Search

Mounting evidence has indicated that early intervention leads to improved clinical and functional outcomes for young persons experiencing recent onset psychosis. As part of a large early detection campaign, the present study aimed to investigate subjective experiences during the duration of untreated psychosis (DUP), or time between psychosis onset and treatment contact. Participants were 10 young adults participating in early intervention services for psychosis. After DUP was estimated during standardized baseline assessment, participants engaged in qualitative interviews focused on their life experiences prior to treatment and leading up to the present. Mixed methods data analyses compared standardized DUP estimates with participants' subjective narratives. Findings revealed that participants experienced and conceptualized a longer trajectory of subjective difficulties (TSD) beginning before and extending beyond standardized DUP estimates. Participants emphasized striving for independence and social belonging. The majority of participants reported benefiting from their current services and believed that earlier support of some kind would have been beneficial. These findings support previous research on subjective barriers to early detection and treatment seeking in young adults experiencing psychosis. Implications and future research directions include further efforts to differentiate the struggles unique to early psychosis from psychosocial risk factors and other challenges of young adulthood. [ABSTRACT FROM AUTHOR]

Aim: Improving timely access to evidence‐based treatment for people aged 14‐65 years experiencing a first episode psychosis (FEP) or an at‐risk mental state (ARMS) for psychosis is a national priority within the United Kingdom. An early intervention in psychosis (EIP) access and waiting time standard has been set which has extended the age range and acceptance criteria for services. Methods: This descriptive evaluation reports upon the referrals and access to treatment times within an EIP service over the first year of operating in line with the access and waiting time standard. Patient pathways and post‐assessment status are also described. Results: The service received 406 referrals, of which 88% (n = 357) were assessed. The mean length of time to treatment was 1.5 weeks, with 88% being seen within 2 weeks. Of those who engaged in an assessment, 34% (n = 138) were identified as ARMS cases and 30% (n = 123) were identified as FEP. Over 35 year olds accounted for 22% (n = 80) of the total accepted cases. Conclusions: The findings indicate clinical and operational issues, which will need careful consideration in the future planning of services. The high number of ARMS cases highlights the importance of clear treatment pathways and targeted interventions and may suggest a need to commission distinct ARMS services. The number of people who met the extended age and service acceptance criteria may suggest a need to adapt or redesign clinical services to meet the age‐specific needs of over 35 year olds and those with an ARMS. It is unclear how changes to the remit of EIP services will impact upon future clinical outcomes. [ABSTRACT FROM AUTHOR]

Recent global crises have created a significant increase in the number of people leaving their countries. Distress experienced by these refugees often leads to posttraumatic stress disorder and depression and can also result in psychotic disorders, substance abuse, and interpersonal violence. The World Health Organization leads the organizing of refugee services as part of a larger initiative to provide mental health services to citizens in low- and middle-income countries. The World Health Organization has identified challenges in providing care, including a provider shortage, issues with how refugees access and receive care and a lack of uniformity in mental health services. By applying the values and systemic orientation of the profession, family therapists can address some of the challenges in treating mental health concerns of these at-risk populations. [ABSTRACT FROM AUTHOR]

Copyright of European Journal of Psychotherapy & Counselling is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Aim: Consumer satisfaction is an increasingly important component in determining the delivery of high quality healthcare, particularly for mental health services. However, the perspectives of the relatives (informal carers) of patient groups remains largely overlooked but is invaluable in mental health settings treating non-capacitous patient groups. The aim of the current study was to assess carer feedback on their experience of an inpatient service for people with long-term psychotic disorders. Method: At discharge from the inpatient service, all informal carers of patients were routinely invited to complete a service feedback questionnaire. This included questions asking their assessment of service setting including cleanliness, communication with staff, quality of service provision, and degree to which they felt involved. Results: Data from 61 carers (62% of eligible sample) collected over a five-year period are presented. Overall, these indicated a high level of satisfaction with the service, a willingness to recommend the service to others, and a positive view of having the opportunity for involvement and inclusion in their relatives' care. Qualitative feedback detailing less helpful aspects of the service highlighted communication issues with staff, being made to wait for things such as gaining entry to the unit, and limited visiting spaces for families. Clinical implications: Carers have an invaluable role to play in optimising patient outcomes in psychosis. Here, we demonstrate that not only is it feasible to elicit their feedback on service provision but also that this provides useful information for assessing service quality and identifying areas in need of improvement. [ABSTRACT FROM AUTHOR]

