scholarly journals Process evaluation of a district mental healthcare plan in Nepal: a mixed-methods case study

BJPsych Open ◽  
2020 ◽  
Vol 6 (4) ◽  
Author(s):  
Nagendra P. Luitel ◽  
Erica Breuer ◽  
Anup Adhikari ◽  
Brandon A. Kohrt ◽  
Crick Lund ◽  
...  
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Mental Health Services ◽  
Health Services ◽  
Health Workers ◽  
Mental Healthcare ◽  
Healthcare Plan ◽  
Facilitating Factors ◽  
Psychotropic Medicines

Background The PRogramme for Improving Mental Health carE (PRIME) evaluated the process and outcomes of the implementation of a mental healthcare plan (MHCP) in Chitwan, Nepal. Aims To describe the process of implementation, the barriers and facilitating factors, and to evaluate the process indicators of the MHCP. Method A case study design that combined qualitative and quantitative methods based on a programme theory of change (ToC) was used and included: (a) district-, community- and health-facility profiles; (b) monthly implementation logs; (c) pre- and post-training evaluation; (d) out-patient clinical data and (e) qualitative interviews with patients and caregivers. Results The MHCP was able to achieve most of the indicators outlined by the ToC. Of the total 32 indicators, 21 (66%) were fully achieved, 10 (31%) partially achieved and 1 (3%) were not achieved at all. The proportion of primary care patients that received mental health services increased by 1200% over the 3-year implementation period. Major barriers included frequent transfer of trained health workers, lack of confidential space for consultation, no mental health supervision in the existing system, and stigma. Involvement of Ministry of Health, procurement of new psychotropic medicines through PRIME, motivation of health workers and the development of a new supervision system were key facilitating factors. Conclusions Effective implementation of mental health services in primary care settings require interventions to increase demand for services and to ensure there is clinical supervision for health workers, private rooms for consultations, a separate cadre of psychosocial workers and a regular supply of psychotropic medicines.

scholarly journals Delivering a complex mental health intervention in low-resource settings: lessons from the implementation of the PRIME mental healthcare plan in primary care in Sehore district, Madhya Pradesh, India

BJPsych Open ◽  
2019 ◽  
Vol 5 (05) ◽  
Author(s):  
Rahul Shidhaye ◽  
Vaibhav Murhar ◽  
Shital Muke ◽  
Ritu Shrivastava ◽  
Azaz Khan ◽  
...  
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Mental Health Services ◽  
Health Services ◽  
Mental Healthcare ◽  
Madhya Pradesh ◽  
Low Resource Settings ◽  
Low Resource ◽  
Implementation Processes ◽  
Healthcare Plan

BackgroundThe PRogramme for Improving Mental health care (PRIME) designed, implemented and evaluated a comprehensive mental healthcare plan (MHCP) for Sehore district, Madhya Pradesh, India.AimsTo provide quantitative measures of outputs related to implementation processes, describe the role of contextual factors that facilitated and impeded implementation processes, and discuss what has been learned from the MHCP implementation.MethodA convergent parallel mixed-methods design was used. The quantitative strand consisted of process data on mental health indicators whereas the qualitative strand consisted of in-depth interviews and focus group discussions with key stakeholders involved in PRIME implementation.ResultsThe implementation of the MHCP in Sehore district in Madhya Pradesh, India, demonstrated that it is feasible to establish structures (for example Mann-Kaksha) and operationalise processes to integrate mental health services in a ‘real-world’ low-resource primary care setting. The key lessons can be summarised as: (a) clear ‘process maps’ of clinical interventions and implementation steps are helpful in monitoring/tracking the progress; (b) implementation support from an external team, in addition to training of service providers, is essential to provide clinical supervision and address the implementation barriers; (c) the enabling packages of the MHCP play a crucial role in strengthening the health system and improving the context/settings for implementation; and (d) engagement with key community stakeholders and incentives for community health workers are necessary to deliver services at the community-platform level.ConclusionsThe PRIME implementation model could be used to scale-up mental health services across India and similar low-resource settings.Declaration of interestNone.

scholarly journals Readiness to Deliver Person-Focused Care in A Fragile Situation: The Case of Mental Health Services in Lebanon

