Sähköiset mielenterveyspalvelut toipumisen näkökulmasta. Integroiva kirjallisuuskatsaus

Kuntoutus ◽  
2020 ◽  
Vol 43 (3) ◽  
pp. 34-50
Author(s):  
Mari Kivistö
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Literature Review ◽  
Future Research ◽  
Service Users ◽  
Personal Recovery ◽  
Recovery Orientation ◽  
Digital Services ◽  
Mental Health Practices

Mielenterveyden häiriöiden merkityksen kasvaminen sekä haasteet mielenterveyspalveluiden järjestämisessä ovat tehneet sähköisten mielenterveyspalveluiden kehittämisestä ja tutkimuksesta ajankohtaista. Nyt COVID-19-pandemia on lisännyt sähköisten mielenterveyspalveluiden tarvetta mutta tuonut samalla näkyviksi organisaatioiden eriytyvät lähtökohdat sähköisten mielenterveyspalveluiden järjestämisessä. Tämän tutkimuksen tavoitteena oli kuvata sähköisten mielenterveyspalveluiden vaikutuksia palvelunkäyttäjien näkökulmasta sekä tunnistaa positiivisesti vaikuttavien sähköisten mielenterveyspalveluiden edellytyksiä. Tutkimus toteutettiin kansainvälisistä tutkimusartikkeleista (n = 27) tietoa kokoavana integroivana kirjallisuuskatsauksena. Analyysimenetelmänä sovellettiin teemoittelua ja tulkintakehyksenä toipumisorientaation (recovery) viitekehystä. Kirjallisuuskatsauksen perusteella sähköiset mielenterveyspalvelut tarjoavat mahdollisuuksia toipumiseen ja sen tukemiseen, mutta toipuminen ehdollistuu sähköisiin mielenterveyspalveluihin liittyvissä toimintakäytännöissä. Tulokset jäsennettiin yksilön laaja-alaista toipumista ja toipumista kokonaisvaltaisesti tukevia sähköisiä mielenterveyspalveluja ilmentävinä yläteemoina, joista edelliseen sisällytettiin alateemat kliininen toipuminen, henkilökohtainen toipuminen ja osallisuuden vahvistuminen ja jälkimmäiseen tietoperusteisuus, tilannekohtaisuus, tuen tarjoaminen, vuorovaikutteisuus, henkilökohtaisuus ja asiakaslähtöisyys. Kirjallisuuskatsaus osoittaa, että tutkimustarpeista huolimatta tiedämme jo paljon tekijöistä, jotka mahdollistavat toipumista edistävien sähköisten mielenterveyspalveluiden toteuttamista. Tätä tietoa on tarpeen hyödyntää myös COVID-19-pandemian muuttamassa toimintaympäristössä. Tulosten sovellettavuutta rajoittaa tutkimustiedon pirstaleisuus sekä se, että tutkimukset kohdistuivat vain henkilöihin, joilla oli pääsy, kyky ja halu sähköisten mielenterveyspalveluiden käyttöön.Abstract Digital mental health services and recovery. An Integrative literature review The increase of mental health disorders and the challenges of delivering mental health services have made the development and research of digital mental health services topical. Currently, the COVID-19 pandemic has increased the need for digital mental health services, but at the same time it has made visible the various potential of organizations for providing digital services. The aim of this study is to describe the effects of digital mental health services from the service users’ perspective and to identify the features of the services that make an impact. The study was conducted as an integrative literature review of international research articles (n = 27). The method used was thematic analysis and a recovery orientation was applied as the interpretation framework. Based on the review, digital mental health services offer opportunities for and support the recovery of service users, but the recovery is conditioned on digital mental health practices. The results were presented as two main-themes: a person’s extensive recovery and digital mental health services that support recovery holistically. The former includes the sub-themes of clinical recovery, personal recovery and participation, and the latter the sub-themes of knowledge orientation, situationality, provision of support, interactivity, personality and client orientation. The integrative literature review shows that despite the need for future research, we already know a great deal about the factors that enable the implementation of digital mental health services that promote recovery. This knowledge needs to be utilized in the operating environment of mental health services, which is currently changing because of the COVID-19 pandemic. The review has some limitations, because research on the subject is fragmentary and the studies involved in the review were only targeted at persons with access to digital mental health services and the ability and motivation to use them. Keywords: mental health, digital services, recovery, integrative literature review

scholarly journals Coercion: an understudied issue in mental health

2017 ◽  
Vol 34 (4) ◽  
pp. 221-222
Author(s):  
B. O’Donoghue
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Community Treatment ◽  
Future Research ◽  
Service Users ◽  
Involuntary Admission ◽  
Community Treatment Orders ◽  
Future Directions ◽  
Alternative Models

