in Indian settings with positive mental health outcomes. Given the possibility of a huge population of young people at-risk or experiencing mental disorders, evidence for the efficacy of youth mental health interventions is crucial.

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2. Looking Back: Reflections on the Reality of Community-Based Mental Health Care

10.36019/9781978818798-003 ◽

2021 ◽

pp. 17-35

Keyword(s):

Mental Health ◽

Health Care ◽

Mental Health Care ◽

Community Based ◽

Looking Back

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Treatment gap and mental health service use among Syrian refugees in Turkey

European Journal of Public Health ◽

10.1093/eurpub/ckz185.579 ◽

2019 ◽

Vol 29 (Supplement_4) ◽

Cited By ~ 1

Author(s):

D C Fuhr ◽

C Ataturk ◽

M McGrath ◽

Z Ilkkursun ◽

A Woodward ◽

...

Keyword(s):

Mental Health ◽

Health Care ◽

Mental Health Care ◽

Service Use ◽

Mental Health Problems ◽

Mental Health Service Use ◽

Continuing Care ◽

Syrian Refugees ◽

Depression And Anxiety ◽

Treatment Gap

Abstract Introduction Turkey hosts the highest number of Syrian refugees in Europe. Refugees are often vulnerable to situational forms of psychosocial distress as a consequence of exposure to war and violence which may result in more profound mental health problems if no treatment is sought. The aim of this study is to report evidence on mental health and psychosocial support (MHPSS) needs, access and barriers to MHPSS care among Syrians refugees living in Istanbul, Turkey. Methods A cross-sectional survey was conducted among Syrian refugees aged 18 years or over in Istanbul (Sultanbeyli) between February and May 2018. Data among 1’678 Syrian refugees were collected on mental health outcomes using the Posttraumatic Stress Disorder (PTSD) Checklist (PCL-5) and the Hopkins Symptoms Checklist (HSCL-25) for depression and anxiety. We also collected data on health care utilization, barriers to seeking and continuing care as well as knowledge and attitudes towards mental health. Descriptive analyses were used. Results The prevalence of PTSD, depression and anxiety was 19.6%, 34.7% and 36.1% respectively. The treatment gap was 89% for PTSD, 90% for anxiety and 88% for depression. 249 respondents (15%) screened positive for either PTSD, depression or anxiety in our survey and self-reported emotional/behavioural problems since arriving in Sultanbeyli. Several structural and attitudinal barriers for not seeking care were reported. Conclusions To overcome the treatment gap, mental health care programmes need to be more responsive to the needs of Syrian refugees. Barriers to seeking and continuing care can be overcome by providing MHPSS services in the community which facilitate access to care. Community-based programmes of care should be supported by activities which increase awareness about mental health issues and tackle negative attitudes towards mental illness. Key messages This study provides the first nationally representative data on the mental health of Syrian refugees in Turkey, and shows that refugees have high mental health needs. Syrian refugees do not seek mental health care despite availability of mental health services in the community.

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