scholarly journals Evaluation of Tu Meke PHO’s Wairua Tangata Programme: a primary mental health initiative for underserved communities

2012 ◽  
Vol 4 (3) ◽  
pp. 242 ◽  
Author(s):  
Sally Abel ◽  
Bob Marshall ◽  
Donny Riki ◽  
Tania Luscombe
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Primary Health Care ◽  
Health Assessment ◽  
Target Population ◽  
Primary Care Providers ◽  
Health Needs ◽  
Care Providers ◽  
Mental Health Needs ◽  
Primary Health

BACKGROUND AND CONTEXT: New Zealand’s primary mental health initiatives (PMHIs) have successfully filled a health service gap and shown good outcomes for many presenting with mild to moderate anxiety/depression in primary health care settings. Maori have higher rates of mental health disorders and complexity of social and mental health needs not matched by access to PMHIs. ASSESSMENT OF PROBLEM: The Wairua Tangata Programme (WTP), a Hawkes Bay PMHI, aimed to provide an integrated, flexible, holistic, tikanga Maori–based therapeutic service targeting underserved Maori, Pacific and Quintile 5 populations. External evaluation of the programme provided formative and outcome feedback. RESULTS: The WTP reported high engagement of Maori (particularly women), low non-attendance rates, good improvements in mental health assessment exit scores, strong stakeholder support and service user gratitude. GPs reported willingness to explore mental health issues in this high needs population. Challenges included engaging Pacific peoples and males and recruiting from scarce Maori, Pacific and male therapist workforces. STRATEGIES FOR IMPROVEMENT: Effectively meeting the target population’s complex social and therapeutic needs required considerable programme flexibility, referral back into the programme and assistance with transitioning to other therapeutic or social support services. Referral criteria required adaptation to accommodate some sectors, especially youth. A group programme was developed specifically for males. LESSONS: A holistic PMHI programme delivered with considerable flexibility and a skilled, culturally fluent team working closely with primary care providers can successfully engage and benefit underserved Maori communities with complex social and mental health needs. Successful targeted programmes are integral to reducing mental health disparities. KEYWORDS: Primary health care; mental health; Maori; medically underserved areas; evaluation

Effectiveness of Primary Health Care Services in Addressing Mental Health Needs of Minority Refugee Population in New Zealand

2017 ◽  
Vol 38 (4) ◽  
pp. 290-300 ◽  
Author(s):  
Jagamaya Shrestha-Ranjit ◽  
Elizabeth Patterson ◽  
Elizabeth Manias ◽  
Deborah Payne ◽  
Jane Koziol-McLain
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Primary Health Care ◽  
New Zealand ◽  
Health Care Services ◽  
Health Needs ◽  
Mental Health Needs ◽  
Care Services ◽  
Primary Health ◽  
Primary Health Care Services

scholarly journals Does mental health needs vary as we grow from pediatrics to adults to elderly? Results from a study in Dubai

2017 ◽  
Vol 1 (1) ◽  
pp. 1
Author(s):  
Kadhim Alabady
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Primary Health Care ◽  
Psychiatric Morbidity ◽  
Mental Illnesses ◽  
Health Needs ◽  
Service Development ◽  
Mental Health Needs ◽  
Primary Health ◽  
The Impact

Purpose: To Provide a baseline of the current picture of major mental health challenges among men and women of different ages in Dubai. which can then be used to measure the impact of interventions or service development. Method: In order to carry out the mental health needs assessment we applied qualitative and quantitative methodology. Results: * The prevalence of people who suffer from different types of mental disorders remains largely unknown, many men and are unwilling to seek professional help because of lack of awareness or the stigma attached to it. * According to the Dubai Household Health Survey DHHS (2009) 14.5% of respondents reported moderate to severe depressive symptoms over a 2-week period. * It was predicted in 2014 that there would be 37,933 people suffering from psychotic disorders of which 29,747 were males. * It is estimated there would be 19,117 adults between the ages of 20 and 64 years with ASD in Dubai for 2014. *It was estimated around 548 residents in Dubai aged 60 years or more in 2014 had dementia (of which 338 were men). Recommendations: * Work is required with primary health care in order to identify men with undiagnosed mental illnesses. Further work is undertaken within primary health care to assess disease registries with the aim of helping GP practices to improve their disease registers. * It is important to conduct local psychiatric morbidity surveys in Dubai to obtain data and assess the prevalence of essential mental health symptoms and conditions. * Continuum of care - a significant gap in the services for adults once they diagnosed with mental disorder.)

scholarly journals Impact of mental health and addiction NIMHANS ECHO on primary care physicians: study from a rural state of India

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S157-S157
Author(s):  
Shabinabegam A M Sheth ◽  
Bhavya Bairy ◽  
Aurobind Ganesh ◽  
Sumi Jain ◽  
Prabhat Chand ◽  
...  
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Health Care ◽  
Primary Health Care ◽  
Health Care Providers ◽  
Mental Health Problems ◽  
Health Problems ◽  
Care Providers ◽  
Primary Health ◽  
Secondary Outcomes

