scholarly journals An Integrated Blueprint for Digital Mental Health Services Amidst COVID-19

10.2196/21718 ◽  
2020 ◽  
Vol 7 (7) ◽  
pp. e21718 ◽  
Author(s):  
Luke Balcombe ◽  
Diego De Leo
Keyword(s):  
Mental Health ◽  
Machine Learning ◽  
Health Care ◽  
Mental Health Services ◽  
Health Services ◽  
Service Delivery ◽  
Mental Health Care ◽  
Real Time ◽  
Health Care Services ◽  
Care Services

In-person traditional approaches to mental health care services are facing difficulties amidst the coronavirus disease (COVID-19) crisis. The recent implementation of social distancing has redirected attention to nontraditional mental health care delivery to overcome hindrances to essential services. Telehealth has been established for several decades but has only been able to play a small role in health service delivery. Mobile and teledigital health solutions for mental health are well poised to respond to the upsurge in COVID-19 cases. Screening and tracking with real-time automation and machine learning are useful for both assisting psychological first-aid resources and targeting interventions. However, rigorous evaluation of these new opportunities is needed in terms of quality of interventions, effectiveness, and confidentiality. Service delivery could be broadened to include trained, unlicensed professionals, who may help health care services in delivering evidence-based strategies. Digital mental health services emerged during the pandemic as complementary ways of assisting community members with stress and transitioning to new ways of living and working. As part of a hybrid model of care, technologies (mobile and online platforms) require consolidated and consistent guidelines as well as consensus, expert, and position statements on the screening and tracking (with real-time automation and machine learning) of mental health in general populations as well as considerations and initiatives for underserved and vulnerable subpopulations.

scholarly journals An Integrated Blueprint for Digital Mental Health Services Amidst COVID-19 (Preprint)

2020 ◽  
Author(s):  
Luke Balcombe ◽  
Diego De Leo
Keyword(s):  
Mental Health ◽  
Machine Learning ◽  
Health Care ◽  
Mental Health Services ◽  
Health Services ◽  
Service Delivery ◽  
Mental Health Care ◽  
Real Time ◽  
Health Care Services ◽  
Care Services

UNSTRUCTURED In-person traditional approaches to mental health care services are facing difficulties amidst the coronavirus disease (COVID-19) crisis. The recent implementation of social distancing has redirected attention to nontraditional mental health care delivery to overcome hindrances to essential services. Telehealth has been established for several decades but has only been able to play a small role in health service delivery. Mobile and teledigital health solutions for mental health are well poised to respond to the upsurge in COVID-19 cases. Screening and tracking with real-time automation and machine learning are useful for both assisting psychological first-aid resources and targeting interventions. However, rigorous evaluation of these new opportunities is needed in terms of quality of interventions, effectiveness, and confidentiality. Service delivery could be broadened to include trained, unlicensed professionals, who may help health care services in delivering evidence-based strategies. Digital mental health services emerged during the pandemic as complementary ways of assisting community members with stress and transitioning to new ways of living and working. As part of a hybrid model of care, technologies (mobile and online platforms) require consolidated and consistent guidelines as well as consensus, expert, and position statements on the screening and tracking (with real-time automation and machine learning) of mental health in general populations as well as considerations and initiatives for underserved and vulnerable subpopulations.

scholarly journals Identifying Military Veterans in a Clinical Research Database using Natural Language Processing

2019 ◽  
Vol 4 (3) ◽  
Author(s):  
Daniel Leightley ◽  
Katharine M Mark ◽  
David Pernet ◽  
Dominic Murphy ◽  
Nicola T Fear ◽  
...  
Keyword(s):  
Mental Health ◽  
Machine Learning ◽  
Health Care ◽  
National Health Service ◽  
Mental Health Care ◽  
Health Care Services ◽  
Automatic Machine ◽  
Machine Learning Method ◽  
Learning Method ◽  
Care Services