Background: Research demonstrates the importance of supporting caregivers of people with psychosis, but routine implementation studies are lacking. We evaluate a newly-developed caregiver support service, offering individual and group psychoeducation, practical advice and emotional support, working alongside usual community mental health provision for people with established psychosis. Aims: We aimed to provide analysis of preliminary data on the rate and suitability of referrals, engagement, and helpfulness, to inform future larger-scale implementation and evaluation. Method: We conducted a mixed-methods audit during the service’s first ten operational months (01 September 2013–30 June 2014). Caregivers gave qualitative feedback and completed measures of the impact of caregiving pre- and post-intervention. Results: Referrals totalled 103 (10/month), with 45 (44%) initial meetings; and 28 (27%) individual interventions (≥1 sessions, mode = 3). Caregivers were predominantly black British/African/Caribbean parents. Self-reported needs and caregiving experiences were consistent with the literature. Two-thirds of caregivers were clinically distressed. Qualitative feedback showed that caregivers valued the service. Outcomes suggest improved experiences of caregiving following intervention. Conclusions: Findings highlight the potential benefits and challenges of routinely providing psychologically-focused caregiver support. Limitations and future plans are discussed. [ABSTRACT FROM PUBLISHER]

An authors' index for the October 2016 issue of the journal is presented.

This study investigated health locus of control and wellbeing of individuals experiencing acute mental health problems in an inpatient ward. No direct relationship was found between these variables; however, differences by demographic variables such as age and ethnicity were identified. [ABSTRACT FROM AUTHOR]

The developing human brain is shaped by environmental exposures-for better or worse. Many exposures relevant to mental health are genuinely social in nature or believed to have social subcomponents, even those related to more complex societal or area-level influences. The nature of how these social experiences are embedded into the environment may be crucial. Here we review select neuroscience evidence on the neural correlates of adverse and protective social exposures in their environmental context, focusing on human neuroimaging data and supporting cellular and molecular studies in laboratory animals. We also propose the inclusion of innovative methods in social neuroscience research that may provide new and ecologically more valid insight into the social-environmental risk architecture of the human brain. [ABSTRACT FROM AUTHOR]

ObjectivesThe presence and extent of mental health inequalities in Scotland is unclear. We investigated ethnic variations in psychiatric hospitalisations and compulsory treatment in relation to socioeconomic indicators. DesignIn a retrospective cohort study design, using data linkage methods, we examined ethnic variations in psychiatric [any psychiatric, mood (affective), and psychotic disorders) hospitalisations and use of the Mental Health (Care and Treatment) (Scotland) Act 2003 (Emergency Detentions (ED), Short-Term Detentions (STD) and Compulsory Treatment Orders (CTO)] using age (and sex for compulsory treatment), car ownership, and housing tenure adjusted risk ratios (RR). 95% CIs for the data below exclude the reference White Scottish group value (100). ResultsCompared to the White Scottish population, Other White British men and women had lower hospitalisation from any psychiatric disorder (RR = 77.8, 95% CI: 71.0–85.2 and 85.8, 95% CI: 79.3–92.9), mood disorder (91.2, 95% CI: 86.9–95.8 and 83.6, 95% CI: 75.1–93.1), psychotic disorder (67.1, 95% CI: 59.9–75.2 and 78.5, 95% CI: 67.6–91.1), CTO (84.6, 95% CI: 72.4–98.9) and STD (88.2, 95% CI: 78.6–99.0). Any Mixed Background women had higher hospitalisation from any psychiatric disorder (137.2, 95% CI: 110.9–169.6) and men and women had a higher risk of psychotic disorder (200.6, 95% CI: 105.7–380.7 and 175.5, 95% CI: 102.3–301.2), CTO (263.0, 95% CI: 105.4–656.3), ED (245.6, 95% CI: 141.6–426.1) and STD (311.7, 95% CI: 190.2–510.7). Indian women had lower risk of any psychiatric disorder (43.2, 95% CI: 28.0–66.7). Pakistani men had lower risk of any psychiatric disorder (78.7, 95% CI: 69.3–89.3), and higher risk of mood disorders (117.5, 95% CI: 100.2–137.9). Pakistani women had similar risk of any psychiatric and mood disorder however, a twofold excess risk of psychotic disorder (227.3, 95% CI: 195.8–263.8). Risk of STD was higher in South Asians (136.9, 95% CI: 109.0–171.9). Chinese men and women had the lowest risk of hospitalisation for any psychiatric disorder (35.3, 95% CI: 23.2–53.7 and 44.5, 95% CI: 30.3–65.5) and mood disorder (51.5, 95% CI: 31.0–85.4 and 47.5, 95% CI: 23.2–97.4) but not psychotic disorders and higher risk for CTO (181.4, 95% CI: 121.0–271.0). African women had higher risk of any psychiatric disorder (139.4, 95% CI: 119.0–163.2). African men and women had the highest risk for psychotic disorders (230.8, 95% CI: 177.8–299.5 and 240.7, 95% CI: 163.8–353.9) and were also overrepresented in STD (214.3, 95% CI: 122.4–375.0) and CTO (486.6, 95% CI: 231.9–1021.1). Differences in hospitalisations were not fully attenuated when adjusted for car ownership and housing tenure and the effect of these adjustments varied by ethnic group. ConclusionOur data show disparate patterns of psychiatric hospitalisations by ethnic group in Scotland providing new observations concerning the mental health care experience of Chinese, Mixed background and White subgroups not fully explained by socioeconomic indicators. For South Asian and Chinese groups in particular, our data indicate under and late utilisation of mental health services. These data call for monitoring and review of services. [ABSTRACT FROM AUTHOR]