2020 ◽  
Author(s):  
Aya Noubani ◽  
Karin Diaconu ◽  
Giulia Loffreda ◽  
Shadi Saleh
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Health Care ◽  
Mental Health Services ◽  
Health Services ◽  
Health System ◽  
Health Care Providers ◽  
Mental Healthcare ◽  
Care Providers ◽  
Health Seeking

Abstract Background: Evidence suggests wide variability in the provision of mental healthcare across countries. Countries experiencing fragility related risks suffer from a high burden of mental-ill health and additionally have limited capacity to scale up mental health services given financial and human resource shortages. Integration of mental health services into routine primary care is one potential strategy for enhancing service availability, however little is known about the experiences of currently active health care providers involved in mental health and psychosocial support (MHPSS) service provision at primary care level. This study aims to determine how healthcare providers offering MHPSS services at primary care levels in Lebanon perceive mental health and the health system’s ability to address the rising mental ill-health burden with a view to identify opportunities for strengthening MHPSS service implementation geared towards integrated person focused care model.Methods: A qualitative study design was adopted including 15 semi-structured interviews and 2 participatory group model-building workshops with health care providers (HCPs) involved in mental healthcare delivery at primary care level. Participants were recruited from two contrasting fragility contexts (Beirut and Beqaa). During workshops, causal loop diagrams depicting shared understandings of factors leading to stress and mental ill health, associated health seeking behaviors, and challenges and barriers within the health system were elicited. This research is part of a larger study focused on understanding the dynamics shaping mental health perceptions and health seeking behaviours among community members residing in Lebanon. Results: Findings are organized around a causal loop diagram depicting three central dynamics as described by workshop participants. First, participants linked financial constraints at household levels and the inability to secure one’s livelihood with contextual socio-political stressors, principally referring to integration challenges between host communities and Syrian refugees. In a second dynamic, participants linked exposure to war, conflict and displacement to the occurrence of traumatic events and high levels of distress as well as tense family and community relations. Finally, participants described a third dynamic linking cultural norms and patriarchal systems to exposure to violence and intergenerational trauma among Lebanon’s populations. When describing help-seeking pathways, participants noted the strong influence of social stigma within both the community and among health professionals; the latter was noted to negatively affect patient-provider relationships. Participants additionally spoke of difficulties in the delivery of mental health services and linked this to the design of the health system itself, noting the current system being geared towards patient centered care, which focuses on the patient’s experiences with a disease only, rather than person focused care where providers and patients acknowledge broader structural and social influences on health and work together to reach appropriate decisions for tackling health and other social needs. Barriers to delivery of person focused care include the lack of coherent mental health information systems, limited human capacity to deliver MHPSS services among primary health care staff and inadequate service integration and coordination among the many providers of mental health services in our study contexts. Critically however, provider accounts demonstrate readiness and willingness of health professionals to engage with integrated person focused care models of care.Conclusion: Mental ill health is a major public health problem with implications for individual health and wellbeing; in a fragile context such as Lebanon, the burden of mental ill health is expected to rise and this presents substantive challenges for the existing health system. Concrete multi-sectoral efforts and investments are required to 1) reduce stigma and improve public perceptions surrounding mental ill health and associated needs for care seeking and 2) promote the implementation of integrated person focused care for addressing mental health.

scholarly journals Readiness to deliver person‐focused care in a fragile situation: the case of Mental Health Services in Lebanon

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Aya Noubani ◽  
Karin Diaconu ◽  
Giulia Loffreda ◽  
Shadi Saleh
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Health Care ◽  
Mental Health Services ◽  
Health Services ◽  
Health System ◽  
Health Care Providers ◽  
Mental Healthcare ◽  
Care Providers ◽  
Health Seeking

