scholarly journals Integrating eHealth within a Transforming Mental Healthcare Setting: A Qualitative Study into Values, Challenges, and Prerequisites

2021 ◽  
Vol 18 (19) ◽  
pp. 10287
Author(s):  
Karin Lorenz-Artz ◽  
Joyce Bierbooms ◽  
Inge Bongers
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Mental Healthcare ◽  
Healthcare Setting ◽  
High Impact ◽  
Future Research ◽  
Community Based ◽  
Main Challenge ◽  
Care Models

Mental health care is shifting towards more person-centered and community-based health care. Although integrating eHealth within a transforming healthcare setting may help accomplishing the shift, research studying this is lacking. This study aims to improve our understanding of the value of eHealth within a transforming mental healthcare setting and to define the challenges and prerequisites for implementing eHealth in particular within this transforming context. In this article, we present the results of 29 interviews with clients, social network members, and professionals of an ambulatory team in transition within a Dutch mental health care institute. The main finding is that eHealth can support a transforming practice shifting towards more recovery-oriented, person-centered, and community-based service in which shared-decision making is self-evident. The main challenge revealed is how to deal with clients’ voices, when professionals see the value of eHealth but clients do not want to start using eHealth. The shift towards client-centered and network-oriented care models and towards blended care models are both high-impact changes in themselves. Acknowledging the complexity of combining these high-impact changes might be the first step towards creating blended client-centered and network-oriented care. Future research should examine whether and how these substantial shifts could be mutually supportive.

scholarly journals The Effect of Expanded Access to Mental Health Care on Economic Status of Households with a Person with a Mental Disorder in Rural Ethiopia: A Controlled Before-After Study

2021 ◽  
Author(s):  
Yohannes Hailemichael ◽  
Damen Hailemariam ◽  
Kebede Tirfessa ◽  
Sumaiyah Docrat ◽  
Atalay Alem ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Economic Status ◽  
Mental Healthcare ◽  
Secular Trends ◽  
Community Control ◽  
Consumption Expenditure ◽  
Community Based ◽  
Expanded Access

Abstract BackgroundPoverty and mental illness are strongly associated. The aim of this study was to investigate the economic impact of implementing a district level integrated mental healthcare plan for people with severe mental disorders (SMD) and depression compared to secular trends in the general population in a rural Ethiopian setting.MethodsA community-based, controlled before-after study design was used to assess changes in household economic status and catastrophic out-of-pocket (OOP) payments in relation to expanded access to mental health care. Two household samples were recruited, each with a community control group: (1) SMD sub-study and (2) depression sub-study. In the SMD sub-study, 290 households containing a member with SMD and 289 comparison households without a person with SMD participated. In the depression sub-study, 129 households with a person with depression and 129 comparison households. The case and comparison cohorts were followed up over 12 months. Propensity score matching and multivariable regression analyses were conducted. ResultsProvision of mental healthcare in the district was associated with a greater increase in income (Birr 919.53, 95% CI: 34.49, 4573.56) but no significant changes in consumption expenditure (Birr 176.25, 95% CI: -1338.19, 1690.70) in households of people with SMD compared to secular trends in comparison households. In households of people with depression, there was no significant change in income (Birr 227.78, 95% CI: -1361.21, 1816.79) or consumption expenditure (Birr -81.20, 95% CI: -2572.57, 2410.15). The proportion of households incurring catastrophic OOP payments at the ≥10% and ≥40% thresholds were significantly reduced after the intervention in the SMD (from 20.3% to 9.0%, p=0.002, and 31.9% to 14.9%, p< 0.001) and in the depression intervention (from 19.6% to 5.3%, p=0.003, and 25.2% to 11.8%, p= 0.015). Nonetheless, households of persons with SMD or depression remained impoverished relative to comparison groups at follow-up. Households of people with SMD and depression were significantly less likely to be enrolled in community-based health insurance (CBHI) than comparison households. ConclusionsOur findings support global initiatives to scale up mental healthcare as part of universal health coverage initiatives, alongside interventions to support social inclusion and targeted financial protection for vulnerable households.

Integrating eHealth within a transforming healthcare setting: a qualitative study into values, challenges, and prerequisites. (Preprint)

2021 ◽  
Author(s):  
Karin CAG Lorenz-Artz ◽  
Joyce JPA Bierbooms ◽  
Inge MB Bongers
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Healthcare Service ◽  
Healthcare Setting ◽  
Successful Implementation ◽  
Structured Interviews ◽  
Community Based ◽  
Access To Treatment ◽  
Healthcare Settings

