scholarly journals Choice in mental health: myths and possibilities

2007 ◽  
Vol 13 (1) ◽  
pp. 60-67 ◽  
Author(s):  
Koravangattu Menon Valsraj ◽  
Nichola Gardner
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Social Inclusion ◽  
Mental Health Problems ◽  
National Policy ◽  
Mental Healthcare ◽  
Policy Makers ◽  
Healthcare Model ◽  
The Government

The government in England and Wales is promoting policies and initiatives to offer patients choice across all healthcare specialties. This has raised concerns in mental healthcare, particularly if the physical healthcare model of implementation is imposed. However, the ‘choice agenda’ is an opportunity for mental health services to be innovative and act as beacons to other disciplines in healthcare. The south-east London programme introducing choice in mental health services is offered as an example here. There already exists an ‘ethos of choice’ within mental health services, but current practices may require a focused approach and structuring to fit in with national policy. This also might be necessary to influence policy makers to take a different perspective on choice in mental health. The principle of choice goes hand in hand with the drive towards greater social inclusion for people with mental health problems.

scholarly journals The global challenge of providing mental health services in poverty: the situation of Northern Haiti

2021 ◽  
pp. 1-4
Author(s):  
Jude Mary Cénat ◽  
Boniface Harerimana ◽  
Guesly Michel ◽  
Sara-Emilie McIntee ◽  
Joana N. Mukunzi ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Health Centre ◽  
Mental Healthcare ◽  
Health Issues ◽  
Physical Pain ◽  
Policy Makers ◽  
Global Challenge ◽  
Mental Health Centre

When people living in poverty are asked to describe their living conditions, mental health issues quickly come to mind (grief, sadness, anger, fear, bitterness, frustration, discontent, anxiety, and emotional damage consisting of low mood and depression, fatigue, hypersensitivity, sleep difficulties and physical pain). Although the association between poverty and mental health have been widely demonstrated in the literature, care must be taken to avoid the psychiatrization of poverty. However, how can healthcare be provided to people living in poverty when basic needs are not met? This article explores the global challenge of providing mental health services in impoverished populations, using the example of the poorest country in America: Haiti. It examines the availability of services offered through the Mental Health Centre at Morne Pelé, and the necessity for innovative and comprehensive approaches to provide culturally appropriate care that meets the real needs of populations. It highlights effective measures that policy makers should implement to develop an efficient mental healthcare system based on the lessons of the Mental Health Centre at Morne Pelé.

scholarly journals Young Adults in Nature-Based Services in Norway—In-Group and Between-Group Variations Related to Mental Health Problems

2018 ◽  
Vol 9 ◽  
pp. 110-133
Author(s):  
Anne Mari Steigen ◽  
Bengt Eriksson ◽  
Ragnfrid Eline Kogstad ◽  
Helge Prytz Toft ◽  
Daniel Bergh
Keyword(s):  
Mental Health ◽  
Young Adults ◽  
Mental Health Services ◽  
General Population ◽  
Health Services ◽  
Mental Health Problems ◽  
Population Sample ◽  
Mental Healthcare ◽  
Health Problems ◽  
Local Mental Health

Young adults with mental health problems who do not attend school or work constitute a significant welfare challenge in Norway. The welfare services available to these individuals include nature-based services, which are primarily located on farms and integrate the natural and agricultural environment into their daily activities. The aim of this study is to examine young adults (16–30 years old) not attending school or work who participated in nature-based services in Norway. In particular, the study analyses mental health problems among the participants and in-group variations regarding their symptoms of mental health problems using the Hopkins Symptoms Checklist (HSCL-10). This paper compares symptoms of mental health problems among participants in nature-based services with those of a sample from the general population and a sample of those receiving clinical in-patient mental healthcare. A questionnaire was developed for the study and was completed by 93 participants in nature-based services. The majority of these participants were recruited from the Norwegian Labour and Welfare Administration (NAV), local mental health services, and school authorities. Results indicate that just more than half of the respondents exhibited symptoms of mental health problems based on their HSCL-10 scores. In general, they reported fewer symptoms than the clinical in-patient sample (18–30 years old) and more symptoms than the general population sample (18–19 years old). Among the participants in nature-based services, those recruited through NAV and local mental health services exhibited no differences in symptoms. Half of the participants older than 23 years in nature-based services had not completed upper secondary school. The participants, including those with symptoms of mental health problems and low expectations at the outset of their participation, generally expressed high satisfaction with the services.

scholarly journals Challenges during the transition from child and adolescent mental health services to adult mental health services