BackgroundThere is a lack of quantitative evidence concerning United Kingdom veterans who access secondary mental health care. This is mainly due to a person’s veteran status not being routinely collected when they enter the health care system. Main AimThe study aimed to develop an NLP approach for identifying veterans accessing secondary mental health care services using National Health Service electronic health records. MethodsVeterans were identified using the South London and Maudsley Biomedical Research Centre (SLaM) case register – a database holding secondary mental health care electronic records for the South London and Maudsley National Health Service Trust of 300,000 patients. We developed two methods. An NLP and machine learning tool were developed to automatically evaluate personal history statements written by clinicians. ResultsThis study showed that it was possible to identify veterans using the NLP and machine learning approach on a sub-set of 4,200 patients. The automatic machine learning method was able to identify 270 veterans representing an accuracy of 97.2%. It is estimated to take between 6 to 16 minutes to manually search patient history statements whereas the automatic machine learning method took only one minute to run. ConclusionWe have shown that it is possible to identify veterans using NLP combined with machine learning. This work contributes towards the development of a more comprehensive picture of veterans who are accessing secondary mental health care services in the UK. It represents a first step in identifying veterans from one dataset and we hope that future research can inform the possibility of deploying the methods nationally. Despite our success in the current work, the tools are tailored to the SLaM dataset and future work is needed to develop a more agnostic framework. FundingForces in Mind Trust

scholarly journals Impact of School-Based Health Centers on Students with Mental Health Problems

2008 ◽  
Vol 123 (6) ◽  
pp. 768-780 ◽  
Author(s):  
Jeff J. Guo ◽  
Terrance J. Wade ◽  
Kathryn N. Keller
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Services ◽  
Health Services ◽  
Health Care Services ◽  
Mental Health Problems ◽  
Health Problems ◽  
Care Services ◽  
School Based ◽  
School Based Health Centers

Objectives. School-based health centers (SBHCs) play an increasingly major role in providing mental health services for students. This study evaluated the impact of SBHCs on mental health-care services and psychosocial health-related quality of life (HRQOL). Methods. Four SBHC intervention and two matched non-SBHC school districts were examined from 1997 to 2003. The SBHC intervention began in 2000. Data included child and parent pediatric HRQOL and Ohio Medicaid claims. A longitudinal quasi-experimental time-series repeated measures design was used for this study, involving analysis of covariance to assess health costs and regression analyses for HRQOL scores. Results. After the SBHC program, proportions of students accessing mental health-care services for urban and rural SBHC intervention schools increased 5.6% (χ2=39.361, p<0.0001) and 5.9% (χ2=5.545, p<0.0001), respectively, compared with increases of 2.6% (χ2=2.670, p=0.1023) and 0.2% (χ2=0.006, p=0.9361) for urban and rural non-SBHC schools, respectively. Using data from 109 students with mental health problems based on Medicaid claims, the study found SBHC students had significantly lower total health-care costs (F=5.524, p=0.005) and lower costs of mental health services (F=4.820, p=0.010) compared with non-SBHC students. While improvements over time in HRQOL for SBHC students compared with non-SBHC students and students from non-SBHC schools were observed, only some were statistically significant. Conclusions. SBHC programs increase the proportion of students who receive mental health services and may improve pediatric HRQOL. SBHC students with mental health problems had lower total Medicaid reimbursements compared with non-SBHC students.

scholarly journals Mental Health Service in Ghana: A Review of the Case

2017 ◽  
Vol 6 (4) ◽  
pp. 299 ◽  
Author(s):  
Samuel Adu-Gyamfi
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Service ◽  
Mental Health Services ◽  
Health Service ◽  
Health Services ◽  
Service Delivery ◽  
Mental Health Care ◽  
Psychiatric Hospitals ◽  
The Government

