scholarly journals Pathways to mental health care in KwaZulu - Natal

Curationis ◽  
2004 ◽  
Vol 27 (3) ◽  
Author(s):  
L.P. Mkize ◽  
L.R. Uys
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Illness ◽  
Mental Health Care ◽  
Service Providers ◽  
Mental Illnesses ◽  
Structured Interviews ◽  
Violent Behaviour ◽  
Health Institution ◽  
Mental Health Institution

The understanding of popular beliefs about mental health care and the pathways clients take prior to admission to a mental health institution is vital in planning to reduce delays in seeking treatment. The objectives of this exploratory survey were to determine pathways of care the clients with mental illness take, which ultimately lead to the mental health institution, the effects of socio-cultural and economic factor on the pathways to mental health care and the satisfaction with different service providers consulted. Data was gathered through semi-structured interviews. The results indicate that African clients interpret mental illness as bewitchment. Delays in seeking appropriate mental health care are experienced because traditional and faith healers are the first port of call. The short pathways are used when the first signs of psychotic features are severe, including like aggressive or violent behaviour. Financial constraints seem to be the problem for most of the clients in accessing mental health care. Furthermore, defaulting treatment was also observed due to the fact that mental illnesses are stigmatised in African communities.

“Hear me out”: Experiences of mothers suffering from severe mental illness with health care providers – A qualitative perspective

2017 ◽  
Vol 41 (S1) ◽  
pp. s899-s899 ◽  
Author(s):  
D. Banerjee ◽  
G. Desai ◽  
P.S. Chandra
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Illness ◽  
Severe Mental Illness ◽  
Health Care Providers ◽  
Service Providers ◽  
Care Providers ◽  
Structured Interviews ◽  
Seeking Help ◽  
Competing Interest

BackgroundContrary to popular myth, majority of mentally ill women are mothers with increasing number of them seeking help. Little is known about their own experiences in this regard and the extent to which their needs are met.ObjectivesTo assess the barriers and facilitators in seeking help from mental health care providers in matters of pregnancy and parenting.MethodsThe study used qualitative design with social constructivist paradigm. A purposive sample of 30 mothers with severe mental illness was obtained. Data was collected through one-to-one in-depth semi-structured interviews. After verbatim transcription, inductive thematic analysis was used to explore transcripts.ResultsMost women considered motherhood “central” to their lives and almost all of them experienced the burden of the “dual role”. Main barriers in seeking help were stigma, treatment side effects, wrong information and time constraints. Whereas self-advocacy, early engagement, education of women and involvement of the family with service providers were the facilitating factors. The prime expectations of the mothers as identified were early and direct communication, patient audience and basic guidance in regards to child health and parenting issues.ConclusionWomen who are mothers and also users of mental health services face special challenges in managing the contradictory aspects of their dual identity. Hearing their voices are essential for service provision and ensuring adequate mental health needs. Early and direct intervention along with understanding and addressing critical areas are necessary for proper care of both the mother and child.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Attitudes toward Psychology, Psychiatry and Mental Illness in the Central Eastern Cape of South Africa

1996 ◽  
Vol 26 (4) ◽  
pp. 221-225 ◽  
Author(s):  
Christopher R. Stones
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Illness ◽  
Mental Health Care ◽  
Service Providers ◽  
Psychiatric Treatment ◽  
First Year ◽  
Eastern Cape ◽  
Medical Practitioners ◽  
General Medical Practitioners

