scholarly journals Ethical Arguments for Providing Access to Mental Health Care through Longitudinal Relationships

2021 ◽  
pp. 1-8
Author(s):  
Charlene Sathi ◽  
Lydia S. Dugdale
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Mentally Ill ◽  
Health Clinics ◽  
Health Care Interventions ◽  
Community Health Clinics ◽  
History Of ◽  
Longitudinal Relationships ◽  
Medicine Community

A focus on access to mental health care is critical for beneficent and just care of individuals experiencing homelessness. The delivery of this care is strengthened through building longitudinal relationships between clinicians and persons experiencing homelessness—relationships that are best understood, perhaps, through the lens of attachment theory. In this paper, we look at the prevalence of mental illness among individuals experiencing homelessness and the history of deinstitutionalization of the mentally ill. We then evaluate how three modern-day interventions—street medicine, community health clinics, and supportive housing programs—play integral roles in providing mental health care and constructing a trusting relationship. We conclude with a call for increased funding to support the expansion of these essential mental health care interventions, especially in the aftermath of COVID-19.

Reducing Seclusion and Restraint in Mental Health Care: A European Challenge

2009 ◽  
Vol 24 (S1) ◽  
pp. 1-1 ◽  
Author(s):  
T. Steinert
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Mentally Ill ◽  
Physical Restraint ◽  
European Countries ◽  
Psychiatric Institutions ◽  
History Of ◽  
Degrading Treatment

The discussion on the use of coercive interventions such as seclusion and restraint accompanies the history of psychiatry from its beginning. It is the oldest and still topical issue of psychiatric institutions. Nowadays, the political growing together of Europe puts questions of common ethical standards on the agenda. The quality of psychiatric care and particularly the use of freedom-restricting coercive measures for mentally ill people are a challenge for modern civilized societies. There is a wide variety in the use of coercive interventions in different European countries in the past and the presence. An important supra-national institution dealing with the issue of coercive interventions in mental health care is the CPT (Committee for the Prevention of Inhumane or degrading Treatment or Punishment). Available data on the use of coercive interventions in different countries were found by literature review. The percentage of admissions exposed to seclusion or restraint varies from zero (Iceland) to 35% (Austria). The median duration of a coercive measure varies from 15 minutes (physical restraint, UK) to 16 days (seclusion, Netherlands). Recently, in several European countries (Finland, Germany, Netherlands, Norway, Switzerland, UK) initiatives have emerged to reduce seclusion and restraint. Obstacles for decreasing coercion in clinical psychiatry are discussed, suggestions for action are given.

Roles of Psychological Distress and Social Support in the Relationship Between Childhood Maltreatment and Perceived Needs for Mental Health Care

2021 ◽  
pp. 088626052110063
Author(s):  
Tingting Gao ◽  
Songli Mei ◽  
Muzi Li ◽  
Carl D’ Arcy ◽  
Xiangfei Meng
Keyword(s):  
Mental Health ◽  
Social Support ◽  
Health Care ◽  
Psychological Distress ◽  
Mental Health Care ◽  
Childhood Maltreatment ◽  
Perceived Needs ◽  
Perceived Need ◽  
History Of ◽  
The Relationship

Childhood maltreatment is a major public health issue worldwide. It increases a range of health-risk behaviors, psychological and physical problems, which are associated with an increased need for mental health services in adulthood. Identification of mediating factors in the relationship between maltreatment and seeking mental health care may help attenuate the negative consequences of childhood maltreatment and promote more appropriate treatment. This study aims to examine whether the relationship between childhood maltreatment and perceived need for mental health care is mediated by psychological distress and/or moderated by social support. Data from the Canadian Community Health Survey-Mental Health 2012 are analyzed. A total of 8,993 participants, who had complete information on childhood maltreatment and diagnoses of mental disorders or psychological distress, are included in this study. Structural equation modeling and the PROCESS macro were used to identify relationships among childhood maltreatment, perceived needs for mental health care, and psychological distress. Hierarchical linear regression was then used to verify the moderated mediation model. We found that psychological distress partially mediated the effect of childhood maltreatment on perceived needs for mental health care in adulthood. Social support played an important role in terms of moderating the relationship between maltreatment and perceived needs for care. For those with a history of childhood maltreatment, those who perceived a low level of social support were more likely to have higher levels of psychological distress and perceived need for mental health care. This is the first study to identify the separate and combined roles of psychological distress and social support in the relationship between childhood maltreatment and perceived need for mental health care. Selective prevention strategies should focus on social support to improve mental health services among people with a history of childhood maltreatment.

