6,301 results
Search Results
2. Service design for children and young people with common mental health problems: literature review, service mapping and collective case study.
- Author
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Pryjmachuk S, Kirk S, Fraser C, Evans N, Lane R, Neill L, Camacho E, Bower P, Bee P, and McDougall T
- Subjects
- Humans, Child, Adolescent, COVID-19 epidemiology, England, Wales, Cost-Benefit Analysis, Health Services Accessibility organization & administration, Male, Female, Child Health Services organization & administration, SARS-CoV-2, Mental Health Services organization & administration, Mental Disorders therapy
- Abstract
Background: The mental health of children/young people is a growing concern internationally. Numerous reports and reviews have consistently described United Kingdom children's mental health services as fragmented, variable, inaccessible and lacking an evidence base. Little is known about the effectiveness of, and implementation complexities associated with, service models for children/young people experiencing 'common' mental health problems like anxiety, depression, attention deficit hyperactivity disorder and self-harm., Aim: To develop a model for high-quality service design for children/young people experiencing common mental health problems by identifying available services, barriers and enablers to access, and the effectiveness, cost effectiveness and acceptability of such services., Design: Evidence syntheses with primary research, using a sequential, mixed-methods design. Inter-related scoping and integrative reviews were conducted alongside a map of relevant services across England and Wales, followed by a collective case study of English and Welsh services., Setting: Global (systematic reviews); England and Wales (service map; case study)., Data Sources: Literature reviews: relevant bibliographic databases and grey literature. Service map: online survey and offline desk research. Case study: 108 participants (41 children/young people, 26 parents, 41 staff) across nine case study sites., Methods: A single literature search informed both reviews. The service map was obtained from an online survey and internet searches. Case study sites were sampled from the service map; because of coronavirus disease 2019, case study data were collected remotely. 'Young co-researchers' assisted with case study data collection. The integrative review and case study data were synthesised using the 'weaving' approach of 'integration through narrative'., Results: A service model typology was derived from the scoping review. The integrative review found effectiveness evidence for collaborative care, outreach approaches, brief intervention services and the 'availability, responsiveness and continuity' framework. There was cost-effectiveness evidence only for collaborative care. No service model appeared to be more acceptable than others. The service map identified 154 English and Welsh services. Three themes emerged from the case study data: 'pathways to support'; 'service engagement'; and 'learning and understanding'. The integrative review and case study data were synthesised into a coproduced model of high-quality service provision for children/young people experiencing common mental health problems., Limitations: Defining 'service model' was a challenge. Some service initiatives were too new to have filtered through into the literature or service map. Coronavirus disease 2019 brought about a surge in remote/digital services which were under-represented in the literature. A dearth of relevant studies meant few cost-effectiveness conclusions could be drawn., Conclusions: There was no strong evidence to suggest any existing service model was better than another. Instead, we developed a coproduced, evidence-based model that incorporates the fundamental components necessary for high-quality children's mental health services and which has utility for policy, practice and research., Future Work: Future work should focus on: the potential of our model to assist in designing, delivering and auditing children's mental health services; reasons for non-engagement in services; the cost effectiveness of different approaches in children's mental health; the advantages/disadvantages of digital/remote platforms in delivering services; understanding how and what the statutory sector might learn from the non-statutory sector regarding choice, personalisation and flexibility., Study Registration: This study is registered as PROSPERO CRD42018106219., Funding: This award was funded by the National Institute for Health and Care Research (NIHR) Health and Social Care Delivery Research programme (NIHR award ref: 17/09/08) and is published in full in Health and Social Care Delivery Research ; Vol. 12, No. 13. See the NIHR Funding and Awards website for further award information.
- Published
- 2024
- Full Text
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3. 'Boost Camp', a universal school-based transdiagnostic prevention program targeting adolescent emotion regulation; evaluating the effectiveness by a clustered RCT: a protocol paper.
- Author
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Volkaert B, Wante L, Vervoort L, and Braet C
- Subjects
- Adolescent, Adolescent Behavior, Cluster Analysis, Emotions, Female, Humans, Male, Mental Health, Parents, Randomized Controlled Trials as Topic, Reproducibility of Results, Surveys and Questionnaires, Mental Disorders prevention & control, Mental Health Services, School Health Services, Self-Control psychology, Students psychology
- Abstract
Background: The transition from childhood into adolescence can be considered as a critical developmental period. Moreover, adolescence is associated with a decreased use of adaptive emotion regulation strategies and an increased use of maladaptive emotion regulation strategies increasing the risk of emotional problems. Targeting emotion regulation is therefore seen as an innovative prevention approach. The present study aims to evaluate the effectiveness of Boost camp, an innovative school-based prevention program targeting ER, on adolescents' emotion regulation skills and emotional wellbeing. Also secondary outcomes and possible moderators will be included., Methods: The aim is to reach 300 adolescents (16 class groups, 6 schools) in their first year of high school. A clustered Randomized Controlled Trial (RCT) with two conditions, intervention (n = 150) and control (n = 150), will be set up. Adolescents in the intervention condition will receive 14 lessons over the course of 2 days, followed by Booster sessions, and will be compared with adolescents in a non-intervention control group. The outcomes will be measured by self-report questionnaires at baseline, immediately after Boost camp, and at three and 6 months follow-up., Discussion: Data-collection is planned to be completed in May 2018. Data-analyses will be finished the end of 2018. The presented paper describes the Boost camp program and the clustered RCT design to evaluate its effectiveness. It is expected that Boost camp will have beneficial effects. If found effective, Boost camp will have the potential to increase adolescent's ER and well-being, and reduce the risk to become adults in need. The trials is registered on the 13th of June 2017 in ISRCTN registry [ISRCTN68235634].
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- 2018
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4. Conceptual framework on barriers and facilitators to implementing perinatal mental health care and treatment for women: the MATRIx evidence synthesis.
- Author
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Webb R, Ford E, Shakespeare J, Easter A, Alderdice F, Holly J, Coates R, Hogg S, Cheyne H, McMullen S, Gilbody S, Salmon D, and Ayers S
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- Female, Humans, Pregnancy, Health Services Accessibility organization & administration, Mental Disorders therapy, Mental Health Services organization & administration, Perinatal Care organization & administration
- Abstract
Background: Perinatal mental health difficulties can occur during pregnancy or after birth and mental illness is a leading cause of maternal death. It is therefore important to identify the barriers and facilitators to implementing and accessing perinatal mental health care., Objectives: Our research objective was to develop a conceptual framework of barriers and facilitators to perinatal mental health care (defined as identification, assessment, care and treatment) to inform perinatal mental health services., Methods: Two systematic reviews were conducted to synthesise the evidence on: Review 1 barriers and facilitators to implementing perinatal mental health care; and Review 2 barriers to women accessing perinatal mental health care. Results were used to develop a conceptual framework which was then refined through consultations with stakeholders., Data Sources: Pre-planned searches were conducted on MEDLINE, EMBASE, PsychInfo and CINAHL. Review 2 also included Scopus and the Cochrane Database of Systematic Reviews., Review Methods: In Review 1, studies were included if they examined barriers or facilitators to implementing perinatal mental health care. In Review 2, systematic reviews were included if they examined barriers and facilitators to women seeking help, accessing help and engaging in perinatal mental health care; and they used systematic search strategies. Only qualitative papers were identified from the searches. Results were analysed using thematic synthesis and themes were mapped on to a theoretically informed multi-level model then grouped to reflect different stages of the care pathway., Results: Review 1 included 46 studies. Most were carried out in higher income countries and evaluated as good quality with low risk of bias. Review 2 included 32 systematic reviews. Most were carried out in higher income countries and evaluated as having low confidence in the results. Barriers and facilitators to perinatal mental health care were identified at seven levels: Individual (e.g. beliefs about mental illness); Health professional (e.g. confidence addressing perinatal mental illness); Interpersonal (e.g. relationship between women and health professionals); Organisational (e.g. continuity of carer); Commissioner (e.g. referral pathways); Political (e.g. women's economic status); and Societal (e.g. stigma). These factors impacted on perinatal mental health care at different stages of the care pathway. Results from reviews were synthesised to develop two MATRIx conceptual frameworks of the (1) barriers and (2) facilitators to perinatal mental health care. These provide pictorial representations of 66 barriers and 39 facilitators that intersect across the care pathway and at different levels., Limitations: In Review 1 only 10% of abstracts were double screened and 10% of included papers methodologically appraised by two reviewers. The majority of reviews included in Review 2 were evaluated as having low ( n = 14) or critically low ( n = 5) confidence in their results. Both reviews only included papers published in academic journals and written in English., Conclusions: The MATRIx frameworks highlight the complex interplay of individual and system level factors across different stages of the care pathway that influence women accessing perinatal mental health care and effective implementation of perinatal mental health services., Recommendations for Health Policy and Practice: These include using the conceptual frameworks to inform comprehensive, strategic and evidence-based approaches to perinatal mental health care; ensuring care is easy to access and flexible; providing culturally sensitive care; adequate funding of services; and quality training for health professionals with protected time to do it., Future Work: Further research is needed to examine access to perinatal mental health care for specific groups, such as fathers, immigrants or those in lower income countries., Trial Registration: This trial is registered as PROSPERO: (R1) CRD42019142854; (R2) CRD42020193107., Funding: This award was funded by the National Institute for Health and Care Research (NIHR) Health and Social Care Delivery Research programme (NIHR award ref: NIHR 128068) and is published in full in Health and Social Care Delivery Research ; Vol. 12, No. 2. See the NIHR Funding and Awards website for further award information.
- Published
- 2024
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5. Commentary to the Paper 'Prevalence of the Most Frequent Neuropsychiatric Diagnoses in Hospitalized SARS-CoV-2 Patients Evaluated by Liaison Psychiatry: Cross-Sectional Study'
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Gabriela Andrade, Rodrigo Saraiva, Licínia Ganança, Carlos Góis, and Filipa Novais
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COVID-19 ,Delirium ,Mental Health Services ,Psychiatry ,Referral and Consultation ,Medicine ,Medicine (General) ,R5-920 - Abstract
N/a.
- Published
- 2022
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6. A two-arm, randomised feasibility trial using link workers to improve dental visiting in people with severe mental illness: a protocol paper.
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Hilton, Claire, Morris, Abigail, Burnside, Girvan, Harris, Rebecca, Aggarwal, Vishal R., Procter, Sarah, Griffiths, Robert, French, Paul, Laverty, Louise, Lobban, Fiona, Berry, Katherine, Shiers, David, Golby, Rebecca, Fazekas, Fanni, Valemis, Kyriakos, Perry, Antonia, Newens, Connie, Kerry, Eirian, Mupinga, Pauline, and Gkioni, Efstathia
- Subjects
- *
PEOPLE with mental illness , *DENTAL care utilization , *MENTAL health services , *DENTAL personnel , *MEDICAL care - Abstract
Background: People with severe mental illness (e.g. psychosis, bipolar disorder) experience poor oral health compared to the general population as shown by more decayed, missing and filled teeth and a higher prevalence of periodontal disease. Attending dental services allows treatment of oral health problems and support for prevention. However, people with severe mental illness face multiple barriers to attending routine dental appointments and often struggle to access care. Link work interventions use non-clinical support staff to afford vulnerable populations the capacity, opportunity, and motivation to navigate use of services. The authors have co-developed with service users a link work intervention for supporting people with severe mental illness to access routine dental appointments. The Mouth Matters in Mental Health Study aims to explore the feasibility and acceptability of this intervention within the context of a feasibility randomised controlled trial (RCT) measuring outcomes related to the recruitment of participants, completion of assessments, and adherence to the intervention. The trial will closely monitor the safety of the intervention and trial procedures. Methods: A feasibility RCT with 1:1 allocation to two arms: treatment as usual (control) or treatment as usual plus a link work intervention (treatment). The intervention consists of six sessions with a link worker over 9 months. Participants will be adults with severe mental illness receiving clinical input from secondary care mental health service and who have not attended a planned dental appointment in the past 3 years. Assessments will take place at baseline and after 9 months. The target recruitment total is 84 participants from across three NHS Trusts. A subset of participants and key stakeholders will complete qualitative interviews to explore the acceptability of the intervention and trial procedures. Discussion: The link work intervention aims to improve dental access and reduce oral health inequalities in people with severe mental illness. There is a dearth of research relating to interventions that attempt to improve oral health outcomes in people with mental illness and the collected feasibility data will offer insights into this important area. Trial registration: The trial was preregistered on ISRCTN (ISRCTN13650779) and ClinicalTrials.gov (NCT05545228). [ABSTRACT FROM AUTHOR]
- Published
- 2023
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7. The New Collected Papers of Biodynamic Psychology, Massage and Psychotherapy: 2022.
