scholarly journals Impact of the COVID-19 Pandemic on the General Mental Health in Sweden: No Observed Changes in the Dispensed Amount of Common Psychotropic Medications in the Region of Scania

2021 ◽  
Vol 12 ◽  
Author(s):  
Mirjam Wolfschlag ◽  
Cécile Grudet ◽  
Anders Håkansson
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Interrupted Time Series ◽  
Psychotropic Medications ◽  
Interrupted Time Series Analysis ◽  
Swedish Population ◽  
General Mental Health ◽  
Before And After ◽  
The One

Some first investigations have focused on the consequences of the COVID-19 pandemic for the general mental health after its outbreak in 2020. According to multiple self-reporting surveys, symptoms of stress, anxiety, and depression have risen worldwide. Even some studies based on health care records start to be published, providing more objective and statistically reliable results. Additionally, concerns have been raised, to what extend the access to mental health care has been compromised by the COVID-19 outbreak. The aim of this study was to detect changes in prescription trends of common psychotropic medications in the Swedish region of Scania. The monthly dispensed amounts of selected pharmaceuticals were compared from January 2018 until January 2021, regarding the prescription trends before and after the outbreak of COVID-19. Using an interrupted time series analysis for each medication, no general trend changes were observed. On the one hand, a possible deterioration of the general mental health could not be confirmed by these results. On the other hand, the access to mental health care did not seem to be impaired by the pandemic. When interpreting findings related to the COVID-19 pandemic, regional differences and country-specific approaches for coping with the pandemic should be considered. The Swedish population, for instance, never experienced a full “lock-down” and within Sweden the time point of the outbreak waves differed regionally. In general, the effects of the COVID-19 outbreak on mental health are still unclear and need to be investigated further in an international comparison.

scholarly journals Antidepressant and mental health care utilization in pregnant women with depression and/or anxiety: an interrupted time-series analysis

2021 ◽  
Author(s):  
Nhung TH Trinh ◽  
Hedvig ME Nordeng ◽  
Gretchen Bandoli ◽  
Malin MC Eberhard-Gran ◽  
Angela Lupattelli
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Time Series ◽  
Health Care Utilization ◽  
Mental Health Care ◽  
Time Window ◽  
Interrupted Time Series ◽  
Care Utilization ◽  
Interrupted Time Series Analysis ◽  
Mental Health Care Utilization

Objectives To assess mental health care utilization patterns during and after pregnancy in women with depression and/or anxiety in Norway according to antidepressant fill trajectories in pregnancy. Method We conducted a registry-linkage cohort study of pregnancies within women having outpatient visit for depression and/or anxiety and antidepressant fills in the six months prior to pregnancy identified from four national registries of Norway (2009-2018). Number of consultations for depression/anxiety per 100 pregnancies as proxy of mental health care utilization were modelled using interrupted time-series analysis with first month into pregnancy and first month after delivery as interruption points. We investigated the time window including six months prior to pregnancy, eight months into pregnancy and one year postpartum. Antidepressant fill trajectories in the corresponding time window were identified using longitudinal k-means trajectory modelling. Results The cohort included 8,460 pregnancies within 8,062 women with depression/anxiety. We observed reduced mental health care utilization when pregnant women entered the course of pregnancy (negative slopes during pregnancy for all psychiatric specialists and psychologists). The declines were observed for all antidepressant fill trajectories (i.e., discontinuers and continuers) except interrupters (i.e., discontinued then resumed treatment). We found increased mental health care utilization in the postpartum year, notably in interrupters (positive slopes in consultation rates with specialists of outpatient clinics and public-contracted psychiatrists).. Conclusions Pregnancy was associated with reduced mental health care utilization regardless of whether antidepressant treatment was maintained during pregnancy or not. Increases in mental health care utilization were observed in the postpartum year, especially in interrupters.

Diagnosis as a Detriment: A Cognitive Approach to Understanding the Depressive Experience

2015 ◽  
Vol 17 (2) ◽  
pp. 125-134 ◽  
Author(s):  
Evan Hy Einstein
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Theoretical Model ◽  
Mental Health Care ◽  
Cognitive Model ◽  
Clinical Applications ◽  
Psychotropic Medications ◽  
Cognitive Mechanisms ◽  
Cognitive Approach ◽  
The Brain

Depression is currently understood within a biomedical paradigm. This paradigm is an example of reductionism; people are clinically diagnosed and categorized based on behavior and affect, while they are then prescribed psychotropic medications based on an inconclusively correlated neurotransmitter imbalance in the brain. In this article, clinical diagnosis and labeling are explored with respect to their detrimental potential. A framework of embodied cognition is used to conceptualize a cognitive model of depressive experience. This theoretical model explores the potentially self-reinforcing cognitive mechanisms behind a depressive experience, with the goal of highlighting the possibility of diagnosis as a detrimental influence on these mechanisms. The aim of this article is to further a discussion about our current mental health care paradigm and provide an explanation as to how it could cause harm to some. Clinical applications of the model are also discussed pertaining to the potential of rendering formal dichotomist diagnoses irrelevant to the ultimate goal of helping people feel better.

scholarly journals The Results of Clinician-Focused Implementation Strategies on Uptake and Outcome of Measurement-Based Care in General Mental Health Care

