scholarly journals Getting Rural Children through the Door: Perceived Barriers to Mental Health Care for School-Aged Children in Rural Areas

2018 ◽  
Vol 39 (1) ◽  
Author(s):  
Jacob Blackstock ◽  
Ki Byung Chae ◽  
Gary W. Mauk ◽  
Angela McDonald
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Rural Communities ◽  
Mental Health Services ◽  
Health Services ◽  
Mental Health Care ◽  
Urban Areas ◽  
Future Research ◽  
Rural Children ◽  
School Aged Children

With creativity and collaboration, children in rural communities who have the same mental health needs as children in urban areas can achieve access to mental health care. This review of the literature explores barriers to mental health services facing school-aged children residing in rural communities and focuses on how challenges unique to rural communities affect the type of care rural children ultimately receive. This review aligns with the NREA Research Agenda priority area “access to counseling/mental health services” (NREA, 2018). The discussion incorporates national trends in the treatment of children with mental health concerns and highlights some surprising facts about the state of mental health care in rural school and examines the following factors: (1) belief, (2) family poverty, (3) school support, (4) community resources, and (5) awareness. The review concludes by outlining opportunities for advocacy and proposed solutions for improving mental health care access for rural children and suggesting directions for future research.

The cost of mental health services. Prospects for future research

1997 ◽  
Vol 6 (S1) ◽  
pp. 199-208 ◽  
Author(s):  
Juan M. Cabasés
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Services ◽  
Health Services ◽  
Mental Health Care ◽  
Health Care Policy ◽  
Burden Of Illness ◽  
Health Care Systems ◽  
Indirect Costs ◽  
Future Research

The setting of priorities in mental health care evaluation requires considering future trends in mental health services. Three areas of change are mentioned in this paper: the development of services, the increase of the burden of illness, and reform processes in health care systems. Economic evaluation of mental health services has to consider the different roles of the agents acting in mental health care, policy-makers, companies, researchers and care professionals, and patients and their relatives.Despite the increasing work done, most mental health care interventions have either not been evaluated or have been ill evaluated. There is a sense of paucity of measurement that has to be enriched with more and better evaluative research. Some unresolved methodological issues are commented on in this paper. In particular, direct costs outside the health care sector, indirect costs and quality of life measurement are briefly analysed.

Demographic and psychiatric predictors of engagement in psychotherapy services conducted via clinical video telehealth

2018 ◽  
Vol 26 (1-2) ◽  
pp. 113-118
Author(s):  
Lisa M Valentine ◽  
Shannon D Donofry ◽  
Minden B Sexton
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Services ◽  
Health Services ◽  
Mental Health Care ◽  
Health Care Services ◽  
Mental Health Problems ◽  
Future Research ◽  
Health Administration ◽  
Symptom Profile

IntroductionMilitary veterans are at high risk for developing mental health problems. Unfortunately, veterans have relatively low rates of engagement in mental health services compared with non-veterans. In order to address barriers to mental health care services, the Veteran’s Health Administration (VHA) has implemented clinical video telehealth (CVT). Although the effectiveness of this technology appears promising, there is limited research evaluating rates of engagement in CVT mental health services or what factors may predict premature attrition from mental health care delivered via this format.MethodsThe present study aimed to investigate treatment engagement among veterans enrolled in psychotherapy delivered via CVT, as well as to explore the effects of various demographic and clinical characteristics on these outcomes. Participants were 250 veterans with consults placed to the CVT clinic at a large Midwestern VHA. To evaluate characteristics related to therapy retention, demographic and symptom profile information was gathered from a subset of 93 participants who attended at least one CVT psychotherapy appointment.ResultsResults indicated there were no significant demographic differences between veterans who attended at least one CVT appointment and those who did not attend at least one session. Demographic variables were not related to the number of CVT visits attended. Regarding psychological characteristics, veterans with anxiety disorders attended fewer CVT appointments overall than veterans with mood disorders and attendance at CVT was negatively correlated with anxiety severity.DiscussionThese findings have potential implications for providers working in CVT clinics as well as for future research in this area.

scholarly journals Asian Americans and Mental Health: Cultural Barriers to Effective Treatment

Elements ◽  
2005 ◽  
Vol 1 (1) ◽  
Author(s):  
Heather K. Speller
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Services ◽  
Health Services ◽  
Mental Health Care ◽  
Asian American ◽  
Racial Minorities ◽  
Cultural Barriers ◽  
Real Problem ◽  
Surgeon General

Disparities in mental health care for racial minorities remains a serious and very real problem calling for immediate attention. The 2001 report of the Surgeon General affirmed that ethnic and racial minorities have less access to and availability of mental health services, and are subsequently less likely to receive needed mental health services. This paper examines a range of issues regarding Asian American mental health. It presents the practical and cultural barriers that members of this ethnic group confront when seeking mental health care and explains how cultural differences sometimes result in misdiagnosis and ineffective treatment. It also explores ways that the American mental health care system can improve to accommodate diverse ethnic groups.