Abstract Background Evidence suggests wide variability in the provision of mental healthcare across countries. Countries experiencing fragility related risks suffer from a high burden of mental-ill health and additionally have limited capacity to scale up mental health services given financial and human resource shortages. Integration of mental health services into routine primary care is one potential strategy for enhancing service availability, however little is known about the experiences of currently active health care providers involved in mental health and psychosocial support service (MHPSS) provision at primary care level. This study aims to determine how healthcare providers offering MHPSS services at primary care levels in Lebanon perceive mental health and the health system’s ability to address the rising mental ill-health burden with a view to identify opportunities for strengthening MHPSS service implementation geared towards integrated person focused care model. Methods A qualitative study design was adopted including 15 semi-structured interviews and 2 participatory group model-building workshops with health care providers (HCPs) involved in mental healthcare delivery at primary care level. Participants were recruited from two contrasting fragility contexts (Beirut and Beqaa). During workshops, causal loop diagrams depicting shared understandings of factors leading to stress and mental ill health, associated health seeking behaviors, and challenges and barriers within the health system were elicited. This research is part of a larger study focused on understanding the dynamics shaping mental health perceptions and health seeking behaviours among community members residing in Lebanon. Results Findings are organized around a causal loop diagram depicting three central dynamics as described by workshop participants. First, participants linked financial constraints at household levels and the inability to secure one’s livelihood with contextual socio-political stressors, principally referring to integration challenges between host communities and Syrian refugees. In a second dynamic, participants linked exposure to war, conflict and displacement to the occurrence of traumatic events and high levels of distress as well as tense family and community relations. Finally, participants described a third dynamic linking cultural norms and patriarchal systems to exposure to violence and intergenerational trauma among Lebanon’s populations. When describing help-seeking pathways, participants noted the strong influence of social stigma within both the community and among health professionals; the latter was noted to negatively affect patient-provider relationships. Participants additionally spoke of difficulties in the delivery of mental health services and linked this to the design of the health system itself, noting the current system being geared towards patient centered care, which focuses on the patient’s experiences with a disease only, rather than person focused care where providers and patients acknowledge broader structural and social influences on health and work together to reach appropriate decisions for tackling health and other social needs. Barriers to delivery of person focused care include the lack of coherent mental health information systems, limited human capacity to deliver MHPSS services among primary health care staff and inadequate service integration and coordination among the many providers of mental health services in our study contexts. Critically however, provider accounts demonstrate readiness and willingness of health professionals to engage with integrated person focused care models of care. Conclusions Mental ill health is a major public health problem with implications for individual health and wellbeing; in a fragile context such as Lebanon, the burden of mental ill health is expected to rise and this presents substantive challenges for the existing health system. Concrete multi-sectoral efforts and investments are required to (1) reduce stigma and improve public perceptions surrounding mental ill health and associated needs for care seeking and (2) promote the implementation of integrated person focused care for addressing mental health.

scholarly journals A qualitative study of experiences of NHS mental healthcare workers during the Covid-19 pandemic

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Elisa Liberati ◽  
Natalie Richards ◽  
Janet Willars ◽  
David Scott ◽  
Nicola Boydell ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Healthcare Workers ◽  
Clinical Decision Making ◽  
Health Workers ◽  
Comparative Method ◽  
Mental Healthcare ◽  
Community Mental Health Services ◽  
Clinical Decision

Abstract Background The Covid-19 pandemic has imposed extraordinary strains on healthcare workers. But, in contrast with acute settings, relatively little attention has been given to those who work in mental health settings. We aimed to characterise the experiences of those working in English NHS secondary mental health services during the first wave of the pandemic. Methods The design was a qualitative interview-based study. We conducted semi-structured, remote (telephone or online) interviews with 35 members of staff from NHS secondary (inpatient and community) mental health services in England. Analysis was based on the constant comparative method. Results Participants reported wide-ranging changes in the organisation of secondary mental health care and the nature of work in response to the pandemic, including pausing of all services deemed to be “non-essential”, deployment of staff across services to new and unfamiliar roles, and moves to remote working. The quality of participants’ working life was impaired by increasing levels of daily challenge associated with trying to provide care in trying and constrained circumstances, the problems of forging new ways of working remotely, and constraints on ability to access informal support. Participants were confronted with difficult dilemmas relating to clinical decision-making, prioritisation of care, and compromises in ability to perform the therapeutic function of their roles. Other dilemmas centred on trying to balance the risks of controlling infection with the need for human contact. Many reported features of moral injury linked to their perceived failures in providing the quality or level of care that they felt service users needed. They sometimes sought to compensate for deficits in care through increased advocacy, taking on additional tasks, or making exceptions, but this led to further personal strain. Many experienced feelings of grief, helplessness, isolation, distress, and burnout. These problems were compounded by sometimes poor communication about service changes and by staff feeling that they could not take time off because of the potential impact on others. Some reported feeling poorly supported by organisations. Conclusions Mental health workers faced multiple adversities during the pandemic that were highly consequential for their wellbeing. These findings can help in identifying targets for support.

scholarly journals Use of Mental Health Services for Patients Diagnosed with Major Depressive Disorders in Primary Care