2020 ◽  
Vol 44 (4) ◽  
pp. 163-168 ◽  
Author(s):  
Gaelle Hendrickx ◽  
Veronique De Roeck ◽  
Athanasios Maras ◽  
Gwen Dieleman ◽  
Suzanne Gerritsen ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Young People ◽  
Health Services ◽  
Mental Health Problems ◽  
Mental Healthcare ◽  
Transition Process ◽  
Child And Adolescent ◽  
Smooth Transition ◽  
Adult Mental Health

The transition from child and adolescent to adult mental health services for young people with mental health problems is of international concern. Despite the high prevalence of mental disorders during adolescence and their tendency to continue during adulthood, the majority of young people do not experience continuity of care. The aim of this review paper is to unravel the complexity of transitional mental healthcare to clinicians, policy makers and mental health service managers, and to address challenges to a smooth transition process at all levels.

scholarly journals Culturally adapted mental healthcare: evidence, problems and recommendations

2015 ◽  
Vol 39 (4) ◽  
pp. 153-155 ◽  
Author(s):  
Sokratis Dinos
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Mental Health Professionals ◽  
Minority Groups ◽  
Mental Health Problems ◽  
Mental Healthcare ◽  
Health Problems ◽  
Cultural Adaptations ◽  
Culturally Adapted

SummaryEvidence suggests disparities in the prevalence of mental health problems and access to mental healthcare for a number of minority groups. The main response from mental health services falls into two related categories: (a) cultural adaptations of existing evidence-based interventions (EBIs) and/or (b) cultural competence of mental health professionals. This editorial looks at the evidence on culturally adapted EBIs and argues that although such interventions can be effective, they also carry the risk of alienating members of the groups they are aimed at. Recommendations focus on identifying issues that pertain to being from a racial minority and/or possessing other stigmatised identities that can have an impact on mental health problems, which may be overlooked by mental health services by assuming an overarching predominant cultural identity.

scholarly journals Process, outcome and experience of transition from child to adult mental healthcare: multiperspective study

2010 ◽  
Vol 197 (4) ◽  
pp. 305-312 ◽  
Author(s):  
Swaran P. Singh ◽  
Moli Paul ◽  
Tamsin Ford ◽  
Tami Kramer ◽  
Tim Weaver ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Information Transfer ◽  
Mental Health Problems ◽  
Transition Planning ◽  
Qualitative Interviews ◽  
Mental Healthcare ◽  
Transition Process ◽  
Service Users

BackgroundMany adolescents with mental health problems experience transition of care from child and adolescent mental health services (CAMHS) to adult mental health services (AMHS).AimsAs part of the TRACK study we evaluated the process, outcomes and user and carer experience of transition from CAMHS to AMHS.MethodWe identified a cohort of service users crossing the CAMHS/AMHS boundary over 1 year across six mental health trusts in England. We tracked their journey to determine predictors of optimal transition and conducted qualitative interviews with a subsample of users, their carers and clinicians on how transition was experienced.ResultsOf 154 individuals who crossed the transition boundary in 1 year, 90 were actual referrals (i.e. they made a transition to AMHS), and 64 were potential referrals (i.e. were either not referred to AMHS or not accepted by AMHS). Individuals with a history of severe mental illness, being on medication or having been admitted were more likely to make a transition than those with neurodevelopmental disorders, emotional/neurotic disorders and emerging personality disorder. Optimal transition, defined as adequate transition planning, good information transfer across teams, joint working between teams and continuity of care following transition, was experienced by less than 5% of those who made a transition. Following transition, most service users stayed engaged with AMHS and reported improvement in their mental health.ConclusionsFor the vast majority of service users, transition from CAMHS to AMHS is poorly planned, poorly executed and poorly experienced. The transition process accentuates pre-existing barriers between CAMHS and AMHS.

The ghettoization of persons with severe mental illnesses

2019 ◽  
Vol 23 (1) ◽  
pp. 53-57 ◽  
Author(s):  
Janet Laura Stewart
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Health Research ◽  
Social Inclusion ◽  
Mental Healthcare ◽  
Mental Health Research ◽  
Mental Illnesses ◽  
Support Worker ◽  
Content Type