2021 ◽  
Author(s):  
Maartje van Sonsbeek ◽  
Giel J. M. Hutschemaekers ◽  
Jan W. Veerman ◽  
Ad Vermulst ◽  
Bea G. Tiemens
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Treatment Outcome ◽  
Mental Health Care ◽  
Implementation Strategies ◽  
Completion Rate ◽  
Treatment Length ◽  
General Mental Health ◽  
Measurement Based Care ◽  
Satisfaction With Treatment

Abstract BACKGROUND: Measurement-Based Care (MBC) is a promising way to improve outcomes in clinical practice, but the implementation of MBC is often problematic and the uptake by clinicians is low.METHODS: We used an effectiveness-implementation hybrid design based on Grol and Wensing’s implementation framework to examine the results of clinician-focused implementation strategies on both clinicians’ uptake of MBC and outcomes of MBC for clients in general mental health care. Primary outcomes were questionnaire completion rate and discussion of feedback. Secondary outcomes were treatment outcome, treatment length, and satisfaction with treatment. RESULTS: There was a significant medium effect of the MBC implementation strategies on questionnaire completion rate (one part of the clinicians’ uptake), but no significant effect on the amount of discussion of the feedback (the other part of the clinicians’ uptake). Neither was there a significant effect on clients’ outcomes (treatment outcome, treatment length, satisfaction with treatment).CONCLUSIONS: Establishing and sustaining MBC in real world general mental health care is very complex. Our study helps to disentangle the effects of MBC implementation strategies on differential clinician uptake, but the effects of MBC implementation strategies on client outcomes need further examination.

scholarly journals Nonprofessional Peer Support to Improve Mental Health: Randomized Trial of a Scalable Web-Based Peer Counseling Course

10.2196/17164 ◽  
2020 ◽  
Vol 22 (9) ◽  
pp. e17164 ◽  
Author(s):  
Samantha L Bernecker ◽  
Joseph Jay Williams ◽  
Norian A Caporale-Berkowitz ◽  
Akash R Wasil ◽  
Michael J Constantino
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Health Care System ◽  
Skills Training ◽  
Counseling Skills ◽  
Web Based ◽  
Mental Health Care System ◽  
Before And After ◽  
Care System

Background Millions of people worldwide are underserved by the mental health care system. Indeed, most mental health problems go untreated, often because of resource constraints (eg, limited provider availability and cost) or lack of interest or faith in professional help. Furthermore, subclinical symptoms and chronic stress in the absence of a mental illness diagnosis often go unaddressed, despite their substantial health impact. Innovative and scalable treatment delivery methods are needed to supplement traditional therapies to fill these gaps in the mental health care system. Objective This study aims to investigate whether a self-guided web-based course can teach pairs of nonprofessional peers to deliver psychological support to each other. Methods In this experimental study, a community sample of 30 dyads (60 participants, mostly friends), many of whom presented with mild to moderate psychological distress, were recruited to complete a web-based counseling skills course. Dyads were randomized to either immediate or delayed access to training. Before and after training, dyads were recorded taking turns discussing stressors. Participants’ skills in the helper role were assessed before and after taking the course: the first author and a team of trained research assistants coded recordings for the presence of specific counseling behaviors. When in the client role, participants rated the session on helpfulness in resolving their stressors and supportiveness of their peers. We hypothesized that participants would increase the use of skills taught by the course and decrease the use of skills discouraged by the course, would increase their overall adherence to the guidelines taught in the course, and would perceive posttraining counseling sessions as more helpful and their peers as more supportive. Results The course had large effects on most helper-role speech behaviors: helpers decreased total speaking time, used more restatements, made fewer efforts to influence the speaker, and decreased self-focused and off-topic utterances (ds=0.8-1.6). When rating the portion of the session in which they served as clients, participants indicated that they made more progress in addressing their stressors during posttraining counseling sessions compared with pretraining sessions (d=1.1), but they did not report substantive changes in feelings of closeness and supportiveness of their peers (d=0.3). Conclusions The results provide proof of concept that nonprofessionals can learn basic counseling skills from a scalable web-based course. The course serves as a promising model for the development of web-based counseling skills training, which could provide accessible mental health support to some of those underserved by traditional psychotherapy.

scholarly journals Mental Health Recovery: Evaluation of a Recovery-Oriented Training Program

2012 ◽  
Vol 2012 ◽  
pp. 1-8 ◽  
Author(s):  
G. K. M. L. Wilrycx ◽  
M. A. Croon ◽  
A. H. S. van den Broek ◽  
Ch. van Nieuwenhuizen
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Illness ◽  
Mental Health Care ◽  
Training Program ◽  
Serious Mental Illness ◽  
Health Care Professionals ◽  
Interrupted Time Series ◽  
Knowledge And Attitudes ◽  
Using Data

Aim. This study investigates the effectiveness of a recovery-oriented training program on knowledge and attitudes of mental health care professionals towards recovery of people with serious mental illness.Methods. Using data from a longitudinal study of recovery, changes in knowledge and attitudes of 210 mental health care professionals towards recovery were explored using the Recovery Attitude Questionnaire and the Recovery Knowledge Inventory. The study uses a two-group multiple intervention interrupted time-series design which is a variant of the stepped-wedge trial design. A total of six measurements occasions took place.Results. This study shows that professionals' attitudes towards recovery from mental illness can improve with training. After two intensive recovery-oriented training sessions, mental health care professionals have a more positive attitude towards recovery in clinical practice.Conclusion. A recovery-oriented training program can change attitudes of mental health care professionals towards recovery of serious mental illness.

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