2021 ◽  
Vol 18 (3) ◽  
pp. 885
Author(s):  
Laura González-Suñer ◽  
Cristina Carbonell-Duacastella ◽  
Ignacio Aznar-Lou ◽  
Maria Rubio-Valera ◽  
Maria Iglesias-González ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Mental Health ◽  
Primary Care ◽  
Mental Health Services ◽  
Health Services ◽  
Depressive Disorders ◽  
Mental Healthcare ◽  
Major Depressive ◽  
Use Of Services

Major depressive disorder (MDD) is one of the most disabling diseases worldwide, generating high use of health services. Previous studies have shown that Mental Health Services (MHS) use is associated with patient and Family Physician (FP) factors. The aim of this study was to investigate MHS use in a naturalistic sample of MDD outpatients and the factors influencing use of services in specialized psychiatric care, to know the natural mental healthcare pathway. Non-randomized clinical trial including newly depressed Primary Care (PC) patients (n = 263) with a 12-month follow-up (from 2013 to 2015). Patient sociodemographic variables were assessed along with clinical variables (mental disorder diagnosis, severity of depression or anxiety, quality of life, disability, beliefs about illness and medication). FP (n = 53) variables were also evaluated. A multilevel logistic regression analysis was performed to assess factors associated with public or private MHS use. Subjects were clustered by FP. Having previously used MHS was associated with the use of MHS. The use of public MHS was associated with worse perception of quality of life. No other sociodemographic, clinical, nor FP variables were associated with the use of MHS. Patient self-perception is a factor that influences the use of services, in addition to having used them before. This is in line with Value-Based Healthcare, which propose to put the focus on the patient, who is the one who must define which health outcomes are relevant to him.

scholarly journals Experiences of NHS Mental Healthcare Workers During the Covid-19 Pandemic: Qualitative Study

2021 ◽  
Author(s):  
Elisa Liberati ◽  
Natalie Richards ◽  
Janet Willars ◽  
David Scott ◽  
Nicola Boydell ◽  
...  
Keyword(s):  
Mental Health ◽  
Decision Making ◽  
Mental Health Services ◽  
Health Services ◽  
Healthcare Workers ◽  
Clinical Decision Making ◽  
Health Workers ◽  
Comparative Method ◽  
Mental Healthcare ◽  
Community Mental Health Services

Abstract Background: The Covid-19 pandemic has imposed extraordinary strains on healthcare workers, but, in contrast with acute settings, relatively little attention has been given to those who work in mental health settings. We aimed to characterise the experiences of those working in English NHS secondary mental health services during the first wave of the pandemic.Methods: The design was a qualitative interview-based study. We conducted semi-structured, remote (telephone or online) interviews with 35 members of staff from NHS secondary (inpatient and community) mental health services in England. Analysis was based on the constant comparative method. Results: Participants reported wide-ranging changes in the organisation of secondary mental health care and the nature of work in response to the pandemic, including pausing of all services deemed to be “non-essential”, deployment of staff across services to new and unfamiliar roles, and moves to remote working. The quality of participants’ working life was impaired by increasing levels of daily challenge associated with trying to provide care in trying and constrained circumstances, the problems of forging new ways of working remotely, and constraints on ability to access informal support for decision-making. Participants were confronted with difficult dilemmas relating to clinical decision-making, prioritisation of care, and compromises in ability to perform the therapeutic function of their roles. Other dilemmas centred on trying to balance the risks of controlling infection with the need for human contact. Many reported features of moral injury linked to their perceived failures in providing the quality or level of care that they felt service users needed. They sometimes sought to compensate for deficits in care through increased advocacy, taking on additional tasks, or making exceptions, but this led to further personal strain. Many experienced feelings of grief, helplessness, isolation, distress, and burnout. These problems were compounded by sometimes poor communication about service changes and by staff feeling that they could not take time off because of the potential impact on others. Some reported feeling poorly supported by organisations. Conclusions: Mental health workers faced multiple adversities during the pandemic that were highly consequential for their wellbeing. These findings help in identifying targets for support.

scholarly journals Integrating Mental Health into Primary Care Using a Population Based Approach: Six Years Outcome of Aro Primary Care Mental Health Programme for Ogun State, Nigeria

2018 ◽  
Vol 3 (2) ◽  
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Health Care ◽  
Primary Health Care ◽  
Mental Health Services ◽  
Health Services ◽  
Health Workers ◽  
Population Based ◽  
Ogun State ◽  
Primary Health