Mental health care in Ghana has been fraught with several challenges leading to stagnant growth in mental health service delivery and in some cases a severe depreciation in the nature of care. The Government of Ghana pays little or no attention to mental health care in the country, a situation that has led to poor service delivery in the three major psychiatric hospitals in Ghana. The implementation of the Ghana Mental Act of 2012 has also been faced with major challenges with no significant progress being made. This studytherefore sought to review and document the development of mental health care services in Ghana. Specifically, the study examined the various legislations on mental health that have been enacted  in Ghana since 1900; investigated the implementation of the current Mental Health Act of Ghana; found out whether the Ghanaian government has prioritise mental health services in the country and assessed the challenges and problems that confronted mental health services in Ghana since 1900.The study concludes that, since 1888 efforts have been made by various governments to legislate the provision of mental services in Ghana. However, these legislations have not always protected the rights and interest of the mentally ill.

scholarly journals The balance of adult mental health care: provision of core health versus other types of care in eight European countries

2018 ◽  
Vol 29 ◽  
Author(s):  
G. Cetrano ◽  
L. Salvador-Carulla ◽  
F. Tedeschi ◽  
L. Rabbi ◽  
M. R. Gutiérrez-Colosía ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Services ◽  
Health Services ◽  
Mental Health Care ◽  
Health Systems ◽  
European Countries ◽  
Mental Health Systems ◽  
Term Care ◽  
Care Services

Abstract Aims Although many mental health care systems provide care interventions that are not related to direct health care, little is known about the interfaces between the latter and core health care. ‘Core health care’ refers to services whose explicit aim is direct clinical treatment which is usually provided by health professionals, i.e., physicians, nurses, psychologists. ‘Other care’ is typically provided by other staff and includes accommodation, training, promotion of independence, employment support and social skills. In such a definition, ‘other care’ does not necessarily mean being funded or governed differently. The aims of the study were: (1) using a standard classification system (Description and Evaluation of Services and Directories in Europe for Long Term Care, DESDE-LTC) to identify ‘core health’ and ‘other care’ services provided to adults with mental health problems; and (2) to investigate the balance of care by analysing the types and characteristics of core health and other care services. Methods The study was conducted in eight selected local areas in eight European countries with different mental health systems. All publicly funded mental health services, regardless of the funding agency, for people over 18 years old were identified and coded. The availability, capacity and the workforce of the local mental health services were described using their functional main activity or ‘Main Types of Care’ (MTC) as the standard for international comparison, following the DESDE-LTC system. Results In these European study areas, 822 MTCs were identified as providing core health care and 448 provided other types of care. Even though one-third of mental health services in the selected study areas provided interventions that were coded as ‘other care’, significant variation was found in the typology and characteristics of these services across the eight study areas. Conclusions The functional distinction between core health and other care overcomes the traditional division between ‘health’ and ‘social’ sectors based on governance and funding. The overall balance between core health and other care services varied significantly across the European sites. Mental health systems cannot be understood or planned without taking into account the availability and capacity of all services specifically available for this target population, including those outside the health sector.

scholarly journals Mapping services at two Nairobi County primary health facilities: identifying challenges and opportunities in integrated mental health care as a Universal Health Coverage (UHC) priority

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Manasi Kumar ◽  
Vincent Nyongesa ◽  
Martha Kagoya ◽  
Byamah B. Mutamba ◽  
Beatrice Amugune ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Primary Health Care ◽  
Mental Health Services ◽  
Health Services ◽  
Health Care Providers ◽  
Health Care Services ◽  
Care Providers ◽  
Care Services ◽  
Primary Health