Coercion in mental health services is a controversial practice, yet it is a relatively understudied area. This special themed edition draws upon research from the international community with the aim of addressing issues related to coercion and involuntary admission. The issue covers topics such as community treatment orders, service users’ perspectives, alternative models of involving service users in their treatment, and future directions for coercion research. It is hoped that this edition will encourage funding and inspire future research on this important topic.

Enhancing recovery orientation within mental health services: expanding the utility of values

2016 ◽  
Vol 11 (1) ◽  
pp. 23-32 ◽  
Author(s):  
Virginia C Williams ◽  
Frank P. Deane ◽  
Lindsay G Oades ◽  
Trevor P Crowe ◽  
Joseph Ciarrochi ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Training Transfer ◽  
Mental Health Recovery ◽  
Social Implications ◽  
Personal Recovery ◽  
Content Type ◽  
Recovery Orientation ◽  
Novel Approach

Purpose – The purpose of this paper is to review the role of values within contemporary mental health recovery services, outlining the rationale and approach for a specific values-focused staff intervention to promote autonomously motivated uptake of recovery-oriented practices. Design/methodology/approach – Recent advances in understanding of the enduring gap between ideological and applied acceptance of personal recovery within mental health services are outlined, with particular focus on the limited utility of training programmes as a means to promoting implementation. Frequently, mental health service organisations have adopted recovery policies in a primarily “top-down” fashion standing in contrast to the high autonomy approaches espoused for service users. Drawing from the extensive research related to Self-Determination Theory (SDT), a complementary focus on “bottom-up” approaches that enable service-delivery staff to develop a sense of autonomy for changed work practices in order to increase implementation is indicated. Findings – Application of values-focused interventions for mental health recovery staff parallel to the approaches acknowledged as effective for service participants are likely to be effective in promoting implementation of newly trained recovery-oriented practices. Research limitations/implications – The paper is conceptual in nature and therefore reflects the priorities and views of the authors but the paper draws together well-established literature to develop a novel approach to a highly relevant issue. Practical implications – Training transfer and implementation of evidence-based practice are issues with broad relevance and the explication of additional methods to promote employee uptake of new practices is a key priority for organisations and policy makers. Social implications – Significant social implications include furthering the discussion and insight to the development of effective delivery of mental health services to individuals accessing service. Originality/value – A novel aspect of this paper is the provision of a theoretical rationale for the application of SDT as a framework for understanding the continuing challenge of recovery operationalisation, which despite the conceptual good-fit, currently stands as an association not well exploited. Moreover, this paper proposes values-clarification and coaching as a specific and reproducible approach to enhancing recovery-oriented service provision.

Personal recovery and mental health services: a practice framework

2011 ◽  
Vol 38 (S 01) ◽  
Author(s):  
C Le Boutillier ◽  
V Bird ◽  
M Leamy ◽  
J Williams ◽  
M Slade
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Personal Recovery ◽  
Practice Framework

scholarly journals Remote care for mental health: qualitative study with service users, carers and staff during the COVID-19 pandemic

BMJ Open ◽  
2021 ◽  
Vol 11 (4) ◽  
pp. e049210
Author(s):  
Elisa Liberati ◽  
Natalie Richards ◽  
Jennie Parker ◽  
Janet Willars ◽  
David Scott ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Service ◽  
Health Services ◽  
Mental Healthcare ◽  
Well Being ◽  
Comparison Method ◽  
Service Users ◽  
Qualitative Interview Study ◽  
Remote Care

