scholarly journals Links between health-related social needs and mental health care disparities: Implications for clinical practice.

2020 ◽  
Vol 8 (2) ◽  
pp. 103-114
Author(s):  
Jocelyn Kuhn ◽  
Megan Bair-Merritt ◽  
Ziming Xuan ◽  
Caroline J. Kistin
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Clinical Practice ◽  
Mental Health Care ◽  
Health Care Disparities ◽  
Social Needs ◽  
Health Related

scholarly journals Cross-Sectional Study of Mental Health Related Knowledge and Attitudes Among Care Assistant Workers in Guangzhou, China

2020 ◽  
Author(s):  
Jie Li ◽  
Xiao-Ling Duan ◽  
Hua-Qing Zhong ◽  
Wen Chen ◽  
Sara Evans‑Lacko ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Disorders ◽  
Linear Regression ◽  
Mental Health Care ◽  
Health Staff ◽  
Care Providers ◽  
Knowledge And Attitudes ◽  
Additional Item ◽  
Health Related

Abstract Background: Care assistant workers (CAWs) are a part of a new pattern of mental health care providers in China and play a significant role in bridging the human resource shortage. CAWs in China mainly include community cadres, community mental health staff and community policemen. The mental health related knowledge and attitudes of CAWs could influence their mental health care delivery. This study aimed to assess the mental health related knowledge and attitudes of CAWs in Guangzhou, China. Methods: In November 2017, a study was conducted among 381 CAWs from four districts of Guangzhou, China. Participants were assessed using the Perceived Devaluation and Discrimination Scale (PDD), the Mental Health Knowledge Schedule (MAKS), and the Mental illness: Clinicians’ Attitudes (MICA). Data were analyzed by descriptive statistics, ANOVA, Bonferroni corrections and multivariable linear regression. Results: The mean scores (standard deviation) of PDD, MAKS and MICA were 36.45 (6.54), 22.72 (2.56), 51.67 (7.88), respectively. Univariate analyses showed that the older CAWs, community policemen and those who were less willing to deliver care had significant higher MICA scores when compared with other staff (P < 0.001). However, participants who disagreed additional item 1（views towards inpatients) and additional item 2 (affiliate stigma) had a significant lower MICA scores when compared with those who agreed (P < 0.001). Multivariable linear regression showed that after controlling some variables, care willingness and PDD total score were significantly positively associated with the MICA total score (all P < 0.05), while attitudes on additional items were significantly negatively associated with the MICA total score (all P < 0.01).Conclusion: These findings suggest negative attitudes towards people with mental disorders among CAWs are common, especially among older staff. Community policemen suggest that they applied stereotypes of ‘violent mentally ill’ people to all people they deal with who have mental disorders. The results also indicate human rights are being paid attention to now, but need to be improved in the future. Strategies to improve attitudes and to reduce stigma and discrimination should be conducted with particular staff groups.

scholarly journals Het contacteren van professionele hulpverleners omwille van sociale of emotionele problemen bij net‐gehuwde en net‐samenwonende koppels : de rol van partner- en relatiekenmerken

2013 ◽  
Vol 3 (8) ◽  
pp. 1-26
Author(s):  
Elien Colman ◽  
Veerle Buffel ◽  
Piet Bracke
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Male Partner ◽  
Health Care Use ◽  
Living Together ◽  
Individual Determinants ◽  
Partner Characteristics ◽  
Health Related ◽  
Mental Health Care Use

