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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.)

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.)

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.)

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.

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.)

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.)

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.)

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.

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].

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.

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.)

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.

Goal: Quebec's three mental health university institutes (DMHUI, IUSMM and the IUSMQ) and the Centre hospitalier universitaire de Sherbrooke submitted a statement to the provincial consultation forum on the 2014-2020 Mental Health Action Plan (MHAP), which was held in January 2014 and organized by the Ministère de la Santé et des Services sociaux (MSSS). This article presents these institutes' main recommendations., Method: Mental health university institutes deliver a wide and diverse range of services. They know about the challenges of organizing mental health services and are aware of national and international trends in the delivery of the best organizational and clinical practices in mental health. It is therefore as key stakeholders in the mental health care network that they commented on each component in the working paper., Results: The proposed orientations are consistent with the 2005-2010 MHAP. The presented themes clearly reflect current issues, although the guidelines must be more explicit regarding the vision of how services will be organized in coming years. These institutes therefore suggest that the following principles be included: the full exercise of citizenship rights, the organization of services within integrated networks, performance, continuous improvement and innovation, as well as a global and integrated vision of health. The complexity of today's problems requires flexibility, complementarity and continuity of services, particularly for youth, aboriginals, and people with concomitant disorders. These institutions therefore stress the importance of prevention, early intervention programs, and increased support for first-line general practitioners and health care professionals. They also emphasized that specialized inpatient and outpatient services should not be neglected. Community services must also be structured around various levels of support, such as ICM and ACT, as well as around specialized programs available in hospital outpatient clinics. The development and transfer of knowledge remain a central issue when it comes to improving the mental health of the general population. The consolidation of ultra-specialized services, teaching and research should be included in the next MHAP. Finally, a global health perspective must go beyond the MSSS framework to become a governmental and interministerial commitment based on a vision of public mental health that incorporates the health status of the general population and accounts for social determinants., Conclusion: It is important to have a national plan that promotes a vision. This plan must be part of an interministerial action plan that truly supports the full exercise of citizenship rights and the fight against stigmatization in collaboration with people who use these services and their families.

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.

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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.)

Over the last 10 years, the social inclusion agenda has been gaining momentum as a policy driver in mental health services. Prior to the seminal Social Exclusion Unit (SEU) report, Mental Health and Social Exclusion, there was a lack of awareness concerning the pervasive links between social exclusion and mental health problems. In the report, the SEU suggested that mental health practitioners themselves may actually be contributing to this social exclusion. This finding has been given limited coverage in both social inclusion literature and research. The current paper is a positioned commentary further exploring the relationship between practitioners and the social exclusion of mental health service users. A literature review was conducted in order to identify themes among factors which appear to moderate and contribute to this relationship. These factors are presented and implications for inclusive practice are explored.

In a national survey, 82% of U.S. neuropsychologists who offered services to Hispanics self-reported inadequate preparation to work with this population (Echemendia, Harris, Congett, Diaz, & Puente, 1997). The purpose of this paper is to improve the quality and accessibility of neuropsychological services for Hispanic people living in the United States by giving guidance for service delivery, training, and organizational policy. General guidance towards this end comes from professional ethics for psychologists and interpreters/translators, federal civil rights law, the International Test Commission, and the Office of Minority Health of the U.S. Department of Health and Human Services, among others. This guidance is specifically applied here to cover professional cultural and linguistic competence of neuropsychologists, psychometrists, interpreters, translators, and consultants; languages of evaluation; use of interpreters; evaluation of acculturation; test translation, adaptation, and interpretation; application of test norms; intervention issues; reimbursement; and organizational issues.

Objective: The aim of this article was to examine the concept of mental health and the policies that have been advanced to improve the wellbeing of the population., Conclusions: In the last century there have been many changes in the phenomena of psychiatric disorder, the management of those disorders and the outcomes. All of the changes have largely been due to the efforts of those working pragmatically at the coalface. There is little to suggest that the plans and programs advanced in the last half century have achieved more than enhancing the status of those who advance them., Conclusion: It is difficult to define mental health and equally difficult to develop a comprehensive program that will benefit the whole field.

Objective: Medication documentation is a critical aspect of quality patient care. The current study examined whether electronic medical records provide medication documentation that is more complete and faster to retrieve than traditional paper records., Method: This study involves a comparison of archived paper medical records to recent electronic medical records through chart review. A convenient sample of three large community mental health centers in Indiana was used. Medical charts for 180 patients with schizophrenia were rated on a checklist composed of 16 items that was adapted from a national project. Documentation that existed before implementation of the electronic medical record system was compared with that after implementation at each of the three centers. The main outcome measures were completeness and retrieval time of medication documentation., Results: Electronic medical records provided medication documentation that was more complete and faster to retrieve than paper records across all centers and within each center. On average, electronic medical records were 40% more complete and 20% faster to retrieve., Conclusion: Electronic records have potential to improve medication management for patients in mental health centers over traditional records. However, medication documentation for patients diagnosed with schizophrenia was found to be deficient in many areas, regardless of documentation format.

Good mental health provides an essential foundation for normal growth and development through adolescence and into adulthood. Many adolescents, however, experience mental health problems that significantly impede the attainment of their full potential. The majority of these adolescents do not receive needed mental health services, in part because of financial obstacles to care. This article reviews the magnitude and impact of mental health problems during adolescence and highlights the importance of insurance coverage in assuring access to mental health services for adolescents. Significant limitations in private health insurance coverage of mental health services are outlined. Recent federal and state efforts to move toward parity in private insurance coverage between mental and physical health services are discussed, including an explanation of the role of Medicaid and the State Children's Health Insurance Program (SCHIP) in providing access to mental health services for adolescents. Finally, other elements that would facilitate financial access to essential mental health services for adolescents are presented.

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]

Throughout history the legislative framework for the treatment of the mentally ill has reflected societies' attitudes, and the proposals in the United Kingdom (UK) government's White Paper 'Reforming the Mental Health Act' are no exception. This paper examines some of the fundamental ethical issues invoked by the proposals, particularly the concept of paternalism and use of risk assessment in determining 'best interests'. The issue of power in relation to the mentally ill is also examined, alongside the impact of the change on nurses' ethical decision making. As will be seen, the proposed Act will require high standards of professional practice to ensure the ethical application of care, particularly in the case of individuals diagnosed as suffering from 'dangerous and severe personality disorders'. Nurses need to ensure that the interventions used are of the highest quality and are indeed in the patient's 'best interests'. If they are not, then again nurses need to be very clear as to why the profession should be involved at all. Nurses should demonstrate vigilance and high professional standards to ensure they are maintaining rigorous safeguards to promote the public interest. Although relating specifically to UK legislation the underlying ethical dilemmas posed by this proposed legislation are relevant to all mental health nurses, as they challenge fundamental assumptions regarding the role of nurses in supporting mental health legislation that may have a social, rather than therapeutic, function.

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]

Traditional and ethnographic content analyses of 23 position papers on mental health care reform issued during 1993 yield a comprehensive overview of the specific subjects and broad policy issues that were of concern at that time. Five concrete aspects of mental health service delivery systems and eight policy issues were identified as most important in position papers by service provider organizations and advocacy groups. These analyses identified overall similarities in the content of the position papers, although interesting differences among organizations emerged. The analyses also identified a measure of the quality of policy discussions that is derived from comparing the frequency of concrete references to aspects of mental health care with references to broader policy issues.

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.)

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).)