PERSON-CENTERED CARE PLANNING AND SHARED DECISION MAKING FOR MENTAL AND COMORBID CONDITIONS

2020 ◽  
Author(s):  
Helen Millar ◽  
Ihsan M Salloum
Keyword(s):  
Mental Health ◽  
Life Expectancy ◽  
Mental Health Problems ◽  
Well Being ◽  
Care Planning ◽  
Shared Decision ◽  
Coordinated Care ◽  
Model Of Care ◽  
Person Centered Care ◽  
Centered Care

Developments in person-centered coordinated care are essential given the challenges of the growing epidemic of physical comorbidity in the mentally ill population. Excessive deaths due to comorbidity, especially cardiovascular disease, continue to contribute to the significant reduction in life expectancy in people with mental health problems. Contemporary and proposed models are now available to provide evidence for a way forward in this field. Practical guidance on implementation using person-centered care planning has now been developed to promote a more collaborative and integrated approach as a solution to the current single disease focused model of care, which is failing this patient group. The WHO perspective supports this strategy with the recent global objectives outlining proactive and preventative strategies and interventions to tackle comorbidity. The emphasis is on a transformation of current systems using evidence-based approaches for more integration to support the delivery of more effective and efficient care for those with mental disorders and other comorbid chronic diseases. Coordinated, collaborative, system-wide strategies encompass transparent shared decision making in prevention, early intervention, treatment options, lifestyle management and pharmacological rationalization. Hence urgent action is required to help create the conditions to enable the delivery of person-centered coordinated care in health care systems by involving commissioning bodies, clinicians, patient groups along with voluntary and other community providers. Contemporary models of care for comorbidity emphasize the importance of coordination in the management of physical well-being from the onset of treatment of people with mental health problems in order to ensure better outcomes, improved overall well-being, and a longer life expectancy. Illustratively, no further funds are available to implement this shift in the model of care in the United Kingdom, so redesign and redistribution of current resources will be key to promote this more seamless coordinated system of care to improve the quality of life and life expectancy for this population.

scholarly journals 2056 Culture meets person-centered care: An empirical study of mental health and care planning among Latinx and Asian communities

2018 ◽  
Vol 2 (S1) ◽  
pp. 67-67
Author(s):  
Miraj U. Desai ◽  
Nadika Paranamana ◽  
Maria Restrepo-Toro ◽  
Luz Ocasio ◽  
Yolanda Herring ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Disparities ◽  
Lived Experience ◽  
Cultural Values ◽  
Care Planning ◽  
Health Providers ◽  
Process Of Care ◽  
Provider Perspectives ◽  
Person Centered Care ◽  
Centered Care

OBJECTIVES/SPECIFIC AIMS: This poster will present preliminary results from a study examining whether person-centered care planning—a new innovation in community mental health care—responds to the culture of, and helps reduce health disparities among, Latinx and Asian populations. METHODS/STUDY POPULATION: The study was funded by an NIMH/NIH Administrative Supplement for Minority Health and Mental Health Disparities Research and approved by the Institutional Review Board of the authors’ university. Participants included 26 mental health clients and 12 mental health providers of diverse backgrounds. The study employed empirical qualitative methods to explore client understandings of mental health, client experiences of culture and discrimination, and the process of care engagement and care planning from both client and provider perspectives. The analysis team itself included people of Latinx and Asian background, as well as a person with lived experience of mental health recovery. RESULTS/ANTICIPATED RESULTS: We anticipate that the results will show ways in which person-centered care successfully incorporates clients’ goals, but that there will also be evidence of ways in which the clinical encounter struggles to incorporate more social, collective, and cultural values and approaches. DISCUSSION/SIGNIFICANCE OF IMPACT: The poster will present up-to-date findings on this project, which speaks to pressing issues of health equity and community engagement for 2 of the fastest growing populations in the country.

scholarly journals Osteopathy and Mental Health: An Embodied, Predictive, and Interoceptive Framework

2021 ◽  
Vol 12 ◽  
Author(s):  
Lucas Bohlen ◽  
Robert Shaw ◽  
Francesco Cerritelli ◽  
Jorge E. Esteves
Keyword(s):  
Mental Health ◽  
Musculoskeletal Disorders ◽  
Mental Health Problems ◽  
Physical Symptoms ◽  
Health Problems ◽  
Future Research ◽  
Prediction Errors ◽  
Perceptual Inference ◽  
Person Centered Care ◽  
Centered Care