Introduction: Integration of mental health services into Primary Health Care (PHC) is a proven way of reducing the treatment gap in developing countries. A major constraint to scaling up mental health services in developing countries is scarcity of mental health professionals. A practical solution is to adopt task shifting and task sharing strategies involving Primary Health Care Workers (PHW). One of the major challenges of such integrative services is their long term outcomes and sustainability. The Neuropsychiatric Hospital Aro, Abeokuta, Nigeria embarked on mental health services provision across primary health care facilities in Ogun state six (6) years ago. Objective: This report describes the development, challenges of the programme and presents a post-implementation evaluation after 6 years of its commencement. Methods: Applying a population based expansion of pilot- tested integration model of Aro Primary Care Mental Health Programme (APCMHP) for Ogun State, 80 PHC workers were trained using an adapted mental health Gap Action Programme (mhGAP) intervention guide to assess and treat/refer 5 priority conditions: Psychosis, Depression, Epilepsy, Alcohol and Substance abuse and Other Significant Emotional Complaints (OSEC).There was mental health service provision in 40 designated PHC centers across Ogun state. There was support and supervision of the trained health workers by field supervisors, supplementary training and re-training for skill sustenance, periodic stakeholders meeting with Local Government Service Commission, zonal consultants’ review, financial and other resources commitment by the hospital, monthly programme evaluation and monitoring by the faculty members. We reviewed caseload of patients managed by trained PHC Workers since commencement of the programme in November 2011 till October 2017 (6 years period) using descriptive statistics. Appropriate ethical approval was obtained. Results: During the six-year period (November 2011-October 2017), 2194 cases (average of 366 new cases yearly) were identified and treated by Trained Health Workers (THWs). About 90% of cases were Psychosis and Epilepsy. There was a steady attrition of THWs and at the end of the sixth year only 29% of the THWs remained within the programme. Treatment outcomes were fair as over 50% of patients had ≥ 3 follow-up visits, symptom remission of ≥ 30% and a subjective improvement in Global Ratings. Conclusion: Our project has demonstrated that it is feasible, practicable and cost effective with community acceptance to scale up mental health services at primary care setting in Nigeria using adapted mhGAP-IG document. The need to understand the dynamics and econometrics of sustainable primary mental health services is indicated.

scholarly journals Status of primary and secondary mental healthcare of people with severe mental illness: an epidemiological study from the UK PARTNERS2 programme

BJPsych Open ◽  
2021 ◽  
Vol 7 (2) ◽  
Author(s):  
Siobhan Reilly ◽  
Catherine McCabe ◽  
Natalie Marchevsky ◽  
Maria Green ◽  
Linda Davies ◽  
...  
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Mental Illness ◽  
Mental Health Services ◽  
Health Services ◽  
Severe Mental Illness ◽  
Medical Records ◽  
Secondary Care ◽  
Mental Healthcare ◽  
The Uk

Background There is global interest in the reconfiguration of community mental health services, including primary care, to improve clinical and cost effectiveness. Aims This study seeks to describe patterns of service use, continuity of care, health risks, physical healthcare monitoring and the balance between primary and secondary mental healthcare for people with severe mental illness in receipt of secondary mental healthcare in the UK. Method We conducted an epidemiological medical records review in three UK sites. We identified 297 cases randomly selected from the three participating mental health services. Data were manually extracted from electronic patient medical records from both secondary and primary care, for a 2-year period (2012–2014). Continuous data were summarised by mean and s.d. or median and interquartile range (IQR). Categorical data were summarised as percentages. Results The majority of care was from secondary care practitioners: of the 18 210 direct contacts recorded, 76% were from secondary care (median, 36.5; IQR, 14–68) and 24% were from primary care (median, 10; IQR, 5–20). There was evidence of poor longitudinal continuity: in primary care, 31% of people had poor longitudinal continuity (Modified Modified Continuity Index ≤0.5), and 43% had a single named care coordinator in secondary care services over the 2 years. Conclusions The study indicates scope for improvement in supporting mental health service delivery in primary care. Greater knowledge of how care is organised presents an opportunity to ensure some rebalancing of the care that all people with severe mental illness receive, when they need it. A future publication will examine differences between the three sites that participated in this study.

