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2. Using the Nominal Group Technique to determine a nursing framework for a forensic mental health service: A discussion paper.
- Author
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Maguire T, Garvey L, Ryan J, Olasoji M, and Willets G
- Subjects
- Humans, Inpatients, Mental Health Services, Psychiatric Nursing
- Abstract
The Nominal Group Technique is a method used to explore issues, generate ideas, and reach consensus on a topic. The Nominal Group Technique includes individual and group work and is designed to ensure participants have the same opportunity to engage and provide their opinions. While the technique has been used for around six decades to assist groups, in industry, and government organizations to examine issues and make decisions, this technique has received limited attention in nursing research, particularly in mental health. This discussion paper describes the use of a modified Nominal Group Technique for a study designed to determine a nursing decision-making framework for a state-wide forensic mental health service. Modifications were made to the traditional technique, to enable participants to make an informed and collective decision about a suitable framework for the novice to expert nurses, across secure inpatient, prison, and community forensic mental health settings. The Nominal Group Technique generated rich data and offered a structured approach to the process. We argue that the Nominal Group Technique offers an exciting and interactive method for nursing research and can increase opportunity for minority group members to participate. This technique also offers a time efficient way to engage busy clinical nurses to participate in research, with the advantage of members knowing the decision on the day of the group. Consideration, however, needs to be given to the duration and effect on participant concentration, and if not actively managed by facilitators, the possible emergence of group dynamics affecting individuals' decisions., (© 2022 The Authors. International Journal of Mental Health Nursing published by John Wiley & Sons Australia, Ltd.)
- Published
- 2022
- Full Text
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3. [Letter to the Editor About the Paper "Mental Health in Primary Health Care: Challenges and Opportunities in the Context of a Pandemic": Questions About Serious Mental Illness].
- Author
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Isaac J, Heleno B, and Gonçalves-Pereira M
- Subjects
- Humans, Pandemics, Mental Health, Primary Health Care, Mental Health Services, Mental Disorders epidemiology, Mental Disorders therapy
- Published
- 2022
- Full Text
- View/download PDF
4. Open Dialogue, need-adapted mental health care, and implementation fidelity: A discussion paper.
- Author
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Waters E, Ong B, Mikes-Liu K, McCloughen A, Rosen A, Mayers S, Sidis A, Dawson L, and Buus N
- Subjects
- Finland, Humans, Mental Health, Mental Health Services
- 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., (© 2021 John Wiley & Sons Australia, Ltd.)
- Published
- 2021
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5. [DNVF-Discussion paper - Specificities, Challenges and Aims of Mental Health Service Research in Germany].
- Author
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Schwarz J, von Peter S, Baumeister H, Dahling V, Gühne U, Gouzoulis-Mayfrank E, Härter M, Haun MW, Jacke C, Lehmann I, Neumann A, Pfennig A, Salize HJ, Timm S, Wiegand-Grefe S, Riedel-Heller SG, and Heinze M
- Subjects
- Germany, Humans, Health Services Research, Mental Health Services
- Abstract
Research in mental health services in Germany is of increasing relevance. To this end, the recently founded "Mental Health Working Group" as part of the German Network of Health Services Research (DNVF) has written a discussion paper presenting key specifics, challenges, and goals of health service research in the field of mental health. Some research-relevant specifics in the area of mental health care, pragmatic challenges of research organization, ethical problems, and particular research topics in this field are presented and discussed critically., Competing Interests: Die Autorinnen/Autoren geben an, dass kein Interessenkonfliktbesteht., (Thieme. All rights reserved.)
- Published
- 2021
- Full Text
- View/download PDF
6. Analysis and critique of 'Transforming children and young people's mental health provision: A green paper': Some implications for refugee children and young people.
- Author
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Cox P and McDonald JM
- Subjects
- Adolescent, Child, England, Humans, Wales, Wounds and Injuries, Culturally Competent Care, Mental Health Services, Refugees psychology, Social Stigma
- 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
- 2020
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7. The Educational Value of Outpatient Consultation-Liaison Rotations: A White Paper From the Academy of Consultation-Liaison Psychiatry Residency Education Subcommittee.
- Author
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Zimbrean PC, Ernst CL, Forray A, Beach SR, Lavakumar M, Siegel AM, Soeprono T, and Schwartz AC
- Subjects
- Curriculum standards, Delivery of Health Care, Integrated, Education, Medical, Humans, Ambulatory Care Facilities, Internship and Residency standards, Mental Health Services, Outpatients, Psychiatry education, Referral and Consultation standards
- 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., (Copyright © 2020 Academy of Consultation-Liaison Psychiatry. Published by Elsevier Inc. All rights reserved.)
- Published
- 2020
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8. Quality improvement and models of behavioral healthcare integration: Position paper #2 from the International Society of Psychiatric-Mental Health Nurses.
- Author
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Shell LP, Newton M, Soltis-Jarrett V, Ragaisis KM, and Shea JM
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- Clinical Competence, Continuity of Patient Care, Hospitals, Humans, Patient Safety, Primary Health Care, Delivery of Health Care, Integrated, Mental Health Services organization & administration, Nurse's Role, Psychiatric Nursing education, Quality Improvement
- Abstract
This is the second article in a series written to present and address the position of the International Society of Psychiatric-Mental Health Nurses (ISPN) related to the notion of behavioral healthcare integration and the role of nurses in the 21st century. The first article addressed assumptions, definitions and roles related to the integration of behavioral healthcare. The purpose of this article is to focus on Integrated Care within the context of recent initiatives that endeavor to improve quality, safety and reduce costs in the US healthcare system also known as the "Triple Aim" (or more recently, the Quadruple Aim). This paper specifically focuses on the role of nurses and nursing practice by: (a) connecting the concept of integrated behavioral healthcare to quality improvement (QI) and the Quadruple Aim, and (b) highlighting examples of models of integration currently in use. Discussion of models of integration compares ways various models reinforce and actualize integration of behavioral health within primary care, in various special populations across the continuum of care, and in both inpatient and community settings. This paper also stresses innovative training programs offering nurses the skills for learning behavioral health integration through online modules and participation in Interprofessional Education (IPE) activities often through simulation approaches. This 2nd manuscript is consistent with the ISPN 2016 Position Paper and reinforces the necessity for all nurses to be educated on both the Quadruple Aim and behavioral health integration to improve patient care and subsequent care outcomes., (Copyright © 2019. Published by Elsevier Inc.)
