scholarly journals From Research to Practice: Ten Lessons in Delivering Digital Mental Health Services

2019 ◽  
Vol 8 (8) ◽  
pp. 1239 ◽  
Author(s):  
Nickolai Titov ◽  
Heather D. Hadjistavropoulos ◽  
Olav Nielssen ◽  
David C. Mohr ◽  
Gerhard Andersson ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Psychological Treatment ◽  
Large Body ◽  
Routine Care ◽  
Outcome Data ◽  
Lessons Learned ◽  
Funding Policy ◽  
Four Levels

There is a large body of research showing that psychological treatment can be effectively delivered via the internet, and Digital Mental Health Services (DMHS) are now delivering those interventions in routine care. However, not all attempts to translate these research outcomes into routine care have been successful. This paper draws on the experience of successful DMHS in Australia and Canada to describe ten lessons learned while establishing and delivering internet-delivered cognitive behavioural therapy (ICBT) and other mental health services as part of routine care. These lessons include learnings at four levels of analysis, including lessons learned working with (1) consumers, (2) therapists, (3) when operating DMHS, and (4) working within healthcare systems. Key themes include recognising that DMHS should provide not only treatment but also information and assessment services, that DMHS require robust systems for training and supervising therapists, that specialist skills are required to operate DMHS, and that the outcome data from DMHS can inform future mental health policy. We also confirm that operating such clinics is particularly challenging in the evolving funding, policy, and regulatory context, as well as increasing expectations from consumers about DMHS. Notwithstanding the difficulties of delivering DMHS, we conclude that the benefits of such services for the broader community significantly outweigh the challenges.

Promoting Integrated Mental Health Care Services in Disaster Response Programs: Lessons Learned After the Impact of Hurricane María in Puerto Rico

2019 ◽  
Vol 14 (1) ◽  
pp. 130-138
Author(s):  
Julio C. Jiménez Chávez ◽  
Esteban Viruet Sánchez ◽  
Fernando J. Rosario Maldonado ◽  
Axel J. Ramos Lucca ◽  
Barbara Barros Cartagena
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Low Socioeconomic Status ◽  
Disaster Response ◽  
Health Care Services ◽  
Secondary Data ◽  
Lessons Learned ◽  
Care Services ◽  
The Impact

ABSTRACTMeteorological and even human-made disasters are increasing every year in frequency and magnitude. The passage of a disaster affects a society without distinction, but groups with social vulnerability (low socioeconomic status, chronic medical, or psychological conditions, limited access to resources) face the most significant impact. As a result, psychological and behavioral symptoms (eg, depression and anxiety) can ensue, making the immediate response of mental health services crucial. Secondary data from a database of a temporary healthcare unit were analyzed. A total of 54 records were reviewed to collect information; univariate and bivariate analyses were done. The purpose of this article is to present our experience regarding the incorporation of a mental health services model, with its respective benefits and challenges, into a temporary healthcare unit, after Hurricane Maria in 2017.

scholarly journals Improving Implementation of eMental Health for Mood Disorders in Routine Practice: Systematic Review of Barriers and Facilitating Factors

2018 ◽  
Vol 5 (1) ◽  
pp. e20 ◽  
Author(s):  
Christiaan Vis ◽  
Mayke Mol ◽  
Annet Kleiboer ◽  
Leah Bührmann ◽  
Tracy Finch ◽  
...  
Keyword(s):  
Mental Health ◽  
Systematic Review ◽  
Health Care ◽  
Mental Health Services ◽  
Health Services ◽  
Mental Health Care ◽  
Mood Disorders ◽  
Routine Care ◽  
System Level ◽  
Routine Practice

