scholarly journals Improving Customisation in Clinical Pathways by Using a Modular Perspective

2021 ◽  
Vol 18 (21) ◽  
pp. 11129
Author(s):  
Anne van Dam ◽  
Margot Metz ◽  
Bert Meijboom
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Clinical Pathways ◽  
Evidence Based ◽  
Structured Interviews ◽  
Treatment Needs ◽  
Health Care Organisation ◽  
Care Organisation ◽  
Care Processes

A standardised system of clinical pathways often conflicts with providing patient-centred heterogeneous care. Mental health care organisations are searching for new methods to become responsive towards unique treatment needs. Modularity is a method increasingly suggested to reconcile standardisation and customisation. The aim is to investigate the extent to which modularity can be applied to make clinical pathways in specialist mental health care more flexible in order to stimulate shared decision making (SDM) and thereby customise care processes to patient contexts while maintaining evidence-based standards. Methods consist of literature research and a theory-based case study including document analysis and semi-structured interviews, which were performed at a Dutch specialist mental health care organisation. The results show that in current literature two modularity-based structures are proposed that support flexibility and customisation, i.e., ‘Prototype’ and ‘Menu-based’. This study reveals that departments tend to use the prototype method if they have predictable patient needs, evidence-based methods are available and there is sequency in treatment components. The menu-based method is preferred if there are unpredictable needs, or the evidence needed to create interconnectedness in treatment is lacking. In conclusion, prototype or menu-based methods are both suitable for applying SDM and reaching customisation in practice. The choice is determined by three characteristics: predictability of needs, availability of evidence and the interconnectedness of treatment components.

scholarly journals The problems of offenders with mental disorders: A plurality of perspectives within a single mental health care organisation

2006 ◽  
Vol 63 (4) ◽  
pp. 1097-1108 ◽  
Author(s):  
Jacqueline P. Davies ◽  
Bob Heyman ◽  
Paul M. Godin ◽  
Monica P. Shaw ◽  
Lisa Reynolds
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Disorders ◽  
Mental Health Care ◽  
Health Care Organisation ◽  
Care Organisation

scholarly journals Successful implementation of self-managing teams

2019 ◽  
Vol 32 (1) ◽  
pp. 113-128 ◽  
Author(s):  
Wilke Weerheim ◽  
Lisa Van Rossum ◽  
Wouter Dirk Ten Have
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Success Factors ◽  
Successful Implementation ◽  
Health Care Organisation ◽  
Content Type ◽  
Care Organisation ◽  
Open Coding ◽  
Organisation Structure

Purpose Following health-care organisations, many mental health-care organisations nowadays consider starting to work with self-managing teams as their organisation structure. Although the concept could be effective, the way of implementing self-managing teams in an organisation is crucial to achieve sustainable results. Therefore, this paper aims to examine how working with self-managing teams can be implemented successfully in the mental health-care sector where various factors for the successful implementation are distinguished. Design/methodology/approach This qualitative case study is executed by analysing 18 interviews within two self-managing teams in a mental health-care organisation located in the Netherlands. A coding process is executed in two steps. The first step is open coding, to make small summarising notes within each interview section. The second step is refocused coding, where the open codes were collected, categorised and summarised by searching for recurrence and significance. The coding process is made visible within a code tree. This code tree formed the basis for writing the findings. Findings Success factors for the implementation of a self-managing team that resulted from this research are a clear task portfolio division, good relationships within the team and a coaching trajectory with attention for a possible negative past. Originality/value By having used a specific change management model, the Change Competence Model, it can be concluded that a high change capacity will positively influence the success of a self-managing team in the context of a mental health-care organisation.

Suicidal ideation in an ethnically mixed, highland Guatemalan community

2021 ◽  
pp. 136346152097693
Author(s):  
Carla Pezzia ◽  
Luisa M. Hernandez
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Ethnic Identity ◽  
Suicidal Ideation ◽  
Mental Health Care ◽  
Protective Factor ◽  
Indigenous Populations ◽  
Structured Interviews ◽  
And Gender ◽  
Survey Responses

Reported suicide rates in Latin America remain low, but there is evidence to suggest they may be increasing, particularly among indigenous populations. To better understand who may be at risk for suicide, we examined the prevalence of suicidal ideation and explored factors contributing to suicidal thoughts in an ethnically mixed, highland Guatemalan community. The data presented in this article are from a mixed methods ethnographic field project conducted over 15 months from 2010 to 2011 in Panajachel, Guatemala. We surveyed a random sample of 350 community members. Survey questions included standardized modules from the Mini-International Neuropsychiatric Interview, as well as questions on experiences of violence and mental health care. We also conducted semi-structured interviews with 13 self-selected survey participants with current suicidal ideation. These interviews included questions regarding survey responses, experiences of mental illness, and access to mental health care. A total of 55 survey participants (N = 350; 15.7%) scored positive for suicidality. Ethnic identity, gender, psychiatric illness, and experiences of violence were all correlated to suicidal ideation. Qualitative interview data highlight distinctions between genders within prominent themes of religion, family, experiences of violence, and seeking resources. Three key findings emerged from our research that are relevant to the literature: 1) ethnic identity may be both a critical risk and a protective factor for suicide in some indigenous people; 2) intersections between violence and gender highlight different patterns in suicidal ideation; and 3) high rates of suicidal ideation and other psychiatric comorbidities underscore the need for greater access to mental health services.

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.

Mental Health Care Interventions in Child Welfare: Integrative Review of Evidence-Based Literature

2018 ◽  
Vol 39 (9) ◽  
pp. 746-756
Author(s):  
Mari Lahti ◽  
Merle Linno ◽  
Janika Pael ◽  
Margit Lenk-Adusoo ◽  
Eeva Timonen-Kallio
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Child Welfare ◽  
Mental Health Care ◽  
Integrative Review ◽  
Evidence Based ◽  
Health Care Interventions

scholarly journals Adolescents with mental disorders while serving time and being subjected to socio-educative measures

2014 ◽  
Vol 19 (3) ◽  
pp. 891-898 ◽  
Author(s):  
Natália Pereira Gonçalves Vilarins
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Disorders ◽  
Mental Health Care ◽  
Participant Observation ◽  
Federal District ◽  
Adolescent Offenders ◽  
Structured Interviews ◽  
Research Committee ◽  
Ethics Research

This article examines how adolescent offenders with mental disorders are treated by socio-educative internment treatment. These adolescents come under the aegis of medicine and justice in a contradictory relationship between full protection, vulnerability of a developing person with a mental disorder and a juvenile delinquency offense. In this respect, the legal punishment prevails to the detriment of health care. After approval of the research project by an Ethics Research Committee, field research was conducted in the Youth Detention Unit of the Pilot Plan of the Brazilian Federal District. Data were collected through research of documents involving 35 medical records of adolescent users of psychotropic drugs in 2010, as well as participant observation and semi-structured interviews with professionals from the Youth Detention Unit and adolescent judiciary. In the review of the care provided to adolescent offenders with mental disorders under the childhood and youth policy and the mental health policy, it was revealed that the mental health care provided in the Youth Detention Unit or in the external mental health care services involved the prescription of medication.

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