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.

ICD-11 Psychotic Disorders: Preliminary Results of the Case-controlled Studies and the Russian Opinion

2017 ◽  
Vol 41 (S1) ◽  
pp. S227-S227
Author(s):  
M. Kulygina ◽  
V. Krasnov ◽  
P. Ponisovskiy ◽  
J. Keeley ◽  
G. Reed
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Clinical Practice ◽  
Mental Health Care ◽  
Health Care Professionals ◽  
Psychotic Disorders ◽  
Field Studies ◽  
General Situation ◽  
Internet Study ◽  
Competing Interest

IntroductionOne of the WHO's innovations for improving the ICD-11 chapter Mental and Behavioral Disorders was the creation of the Global Clinical Practice Network (GCPN), an international network of more than 12,000 mental health and primary care professionals from 144 countries.Aims and objectivesIn order to evaluate perceived clinical utility of the ICD-11 guidelines, the case-controlled field studies that involved the application of the proposed diagnostic guidelines to standardized case material were implemented via the Internet in different languages.MethodTwo hundred and seventy-eight Russian mental health care professionals, the GCPN members, have participated in case controlled Internet study for the chapter “Schizophrenia and Other Primary Psychotic Disorders”. Russian participants were represented by psychiatrists mostly (89%) and much less by psychologists (8%) which corresponds with the general situation in the Russian mental health care system.ResultsRussian clinicians have used the proposed ICD-11 diagnostic guidelines successfully to assess delusional disorder as well as schizophrenia. But there were certain categories (schizoaffective disorder, subthreshold delusions) with which the participants seemed to struggle. The critical comments were focused on opposing so called syndrome-based assessment and nosological diagnostics. Most concerns were about elimination of Schizophrenia subtypes.ConclusionRussian mental health care professionals proved to be interested in ICD revision process and demonstrated their special diagnostics opinion based on rich clinical traditions and psychopathological approach. In order to use ICD-11 guidelines in clinical practice more efficiently supplementary appropriate training would be needed.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Place of Structured Psychotherapies in Clinical Practice

2003 ◽  
Vol 11 (2) ◽  
pp. 204-208 ◽  
Author(s):  
Michael Robertson
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Illness ◽  
Psychological Distress ◽  
Clinical Practice ◽  
Mental Health Care ◽  
Cost Effective ◽  
Evidence Base ◽  
Social Model ◽  
Cost Effective Alternative

Objective: To critically evaluate the place of structured psychotherapies in contemporary psychiatric practice. Conclusions: Structured psychotherapies are a valuable intervention in psychiatrists’ management of mental illness and psychological distress. They enjoy the support of a solid evidence base of efficacy, although the information provided by empirical research is misleading if not balanced with the wisdom of clinical experience. These treatments do not represent a cost-effective alternative to longer-term therapies. In the hands of experienced clinicians, structured psychotherapies can be highly effective in a variety of practice settings and help to deliver quality mental health care along the bio-psycho-social model.

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.

Conclusion: Successes Since the First Edition and Pressing Issues for the Future of Adolescent Mental and Behavioral Health

2017 ◽  
pp. 633-638
Author(s):  
Daniel Romer
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Behavioral Health ◽  
Youth Development ◽  
Development Strategy ◽  
Evidence Base ◽  
Gun Violence ◽  
Delivery Of Care ◽  
Health Care Practitioners

Despite improvements in the delivery of care for adolescent mental and behavioral conditions since the first edition of this book, many challenges remain. This concluding chapter highlights some of the most pressing issues. These include the need for more mental health care practitioners, a greater evidence base for the treatment of adolescent conditions, and more focus on reducing family poverty. Given the high rates of gun violence, including homicides and suicides, efforts are needed to reduce access to these weapons. Promising directions in research and the need for a national youth development strategy are also discussed.

scholarly journals Admission experiences of psychiatric patients in tertiary care: An implication toward Mental Health Care Bill, 2013