- Published
- 2019
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9. Peer work in Open Dialogue: A discussion paper.
- Author
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Bellingham B, Buus N, McCloughen A, Dawson L, Schweizer R, Mikes-Liu K, Peetz A, Boydell K, and River J
- Subjects
- Australia, Finland, Humans, Mental Disorders psychology, Social Support, Mental Disorders therapy, Mental Health Services, Peer Group
- Abstract
Open Dialogue is a resource-oriented approach to mental health care that originated in Finland. As Open Dialogue has been adopted across diverse international healthcare settings, it has been adapted according to contextual factors. One important development in Open Dialogue has been the incorporation of paid, formal peer work. Peer work draws on the knowledge and wisdom gained through lived experience of distress and hardship to establish mutual, reciprocal, and supportive relationships with service users. As Open Dialogue is now being implemented across mental health services in Australia, stakeholders are beginning to consider the role that peer workers might have in this model of care. Open Dialogue was not, initially, conceived to include a specific role for peers, and there is little available literature, and even less empirical research, in this area. This discussion paper aims to surface some of the current debates and ideas about peer work in Open Dialogue. Examples and models of peer work in Open Dialogue are examined, and the potential benefits and challenges of adopting this approach in health services are discussed. Peer work in Open Dialogue could potentially foster democracy and disrupt clinical hierarchies, but could also move peer work from reciprocal to a less symmetrical relationship of 'giver' and 'receiver' of care. Other models of care, such as lived experience practitioners in Open Dialogue, can be conceived. However, it remains uncertain whether the hierarchical structures in healthcare and current models of funding would support any such models., (© 2018 Australian College of Mental Health Nurses Inc.)
- Published
- 2018
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10. 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
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11. '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
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- 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].
- Published
- 2018
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12. [Position paper about the care of refugees : A statement about the psychosocial health care of refugees].
- Author
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Danzinger C, Fellinger M, Fellinger-Vols W, Psota G, Wancata J, Wimmer A, and Wochele-Thoma T
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- Austria, Education, Employment, Housing, Humans, Safety, World Health Organization, Mental Health Services organization & administration, Mental Health Services supply & distribution, Refugees psychology, Refugees statistics & numerical data
- Abstract
This paper is general statement about the psychosocial care of refugees, developed by the of the Austrian Society for Psychiatry, Psychotherapy and Psychosomatics as well as by the Austrian Society for Social Psychiatry. Reasons of recent wave of refugees and the usual mental disorders among refugees are described. The increasing number of refugees, asylum seekers and irregular migrants poses a challenge for mental health services in Europe. As a consequence, several expert recommendations were given. As a first step, basic needs of refugees such as regular housing facilities, sufficient nutrition and safety in everyday life should be met. Fast decisions about the applications for asylum and support of social integration through education and employment are essential for mental health. Provision of mental health care should be needs based as described by the intervention pyramid for mental health and psychosocial support as given by the Inter-Agency Standing Committee of the World Health Organization. In addition, culture-specific aspects must be considered in everyday clinical work and the training of health professionals.
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- 2018
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13. Integrated Behavioral Healthcare: Assumptions, Definition and Roles: Position Paper From the International Society of Psychiatric-Mental Health Nurses.
- Author
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Soltis-Jarrett V, Shea J, Ragaisis KM, Shell LP, and Newton M
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- Advanced Practice Nursing, Humans, Primary Health Care, Delivery of Health Care, Integrated, Mental Health Services, Nurse's Role, Psychiatric Nursing, Societies, Nursing
- Published
- 2017
- Full Text
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14. Assessing the Training for Certified Peer Support Specialists Who Provide Mental Health and Substance Use Services.
- Author
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Adjabeng BK and de Saxe Zerden L
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- Humans, Female, Male, Adult, Middle Aged, United States, Mental Disorders therapy, Surveys and Questionnaires, Social Support, Certification, North Carolina, Peer Group, Substance-Related Disorders therapy, Mental Health Services
- Abstract
The behavioral health system's peer support workforce must be adequately trained to perform peer support services, but evidence of the adequacy of their training needs to be improved. With survey data from 667 certified peer support specialists (CPSS) from North Carolina, Kentucky, Virginia, and Tennessee, this study used (a) binomial probability test to assess perceptions about the adequacy of the workforce's training, (b) latent profile analysis to identify patterns and predictors of perceptions about the SAMHSA core competencies covered in their training, and (c) thematic analysis to identify additional training needs. Most respondents identified as White (72%), female (73%), and had some college education (83%). Most of the workforce (> 90%) felt prepared to provide services, regardless of their state. Highly and moderately sufficient coverage emerged as two distinct response patterns regarding coverage of the SAMSHA core competencies, with respondents' years of experience, state of residence, education level, race, and sense of preparedness predicting the probability of fitting into either profile. Participants desired additional training in trauma-informed practices, motivational interviewing, and new treatment approaches. Peers' experiences and perspectives were similar across different states. The findings suggest booster training sessions or continuing education opportunities are needed to maintain a robust and well-prepared peer support workforce. States should consider reciprocity agreements to enable the trained workforce to practice across states. A key implication for the training content is the need to incorporate contemporary issues relating to mental health and substance use disorders to better meet behavioral health needs., (© 2024. National Council for Mental Wellbeing.)
- Published
- 2024
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15. The integration of care for mental health, substance abuse, and other behavioral health conditions into primary care: executive summary of an American College of Physicians position paper.