Globally, mental and musculoskeletal disorders present with high prevalence, disease burden, and comorbidity. In order to improve the quality of care for patients with persistent physical and comorbid mental health conditions, person-centered care approaches addressing psychosocial factors are currently advocated. Central to successful person-centered care is a multidisciplinary collaboration between mental health and musculoskeletal specialists underpinned by a robust therapeutic alliance. Such a collaborative approach might be found in osteopathy, which is typically utilized to treat patients with musculoskeletal disorders but may arguably also benefit mental health outcomes. However, research and practice exploring the reputed effect of osteopathy on patients with mental health problems lack a robust framework. In this hypothesis and theory article, we build upon research from embodied cognition, predictive coding, interoception, and osteopathy to propose an embodied, predictive and interoceptive framework that underpins osteopathic person-centered care for individuals with persistent physical and comorbid mental health problems. Based on the premise that, for example, chronic pain and comorbid depression are underlined by overly precise predictions or imprecise sensory information, we hypothesize that osteopathic treatment may generate strong interoceptive prediction errors that update the generative model underpinning the experience of pain and depression. Thus, physical and mental symptoms may be reduced through active and perceptual inference. We discuss how these theoretical perspectives can inform future research into osteopathy and mental health to reduce the burden of comorbid psychological factors in patients with persistent physical symptoms and support person-centered multidisciplinary care in mental health.

Delivering Person-Centered Care in Community Mental Health Programs

2020 ◽  
Vol 30 (8) ◽  
pp. 907-917
Author(s):  
Mimi Choy-Brown ◽  
Victoria Stanhope ◽  
Nathaniel Williams ◽  
Lynden Bond
Keyword(s):  
Mental Health ◽  
Community Mental Health ◽  
Community Treatment ◽  
Health Programs ◽  
Care Planning ◽  
Mixed Effect ◽  
Person Centered Care ◽  
Program Type ◽  
Centered Care ◽  
Mental Health Programs

The aim of this study was to examine the extent of and variation in person-centered care across programs within community mental health clinics. Service plans ( N = 160) from programs within eight clinics were assessed for person-centered care planning using an objective fidelity measure. Univariate statistics calculated overall fidelity to person-centered care planning and mixed-effect regression models examined person-centered care planning by program type. Overall, providers demonstrated low levels of competency in person-centered care planning. There were significant differences according to program type, with providers from assertive community treatment programs demonstrating the highest level of competency. Providers need more training and support to implement person-centered care consistently across community mental health programs. Those program types with associated fidelity measures that include person-centered care had a higher level of competence confirming the value of fidelity measurement in promoting quality services.

scholarly journals A Preference-Based Model of Care: An Integrative Theoretical Model of the Role of Preferences in Person-Centered Care

2019 ◽  
Vol 60 (3) ◽  
pp. 376-384 ◽  
Author(s):  
Kimberly Van Haitsma ◽  
Katherine M Abbott ◽  
Annabelle Arbogast ◽  
Lauren R Bangerter ◽  
Allison R Heid ◽  
...  
Keyword(s):  
Older Adults ◽  
Theoretical Model ◽  
Positive Emotions ◽  
Positive Impact ◽  
Well Being ◽  
Cognitive Capacity ◽  
Model Of Care ◽  
Person Centered Care ◽  
Centered Care ◽  
Services And Supports

Abstract Knowledge of individuals’ everyday preferences is a cornerstone of person-centered care (PCC). Initial evidence demonstrates the positive impact of honoring preferences in care for older adults receiving long-term services and supports (LTSS). Yet, the mechanisms through which preference-based care affects individual well-being remain poorly understood. This article proposes a theoretical model of PCC entitled the Preference-Based Model of Care that integrates the Theory of Human Motivation, Self-determination Theory, the Competence-Press Model of person and environment fit, the Living Systems Framework, and the Broaden-and-Build theory of positive emotions to deepen our understanding of the processes through which preference-based care affects well-being among older adults receiving LTSS. The Preference-Based Model of Care illustrates how goal-directed behaviors facilitate need fulfillment through the expression of individual preferences and how these behaviors mediate the relationship between person–environment fit and affect balance within a particular social, cultural, and political context. The Preference-Based Model of Care can advance research on PCC in LTSS and can inform LTSS clinical practice guidelines for older adults, regardless of functional or cognitive capacity.

scholarly journals Supporting the emotional needs of young people in care: a qualitative study of foster carer perspectives

