scholarly journals Adapting practice in mental healthcare settings during the COVID-19 pandemic and other contagions: systematic review

BJPsych Open ◽  
2021 ◽  
Vol 7 (2) ◽  
Author(s):  
Jessica Raphael ◽  
Rachel Winter ◽  
Katherine Berry
Keyword(s):  
Mental Health ◽  
Systematic Review ◽  
Mental Health Services ◽  
Health Services ◽  
Infection Control ◽  
Mental Healthcare ◽  
Well Being ◽  
Healthcare Services ◽  
Control Measures ◽  
Infection Control Measures

Background During the global COVID-19 pandemic, there has been guidance concerning adaptations that physical healthcare services can implement to aid containment, but there is relatively little guidance for how mental healthcare services should adapt service provision to better support staff and patients, and minimise contagion spread. Aims This systematic review explores service adaptations in mental health services during the COVID-19 pandemic and other contagions. Method The Allied and Complementary Medicine database (AMED), the Cumulative Index to Nursing and Allied Health Literature (CINAHL), EMBASE, Medline, PsycINFO and Web of Science were systematically searched for published studies from database inception to April 2020. Data were extracted focusing on changes to mental health services during contagion outbreaks. Data were analysed with thematic analysis. Results Nineteen papers were included: six correspondence/point-of-view papers, five research papers, five reflection papers, two healthcare guideline documents and one government document. Analysis highlighted four main areas for mental health services to consider during contagion outbreaks: infection control measures to minimise contagion spread, including procedural and practical solutions across different mental health settings; service delivery, including service changes, operational planning and continuity of care; staff well-being (psychological and practical support); and information and communication. Conclusions Mental health services need to consider infection control measures and implement service changes to support continuity of care, and patient and staff well-being. Services also need to ensure they are communicating important information in a clear and accessible manner with their staff and patients, regarding service delivery, contagion symptoms, government guidelines and well-being.

scholarly journals Remote care for mental health: qualitative study with service users, carers and staff during the COVID-19 pandemic

BMJ Open ◽  
2021 ◽  
Vol 11 (4) ◽  
pp. e049210
Author(s):  
Elisa Liberati ◽  
Natalie Richards ◽  
Jennie Parker ◽  
Janet Willars ◽  
David Scott ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Service ◽  
Health Services ◽  
Mental Healthcare ◽  
Well Being ◽  
Comparison Method ◽  
Service Users ◽  
Qualitative Interview Study ◽  
Remote Care

ObjectivesTo explore the experiences of service users, carers and staff seeking or providing secondary mental health services during the COVID-19 pandemic.DesignQualitative interview study, codesigned with mental health service users and carers.MethodsWe conducted semistructured, telephone or online interviews with a purposively constructed sample; a lived experience researcher conducted and analysed interviews with service users. Analysis was based on the constant comparison method.SettingNational Health Service (NHS) secondary mental health services in England between June and August 2020.ParticipantsOf 65 participants, 20 had either accessed or needed to access English secondary mental healthcare during the pandemic; 10 were carers of people with mental health difficulties; 35 were members of staff working in NHS secondary mental health services during the pandemic.ResultsExperiences of remote care were mixed. Some service users valued the convenience of remote methods in the context of maintaining contact with familiar clinicians. Most participants commented that a lack of non-verbal cues and the loss of a therapeutic ‘safe space’ challenged therapeutic relationship building, assessments and identification of deteriorating mental well-being. Some carers felt excluded from remote meetings and concerned that assessments were incomplete without their input. Like service users, remote methods posed challenges for clinicians who reported uncertainty about technical options and a lack of training. All groups expressed concern about intersectionality exacerbating inequalities and the exclusion of some service user groups if alternatives to remote care are lost.ConclusionsThough remote mental healthcare is likely to become increasingly widespread in secondary mental health services, our findings highlight the continued importance of a tailored, personal approach to decision making in this area. Further research should focus on which types of consultations best suit face-to-face interaction, and for whom and why, and which can be provided remotely and by which medium.

scholarly journals Understanding barriers to accessing mental health services for newcomers to Canada using Peterborough, Ontario, as an illustrative example

2021 ◽  
Author(s):  
Nurun Layla Chowdhury
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Help Seeking ◽  
Mental Healthcare ◽  
Healthcare Services ◽  
Mental Illnesses ◽  
Cultural Barriers ◽  
Accurate Information