- Author
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Crowley RA and Kirschner N
- Subjects
- Delivery of Health Care, Integrated economics, Humans, Insurance Coverage, Insurance, Health, Reimbursement, Mental Disorders psychology, Mental Health Services economics, Primary Health Care economics, Social Stigma, Substance-Related Disorders psychology, Workforce, Delivery of Health Care, Integrated organization & administration, Mental Disorders therapy, Mental Health Services organization & administration, Primary Health Care organization & administration, Substance-Related Disorders therapy
- Abstract
Behavioral health care includes care for patients around mental health and substance abuse conditions, health behavior change, life stresses and crises, and stress-related physical symptoms. Mental and substance use disorders alone are estimated to surpass all physical diseases as a major cause of worldwide disability by 2020. The literature recognizes the importance of the health care system effectively addressing behavioral health conditions. Recently, there has been a call for the use of the primary care delivery platform and the related patient-centered medical home model to effectively address these conditions. This position paper focuses on the issue of better integration of behavioral health into the primary care setting. It provides an environmental scan of the current state of conditions included in the concept of behavioral health and examines the arguments for and barriers to increased integration into primary care. It also examines various approaches of integrated care delivery and offers a series of policy recommendations that are based on the reviewed information and evidence to inform the actions of the American College of Physicians and its members regarding advocacy, research, and practice.
- Published
- 2015
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16. The relevance of EPA guidance papers in the framework of the European Psychiatric Association.
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Heun R and Gaebel W
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- Europe, Humans, Mental Disorders prevention & control, Mental Health, Practice Guidelines as Topic, Evidence-Based Medicine standards, Mental Health Services standards, Psychiatry standards, Societies, Medical standards
- Published
- 2015
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17. Recovery support can help people in forensic mental health services, says briefing paper.
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- Organizational Innovation, United Kingdom, Mental Health Services organization & administration
- Published
- 2014
18. Response to Maria Papadima's commentary on MacKean et al. (2023) and Midgley et al.'s (2021) papers about an internet-based psychodynamic treatment.
- Author
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Midgley, Nick, Mechler, Jakob, and Lindqvist, Karin
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- *
THERAPEUTICS , *COMPUTERS in medicine , *INTERNET , *PSYCHODYNAMIC psychotherapy , *PSYCHOEDUCATION , *EXPERIENCE , *MENTAL depression , *PSYCHOTHERAPY , *MENTAL health services , *ADOLESCENCE - Published
- 2023
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19. Conceptual framework on barriers and facilitators to implementing perinatal mental health care and treatment for women: the MATRIx evidence synthesis.
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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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20. 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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21. Propelling the Global Advancement of School Mental Health.
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Weist MD, Hoover SA, Daly BP, Short KH, and Bruns EJ
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- Child, Adolescent, Humans, United States, Schools, Students, Health Promotion, School Health Services, Mental Health, Mental Health Services
- Abstract
Rates of mental health problems and disorders in children and youth have been increasing for at least three decades, and these have escalated due to the pandemic and multiple other societal stressors. It is increasingly recognized that students and families frequently struggle to receive needed care through traditional locations such as specialty mental health centers. Upstream mental health promotion and prevention strategies are gaining support as a public health approach to supporting overall population well-being, better utilizing a limited specialty workforce, and reducing illness. Based on these recognitions, there has been a progressive and escalating movement toward the delivery of mental health support to children and youth "where they are," with a prominent and more ecologically valid environment being schools. This paper will provide a brief review of the escalating mental health needs of children and youth, advantages of school mental health (SMH) programs in better meeting these needs, example model SMH programs from the United States and Canada, and national and international SMH centers/networks. We conclude with strategies for further propelling the global advancement of the SMH field through interconnected practice, policy, and research., (© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)
- Published
- 2023
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22. Finding a Way to the Child: Selected Clinical Papers 1983–2021 Margaret Rustin.
- Author
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Kegerreis, Susan
- Subjects
- *
MENTAL health services , *EMOTIONAL state - Abstract
As some of the psychoanalytic world still struggles to give due weight to psychosocial factors in our patients' difficulties, Rustin presents us with both a straightforwardly sensible and a subtle awareness of the complexity of the interactions between a child's internal world and their external world. As I embarked on reading this selection of past papers by Margaret Rustin, I set about it in the way I have often used in book reviews - copying particularly inspiring or insightful phrases into a document so I could refer to them or quote them in the review to come. Finding a Way to the Child: Selected Clinical Papers 1983-2021 Margaret Rustin. [Extracted from the article]
- Published
- 2023
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23. 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]
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- 2023
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24. soulspace: Integrated youth mental health care in Berlin, Germany-An introduction to the program and a description of its users.
- Author
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Bechdolf A, Hanser S, Baumgardt J, Brose A, Jäckel D, Döring S, Holzner L, Aliakbari N, von Hardenberg L, Shmuilovich O, Gencaggi D, Schellong M, Izat Y, Leopold S, Ituarte BP, and Leopold K
- Subjects
- Humans, Adolescent, Young Adult, Male, Female, Adult, Berlin, Mental Disorders therapy, Health Services Accessibility, Adolescent Health Services organization & administration, Germany, Community Mental Health Services organization & administration, Early Medical Intervention, Mental Health Services organization & administration, Delivery of Health Care, Integrated organization & administration
- Abstract
Aim: A substantial gap between young people's need for mental health care services and their actual access to such services led worldwide organizations (e.g., the WHO) to recommend the implementation of early intervention programs and youth mental health services. Some countries around the world have established structures to meet this recommendation. In this paper, we describe soulspace as the first integrated youth mental health service for young people aged between 15 and 35 years in Berlin, Germany., Methods: We introduce soulspace as easily accessible mental health care for young people, and we characterize soulspace along the lines of the internationally established eight key principles of integrated youth mental health services (Killackey, et al., 2020, World Economic Forum). Soulspace is a cooperation between clinical outpatient units of psychiatric clinics for adolescents and young adults as well as a community-based counselling service. It provides initial contact, counselling, diagnostics, and treatment., Results: Our analyses of the pathways to soulspace and the characteristics of the soulspace users suggest that the low threshold is a facilitator to help finding for young people in comparison to more conventional early intervention models. That is, having transferred the early intervention center in a youth-facing counselling service as was done in soulspace seems to have reduced the threshold to seek help for families and for young people in need for support., Conclusions: In summary, with soulspace, an easily accessible mental health care service was established that integrates counselling and specialized psychiatric treatment if needed., (© 2024 The Authors. Early Intervention in Psychiatry published by John Wiley & Sons Australia, Ltd.)