- Author
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Ludwig, Mark
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- *
PSYCHOTHERAPY , *SOCIAL workers , *MENTAL health services , *PSYCHOLOGY , *DANCE therapy - Published
- 2023
8. Response to the white paper on MHA reform: marginalisation of patients detained under part III of the MHA
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Sarah Markham
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Psychiatry ,Government ,medicine.medical_specialty ,Common law ,Mental Health Act ,RC435-571 ,risk assessment ,mental health services ,Civil liberties ,forensic psychiatry ,Statute ,Psychiatry and Mental health ,White paper ,Neurology ,Political science ,Law ,Forensic psychiatry ,Commentary ,Duty of care ,medicine ,Neurology (clinical) ,risk - Abstract
In England and Wales, the Mental Health Act (MHA) 1983 provides the legal framework for the detention of individuals suffering from a mental disorder if they are judged to present a risk of harm to self or others. The MHA removes from certain psychiatric patients civil liberties otherwise inherent in our legal system. Through both statute and common law, it balances a patient’s right to autonomy with psychiatrists' duty of care by reference to the health and safety of the patient. It also balances the civil rights of individual patients against the right of society to protection.1 The 2018 Independent Review of the Mental Health Act (1983) set out recommendations for the government on how the MHA and associated practice needed to change in its final report ‘Modernising the Mental Health Act’.2 This led to the development of the government’s plans to reform the Act, together with the associated policy and practice, as set out in the white paper.3 The proposals take forward the recommendations made by the Independent Review and the full government response. The government is now consulting on its proposals before bringing forward a bill to amend the act. This commentary highlights the white paper’s marginalisation of patients detained under part III of the MHA. As a member of the Independent Review’s Department of Health and Social Care Topic Groups tasked with formulating recommendations for revision of the detention criteria and part III of the MHA, I am delighted that so many of our recommendations have been approved or are being given serious consideration by the government. However, I have substantial concerns about the white paper’s differential approach to civil (part II) and forensic (part III) patients, specifically the exclusion of forensic patients from the proposed changes to the detention criteria in the MHA. …
- Published
- 2021
9. Graphic Paper: The impact of digital communication on adolescent to adult mental health service transitions.
- Author
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Brenchley, Alex
- Abstract
Background: Inaccessible services and poor communication are barriers to successful transitions between adolescent and adult mental health services, for which digital communications (DC) offer a possible solution. Aims: To investigate the role of DC, including smartphone apps, email and text, given the known barriers and facilitators of mental health service transitions reported in the literature. Methods: Use of Neale's (2016) iterative categorisation technique to undertake a secondary analysis of qualitative data collected for the Long-term conditions Young people Networked Communication (LYNC) study. Results: DC were used successfully by young people and staff in ways that ameliorated known barriers to service transitions. They engendered responsibility in young people, promoted service access and contributed to client safety, particularly in times of crisis. DC risks included over-familiarity between young people and staff, and the possibility that messages could go unread. Conclusions: DC have the potential to facilitate trust and familiarity during and after transition to adult mental health services. They can strengthen young people's perceptions of adult services as supportive, empowering and available. DC can be used for frequent 'check-ins' and remote digital support for social and personal problems. They provide an additional safety net for at-risk individuals, but require careful boundary setting. [ABSTRACT FROM AUTHOR]
- Published
- 2023
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10. Engaging Black youth in depression and suicide prevention treatment within urban schools: study protocol for a randomized controlled pilot.
- Author
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Lindsey MA, Mufson L, Vélez-Grau C, Grogan T, Wilson DM, Reliford AO, Gunlicks-Stoessel M, and Jaccard J
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- Humans, Adolescent, Depression diagnosis, Depression prevention & control, Suicide Prevention, Randomized Controlled Trials as Topic, Mental Health Services, Interpersonal Psychotherapy, School Mental Health Services
- Abstract
Background: Depression continues to be an ongoing threat to adolescent well-being with Black adolescents being particularly vulnerable to greater burdens of depression as well as lower mental health service utilization. Black adolescents are likely to have untreated depression due to social network influences, varied perceptions of services and providers, or self-stigma associated with experiencing depressive symptoms. Furthermore, if or when treatment is initiated, low engagement and early termination are common. To address this gap, a trial is being conducted to preliminarily test the effectiveness of an engagement intervention targeting Black adolescents with depression in school mental health services in New York City., Methods: A total of 60 Black middle and high school adolescents displaying depressive symptoms are equally randomized (based on school site) to the treatment arms. Both trial arms deliver Interpersonal Psychotherapy for Depressed Adolescents (IPT-A), a time-limited, evidence-based treatment for depression. Additionally, one arm pairs IPT-A with a brief, multi-level engagement intervention, the Making Connections Intervention (MCI), involving adolescents, caregivers, and clinicians. Outcomes of interest are group differences in depression and suicide ideation, adolescent and caregiver engagement, and mental health service use., Discussion: This trial will serve as an efficacy assessment of the MCI among a sample of Black adolescent students with depressive symptoms. Clinical and implementation results will be used to inform future research to further test the MCI intervention in a larger sample., Trial Registration: Registered by ClinicalTrials.gov on May 3, 2019, identifier: NCT03940508., (© 2024. The Author(s).)
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- 2024
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11. Factors within the clinical encounter that impact upon risk assessment within child and adolescent mental health services: a rapid realist synthesis.
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Cantrell A, Sworn K, Chambers D, Booth A, Taylor Buck E, and Weich S
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- Humans, Adolescent, Risk Assessment methods, Child, Suicide psychology, United Kingdom epidemiology, Adolescent Health Services, Self-Injurious Behavior epidemiology, Self-Injurious Behavior diagnosis, Mental Health Services
- Abstract
Background: Risk assessment is a key process when a child or adolescent presents at risk for self-harm or suicide in a mental health crisis or emergency. Risk assessment by a healthcare professional should be included within a biopsychosocial assessment. However, the predictive value of risk-screening tools for self-harm and suicide in children and adolescents is consistently challenged. A review is needed to explore how best to undertake risk assessment and the appropriate role for tools/checklists within the assessment pathway., Aims: To map research relating to risk assessment for child and adolescent mental health and to identify features that relate to a successful risk assessment., Objectives: To review factors within the clinical encounter that impact upon risk assessments for self-harm and suicide in children and adolescents: i. to conduct a realist synthesis to understand mechanisms for risk assessment, why they occur and how they vary by context ii. to conduct a mapping review of primary studies/reviews to describe available tools of applicability to the UK., Data Sources: Databases, including MEDLINE, PsycINFO
® , EMBASE, CINAHL, HMIC, Science and Social Sciences Citation Index and the Cochrane Library, were searched (September 2021). Searches were also conducted for reports from websites., Review Methods: A resource-constrained realist synthesis was conducted exploring factors that impact upon risk assessments for self-harm and suicide. This was accompanied by a mapping review of primary studies/reviews describing risk-assessment tools and approaches used in UK child and adolescent mental health. Following piloting, four reviewers screened retrieved records. Items were coded for the mapping and/or for inclusion in the realist synthesis. The review team examined the validity and limitations of risk-screening tools. In addition, the team identified structured approaches to risk assessment. Reporting of the realist synthesis followed RAMESES guidelines., Results: From 4084 unique citations, 249 papers were reviewed and 41 studies (49 tools) were included in the mapping review. Eight reviews were identified following full-text screening. Fifty-seven papers were identified for the realist review. Findings highlight 14 explanations (programme theories) for a successful risk assessment for self-harm and suicide. Forty-nine individual assessment tools/approaches were identified. Few tools were developed in the UK, specifically for children and adolescents. These lacked formal independent evaluation. No risk-screening tool is suitable for risk prediction; optimal approaches incorporate a relationship of trust, involvement of the family, where appropriate, and a patient-centred holistic approach. The objective of risk assessment should be elicitation of information to direct a risk formulation and care plan., Limitations: Many identified tools are well-established but lack scientific validity, particularly predictive validity, or clinical utility. Programme theories were generated rapidly from a survey of risk assessment., Conclusions: No single checklist/approach meets the needs of risk assessment for self-harm and suicide. A whole-system approach is required, informed by structured clinical judgement. Useful components include a holistic assessment within a climate of trust, facilitated by family involvement., Study Registration: This study is registered as PROSPERO CRD42021276671., Funding: This award was funded by the National Institute for Health and Care Research (NIHR) Health and Social Care Delivery Research programme (NIHR award ref: NIHR135079) and is published in full in Health and Social Care Delivery Research ; Vol. 12, No. 1. See the NIHR Funding and Awards website for further award information.- Published
- 2024
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12. Open Dialogue, need‐adapted mental health care, and implementation fidelity: A discussion paper
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Anna Sidis, Lisa Dawson, Steven Mayers, Edward K. Waters, Andrea McCloughen, Alan Rosen, Niels Buus, Kristof Mikes-Liu, and Benjamin Ong
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Mental Health Services ,Evidence-based nursing ,media_common.quotation_subject ,Psychological intervention ,Fidelity ,03 medical and health sciences ,0302 clinical medicine ,nursing ,Health care ,Humans ,Quality (business) ,Finland ,media_common ,implementation science ,Medical education ,philosophy ,030504 nursing ,business.industry ,Perspective (graphical) ,Flexibility (personality) ,evidence-based nursing ,Mental health ,030227 psychiatry ,Mental Health ,psychiatric nursing ,Pshychiatric Mental Health ,0305 other medical science ,business ,Psychology ,mental health - Abstract
Open Dialogue is a need-adapted approach to mental health care that was originally developed in Finland. Like other need-adapted approaches, Open Dialogue aims to meet consumer’s needs and promote collaborative person-centred dialogue to support recovery. Need-adapted mental health care is distinguished by flexibility and responsiveness. Fidelity, defined from an implementation science perspective as the delivery of distinctive interventions in a high quality and effective fashion is a key consideration in health care. However, flexibility presents challenges for evaluating fidelity, which is much easier to evaluate when manualization and reproducible processes are possible. Hence, it remains unclear whether Open Dialogue and other need-adapted mental health interventions can be meaningfully evaluated for fidelity. The aim of this paper was to critically appraise and advance the evaluation of fidelity in need-adapted mental health care, using Open Dialogue as a case study. The paper opens a discussion about how fidelity should be evaluated in flexible, complex interventions, and identifies key questions that need to be asked by practitioners working in need-adapted mental health care to ensure they deliver these interventions as intended and in an evidence-based fashion.
- Published
- 2021
13. Service user experiences of participating in a Recovery and Collaborative Care Planning Café framed with CHIME: 'A co-produced narrative paper'.