ObjectivesTo explore the experiences of service users, carers and staff seeking or providing secondary mental health services during the COVID-19 pandemic.DesignQualitative interview study, codesigned with mental health service users and carers.MethodsWe conducted semistructured, telephone or online interviews with a purposively constructed sample; a lived experience researcher conducted and analysed interviews with service users. Analysis was based on the constant comparison method.SettingNational Health Service (NHS) secondary mental health services in England between June and August 2020.ParticipantsOf 65 participants, 20 had either accessed or needed to access English secondary mental healthcare during the pandemic; 10 were carers of people with mental health difficulties; 35 were members of staff working in NHS secondary mental health services during the pandemic.ResultsExperiences of remote care were mixed. Some service users valued the convenience of remote methods in the context of maintaining contact with familiar clinicians. Most participants commented that a lack of non-verbal cues and the loss of a therapeutic ‘safe space’ challenged therapeutic relationship building, assessments and identification of deteriorating mental well-being. Some carers felt excluded from remote meetings and concerned that assessments were incomplete without their input. Like service users, remote methods posed challenges for clinicians who reported uncertainty about technical options and a lack of training. All groups expressed concern about intersectionality exacerbating inequalities and the exclusion of some service user groups if alternatives to remote care are lost.ConclusionsThough remote mental healthcare is likely to become increasingly widespread in secondary mental health services, our findings highlight the continued importance of a tailored, personal approach to decision making in this area. Further research should focus on which types of consultations best suit face-to-face interaction, and for whom and why, and which can be provided remotely and by which medium.

scholarly journals Living with Psychosis without Mental Health Services: A Narrative Interview Study

BMJ Open ◽  
2021 ◽  
Vol 11 (7) ◽  
pp. e045661
Author(s):  
Rose McGranahan ◽  
Zivile Jakaite ◽  
Alice Edwards ◽  
Stefan Rennick-Egglestone ◽  
Mike Slade ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Interview Study ◽  
Future Research ◽  
Psychotic Experiences ◽  
Making Sense ◽  
Narrative Interview ◽  
External Sources ◽  
Past Experiences

ObjectivesLittle research has looked at how people who do not use mental health services experience psychosis. Thus, the present study aimed to explore the experiences and views of people with psychosis who have neither sought nor received support from mental health services for at least 5 years.DesignA narrative interview study. Thematic analysis was used to analyse the data.SettingEngland.ParticipantsTwenty-eight participants with self-defined psychotic experiences were asked to provide a free narrative about their experiences.ResultsFive themes were identified: (1) Perceiving psychosis as positive; (2) Making sense of psychotic experiences as a more active psychological process to find explanations and meaning; (3) Finding sources of strength, mainly in relationships and the environment, but outside of services; (4) Negative past experiences of mental health services, leading to disengagement and (5) Positive past experiences with individual clinicians, as an appreciation of individuals despite negative views of services as a whole.ConclusionsPerceiving psychosis as something positive, a process of making sense of psychotic experiences and the ability to find external sources of strength all underpin—in addition to negative experiences with services—a choice to live with psychosis outside of services. Future research may explore to what extent these perceptions, psychological processes and abilities can be facilitated and strengthened, in order to support those people with psychosis who do not seek treatment and possibly also some of those who are in treatment.

A day in the life of a peer support worker: re-entry

2016 ◽  
Vol 20 (3) ◽  
pp. 149-152
Author(s):  
Emma Watson
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Peer Support ◽  
Design Methodology ◽  
Narrative Approach ◽  
Personal Recovery ◽  
Support Worker ◽  
Content Type ◽  
Returning To Work

Purpose – The purpose of this paper is to share the experiences and reflections of a peer support worker over the course of a day working in mental health services. Design/methodology/approach – A narrative approach has been taken to structure reflections based on the experience of returning to work after taking sick leave. Findings – Reflections are offered based on the process of returning to work and the way that this experience sheds light on personal recovery. Originality/value – This paper adds to the small number of accounts of the experiences of peer support working in mental health services and as such is highly original.

scholarly journals Schizophrenia in The Context of Mental Health Services in Palestine: a literature review

2020 ◽  
Author(s):  
Mohammad Marie ◽  
Zareefa Shaabna ◽  
Manahel Saleh
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Mental Health Services ◽  
Health Services ◽  
Literature Review ◽  
Political Violence ◽  
Mental Health Problems ◽  
Arab World ◽  
Heart Diseases ◽  
Mental Illness Stigma

