Mental Health Professionals
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2021 ◽  
pp. 1-12
Idura N. Hisham ◽  
Jacqueline Sin ◽  
Khadj Rouf ◽  
Danny Taggart ◽  
Giles Townsend ◽  

SUMMARY No recent pandemic has had such a severe socioeconomic impact as COVID-19. Significant economic uncertainty and social restrictions have led to increased levels of stress for many. There has been increased social isolation, financial stress and alcohol intake, all of which can increase domestic abuse and other forms of household abuse. Increases in abuse in the home found in other public health emergencies and economic recessions can be seen now – reported UK domestic abuse rates have increased since the start of COVID-19. This article focuses on how COVID-19 and its anticipated aftermath exacerbate the risk factors for domestic abuse in the general population and discusses clinical implications for mental health practitioners in the UK. It aims to provide a point of learning based on previous disease outbreaks and recessions, with a focus on specific factors, such as unemployment and alcohol misuse, and how these contribute to increasing incidence and severity of abuse – and more importantly, how mental health professionals can mitigate these for patients, 1 in 3 of whom are estimated to have already experienced abuse before the COVID-19 pandemic.

Tamir Magal ◽  
Maya Negev ◽  
Hanoch Kaphzan

Despite proven advantages for the use of telemedicine in psychiatry, mental healthcare professionals have shown deep-seated mistrust and suspicion of telepsychiatry, which hinders its widespread application. The current study examines the attitudes of Israeli mental health professionals towards telepsychiatry and seeks to uncover the effects of experience and organizational affiliation on its adoption. The methodology included qualitative and thematic analysis of 27 in-depth interviews with Israeli mental health professionals, focusing on three major themes—clinical quality, economic efficiency, and the effects on the work–life balance of healthcare professionals. The attitudes of mental health professionals were found to be widely divergent and sharply dichotomized regarding different aspects of telepsychiatry and its suitability for mental healthcare services. However, there was a general consensus that telemedicine may not fulfil its promise of being a panacea to the problems of modern public medicine. In addition, attitudes were related to hierarchical position, organizational affiliation, and personal experience with telepsychiatry. Specifically, organizational affiliation influenced experience with and support for the assimilation of telepsychiatry. The study also revealed the role of organizational leadership and culture in promoting or inhibiting the proliferation and adoption of innovative technologies and services in modern medicine.

2021 ◽  
Vol 11 ◽  
Lynn Ponton ◽  
Samuel L. Judice ◽  
Theodore Petti

Background Objectives: Thirty-three states and the District of Columbia (DC) have enacted some form of legalized cannabis or cannabinoid for medical conditions (MMJ), 11 of them and DC for recreational use. It has become critical for psychiatrists and other mental health professionals working with adolescents to be aware of diversion of marijuana (MJ) to youth and subsequent potential adverse effects in environments with widely different regulations. The experience of two office-based psychiatrists in California (the first state to legalize MMJ) through case presentations and an informal practice review illustrate the role that diverted MMJ plays in the clinical presentation of youth for psychiatric care, highlighting clinical implications and guidelines for treators as states legalize MJ for adult recreational use. Methods: Two child and adolescent psychiatrists practicing in California over the last twenty years report on their experiences working with adolescent patients and their families during the period of legalized MMJ. After a comprehensive literature review, they report their clinical observations and make recommendations for treators of adolescents. Discussion: There is general confusion among adolescents and their parents about MJ and MMJ. There is a lack of clear regulatory guidelines and a need for better clinical training for prescribing physicians. Diversion of MMJ to teens during periods of legalization of medical marijuana is common in states where it has been not legislated or regulated sufficiently to provide effective safeguards. This lax approach is demonstrated by our case reports and clinical review. Similar experiences have been reported elsewhere. Increased problems with diversion are expected as legalization efforts continue. Professionals and their organizations need to become more active in advocating policies to protect youth from potential harm related to cannabis use and abuse and carefully evaluate its use among their teen patients.

2021 ◽  
Vol 21 (1) ◽  
Nafiso Ahmed ◽  
Sally Barlow ◽  
Lisa Reynolds ◽  
Nicholas Drey ◽  
Fareha Begum ◽  