- Author
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Williams, Lyn, Armitage, Claire, Richardson, Azar, Davies, Firoza, Smith, April, and Adnath, Jayshree
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PATIENT participation ,CONVALESCENCE ,SERIAL publications ,ATTITUDES of medical personnel ,CONSUMER attitudes ,INTERVIEWING ,MEDICAL protocols ,QUALITATIVE research ,NATIONAL health services ,LEARNING strategies ,ADVANCE directives (Medical care) ,INTERPROFESSIONAL relations ,QUALITY assurance ,THEMATIC analysis ,PATIENT-professional relations ,MENTAL health services ,VIDEO recording ,STORYTELLING - Abstract
This paper builds on a previous article describing an innovative approach to enhance the service user and practitioner's experience of novel collaborative approach to service improvement. It aims to explore the impact of this through the voices of service users as collaborators and co-authors. The Recovery and Collaborative Care Planning Café (RCCPC) designed with World Café principles, created a safe space to foster inquiry and learning about recovery between service users, carers, and practitioners in an NHS Trust. An important part of the method was in changing conversations towards recovery and living well with conditions applying CHIME concepts (Connectedness, Hope, Identity, Meaning, and Empowerment). Story is a qualitative method known as a well-established effective means of engaging others in sharing experiences and perspectives. Through the stories of service users' experiences participating in the RCCP Cafe, it was clear that they felt that CHIME concepts had a positive impact on the way that their conversations evolved. Accounts of how these conversations had resulted in personal growth and increased connectedness emerged. [ABSTRACT FROM AUTHOR]
- Published
- 2023
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14. Physician Suicide Prevention and the Ethics and Role of a Healing Community: an American College of Physicians Policy Paper.
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DeCamp, Matthew and Levine, Mark
- Subjects
- *
SUICIDE prevention , *SUICIDE victims , *MENTAL health services , *SUICIDE statistics , *MENTAL health screening , *UNIVERSITY towns , *PHYSICIANS , *PUBLIC health - Abstract
Suicide is a major global public health issue, and in recent years, there has been increasing recognition of the problem of physician suicide. This American College of Physicians policy paper examines, from the perspective of ethics, the issues that arise when individuals and institutions respond to physician suicides and when they engage in broader efforts aimed at physician suicide prevention. Emphasizing the medical profession as a unique moral community characterized by ethical and professional commitments of service to patients, each other, and society, this paper offers guidance regarding physician suicide and the role of a healing community. The response to an individual physician suicide should be characterized by respect and concern for those who are grieving, the creation of a supportive environment for suicide loss survivors, and careful communication about the event. Because suicide is a complex problem, actions aimed at preventing suicide must occur at the individual, interpersonal, community, and societal levels. The medical community has an obligation to foster a culture that supports education, screening, and access to mental health treatment, beginning at the earliest stages of medical training. [ABSTRACT FROM AUTHOR]
- Published
- 2021
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15. Integration, effectiveness and costs of different models of primary health care provision for people who are homeless: an evaluation study.
- Author
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Crane M, Joly L, Daly BJ, Gage H, Manthorpe J, Cetrano G, Ford C, and Williams P
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- Child, Humans, Mental Health, England epidemiology, Primary Health Care, Mental Health Services, Ill-Housed Persons
- Abstract
Background: There is a high prevalence of health problems among single people who are homeless. Specialist primary health care services for this population have been developed in several locations across England; however, there have been very few evaluations of these services., Objectives: This study evaluated the work of different models of primary health care provision in England to determine their effectiveness in engaging people who are homeless in health care and in providing continuity of care for long-term conditions. It concerned single people (not families or couples with dependent children) staying in hostels, other temporary accommodation or on the streets. The influence on outcomes of contextual factors and mechanisms (service delivery factors), including integration with other services, were examined. Data from medical records were collated on participants' use of health care and social care services over 12 months, and costs were calculated., Design and Setting: The evaluation involved four existing Health Service Models: (1) health centres primarily for people who are homeless (Dedicated Centres), (2) Mobile Teams providing health care in hostels and day centres, (3) Specialist GPs providing some services exclusively for patients who are homeless and (4) Usual Care GPs providing no special services for people who are homeless (as a comparison). Two Case Study Sites were recruited for each of the specialist models, and four for the Usual Care GP model., Participants: People who had been homeless during the previous 12 months were recruited as 'case study participants'; they were interviewed at baseline and at 4 and 8 months, and information was collected about their circumstances and their health and service use in the preceding 4 months. Overall, 363 participants were recruited; medical records were obtained for 349 participants. Interviews were conducted with 65 Case Study Site staff and sessional workers, and 81 service providers and stakeholders., Results: The primary outcome was the extent of health screening for body mass index, mental health, alcohol use, tuberculosis, smoking and hepatitis A among participants, and evidence of an intervention if a problem was identified. There were no overall differences in screening between the models apart from Mobile Teams, which scored considerably lower. Dedicated Centres and Specialist GPs were more successful in providing continuity of care for participants with depression and alcohol and drug problems. Service use and costs were significantly higher for Dedicated Centre participants and lower for Usual Care GP participants. Participants and staff welcomed flexible and tailored approaches to care, and related services being available in the same building. Across all models, dental needs were unaddressed and staff reported poor availability of mental health services., Limitations: There were difficulties recruiting mainstream general practices for the Usual Care GP model. Medical records could not be accessed for 14 participants of this model., Conclusions: Participant characteristics, contextual factors and mechanisms were influential in determining outcomes. Overall, outcomes for Dedicated Centres and for one of the Specialist GP sites were relatively favourable. They had dedicated staff for patients who were homeless, 'drop-in' services, on-site mental health and substance misuse services, and worked closely with hospitals and homelessness sector services., Funding: This project was funded by the National Institute for Health and Care Research (NIHR) Health and Social Care Delivery Research programme (HSDR 13/156/03) and will be published in full in Health and Social Care Delivery Research ; Vol. 11, No. 16. See the NIHR Journals Library website for further project information.
- Published
- 2023
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16. Program Report: Children and Families.
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Currie, Janet and Aizer, Anna
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MENTAL health services ,MEDICAL care ,POOR families ,NATIVE American children ,FOOD stamps ,HEAD Start programs ,SCHOOL year - Abstract
The article discusses the renaming of the Program on Children to the Program on Children and Families, reflecting the broad range of research conducted by its affiliates. It highlights the importance of early-life conditions and public programs in shaping children's outcomes. The article also explores the effects of the social safety net on child health and well-being, as well as the impact of cash transfers and early childhood education programs. Additionally, it discusses the positive effects of access to medical care, particularly for marginalized Black children. The text discusses various research studies on the impact of different factors on children and families. It highlights the positive effects of increasing access to medical care through community health centers on birth outcomes. It also emphasizes the benefits of Medicaid coverage for undocumented women during pregnancy and its positive impact on prenatal care and birth weight. The text further explores intergenerational impacts of Medicaid expansions and the importance of parental investments in children's well-being. It touches on emerging areas of research such as child mental health, abortion access, gun violence, and the impact of COVID-19 on families and children. This document contains a list of research papers and working papers related to various topics concerning children's well-being, social safety nets, and related issues. The papers cover a range of subjects, including the effects of welfare programs on crime, the impact of cash transfers on employment outcomes, the benefits of early childhood education, the consequences of poor childhood health, and the effects of restrictive abortion legislation. The papers provide valuable insights into these topics and can be useful [Extracted from the article]
- Published
- 2024
17. Analysis and critique of 'Transforming children and young people's mental health provision: A green paper': Some implications for refugee children and young people
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Pat Cox and Jane March McDonald
- Subjects
Mental Health Services ,Adolescent ,Service delivery framework ,Refugee ,media_common.quotation_subject ,Social Stigma ,B760 ,Pediatrics ,03 medical and health sciences ,0302 clinical medicine ,030225 pediatrics ,Humans ,Sociology ,Child ,media_common ,Government ,Refugees ,Wales ,030504 nursing ,business.industry ,Green paper ,B730 ,Public relations ,Mental health ,Culturally Competent Care ,England ,Paradigm shift ,Scale (social sciences) ,Pediatrics, Perinatology and Child Health ,Wounds and Injuries ,0305 other medical science ,business ,Diversity (politics) - Abstract
Adopting a children’s rights perspective, a critique and analysis underpinned by documentary research methodology was undertaken in order to assess the extent to which the government’s Green Paper (Department of Health and Social Care and Department of Education, 2017. Transforming children and young people’s mental health provision: a green paper. Available at: https://www.gov.uk/government/consultations/transforming-children-and-young-peoples-mental-health-provision-a-green-paper (accessed 7 December 2017)) addresses the mental health and well-being needs of refugee children and young people in England and Wales, identifying strengths, limitations and challenges for future policy and practice. Findings suggest that there is much of potential benefit to refugee children and young people’s future mental health and well-being. However, a paradigm shift, explicit in implications, scale and time frame, will be required, if the Green Paper is to achieve those changes in attitudes, practice and service delivery which it anticipates. We argue that this Green Paper’s overarching challenge is that it is premised on Western-centric models in its understanding of the experiences of refugee children and young people, and management of trauma and mental health. It fails to recognize the meanings and significance of culture, and of diversity and difference, and the need to invest in all communities in facilitating engagement and support for children and young people’s mental health issues.
- Published
- 2018
18. A scoping review of trauma informed approaches in acute, crisis, emergency, and residential mental health care.
- Author
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Saunders KRK, McGuinness E, Barnett P, Foye U, Sears J, Carlisle S, Allman F, Tzouvara V, Schlief M, Vera San Juan N, Stuart R, Griffiths J, Appleton R, McCrone P, Rowan Olive R, Nyikavaranda P, Jeynes T, K T, Mitchell L, Simpson A, Johnson S, and Trevillion K
- Subjects
- Pregnancy, Humans, Female, Mental Health, Mental Health Services
- Abstract
Experiences of trauma in childhood and adulthood are highly prevalent among service users accessing acute, crisis, emergency, and residential mental health services. These settings, and restraint and seclusion practices used, can be extremely traumatic, leading to a growing awareness for the need for trauma informed care (TIC). The aim of TIC is to acknowledge the prevalence and impact of trauma and create a safe environment to prevent re-traumatisation. This scoping review maps the TIC approaches delivered in these settings and reports related service user and staff experiences and attitudes, staff wellbeing, and service use outcomes.We searched seven databases (EMBASE; PsycINFO; MEDLINE; Web of Science; Social Policy and Practice; Maternity and Infant Care Database; Cochrane Library Trials Register) between 24/02/2022-10/03/2022, used backwards and forwards citation tracking, and consulted academic and lived experience experts, identifying 4244 potentially relevant studies. Thirty-one studies were included.Most studies (n = 23) were conducted in the USA and were based in acute mental health services (n = 16). We identified few trials, limiting inferences that can be drawn from the findings. The Six Core Strategies (n = 7) and the Sanctuary Model (n = 6) were the most commonly reported approaches. Rates of restraint and seclusion reportedly decreased. Some service users reported feeling trusted and cared for, while staff reported feeling empathy for service users and having a greater understanding of trauma. Staff reported needing training to deliver TIC effectively.TIC principles should be at the core of all mental health service delivery. Implementing TIC approaches may integrate best practice into mental health care, although significant time and financial resources are required to implement organisational change at scale. Most evidence is preliminary in nature, and confined to acute and residential services, with little evidence on community crisis or emergency services. Clinical and research developments should prioritise lived experience expertise in addressing these gaps., (© 2023. BioMed Central Ltd., part of Springer Nature.)
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- 2023
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19. Current insights of community mental healthcare for people with severe mental illness: A scoping review.