scholarly journals Converging perspectives of providers and student users on extending a patient portal into a university-based mental health service: A qualitative study

2020 ◽  
Author(s):  
N Gasteiger ◽  
Theresa Fleming ◽  
K Day
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Service ◽  
Mental Health Services ◽  
Health Service ◽  
Qualitative Study ◽  
Health Services ◽  
Mental Health Care ◽  
Patient Portal ◽  
Patient Portals

© 2020 The Authors Background: Patient portals have the potential to increase access to mental health services. However, a lack of research is available to guide practices on extending patient portals into mental health services. This study explored stakeholder (student service users' and health providers') expectations and perceptions of extending patient portals into a New Zealand university-based mental health service. Materials and methods: This qualitative study explored the perspectives of 17 students and staff members at a university-based health and counselling service on an Internet-based patient portal through a software demonstration, two focus groups and 13 interviews. Data were analyzed thematically. Results: Staff and students perceived the patient portal as useful, easy to use and expected it to help make mental health care more accessible. Staff were most concerned with the portal's ability to support their triage processes and that it might enable students to ‘counselor hop’ (see multiple counselors). Staff recommended extension into services that do not require triage. Most students expected the portal to enhance patient-counselor contact and rapport, through continuity of care. Students were concerned with appointment waiting times, the stigmatization of poor mental health and their capacity to seek help. They considered the portal might assist with this. Students recommended extension into all services, including urgent appointments. After viewing findings from initial student and staff groups, staff concluded that extending a patient portal into their counseling services should be prioritized. Conclusion: This research suggests that there is value in extending patient portals into mental health care, especially into low-risk services. Future research should explore opportunities to support triage and appointment-making processes for mental health services, via patient portals.

scholarly journals Operational challenges in conducting a community-based technology-enabled mental health services delivery model for rural India: Experiences from the SMART Mental Health Project

2018 ◽  
Vol 3 ◽  
pp. 43
Author(s):  
Pallab K. Maulik ◽  
Sudha Kallakuri ◽  
Siddhardha Devarapalli
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Services ◽  
Health Services ◽  
Mental Health Care ◽  
Rural India ◽  
Operational Strategies ◽  
Health Services Delivery ◽  
Services Delivery ◽  
Health Project

Background: There are large gaps in the delivery of mental health care in low- and middle-income countries such as India, and the problems are even more acute in rural settings due to lack of resources, remoteness, and lack of infrastructure, amongst other factors. The Systematic Medical Appraisal Referral and Treatment (SMART) Mental Health Project was conceived as a mental health services delivery model using technology-based solutions for rural India. This paper reports on the operational strategies used to facilitate the implementation of the intervention. Method: Key components of the SMART Mental Health Project included delivering an anti-stigma campaign, training of primary health workers in screening, diagnosing and managing stress, depression and increased suicide risk and task sharing of responsibilities in delivering care; and using mobile technology based electronic decision support systems to support delivery of algorithm based care for such disorders. The intervention was conducted in 42 villages across two sites in the state of Andhra Pradesh in south India. A pre-post mixed methods evaluation was done, and in this paper operational challenges are reported. Results: Both quantitative and qualitative results from the evaluation from one site covering about 5000 adults showed that the intervention was feasible and acceptable, and initial results indicated that it was beneficial in increasing access to mental health care and reducing depression and anxiety symptoms. A number of strategies were initiated in response to operational challenges to ensure smoother conduct of the project and facilitated the project to be delivered as envisaged. Conclusions: The operational strategies initiated for this project were successful in ensuring the delivery of the intervention. Those, coupled with other more systematic processes have informed the researchers to understand key processes that need to be in place to develop a more robust study, that could eventually be scaled up.

Introducing Shared Mental Health Care in Northwestern Ontario: An Analysis of Changing Referral Patterns of Primary Care Providers

2015 ◽  
Vol 34 (2) ◽  
pp. 63-72 ◽  
Author(s):  
Graham Gaylord ◽  
S. Kathleen Bailey ◽  
John M. Haggarty
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Health Care ◽  
Mental Health Services ◽  
Health Services ◽  
Mental Health Care ◽  
Community Mental Health Services ◽  
Primary Care Providers ◽  
Care Providers ◽  
Referral Patterns

This study describes a shared mental health care (SMHC) model introduced in Northern Ontario and examines how its introduction affected primary care provider (PCP) mental health referral patterns. A chart review examined referrals (N = 4,600) from 5 PCP sites to 5 outpatient community mental health services from January 2001 to December 2005. PCPs with access to SMHC made significantly more mental health referrals (p < 0.001). Two demographically similar PCPs were then compared, one co-located with SMHC. Referrals for depression to non-SMHC mental health services were 1.69 times more likely to be from the PCP not co-located with SMHC (p < 0.001). Findings suggest SMHC increases access to care and decreases demand on existing mental health services.