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 109 Near-fatal suicide attempts among Canadian Youth: A CPSP Study

2020 ◽  
Vol 25 (Supplement_2) ◽  
pp. e45-e45 ◽  
Author(s):  
Rachel Mitchell ◽  
Cornelius Ani ◽  
James Irvine ◽  
Claude Cyr ◽  
Ari Joffe ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Suicide Attempt ◽  
Mental Health Care ◽  
Family Conflict ◽  
Suicide Attempts ◽  
Suicide Mortality ◽  
Prevention Interventions ◽  
History Of ◽  
Self Harm

Abstract Background Suicide is the second leading cause of death among Canadian adolescents. Youth who make near fatal suicide attempts, such as those requiring intensive care unit (ICU) level care, are the closest proxy to those that die by suicide; however, there is limited data on this group. Objectives To evaluate the minimum incidence rate and patterns of presentation of youth (under 18 years of age) admitted to the ICU for medically serious self-inflicted injury. Design/Methods From January 2017 to December 2018, over 2,700 paediatricians/subspecialist members of the Canadian Paediatric Surveillance Program were electronically surveyed on a monthly basis regarding cases of medically serious self-harm. Participants completed a detailed questionnaire about the reported case and descriptive statistics were used for analyses. Results Ninety-four cases (71 female; mean age 15.2 years) of confirmed (n=87) and suspected/probable (n=7) medically serious self-harm were reported. The majority (87%) of cases were reported from 4 out of 13 provinces and territories in Canada (Alberta, British Columbia, Ontario, Quebec). There were 11 deaths by suicide (M>F; p<.05). Medication ingestion was the most common method of self-harm among females (76% F vs. 52% M; p=.03) compared with hanging among males (14% F vs. 39% M; p=.009). More females than males had a prior suicide attempt (62% F vs. 32% M; p=.07) and a history of non-suicidal self-injury (NSSI) (65% F vs. 14% M; p<.05), although only history of NSSI reached significance. More females than males had a past psychiatric diagnosis (77% F vs. 55% M; p=.05), and past use of mental health services (69% F vs. 30% M; p<.001), although only service use reached significance. Half of the youth left evidence of intent (54%) and 33% of parents of included youth were aware that their child was considering suicide. Family conflict was the most common precipitating factor for suicide attempt in both females and males (46%). Conclusion These Canadian findings are consistent with international epidemiologic data that observe a gender paradox of higher rates of suicide attempts in females and greater mental health care engagement but increased suicide mortality in males with decreased involvement with mental health care. This study suggests that family conflict is a potential target for suicide prevention interventions among youth. Future research focusing on gender-specificity in risk factor identification and effectiveness of primary prevention interventions among youth is warranted.

Coercion in Community Mental Health Care

2016 ◽  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Mentally Ill ◽  
Community Care ◽  
Current Knowledge ◽  
Community Services ◽  
Community Treatment ◽  
Community Treatment Orders ◽  
Improved Outcome

The use of coercion is one of the defining issues of mental health care and has been intensely controversial since the very earliest attempts to contain and treat the mentally ill. The balance between respecting autonomy and ensuring that those who most need treatment and support are provided with it has never been finer, with the ‘move into the community’ in many high-income countries over the last 50 years and the development of community services. The vast majority of patients worldwide now receive mental health care outside hospital, and this trend is increasing. New models of community care, such as assertive community treatment (ACT), have evolved as a result and there are widespread provisions for compulsory treatment in the community in the form of community treatment orders. These legal mechanisms now exist in over 75 jurisdictions worldwide. Many people using community services feel coerced, but at the same time intensive forms of treatment such as ACT, which arguably add pressure to patients to engage in treatment, have been associated with improved outcome. This volume draws together current knowledge about coercive practices worldwide, both those founded in law and those ‘informal’ processes whose coerciveness remains contested. It does so from a variety of perspectives, drawing on diverse disciplines such as history, law, sociology, anthropology, and medicine and for is explored

scholarly journals Patterns of mental health care in a seaside lodging house

1993 ◽  
Vol 17 (2) ◽  
pp. 82-83
Author(s):  
John Barnes ◽  
Greg Wilkinson
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Illness ◽  
General Practitioner ◽  
Mental Health Services ◽  
Health Services ◽  
Mental Health Care ◽  
Mentally Ill ◽  
Local Sources

Much of the medical care of the long-term mentally ill falls to the general practitioner (Wilkinson et al, 1985) and, for example, a survey in Buckinghamshire showed that these patients consult their general practitioner (GP) twice as often as mental health services. Lodging house dwellers are known to show an increased prevalence of major mental illness and to suffer much secondary social handicap, presenting a challenge to helping services of all disciplines. For this reason we chose a lodging house in which to explore further the relationships between mental illness and residents' present contact with their GP, mental health services and other local sources of help.

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