Purpose The purpose of this paper is to outline the reflections of a person with lived experience of a severe mental illness (SMI) and former peer support worker in Montreal, Quebec, Canada, who has also worked for seven years in mental health research. It describes a tendency of resources and services to create ghettos of people with SMIs by failing to support the integration of people with SMIs into the community at large or in exploring options for meaningful, fulfilling occupation, reinforcing social exclusion and ghettoization. Design/methodology/approach This paper shows a reflective and narrative account of personal experiences and observations of the ghettoizing tendency in mental health services. Findings Mental healthcare professionals tend to support people with SMIs in engaging activities within resources for the mentally ill, and not in carrying out activities in the community at large. The range of activities offered is limited, an obstacle to finding meaningful, fulfilling occupation. Harmful psychological effects include self-stigma, low self-esteem and a sense of marginalization, generating a ghettoized mentality. The difficulties encountered in an effort to leave the mental health ghetto are touched on with examples of how to overcome them. Practical implications The need for professional support for social integration of people with SMIs is identified, which could ultimately favor social inclusion of people with SMIs. Originality/value It is written from the perspective of a user and provider of mental health services, who also has seven years’ experience in mental health research.

scholarly journals “I wouldn’t know where to start”: Perspectives from clinicians, agency leaders, and autistic adults on improving community mental health services for autistic adults

Autism ◽  
2019 ◽  
Vol 24 (4) ◽  
pp. 919-930 ◽  
Author(s):  
Brenna B Maddox ◽  
Samantha Crabbe ◽  
Rinad S Beidas ◽  
Lauren Brookman-Frazee ◽  
Carolyn C Cannuscio ◽  
...  
Keyword(s):  
Mental Health ◽  
Developmental Disabilities ◽  
Mental Health Services ◽  
Community Mental Health ◽  
Health Services ◽  
Mental Health Problems ◽  
Mental Healthcare ◽  
Community Mental Health Services ◽  
The United States ◽  
Autistic Adults

Most autistic adults struggle with mental health problems, and traditional mental health services generally do not meet their needs. This study used qualitative methods to identify ways to improve community mental health services for autistic adults for treatment of their co-occurring psychiatric conditions. We conducted semistructured, open-ended interviews with 22 autistic adults with mental healthcare experience, 44 community mental health clinicians, and 11 community mental health agency leaders in the United States. The participants identified clinician-, client-, and systems-level barriers and facilitators to providing quality mental healthcare to autistic adults. Across all three stakeholder groups, most of the reported barriers involved clinicians’ limited knowledge, lack of experience, poor competence, and low confidence working with autistic adults. All three groups also discussed the disconnect between the community mental health and developmental disabilities systems, which can result in autistic adults being turned away from services when they contact the mental health division and disclose their autism diagnosis during the intake process. Further efforts are needed to train clinicians to work more effectively with autistic adults and to increase coordination between the mental health and developmental disabilities systems. Lay Abstract Most autistic adults struggle with mental health problems, such as anxiety and depression. However, they often have trouble finding effective mental health treatment in their community. The goal of this study was to identify ways to improve community mental health services for autistic adults. We interviewed 22 autistic adults with mental healthcare experience, 44 community mental health clinicians (outpatient therapists, case managers, and intake coordinators), and 11 community mental health agency leaders in the United States. Our participants identified a variety of barriers to providing quality mental healthcare to autistic adults. Across all three groups, most of the reported barriers involved clinicians’ limited knowledge, lack of experience, poor competence, and low confidence working with autistic adults. All three groups also discussed the disconnect between the community mental health and developmental disabilities systems and the need to improve communication between these two systems. Further efforts are needed to train clinicians and provide follow-up consultation to work more effectively with autistic adults. A common suggestion from all three groups was to include autistic adults in creating and delivering the clinician training. The autistic participants provided concrete recommendations for clinicians, such as consider sensory issues, slow the pace, incorporate special interests, use direct language, and set clear expectations. Our findings also highlight a need for community education about co-occurring psychiatric conditions with autism and available treatments, in order to increase awareness about treatment options.

scholarly journals Attitudes and perceived barriers to mental healthcare in the People’s Liberation Army Navy: study from a navy base

2020 ◽  
pp. jramc-2019-001396 ◽  
Author(s):  
Ren-Ping Gu ◽  
X R Liu ◽  
X F Ye
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Mental Health Problems ◽  
Mental Healthcare ◽  
Health Problems ◽  
Perceived Barriers ◽  
People's Liberation Army ◽  
Willingness To Seek Help ◽  
People’S Liberation Army