BMJ Open ◽  
2020 ◽  
Vol 10 (3) ◽  
pp. e033317
Author(s):  
Rachel M Hiller ◽  
Sarah L Halligan ◽  
Richard Meiser-Stedman ◽  
Elizabeth Elliott ◽  
Emily Rutter-Eley
Keyword(s):  
Mental Health ◽  
Young People ◽  
Mental Health Problems ◽  
Well Being ◽  
Health Needs ◽  
Depth Information ◽  
Emotional Needs ◽  
Mental Health Systems ◽  
Mental Health Needs ◽  
Qualitative Focus Groups

ObjectivesYoung people who have been removed from their family home and placed in care have often experienced maltreatment and there is well-developed evidence of poor psychological outcomes. Once in care, foster carers often become the adult who provides day-to-day support, yet we know little about how they provide this support or the challenges to and facilitators of promoting better quality carer–child relationships. The aim of this study was to understand how carers support the emotional needs of the young people in their care and their views on barriers and opportunities for support.Design and participantsParticipants were 21 UK foster carers, recruited from a local authority in England. They were predominantly female (86%), aged 42–65 years old and ranged from those who were relatively new to the profession (<12 months’ experience) to those with over 30 years of experience as a carer. We ran three qualitative focus groups to gather in-depth information about their views on supporting their foster children’s emotional well-being. Participants also completed short questionnaires about their training experiences and sense of competence.ResultsOnly half of the sample strongly endorsed feeling competent in managing the emotional needs of their foster children. While all had completed extensive training, especially on attachment, diagnosis-specific training for mental health problems (eg, trauma-related distress, depression) was less common. Thematic analysis showed consistent themes around the significant barriers carers faced navigating social care and mental health systems, and mixed views around the best way to support young people, particularly those with complex mental health needs and in relation to reminders of their early experiences.ConclusionsFindings have important implications for practice and policy around carer training and support, as well as for how services support the mental health needs of young people in care.

Comparing the social networks of service users with long term mental health needs living in community with those in a general adult in-patient unit

2021 ◽  
pp. 002076402110175
Author(s):  
Roberto Rusca ◽  
Ike-Foster Onwuchekwa ◽  
Catherine Kinane ◽  
Douglas MacInnes
Keyword(s):  
Mental Health ◽  
Social Networks ◽  
Social Network ◽  
Patient Group ◽  
Mental Health Problems ◽  
Well Being ◽  
Health Problems ◽  
Practical Support ◽  
The Social

Background: Relationships are vital to recovery however, there is uncertainty whether users have different types of social networks in different mental health settings and how these networks may impact on users’ wellbeing. Aims: To compare the social networks of people with long-term mental illness in the community with those of people in a general adult in-patient unit. Method: A sample of general adult in-patients with enduring mental health problems, aged between 18 and 65, was compared with a similar sample attending a general adult psychiatric clinic. A cross-sectional survey collected demographic data and information about participants’ social networks. Participants also completed the Short Warwick Edinburgh Mental Well-Being Scale to examine well-being and the Significant Others Scale to explore their social network support. Results: The study recruited 53 participants (25 living in the community and 28 current in-patients) with 339 named as important members of their social networks. Both groups recorded low numbers in their social networks though the community sample had a significantly greater number of social contacts (7.4 vs. 5.4), more monthly contacts with members of their network and significantly higher levels of social media use. The in-patient group reported greater levels of emotional and practical support from their network. Conclusions: People with serious and enduring mental health problems living in the community had a significantly greater number of people in their social network than those who were in-patients while the in-patient group reported greater levels of emotional and practical support from their network. Recommendations for future work have been made.

scholarly journals Dual impacts of coronavirus anxiety on mental health in 35 societies

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Sylvia Xiaohua Chen ◽  
Jacky C. K. Ng ◽  
Bryant P. H. Hui ◽  
Algae K. Y. Au ◽  
Wesley C. H. Wu ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Health Problems ◽  
Severe Depression ◽  
Psychological Adaptation ◽  
Well Being ◽  
Subjective Health ◽  
Depression Symptoms ◽  
Subjective Well Being ◽  
Emotional Symptoms ◽  
Perceived Vulnerability

