Mental Health Care
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2021 ◽  
Author(s):  
Sari L. Reisner ◽  
Matan Benyishay ◽  
Brooke Stott ◽  
Virginia Vedilago ◽  
Anthony Almazan ◽  
...  

Author(s):  
Frances B. Slaven ◽  
Yvonne Erasmus ◽  
Margot Uys ◽  
Pierre-Emile Bruand ◽  
Beki Magazi ◽  
...  

Background: South Africa faces a number of significant challenges apropos mental health service delivery, including a large treatment gap, a high rate of readmission, over-burdened specialist tertiary facilities, and slow integration of mental health into general health services. The South African National Mental Health Education Programme implemented between February 2019 and December 2019, aimed to upskill health workers to diagnose and manage mental disorders at primary and secondary levels of care.Aim: This study aimed to assess the evolution of training participants’ self-reported competency in mental health care and the number of referrals made to higher levels of care as well as to reflect on the possible broader effects of the training.Setting: The programme and study were conducted in South Africa with Medical Officers and Professional Nurses working at public sector primary and secondary level health care facilities.Methods: A descriptive observational study collected data from training participants through a pre- and post-course, and 3-month follow-up survey.Results: The average confidence ratings for performing mental health care activities and managing mental health conditions increased from pre- to post-course, and was either maintained or increased further at 3-month follow-up. A decrease in the self-reported percentage of patients being referred to a higher level of care was observed 3-months after the training.Conclusion: The evaluation suggests that a brief training intervention such this can go a long way in increasing the confidence of primary and secondary level health care workers in managing common mental health conditions and adhering to the provisions of legislation.


2021 ◽  
Author(s):  
Michelle Zepeda ◽  
Stephanie Deighton ◽  
Veronika Markova ◽  
Joshua Madsen ◽  
Nicole Racine

The COVID-19 pandemic has prompted unprecedented disruptions to the daily lives of children and adolescents worldwide, which has been associated with an increase of anxiety and depressive symptoms in youth. However, due to public health measures, in-person psychosocial care has been affected causing barriers to mental health care access. This study investigated the feasibility, acceptability and preliminary effectiveness of iCOPE with COVID-19, a brief telemental health intervention for children and adolescents to address anxiety symptoms. Sessions were provided exclusively using videoconferencing technology. Feasibility and acceptability were measured with client satisfaction data. The main outcome measure for effectiveness was anxiety symptom severity measured using the Screen for Child Anxiety and Related Disorders (SCARED). Results indicated that the treatment was well accepted by participants. Significant reductions in anxiety were noted for social anxiety, and were observed to be trending towards a mean decrease for total anxiety. The findings suggest that this brief telemental health intervention focused on reducing anxiety related to COVID-19 is acceptable and feasible to children and adolescents. Future research using a large sample and with a longer follow-up period could inform whether symptom decreases are sustained over time.


2021 ◽  
Author(s):  
Yakoub Aden Abdi ◽  
Nasir Ibrahim Said ◽  
Yusuf Abdi Hared ◽  
Ismail Ayeh ◽  
Said Ahmed Walhad

Background: The situation of mental health globally is alarming particularly in developing countries. In Somaliland/Somalia, every third person may be suffering from some sort of mental illness according to the World Health Organization. Major barriers to improve mental health include stigma and lack of skilled human resources. Objectives: The aim was to explore the feasibility of organizing integrated community-based mental, epilepsy and mother and child health services delivered by trained female community health workers (FCHWs) in three urban sites (Borama, Baki and Dila) in the Awdal Region, Somaliland. Methods: After selection of the 3 project sites and recruitment and training of project staff, a baseline survey was carried out. First, the sites were properly mapped based on existing geographical administrative sectors and sub-sectors of the sites. Then a representative sample of 2,722 households was randomly selected from all the 3 sites. The female head of each of those households were then interviewed using a questionnaire containing 22 questions on the target groups. The questionnaire responses were coded, and data analysed using Statistical software program, SPSS. After the baseline survey, the FCHWs were deployed in the sites assigning a specified area to each female worker. The FCHWs worked 6 hours per day 6 days per week and were required to visit 6 families each day including follow-ups. Their activities included identification of patients with severe mental illness (SMI) or with epilepsy, counselling, distribution of medications, follow-up of patients already on medication, referral, stigma reduction and documentation of their daily activities in logbooks. Results: The baseline study showed that 12% of the households were taking care of at least one person with SMI each, while 7% had one person with epilepsy each. Of the patients with SMI, 18% were on chains. During the project period (2015-2019), the number of people with SMI or with epilepsy who benefited from the project was 2.225 and 738 respectively and their families empowered through increased mental health awareness. Among the patients with SMI, 237 were on chains before intervention and 85% of them were successfully released from their shackles. Conclusions: This project has shown that deployment of trained and supported FCHWs can be used to reduce the mental health care gap in Somaliland. It is suggested as a model project which could, hopefully, be replicated and tested in other similar settings.