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van Genk, Caroline, Roeg, Diana, van Vugt, Maaike, van Weeghel, Jaap, and Van Regenmortel, Tine
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PEOPLE with mental illness ,MENTAL health services ,COMMUNITIES ,COMMUNITY mental health services ,SOCIAL support ,HUMANISTIC psychology ,SOCIAL integration - Abstract
Background: For the last four decades, there has been a shift in mental healthcare toward more rehabilitation and following a more humanistic and comprehensive vision on recovery for persons with severe mental illness (SMI). Consequently, many community-based mental healthcare programs and services have been developed internationally. Currently, community mental healthcare is still under development, with a focus on further inclusion of persons with enduring mental health problems. In this review, we aim to provide a comprehensive overview of existing and upcoming community mental healthcare approaches to discover the current vision on the ingredients of community mental healthcare. Methods: We conducted a scoping review by systematically searching four databases, supplemented with the results of Research Rabbit, a hand-search in reference lists and 10 volumes of two leading journals. We included studies on adults with SMI focusing on stimulating independent living, integrated care, recovery, and social inclusion published in English between January 2011 and December 2022 in peer-reviewed journals. Results: The search resulted in 56 papers that met the inclusion criteria. Thematic analysis revealed ingredients in 12 areas: multidisciplinary teams; collaboration within and outside the organization; attention to several aspects of health; supporting full citizenship; attention to the recovery of daily life; collaboration with the social network; tailored support; well-trained staff; using digital technologies; housing and living environment; sustainable policies and funding; and reciprocity in relationships. Conclusion: We found 12 areas of ingredients, including some innovative topics about reciprocity and sustainable policies and funding. There is much attention to individual ingredients for good community-based mental healthcare, but very little is known about their integration and implementation in contemporary, fragmented mental healthcare services. For future studies, we recommend more empirical research on community mental healthcare, as well as further investigation(s) from the social service perspective, and solid research on general terminology about SMI and outpatient support. [ABSTRACT FROM AUTHOR]
- Published
- 2023
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20. The Educational Value of Outpatient Consultation-Liaison Rotations: A White Paper From the Academy of Consultation-Liaison Psychiatry Residency Education Subcommittee
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Ariadna Forray, Andrew M. Siegel, Thomas M. Soeprono, Carrie L. Ernst, Mallika Lavakumar, Paula C. Zimbrean, Ann C. Schwartz, and Scott R. Beach
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Mental Health Services ,medicine.medical_specialty ,animal diseases ,education ,Psychological intervention ,MEDLINE ,Collaborative Care ,PsycINFO ,digestive system ,Ambulatory Care Facilities ,Article ,03 medical and health sciences ,0302 clinical medicine ,consultation-liaison psychiatry ,Arts and Humanities (miscellaneous) ,Outpatients ,medicine ,collaborative care ,Humans ,Curriculum ,Referral and Consultation ,Applied Psychology ,integrated care ,Psychiatry ,Education, Medical ,business.industry ,Delivery of Health Care, Integrated ,Internship and Residency ,bacterial infections and mycoses ,Mental health ,030227 psychiatry ,Integrated care ,Psychiatry and Mental health ,stomatognathic diseases ,Family medicine ,Liaison psychiatry ,business ,medical education ,030217 neurology & neurosurgery - Abstract
Background As mental health services in outpatient medical clinics expand, psychiatrists must be trained to practice in these settings. Objectives The Academy of Consultation-Liaison Psychiatry residency education subcommittee convened a writing group with the goal of summarizing the current evidence about outpatient consultation-liaison psychiatry (CLP) training and providing a framework for CLP educators who are interested in developing outpatient CLP rotations within their programs. Method MEDLINE (via PubMed), Embase, and PsycINFO (via OVID) were reviewed each from inception to December 2019, for psychiatric CLP services in ambulatory settings that involved residents or fellows. The CLP education guidelines were reviewed for recommendations relevant to outpatient CLP. We also searched MedEd portal for published curriculums relevant to CLP. The group held 2 conferences to reach consensus about recommendations in setting up outpatient CLP rotations. Results Seventeen articles, 3 Academy of Consultation-Liaison Psychiatry–supported guidelines, and 8 online didactic resources were identified as directly reporting on the organization and/or impact of an outpatient CLP rotation. These manuscripts indicated that residents found outpatient CLP rotations effective and relevant to their future careers. However, the literature provided few recommendations for establishing formal outpatient CLP training experiences. Conclusions Outpatient CLP rotations offer multiple benefits for trainees, including exposure to specific clinical scenarios and therapeutic interventions applicable only in the outpatient setting, increased continuity of care, and the unique experience of providing liaison and education to non-mental health providers. The article outlines recommendations and examples for developing outpatient CLP rotations which CLP educators can incorporate in their programs.
- Published
- 2020
21. Shared Decision Making in a Youth Mental Health Service Design and Research Project: Insights From the Pan-Canadian ACCESS Open Minds Network.
- Author
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Guinaudie C, Mireault C, Tan J, Pelling Y, Jalali S, Malla A, and Iyer SN
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- Adolescent, Canada, Decision Making, Decision Making, Shared, Health Services Accessibility, Humans, Mental Disorders therapy, Mental Health Services
- Abstract
Shared decision making (SDM) is the process by which health care providers and patients collaborate to make health care decisions. This collaboration leads to informed decision making and improved outcomes. However, research on SDM specific to the field of youth mental health is scarce. ACCESS Open Minds (ACCESS OM) is a youth mental health research and evaluation project that implemented and evaluated SDM practices within its various activities and operations. The ACCESS OM network spans a diversity of youth mental health settings across Canada, and includes various stakeholders such as youth, family members and carers, clinicians, researchers, and policy makers. The project values all types of knowledge (specifically, experiential, cultural, clinical, and scientific knowledge) as necessary to lead to better health research, care delivery, and outcomes for patients and their communities. Similarly, it acknowledges the lived experience of patients and, family and carers as expertise. Through the integration of SDM practices, ACCESS OM has formulated valuable insights that can be applied to other health problems and settings. This paper, written by youth and family council members, operational staff, and researchers from the project, will share challenges and solutions that arose in the integration of SDM practices within ACCESS OM's knowledge translation strategy, governance structures, clinical contexts, and capacity-building initiatives. Shared Decision Making in a Youth Mental Health Service Design and Research Project: Insights From the Pan-Canadian ACCESS Open Minds Network (MP4 234838 kb).
- Published
- 2020
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22. A Brief Reflection on Paper Titled "Mental Health Training of Primary Health Care Workers: Case Reports from Sri Lanka, Pakistan, and Jordan".
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Budosan, Boris
- Subjects
- *
EVALUATION of human services programs , *MENTAL health , *PRIMARY health care , *MENTAL health services - Published
- 2023
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23. Reliability of Paper-Based Routine Documentation in Psychiatric Inpatient Care and Recommendations for Further Improvement.
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Fröhlich, Daniela, Bittersohl, Christin, Schroeder, Katrin, Schöttle, Daniel, Kowalinski, Eva, Borgwardt, Stefan, Lang, Undine E., and Huber, Christian G.
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MENTAL health services ,INPATIENT care ,DOCUMENTATION ,RELIABILITY in engineering ,ORGANIZATIONAL change ,UNIVERSITY hospitals - Abstract
Background: Health services research is of increasing importance in current psychiatry. Therefore, large datasets and aggregation of data generated by electronic routine documentation due to legal, financial, or administrative purposes play an important role. However, paper-based routine documentation is still of interest. It remains relevant in less developed health care systems, in emergency settings, and in long-term retrospective and historical studies. Whereas studies examining the reliability of electronic routine documentation support the application of routine data for research purposes, our knowledge regarding reliability of paper-based routine documentation is still very sparse. Methods: Basic documentation (BADO) was completed on paper forms and digitalized manually for all inpatients of the Department of Psychiatry and Psychotherapy, University Hospital Hamburg-Eppendorf, Germany, treated within the time period from 1998 to 2006. Four hundred twelve cases of first-episode psychosis patients were chosen for comparison with clinical data from paper-based patient files. The percentage of missing information, the percentage of correct classifications, sensitivity, and positive predictive value were calculated for all applicable variables. Results: In eight cases (1.9%), a BADO form was available, but was not filled in. In 37 cases (7.0%), the patient files were lost and could not be obtained from the centralized archive. Routine data were available for all other cases in 20 (58.8%) of the examined 34 variables, and the percentage of missing data for the remaining variables ranged between 0.3% and 22.9%, with only the variables education and suicidality during treatment having more than 5% missing data. In general, the overall rate of correct classifications was high, with a median percentage of 86.4% to 99.7% for the examined variables. Sensitivity was above 75% for eight and <75% but above 50% for six of the examined 17 variables. Values for the positive predictive value were above 75% for nine and <75% but above 50% for three variables. Conclusion: In summary, paper-based routine documentation reaches acceptable reliability, but this is dependent on the chosen documentation categories and variables. Based on the present findings, paper-based routine documentation can indeed be used for quality management, organizational development, and health services research. Its limitations, however, have to be kept in mind. [ABSTRACT FROM AUTHOR]
- Published
- 2020
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24. The ReCoN intervention: a co-created comprehensive intervention for primary mental health care aiming to prevent involuntary admissions.
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Wormdahl I, Hatling T, Husum TL, Kjus SHH, Rugkåsa J, Brodersen D, Christensen SD, Nyborg PS, Skolseng TB, Ødegård EI, Andersen AM, Gundersen E, and Rise MB
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- Adult, Coercion, Hospitalization, Humans, Mental Health, Mental Disorders psychology, Mental Disorders therapy, Mental Health Services
- Abstract
Background: Reducing involuntary psychiatric admissions is a global concern. In Norway, the rate of involuntary admissions was 199 per 100,000 people 16 years and older in 2020. Individuals' paths towards involuntary psychiatric admissions usually unfold when they live in the community and referrals to such admissions are often initiated by primary health care professionals. Interventions at the primary health care level can therefore have the potential to prevent such admissions. Interventions developed specifically for this care level are, however, lacking. To enhance the quality and development of services in a way that meets stakeholders' needs and facilitates implementation to practice, involving both persons with lived experience and service providers in developing such interventions is requested., Aim: To develop a comprehensive intervention for primary mental health care aiming to prevent involuntary admissions of adults., Methods: This study had an action research approach with a participatory research design. Dialogue conferences with multiple stakeholders in five Norwegian municipalities, inductive thematic analysis of data material from the conferences, and a series of feedback meetings were conducted., Results: The co-creation process resulted in the development of the ReCoN (Reducing Coercion in Norway) intervention. This is a comprehensive intervention that includes six strategy areas: [1] Management, [2] Involving Persons with Lived Experience and Family Carers, [3] Competence Development, [4] Collaboration across Primary and Specialist Care Levels, [5] Collaboration within the Primary Care Level, and [6] Tailoring Individual Services. Each strategy area has two to four action areas with specified measures that constitute the practical actions or tasks that are believed to collectively impact the need for involuntary admissions., Conclusions: The ReCoN intervention has the potential for application to both national and international mental health services. The co-creation process with the full range of stakeholders ensures face validity, acceptability, and relevance. The effectiveness of the ReCoN intervention is currently being tested in a cluster randomised controlled trial. Given positive effects, the ReCoN intervention may impact individuals with a severe mental illness at risk of involuntary admissions, as more people may experience empowerment and autonomy instead of coercion in their recovery process., (© 2022. The Author(s).)