A survey of attitudes held by a large sample of university students as well as by smaller samples of psychologists, general medical practitioners, members of the public, psychiatric hospital staff and patients in the central eastern Cape toward mental illness and mental health-care service providers was conducted during the early part of 1994. It was found that marked differences existed between the different samples and that the extent of a person's knowledge about mental illness, as well as the degree of contact with mental-health professionals and their services, were important influences on the attitudes of respondents. In particular, third-year psychology students tended to be more negatively disposed to psychiatric treatment than those students in their first year of study. Conversely, the attitudes of final-year students toward the discipline of psychology were more positive than those held by students in their first year of studying psychology. Within both the student and the patient samples, only a small minority indicated that they would first seek help from general medical practitioners if they were ever to contemplate taking their own lives or if they were seriously mentally ill. Psychiatric patients and service providers indicated their confidence in psychiatric treatment and the psychiatrist was considered to be the most appropriate professional to deal with mental illness. Members of the general public were found to be more optimistic than psychologists about the efficacy of psychological and psychiatric treatment, but less so than general medical practitioners. Although mental health-care professionals were viewed in a favourable light, most respondents indicated that they would nevertheless prefer to approach a friend in times of psychological distress.

scholarly journals Pathways to mental health care in Nepal: a 14-center nationwide study

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Anoop Krishna Gupta ◽  
Sulochana Joshi ◽  
Bikram Kafle ◽  
Ranjan Thapa ◽  
Manisha Chapagai ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Mental Health Professionals ◽  
Clinical Presentation ◽  
Service Providers ◽  
Mental Illnesses ◽  
World Health ◽  
Pathways To Care ◽  
Duration Of Untreated Illness

Abstract Background Pathways to care studies are feasible and tested means of finding the actual routes taken by patients before reaching proper care. In view of the predominance of nonprofessional service providers and the lack of previous large studies on pathways in Nepal, this multicenter study is needed. The aim of the study was to trace the various pathways and carers involved in mental health care; assess clinical variables such as the duration of untreated illness, clinical presentation and treatment; and compare geographically and culturally diverse landscapes. Methods This was a cross-sectional, convenience sampling study performed at 14 centers where new cases were being taken. The World Health Organization Study of the Pathways-to-Care Schedule was applied. The Nepali version of the encounter form was used. The data were collected between 17 September and 16 October 2020 and were analyzed using the Statistical Package for the Social Sciences (SPSS). Additionally, perspectives from local investigators were collected and discussed. Results Most of the first carers were native/religious faith healers (28.2%), followed by psychiatrists (26%). The median duration for the first psychiatric consultation was 3 weeks. The duration of untreated illness was 30.72 ± 80.34 (median: 4) weeks, and the time taken for this journey was 94.99 ± 274.58 (median: 30) min. The longest delay from the onset of illness to psychiatric care was for epilepsy {90.0 ± 199.0 (median: 25.5)} weeks, followed by neurotic illness {22.89 ± 73.45 (median: 2)} and psychotic illness {10.54 ± 18.28 (median: 2)} weeks. Overall, most patients with severe mental illnesses (SMIs) had their first contact with faithhealers (49%), then met with medical doctors (13%) or psychiatrists (28%). Marked differences in clinical presentation surfaced when hilly centers were compared with the Terai belt. Conclusions Faith healers, general practitioners and hospital doctors are major carers, and the means of educating them for proper referral can be considered. The investigators see several hindrances and opportunities in the studied pathways. The employment of more mental health professionals and better mental health advocacy, public awareness programs and school education are suggested strategies to improve proper mental health care.

scholarly journals Stigma and discrimination limit access to mental health care

2008 ◽  
Vol 17 (1) ◽  
pp. 14-19 ◽  
Author(s):  
Graham Thornicroft
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Illness ◽  
Mental Health Care ◽  
Low Income ◽  
Help Seeking ◽  
Mental Illnesses ◽  
Low Income Countries ◽  
Stigma And Discrimination ◽  
Epidemiological Surveys

AbstractThis editorial provides an overview of how far access to mental health care is limited by perceptions of stigma and anticipated discrimination. Globally over 70% of young people and adults with mental illness receive no treatment from healthcare staff. The rates of non-treatment are far higher in low income countries. Evidence from some descriptive studies and epidemiological surveys suggest that potent factors increasing the likelihood of treatment avoidance, or long delays before presenting for care include: (i) lack of knowledge about the features and treatability of mental illnesses; (ii) ignorance about how to access assessment and treatment; (iii) prejudice against people who have mental illness, and (iv) expectations of discrimination against people who have a diagnosis of mental illness. The associations between low rates of help seeking, and stigma and discrimination are as yet poorly understood and require more careful characterisation and analysis, providing the platform for more effective action to ensure that a greater proportion of people with mental illness are effectively treated in future.

