Mental health care practices and educational needs of general practitioners

1995 ◽  
Vol 162 (3) ◽  
pp. 139-142 ◽  
Author(s):  
Philayrath Phongsavan ◽  
Brian F Oldenburg ◽  
Jeanette E Ward ◽  
J Jill Gordon
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
General Practitioners ◽  
Educational Needs ◽  
Health Care Practices ◽  
Care Practices

Ethically Sensitive Mental Health Care: Is there a Need for a Unique Ethics for Psychiatry?

2003 ◽  
Vol 37 (2) ◽  
pp. 143-149 ◽  
Author(s):  
Andrew Crowden
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Conceptual Analysis ◽  
Practical Wisdom ◽  
Care Practice ◽  
Health Care Practice ◽  
Health Care Practices ◽  
Unique Nature ◽  
Care Practices

Objective: This article takes up the challenge to comment and extend on Jennifer Radden's claims for a ‘unique ethics for psychiatry’ articulated in ‘Notes towards a professional ethics for psychiatry’, Australian and New Zealand Journal of Psychiatry 2002; 36:52–59. Method: The author is analytically trained in bioethics and employs the method of conceptual analysis. Results: Psychiatry is a unique mental health care practice which calls for unique ethical responses. However, it doesn't necessarily follow that a unique ethics for psychiatry is required. Conclusions: A more plausible explanation for how philosophical ethics informs the unique nature of psychiatric practice is better articulated within claims about the role-related nature of particular health care practices and the influence that the virtue of phronesis (practical wisdom) has on a clinician's decision-making and judgement.

scholarly journals AS PRÁTICAS ATUAIS DE CUIDADO EM SAÚDE MENTAL NO CONTEXTO DA COVID-19: UMA REVISÃO INTEGRATIVA / CURRENT MENTAL HEALTH CARE PRACTICES IN THE CONTEXT OF COVID-19: AN INTEGRATIVE REVIEW

2020 ◽  
Vol 6 (12) ◽  
pp. 98977-98989
Author(s):  
Caroline Vezine Brabicoski ◽  
Lara Simone Messias Floriano ◽  
Suellen Vienscoski Skupien ◽  
Alessandra Rodrigues Martins ◽  
Guilherme Arcaro ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Integrative Review ◽  
Health Care Practices ◽  
Care Practices

Immigrant Mental Health Care Practices of Pediatricians: A Chart Review

2008 ◽  
Author(s):  
Casey N. Tallent ◽  
Ashlea E. Franques ◽  
Oksana Yakushko ◽  
Santi Budiasih ◽  
Cristina Fernandez
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Chart Review ◽  
Health Care Practices ◽  
Immigrant Mental Health ◽  
Care Practices

scholarly journals Consensus on strategies for implementing high priority mental health care practices within the US Department of Veterans Affairs

2021 ◽  
Vol 2 ◽  
pp. 263348952110046
Author(s):  
Thomas J Waltz ◽  
Byron J Powell ◽  
Monica M Matthieu ◽  
Jeffrey L Smith ◽  
Laura J Damschroder ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Implementation Science ◽  
Prolonged Exposure ◽  
Implementation Strategies ◽  
Health Care Practices ◽  
Prolonged Exposure Therapy ◽  
Outcome Monitoring ◽  
Care Practices

Background: Identifying feasible and effective implementation strategies remains a significant challenge. At present, there is a gap between the number of strategies prospectively included in implementation trials, typically four or fewer, and the number of strategies utilized retrospectively, often 20 or more. This gap points to the need for developing a better understanding of the range of implementation strategies that should be considered in implementation science and practice. Methods: This study elicited expert recommendations to identify which of 73 discrete implementation strategies were considered essential for implementing three mental health care high priority practices (HPPs) in the US Department of Veterans Affairs: depression outcome monitoring in primary care mental health ( n = 20), prolonged exposure therapy for treating posttraumatic stress disorder ( n = 22), and metabolic safety monitoring for patients taking antipsychotic medications ( n = 20). Participants had expertise in implementation science, the specific HPP, or both. A highly structured recommendation process was used to obtain recommendations for each HPP. Results: Majority consensus was identified for 26 or more strategies as absolutely essential; 53 or more strategies were identified as either likely essential or absolutely essential across the three HPPs. Conclusions: The large number of strategies identified as essential starkly contrasts with existing research that largely focuses on application of single strategies to support implementation. Systematic investigation and documentation of multi-strategy implementation initiatives is needed. Plain Language Summary Most implementation studies focus on the impact of a relatively small number of discrete implementation strategies on the uptake of a practice. However, studies that systematically survey providers find that dozens or more discrete implementation strategies can be identified in the context of the implementation initiative. This study engaged experts in implementation science and clinical practice in a structured recommendation process to identify which of the 73 Expert Recommendations for Implementing Change (ERIC) implementation strategies were considered absolutely essential, likely essential, likely inessential, and absolutely inessential for each of the three distinct mental health care practices: depression outcome monitoring in primary care, prolonged exposure therapy for posttraumatic stress disorder, and metabolic safety monitoring for patients taking antipsychotic medications. The results highlight that experts consider a large number of strategies as absolutely or likely essential for supporting the implementation of mental health care practices. For example, 26 strategies were identified as absolutely essential for all three mental health care practices. Another 27 strategies were identified as either absolutely or likely essential across all three practices. This study points to the need for future studies to document the decision-making process an initiative undergoes to identify which strategies to include and exclude in an implementation effort. In particular, a structured approach to this documentation may be necessary to identify strategies that may be endogenous to a care setting and that may not be otherwise be identified as being “deliberately” used to support a practice or intervention.