Markedly raised incidence rates of schizophrenia and other psychotic disorders have been observed in several migrant and ethnic minority groups. To contribute to a better understanding of the elevated risk for psychotic disorders that is conferred by migration status, the present study examined effects associated with migration risk status on schizotypal personality traits, which are thought to reflect an underlying vulnerability to psychotic disorder. Effects of migration status were also compared to effects associated with a family history of psychopathology, which represents a robust nonspecific risk factor. We assessed schizotypal traits, using the Schizotypal Personality Questionnaire (SPQ), in a community-based sample of 62 Moroccan migrants and 41 Dutch nonmigrants, who were classified by the presence or absence of a family history of psychopathology. Overall, Moroccan migrants obtained higher SPQ scores than Dutch nonmigrants. However, migrants who had been classified as having a familial load of psychopathology displayed higher SPQ scores than migrants without such a family history, who in turn did not differ from Dutch nonmigrants. Furthermore, migrants with a familial load, relative to migrants without such a family history, reported higher levels of substance use and feelings of anxiety or depression, and perceived more often ethnic discrimination, which closely paralleled their SPQ scores. These findings indicate that primarily those migrants who are both intrinsically vulnerable and chronically exposed to social adversity, particularly ethnic discrimination, are at elevated risk for psychotic and other disorders. The results add to the evidence that migration status and perceived discrimination are associated with mental health. [ABSTRACT FROM AUTHOR]

This paper examines the views and experiences of using and providing mental health services from the perspectives of black African and black African Caribbean mental health service users, their carers, voluntary services and a range of statutory mental health professionals and commissioners in Birmingham, UK. Using a qualitative approach, data were collected through telephone interviews (n = 15), individual face-to-face (n = 20) and focus group interviews (n = 12), and analysed using Krueger's framework and Rabiee's guidelines. Findings showed differences in the experiences of mental health services amongst African Caribbean and their African counterparts, the impact of social inequality on mental health and the needs of asylum seekers and refugees. It highlighted the important role of voluntary organizations in provision of care and support, insufficient provision of psychological therapies and concerns about high dosage of medication. The implications for practice are discussed, particularly the role of health beliefs in help-seeking behaviour and barriers to accessibility of mental health services. [ABSTRACT FROM AUTHOR]

The present study examined Queensland Transcultural Mental Health Centre (QTMHC) client characteristics in order to provide a better understanding for development of future health service delivery models. Archived data that was collected for 1499 clients over a two year period (2007-2009) was analysed using descriptive statistics and c2. The results indicated that clients were referred from a range of sources and were generally adults. There were more women than men, who sought services. At least half of the clients had language barriers and relied on bilingual workers. Most frequently expressed mental health issues were mood disorder symptoms, followed by symptoms of schizophrenia and psychosis and anxiety. Acculturation strains and stressors were described as the most common psychosocial issues. Mental health and psychosocial issues differed for age, gender and world regions from which the CALD clients originated. The findings provided an understanding of clients who seek services at QTMHC. Various ways in which transcultural services and data bases can be further improved are discussed. [ABSTRACT FROM AUTHOR]

The present study examined the association between ethnicity and clinical characteristics of patients admitted to a psychiatric inpatient unit in Portugal. The only ethnicity-related terms routinely recorded in the medical records were "Black" (mainly from the African Portuguesespeaking countries of Cape Verde, Angola, Guinea, Sao Tome and Mozambique) and "White." Black immigrants appeared to be overrepresented, comprising 19.6% of inpatients; and were younger and more frequently male when compared with White inpatients. They were more frequently diagnosed with schizophrenia and acute or transient psychosis, and less frequently diagnosed with delusional and personality disorders than White inpatients. These results are consistent with previous studies in the US and UK, and highlight the need for more culturally sensitive care in mental health services. [ABSTRACT FROM AUTHOR]