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- 2022
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25. ‘Boost Camp’, a universal school-based transdiagnostic prevention program targeting adolescent emotion regulation; evaluating the effectiveness by a clustered RCT: a protocol paper
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Caroline Braet, Brenda Volkaert, Laura Wante, and Leentje Vervoort
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Male ,Mental Health Services ,Parents ,050103 clinical psychology ,medicine.medical_specialty ,Adolescent ,Emotions ,Adolescents ,Prevention program ,Self-Control ,law.invention ,Study Protocol ,Randomized controlled trial ,law ,Surveys and Questionnaires ,Intervention (counseling) ,Epidemiology ,Cluster Analysis ,Humans ,Medicine ,0501 psychology and cognitive sciences ,Students ,Set (psychology) ,Randomized Controlled Trials as Topic ,School Health Services ,Protocol (science) ,business.industry ,Mental Disorders ,Emotion regulation ,lcsh:Public aspects of medicine ,Public health ,05 social sciences ,Public Health, Environmental and Occupational Health ,Reproducibility of Results ,lcsh:RA1-1270 ,Emotional wellbeing ,Mental Health ,Adolescent Behavior ,Female ,School based ,Biostatistics ,business ,School-based ,050104 developmental & child psychology ,Clinical psychology - Abstract
Background The transition from childhood into adolescence can be considered as a critical developmental period. Moreover, adolescence is associated with a decreased use of adaptive emotion regulation strategies and an increased use of maladaptive emotion regulation strategies increasing the risk of emotional problems. Targeting emotion regulation is therefore seen as an innovative prevention approach. The present study aims to evaluate the effectiveness of Boost camp, an innovative school-based prevention program targeting ER, on adolescents’ emotion regulation skills and emotional wellbeing. Also secondary outcomes and possible moderators will be included. Methods The aim is to reach 300 adolescents (16 class groups, 6 schools) in their first year of high school. A clustered Randomized Controlled Trial (RCT) with two conditions, intervention (n = 150) and control (n = 150), will be set up. Adolescents in the intervention condition will receive 14 lessons over the course of 2 days, followed by Booster sessions, and will be compared with adolescents in a non-intervention control group. The outcomes will be measured by self-report questionnaires at baseline, immediately after Boost camp, and at three and 6 months follow-up. Discussion Data-collection is planned to be completed in May 2018. Data-analyses will be finished the end of 2018. The presented paper describes the Boost camp program and the clustered RCT design to evaluate its effectiveness. It is expected that Boost camp will have beneficial effects. If found effective, Boost camp will have the potential to increase adolescent’s ER and well-being, and reduce the risk to become adults in need. The trials is registered on the 13th of June 2017 in ISRCTN registry [ISRCTN68235634].
- Published
- 2018
26. Forced Migration: A Relational Wellbeing Approach.
- Author
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Kohli, Ravi K. S., Fylkesnes, Marte Knag, Kaukko, Mervi, and White, Sarah C.
- Subjects
FORCED migration ,WELL-being ,MENTAL health services ,KINSHIP ,YOUNG adults ,RELIGIOUS communities - Abstract
This document is a summary of a special issue in the journal "Social Sciences" that examines the concept of relational wellbeing among young refugees. The papers in the issue explore various dimensions of relational wellbeing and highlight the challenges and resilience of young refugees. The authors emphasize the importance of relationships and call for a relational approach in policy and resource distribution to better support the needs of young refugees. [Extracted from the article]
- Published
- 2024
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27. Editorial - IJIH Volume 19, Issue 1.
- Author
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Dickson, Michelle
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INDIGENOUS Australians ,MENTAL health services ,COVID-19 pandemic ,AUSTRALIANS ,INDIGENOUS youth - Abstract
This document is an editorial from the International Journal of Indigenous Health, Volume 19, Issue 1. The guest editors, from the Poche Centre for Indigenous Health at the University of Sydney, present a collection of research papers that focus on research collaborations that enhance and embed Indigenous ways of Knowing, Being, and Doing. The papers highlight the importance of privileging Indigenous voices in research and emphasize the potential for transforming health experiences for Indigenous people globally. The editorial also provides Australian context, discussing the recent national referendum on constitutional recognition of Aboriginal and Torres Strait Islander people, which resulted in a rejection of recognition. Despite this setback, the editorial emphasizes the ongoing fight for recognition, voice, and truth-telling and the importance of research collaborations that center Indigenous knowledges. [Extracted from the article]
- Published
- 2024
28. Educational interventions: equipping general practice for youth mental health and substance abuse. A discussion paper
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Elisabeth Schaffalitzky, Andrew O’Regan, and Walter Cullen
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Mental Health Services ,medicine.medical_specialty ,Adolescent ,Substance-Related Disorders ,media_common.quotation_subject ,Population ,General Practice ,Psychological intervention ,03 medical and health sciences ,0302 clinical medicine ,Nursing ,Intervention (counseling) ,Health care ,medicine ,Humans ,030212 general & internal medicine ,Psychiatry ,education ,Health policy ,media_common ,Patient Care Team ,education.field_of_study ,Primary Health Care ,business.industry ,Addiction ,General Medicine ,Patient Acceptance of Health Care ,medicine.disease ,Mental health ,3. Good health ,030227 psychiatry ,Substance abuse ,Mental Health ,Adolescent Health Services ,Education, Medical, Graduate ,Research Design ,business ,Ireland - Abstract
Youth mental health issues and substance abuse are important causes of morbidity and mortality in Ireland. General practice is a frequent point of contact for young people, however, reluctance amongst this population group to disclose mental health issues and a lack of confidence amongst GPs in dealing with them have been reported. Focussed training interventions with formal evaluation of their acceptability and effectiveness in achieving learning, behavioural change and impact on clinical practice are needed. This paper aims to examine the literature on general practice in youth mental health, specifically, factors for an educational intervention for those working with young people in the community. This review paper was carried out by an online search of PubMed on the recent literature on mental health and on educational interventions for health care workers in primary care. A number of papers describing educational interventions for GPs and primary care workers were found and analysed. Key areas to be addressed when identifying and treating mental health problems were prevention, assessment, treatment, interaction with other services and ongoing support. Important elements of an educational intervention were identified. Several barriers exist that prevent the identification and treatment of these problems in primary care. An educational intervention should help GPs address these issues. Any intervention should be rigorously evaluated. With the shift in services to the community in Irish health policy, the GP with appropriate training could take the lead in early intervention in youth mental health and addiction.
- Published
- 2014
29. Hospital management of self harm in adults in England: study contains important data not reported in the paper
- Author
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Mitchell, Alex J
- Subjects
Adult ,Hospitalization ,Mental Health Services ,England ,Risk Factors ,Humans ,Suicide, Attempted ,Letters ,Delivery of Health Care ,Risk Assessment ,Self-Injurious Behavior - Published
- 2016
30. Addressing distress management challenges: Recommendations from the consensus panel of the American Psychosocial Oncology Society and the Association of Oncology Social Work.
- Author
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Deshields TL, Wells-Di Gregorio S, Flowers SR, Irwin KE, Nipp R, Padgett L, and Zebrack B
- Subjects
- Delivery of Health Care organization & administration, Health Services Accessibility organization & administration, Health Services Accessibility standards, Healthcare Disparities, Humans, Mass Screening organization & administration, Neoplasms complications, Patient Reported Outcome Measures, Delivery of Health Care standards, Mass Screening standards, Mental Health Services organization & administration, Mental Health Services standards, Neoplasms psychology, Psychological Distress, Stress, Psychological diagnosis, Stress, Psychological etiology, Stress, Psychological therapy
- Abstract
Distress management (DM) (screening and response) is an essential component of cancer care across the treatment trajectory. Effective DM has many benefits, including improving patients' quality of life; reducing distress, anxiety, and depression; contributing to medical cost offsets; and reducing emergency department visits and hospitalizations. Unfortunately, many distressed patients do not receive needed services. There are several multilevel barriers that represent key challenges to DM and affect its implementation. The Consolidated Framework for Implementation Research was used as an organizational structure to outline the barriers and facilitators to implementation of DM, including: 1) individual characteristics (individual patient characteristics with a focus on groups who may face unique barriers to distress screening and linkage to services), 2) intervention (unique aspects of DM intervention, including specific challenges in screening and psychosocial intervention, with recommendations for resolving these challenges), 3) processes for implementation of DM (modality and timing of screening, the challenge of triage for urgent needs, and incorporation of patient-reported outcomes and quality measures), 4) organization-inner setting (the context of the clinic, hospital, or health care system); and 5) organization-outer setting (including reimbursement strategies and health-care policy). Specific recommendations for evidence-based strategies and interventions for each of the domains of the Consolidated Framework for Implementation Research are also included to address barriers and challenges., (© 2021 The Authors. CA: A Cancer Journal for Clinicians published by Wiley Periodicals LLC on behalf of American Cancer Society.)
- Published
- 2021
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31. Solution-focused approaches in adult mental health research: A conceptual literature review and narrative synthesis.
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Jerome, Lauren, McNamee, Philip, Abdel-Halim, Nadia, Elliot, Kathryn, and Woods, Jonathan
- Subjects
PSYCHIATRIC research ,MENTAL health services ,SOLUTION-focused therapy ,ADULTS ,THEMATIC analysis - Abstract
Solution-focused approaches are one approach to treatment used in a wide variety of settings in modern mental healthcare services. As yet, there has been no overall synthesis of how this approach is understood in the adult mental health literature. This conceptual review aimed to synthesize the ways that solutionfocused approaches have been conceptualized and understood, within the adult mental health literature, in the five decades since their conception. A systematic search followed by multiple techniques from the narrative synthesis approach were used to develop a conceptual framework of the extracted data. Fifty-six papers published between 1993 and 2019 were included in the review. These papers spanned a variety of clinical contexts and countries, but despite this the underlying key principles and concepts of solution-focused approaches were remarkably similar over time and setting. Thematic analysis of extracted data outlined five key themes relevant to the conceptualization of this approach. This conceptual framework will help support clinicians using solution-focused techniques or therapies by giving them a coherent understanding of such approaches, by what mechanisms they work, and how key principles of this approach can be utilized in adult mental health settings. [ABSTRACT FROM AUTHOR]
- Published
- 2023
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32. Call for Papers: PLOS Medicine Special Issue on the COVID-19 Pandemic and Global Mental Health.
- Author
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PLOS Medicine Editors
- Subjects
- *
COVID-19 pandemic , *MENTAL health , *WORLD health , *MENTAL health services , *MEDICAL care , *MENTAL health policy - Abstract
The editors of I PLOS Medicine i together with Guest Editors Vikram Patel, Daisy Fancourt, Toshi A Furukawa, and Lola Kola are excited to announce a forthcoming special issue devoted to the impact of the COVID-19 pandemic on global mental health. In this forward-looking Special Issue, I PLOS Medicine i and our Guest Editors wish to invite work with the potential to mitigate the mental health consequences of the current pandemic and strengthen the global response to future pandemics. [Extracted from the article]
- Published
- 2022
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33. Visualizing healthcare system variability and resilience: a longitudinal study of patient movements following discharge from a Swedish psychiatric clinic.