2017 ◽  
Vol 08 (01) ◽  
pp. 089-095 ◽  
Author(s):  
Vijayalakshmi Poreddi ◽  
Rajalakshmi Ramu ◽  
Sugavana Selvi ◽  
Sailaxmi Gandhi ◽  
Lalitha Krishnasamy ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Psychiatric Hospital ◽  
Psychotic Disorders ◽  
Psychiatric Patients ◽  
Care Center ◽  
Tertiary Care ◽  
Perceived Coercion ◽  
Negative Pressures

ABSTRACT Background: Coercion is not uncommon phenomenon among mental health service users during their admission into psychiatric hospital. Research on perceived coercion of psychiatric patients is limited from India. Aim: To investigate perceived coercion of psychiatric patients during admission into a tertiary care psychiatric hospital. Materials and Methods: This was a cross-sectional descriptive survey carried out among randomly selected psychiatric patients (n = 205) at a tertiary care center. Data were collected through face-to-face interviews using structured questionnaire. Results: Our findings revealed that participants experienced low levels of coercion during their admission process. However, a majority of the participants were threatened with commitment (71.7%) as well as they were sad (67.8%), unpleased (69.7%), confused (73.2%), and frightened (71.2%) with regard to hospitalization into a psychiatric hospital. In addition, the participants expressed higher levels of negative pressures (mean ± standard deviation, 3.76 ± 2.12). Participants those were admitted involuntarily (P > 0.001), diagnosed to be having psychotic disorders (P > 0.003), and unmarried (P > 0.04) perceived higher levels of coercion. Conclusion: The present study showed that more formal coercion was experienced by the patients those got admitted involuntarily. On the contrary, participants with voluntary admission encountered informal coercion (negative pressures). There is an urgent need to modify the Mental Health Care (MHC) Bill so that treatment of persons with mental illness is facilitated. Family member plays an important role in providing MHC; hence, they need to be empowered.

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.

The evidence base for mental health care

2009 ◽  
pp. 49-70
Author(s):  
Graham Thornicroft ◽  
Michele Tansella
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Evidence Base

Descriptive study of patients with intellectual disability attended in a community mental health care center

2017 ◽  
Vol 41 (S1) ◽  
pp. S599-S600
Author(s):  
S. Oller Canet ◽  
E. Pérez Sánchez ◽  
L. Alba Pale ◽  
E. Mur Mila ◽  
B. Samsó Buixareu ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Intellectual Disability ◽  
Community Mental Health ◽  
Mental Health Care ◽  
Aggressive Behavior ◽  
Psychotic Disorders ◽  
Care Center ◽  
Community Mental Health Care ◽  
Health Care Center

IntroductionThe rate of mental illness among people with intellectual disability is at least 2.5 times higher than in the general population [1].ObjectiveTo describe the clinical and sociodemographic characteristics of all patients with intellectual disability treated in a community mental health care center (CMH) located in a city of 120,000 inhabitants on the outskirts of Barcelona with a high poverty index.MethodsDocuments and patient records were reviewed. Clinical, sociodemographic and other treatment data of patients with intellectual disability treated at the CMH were collected.ResultsThe sample consisted of 118 patients. Mean age: 39.5 (SD: 15), 54% men. 92% single and 23.7% legally incapacitated. 46.6% never completed basic education and 44.1% completed primary school. Employment status: 14.4% unemployed, 14.4% currently active, and 50% pensioned. Patients living mainly with their family (parents:) 86%. 68.6% of patients showed aggressive behavior, but the rate of hospital psychiatric admissions was low (mean: 1.1 (SD: 2.3)). Organic comorbidity: 44.9%. Functionality measured with GAF mean: 45 (SD: 12). Level of intellectual disability was mostly mild (62%). Psychiatric diagnoses were: psychotic disorders: 49.25%, affective disorders: 6.8%, personality disorder: 3.4%, Obsessive-compulsive disorder: 3.4%, autism: 11.9% and other diagnoses: 37.3%. Patients treated with anti-psychotics: 78.8%, anti-depressants: 40.7%, and mood stabilizers: 70.5%.ConclusionsIntellectually disabled patients from our sample showed high comorbidity with psychotic disorders, were highly medicated and often exhibited aggressive behavior.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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