Abstract Background: Mental health conditions remain a significant cause of disability in the Arab World. Palestinians are predominantly at a higher risk for mental health problems due to their chronic exposure to political violence, prolonged displacement, and others as limited professional, educational, financial opportunities and mental health services. Schizophrenia is an overwhelming mental illness that affects nearly one percent of the various populations throughout the world. Studies have shown patients with schizophrenia die prematurely and have lower life expectancy compared to the general population. Moreover, antipsychotic medications and client’s lifestyle play a significant role in increased morbidity and mortality in these patients. The present study willingly undertakes a literature review on schizophrenia in the context of mental health services in Palestine.Methods: Studies were identified through PubMed, Science Direct, Google Scholar, CINAHL, Semantic Scholar and Elsevier.Results: Twenty-four studies were included in this review; eleven articles related to schizophrenia and thirteen articles related to mental health services in Westbank and Gaza. Results revealed the life of patients with schizophrenia in Palestine is complicated. Barriers as lacking awareness about mental illness, stigma, inconsistent availability of medications, absence of multidisciplinary teamwork, insufficient specialists, fragmented mental health system, occupation, and other obstacles stand in the face of improving the quality of life among these patients.Limitations: Palestine is a state that is seeking independence with a scarcity of resources. It has been described as “uncharted territories'' due to a lack of data, resources and records. As a result, there is insufficient data regarding schizophrenia in Palestine. Therefore, a thesis study that estimated Ten years’ risk of coronary heart diseases in patients with schizophrenia was included.Conclusions: Recommendations include ending the occupation as the leading cause of mental illness for Palestinians and implementing efficient and effective mental health nursing care through the multidisciplinary work and raising awareness regarding mental illness to fight the stigma.

scholarly journals Integrating Mental Health Services into the Primary Health Care System: The Need for Reform in Iran

2021 ◽  
Author(s):  
Ahmad Hajebi ◽  
Vandad Sharifi ◽  
Maryam Abbasinejad ◽  
Ali Asadi ◽  
Nahid Jafari ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Primary Health Care ◽  
Mental Health Services ◽  
Health Services ◽  
Literature Review ◽  
Financial Resources ◽  
Primary Health Care System ◽  
Primary Health ◽  
Integrated Mental Health

Objective: The main objective of this study was to review aspects of the current situation and structure of the integrated mental health care services for planning a reform. Aspects of the newly designed infrastructure, along with specification of duties of the various human resources, and its relation with Iran’s Comprehensive Mental and Social Health Services (the SERAJ Program), will also be presented Method: This is a study on service design and three methods of literature review, deep interview with stakeholders, and focused group discussions. In the literature review, national and international official documents, including official reports of the World Health Organization (WHO) and consultant field visits, were reviewed. Deep semi-structured interviews with 9 stakeholders were performed and results were gathered and categorized into 3 main questions were analyzed using the responsibility and effectiveness matrix method. The Final results were discussed with experts, during which the main five-domain questions were asked and the experts’ opinions were observed. Results: In this study, the main gaps of the public mental health care (PHC) services in Iran were identified, which included reduction of risk factors for mental disorders, training the general population, early recognition and treatment of patients with mental disorders, educating patients and their families, and rehabilitation services. The new model was then proposed to fill these gaps focusing on increasing access, continuity of care, coordination in service delivery, and comprehensiveness of care. A mental health worker was placed besides general healthcare workers and general practitioners (GPs). Services were prioritized and the master flowchart for mental health service delivery was designed. Conclusion: A reform was indeed necessary in the integrated mental health services in Iran, but regarding the infrastructure needed for this reform, including human and financial resources, support of the senior authorities of the Ministry of Health (MOH) is necessary for the continuity and enhancement of services. In this model, attention has been given to the principles of integrating mental health services into primary health care. Current experience shows that the primary health care system has been facing many executive challenges, and mental health services are not exclusion to this issue. Monitoring and evaluation of this model of service and efforts for maintaining sustainable financial resources is recommended to make a reform in this system and to stabilize it.

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