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Aim and objectives: Describe patients' and family members' perceptions of family support from nurses and other mental healthcare professionals, and quality of care in community mental healthcare service. Further, compare the perceptions of patients and family members. Background: While patients value family involvement, family members feel unprepared and lack the necessary skills to be supportive. Since healthcare professionals predominantly focus on patients, they may fail to understand the complex needs of families. Family perceived support and quality of community mental health care may vary across patients and family members. Design and methods: Cross‐sectional study with patients suffering from mental illness and family members in community mental healthcare services in Norway. Altogether 86 participants, of whom 33 patients and 33 family members had a family relationship—paired samples. Participants filled in the translated version of the Iceland Family Perceived Support Questionnaire (FPSQ‐N) and Quality in Psychiatric Care—Community Out‐Patient (QPC‐COP) and Community Out‐Patient Next of Kin (QPC‐COPNK). STROBE checklist was used. Results: Family members scored family perceived support and quality of community mental health care lower than patients. Family members feel the loss of support. Patient and family members found the Patient—healthcare professionals' relationship to be of high quality, while family members gave low score to being respected and invited to take part in care by nurses and other mental healthcare professionals. Conclusion: Family members' unmet need of support highlights the need for nurses and other community mental healthcare professionals to assess complex family needs and to intervene. Barriers to collaboration exist, and family members need to be respected and invited into community mental health care. Relevance to clinical practice: Contributes knowledge of how to meet the family's needs and provides a basis for further care and treatment development in similar contexts nationally and internationally. [ABSTRACT FROM AUTHOR]

The aim of this study was to evaluate the usefulness of Family-Centered Support Conversations (FCSC) offered in community mental health care in Norway to young adults and their families experiencing mental illness. The FCSC is a family nursing intervention based on the Calgary Family Assessment and Intervention Models and the Illness Beliefs Model and is focused on how family members can be supportive to each other, how to identify strengths and resources of the family, and how to share and reflect on the experiences of everyday life together while living with mental illness. Interviews were conducted with young adults and their family members in Norway who had received the FCSC intervention and were analyzed using phenomenography. Two descriptive categories were identified: "Facilitating the sharing of reflections about everyday life" and "Possibility of change in everyday life." The family nursing conversations about family structure and function in the context of mental illness allowed families to find new meanings and possibilities in everyday life. Health care professionals can play an important role in facilitating a safe environment for young adults and their families to talk openly about the experience of living with and managing mental illness. [ABSTRACT FROM AUTHOR]

BackgroundThere is a need for interventions that effectively reduce compulsory admission to psychiatry. We conducted a randomised controlled trial to investigate whether an innovative intervention programme prevents compulsory re-admission in people with serious mental illness.MethodsThe programme addresses primarily patients’ self-management skills. It consists of individualised psychoeducation focusing on behaviours prior to and during illness-related crises, crisis cards and, after discharge from the psychiatric hospital, a 24-month preventive monitoring. A total of 238 inpatients with compulsory admission(s) in the past were randomised to the intervention group or to treatment as usual (TAU).ResultsFewer participants who completed the 24-month programme were compulsorily readmitted to psychiatry (28%), compared with those receiving TAU (43%). Likewise, the number of compulsory readmissions per patient was significantly lower (0.6 v. 1.0) and involuntary episodes were shorter (15 v. 31 days), compared with TAU. A negative binomial regression model showed a significant intervention effect (RR 0.6; 95% confidence interval 0.3–0.9); further factors linked to the risk of compulsory readmission were the number of compulsory admissions in the patient's history (RR 2.8), the diagnosis of a personality disorder (RR 2.8), or a psychotic disorder (RR 1.9). Dropouts (37% intervention group; 22% TAU) were characterised by a high number of compulsory admissions prior to the trial, younger age and foreign nationality.ConclusionsThis study suggests that this intervention is a feasible and valuable option to prevent compulsory re-hospitalisation in a high-risk group of people with severe mental health problems, social disabilities, and a history of hospitalisations. [ABSTRACT FROM AUTHOR]

Significant numbers of involuntary admissions and the fact that compulsory hospitalization is a drastic intervention in a patient’s life justify the introduction of preventive measures. This study looks at the five-year outcome of involuntary admissions after psychiatric emergency consultations in Amsterdam. A cohort of 460 involuntarily admitted patients was investigated prospectively. The annual numbers of involuntary readmissions and the utilization of mental health services were studied, with sociodemographic and clinical characteristics and psychiatric history as predictors. The odds ratios for involuntary readmission during the fourth and fifth follow-up years were 0.71 (95%CI = 0.50–1.01;P = 0.059) and 0.64 (95%CI = 0.45–0.92;P = 0.015), respectively. Readmission was associated with low discontinuity of treatment (Chi2P ≤ 0.001) and high total consumption of services (Chi2P ≤ 0.001) during follow-up. It emerged that involuntary readmission could be predicted on the basis of high care consumption five years before inclusion (OR 2.61 CI 1.44–4.73;P0.002), a history of involuntary admission (OR 1.56 CI = 1.03–2.35;P = 0.034), being older than 44 years at baseline (OR 0.57 CI = 0.39–0.84;P =0.007), and living alone (OR 1.68 CI = 1.22–02.33;P = 0.002). The risk of involuntary readmission declines after three years. In Amsterdam, low levels of treatment discontinuity and high levels of service use do not seem to reduce this risk for patients with severe and persistent psychiatric disorders. Our findings should be an incentive to explore and reappraise the methods employed in our current system of community mental health care. [ABSTRACT FROM PUBLISHER]