scholarly journals Impact of integrated district level mental health care on clinical and functioning outcomes of people with depression and alcohol use disorder in Nepal: a non-randomised controlled study

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
M. J. D. Jordans ◽  
E. C. Garman ◽  
N. P. Luitel ◽  
B. A. Kohrt ◽  
C. Lund ◽  
...  
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Alcohol Use ◽  
Mental Health Services ◽  
Health Services ◽  
Health Workers ◽  
Psychological Treatment ◽  
Controlled Study ◽  
Primary Care Mental Health ◽  
Treatment Groups

Abstract Background Integration of mental health services into primary healthcare is proliferating in low-resource countries. We aimed to evaluate the impact of different compositions of primary care mental health services for depression and alcohol use disorder (AUD), when compared to usual primary care services. Methods We conducted a non-randomized controlled study in rural Nepal. We compared treatment outcomes among patients screening positive and receiving: (a) primary care mental health services without a psychological treatment component (TG); (b) the same services including a psychological treatment (TG + P); and (c) primary care treatment as usual (TAU). Primary outcomes included change in depression and AUD symptoms, as well as disability. Disability was measured using the 12-item WHO Disability Assessment Schedule. Symptom severity was assessed using the 9-item Patient Health Questionnaire for depression, the 10-item Alcohol Use Disorders Identification Test for AUD. We used negative binomial regression models for the analysis. Results For depression, when combining both treatment groups (TG, n = 77 and TG + P, n = 60) compared to TAU (n = 72), there were no significant improvements. When only comparing the psychological treatment group (TG + P) with TAU, there were significant improvements for symptoms and disability (aβ = − 2.64; 95%CI − 4.55 to − 0.74, p = 0.007; aβ = − 12.20; 95%CI − 19.79 to − 4.62; p = 0.002, respectively). For AUD, when combining both treatment groups (TG, n = 92 and TG + P, n = 80) compared to TAU (n = 57), there were significant improvements in AUD symptoms and disability (aβ = − 15.13; 95%CI − 18.63 to − 11.63, p < 0.001; aβ = − 9.26; 95%CI − 16.41 to − 2.12, p = 0.011; respectively). For AUD, there were no differences between TG and TG + P. Patients’ perceptions of health workers’ skills in common psychological factors were associated with improvement in depression patient outcomes (β = − 0.36; 95%CI − 0.55 to − 0.18; p < 0.001) but not for AUD patients. Conclusion Primary care mental health services for depression may only be effective when psychological treatments are included. Health workers’ competencies as perceived by patients may be an important indicator for treatment effect. AUD treatment in primary care appears to be beneficial even without additional psychological services.

scholarly journals What have we learned about what works in sustaining mental health care and support services during a pandemic? Transferable insights from the COVID-19 response

2021 ◽  
Author(s):  
Nicola Cogan ◽  
Heather Archbold ◽  
Karen Deakin ◽  
Bethany Griffith ◽  
Isabel Sáez Berruga ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Services ◽  
Health Services ◽  
Mental Health Care ◽  
Support Services ◽  
Health Workers ◽  
Mental Healthcare ◽  
Lessons Learned ◽  
Care And Support

Efforts have been made to adapt the delivery of mental health care and support services to the demands of COVID-19. Here we detail the perspectives and experiences of mental health workers (MHWs), in relation to what they found helpful when adapting mental health services during the COVID-19 pandemic and responding to its demands. We were interested in exploring what has helped to support MHWs’ own health and wellbeing given that staff wellbeing is central to sustaining the delivery of quality mental health services moving forward. Individual interviews were conducted with MHWs (n = 30) during the third COVID-19 lockdown. Interviews were audio-recorded, transcribed and managed using NVIVO. Qualitative data was analyzed using an inductive thematic approach. Three major themes were created, which emphasized the importance of: (1) 'self-care and peer support (checking in with each other)', (2) 'team cohesion and collaboration' and (3) 'visible and supportive management and leadership (new ways of working)'. Our findings emphasize the importance of individual, team and systems-based support in helping MHWs maintain their own wellbeing, whilst adapting and responding to the challenges in providing mental health care and support during this pandemic. Guidance and direction from management, with adaptive leadership in providing sustained, efficient, and equitable delivery of mental healthcare, is essential. Our findings support future policy, research and mental health practice developments through sharing important salutogenic lessons learned and transferable insights which may help with preparedness for future pandemics.

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