Mental disorders in conflict-affected populations: epidemiological modelling for targeted mental health program development

2016 ◽  
Author(s):  
Fiona Jayne Charlson
Keyword(s):  
Mental Health ◽  
Mental Disorders ◽  
Program Development ◽  
Health Program ◽  
Mental Health Program ◽  
Epidemiological Modelling

Care at door-steps for persons with severe mental disorders: A pilot experience from Karnataka district mental health program

2020 ◽  
pp. 002076402098385
Author(s):  
Vinay Basavaraju ◽  
Manisha Murugesan ◽  
Channaveerachari Naveen Kumar ◽  
Guru S Gowda ◽  
Santhosh Kumar Tamaraiselvan ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Disorders ◽  
Health Program ◽  
Burden Of Illness ◽  
Clinical Care ◽  
Mental Health Program ◽  
Severe Mental Disorders ◽  
South Indian ◽  
Pilot Experience ◽  
Drop Outs

Background: Public funded outreach services for persons with severe mental disorders (SMDs), a norm in developed nations, is non-existent in India. We share our pilot experience with an indigenous model named ‘Care at Doorsteps’ (CADs) for persons with SMDs who dropped out from clinical care of District Mental Health Program (DMHP) at three sites of Karnataka, a south Indian state. Aim: The objectives of this study were to identify the reasons for drop outs from routine care and to assess the burden of illness and disability after the intervention. Methodology: Six-month prospective observational study on patients aged 18–60 years, diagnosed as Schizophrenia or bipolar disorder was conducted. Three home visits were made by the team and provided medications, also offered brief psychoeducation and counselling. Care-givers were interviewed to identify the reasons for drop outs and their expectations from the treating team. Patients were also assessed using the Clinical Global Impression Scale (CGI), Indian Disability Evaluation and Assessment Scale (IDEAS) and Burden Assessment Schedule (BAS) during each visit. Results: Ninety-six patients (50 males and 46 females) were followed up, of which 85 had a diagnosis of schizophrenia and 11 with bipolar illness. Common reasons for drop out were: single caregiver (breadwinner) unable to accompany the patient, loss of faith in medical treatment and financial constraints. Symptomatic improvement and restoration of productive work were the priority expectations. Over the course, the mean CGI-S showed significant reduction (4.81 ± 1.57, 4.46 ± 1.32 and 4.11 ± 1.39 respectively; p = 0.001). Mean score on BAS showed a significant reduction (85.76 ± 12.15, 83.46 ± 11.30, 84.27 ± 11.82; p = 0.04). Mean total IDEAS scores did not show significant change (13.27 ± 4.78, 12.82 ± 4.24, 13.17 ± 4.40; p = 0.16). Conclusion: Meaningful assertive outreach care is feasible in India and is found to be useful for persons with SMDs by utilising the already existing public sector resources.

Data utilization for local mental health program development

1967 ◽  
Vol 3 (1) ◽  
pp. 30-32 ◽  
Author(s):  
Dorothy N. Moore ◽  
Bernard L. Bloom ◽  
Sheldon Gaylin ◽  
Max Pepper ◽  
Charles Pettus ◽  
...  
Keyword(s):  
Mental Health ◽  
Program Development ◽  
Health Program ◽  
Mental Health Program ◽  
Data Utilization ◽  
Local Mental Health

scholarly journals An economic evaluation of a mobile text messaging intervention to improve mental health care in resource-poor communities in China: a cost-effectiveness study

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Rubee Dev ◽  
Jinghua Li ◽  
Donglan Zhang ◽  
Yiyuan Cai ◽  
Chun Hao ◽  
...  
Keyword(s):  
Mental Health ◽  
Economic Evaluation ◽  
Cost Effectiveness ◽  
Mental Disorders ◽  
Health Program ◽  
Mental Health Program ◽  
Cost Utility ◽  
Severe Mental Disorders ◽  
Community Based ◽  
The Cost

Abstract Background Severe mental disorders, a leading cause of disability has become a major public health problem. In order to promote mental health, a series of programs have been promulgated by the Chinese government. However, economic evaluations of such programs are lacking. The purpose of this study is to develop and validate an economic model to assess the cost and health outcomes of the LEAN (Lay health supporters, E-platform, Award, and iNtegration) program, and to perform an economic evaluation of LEAN versus the nationwide community-based mental health program that provides free antipsychotic medications. Methods A cost-effectiveness and cost-utility analysis of the LEAN intervention will be performed. A Markov model will be developed, validated and used to assess and compare the costs and outcomes for the LEAN intervention versus nationwide community-based mental health program. The calculated sample size is 258 participants for the analysis. A societal perspective will be applied with the time horizon of 1-year after the termination of the LEAN program. The cost-utility will be measured primarily using Quality Adjusted Life Years and the cost-effectiveness will be measured using number of relapses and number of re-hospitalizations avoided 6-month after the intervention. Univariate and probabilistic sensitivity analysis will be conducted for the analysis of uncertainty. Discussion If proven cost-effective, this study will contribute to the nationwide implementation of the program, not only for schizophrenia but for all kind of severe mental disorders. Markov model developed as part of the study will benefit potential researchers in analyzing cost-effectiveness of other programs. The Chinese context of the study may limit the generalizability of the study results to some extent. Trial registration This study was registered in a Chinese Clinical Trial Registry (ChiCTR2000034962) on 25 July 2020.

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