scholarly journals Intent to Adopt Video-Based Integrated Mental Health Care and the Characteristics of its Supporters: Mixed Methods Study Among General Practitioners Applying Diffusion of Innovations Theory

10.2196/23660 ◽  
2020 ◽  
Vol 7 (10) ◽  
pp. e23660
Author(s):  
Markus W Haun ◽  
Isabella Stephan ◽  
Michel Wensing ◽  
Mechthild Hartmann ◽  
Mariell Hoffmann ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
General Practitioners ◽  
Diffusion Of Innovations ◽  
Significant Proportion ◽  
The United States ◽  
Diffusion Of Innovations Theory ◽  
Early Adopters ◽  
Adopter Categories

Background Most people with common mental disorders, including those with severe mental illness, are treated in general practice. Video-based integrated care models featuring mental health specialist video consultations (MHSVC) facilitate the involvement of specialist mental health care. However, the potential uptake by general practitioners (GPs) is unclear. Objective This mixed method preimplementation study aims to assess GPs’ intent to adopt MHSVC in their practice, identify predictors for early intent to adopt (quantitative strand), and characterize GPs with early intent to adopt based on the Diffusion of Innovations Theory (DOI) theory (qualitative strand). Methods Applying a convergent parallel design, we conducted a survey of 177 GPs and followed it up with focus groups and individual interviews for a sample of 5 early adopters and 1 nonadopter. We identified predictors for intent to adopt through a cumulative logit model for ordinal multicategory responses for data with a proportional odds structure. A total of 2 coders independently analyzed the qualitative data, deriving common characteristics across the 5 early adopters. We interpreted the qualitative findings accounting for the generalized adopter categories of DOI. Results This study found that about one in two GPs (87/176, 49.4%) assumed that patients would benefit from an MHSVC service model, about one in three GPs (62/176, 35.2%) intended to adopt such a model, the availability of a designated room was the only significant predictor of intent to adopt in GPs (β=2.03, SE 0.345, P<.001), supporting GPs expected to save time and took a solution-focused perspective on the practical implementation of MHSVC, and characteristics of supporting and nonsupporting GPs in the context of MHSVC corresponded well with the generalized adopter categories conceptualized in the DOI. Conclusions A significant proportion of GPs may function as early adopters and key stakeholders to facilitate the spread of MHSVC. Indeed, our findings correspond well with increasing utilization rates of telehealth in primary care and specialist health care services (eg, mental health facilities and community-based, federally qualified health centers in the United States). Future work should focus on specific measures to foster the intention to adopt among hesitant GPs.

On the same page or in a different book? A pilot project on the perceptions of educational needs in an era of shifting mental health care to primary care (Preprint)

2021 ◽  
Author(s):  
Stephanie Sutherland ◽  
Dahn Jeong ◽  
Michael Cheng ◽  
Mireille St-Jean ◽  
Alireza Jalali
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Health Care ◽  
Mental Health Care ◽  
Medical Management ◽  
Family Physicians ◽  
Educational Needs ◽  
Health Conditions ◽  
Care Providers ◽  
Mental Health Conditions

BACKGROUND There is an unmet need for mental health care in Canada. Seventy-five percent of visits for mental health services are related to mood and anxiety disorder, which occur most frequently in the primary care setting. Primary care providers such as general practitioners and family physicians are essential part of mental health care services. However, it is currently not well known what is needed to increase care providers’ willingness, comfort and skills to adequately provide care. OBJECTIVE The aim of this study was to understand the caregiver and family physician needs regarding the care and medical management of individuals with mental health conditions. METHODS A needs assessment was designed to understand the educational needs of caregivers and family physicians with regard to the provision of mental health care, specifically, to seek advice of the format and delivery mode for an educational curriculum to be accessed by both stakeholder groups. Exploratory qualitative interviews were conducted and data was collected and analysed iteratively until thematic saturation was achieved. RESULTS Caregivers of individuals with mental health conditions (n=24) and family physicians (n=10) were interviewed. Both caregivers and family physicians expressed dissatisfaction with the status quo regarding the provision of mental health care at the family physician’s office. They stated that there was a need for more educational materials as well as additional supports. Caregivers expressed a general lack of confidence in family physicians to manage their son/daughter’s mental health condition, while family physicians sought more networking opportunities to improve and facilitate provision of mental health care. CONCLUSIONS Robust qualitative studies are necessary to identify the educational and medical management needs of caregivers and family physicians. Understanding each other’s perspectives is an essential first step to collaboratively designing, implementing, and the subsequent evaluation of community-based mental health care. Fortunately, there are initiatives underway already to address these need areas (e.g. websites such as eMentalHealth.ca/PrimaryCare as well as mentorship and collaborative care network) and information from this study can help inform the gaps in those existing initiatives. CLINICALTRIAL NA

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