The quality of an individual’s mental health has a significant impact on their quality of life, as well as on the cost to society. Regular access to mental health services can help mitigate the risk factors of developing mental illnesses. This paper examines barriers to accessing mental health services, using the community of Peterborough, Ontario, as an example. Social, economic, and cultural barriers impact help-seeking amongst immigrants, putting them at a higher risk of developing mental disorders. The social determinants of mental health can be useful when developing policies aimed at improving utilization of mental healthcare services. Policy makers need to first focus on collecting accurate information on the population, and then developing targeted solutions to eliminate barriers such as language and employment that prevent help-seeking in immigrants.

scholarly journals The Impact of the COVID-19 Pandemic and Societal Infection Control Measures on Children and Adolescents' Mental Health: A Scoping Review

2021 ◽  
Vol 12 ◽  
Author(s):  
Jamile Marchi ◽  
Nina Johansson ◽  
Anna Sarkadi ◽  
Georgina Warner
Keyword(s):  
Mental Health ◽  
Physical Activity ◽  
Infection Control ◽  
Children And Adolescents ◽  
Scoping Review ◽  
Well Being ◽  
Control Measures ◽  
Parenting Support ◽  
Infection Control Measures ◽  
The Impact

Background: The COVID-19 pandemic is primarily a crisis that affects people's physical health. However, it is well-known from previous epidemics and pandemics that there are other indirect negative impacts on mental health, among others. The purpose of this scoping review was to explore and summarise primary empirical research evidence on how the COVID-19 pandemic and societal infection control measures have impacted children and adolescents' mental health.Methods: A literature search was conducted in five scientific databases: PubMed, APA PsycINFO, Web of Science, CINHAL, and Social Science Premium Collection. The search string was designed using the Population (0–18 years), Exposure (COVID-19), Outcomes (mental health) framework. Mental health was defined broadly, covering mental well-being to mental disorders and psychiatric conditions.Results: Fifty-nine studies were included in the scoping review. Of these, 44 were cross-sectional and 15 were longitudinal studies. Most studies reported negative impact of the COVID-19 pandemic on child and adolescent mental health outcomes, yet the evidence was mixed. This was also the case for studies investigating societal control measures. Strong resilience, positive emotion regulation, physical activity, parental self-efficacy, family functioning and emotional regulation, and social support were reported as protective factors. On the contrary, emotional reactivity and experiential avoidance, exposure to excessive information, COVID-19 school concerns, presence of COVID-19 cases in the community, parental mental health problems, and high internet, social media and video game use were all identified as potentially harmful factors.Conclusions: Due to the methodological heterogeneity of the studies and geographical variation, it is challenging to draw definitive conclusions about the real impact of the COVID-19 pandemic on the mental health of children and adolescents. However, the existing body of research gives some insight to how parents, clinicians and policy makers can take action to mitigate the effects of COVID-19 and control measures. Interventions to promote physical activity and reduce screen time among children and adolescents are recommended, as well as parenting support programs.

Bridging the skills gap: apprentice assistant practitioners having an impact in mental healthcare services

2019 ◽  
Vol 13 (9) ◽  
pp. 452-457 ◽  
Author(s):  
Andy Morris ◽  
Patricia Donovan
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Mental Healthcare ◽  
Present Situation ◽  
Healthcare Services ◽  
Skills Gap ◽  
Assistant Practitioner

It is important to have a well-trained workforce and this is especially so in mental healthcare services. This article is the first of four looking at mental healthcare services and the apprentice assistant practitioner (AAP). The background to the introduction of assistant practitioners (AP), both in generic terms and more specifically their potential in mental health provision, will be explored. The present situation in mental health services will be examined, along with how the AP role might help mitigate some of the critical challenges faced in this area of health. The development of higher apprenticeships will be discussed in relation to standardisation of the AP role and how universally recognised apprenticeship standards around knowledge, behaviours and values will aid a more consistent understanding of the AP position and their consequent deployment in services.

How Can Guidance Recommendations Contribute to Better Mental Health?