AbstractThe spread of coronavirus disease 2019 (COVID-19) has affected both physical health and mental well-being around the world. Stress-related reactions, if prolonged, may result in mental health problems. We examined the consequences of the COVID-19 pandemic on mental health in a multinational study and explored the effects of government responses to the outbreak. We sampled 18,171 community adults from 35 countries/societies, stratified by age, gender, and region of residence. Across the 35 societies, 26.6% of participants reported moderate to extremely severe depression symptoms, 28.2% moderate to extremely severe anxiety symptoms, and 18.3% moderate to extremely severe stress symptoms. Coronavirus anxiety comprises two factors, namely Perceived Vulnerability and Threat Response. After controlling for age, gender, and education level, perceived vulnerability predicted higher levels of negative emotional symptoms and psychological distress, whereas threat response predicted higher levels of self-rated health and subjective well-being. People in societies with more stringent control policies had more threat response and reported better subjective health. Coronavirus anxiety exerts detrimental effects on subjective health and well-being, but also has the adaptive function in mobilizing safety behaviors, providing support for an evolutionary perspective on psychological adaptation.

scholarly journals Person-centered dementia care in home care services – highly recommended but still challenging to obtain: a qualitative interview study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Kari-Anne Hoel ◽  
Anne Marie Mork Rokstad ◽  
Ingvild Hjorth Feiring ◽  
Bjørn Lichtwarck ◽  
Geir Selbæk ◽  
...  
Keyword(s):  
Decision Making ◽  
Home Care ◽  
Shared Decision Making ◽  
Care Service ◽  
Home Care Services ◽  
Shared Decision ◽  
Care Services ◽  
Person Centered Care ◽  
People With Dementia ◽  
Centered Care

Abstract Background Dementia is one of the main causes of disability and dependence in older people, and people with dementia need comprehensive healthcare services, preferably in their own homes. A well-organized home care service designed for people with dementia is necessary to meet their needs for health- and social care. Therefore, it is important to gain knowledge about how people with dementia experience the home care service and if the service responds to their wishes and needs. The aim of this study was to explore the experience of home care services among people with dementia, to understand the continuity in services, how the service was adapted to people with dementia, and how the patient experienced person-centered care and shared decision-making. Methods We used a qualitative, exploratory design based on a phenomenological-hermeneutic approach and performed individual in-depth interviews with persons with dementia. A convenience sample of 12 persons with moderate to severe degrees of dementia from four Norwegian municipalities participated in the study. The interviews were conducted in February 2019. Results The findings identified that the participants appreciated the possibility to stay safely in their own homes and mostly experienced good support from staff. They expressed various views and understanding of the service and experienced limited opportunities for user involvement and individualized, tailored service. The overall theme summarizing the findings was: “It is difficult for people with dementia to understand and influence home care services, but the services facilitate the possibility to stay at home and feel safe with support from staff.” Conclusion The participants did not fully understand the organization of the care and support they received from the home care services, but they adapted to the service without asking for changes based on their needs or desires. Although person-centered care is recommended both nationally and internationally, the participants experienced little inclusion in defining the service they received, and it was perceived as unclear how they could participate in shared decision-making.

scholarly journals Coping Strategies by University Students in Response to COVID-19: Differences between Community and Clinical Groups

2021 ◽  
Vol 10 (11) ◽  
pp. 2499
Author(s):  
Víctor-María López-Ramos ◽  
Benito León-del-Barco ◽  
Santiago Mendo-Lázaro ◽  
María-Isabel Polo-del-Río
Keyword(s):  
Mental Health ◽  
Coping Strategies ◽  
Mental Health Problems ◽  
Clinical Sample ◽  
Characteristic Curve ◽  
Well Being ◽  
Clinical Group ◽  
Cognitive Avoidance ◽  
Coping Response ◽  
Community Group

Last year, the COVID-19 pandemic had severe consequences on the health and well-being of millions of people. Different studies try to identify the main effects that the crisis and several lockdowns have had on the citizens’ mental health. This research analyses the coping strategies generated by students from a community group and a clinical group in response to this crisis, using the Coping Responses Inventory—Adult Form (CRI-A) by Moos with a sample of 1074 students of Universidad de Extremadura. Multivariate analysis and receiver operating characteristic curve analysis have been carried out, revealing, amongst other things, a greater predisposition of the clinical sample towards factors such as seeking guidance and support, cognitive avoidance or emotional discharge. Results show that students with prior mental health problems perform an unhealthy coping response based on avoidance strategies. This group of students suffers a double source of distress and anxiety, one derived from their prior psychopathologic problems and the stress of the lockdown and another one originating from an inefficient coping response, which makes coping strategies raise levels of distress and anxiety.

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