- Author
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Svensson J and Bergström J
- Subjects
- Ambulatory Care Facilities statistics & numerical data, Emergency Service, Hospital statistics & numerical data, Health Services Research, Humans, Longitudinal Studies, Mental Health Services statistics & numerical data, Patient Safety, Retrospective Studies, Risk Management, Sweden, Ambulatory Care Facilities organization & administration, Mental Disorders therapy, Mental Health Services organization & administration, Patient Discharge, Transitional Care organization & administration
- Abstract
Background: As healthcare becomes increasingly complex, new methods are needed to identify weaknesses in the system that could lead to increased risk. Traditionally, the focus for patient safety is to study incident reports and adverse events, but that starting point has been contested with a new era of safety investigations: the analysis of everyday clinical work, and the resilient healthcare. This study introduces a new approach of system monitoring as a way to strengthen patient safety and has focused on discharge in psychiatry as a risk for adverse outcomes. The aim was to analyse a psychiatric clinic's everyday 'normal' performance variability of discharge from inpatient psychiatric care to outpatient care., Method: A retrospective longitudinal correlation study with a strategic selection. Data consist of 70,797 patient visits within one psychiatric clinic, and the visits were compared between 81 different wards in Stockholm County by using a model of time-lapse visualization., Results: The time-lapse visualization shows a discrepancy in types of visits and the proportion of cancelled visits to the outward units. 42% of all patients that were scheduled as an outward patient, did not complete this transition, but instead, they revisit the clinics' emergency ward and did not receive the planned care treatment. The patients who visit the emergency ward instead of their planned outpatient visit did this within 20 days., Conclusions: The findings show a potential increased demand for emergency psychiatric care from 2010 to 2018 within the clinic. It also suggests that the healthcare system creates a space of temporal as well as functional variability, and that patients use this space to adapt to their changing conditions. This understanding can assist management in prioritising allocation of resources and thereby strengthen patient safety. Today's incident reporting systems in healthcare are ineffective in monitoring patterns of more cancelled visits in outward units and sooner visit to the emergency ward. By using time-lapse visualization of patient interactions, stakeholders might analyse current-, and estimate future, stressors within the system to identify and understand potential system migration towards risk in healthcare. This could help healthcare management understand where resources should be prioritized.
- Published
- 2020
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34. Paper: Policy reforms urgently needed to mitigate racial disparities in perinatal mental health conditions.
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MENTAL health ,MENTAL health policy ,RACIAL inequality ,MENTAL health services ,MEDICAL personnel ,WOMEN'S mental health - Abstract
A team of researchers is calling for comprehensive changes to U.S. health care and social policies to address racial disparities in perinatal mental health conditions. They propose seven recommendations, including a national training program for health care providers, payment models for community-based services, paid family leave, expanded funding for perinatal psychiatry access programs, and access to safe abortions and contraception. The team emphasizes the need for reproductive justice and highlights the gaps in equity, access, research data, and social determinants of health. They also advocate for workplace policies that support families, such as paid parental leave and high-quality child care. [Extracted from the article]
- Published
- 2024
35. Intensive community care services for children and young people in psychiatric crisis: an expert opinion.
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Keiller, Eleanor, Masood, Saba, Wong, Ben Hoi-ching, Avent, Cerian, Bediako, Kofi, Bird, Rebecca Margaret, Boege, Isabel, Casanovas, Marta, Dobler, Veronika Beatrice, James, Maya, Kiernan, Jane, Martinez-Herves, Maria, Ngo, Thinh Vinh Thanh, Pascual-Sanchez, Ana, Pilecka, Izabela, Plener, Paul L, Prillinger, Karin, Lim, Isabelle Sabbah, Saour, Tania, and Singh, Nidhita
- Subjects
YOUNG adults ,CRITICAL care medicine ,MENTAL health services ,COMMUNITY services ,CHILD care ,PSYCHIATRIC nursing ,PSYCHIATRIC clinics - Abstract
Background: Children and young people's (CYP) mental health is worsening, and an increasing number are seeking psychiatric and mental health care. Whilst many CYPs with low-to-medium levels of psychiatric distress can be treated in outpatient services, CYPs in crisis often require inpatient hospital treatment. Although necessary in many cases, inpatient care can be distressing for CYPs and their families. Amongst other things, inpatient stays often isolate CYPs from their support networks and disrupt their education. In response to such limitations, and in order to effectively support CYPs with complex mental health needs, intensive community-based treatment models, which are known in this paper as intensive community care services (ICCS), have been developed. Although ICCS have been developed in a number of settings, there is, at present, little to no consensus of what ICCS entails. Methods: A group of child and adolescent mental health clinicians, researchers and academics convened in London in January 2023. They met to discuss and agree upon the minimum requirements of ICCS. The discussion was semi-structured and used the Dartmouth Assertive Community Treatment Fidelity Scale as a framework. Following the meeting, the agreed features of ICCS, as described in this paper, were written up. Results: ICCS was defined as a service which provides treatment primarily outside of hospital in community settings such as the school or home. Alongside this, ICCS should provide at least some out-of-hours support, and a minimum of 90% of CYPs should be supported at least twice per week. The maximum caseload should be approximately 5 clients per full time equivalent (FTE), and the minimum number of staff for an ICCS team should be 4 FTE. The group also confirmed the importance of supporting CYPs engagement with their communities and the need to remain flexible in treatment provision. Finally, the importance of robust evaluation utilising tools including the Children's Global Assessment Scale were agreed. Conclusions: This paper presents the agreed minimum requirements of intensive community-based psychiatric care. Using the parameters laid out herein, clinicians, academics, and related colleagues working in ICCS should seek to further develop the evidence base for this treatment model. [ABSTRACT FROM AUTHOR]
- Published
- 2023
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36. Impacts of health care service changes implemented due to COVID‐19 on children and young people with long‐term disability: A mapping review.
- Author
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Merrick, Hannah, Driver, Helen, Main, Chloe, Kenny, Ryan P. W., Richmond, Catherine, Allard, Amanda, Bola, Kulwinder, Morris, Christopher, Parr, Jeremy R., Pearson, Fiona, Pennington, Lindsay, Exley, Cath, Teare, Dawn, Yu, Ge, Carr, Sara, Haining, Shona, Platts, Lesley, Gray, Laura, and Heslop, Philip
- Subjects
CHILDREN with disabilities ,YOUNG adults ,MEDICAL care ,MENTAL health services ,PEOPLE with disabilities ,COVID-19 pandemic - Abstract
Aim: To identify the research on childhood disability service adaptations and their impact on children and young people with long‐term disability during the COVID‐19 pandemic. Method: A mapping review was undertaken. We searched the World Health Organization Global COVID‐19 database using the search terms 'children', 'chronic/disabling conditions', and 'services/therapies'. Eligible papers reported service changes for children (0–19 years) with long‐term disability in any geographical or clinical setting between 1st January 2020 and 26th January 2022. Papers were charted across the effective practice and organization of care taxonomy of health system interventions and were narratively synthesized; an interactive map was produced. Results: Reduction of face‐to‐face care and usual provision had a huge impact on children and families. Adoption of telehealth provided continuity for the care and management of some conditions. There was limited evidence of changes to mental health services, transitions of care, social care, or child‐reported satisfaction or acceptability of service changes. Interpretation: The long‐term impacts of service change during the pandemic need full evaluation. However, widespread disruption seems to have had a profound impact on child and carer health and well‐being. Service recovery needs to be specific to the individual needs of children with a disability and their families. This should be done through coproduction to ensure that service changes meet needs and are accessible and equitable. [ABSTRACT FROM AUTHOR]
- Published
- 2023
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37. Editorial: Community series in mental illness, culture, and society: dealing with the COVID-19 pandemic, volume VIII.
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de Filippis, Renato, El Hayek, Samer, and Shalbafan, Mohammadreza
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COVID-19 pandemic ,MENTAL illness ,MEDICAL personnel ,MENTAL health services ,MEDICAL students ,OCCUPATIONAL therapists ,PSYCHIATRIC nursing - Abstract
This document is an editorial from the journal Frontiers in Psychiatry that explores the cultural and social implications of the COVID-19 pandemic. It discusses how different countries, minorities, and special populations have experienced and adapted to the pandemic. The editorial highlights various research articles that examine the impact of COVID-19 on healthcare professionals, students, trainees, residents, and special populations. The document provides a summary of these papers, which cover a range of topics including help-seeking messages, art therapy, mental health policies, behavioral patterns, medication trends, suicide rates, burnout among healthcare workers, and the management of long-term consequences. The document concludes by acknowledging the global impact of the pandemic and expressing hope for better understanding and addressing its challenges. [Extracted from the article]
- Published
- 2024
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38. Recovery for all in the community; position paper on principles and key elements of community-based mental health care.
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Keet, René, de Vetten-Mc Mahon, Marjonneke, Shields-Zeeman, Laura, Ruud, Torleif, van Weeghel, Jaap, Bahler, Michiel, Mulder, Cornelis L., van Zelst, Catherine, Murphy, Billy, Westen, Koen, Nas, Chris, Petrea, Ionela, and Pieters, Guido
- Subjects
- *
MENTAL health services , *COMMUNITY mental health services , *MEDICAL care - Abstract
Background: Service providers throughout Europe have identified the need to define how high-quality community-based mental health care looks to organize their own services and to inform governments, commissioners and funders. In 2016, representatives of mental health care service providers, networks, umbrella organizations and knowledge institutes in Europe came together to establish the European Community Mental Health Services Provider (EUCOMS) Network. This network developed a shared vision on the principles and key elements of community mental health care in different contexts. The result is a comprehensive consensus paper, of which this position paper is an outline. With this paper the network wants to contribute to the discussion on how to improve structures in mental healthcare, and to narrow the gap between evidence, policy and practice in Europe. Main text: The development of the consensus paper started with an expert workshop in April 2016. An assigned writing group representing the workshop participants built upon the outcomes of this meeting and developed the consensus paper with the input from 100 European counterparts through two additional work groups, and two structured feedback rounds via email. High quality community-based mental health care: 1) protects human rights; 2) has a public health focus; 3) supports service users in their recovery journey; 4) makes use of effective interventions based on evidence and client goals; 5) promotes a wide network of support in the community and; 6) makes use of peer expertise in service design and delivery. Each principle is illustrated with good practices from European service providers that are members of the EUCOMS Network. Conclusions: Discussion among EUCOMS network members resulted in a blueprint for a regional model of integrated mental health care based upon six principles. [ABSTRACT FROM AUTHOR]
- Published
- 2019
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- View/download PDF
39. Empowering understanding: navigating consent to ketamine treatment in adolescent mental health.
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Sathappan, Aakash and Yudkoff, Benjamin
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MENTAL health services ,TRANSCRANIAL magnetic stimulation ,INFORMED consent (Medical law) ,MENTAL illness ,ELECTROCONVULSIVE therapy ,KETAMINE abuse - Abstract
The rising prevalence of mental health disorders in adolescents, compounded by treatment resistance, underscores the need for innovative interventions. Ketamine, recognized for its rapid antidepressant and anti-suicidal effects in adults, has recently emerged as a potential treatment for adolescents with treatment-resistant depression and suicidality. This paper aims to highlight key elements of the informed consent process, including obtaining parental consent and adolescent assent, and discussing the nature of ketamine treatment, its benefits, and potential risks. Obtaining informed consent for ketamine treatment in this demographic poses unique challenges. During the informed consent process, clinicians should balance an adolescent’s growing autonomy with parental consent and address the distinct features of treatment, including ketamine’s potential to induce psychedelic-like effects. Additionally, clinicians should highlight the “off-label” use in this population and the uncertainty inherent to treatment at this time, including the lack of data on repeated ketamine exposure on the developing brain. This paper also addresses challenging scenarios related to informed consent for this treatment, such as instances when parents are willing to consent but the adolescent refuses. Alternative treatment strategies such as transcranial magnetic stimulation (TMS) and electroconvulsive therapy (ECT) are also considered. In conclusion, while an emerging body of evidence suggests that ketamine shows potential for the acute treatment of adolescents with severe depression and suicidality, adherence to informed consent principles is paramount to ensure best clinical practices and uphold ethical standards amidst the current landscape of ongoing research. [ABSTRACT FROM AUTHOR]
- Published
- 2024
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- View/download PDF
40. Navigating the cultural adaptation of a US-based online mental health and social support program for use with young Aboriginal and Torres Strait Islander males in the Northern Territory, Australia: Processes, outcomes, and lessons.