Onderzoek naar de determinanten van het gebruik van professionele hulpverlening omwille van sociale en emotionele problemen heeft zich tot nu toe hoofdzakelijk geconcentreerd op het belang van individuele kenmerken.  In deze bijdrage gaan we na of het zorggebruik van net‐gehuwde en net‐samenwonende mannen en vrouwen (N=798 koppels) ook beïnvloed wordt door hun partner, hun relatie (duur, gezondheidsgerelateerde steun en conflict) en het verbreken van een eerdere samenwoonrelatie. We vinden geen directe invloed van intieme relaties bij mannen, maar bij vrouwen vinden we dat diegenen die ooit gescheiden zijn en diegenen die veel conflicten hebben met hun partner een minder goede mentale gezondheid hebben en bijgevolg een grotere kans hebben om een professionele hulpverlener gecontacteerd te hebben. Uit de resultaten blijkt ook dat, los van de behoefte aan hulp, vrouwen minder vaak een professionele hulpverlener contacteren, naargelang ze langer samenwonen met hun partner. Het belang van deze resultaten voor verder onderzoek en het beleid worden besproken. Abstract : Although the literature on determinants of health care use has traditionally been concentrating on individual determinants, the couple can also be considered as an important entity in the study of mental health care use. We examine how the mental health care use of recently cohabiting or newlywed men and women (N=798 couples) is influenced by the mental health care use of their partner, characteristics of their relationship (years living together, health‐related support, conflict) and a broken cohabiting relationship. We find no direct effects of intimate relationships on men’s mental health care use. Among women, results show that those who have ever been separated and those who have more conflicts with their partner have a higher health care use, which can be attributed to their higher need for care. Results also show that the longer women live with their male partner, the less mental health care they consume.

Lost in Dialogue

2016 ◽  
Author(s):  
Giovanni Stanghellini
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Clinical Practice ◽  
Mental Disorders ◽  
Mental Health Care ◽  
External World ◽  
Life World ◽  
Therapeutic Practice ◽  
Mental Pathology ◽  
Unitary Concept

This book will build on and develop the assumption that to be human means to be in dialogue. Dialogue is a unitary concept that will attempt to address in a coherent way three essential issues for clinical practice: ‘What is a human being?’, ‘What is mental pathology?’, and ‘What is care?’. It will argue that to be human means to be in dialogue with alterity, that mental pathology is the outcome of a crisis of one’s dialogue with alterity, and that care is a method wherein dialogues take place whose aim is to re-enact interrupted dialogue with alterity within oneself and with the external world.This book is an attempt to re-establish such a fragile dialogue of the soul with herself and with others. Such an attempt is based on two pillars: a dialectic, person-centred understanding of mental disorders, and values-based practice. Building on and extending these two approaches, it aims to improve therapeutic practice in mental health care. Within this framework, care is a dialogue with a method—or better, a method wherein dialogues take place whose aim is to re-enact interrupted dialogue with alterity within oneself and with the external world. The method at issue includes devices and practices that belong both to logic—e.g. the method for unfolding the Other’s life-world and to rescue its fundamental structure—and empathy—e.g. the readiness to offer oneself as a dialoguing person, and the capacity to resonate with the Other’s experience and attune/regulate the emotional field.

scholarly journals Implementation of treatment guidelines for specialist mental health care

2014 ◽  
Vol 20 (2) ◽  
pp. 82-82
Author(s):  
C. Barbui ◽  
F. Girlanda ◽  
E. Ay ◽  
A. Cipriani ◽  
T. Becker ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Clinical Practice ◽  
Mental Health Care ◽  
Patient Outcomes ◽  
Psychotic Disorders ◽  
Treatment Guidelines ◽  
Evidence Base ◽  
Provider Performance

A huge gap exists between the production of evidence and its take-up in clinical practice settings. To fill this gap, treatment guidelines, based on explicit assessments of the evidence base, are commonly employed in several fields of medicine, including schizophrenia and related psychotic disorders. It remains unclear, however, whether treatment guidelines have any impact on provider performance and patient outcomes, and how implementation should be conducted to maximise benefit.

scholarly journals Pathways Into and Out of Homelessness Among People with Severe Mental Illness in Rural Ethiopia: A Qualitative Study

2020 ◽  
Author(s):  
Caroline Smartt ◽  
Kaleab Ketema ◽  
Souci Frissa ◽  
Bethlehem Tekola ◽  
Rahel Birhane ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Illness ◽  
Mental Health Care ◽  
Severe Mental Illness ◽  
Low Income ◽  
Community Intervention ◽  
Social Needs ◽  
Rural Setting ◽  
Study Participants