AimsAs per National Mental Health Survey-2015-16, 83 out of 100 people having mental health problems do not have access to care in India. Further, primary health care providers (PCPs) have not been adequately trained in the screening, diagnosis, and initial management of common mental health conditions. There is thus a need to train health care providers at the State level to incorporate mental health into primary health care. In this paper, we report the findings of a collaborative project between the National Institute of Mental Health and Neuro Sciences (NIMHANS) Bangalore India, and the state of Chhattisgarh incorporating mental health into primary care and addressing urban-rural disparities through tele-mentoring.MethodWe assessed the impact of the NIMHANS Extended Community Health Care Outcome (ECHO), an online, blended training program on participants' knowledge and competence (primary outcome) and commitment, satisfaction, and performance (Secondary outcomes) using Moore's evaluation framework. Primary and secondary outcomes were determined through a pre-post evaluation, assessment of trainee participation in the quarterly tele ECHO clinic as well as periodic assignments, respectively.ResultOver ten months of the NIMHANS ECHO program, there was a significant improvement in the participants' knowledge post-ECHO (p < 0.05, t = −3.52). Self-efficacy in diagnosis and management of mental health problems approached significance; p < 0.001. Increased engagement in tele-ECHO sessions was associated with better performance for declarative and procedural knowledge. The attrition rate was low (5 out of 30 dropped out), and satisfaction ratings of the course were high across all fields. The participants reported a 10- fold increase in the number of patients with mental health problems they had seen, following the training. A statistically significant increase in the number of psychotropic drugs prescribed post ECHO with t = −3.295, p = 0.01.ConclusionThe outcomes indicate that the NIMHANS ECHO with high participant commitment is a model with capacity building potential in mental health and addiction for remote and rural areas by leveraging technology. This model has the potential to be expanded to other states in the country in providing mental health care to persons in need of care.

scholarly journals Does mhGAP training of primary health care providers improve the identification of child- and adolescent mental, neurological or substance use disorders? Results from a randomized controlled trial in Uganda

2018 ◽  
Vol 5 ◽  
Author(s):  
A. Akol ◽  
F. Makumbi ◽  
J. N. Babirye ◽  
J. S. Nalugya ◽  
S. Nshemereirwe ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Randomized Controlled Trial ◽  
Primary Health Care ◽  
Health Care Providers ◽  
Controlled Trial ◽  
Child And Adolescent ◽  
Care Providers ◽  
Randomized Controlled ◽  
Primary Health

Background.Integrating child and adolescent mental health (CAMH) into primary health care (PHC) using the WHO mental health gap action program (mhGAP) is recommended for closing a mental health treatment gap in low- and middle-income countries, but PHC providers have limited ability to detect CAMH disorders. We aimed to evaluate the effect of PHC provider mhGAP training on CAMH disorder identification in Eastern Uganda.Methods.Thirty-six PHC clinics participated in a randomized controlled trial which compared the proportion of intervention (n= 18) to control (n= 18) clinics with a non-epilepsy CAMH diagnosis over 3 consecutive months following mhGAP-oriented CAMH training. Fisher's exact test and logistic regression based on intention to treat principles were applied. (clinicaltrials.gov registration NCT02552056).Results.Nearly two thirds (63.8%, 23/36) of all clinics identified and recorded at least one non-epilepsy CAMH diagnosis from 40 692 clinic visits of patients aged 1–18 recorded over 4 months. The proportion of clinics with a non-epilepsy CAMH diagnosis prior to training was 27.7% (10/36, similar between study arms). Training did not significantly improve intervention clinics’ non-epilepsy CAMH diagnosis (13/18, 72.2%) relative to the control (7/18, 38.9%) arm,p= 0.092. The odds of identifying and recording a non-epilepsy CAMH diagnosis were 2.5 times higher in the intervention than control arms at the end of 3 months of follow-up [adj.OR 2.48; 95% CI (1.31–4.68);p= 0.005].Conclusion.In this setting, mhGAP CAMH training of PHC providers increases PHC clinics’ identification and reporting of non-epilepsy CAMH cases but this increase did not reach statistical significance.

Mothers’ perceptions of primary health-care providers: thematic analysis of responses to open-ended survey questions

2015 ◽  
Vol 21 (1) ◽  
pp. 58 ◽  
Author(s):  
L. Corr ◽  
H. Rowe ◽  
J. Fisher
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Primary Health Care ◽  
Health Care Providers ◽  
Family Health ◽  
Care Providers ◽  
Psychiatric Interview ◽  
Early Parenting ◽  
Primary Health ◽  
Maternal Child