Background Electronic mental health interventions (eMental health or eMH) can be used to increase accessibility of mental health services for mood disorders, with indications of comparable clinical outcomes as face-to-face psychotherapy. However, the actual use of eMH in routine mental health care lags behind expectations. Identifying the factors that might promote or inhibit implementation of eMH in routine care may help to overcome this gap between effectiveness studies and routine care. Objective This paper reports the results of a systematic review of the scientific literature identifying those determinants of practices relevant to implementing eMH for mood disorders in routine practice. Methods A broad search strategy was developed with high sensitivity to four key terms: implementation, mental health care practice, mood disorder, and eMH. The reach, effectiveness, adoption, implementation, and maintenance (RE-AIM) framework was applied to guide the review and structure the results. Thematic analysis was applied to identify the most important determinants that facilitate or hinder implementation of eMH in routine practice. Results A total of 13,147 articles were screened, of which 48 studies were included in the review. Most studies addressed aspects of the reach (n=33) of eMH, followed by intervention adoption (n=19), implementation of eMH (n=6), and maintenance (n=4) of eMH in routine care. More than half of the studies investigated the provision of mental health services through videoconferencing technologies (n=26), followed by Internet-based interventions (n=20). The majority (n=44) of the studies were of a descriptive nature. Across all RE-AIM domains, we identified 37 determinants clustered in six main themes: acceptance, appropriateness, engagement, resources, work processes, and leadership. The determinants of practices are expressed at different levels, including patients, mental health staff, organizations, and health care system level. Depending on the context, these determinants hinder or facilitate successful implementation of eMH. Conclusions Of the 37 determinants, three were reported most frequently: (1) the acceptance of eMH concerning expectations and preferences of patients and professionals about receiving and providing eMH in routine care, (2) the appropriateness of eMH in addressing patients’ mental health disorders, and (3) the availability, reliability, and interoperability with other existing technologies such as the electronic health records are important factors for mental health care professionals to remain engaged in providing eMH to their patients in routine care. On the basis of the taxonomy of determinants of practices developed in this review, implementation-enhancing interventions can be designed and applied to achieve better implementation outcomes. Suggestions for future research and implementation practice are provided.

scholarly journals Sexual violence and mental health services: a call to action

2019 ◽  
Vol 28 (6) ◽  
pp. 594-597 ◽  
Author(s):  
Elizabeth Hughes ◽  
Michael Lucock ◽  
Charlie Brooker
Keyword(s):  
Mental Health ◽  
Sexual Assault ◽  
Mental Health Services ◽  
Health Services ◽  
Sexual Violence ◽  
Routine Care ◽  
Call To Action ◽  
Clear Association ◽  
History Of

AbstractPeople who experience sexual violence are highly likely to experience psychological and/or mental health (MH) problems as a result. People who use MH services often have a history of sexual assault and are also likely to be revictimised as an adult. Yet despite there being a very clear association, MH services are not yet performing routine enquiry, and even if they do, are not confident about how to record and manage disclosures. There is some emerging evidence that people with MH problems are exposed to sexual violence in inpatient MH settings, perpetrated by both other patients or members of staff. In this editorial, we explore the evidence to support a wider focus on sexual violence as a part of routine care, as well as some recommendations about how staff can more effectively discuss sexual issues including that of sexual victimisation.

Investigating Family-Based Alternatives to Institution-Based Mental Health Services for South: Lessons Learned from the Pilot Study of a Randomized Field Trial

1997 ◽  
Vol 26 (3) ◽  
pp. 226-233 ◽  
Author(s):  
Scott W. Henggeler ◽  
Melisa D. Rowland ◽  
Susan G. Pickrel ◽  
Stacey L. Miller ◽  
Phillippe B. Cunningham ◽  
...  
Keyword(s):  
Mental Health ◽  
Pilot Study ◽  
Mental Health Services ◽  
Health Services ◽  
Field Trial ◽  
Lessons Learned ◽  
Randomized Field Trial ◽  
Family Based

scholarly journals Advancing methodology for scoping reviews: recommendations arising from a scoping literature review (SLR) to inform transformation of children and adolescent mental health services.

2020 ◽  
Author(s):  
Joanna K Anderson ◽  
Emma Howarth ◽  
Maris Vainre ◽  
Ayla Humphrey ◽  
Peter B. Jones ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Research Evidence ◽  
Evidence Synthesis ◽  
Large Body ◽  
Adolescent Mental Health ◽  
Children And Adolescent ◽  
Scoping Reviews ◽  
Literature Reviews

Abstract Background: There is consensus that health services commissioning and clinical practice should be driven by scientific evidence. However, workload pressures, accessibility of peer reviewed publications and skills to find, appraise, and synthesise relevant evidence are often cited as barriers to uptake of research evidence by practitioners and commissioners alike. In recent years a growing requirement for rapid evidence synthesis to inform commissioning decisions about healthcare service delivery and provision of care contributed to an increasing popularity of scoping literature reviews (SLRs). Yet, comprehensive guidelines for conducting and reporting SLRs are still relatively scarce. Methods: The exemplar review used as a worked example aimed to provide a readily available, comprehensive, and user-friendly repository of research evidence for local commissioners to help them make evidence-informed decisions about redesigning East of England Children and Adolescent Mental Health Services. In conducting the review, we were broadly guided by Arksey and O’Malley’s framework, however some modifications were made at different stages to better reflect the largely pragmatic objective of this review. This paper compares the methodology used with existing methodological frameworks for scoping studies, to add to the existing knowledge base.Results: We proposed the following advancements to the existing SLR frameworks: (i) Assemble a research team with complementary skills and expertise; (ii); Draw on expertise of external partners, particularly practitioners, decision-makers and commissioners who will be translating findings into practice; (iii) Pre-register the review protocol. Keep a detailed record of all steps and decisions and consider how they would impact on generalisability and utility of review findings; (iv) Use systematic procedures for literature searchers, selection of studies, data extraction and analysis; (v) If feasible, appraise the quality of included evidence; (vi) Be transparent about limitations of findings.Conclusions: Despite some methodological limitations, scoping literature reviews are a useful method of rapidly synthesising a large body of evidence to inform commissioning and transformation of CAMHS. SLRs allow researchers to start with a broader questions, to explore the issue from different perspectives and perhaps find more comprehensive solutions that are not only effective, but also accounted for their feasibility and acceptability to key stakeholders.