Abstract Background: Little is known about the pathways followed into and out of homelessness among people with severe mental illness (SMI) living in rural, low-income country settings. Understanding these pathways is essential for the development of effective interventions to address homelessness and promote recovery. The aim of this study was to explore pathways into and out of homelessness in people with SMI in rural Ethiopia.Methods: In-depth interviews were conducted with 15 people with SMI who had experienced homelessness and 11 caregivers. Study participants were identified through a larger project implementing a multi-component district level plan to improve access to mental health care in primary care (PRIME). Thematic analysis was conducted using an inductive approach.Results: Study participants reported different patterns of homelessness, with some having experienced chronic and others an intermittent course. Periods of homelessness occurred when family resources were overwhelmed or not meeting the needs of the person with SMI. The most important pathways into homelessness were reported to result from family conflict and the worsening of mental ill health, interplaying with substance use in many cases. Participants also mentioned escape and/or wanting a change in environment, financial problems, and discrimination from the community as contributing to them leaving the home. Pathways out of homelessness included contact with (mental and physical) health care as a catalyst to the mobilization of other supports, family and community intervention, and self-initiated return.Conclusions: Homelessness in people with SMI in this rural setting reflected complex health and social needs that were not matched by adequate care and support. Interventions to prevent and tackle homelessness need to focus on increasing family support, and ensuring access to housing, mental health care and social support.

scholarly journals Perceived Drivers and Barriers to the Adoption of eMental Health by Psychologists: The Construction of the Levels of Adoption of eMental Health Model (Preprint)

2017 ◽  
Author(s):  
Milou A Feijt ◽  
Yvonne AW de Kort ◽  
Inge MB Bongers ◽  
Wijnand A IJsselsteijn
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Clinical Practice ◽  
Mental Health Care ◽  
Health Care Professionals ◽  
Clinical Psychologists ◽  
Qualitative Descriptive ◽  
New Treatment ◽  
Health Model ◽  
Structured Representation

BACKGROUND The internet offers major opportunities in supporting mental health care, and a variety of technology-mediated mental and behavioral health services have been developed. Yet, despite growing evidence for the effectiveness of these services, their acceptance and use in clinical practice remains low. So far, the current literature still lacks a structured insight into the experienced drivers and barriers to the adoption of electronic mental health (eMental health) from the perspective of clinical psychologists. OBJECTIVE The aim of this study was to gain an in-depth and comprehensive understanding of the drivers and barriers for psychologists in adopting eMental health tools, adding to previous work by also assessing drivers and analyzing relationships among these factors, and subsequently by developing a structured representation of the obtained findings. METHODS The study adopted a qualitative descriptive approach consisting of in-depth semistructured interviews with clinical psychologists working in the Netherlands (N=12). On the basis of the findings, a model was constructed that was then examined through a communicative validation. RESULTS In general, a key driver for psychologists to adopt eMental health is the belief and experience that it can be beneficial to them or their clients. Perceived advantages that are novel to literature include the acceleration of the treatment process, increased intimacy of the therapeutic relationship, and new treatment possibilities due to eMental health. More importantly, a relation was found between the extent to which psychologists have adopted eMental health and the particular drivers and barriers they experience. This differentiation is incorporated in the Levels of Adoption of eMental Health (LAMH) model that was developed during this study to provide a structured representation of the factors that influence the adoption of eMental health. CONCLUSIONS The study identified both barriers and drivers, several of which are new to the literature and found a relationship between the nature and importance of the various drivers and barriers perceived by psychologists and the extent to which they have adopted eMental health. These findings were structured in a conceptual model to further enhance the current understanding. The LAMH model facilitates further research on the process of adopting eMental health, which will subsequently enable targeted recommendations with respect to technology, training, and clinical practice to ensure that mental health care professionals as well as their clients will benefit optimally from the current (and future) range of available eMental health options.

Identity and Agency

2014 ◽  
Author(s):  
George Graham
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Illness ◽  
Clinical Practice ◽  
Mental Health Care ◽  
Personal Identity ◽  
Subjective Experience ◽  
Moral Principles ◽  
Identity And Agency

Even the best moral principles for patient care and psychiatric ethics are likely to be misapplied or stumble in clinical practice, without sound and sensible recognition of how to understand the concepts of a patient’s personal identity and self-responsible or reflective agency. In this chapter I sketch an account of how personal identity and self-responsible agentive capacity are best described for understanding mental illness and in clinical practice. The account aims to be true to the subjective experience of reflective personhood and self-responsible agency as well as to the perspective of the mental health care clinician. Special attention is given to certain background moral principles that help to clinically frame the importance of patient identity and agency.

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