2017 ◽  
Vol 41 (S1) ◽  
pp. S12-S12
Author(s):  
W. Gaebel
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Mental Healthcare ◽  
Healthcare Services ◽  
European Countries ◽  
Healthcare Provision ◽  
Distributed Resources ◽  
Deutschland Gmbh

IntroductionIn European countries, the quality of mental healthcare services is often limited due to scarce and inequitable distributed resources, and inefficient use of existing resources. Against this background, the EPA Guidance provides recommendations on how to optimize quality of mental healthcare for all European countries.ObjectivesProvision of guidance recommendations in order to support optimization and harmonization of mental healthcare services in European countries.MethodsBy means of evidence and consensus-based methods EPA guidance papers are developed by experts in psychiatry and related fields [1].ResultsAs of 2012, five EPA guidance series have been developed and published [2]. They focus on various aspects of mental healthcare and clinical situations that have not been covered by medical guidelines yet but are considered important to deliver high quality mental healthcare. Papers deal amongst others with topics relating to quality assurance of mental health services, as quality of mental health service structures and processes, and building trust in mental health services.ConclusionsEPA guidance recommendations can improve mental healthcare provision and thereby contribute to better mental health of persons receiving mental healthcare. For this purpose, recommendations need to be widely disseminated and implemented in European countries.Disclosure of interestUnterstützung bei Symposien/Symposia Support− Janssen-Cilag GmbH, Neuss− Aristo Pharma GmbH, Berlin− Lilly Deutschland GmbH, Bad Homburg− Servier Deutschland GmbH, München− Fakultätsmitglied/Faculty Member− Lundbeck International Neuroscience Foundation (LINF), Dänemark

scholarly journals Perceived Barriers to Mental Health Services among the Elderly in the Rural of Vietnam: A Cross Sectional Survey in 2019

2021 ◽  
Vol 14 ◽  
pp. 117863292110260
Author(s):  
Nguyen Hang Nguyet Van ◽  
Nguyen Thi Khanh Huyen ◽  
Mai Thi Hue ◽  
Nguyen Thanh Luong ◽  
Pham Quoc Thanh ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Rural Areas ◽  
Mental Healthcare ◽  
Healthcare Services ◽  
Perceived Barriers ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Important Indicator

While the burden of neurological and mental disorders has been drastically increased in Vietnam, the current mental healthcare services do not meet the public demand. In order to determine perceived barriers to the use of mental health services, we conducted a cross-sectional study on 376 elderly people from a rural district in Hanoi, Vietnam. We found that depression may be an important indicator of the need for formal and informal community and home care mental health services. Barriers to mental healthcare access were categorized into 7 groups namely stigma, emotional concerns, participation restrictions, service satisfaction, time constraints, geographic and financial conditions, and availability of services. The most significant barriers are the limited availability of and accessibility to health professionals and services in rural areas. Our study highlights the urgent efforts that need to be made in order to enhance availability of mental healthcare services in rural areas of Vietnam.

Self-casting and alter-casting: Healthcare professionals’ boundary work in response to peer workers

2021 ◽  
pp. 001139212110485
Author(s):  
Margaretha Järvinen ◽  
Malene Lue Kessing
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Healthcare Professionals ◽  
Boundary Work ◽  
Mental Healthcare ◽  
Healthcare Services ◽  
Recovery Model ◽  
Recovery Orientation ◽  
Professional Boundary

Within mental health services, the recovery model has been a guiding philosophy over the past decades. This model stresses ‘person-centred care’ and focuses on assisting service users to live a meaningful and hopeful life even if their illness has not been cured. As part of the recovery orientation, ‘peer workers’ (PWs), i.e. people with lived experiences of mental illness, are increasingly employed within mental health services. In this article, the authors explore how these changes open up frontiers and set in motion boundary work and identity discussions among healthcare professionals. Empirically, the article draws on qualitative data – interviews with healthcare professionals and observations of meetings – collected in mental healthcare services in Denmark. Theoretically, the article combines literature on professional boundary work with theories on ‘self-casting’, ‘alter-casting’ and ‘othering’. Analysing two sets of demarcations – those between healthcare professionals and PWs, and those between professionals and patients – the study shows how the recovery model leads to defensive boundary work as well as an opening up of boundaries.

scholarly journals Psychometric properties of the Five‐item World Health Organization Well‐being Index used in mental health services: Protocol for a systematic review