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Opozda, Melissa J., Bonson, Jason, Vigona, Jahdai, Aanundsen, David, Paradisis, Chris, Anderson, Peter, Stahl, Garth, Watkins, Daphne C., Black, Oliver, Brickley, Bryce, Canuto, Karla J., Drummond, Murray J. N., Miller Jr., Keith F., Oth, Gabriel, Petersen, Jasmine, Prehn, Jacob, Raciti, Maria M., Robinson, Mark, Rodrigues, Dante, and Stokes, Cameron
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EDUCATION of Torres Strait Islanders ,SOCIAL media ,HUMAN services programs ,MENTAL health services ,MENTAL health ,GENDER identity ,GROUP identity ,RESEARCH funding ,MEDICAL care ,EDUCATIONAL outcomes ,CULTURE ,MASCULINITY ,INTERNET ,PSYCHOLOGICAL adaptation ,ATTITUDE (Psychology) ,BLACK people ,ONLINE education ,MATHEMATICAL models ,CURRICULUM planning ,SOCIAL support ,HEALTH promotion ,COLLEGE students ,THEORY ,WELL-being - Abstract
Background: Despite disproportionate rates of mental ill-health compared with non-Indigenous populations, few programs have been tailored to the unique health, social, and cultural needs and preferences of young Aboriginal and Torres Strait Islander males. This paper describes the process of culturally adapting the US-based Young Black Men, Masculinities, and Mental Health (YBMen) Project to suit the needs, preferences, culture, and circumstances of Aboriginal and Torres Strait Islander males aged 16–25 years in the Northern Territory, Australia. YBMen is an evidence-based social media-based education and support program designed to promote mental health, expand understandings of gender and cultural identities, and enhance social support in college-aged Black men. Methods: Our adaptation followed an Extended Stages of Cultural Adaptation model. First, we established a rationale for adaptation that included assessing the appropriateness of YBMen's core components for the target population. We then investigated important and appropriate models to underpin the adapted program and conducted a non-linear, iterative process of gathering information from key sources, including young Aboriginal and Torres Strait Islander males, to inform program curriculum and delivery. Results: To maintain program fidelity, we retained the core curriculum components of mental health, healthy masculinities, and social connection and kept the small cohort, private social media group delivery but developed two models: 'online only' (the original online delivery format) and 'hybrid in-person/online' (combining online delivery with weekly in-person group sessions). Adaptations made included using an overarching Aboriginal and Torres Strait Islander social and emotional wellbeing framework and socio-cultural strengths-based approach; inclusion of modules on health and wellbeing, positive Indigenous masculinities, and respectful relationships; use of Indigenous designs and colours; and prominent placement of images of Aboriginal and Torres Strait Islander male sportspeople, musicians, activists, and local role models. Conclusions: This process resulted in a culturally responsive mental health, masculinities, and social support health promotion program for young Aboriginal and Torres Strait Islander males. Next steps will involve pilot testing to investigate the adapted program's acceptability and feasibility and inform further refinement. Keywords: Aboriginal, Torres Strait Islander, Indigenous, Australia, male, cultural adaptation, social media, mental health, masculinities, social support. [ABSTRACT FROM AUTHOR]
- Published
- 2024
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- View/download PDF
41. "I'm not an anxious person": end-of-life care workers constructing positive psychological states.
- Author
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Edmonds, David Matthew and Zayts-Spence, Olga
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MENTAL health services ,TERMINAL care ,MENTAL health policy ,PSYCHIATRIC research ,THEMATIC analysis - Abstract
Background: Mental health is an issue of social and economic importance. Sociocultural and scholarly attention has largely focused on the negative aspects of mental health. That is, on mental disorders and illness and how they adversely impact our lives. In contrast, this paper forms part of a recent alternative empirical perspective in discourse-based research, by focusing on the positive aspects of mental health. In this article, we investigate how end-of-life care workers construct their positive psychological states. Methods: Our data are 38 audio-recorded and transcribed semi-structured interviews with end-of-life care workers from Hong Kong and the United Kingdom. We utilized thematic analysis to identify common categorial strands across the data and discourse analysis to identify the linguistic strategies that these interviewees used to talk about their mental health. Results: Our thematic analysis generated a superordinate theme across the interviews—namely, that of end-of-life care workers talking about their positive psychological states. We identify three generic ways that end-of-life care workers talked about these psychological states; by "foregrounding the positive," "reformulating the negative," and "dismissing the negative." Our analysis also explicates how interviewees connected social and organizational support to being a benefit to their psychological states. Conclusions: Our work contributes to existing discourse-based and sociolinguistic research on mental health by turning their focus towards a consideration of its positive dimensions. We also identify recurrent linguistics strategies used by people to construct their mental health. Our analyses point to the importance of investigating mental health as a multidimensional concept that considers participants' own reflections on their mental health. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
42. Bringing the voice of social housing tenants into shaping the health and care research agenda.
- Author
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Phillips, Olivia R., Mardell, Denise, Stephenson, Kolin, Hussain, Sabrina, Burton, Dawn, Bernard, Barbara, Stevenson, Sue, and Morling, Joanne R.
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INFECTIOUS disease transmission ,MENTAL health services ,BUSINESS partnerships ,PUBLIC health research ,PATIENT participation - Abstract
Background: A larger percentage of social housing tenants have poorer physical and mental health outcomes compared to private renters and homeowners. They are also at a greater risk of respiratory conditions, cardiovascular disease, communicable disease transmission and mortality. One approach that aims to reduce health inequalities is to create research partnerships with underserved local communities. Our primary aim was to develop a research partnership with social housing tenants in Nottingham and our secondary aim was to explore the health priorities of these social housing tenants to inform future research applications. We also hope to provide a descriptive process of PPI within a social housing context for other researchers to learn from. Methods: We used Public and Patient Involvement (PPI) as the foundation of this work, as we believed that people with lived experience of social housing, also end-users of the research, were best placed to inform us of the areas with the greatest research need. Through online and in-person focus groups, we discussed with tenants, collectively named a Social Advisory Group (SAG), their health concerns and priorities. Together they raised 26 health issues, which were combined with 22 funding opportunity themes being offered by the NIHR (National Institute for Health and Care Research). This was with the purpose of investigating whether there was alignment between the health needs of Nottingham's social housing tenants and the NIHR's research priorities. A prioritisation technique (Diamond Nine) was used to sort in total, 48 areas of health and wellbeing, into three top priorities. Tenants were provided the opportunity to be involved in public health research in other ways too, such as reviewing this paper and also an NIHR Programme Development Grant application to expand and continue this work. One was also offered the opportunity to be a public co-applicant. Results: The group prioritised improvements in the quality of social housing, mental health and healthcare services. There was only some alignment between these and the NIHR funding themes. Other factors, such as age and race, also determined individual health priorities.. The diversity and reach of the current project were limited, however this is something we hope to improve in the future with more funding. We learned that tenants have varying degrees of mobility and technological abilities, requiring both online and in-person meetings. Plain English summary: Social housing is offered to people who cannot afford to buy or rent in the open market, and a larger percentage of social housing tenants have poorer physical and mental health outcomes compared to the general population. One approach that aims to reduce health inequalities is to create sustainable research partnerships with underserved local communities. Our primary aim was to involve social housing tenants in public health research, as they are best placed to tell us the type of research they would benefit from. The secondary aim was to explore the health priorities of social housing tenants to inform future research applications. We also hope to describe the process of PPI within a social housing context for other researchers to learn from. To achieve these aims, we established a research partnership with a group of social housing tenants in Nottingham and spoke to them about the areas of their health they wanted to improve (i.e., their priorities). The topics that were discussed the most were the need for improved mental health, quality of social housing and healthcare services, however this varied between individuals according to race and age. We learned several things throughout this process. Firstly, the combination of mobility and technological abilities amongst tenants meant that meetings must be held both in-person and online. This ensured they remained accessible and convenient. Secondly, we learnt that in-person meetings should be held in a neutral space to encourage different members of the group to attend. Finally, in general, people were very enthusiastic about this partnership and were committed to seeing improvements in public health. We therefore provided more opportunities for the group to be involved in research. For example, they were offered the opportunity to write and edit a lay summary for a future research application, which was based on the priorities identified in this paper. One member of the group was nominated to be the public co-applicant , which would allow us to increase the reach of this housing work across the East Midlands. It would also allow us to increase the diversity of the group, as currently it is made up of mostly retired females of British origin. Involving the public in health research has been central to this process and continues to be important in the production of accessible and relevant research. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
43. De-escalating aggression in acute inpatient mental health settings: a behaviour change theory-informed, secondary qualitative analysis of staff and patient perspectives.
- Author
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Price, Owen, Armitage, Christopher J., Bee, Penny, Brooks, Helen, Lovell, Karina, Butler, Debbie, Cree, Lindsey, Fishwick, Paul, Grundy, Andrew, Johnston, Isobel, Mcpherson, Peter, Riches, Holly, Scott, Anne, Walker, Lauren, and Papastavrou Brooks, Cat
- Subjects
MENTAL health services ,PSYCHOTHERAPY ,EPISODIC memory ,CORPORATE culture ,EMOTION regulation - Abstract
Background: De-escalation is often advocated to reduce harm associated with violence and use of restrictive interventions, but there is insufficient understanding of factors that influence de-escalation behaviour in practice. For the first time, using behaviour change and implementation science methodology, this paper aims to identify the drivers that will enhance de-escalation in acute inpatient and psychiatric intensive care mental health settings. Methods: Secondary analysis of 46 qualitative interviews with ward staff (n = 20) and patients (n = 26) informed by the Theoretical Domains Framework. Results: Capabilities for de-escalation included knowledge (impact of trauma on memory and self-regulation and the aetiology and experience of voice hearing) and skills (emotional self-regulation, distress validation, reducing social distance, confirming autonomy, setting limits and problem-solving). Opportunities for de-escalation were limited by dysfunctional risk management cultures/ relationships between ward staff and clinical leadership, and a lack of patient involvement in safety maintenance. Motivation to engage in de-escalation was limited by negative emotion associated with moral formulations of patients and internal attributions for behaviour. Conclusion: In addition to training that enhances knowledge and skills, interventions to enhance de-escalation should target ward and organisational cultures, as well as making fundamental changes to the social and physical structure of inpatient mental health wards. Psychological interventions targeting negative emotion in staff are needed to increase motivation. This paper provides a new evidence-based framework of indicative changes that will enhance de-escalation in adult acute mental health inpatient and PICU settings. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
44. Consultations With Muslims From Minoritised Ethnic Communities Living in Deprived Areas: Identifying Inequities in Mental Health Care and Support.
