A qualitative investigation of promotores’ perspectives on task-shifting evidence-based mental health care for Latinxs in a rural community.

2020 ◽  
Author(s):  
Araceli Gonzalez ◽  
Louise Dixon ◽  
Francisco Reinosa Segovia ◽  
Denise A. Chavira
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Rural Community ◽  
Task Shifting ◽  
Evidence Based ◽  
Qualitative Investigation

scholarly journals Alternative medicine under the Mental Health Care Act, 2017: Future implications and concerns

2022 ◽  
Vol 07 (01) ◽  
pp. 37-41
Author(s):  
Ramdas Ransing ◽  
Sujita Kumar Kar ◽  
Vikas Menon
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Alternative Medicine ◽  
Mental Healthcare ◽  
Evidence Base ◽  
Evidence Based ◽  
Insufficient Evidence ◽  
Indian Government ◽  
Evidence Based Care

In recent years, the Indian government has been promoting healthcare with an insufficient evidence base, or which is non-evidence-based, alongside delivery of evidence-based care by untrained practitioners, through supportive legislation and guidelines. The Mental Health Care Act, 2017, is a unique example of a law endorsing such practices. In this paper, we aim to highlight the positive and negative implications of such practices for the delivery of good quality mental healthcare in India.

Mental Health Care Interventions in Child Welfare: Integrative Review of Evidence-Based Literature

2018 ◽  
Vol 39 (9) ◽  
pp. 746-756
Author(s):  
Mari Lahti ◽  
Merle Linno ◽  
Janika Pael ◽  
Margit Lenk-Adusoo ◽  
Eeva Timonen-Kallio
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Child Welfare ◽  
Mental Health Care ◽  
Integrative Review ◽  
Evidence Based ◽  
Health Care Interventions

scholarly journals Evaluating agency-led adaptions to an evidence-based lifestyle intervention for adults with serious mental illness

2020 ◽  
Vol 1 ◽  
pp. 263348952094320
Author(s):  
Kelly A Aschbrenner ◽  
Gary R Bond ◽  
Sarah I Pratt ◽  
Kenneth Jue ◽  
Gail Williams ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Illness ◽  
Mental Health Care ◽  
Serious Mental Illness ◽  
Real World ◽  
Evidence Based ◽  
Cardiovascular Risk Reduction ◽  
Evidence Based Practices ◽  
Practical Advantage

Background: Limited empirical evidence exists on the impact of adaptations that occur in implementing evidence-based practices (EBPs) in real-world practice settings. The purpose of this study was to measure and evaluate adaptations to an EBP (InSHAPE) for obesity in persons with serious mental illness in a national implementation in mental health care settings. Methods: We conducted telephone interviews with InSHAPE provider teams at 37 (95%) of 39 study sites during 24-month follow-up of a cluster randomized trial of implementation strategies for InSHAPE at behavioral health organizations. Our team rated adaptations as fidelity-consistent or fidelity-inconsistent. Multilevel regression models were used to estimate the relationship between adaptations and implementation and participant outcomes. Results: Of 37 sites interviewed, 28 sites (76%) made adaptations to InSHAPE ( M = 2.1, SD = 1.3). Sixteen sites (43%) made fidelity-consistent adaptations, while 22 (60%) made fidelity-inconsistent adaptations. The number of fidelity-inconsistent adaptations was negatively associated with InSHAPE fidelity scores (β = −4.29; p < .05). A greater number of adaptations were associated with significantly higher odds of participant-level cardiovascular risk reduction (odds ratio [ OR] = 1.40; confidence interval [CI] = [1.08, 1.80]; p < .05). With respect to the type of adaptation, we found a significant positive association between the number of fidelity-inconsistent adaptations and cardiovascular risk reduction ( OR = 1.59; CI = [1.01, 2.51]; p < .05). This was largely explained by the fidelity-inconsistent adaptation of holding exercise sessions at the mental health agency versus a fitness facility in the community (a core form of InSHAPE) ( OR = 2.52; 95% CI = [1.11, 5.70]; p < .05). Conclusions: This research suggests that adaptations to an evidence-based lifestyle program were common during implementation in real-world mental health practice settings even when fidelity was monitored and reinforced through implementation interventions. Results suggest that adaptations, including those that are fidelity-inconsistent, can be positively associated with improved participant outcomes when they provide a potential practical advantage while maintaining the core function of the intervention. Plain language abstract: Treatments that have been proven to work in research studies are not always one-size-fits-all. In real-world clinical settings where people receive mental health care, sometimes there are good reasons to change certain things about a treatment. For example, a particular treatment might not fit well in a specific clinic or cultural context, or it might not meet the needs of specific patient groups. We studied adaptations to an evidence-based practice (InSHAPE) targeting obesity in persons with serious mental illness made by teams implementing the program in routine mental health care settings. We learned that adaptations to InSHAPE were common, and that an adaptation that model experts initially viewed as inconsistent with fidelity to the model turned out to have a positive impact on participant health outcomes. The results of this study may encourage researchers and model experts to work collaboratively with mental health agencies and clinicians implementing evidence-based practices to consider allowing for and guiding adaptations that provide a potential practical advantage while maintaining the core purpose of the intervention.

Cowboys and Pirates in Mental Health Care: A Musical Autoethnography

2020 ◽  
pp. 153270862097065
Author(s):  
David Carless
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Evidence Based Medicine ◽  
Spoken Word ◽  
Evidence Based ◽  
Health Care Professions ◽  
Personal Consequences ◽  
Or Organization ◽  
Based Medicine

A cowboy can be defined as “an unscrupulous tradesman” and a pirate can be “a person or organization broadcasting without official authorisation.” Looking through a subversive lens, I see both cowboys and pirates operating within the mental health care professions. Cowboys can be validated, authorized, rewarded, and empowered through the machinery of evidence-based medicine. Pirates may be criticized, restricted, marginalized, or dismissed by the same machinery. Through a layered performance of song and spoken word, I explore some of the personal consequences of all this for those living—and suffering—within differing paradigms of health care.

scholarly journals Meditation-Based Lifestyle Modification: Development of an Integrative Mind-Body Program for Mental Health and Human Flourishing

2020 ◽  
pp. 1-11
Author(s):  
Holger Carl Bringmann ◽  
Nicole Bringmann ◽  
Michael Jeitler ◽  
Stefan Brunnhuber ◽  
Andreas Michalsen ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Lifestyle Modification ◽  
Complex Interventions ◽  
Evidence Based ◽  
Processes Of Change ◽  
Clinical Context ◽  
Human Flourishing ◽  
Spiritual Perspectives

Mental disorders are a core health challenge in the 21st century. Integrative mental health care takes an individual, lifestyle-modifying, salutogenic approach, combining somatic, psychosocial, and spiritual perspectives from evidence-based conventional and complementary medicine. In particular, meditation and mindfulness have received growing research interest in the last decade. In this article, we present Meditation-Based Lifestyle Modification (MBLM), a new, complex mind-body intervention for mental health care. It is the first program to intensify meditation practice using classical yoga. The program (a) covers all areas of classical yoga, (b) considers ethical and spiritual aspects of daily life, (c) orients participants toward sustained lifestyle modification, and (d) is applicable in a clinical context. The scientific rationale of the program is outlined in this article, based on the Criteria for Reporting the Development and Evaluation of Complex Interventions in Healthcare. Further research is planned to show the clinical feasibility of MBLM and evaluate its efficacy, processes of change, and cost-effectiveness.

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