IntroductionThe People’s Liberation Army (PLA, China) Navy is increasingly conducting military operations other than war overseas. Factors such as confrontations with pirates, special environments and long sailing times have resulted in mental health problems. However, the navy’s actual utilisation of mental health services is low. This study examined members’ rate of willingness to seek help and the factors that act as barriers to willingness to seek mental health services in the PLA Navy.MethodsThis cross-sectional study was conducted at the Zhoushan Base, operated by the East Sea Fleet, between March 2019 and April 2019. We distributed a 12-item questionnaire to examine participants’ attitudes and perceived barriers to mental healthcare. We recruited 676 navy personnel. Participants’ willingness to seek help if they had mental health problems was also assessed.ResultsThe response rate was 99%. A total of 88.44% of the sample reported being willing to seek help. Univariate analysis suggested that those not willing to seek help were more likely to agree with the items, ‘Mental healthcare does not work’ and ‘My unit leadership might treat me differently’ and all organisational barriers, and they were more likely to have concerns about ‘embarrassment’ and ‘being weak’ than those willing to seek help. After controlling for demographic characteristics, binary logistic regression analyses confirmed that a lack of knowledge regarding the location of mental health clinics and being perceived as weak were the main factors preventing participants’ willingness from seeking help.ConclusionsExtensive efforts to decrease organisational barriers and stigma towards mental healthcare should be a priority for researchers and policymakers to improve the usage of mental health services. Psychoeducation aimed at de-stigmatising mental health problems should be delivered and the accessibility and availability of mental health services should be increased.

scholarly journals Barriers to Accessing Mental Health Services Among Syrian Refugees in Ankara

2021 ◽  
Author(s):  
Cengiz Kilic ◽  
Edip Kaya ◽  
Ozge Karadag ◽  
Sarp Uner
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Mental Health Problems ◽  
Population Sample ◽  
Mental Healthcare ◽  
Health Problems ◽  
Syrian Refugees ◽  
Cross Sectional ◽  
Perceived Need

Abstract Background: Syrian refugees are seriously traumatized by the conflict in their country. Consequently, mental health problems, particularly depression and PTSD, are prevalent among refugees. Despite this fact, they make little use of mental health services. Using a population sample of Syrian refugees living in Ankara, we assessed the perceived need for and contact with mental health services, as well as the barriers to access these services.Methods: This was a cross-sectional study of 420 Syrian refugees living in Ankara city center, using face to face interviews administered at the respondents’ home by trained, Arabic-speaking interviewers. The data were collected in October–November 2016 in two neighborhoods of Ankara, where most of Syrian refugees were concentrated. PTSD and depression were assessed using Harvard Trauma Questionnaire and Beck Depression Inventory, respectively. Both measures have been validated in Arabic.Results: Of all the refugees in our sample, 14.8% (N=62) stated that they felt the need for mental healthcare since arriving in Turkey. The actual number contacting any mental health service, however, was very low (N=6). Multivariate analyses revealed that traumatic stress scores predicted the perceived need for contacting services. Though women reported much higher need for contact with mental health services than men, there was no gender effect on actual contact. Speaking Turkish seemed to increase contact with services, which is in line with language being listed as the most important barrier to accessing care. Conclusions: Our results show that, although refugees with mental health problems are more likely to contact services than others, most of those who need mental health care go untreated, and there is a significant gender inequity in this regard. To address this treatment gap, and to provide adequate care for refugees with mental health problems, common barriers (language, stigma, and awareness) should be identified and dealt with.

scholarly journals Community-based Mental Health Services in Norway

10.17816/cp43 ◽  
2021 ◽  
Vol 2 (1) ◽  
pp. 47-54
Author(s):  
Torleif Ruud ◽  
Svein Friis
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Mental Health Problems ◽  
Service Providers ◽  
Mental Healthcare ◽  
Mental Illnesses ◽  
Community Treatment ◽  
Community Based ◽  
Catchment Areas

Community-based mental healthcare in Norway consists of local community mental health centres (CMHCs) collaborating with general practitioners and primary mental healthcare in the municipalities, and with psychiatrists and psychologists working in private practices. The CMHCs were developed from the 1980s to give a broad range of comprehensive mental health services in local catchment areas. The CMHCs have outpatient clinics, mobile teams, and inpatient wards. They serve the larger group of patients needing specialized mental healthcare, and they also collaborate with the hospital-based mental health services. Both CMHCs and hospitals are operated by 19 health trusts with public funding. Increasing resources in community-based mental healthcare was a major aim in a national plan for mental health between 1999 and 2008. The number of beds has decreased in CMHCs the last decade, while there has been an increase in mobile teams including crisis resolution teams (CRTs), early intervention teams for psychosis and assertive community treatment teams (ACT teams). Team-based care for mental health problems is also part of primary care, including care for patients with severe mental illnesses. Involuntary inpatient admissions mainly take place at hospitals, but CMHCs may continue such admissions and give community treatment orders for involuntary treatment in the community. The increasing specialization of mental health services are considered to have improved services. However, this may also have resulted in more fragmented services and less continuity of care from service providers whom the patients know and trust. This can be a particular problem for patients with severe mental illnesses. As the outcomes of routine mental health services are usually not measured, the effects of community-based mental care for the patients and their families, are mostly unknown.

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