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- 2024
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25. Contextual determinants associated with children's and adolescents' mental health care utilization: a systematic review.
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Verhoog S, Eijgermans DGM, Fang Y, Bramer WM, Raat H, and Jansen W
- Subjects
- Humans, Adolescent, Child, Mental Disorders therapy, Adolescent Health Services, Mental Health Services, Health Services Accessibility, Patient Acceptance of Health Care statistics & numerical data
- Abstract
Determinants at the contextual level are important for children's and adolescents' mental health care utilization, as this is the level where policy makers and care providers can intervene to improve access to and provision of care. The objective of this review was to summarize the evidence on contextual determinants associated with mental health care utilization in children and adolescents. A systematic literature search in five electronic databases was conducted in August 2021 and retrieved 6439 unique records. Based on eight inclusion criteria, 74 studies were included. Most studies were rated as high quality (79.7%) and adjusted for mental health problems (66.2%). The determinants that were identified were categorized into four levels: organizational, community, public policy or macro-environmental. There was evidence of a positive association between mental health care utilization and having access to a school-based health center, region of residence, living in an urban area, living in an area with high accessibility of mental health care, living in an area with high socio-economic status, having a mental health parity law, a mental health screening program, fee-for-service plan (compared to managed care plan), extension of health insurance coverage and collaboration between organizations providing care. For the other 35 determinants, only limited evidence was available. To conclude, this systematic review identifies ten contextual determinants of children's and adolescents' mental health care utilization, which can be influenced by policymakers and care providers. Implications and future directions for research are discussedPROSPERO ID: CRD42021276033., (© 2022. The Author(s).)
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- 2024
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26. The New Collected Papers of Biodynamic Psychology, Massage and Psychotherapy: 2022.
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Ludwig, Mark
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- *
PSYCHOTHERAPY , *SOCIAL workers , *MENTAL health services , *PSYCHOLOGY , *DANCE therapy - Published
- 2023
27. Health Care for Our Nation's Veterans: A Policy Paper From the American College of Physicians
- Author
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Ryan, Crowley, Omar, Atiq, David, Hilden, Thomas G, Cooney, and Michael, Tan
- Subjects
Mental Health Services ,Advisory Committees ,Population ,Holistic Health ,Modernization theory ,Health Services Accessibility ,Patient satisfaction ,Nursing ,Health care ,Internal Medicine ,Electronic Health Records ,Humans ,Medicine ,Health Workforce ,education ,Societies, Medical ,health care economics and organizations ,Patient Care Team ,education.field_of_study ,Primary Health Care ,Emergency management ,Delivery of Health Care, Integrated ,business.industry ,Health Policy ,Medical record ,General Medicine ,Telemedicine ,United States ,United States Department of Veterans Affairs ,Education, Medical, Graduate ,Veterans Health Services ,Position paper ,Private Sector ,Health Services Research ,business ,Administration (government) - Abstract
The Veterans Health Administration (VHA) is the United States' largest integrated health care delivery system, serving over 9 million enrollees at nearly 1300 health care facilities. In addition to providing health care to the nation's military veterans, the VHA has a research and development program, trains thousands of medical residents and other health care professionals, and conducts emergency preparedness and response activities. The VHA has been celebrated for delivering high-quality care to veterans, early adoption of electronic medical records, and high patient satisfaction. However, the system faces challenges, including implementation of an expanded community care program, modernization of its electronic medical records system, and providing care to a population with complex needs. The position paper offers policy recommendations on VHA funding, the community care program, medical and health care professions training, and research and development.
- Published
- 2021
28. Concurrent Paper Sessions.
- Subjects
- *
COCAINE-induced disorders , *MEDICAL personnel , *ALCOHOLISM , *HEALTH facilities , *MENTAL health services - Abstract
The remaining 11 patients still utilizing PES in 2020 had on average seven chronic medical conditions (95% CI: 3.8-10.2), with six patients having at least one alcohol-attributable condition, and were taking on average 11 chronic medications (95% CI: 8.5-13.5). Among all 12 patients still alive and within the state of Connecticut in 2020, all but one patient who required nursing home care continued to utilize PES services, and the majority of patients with substance use disorder continued to report substance use in 2020. Prevalence of Substance Use Disorder in Hospitalized Pediatric Patients With Eating Disorders... B Precious Obehi Eseaton SP 1 sp , Samuel Nwaobi SP 2 sp , Henry Onyeaka SP 3 sp , Abby Enosolease SP 4 sp , Adeolu Funso Oladunjoye SP 5 sp , Ehizogie Edigin SP 6 sp , Adeolu Oladunjoye* SP 5 sp b SP 1 sp University of South Wales, SP 2 sp Piedmont Columbus Regional, SP 3 sp Harvard Medical School, SP 4 sp University of Benin, SP 5 sp Baylor College of Medicine, SP 6 sp Loma Linda University Health B Summary b : We aim to study the prevalence of substance use disorder in hospitalized pediatric patients with eating disorders in the United States. Alcohol use was most frequently reported (16 patients), followed by stimulant use (nine patients), opioid use (seven patients), and then other substances such as sedative-hypnotics and cannabis (four patients). Only a minority of the patients had only METH as a presenting disorder with the most patients also manifesting opioid use disorders. [Extracted from the article]
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- 2023
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29. Factors that impact mental health help-seeking in Australian adolescents: a life-course and socioecological perspective.