2020 ◽  
Vol 76 (9) ◽  
pp. 2426-2433
Author(s):  
Mariela L. Lara‐Cabrera ◽  
Stål Bjørkly ◽  
Carlos De las Cuevas ◽  
Sindre Andre Pedersen ◽  
Ingunn Pernille Mundal
Keyword(s):  
Mental Health ◽  
Systematic Review ◽  
Mental Health Services ◽  
Health Services ◽  
Psychometric Properties ◽  
World Health Organization ◽  
Well Being ◽  
World Health ◽  
Health Organization

General aspects of care: settings of care

Psychiatry ◽  
2019 ◽  
Author(s):  
Rebecca McKnight ◽  
Jonathan Price ◽  
John Geddes
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Mental Disorders ◽  
Health Services ◽  
Mental Healthcare ◽  
The Elderly ◽  
Healthcare Services ◽  
Provision Of Services ◽  
Specific Disorders ◽  
General Aspects

Current mental healthcare services in most of the de­veloped world are unrecognizable compared with those of the mid twentieth century. There has been a major shift from long- term institutional to community care. This chapter describes current approaches to pro­viding mental health services, particularly for people between the ages of 18 and 65 (services for children are discussed in Chapter 17, and services for the elderly in Chapter 18). It is important for all doctors to have a basic understanding of the structure of services for three main reasons: … 1 It will help you to get the most out of clinical rotations in psychiatry, either at undergraduate or postgraduate level. 2 All clinicians need to know when and how to refer their patient to appropriate services. 3 Patients being treated by other medical specialties may have psychiatric co- morbidities. Effective management and liaison with mental health services requires a working knowledge of common conditions and their treatment. … Mental health services are organized in different ways from country to country. This chapter describes mainly the provision of services in the UK, but the prin­ciples apply generally. To understand the range of psychiatric services that are required for a specific community it is necessary to know: … 1 the frequency of mental disorders in the population; 2 the severity of these conditions and the impact they have upon a person’s ability to function; 3 how patients with these disorders come into contact with the health services; 4 what type of services people engage with and find effective. … The local prevalence of mental disorders will vary, but approximate estimates can be obtained from national surveys (Table 11.1). Approximately 20 per cent of adults and 10 per cent of children experi­ence a mental health problem in any given year. A more detailed discussion of the epidemiology of mental health as a whole can be found in Chapter 2, p. 5, and for specific disorders in their individual chapters. The basic principles of the provision of mental health services are the same as for any other health ser­vice. Services should be accessible, comprehensive, appropriate to the needs of the community, offer up- to- date treatments, effective, and economical. Patients should be offered a choice in the treatment they receive, although the caveat to this is when an individual is being treated under the Mental Health Act.

scholarly journals Health System Governance for the Integration of Mental Health Services into Primary Health Care in the Sub-Saharan Africa and South Asia Region: A Systematic Review

2021 ◽  
Vol 58 ◽  
pp. 004695802110285
Author(s):  
Arifah Abd Rahim ◽  
Rosliza Abdul Manaf ◽  
Muhammad Hanafiah Juni ◽  
Normala Ibrahim
Keyword(s):  
Mental Health ◽  
Systematic Review ◽  
Mental Health Services ◽  
Health Services ◽  
Health System ◽  
South Asia ◽  
Mental Healthcare ◽  
Sub Saharan Africa ◽  
Human Resource Capacity ◽  
Sub Saharan

Governance has been highlighted as an important building block underpinning the process of mental health integration into primary healthcare. This qualitative systematic review aims to identify the governance issues faced by countries in the Sub-Saharan Africa and South Asia Region in the implementation of integrated primary mental healthcare. PRISMA guideline was used to conduct a systematic search of relevant studies from 4 online databases that were filtered according to inclusion and exclusion criteria. Using the Critical Appraisal Skills Program (CASP) Qualitative Checklist, a quality appraisal of the selected articles was performed. By drawing upon institutional theory, data was extracted based on a pre-constructed matrix. The CERQual approach synthesized evidence and rank confidence level as low, moderate or high for 5 key findings. From 567 references identified, a total of 8 studies were included. Respondents were policymakers or implementers involved in integrated primary mental healthcare from the national, state, and district level. Overall, the main governance issues identified were a lack of leadership and mental health prioritization; inadequate financing and human resource capacity; and negative mental health perceptions/attitudes. The implication of the findings is that such issues must be addressed for long-term health system performance. This can also improve policymaking for better integration of primary mental health services into the health systems of countries in the Sub-Saharan and South Asia region.

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