How Do School Mental Health Services Vary Across Contexts? Lessons Learned from Two Efforts to Implement a Research-Based Strategy

2018 ◽  
Vol 10 (2) ◽  
pp. 134-146 ◽  
Author(s):  
Kelly Whitaker ◽  
Alexandra Fortier ◽  
Eric J. Bruns ◽  
Semret Nicodimos ◽  
Kristy Ludwig ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
School Mental Health ◽  
Lessons Learned

scholarly journals Counsellors in Primary Care: Benefits and Lessons Learned

2002 ◽  
Vol 47 (9) ◽  
pp. 857-862 ◽  
Author(s):  
Nick Kates ◽  
Anne-Marie Crustolo ◽  
Sheryl Farrar ◽  
Lambrina Nikolaou
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Mental Health Services ◽  
Health Services ◽  
Rating Scale ◽  
Mental Health Problems ◽  
Demographic Data ◽  
Family Physicians ◽  
Lessons Learned ◽  
Primary Care Settings

Objective: To describe a program that integrates mental health counsellors within primary care settings, to present data on the program's impact, and to discuss lessons learned that may apply in other communities. Methods: This paper describes a Canadian program that brings counsellors and psychiatrists into the offices of 87 family physicians in 36 practices in a community of 460 000 in Southern Ontario. It describes the goals and organization of the program and the activities of counsellors when working in primary care. In addition, it summarizes data from the program's evaluation, including demographic data and the individual problems seen and services delivered (all from the program's database) as well as data on patient outcomes using the General Health Questionnaire (GHQ), the Centre for Epidemiological Studies Depression (CESD) Rating Scale, and consumer-satisfaction questionnaires. Results: Each counsellor sees an average of 161 new cases yearly. The major problems are depression, anxiety, and family problems. In fact, over 70% of individuals who are seen show significant improvements in outcomes. The program has led to a significant increase in access to mental health services, a reduction in the use of traditional mental health services, high levels of satisfaction with counsellors and family physicians, and significant improvements in symptoms and functioning of individuals seen. Conclusion: This program has effectively integrated counsellors within primary care settings, increasing the capacity of primary care to handle mental health problems, strengthening links between providers from different sectors, and making mental health care more accessible.

Recovery-oriented intersectoral care between mental health hospitals and community mental health services: An integrative review

2020 ◽  
pp. 002076402096663 ◽  
Author(s):  
Kim Jørgensen ◽  
Tonie Rasmussen ◽  
Morten Hansen ◽  
Kate Andreasson
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Community Mental Health ◽  
Health Services ◽  
Mental Healthcare ◽  
Community Mental Health Services ◽  
Routine Care ◽  
Integrative Review ◽  
Patient Journey ◽  
Mental Health Hospitals

Background: Recovery-oriented intersectoral care is described as an aim in mental healthcare to create a holistic framework for planning that provides integration of treatment and rehabilitation. Existing studies show that nurses and other professionals do not take responsibility for the collaborative element of intersectoral care between mental health hospitals and community mental health services. The users of mental healthcare do not experience their patient journey as a cohesive process when they are discharged from a mental health hospital to community mental health services. Aim: The integrative review aims to examine the professionals’ experience with recovery-oriented intersectoral care between mental health hospitals and community mental health services. Design: Since the aim was to review user experience, we chose an integrative review as an obvious choice for design. Ethical approval: Not applicable. Findings: Seven studies met the inclusion criteria. The interactive inductive and deductive analysis generated four themes, which clarify the experience of professionals with recovery-oriented intersectoral care between the mental health hospitals and community mental health services, namely ‘structurally routine care’, ‘unequal balance of power between the sectors’, ‘bureaucracy as a barrier to recovery-oriented intersectoral care’ and ‘flexible mental healthcare approaches’. Conclusion: This review achieves specific knowledge of recovery-oriented intersectoral care. The studies included show that recovery-oriented intersectoral care is not clearly defined. It is challenging to transfer intersectoral care to an organisation with different structural and linguistic barriers.

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