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Guo S, Goldfeld S, and Mundy L
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- Child, Humans, Male, Female, Adolescent, Longitudinal Studies, Patient Acceptance of Health Care psychology, Australia, Mental Health, Mental Health Services
- Abstract
Background: Help-seeking provides opportunities for early prevention and intervention of mental health problems. However, little is known about factors that impact help-seeking from a life-course and socioecological perspective. This study aimed to examine factors that impact adolescents' formal and informal help-seeking in three population groups: the whole population, adolescents with depressive symptoms and adolescents with anxiety symptoms., Methods: We drew on data from the Longitudinal Study of Australian Children birth cohort. Participants were followed from birth to 14-15 years. Based on previous literature and life-course and socioecological models, we measured a range of factors at individual and family, interpersonal and community levels at three time points (0-1 year, 4-5 years and 12-13 years). Outcomes at 14-15 years were help-seeking behaviours divided into three categories (formal help from health professionals, close informal help from friends and family members and broad informal help from other sources). Generalised linear models with logit-binomial links were used., Results: There were varying and common patterns of influencing factors across the three population groups and sources of help-seeking. In the whole population, five common factors (female, previous depressive or anxiety symptoms, discrimination and bully victimisation) were associated with all three sources of help-seeking. Among adolescents with depressive or anxiety symptoms, four common barriers to help-seeking were male adolescents, speaking a language other than English, having poor relationships with peers and less social support., Conclusion: Both intrinsic and extrinsic barriers exist for adolescents' mental health help-seeking. There are priority groups of adolescents with mental health problems who are unlikely to seek support and warrant attention. There is a need for multisector collaborations to address barriers to mental health care and promote help-seeking among adolescents., (© 2024 Association for Child and Adolescent Mental Health.)
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- 2024
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30. A randomized clinical trial of a gamified app for the treatment of perfectionism.
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Abramovitch A, Uwadiale A, and Robinson A
- Subjects
- Humans, Treatment Outcome, Perfectionism, Mobile Applications, Cognitive Behavioral Therapy methods, Mental Health Services
- Abstract
Objectives: Perfectionism is a common transdiagnostic problem that may lead to substantial distress and functional impairments. Cognitive behavioural therapy (CBT) is an effective treatment for perfectionism. However, the existing significant barriers to access and utilization of mental health services, including among college students, demand the development of low-intensity accessible interventions. The aim of the present study was to evaluate the effectiveness of a low-intensity CBT-based self-help gamified app developed specifically for perfectionism in a sample of college students., Methods: Participants completed assessments of perfectionism, related symptoms, emotional burden and functional impairments at pretreatment, posttreatment and at one-month follow-up., Results: Compared with the waitlist condition (n = 35), the app condition (n = 35) demonstrated a significant and greater reduction in perfectionism, obsessive-compulsive symptoms, functional impairments and subjective ratings of emotional burden., Conclusions: Results suggest that a brief, daily app-based game-like intervention targeting maladaptive perfectionistic beliefs may be a viable, low-cost alternative to traditional CBT treatments for vulnerable populations on college campuses., (© 2023 The Authors. British Journal of Clinical Psychology published by John Wiley & Sons Ltd on behalf of British Psychological Society.)
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- 2024
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31. Impact of counselling provision in primary schools on child and adolescent mental health service referral rates: a longitudinal observational cohort study.
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Grant C, Blackburn R, Harding D, Golden S, Toth K, Scott S, Ford T, and Downs J
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- Humans, Child, Adolescent, Retrospective Studies, Cohort Studies, Schools, Referral and Consultation, Counseling, Mental Health Services
- Abstract
Background: In the United Kingdom, schools play an increasingly important role in supporting young peoples' mental health. While there is a growing evidence base to support the effectiveness of school-based interventions, less is known about how these provisions impact on local Child and Adolescent Mental Health Service (CAMHS) referral rates. There is a concern that an increase in school-based provision might lead to an increase in CAMHS referrals and overwhelm services. We aimed to examine the longitudinal association between Place2Be counselling provision in primary schools on CAMHS referral rates in South London., Method: This was a retrospective cohort study using linked data from the National Pupil Database (NPD) and CAMHS referrals to the South London and Maudsley's NHS Foundation Trust (SLaM) identified through the Clinical Record Interactive Search (CRIS) tool. The cohort included a total of 285 state-maintained primary schools in four London boroughs for the academic years of 2007-2012. During the study period, 23 of these schools received school-based mental health provision from Place2Be. The primary outcome was the incident rate ratio (IRR) of school-level accepted CAMHS referrals in 2012/13 in schools with, or without, Place2Be provision., Results: There was no significant association between elevated rates of CAMHS referral and Place2Be provision, even after comprehensive adjustment for school-level and pupil characteristics (IRR 0.91 (0.67-1.23)). School-level characteristics, including higher proportion of white-British pupils (IRR 1.009 (1.002-1.02)), medical staff ratio (IRR 6.49 (2.05-20.6)) and poorer Ofsted school inspection ratings (e.g. IRR 1.58 (1.06-2.34) for 'Requires Improvement' vs. 'Outstanding') were associated with increased CAMHS referral rates., Conclusions: Place2Be provision did not result in increased specialist mental health referrals; however, other school-level characteristics did. Future research should investigate pupils' Place2Be clinical outcomes, as well the outcomes of individuals referred to CAMHS to better understand which needs are being met by which services., (© 2021 The Authors. Child and Adolescent Mental Health published by John Wiley & Sons Ltd on behalf of Association for Child and Adolescent Mental Health.)
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- 2023
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32. Notes from the youth mental health field: Using movement towards goals as a potential indicator of service change and quality improvement.
- Author
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Jacob J, Edbrooke-Childs J, Costa da Silva L, and Law D
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- Humans, Male, Adolescent, Female, Goals, Quality Improvement, Patient Reported Outcome Measures, Mental Health, Mental Health Services
- Abstract
The aim of this paper is to report our notes from the field on using movement toward goals at an aggregate level as an inference of service effectiveness. Analysis of routinely collected data from UK youth mental health services was conducted (N = 8,172, age M = 13.8, 67% female, 32% male) to explore the impact of including goal-based outcome data in combined calculations of standardized measures based on the principles of reliable change ("measurable change"). Due to the broad nature of standardized measures, inferred validity becomes diluted in any team or service level aggregate analysis. To make inferences that are closer to the person's interpretation of their difficulties, we argue that Idiographic Patient Reported Outcome Measures (I-PROMs) counterbalance these limitations. This is supported by our findings. The measurable change metric is the first step towards enabling national analysis of aggregated I-PROMs. I-PROMs, supplemented by standardized measures should be used to consider service evaluation., (© 2021 Wiley Periodicals LLC.)