Author(s):  
Hanneke Bot

The question this article tries to deal with is: how does mental health talk differfrom dialogue in other public service areas? The contribution starts with a description of the organization of interpreting in health care and the level ofprofessionalization of the field in the Netherlands, which is really not all that different from that in other western countries. Then a description and discussion of some major publications concerning interpreting in (mental) health care and their methodological backgrounds will be presented. However, only a few publications are based on a systematic investigation. Summarizing the findings from these research projects, we can conclude that the interpreter influences the content of the communication in several ways. Firstly, because of language pair dependent changes and, secondly, because of changes that are dependent on the interpreter: his1 (lack of) knowledge of the type of communication in hand; his (lack of) knowledge of the institutional setting in which the communication takes place and the specific linguistic characteristics of that type of talk; his (un)conscious personal ideas, values and norms which make him diverge from the original text. Finally, we will summarize where we stand as far as the knowledge about interpreting in mental health is concerned, and the contribution closes with some proposals for further research.


Author(s):  
Anne van Dam ◽  
Margot Metz ◽  
Bert Meijboom

A standardised system of clinical pathways often conflicts with providing patient-centred heterogeneous care. Mental health care organisations are searching for new methods to become responsive towards unique treatment needs. Modularity is a method increasingly suggested to reconcile standardisation and customisation. The aim is to investigate the extent to which modularity can be applied to make clinical pathways in specialist mental health care more flexible in order to stimulate shared decision making (SDM) and thereby customise care processes to patient contexts while maintaining evidence-based standards. Methods consist of literature research and a theory-based case study including document analysis and semi-structured interviews, which were performed at a Dutch specialist mental health care organisation. The results show that in current literature two modularity-based structures are proposed that support flexibility and customisation, i.e., ‘Prototype’ and ‘Menu-based’. This study reveals that departments tend to use the prototype method if they have predictable patient needs, evidence-based methods are available and there is sequency in treatment components. The menu-based method is preferred if there are unpredictable needs, or the evidence needed to create interconnectedness in treatment is lacking. In conclusion, prototype or menu-based methods are both suitable for applying SDM and reaching customisation in practice. The choice is determined by three characteristics: predictability of needs, availability of evidence and the interconnectedness of treatment components.


2021 ◽  
Vol 12 ◽  
Author(s):  
Ashten R. Duncan ◽  
Grant Daugherty ◽  
Gabrielle Carmichael

Even with the expanding burden of the COVID-19 pandemic on mental health, our approach to mental health care remains largely reactive rather than preventive. This trend is problematic because the majority of outpatient visits to primary care providers across the country is related to unmet mental health needs. Positive psychology has the potential to address these issues within mental health care and provide primary care providers with strategies to serve their patients more effectively. Positive psychology has many frameworks like hope, which can be measured using simple questionnaires in the waiting room. Moreover, there is a growing body of neurobiological evidence that lends credence to positive psychology concepts in the context of differential neuronal activation patterns. Many positive psychological instruments not only have high construct validity but also have connections to observable neurobiological differences tied to differences in psychosocial functioning. Despite the current evidence, we still need robust research that explores if such psychometric measurements and related interventions lead to clinically significant and favorable health outcomes in patients outside of controlled environments.


2021 ◽  
Vol 12 ◽  
Author(s):  
Annette Bauer ◽  
Stephanie Best ◽  
Juliette Malley ◽  
Hanna Christiansen ◽  
Melinda Goodyear ◽  
...  

Objectives: In several high-income countries, family-focused practice programs have been introduced in adult mental health care settings to identify and support children whose parents live with mental health problems. Whilst their common goal is to reduce the impact of parental mental illness on children, the mechanisms by which they improve outcomes in different systems and settings are less well known. This kind of knowledge can importantly contribute to ensuring that practice programs achieve pre-defined impacts.Methods: The aim of this study was to develop knowledge about relationships between contextual factors, mechanisms and impact that could inform a program theory for developing, implementing, and evaluating family-focused practice. Principles of a realist evaluation approach and complex system thinking were used to conceptualize the design of semi-structured in-depth interviews with individuals who led the implementation of programs. Seventeen individuals from eight countries participated in the study.Results: Interviewees provided rich accounts of the components that programs should include, contextual factors in which they operated, as well as the behavior changes in practitioners that programs needed to achieve. Together with information from the literature, we developed an initial program theory, which illustrates the interconnectedness between changes that need to co-occur in practitioners, parents, and children, many of which related to a more open communication about parental mental health problems. Stigma, risk-focused and fragmented health systems, and a lack of management commitment were the root causes explaining, for example, why conversations about parents' mental illness did not take place, or not in a way that they could help children. Enabling practitioners to focus on parents' strengths was assumed to trigger changes in knowledge, emotions and behaviors in parents that would subsequently benefit children, by reducing feelings of guilt and improving self-esteem.Conclusion: To our knowledge, this is the first research, which synthesizes knowledge about how family-focused practice programs works in a way that it can inform the design, implementation, and evaluation of programs. Stakeholder, who fund, design, implement or evaluate programs should start co-developing and using program theories like the one presented in this paper to strengthen the design and delivery of family-focused practice.


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