Contact with people with mental illness is considered to be a promising strategy to change stigmatizing attitudes. This study examines the underlying mechanisms of the association between contact and attitudes toward community mental health care. Data are derived from the 2009 survey 'Stigma in a Global Context-Belgian Mental Health Study', using the Community Mental Health Ideology-scale. Results show that people who received mental health treatment themselves or have a family member who has been treated for mental health problems report more tolerant attitudes toward community mental health care than people with public contact with people with mental illness. Besides, the perception of the effectiveness of the treatment seems to matter too. Furthermore, emotions arising from public contact are associated with attitudes toward community mental health care. The degree of intimacy and the characteristics of the contact relationship clarify the association between contact and attitudes toward community mental health care. [ABSTRACT FROM AUTHOR]

Accessible summary The aim of the study was to get a picture of the self-reported health and physical activity among persons with psychiatric disabilities who were community healthcare users in a community in Sweden. This was carried out through a questionnaire., Out of 319 eligible persons, 103 persons answered the questionnaire. The answers from the questionnaire showed that this group has a high impact of unhealthy risk factors, such as excess weight, low amount of physical activity and a low perceived state of health., About 20% of the participants wanted help with filling out the questionnaire. This was because of difficulties apprehending some of the questions. Helping these participants with the answering process showed complications with this given questionnaire but also highlighted the special considerations related to cognitive difficulties entailed with mental illness. This underlines the need for reflection upon what questions we ask, to whom and how., The results of this study point out that persons with psychiatric disabilities constitute a vulnerable group, in need of adequate health-promoting activities based upon the individual's conditions., Abstract The aim of the study was to survey the self-reported health and physical activity in a sample of community mental healthcare users in a city of Sweden. The study was conducted through a cross-sectional design with participants requested to fill out a self-report questionnaire. Participants ( n = 103) were persons with psychiatric disabilities living in residential psychiatric settings and/or participating in daily activities provided by community mental healthcare services. The results showed that the group is affected with serious risk factors, such as high body mass index, low rated extent and frequency of physical activity and low self-estimated general state of health. Even though some difficulties associated with the answering process of this questionnaire emerged, these self-reported results clearly confirm the fact that persons with psychiatric disabilities constitute a vulnerable group in need for health-promoting caring activities and interventions. [ABSTRACT FROM AUTHOR]

Abstract: Objectives: People with serious mental illness experience heightened physical ill-health. Physical activity is an effective strategy for improving physical health in this group. This paper explores nurse views on the place of physical activity in the physical health care of people with serious mental illness who are receiving mental health care services. Methods: A qualitative exploratory study involving 38 nurses working in a regional and remote area of Queensland, Australia. Focus group interviews were audio recorded and transcribed and a thematic analysis was conducted. Results: Holism was identified as the main theme and physical activity was thought about as an aspect of holism at the level of the person and environment. For nurses, holism equated with supporting consumers in being more physical active and having healthier lifestyles. This was qualified by the sub-themes of fragmentation (that rendered physical activity difficult for consumers, and the nurses supporting them), and integration (where nurses and colleagues sought to address fragmentation in conjunction with consumers, but with transient success). Conclusion: As part of their holistic outlook, nurses recognise the importance of physical activity for consumers'' overall health, and were involved in promoting physical activity through health education. When nurses tried to develop holism in mental health care (e.g. re-integrating services) sources of fragmentation were too significant and wide-ranging to overcome. [Copyright &y& Elsevier]

Mental health care epidemiology seeks to investigate the practical situation of the health care system and services for individuals with mental disorders. In the past decades, mental health care structures in Germany were successively transformed from long-term inpatient treatment capacities to decentralized outpatient and day clinic services. Currently, the proportional relation between treatment facilities in different settings has been stabilized and the strategy of mental health care development focuses on innovative and integrative models of care provision. The aim is to integrate fragmented services by the introduction of network structures to overcome rigid sector boundaries. The need for health care services is associated with multiple factors such as population-based epidemiological data, usage behavior, and health politics. Due to scarce data and poor standards of care it is difficult to determine if current structures of mental health services cover the actual needs. Therefore, a substantial increase of mental health service research is needed. [ABSTRACT FROM AUTHOR]

The article offers a description of a community outreach program developed and applied in Uganda. The program centers on providing effective mental health services in urban hospitals and improving access to psychiatric care to rural areas of the country. It is stated that rates of mental illnesses,which are due to poverty, high prevalence of HIVor AIDS, and severe exsposure to war and rebellion, are high initiating the development of such program.