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- 2023
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33. Response to the white paper on MHA reform: marginalisation of patients detained under part III of the MHA
- Author
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Sarah Markham
- Subjects
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
34. APhA2020 abstracts of contributed papers.
- Subjects
DYSLIPIDEMIA ,MENINGOCOCCAL infections ,MEDICAL personnel ,MEDICAL libraries ,MEDICAL care ,MENTAL health services ,HEALTH facilities - Abstract
These 12 factors include: insufficient/incorrect patient education, insufficient/incorrect patient assessment, lack of consultation, insufficient/incorrect OTC product recommendation, discontinued medications, improper storage, expired medications, incorrect dosing (subtherapeutic/overdose), missing medications, drug-drug interactions/adverse drug reactions, therapeutic duplication, and inappropriate treatment duration. [Extracted from the article]
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- 2020
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35. Reflections on Trauma Systems Therapy for Refugees (TST-R): A Commentary on Dr. Franco's Paper.
- Author
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Sapountzis, Ionas
- Subjects
- *
TRAUMA therapy , *MENTAL health services , *REFUGEE camps , *ADOLESCENT psychotherapy , *VETERANS , *SOCIAL services , *MINORS - Abstract
Dr. Franco also receives permission to take Maria out for walks. Over the course of the treatment, Dr. Franco relies on Narrative Exposure Therapy (NET) to help Maria process the trauma she experienced, on psychodynamic therapy to help her connect what happened to her with her current fears, and on CBT techniques to help Maria recognize unhelpful ways of thinking. In her paper, Dr. Franco gives a painful account of the case of Maria, a seventeen-year-old adolescent who experienced emotional neglect and abandonment as well as sexual, physical and emotional abuse from early on. Maria's individual treatment is presented as part of the Trauma Systems Therapy for Refugees (TST-R) proposed by Ellis et al. ([8]). [Extracted from the article]
- Published
- 2022
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36. Help-seeking behavior among adults who attempted or died by suicide in Ontario, Canada.
- Author
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Barry R, Rehm J, de Oliveira C, Gozdyra P, Chen S, and Kurdyak P
- Subjects
- Male, Female, Humans, Adult, Ontario, Suicide, Attempted psychology, Mental Health, Help-Seeking Behavior, Mental Health Services
- Abstract
Introduction: This study aims to determine the relationship between rurality and help-seeking behavior prior to a suicide or suicide attempt., Methods: Data from 2007 to 2017 were obtained from administrative databases held at ICES, which capture all hospital, emergency department (ED), and general practitioner (GP) visits across Ontario. Rurality was defined using the Rurality Index of Ontario scores. Help-seeking was based on accessing health services 1 year prior to the event., Results: Among those who died by suicide (N = 9848), those living in rural areas were less likely to seek help from a psychiatrist (rural males: AOR = 0.42, 95% CI = 0.31-0.57; rural females: AOR = 0.46, 95% CI = 0.29-0.97) compared with those living in urban areas. We found a similar association among those who attempted suicide (N = 82,480) (rural males: AOR = 0.49, 95% CI = 0.43-0.56; rural females: AOR = 0.51, 95% CI = 0.46-0.57). Rural males and females were more likely to seek care from an ED for mental health reasons compared with urban males and females., Conclusions: Among people who died by suicide, those living in rural areas are generally less likely to access psychiatrists and GPs and more likely to access EDs, suggesting that people living in rural areas may have less access to care than their urban counterparts., (© 2022 American Association of Suicidology.)
- Published
- 2023
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37. The Use of Balanced Scorecards in Mental Health Services: an Integrative Review and Thematic Analysis.
- Author
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Brimelow RE, Amalathas A, Beattie E, Byrne G, and Dissanayaka NN
- Subjects
- Humans, Benchmarking methods, Mental Health Services
- Abstract
Performance management of mental health services (MHS) through quality reporting of strategic indicators and goals is essential to improve efficiency and quality of care. One such method is the balanced scorecard (BSC). This integrative review of peer-reviewed and industry implemented BSCs in MHS aims to inform future development of a more comprehensive mental health-focused benchmarking tool. A two-part systematic literature search consisted of peer-reviewed published literature on MHS specific BSCs utilising the PRISMA guidelines in addition to industry published BSCs available online. A total of 17 unique BSCs were identified. A total of 434 indicators were subject to thematic analysis identifying 11 key themes: prevalence, accessibility, services provided, clinical outcomes, client satisfaction, client involvement, staff motivation, staffing levels, governance and compliance, development, and costs and revenue. These themes represented the measures that MHS believed measured key performance criteria in alignment with their organisational objectives., (© 2022. The Author(s).)
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- 2023
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38. Assembling Adjustment: Parergasia, Paper Technologies, and the Revision of Recovery.
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Healey, Michael N.
- Subjects
- *
DEINSTITUTIONALIZATION , *MENTAL health services , *SCHIZOPHRENIA , *PSYCHIATRIC clinics , *DIAGNOSIS , *MENTAL health - Abstract
Drawing from research on 'paper technologies' conducted by medical historians Volker Hess and Andrew Mendelsohn, among others, this article explores how Adolf Meyer (1866–1950) and his staff at the Phipps Psychiatric Clinic used customized punch cards to develop an alternative conceptualization of schizophrenia: 'parergasia.' It begins by examining 'dementia praecox,' the conceptual precursor to both schizophrenia and parergasia, to explain how earlier paper technologies used to track patients transferred to asylums generated prognostic assumptions that precluded deinstitutionalization and community-based care. It then describes how Meyer's staff modified these technologies to define parergasia in opposition to dementia praecox and other diagnoses that resulted in prolonged hospitalization, primarily by conducting follow-up studies on discharged patients that correlated outcomes with various social factors. After demonstrating how the standardized forms used in these studies limited the possible metrics of recovery, it concludes by suggesting how Meyer's research influenced leaders of the community mental health movement, and prefigured later trends in psychiatric services. [ABSTRACT FROM AUTHOR]
- Published
- 2021
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39. 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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40. 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
- Subjects
- 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).)
- Published
- 2024
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41. Review: Improving access to mental health interventions for children from birth to five years: A Scoping Review.