Assessing Transcendental Experiences vs Mental Illnesses

2017 ◽  
Vol 71 (4) ◽  
pp. 267-273 ◽  
Author(s):  
Shawn Lucas
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Illness ◽  
Mental Health Care ◽  
Assessment Tool ◽  
Mental Illnesses ◽  
Transcendent Experience

In our experience, being able to differentiate between mental illness and transcendent experiences has led patients to remain engaged in treatment. This is important since those who have experienced religious preoccupation are the least likely to seek out mental health care. We have developed a “Transcendent Assessment Tool” to assist clinicians and clients in discerning whether an experience is a delusion or part of a transcendent experience.

Working at the Intersection of Palliative End-of-Life and Mental Health Care: Provider Perspectives

2020 ◽  
pp. 082585972095136
Author(s):  
Tanya Park ◽  
Kathy Hegadoren ◽  
Bernadette Workun
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Illness ◽  
Mental Health Care ◽  
End Of Life ◽  
Structured Interviews ◽  
Provider Perspectives ◽  
Mental Health Care Provider ◽  
Mental Health Challenges

Objective: Palliative, end-of-life care (PEOLC) providers are poorly resourced in addressing the needs of patients with mental health challenges, and the dying experiences of this cohort—particularly those with a comorbid, chronic and persistent mental illness (CPMI)—are poorly documented. We sought to explore the experiences of PEOLC providers with regard to caring for patients with mental health challenges, and gather insights into ways of improving accessibility and quality of PEOLC for these patients. Method: Twenty providers of PEOLC, from different disciplines, took part in semi structured interviews. The data were coded and analyzed using a reflexive, inductive-deductive process of thematic analysis. Results: The most prominent issues pertained to assessment of patients and differential diagnosis of CPMI, and preparedness of caregivers to deliver mental health interventions, given the isolation of palliative care from other agencies. Among the assets mentioned, informal relationships with frontline caregivers were seen as the main support structure, rather than the formal policies and procedures of the practice settings. Strategies to improve mental health care in PEOLC centered on holistic roles and interventions benefiting the entire palliative population, illustrating the participants saw little point in compartmentalizing mental illness, whether diagnosed or not. Significance of Results: Continuity of care and personal advocacy can significantly improve quality of life for end-of-life patients with mental health challenges, but bureaucracy and disciplinary siloing tend to isolate these patients and their caregivers. Improved interdisciplinary connectivity and innovative, hybridized roles encompassing palliation and psychiatry are 2 strategies to address this disconnect, as well as enhanced training in core mental health care competencies for PEOLC providers.

A Tribute to the Late William J. Curran

1996 ◽  
Vol 24 (3) ◽  
pp. 274-275
Author(s):  
O. Lawrence ◽  
J.D. Gostin
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Illness ◽  
United Nations ◽  
Mental Health Care ◽  
Harvard University ◽  
Legal Medicine ◽  
General Assembly ◽  
International Institute ◽  
University Professor

In the summer of 1979, a group of experts on law, medicine, and ethics assembled in Siracusa, Sicily, under the auspices of the International Commission of Jurists and the International Institute of Higher Studies in Criminal Science, to draft guidelines on the rights of persons with mental illness. Sitting across the table from me was a quiet, proud man of distinctive intelligence, William J. Curran, Frances Glessner Lee Professor of Legal Medicine at Harvard University. Professor Curran was one of the principal drafters of those guidelines. Many years later in 1991, after several subsequent re-drafts by United Nations (U.N.) Rapporteur Erica-Irene Daes, the text was adopted by the U.N. General Assembly as the Principles for the Protection of Persons with Mental Illness and for the Improvement of Mental Health Care. This was the kind of remarkable achievement in the field of law and medicine that Professor Curran repeated throughout his distinguished career.

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.

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