BACKGROUND The EU has stated that mental health care services should become more person-centered and community-based. eHealth may contribute to this change by allowing clients to take an active, decision-making role in their healthcare service. In the Netherlands, five organizations currently use the open dialogue (OD) approach, which is an example of a person-centered and community-based healthcare service. OD is a unique approach to organizing care and therapeutic intervention for people who need mental health support. One of these Dutch organizations has integrated the OD approach with eHealth. OBJECTIVE The aim of this study is to help the transition towards person-centered and community-based care models by improving our understanding of eHealth and by showing how eHealth can best be integrated into a transforming healthcare service. The objective is to better understand the value of eHealth within OD practice, and to define the challenges and prerequisites for implementing eHealth within this transforming practice. METHODS This qualitative, practice-oriented field study is part of a pilot project of an ambulatory OD team in a Dutch mental health care institute. In total, 29 semi-structured interviews were held with clients, social network members, and OD professionals between December 2017 and March 2019. We used a thematic coding approach for analyses. RESULTS eHealth was considered mainly beneficial outside the treatment meetings as it improves communication, simplifies planning of treatment meetings, and provides a broader access to treatment. Videoconferencing was considered an acceptable alternative if someone could not attend treatment meetings in person. Several challenges were identified regarding the implementation of eHealth into OD practices: (1) a lack of trust and interest in eHealth, (2) a lack of knowledge about eHealth, (3) the strong conviction that face-to-face contact is needed for effective care, (4) normative pressure to offer eHealth, and (5) introducing eHealth during the start-up of a new OD team. This study has highlighted the multi-level complexity of implementing eHealth and has identified several prerequisites for successful implementation on individual, organization, society, and digital-product levels. CONCLUSIONS The benefits and challenges of eHealth have been identified as well as the prerequisites for its implementation. An important dilemma is to what extent eHealth should be used in healthcare settings when the client is not motivated to use it. We need to find the balance between using eHealth and letting clients refuse to use it. Interviewees emphasized the relevance of a continuous dialogue about eHealth to improve understanding of the possibilities and limitations of eHealth within healthcare settings that are transitioning towards client-centered and network-oriented care, such as OD.

scholarly journals The Quality Mental Health Care Network: A roadmap to improving quality mental healthcare in Canada

2021 ◽  
Vol 34 (2) ◽  
pp. 100-106
Author(s):  
Emily J. Follwell ◽  
Siri Chunduri ◽  
Claire Samuelson-Kiraly ◽  
Nicholas Watters ◽  
Jonathan I. Mitchell
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Focus Groups ◽  
Lived Experiences ◽  
Mental Healthcare ◽  
Care Network ◽  
Key Informant ◽  
Health Care Network

Although there are numerous quality of care frameworks, little attention has been given to the essential concepts that encompass quality mental healthcare. HealthCare CAN and the Mental Health Commission of Canada co-lead the Quality Mental Health Care Network (QMHCN), which has developed a quality mental healthcare framework, building on existing provincial, national, and international frameworks. HealthCare CAN conducted an environmental scan, key informant interviews, and focus groups with individuals with lived experiences to develop the framework. This article outlines the findings from this scan, interviews and focus groups.

scholarly journals Alternative medicine under the Mental Health Care Act, 2017: Future implications and concerns

2022 ◽  
Vol 07 (01) ◽  
pp. 37-41
Author(s):  
Ramdas Ransing ◽  
Sujita Kumar Kar ◽  
Vikas Menon
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Alternative Medicine ◽  
Mental Healthcare ◽  
Evidence Base ◽  
Evidence Based ◽  
Insufficient Evidence ◽  
Indian Government ◽  
Evidence Based Care

In recent years, the Indian government has been promoting healthcare with an insufficient evidence base, or which is non-evidence-based, alongside delivery of evidence-based care by untrained practitioners, through supportive legislation and guidelines. The Mental Health Care Act, 2017, is a unique example of a law endorsing such practices. In this paper, we aim to highlight the positive and negative implications of such practices for the delivery of good quality mental healthcare in India.

scholarly journals Efforts and Challenges to Ensure Continuity of Mental Healthcare Service Delivery in a Low Resource Settings During COVID-19 Pandemic—A Case of a Kenyan Referral Hospital

2021 ◽  
Vol 11 ◽  
Author(s):  
Edith Kwobah ◽  
Florence Jaguga ◽  
Kiptoo Robert ◽  
Elias Ndolo ◽  
Jane Kariuki
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Health Care ◽  
Service Delivery ◽  
Mental Health Care ◽  
Healthcare Service ◽  
Healthcare Delivery ◽  
Mental Healthcare ◽  
Referral Hospital ◽  
Number Of Patients

The rising number of patients with Covid-19 as well as the infection control measures have affected healthcare service delivery, including mental healthcare. Mental healthcare delivery in low and middle income countries where resources were already limited are likely to be affected more during this pandemic. This paper describes the efforts of ensuring mental healthcare delivery is continued in a referral hospital in Kenya, Moi Teaching and Referral hospital, as well as the challenges faced. These efforts are guided by the interim guidelines developed by the Kenyan ministry of health. Some of the adjustments described includes reducing number of patients admitted, shortening the stay in the inpatient setting, using outdoors for therapy to promote physical distancing, utilization of electronic platforms for family therapy sessions, strengthening outpatient services, and supporting primary care workers to deliver mental health care services. Some of the challenges include limited ability to move about, declining ability for patients to pay out of pocket due to the economic challenges brought about by measures to control Covid-19, limited drug supplies in primary care facilities, inability to fully implement telehealth due to connectivity issues and stigma for mental health which results in poor social support for the mentally ill patients. It is clear that current pandemic has jeopardized the continuity of usual mental healthcare in many settings. This has brought to sharp focus the need to decentralize mental health care and promote community based services. Meanwhile, there is need to explore feasible alternatives to ensure continuity of care.

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