- Author
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Hickey L, Harms L, Evans J, Noakes T, Lee H, McSwan A, Bean H, Hope J, Allison L, Price S, and Harris N
- Subjects
- Child, Infant, Humans, Child, Preschool, Mental Health, Risk Factors, Population Groups, Mental Health Services, Child Health Services
- Abstract
Background: In spite of infants and children aged 0-5 years experiencing mental health difficulties being estimated to be in the range of 6%-18% globally, the mental health care needs for this age group are often overlooked in the design of specialist mental health services. Although there is increasing recognition of the importance of infant mental health services and treatments for younger children, access remains a barrier. Mental health services specifically designed for children 0-5 years are vital; however, little is known about how these services ensure access for infants at risk of mental health difficulties and their families. This scoping review seeks to address this knowledge gap., Methods: A scoping review methodology framework was used to search for relevant articles published between January 2000 and July 2021, identified using five databases: MEDLINE, CINAHL, PsycINFO, SocIndex and Web of Science. The selection of studies was based on empirical research about access to infant mental health services and models of care. A total of 28 relevant articles met the eligibility criteria for inclusion in this review., Results: Findings can be summarised under five broad themes: (1) accessibility for at-risk populations (2) the importance of early detection of infants in need of mental health services and interventions; (3) the promotion of culturally responsive services and interventions; (4) ensuring the sustainability of IMH services and programs and (5) the integration of innovative interventions to improve existing practice models., Conclusions: The findings from this scoping review highlight barriers to access and provision of infant mental health services. Future infant mental health service design, informed by research, is needed to improve access for infants and young children with mental health difficulties and their families., (© 2023 Association for Child and Adolescent Mental Health.)
- Published
- 2024
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42. Factors within the clinical encounter that impact upon risk assessment within child and adolescent mental health services: a rapid realist synthesis.
- Author
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Cantrell A, Sworn K, Chambers D, Booth A, Taylor Buck E, and Weich S
- Subjects
- 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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43. Toward Efficient, Sustainable, and Scalable Methods of Treatment Characterization: An Investigation of Coding Clinical Practice from Chart Notes.
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Isenberg BM, Becker KD, Wu E, Park HS, Chu W, Keenan-Miller D, and Chorpita BF
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- Humans, Reproducibility of Results, Clinical Coding, Mental Health Services standards
- Abstract
Purpose: Chart notes provide a low-cost data source that could help characterize what occurs in treatment with sufficient precision to improve management of care. This study assessed the interrater reliability of treatment content coded from chart notes and evaluated its concordance with content coded from transcribed treatment sessions., Method: Fifty randomly selected and digitally recorded treatment events were transcribed and coded for practice content. Independent coders then applied the same code system to chart notes for these same treatment events., Analysis: We measured reliability and concordance of practice occurrence and extensiveness at two levels of specificity: practices (full procedures) and steps (subcomponents of those procedures)., Results: For chart notes, practices had moderate interrater reliability (M k = 0.50, M ICC = 0.56) and steps had moderate (M ICC = 0.74) to substantial interrater reliability (M k = 0.78). On average, 2.54 practices and 5.64 steps were coded per chart note and 4.53 practices and 13.10 steps per transcript. Across sources, ratings for 64% of practices and 41% of steps correlated significantly, with those with significant correlations generally demonstrating moderate concordance (practice M r = 0.48; step M r = 0.47). Forty one percent of practices and 34% of steps from transcripts were also identified in the corresponding chart notes., Conclusion: Chart notes provide an accessible data source for evaluating treatment content, with different levels of specificity posing tradeoffs for validity and reliability, which in turn may have implications for chart note interfaces, training, and new metrics to support accurate, reliable, and efficient measurement of clinical practice., (© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)
- Published
- 2024
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44. Service user perspectives on recovery: the construction of unfulfilled promises in mental health service delivery in Ireland
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Swords, Calvin and Houston, Stan
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- 2024
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45. Supervision of the mental health lived experience workforce in Australia: A scoping review.
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Castles C, Stewart V, Slattery M, Bradshaw N, and Roennfeldt H
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- Humans, Workforce, Australia, Health Personnel, Mental Health, Mental Health Services
- Abstract
The mental health Lived Experience workforce (also referred to as peer workforce) is growing rapidly internationally and within Australia. Peer workers are increasingly employed within multi- and inter-disciplinary teams, often directly supervised by mental health professionals such as nurses. Professional supervision has been identified as fundamental for implementing a sustainable peer workforce, but significant gaps in the literature remain, in particular, an understanding of appropriate supervision practices. This scoping review synthesized academic and grey literature on Lived Experience supervision in Australia, exploring current thoughts on best practices. Four electronic databases were searched, and grey literature was located via Google Advanced searches, contacting Lived Experience experts and conducting web-based desktop searches of key mental health organization websites. Thematic analysis identified and described key characteristics in relation to how supervision is conceptualized and operationalized. Eight peer-reviewed and 46 grey literature documents describing supervision and supervisory practices were analysed. Of these studies, 26 were Lived Experience-led. Analysis revealed four key themes: (i) defining peer supervision, (ii) variability in understanding the purpose of supervision, (iii) approaches to supervision and the need for choice and flexibility, and (iv) qualities and skills of the supervisor. Additionally, the establishment of a national professional organization for peer workers was highlighted to protect the authenticity of Lived Experience roles and develop an effective workforce. Clearly, a sustainable Lived Experience workforce cannot develop in isolation, and mental health nurses, as important allies in mental healthcare, need to work alongside, plan and advocate for appropriate supervision practices for this emerging workforce., (© 2023 The Authors. International Journal of Mental Health Nursing published by John Wiley & Sons Australia, Ltd.)
- Published
- 2023
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46. Experiencing restraint: A dialogic narrative inquiry from a service user perspective.