- Author
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Tannerah, Ashraf, Hazel, Oluwalolami, Desson, Sheree, Farah, Rahima, Kamil‐Thomas, Zalihe, Iqbal, Halima, Eames, Catrin, Saini, Pooja, and Bifarin, Oladayo
- Subjects
MENTAL illness prevention ,HEALTH services accessibility ,HEALTH literacy ,MENTAL health services ,RESEARCH funding ,MEDICAL quality control ,PATIENT safety ,DIVERSITY & inclusion policies ,QUESTIONNAIRES ,CULTURAL competence ,POVERTY areas ,SOCIAL theory ,MUSLIMS ,THEMATIC analysis ,RACISM ,TRUST ,MINORITIES ,SOCIAL support ,HEALTH equity ,HEALTH promotion ,PATIENTS' attitudes ,SOCIAL stigma - Abstract
Background: Limited research concerning existing inequities in mental health care and support services in the United Kingdom captures perceptions and lived experiences of the significantly underrepresented Muslim population. Methods: Underpinned by social constructivist theory, we used consultation to facilitate public and patient involvement and engagement (PPIE) to identify inequities in mental health care and support experienced by Muslims from minoritised ethnic communities living in deprived areas in Liverpool, UK. The rationale was to (a) better inform standards and policies in healthcare and (b) provide a psychologically safe space to members of the Muslim community to share perceptions and experiences of mental health care and support services. To ensure trustworthiness of the data, member checking was adopted. This paper describes the procedure to achieving this consultation, including our recruitment strategy, data collection and analysis as well as key findings. Findings: Twenty‐seven consultees attended the women's consultation and eight consultees attended the men's consultation. Consultees were from Yemeni, Somali, Sudanese, Egyptian, Algerian, Pakistani and Moroccan communities and share the Islamic faith. Four key interlinked themes were identified from consultees' narratives: (1) broken cycle of trust; (2) an overmedicalised model of care; (3) community mental health prevention initiatives; and (4) culturally conscious training and education. Conclusions: The Muslim population has identified numerous barriers to accessing mental health support and there is a need to resource activities that would aid deeper understanding of mental health support needs through continuous and meaningful community initiatives. This would afford mental health practitioners and organisations opportunities for developing realistic anti‐racism strategies, effectively adopting social prescription, strengthening partnerships and collaborations aimed at supporting delivery of evidence‐based mental health care provisions to tackle mental health inequities. Patient and Public Involvement: This paper reports on the involvement and engagement of Muslims from minoritised ethnic communities living in the Liverpool city region. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
45. Improving uptake of population health management through scalable analysis of linked electronic health data.
- Author
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Varady, Andras B and Wood, Richard M
- Subjects
RISK assessment ,PUBLIC health surveillance ,COST control ,DATABASE management ,HUMAN services programs ,MENTAL health services ,POPULATION health management ,SYSTEMS design ,COVID-19 vaccines ,HEALTH planning ,ELECTRONIC data interchange ,ELECTRONIC health records ,SYSTEM integration ,DECISION trees ,SOFTWARE architecture ,HEALTH equity ,MEDICAL care costs - Abstract
Population Health Management – often abbreviated to PHM – is a relatively new approach for healthcare planning, requiring the application of analytical techniques to linked patient level data. Despite expectations for greater uptake of PHM, there is a deficit of available solutions to help health services embed it into routine use. This paper concerns the development, application and use of an interactive tool which can be linked to a healthcare system's data warehouse and employed to readily perform key PHM tasks such as population segmentation, risk stratification, and deriving various performance metrics and descriptive summaries. Developed through open-source code in a large healthcare system in South West England, and used by others around the country, this paper demonstrates the importance of a scalable, purpose-built solution for improving the uptake of PHM in health services. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
46. Session 3595 (Paper): MENTAL HEALTH OF OLDER ADULTS.
- Subjects
MENTAL health of older people ,POST-traumatic stress disorder in old age ,DEPRESSION in old age ,MENTAL health services ,EMOTIONS ,PSYCHOLOGY of middle-aged women ,PSYCHOLOGY of older women - Published
- 2021
47. Adolescent Psychological Assistance Treatment Strategy Integrating Home-School Coordination and Network Information.
- Author
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Li, Yaling
- Subjects
SOCIAL support ,MEDICAL care for teenagers ,COOPERATIVENESS ,PARENTING ,MENTAL health services ,PARENTS - Abstract
With the continuous satisfaction of material life, teenagers' physical health has been generally improved, and all aspects of competition have posed a challenge to teenagers' mental health. Therefore, both at the family level and at the school level, teenagers' mental health education has been paid more and more attention. The school cooperative education model came into being, which has had an important impact on the mental health education of teenagers. Family education is the first level of education for teenagers. Parents' role model, family education concept, and education model all play a key role in the development of children's mental health. Based on this, this paper will focus on optimizing the home-school cooperation strategy, further clarify the main responsibilities of the school, teachers, and parents in the home-school cooperation education in the strategy, establish and improve the home-school cooperation mechanism based on this, and focus on the cultivation of parents' mental health education and teachers' mental health guidance professional skills in this process. Based on the current situation of network home-school mental health coordination and mental health education, this study takes teenagers as the research object, aiming at the common psychological problems in learning, social adaptation, and interpersonal communication, and tries to study the problems of promoting teenagers' mental health from the perspective of integrity and development. The developed home-school collaboration method is to verify that the network home-school collaboration method is more effective than the traditional home-school collaboration method in promoting the mental health development of primary school students, so as to provide a reference for the theory and practice of home-school collaboration under the network environment to carry out mental health education. According to the corresponding network information intelligent algorithm, this paper constantly adjusts the coordination strategy between family and school and guides teenagers to internalize the corresponding excellent behaviour into their own habits. In the experimental part, the psychological assistance treatment scheme proposed in this paper is verified and analysed. The experimental results show that the psychological assistance treatment program for adolescents proposed in this paper has obvious effects. School education has a special mental health counseling center and special psychological teachers, which can carry out mental health education more scientifically. The unity and cooperation between family education and school education can combine the educational power of parents and schools to fully develop the mental health of teenagers. [ABSTRACT FROM AUTHOR]
- Published
- 2022
- Full Text
- View/download PDF
48. The Economics of Child Mental Health: Introducing the Causes and Consequences of Child Mental Health Special Issue.
- Author
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Currie, Janet
- Subjects
MENTAL health ,CHILD mental health services ,SUICIDE prevention ,CHILDREN'S health ,MENTAL health services ,MENTAL health of college students ,SCHOOL bullying ,SCHOOL mental health services ,SUMMER vacations (Schools) - Abstract
This article, published in the Journal of Human Resources, examines the economics of child mental health, with a particular focus on the impact of the COVID-19 pandemic. It emphasizes the increasing recognition of mental health issues in children and their influence on educational and labor market outcomes. The article explores the effectiveness of individual medical treatments for child mental health problems and raises questions about the causes of these issues, intergenerational correlations, the role of schools, and potential interventions. Several research papers are discussed, covering topics such as the intergenerational correlation of mental health problems, the effects of domestic violence, the impact of the pandemic on ADHD diagnoses, school-based mental health services, and interventions in developing countries. These studies contribute to our understanding of child mental health economics and highlight the need for further research and interventions in this field. [Extracted from the article]
- Published
- 2024
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- View/download PDF
49. ‘Dignity and respect’: An example of service user leadership and co‐production in mental health research
- Author
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Claudia Megele, Trish Hafford-Letchfield, Christine Khisa, Alison Faulkner, Sarah Carr, Rachel Cohen, Dorothy Gould, and Jess Holley
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Value (ethics) ,Adult ,Mental Health Services ,Medicine (General) ,media_common.quotation_subject ,Control (management) ,Context (language use) ,Hostility ,Safeguarding ,mental health service users ,Respect ,mental health research ,03 medical and health sciences ,Dignity ,0302 clinical medicine ,R5-920 ,RA0421 ,Special Issue Paper ,medicine ,Humans ,030212 general & internal medicine ,Qualitative Research ,media_common ,user‐led research ,Special Issue Papers ,business.industry ,adult safeguarding ,co‐production ,030503 health policy & services ,Mental Disorders ,survivor research ,Public Health, Environmental and Occupational Health ,Public relations ,Mental health ,Leadership ,Mental Health ,Special Issue on Mental Health ,ComputingMilieux_COMPUTERSANDSOCIETY ,medicine.symptom ,Public aspects of medicine ,RA1-1270 ,0305 other medical science ,business ,Psychology ,Qualitative research - Abstract
This paper explores the methodological aspects of a user‐led study investigating mental health service user experiences of targeted violence and abuse (often called 'hate crime'). 'Keeping Control' was a 16‐month qualitative study, undertaken in the context of adult safeguarding reforms in England. By collecting data on service user concepts and experiences, the research sought to address a gap in research and practice knowledge relating to targeted violence, abuse and hostility against people with mental health problems. In this paper, we discuss the significance of the design and methodology used for this study, with a particular focus on the interviews with service users. The research was both user‐led and carried out in collaboration with practitioners and academics, a form of research co‐production. Our aim is to inform researchers, practitioners and policymakers about the value of user leadership in co‐productive research with practitioners, particularly for a highly sensitive and potentially distressing topic.
- Published
- 2021
50. Novel CHATogether family-centered mental health care in the post-pandemic era: a pilot case and evaluation.
- Author
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Bookman, Caylan J., Nunes, Julio C., Ngo, Nealie T., Twickler, Naomi Kunstler, Smith, Tammy S., Lekwauwa, Ruby, and Yuen, Eunice Y.
- Subjects
FAMILY psychotherapy ,MENTAL health ,MENTAL health services ,PSYCHODYNAMIC psychotherapy ,OUTPATIENT services in hospitals ,PSYCHOLOGICAL distress ,SUICIDAL ideation ,RESEARCH funding ,PARENT-child relationships ,ROLE playing ,PILOT projects ,QUESTIONNAIRES ,FAMILY-centered care ,CASE studies ,COVID-19 pandemic ,ADOLESCENCE - Abstract
Background: The COVID-19 pandemic impacted children, adolescents, and their families, with significant psychosocial consequences. The prevalence of anxiety, depression, and self-injurious behaviors increased in our youth, as well as the number of suicide attempts and hospitalizations related to suicidal ideation. Additionally, parents' mental health saw increasing rates of depression, irritability, and alcohol use combined with worsening family function, child-parent connectedness, positive family expressiveness, and increases in family conflict. In light of these statistics, we created CHATogether (Compassionate Home, Action Together), a pilot family-centered intervention using multi-faceted psychotherapeutic approaches to improve familial communication and relational health between adolescents and their parents. This paper discusses the implementation of the CHATogether intervention at the Adolescent Intensive Outpatient Program (IOP), providing an example of the intervention through an in-depth pilot case, and evaluation of the program's acceptability and feasibility. Methods: This paper describes a case in detail and evaluation from a total of 30 families that completed CHATogether in the initial pilot. Each family had 4–6 one-hour CHATogether sessions during their 6-week treatment course at the IOP. Before and after CHATogether, adolescents and their parents separately completed a questionnaire designed to explore their perceived family conflicts. After completion of the program, participants completed a brief quality improvement survey to assess their overall experience with CHATogether. In the reported case, the family completed Patient-Reported Outcomes Measurement Information System (PROMIS) depressive and anxiety symptoms scales, Conflict Behavior Questionnaires (CBQ), 9-item Concise Health Risk Tracking Self-Report (CHRT-SR9), and help-seeking attitude from adults during distress and suicide concerns. Results: The pilot case showed a trend of improvement in reported depressive and anxiety symptoms, child-parent conflicts, subfactors of suicide risk including pessimism, helplessness, and despair, help-seeking acceptability from parents for suicide concerns, and the establishment of individualized family relationship goals. Preliminary feedback from participating families demonstrated positive effects on intra-family communication and improvement in the overall family dynamic. Adolescents (n = 30/30) and their parents (n = 30/30) rated "strongly agree" or "agree" that their families had benefited from CHATogether and welcomed participation in future program development. Conclusion: This study presents CHATogether as a novel family-centered intervention to address post-pandemic family mental health stress, especially when a family system was disrupted and negatively affected the mental health of children and adolescents. The intervention facilitated positive child-parent communication on a variety of topics, through tools such as emotional expression and help-seeking behavior. The reported pilot case and evaluation suggested CHATogether's acceptability and feasibility in a clinical context. We also provided quality improvement feedback to guide future studies in establishing the efficacy of CHATogether and other similar models of clinical family interventions. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
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