Abstract Background Risk assessment and risk management are fundamental processes in the delivery of safe and effective mental health care, yet studies have shown that service users are often not directly involved or are unaware that an assessment has taken place. Shared decision-making in mental health systems is supported by research and advocated in policy. This systematic review (PROSPERO: CRD42016050457) aimed to explore the perceived barriers and enablers to implementing shared decision-making in risk assessment and risk management from mental health professionals’ perspectives. Methods PRISMA guidelines were followed in the conduct and reporting of this review. Medline, CINAHL, EMBASE, PsycINFO, AMED and Internurse were systematically searched from inception to December 2019. Data were mapped directly into the Theoretical Domains Framework (TDF), a psychological framework that includes 14 domains relevant to behaviour change. Thematic synthesis was used to identify potential barriers and enablers within each domain. Data were then matched to the three components of the COM-B model: Capability, Opportunity, and Motivation. Results Twenty studies met the eligibility criteria. The findings of this review indicate that shared decision-making is not a concept commonly used in mental health services when exploring processes of risk assessment and risk management. The key barriers identified were ‘power and best interest’ (social influences) and ‘my professional role and responsibility’ (social/professional role and identity). Key enablers were ‘therapeutic relationship’ (social influences) and ‘value collaboration’ (reinforcement). The salient barriers, enablers and linked TDF domains matched COM-B components ‘opportunity’ and ‘motivation’. Conclusion The review highlights the need for further empirical research to better understand current practice and mental health professionals’ experiences and attitudes towards shared decision-making in risk assessment and risk management.

2021 ◽  
Vol 21 (1) ◽  
Lingling Chen ◽  
Kitty Vivekananda ◽  
Lili Guan ◽  
Andrea Reupert

Abstract Background Although the experiences of mothers with mental illness are well researched in Western countries, little is known about the experiences of Chinese mothers. This study aims to explore the experiences of family life and parenting of Chinese mothers, in the context of their mental illness. Methods Fourteen Chinese mothers with mental illness undertook in-depth, semi-structured interviews. Interpretative Phenomenological Analysis was employed to guide the data analysis. Results Seven themes were identified: motherhood as a central identity, the stigma associated with being a mother with mental illness, participants’ perceptions about the impact of mental illness on parenting and their children, experiences of talking to children about mental illness, how having children impacts mothers’ illness and recovery, and support obtained and needed. Similar to Western mothers, Chinese mothers experienced stigma and fluctuating mental illness symptoms which impacted on parenting. Unlike mothers based in Western countries, the mothers interviewed in this study highlighted complicated co-caring relationships with parents-in-law and did not raise child custody concerns. Conclusions Mental health professionals need to have the skills to identify and recognize the mothering role of their clients. Culturally sensitive interventions are required to assist Chinese families where mothers have a mental illness. Future research is required to investigate family experiences of parental mental illness from the perspectives of children, partners, and mental health professionals.

2021 ◽  
Vol 21 (1) ◽  
Madhawee Fernando ◽  
Amila Chandrasiri ◽  
Madhubhashinee Dayabandara ◽  
Nicola J. Reavley

Abstract Background Family and friends can play a key role in supporting a person with depression to seek professional help. However, they may lack the knowledge to do so. English-language guidelines for high-income countries have been developed to assist with this. The aim of this study was to adapt the English mental health first aid guidelines for helping a person with depression to the Sri Lankan context. Methods A Delphi expert consensus study involving mental health professionals and people with lived experience (either their own or as carers) was conducted. Participants were recruited from inpatient, outpatient and community care settings. The English-language questionnaire was translated into Sinhala and participants were asked to rate the importance of each item for inclusion in the guidelines for Sri Lanka. Results Data were collected over two survey rounds. A total of 115 panellists (23% male) consisting of 92 mental health professionals and 23 consumers and carers completed the Round 1 questionnaire. A total of 165 items were included in the final guidelines, with 156 adopted from the guidelines for English-speaking countries and 9 generated from the comments of panellists. Conclusions The adapted guidelines were similar to the English-language guidelines. However, new items reflecting culturally relevant approaches to autonomy-granting, communication and culture-specific manifestations of depression were reflected in the adapted version. Further research should explore the use of the adapted guidelines, including their incorporation into Mental Health First Aid Training.

Len Sperry ◽  
Jonathan Sperry

Once understood as useful but optional, case conceptualization is now considered essential and one of the most important of all clinical skills and competencies. As clinicians look for resources to assist in learning and mastering this competency, they must choose among different case conceptualization approaches. They would do well to give serious consideration to those that are both clinically effective and clinician friendly. A truly clinically effective approach explains and guides treatment, and most importantly, predicts challenges and obstacles that are likely to arise over the course of treatment. Most approaches emphasize the functions of explanation and guiding treatment, but seldom include third function which help anticipates likely challenges, which if not proactively addressed are likely to result in therapy interference or premature termination. This function is essential in determining the course and overall effectiveness of therapy. A truly clinician-friendly approach is one that is quick to use and easy to master, and very few approaches can make this claim. The 15 Minute Case Conceptualization is the only approach that is both highly effective and clinician friendly. Research confirms that such case conceptualizations can be completed in only 15 minutes. It is an evidence-based, step-by-step approach that therapists and other mental health professionals need and want.

2021 ◽  
Vol 33 (3) ◽  
pp. 328-333
Anna Antosik Wojcinska ◽  
Gabor Gazdag ◽  
Lukasz Swiecicki ◽  
Beata Majtczak ◽  

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