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Cusack P, McAndrew S, Duckworth J, Cusack F, and McKeown M
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- Humans, Restraint, Physical psychology, Narration, Violence, Mental Disorders therapy, Mental Disorders psychology, Mental Health Services
- Abstract
In recent decades concerns about violence and programs for the minimization of physical restraint, amongst other restrictive practices, have proliferated within mental health policy and practice. Whilst nurses are often called upon when violence occurs within mental health care settings, they often find themselves having the conflicting roles of caring and controlling. Within such situations it is service users, who are experts by experience, who perhaps can offer more meaningful insight into being restrained and thus provide a more appropriate approach in dealing with mental distress. This paper presents the findings of a narrative study of individuals' experiences of physical restraint within the mental health care system. In total 11 mental health service users, who had experienced physical restraint, were interviewed. Frank's (2010, Letting stories breathe: a socio-narratology) guiding questions were used to undertake a dialogical narrative analysis of each story. For the purpose of this paper, four of the 11 stories are presented as these are representative of Frank's 'quest narrative'. However, whilst studies from the service user perspective regarding restraint are scarce, findings are discussed in relation to the grand narrative of restraint. The dialogical relationship between individual stories and the dominant grand narrative implies that the former has the capacity to shape and review the latter within mental health care. Adding to the growing body of evidence of restraint from service users' perspectives could enable nurses to provide more appropriate and meaningful mental health care in times of mental distress. [238]., (© 2023 John Wiley & Sons Australia, Ltd.)
- Published
- 2023
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47. Factor and network analysis of psychosis-like experiences and depressive symptoms in a sample of Finnish adolescents entering psychiatric services.
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Granö N, Lintula S, Therman S, Marttunen M, Lång U, and Ranta K
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- Female, Adolescent, Humans, Male, Depression epidemiology, Depression psychology, Finland epidemiology, Anxiety, Surveys and Questionnaires, Psychiatric Status Rating Scales, Psychotic Disorders diagnosis, Psychotic Disorders epidemiology, Psychotic Disorders psychology, Mental Health Services
- Abstract
Aim: Psychosis-Like Experiences (PLEs) and depressive symptoms are correlated in clinical adolescent populations. However, symptom-level associations between the two phenomena are not clear., Methods: We analysed factor structures of a PLE instrument, the Prodromal Questionnaire-Brief (PQ-B), based on dimensions of positive symptoms of schizophrenia, and a depression measurement instrument, the Beck Depression Inventory (BDI-21A) and performed a network analysis of item-level associations between the two measures. The sample consisted of 417 adolescents (range 13-18 years of age, mean 14.9 years, 72.4% females) entering secondary psychiatric services at Helsinki metropolitan area, Finland., Results: Confirmatory factor analysis resulted in adequately fitting 2-factor solution, one for PQ-B and one for BDI-21, with a strong correlation coefficient of 0.605 between the two factors. In the network analysis, PQ-B and BDI-21 both formed their own clusters, and two significant pathways were estimated between PQ-B and BDI-21 clusters: 1. the association between paranoid thinking and distorted body image, and 2. the association between somatic preoccupation and worry about problems of one's mind., Conclusions: Even though on a general, factor level, PLEs and depressive symptoms were strongly correlated, unique associations between symptoms of the two constructs were sparse. These findings should be considered in the psychiatric assessment and in the care of adolescents., (© 2023 John Wiley & Sons Australia, Ltd.)
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- 2023
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48. Mental health service users' experiences of telehealth interventions facilitated during the COVID-19 pandemic and their relevance to nursing: An integrative review.
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Bright AM and Doody O
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- Humans, Pandemics, COVID-19, Mental Health Services, Telemedicine
- Abstract
WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: Service users report telehealth interventions to be useful in terms of access and convenience however, a preference for face-to-face interventions remains. Nurses are using telehealth interventions in clinical practice however, further research is necessary in this area as the evidence of their involvement is limited. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: This paper highlights the use of telehealth interventions should augment rather than replace face-to-face care provision., Abstract: INTRODUCTION: The Covid-19 pandemic saw the swift implementation of physical and social distancing that impacted the way in which mental health services were facilitated. Consequently, telehealth/e-health interventions are increasing in use., Aim: This integrative review aims to explore existing literature regarding mental health service users' experiences of telehealth interventions facilitated through the COVID-19 pandemic, to determine the visibility of nursing involvement in the facilitation of telehealth interventions and to use these experiences to inform nursing practice., Method: A methodical search of eight (n = 8) academic databases was undertaken using CINAHL, SCOPUS, EMBASE, PsycINFO, Web of Science, Cochrane, MEDLINE and Academic Search Complete between January 2020 and January 2022., Results: A total of 5133 papers were screened by title and abstract of which (n = 77) progressed for full-text screening. Five (n = 5) papers met the inclusion criteria for this review and results were mapped onto the four meta-paradigms of nursing: person; where the findings discuss the acceptability of telehealth interventions; environment; where the findings highlight barriers and facilitators to the use of telehealth interventions; health; where the findings discuss staff time and logistical issues relating to telehealth interventions and nursing; where the findings centre around the therapeutic relationship., Discussion: This review highlights there is a paucity of direct evidence relating to nursing involvement in the facilitation of telehealth interventions. However, there are benefits to the use of telehealth interventions that include increased access to services, less perceived stigma and increased engagement which are relevant to nursing practice. A lack of individual contact and concerns relating to infrastructure indicates a fondness for face-to-face interventions remains high., Implications for Practice: There is a need for further research on the role of the nurse in the facilitation of telehealth interventions, specific interventions used and outcomes of such interventions., (© 2023 The Authors. Journal of Psychiatric and Mental Health Nursing published by John Wiley & Sons Ltd.)
- Published
- 2023
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49. 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
50. Office-based mental healthcare and juvenile arrests.
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Deza M, Lu T, and Maclean JC
- Subjects
- Humans, Crime, Mental Health Services
- Abstract
We estimate the effect of local access to office-based mental healthcare on juvenile arrest outcomes. We leverage variation in the number of offices of physicians and non-physicians specializing in mental healthcare in a county over the period 1999-2016 in a two-way fixed-effects regression. Office-based treatment is the most common modality of mental healthcare received by juveniles. We find that 10 additional offices of physicians and non-physicians specializing in mental healthcare in a county leads a decrease of 2.3%-2.6% in the per capita costs to society of juvenile arrest. Findings are similar for arrest rates although often less precise, which suggests that accounting for social costs is empirically important. Crime imposes substantial costs on society and individuals, and interventions during early life can have more pronounced effects than those received at later stages, therefore our results imply increased juvenile access to mental healthcare may have an unintended benefit for the current and future generations., (© 2022 John Wiley & Sons Ltd.)
- Published
- 2022
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