Availability and accessibility of primary mental health services for adolescents: an overview of national recommendations and services in EU

2020 ◽  
Vol 30 (6) ◽  
pp. 1127-1133
Author(s):  
Pierre-André Michaud ◽  
Annemieke Visser ◽  
Johanna P M Vervoort ◽  
Paul Kocken ◽  
Sijmen A Reijneveld ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Services ◽  
Health Services ◽  
Mental Health Care ◽  
Mental Health Problems ◽  
European Countries ◽  
Future Health ◽  
Horizon 2020 ◽  
Primary Mental Health Care

Abstract Background Mental health problems in adolescence can profoundly jeopardize adolescent current and future health and functioning. We aimed to describe existing recommendations and services regarding the delivery of primary mental health care for adolescents in 31 European countries. Methods Data on the availability and accessibility of primary mental health services were collected, as part of the Horizon 2020-funded project Models of Child Health Appraised. One expert from each country answered a closed items questionnaire during years 2017–18. Results All 31 participating countries had some policy or recommendations regarding the availability and accessibility of primary mental health services for adolescents, but their focus and implementation varied largely between and within countries. Only half of the participating countries had recommendations on screening adolescents for mental health issues and burdens. Merely a quarter of the countries had ambulatory facilities targeting specifically adolescents throughout the whole country. Just over half had some kind of suicide prevention programs. Same-day access to primary care in case of -health emergencies was possible in 21 countries, but often not throughout the whole country. Nineteen countries had strategies securing accessible mental health care for vulnerable adolescents. Conclusions Overall, around half of European countries had strategies securing access to various primary mental health care for adolescents. They frequently did not guarantee care over the whole country and often tackled a limited number of situations. EU countries should widen the range of policies and recommendations governing the delivery of mental health care to adolescents and monitor their implementation.

Expanding the Role of Primary Health Care in the Provision of Mental Health Services to the Population of the Kyrgyz Republic

2017 ◽  
Vol 41 (S1) ◽  
pp. S606-S606
Author(s):  
T. Galako
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Primary Health Care ◽  
Mental Health Services ◽  
Mental Disorders ◽  
Health Services ◽  
Mental Health Care ◽  
Kyrgyz Republic ◽  
Family Doctors ◽  
Primary Health

Providing comprehensive, integrated services in the field of mental health in primary health care (PHC) is a component of the state mental health program for the population of the Kyrgyz republic (KR) in the 2017–2030 biennium. In order to develop an action plan in this area a situational analysis of resources of psychiatric care at PHC level was carried out. There was revealed a significant deficit of specialists, such as family doctors, mental health care professionals. In spite of the need for 3,300 family doctors, only 1706 work, and 80% of them are of retirement age.The results of a research showed a low level of knowledge and skills of family physicians for the early detection of mental disorders and provision of appropriate medical care. There are also a limited number of psychiatrists, especially in rural regions (77% of the required quantity).During recent years, there have been implemented significant changes in the system of mental health services, aimed at improving its quality, the approach to the place of residence of the patient and the prevalence of psychosocial services.Since 2016 in 8 southern regions in the Kyrgyz Republic has been introduced a new model for the provision of comprehensive health care services. Piloting this model involves psychosocial rehabilitation of patients with mental disorders, the help of mobile teams at the place of patient residence, as well as psychoeducation, training, and support to family doctors. These and other measures will help to optimise mental health care at PHC level.Disclosure of interestThe author has not supplied his/her declaration of competing interest.

Compulsory community mental health care: Oceania

2016 ◽  
Author(s):  
Anthony J. O’Brien
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Developing Countries ◽  
Mental Health Services ◽  
Community Mental Health ◽  
Health Services ◽  
Mental Health Care ◽  
Developed Countries ◽  
Community Treatment ◽  
Community Mental Health Care

Oceania is characterized by the diversity of countries and by highly variable provision of mental health services and community mental health care. Countries such as Australian and New Zealand have well-developed mental health services with a high level of provision, but many less developed countries lack mental health infrastructure. Some developing countries such as Samoa and Tonga have passed mental health legislation with provision for community treatment orders, but this legal measure is probably not a useful mechanism for advancing mental health care in developing countries. Instead, efforts to improve provision of care seem best directed to the primary care sector, and to the general health workforce, rather than to specialists. The UN CRPD offer extensions of human rights to people with mental illness and most countries in Oceania have signed it. However, the absence of a regional rights tribunal potentially limits the realization of those rights.

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