General practitioners and maternal, child and family health nurses have a central role in postpartum primary health care for women and their infants. Positive client-provider relationships are particularly important for women experiencing mental health problems or unsettled infant behaviour. However, little is known about their experiences of postnatal primary health care. The study aimed to describe views of postnatal primary health care among women completing a residential early parenting programme and to identify potential strategies to enhance provider-patient interactions. Participants (n = 138) were women admitted with their infants to a private or a public early parenting service in Melbourne, Australia. Women completed a detailed self-report survey, including open-ended questions about experiences of primary health-care services, and a structured psychiatric interview to diagnose anxiety and depression. Survey responses were analysed thematically. Womens’ experiences of primary health care were influenced by their perceptions of provider competence and the quality of interactions. While similar positive characteristics of doctor and nurse care were valued, medical and nursing practices were judged in different ways. Women described GPs who listened, understood and were thorough as providing good care, and maternal, child and family health nurses were valued for providing support, advice and encouragement. Threats to therapeutic relationships with doctors included feeling rushed during consultations, believing that GPs were not mental health-care providers and the clinician not being ‘good’ with the infant; with nurses, problems included feeling judged or given advice that was inconsistent or lacked an evidence-base. Postpartum primary health care will be improved by unhurried consultations, empathic recognition, encouragement, evidence-informed guidance and absence of criticism.

scholarly journals Availability and Implementation of Guidelines in European Child Primary Health Care: How Can We Improve?

2021 ◽  
Author(s):  
Paul Kocken ◽  
Nicole Van Kesteren ◽  
Renate Van Zoonen ◽  
Sijmen Reijneveld
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Primary Health Care ◽  
Clinical Guidelines ◽  
Health Assessment ◽  
Policy Support ◽  
Financial Resources ◽  
Asthma Care ◽  
Mental Health Assessment ◽  
Primary Health

Abstract Clinical guidelines are important for providing high-quality child primary health care. We aimed to assess the availability, use and achieved delivery of guidelines and the European Union (EU). We used a case study design to ascertain expert views on the guideline availability and implementation in six countries representing the EU. The experts completed an online questionnaire (response 49%) on guidelines regarding three topics that represent prevention, physical and mental health care, i.e. vaccination, asthma care and assessment of mental health of children. All countries had guidelines available for asthma care. For vaccination and mental health assessment respondents less agreed that guidelines were available. Implementation of guidelines for vaccination was mostly as intended, but implementation of the guidelines for asthma care and mental health assessment was limited. Notable barriers were complexity of performance, lack of training of professionals or financial resources. Important facilitators for guideline implementation were the fit with routine practice, knowledge and skills of professionals and policy support. We found no clear relationship of guideline availability and implementation with the country’s type of child primary health care system, though strong governance and sufficient financial resources seemed important for guideline availability.Conclusion: Availability and implementation of clinical guidelines in child primary health care vary between EU countries. Implementation conditions can be strongly improved by adequate training of professionals, stronger governance and sufficient financial resources as facilitating factors. This can yield major gains in child health across Europe.

scholarly journals Provision of mental health care within primary care in Peru: A qualitative study exploring the perspectives of psychologists, primary health care providers, and patients

2018 ◽  
Vol 3 ◽  
pp. 9 ◽  
Author(s):  
Victoria Cavero ◽  
Francisco Diez-Canseco ◽  
Mauricio Toyama ◽  
Gustavo Flórez Salcedo ◽  
Alessandra Ipince ◽  
...  
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Health Care ◽  
Primary Health Care ◽  
Mental Health Care ◽  
Health Care Providers ◽  
Care Providers ◽  
Perceived Need ◽  
Primary Health ◽  
Primary Health Care Providers

Background: This study aimed to understand the offer of mental health care at the primary care level, collecting the views of psychologists, primary health care providers (PHCPs), and patients, with a focus on health services in which patients attend regularly and who present a higher prevalence of mental disorders. Methods: A qualitative study was conducted in antenatal care, tuberculosis, HIV/AIDS, and chronic diseases services from six primary health care centers. Semi-structured interviews were conducted with psychologists, PHCPs, and patients working in or attending the selected facilities.  Results: A total of 4 psychologists, 22 PHCPs, and 37 patients were interviewed. A high perceived need for mental health care was noted. PHCPs acknowledged the emotional impact physical health conditions have on their patients and mentioned that referral to psychologists was reserved only for serious problems. Their approach to emotional problems was providing emotional support (includes listening, talk about their patients’ feelings, provide advice). PHCPs identified system-level barriers about the specialized mental health care, including a shortage of psychologists and an overwhelming demand, which results in brief consultations and lack in continuity of care. Psychologists focus their work on individual consultations; however, consultations were brief, did not follow a standardized model of care, and most patients attend only once. Psychologists also mentioned the lack of collaborative work among other healthcare providers. Despite these limitations, interviewed patients declared that they were willing to seek specialized care if advised and considered the psychologist's care provided as helpful; however, they recognized the stigmatization related to seeking mental health care. Conclusions: There is a perceived need of mental health care for primary care patients. To attend these needs, PHCPs provide emotional support and refer to psychology the most severe cases, while psychologists provide one-to-one consultations. Significant limitations in the care provided are discussed.

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