Abstract Introduction There is a need to scale-up mental health service provision in primary health care. The current extent of integration of mental health in primary care is pertinent to promoting and augmenting mental health at this level. We describe a facility mapping exercise conducted in two low-income/primary health facilities in Kenya to identify existing barriers and facilitators in the delivery of mental health services in general and specifically for peripartum adolescents in primary health care as well as available service resources, cadres, and developmental partners on the ground. Method and measures This study utilized a qualitative evidence synthesis through mapping facility-level services and key-stakeholder interviews. Services-related data were collected from two facility in-charges using the Nairobi City County Human Resource Health Strategy record forms. Additionally, we conducted 10 key informant interviews (KIIs) with clinical officers (Clinicians at diploma level), Nurses, Community Health Assistants (CHAs), Prevention of Mother-to-child Transmission of HIV Mentor Mothers (PMTCTMs), around both general and adolescent mental health as well as psychosocial services they offered. Using the World Health Organization Assessments Instrument for Mental Health Systems (WHO-AIMS) as a guideline for the interview, all KII questions were structured to identify the extent of mental health integration in primary health care services. Interview transcripts were then systematically analyzed for common themes and discussed by the first three authors to eliminate discrepancies. Results Our findings show that health care services centered around physical health were offered daily while the mental health services were still vertical, offered weekly through specialist services by the Ministry of Health directly or non-governmental partners. Despite health care workers being aware of the urgent need to integrate mental health services into routine care, they expressed limited knowledge about mental disorders and reported paucity of trained mental health personnel in these sites. Significantly, more funding and resources are needed to provide mental health services, as well as the need for training of general health care providers in the identification and treatment of mental disorders. Our stakeholders underscored the urgency of integrating mental health treatment, prevention, and well-being promotive activities targeting adolescents especially peripartum adolescent girls. Conclusion There is a need for further refining of the integrated care model in mental health services and targeted capacity-building for health care providers to deliver quality services.

scholarly journals A review of a primary mental health service 10 years on

2015 ◽  
Vol 27 (3) ◽  
pp. 78-85
Author(s):  
Sarah Taylor
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Services ◽  
Health Services ◽  
Service Delivery ◽  
Mental Health Care ◽  
Brief Intervention ◽  
Social Worker ◽  
Intervention Service

The past 10 years have seen a shift in mental health care in Aotearoa New Zealand towards early intervention and treatment at a primary care level providing a range of levels of mental health interventions in a variety of settings. Previously specialist mental health care had been the responsibility of community mental health teams and secondary service inpatient care which provided care for people with severe mental illness (3% of the population). In this article, I look at the move towards the provision of primary mental health care. I describe and review the Mental Health Brief Intervention Service in South Canterbury, one of the earliest primary mental health services initiated by the South Canterbury District Health Board, which started in 2005. I present research fi from my Master’s thesis Mental Health Brief Intervention – does it work? An evaluation of practice, and discuss how the Mental Health Brief Intervention Service has made a positive change for general practitioners, the client, the interface with other services including secondary mental health services and service delivery in general. Forms of consumer feedback are discussed along with the changes in the service over the last 10 years. It is written by myself, a social worker, who played an integral part in initiating and establishing the service and continues to have an active role as a clinician within the Mental Health Brief Intervention Service. This article is written to provide social workers with an overview of the establishment of the Mental Health Brief Intervention Service and the impact on service delivery. The role of the social worker is discussed as is the role of other health professionals within the team. 

scholarly journals Pattern of Presentation and Utilization of Services for Mental and Neurological Disorders in Northeastern Nigeria: A Ten-Year Study

2015 ◽  
Vol 2015 ◽  
pp. 1-5 ◽  
Author(s):  
Jidda Mohammed Said ◽  
Abdulmalik Jibril ◽  
Rabbebe Isah ◽  
Omeiza Beida
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Services ◽  
Mental Disorders ◽  
Health Services ◽  
Low Income ◽  
Neurological Disorders ◽  
Health Care Services ◽  
Significant Proportion ◽  
Care Services

Mental and neurological disorders are common in the primary health care settings. The organization of mental health services focuses on a vertical approach. The northeast as other low income regions has weak mental health services with potentially huge mental health burden. The manner of presentations and utilization of these services by the population may assist in determining treatment gap. We investigated the pattern and geographical distribution of presentations with mental disorders and explored the linkages with primary care in northeastern Nigeria over the last decade. A retrospective review of hospital-based records of all the available mental health service units in the region was conducted over a decade spanning between January 2001 and December 2011. A total of 47, 664 patients attended available mental health facilities within the past decade in the northeast. Overwhelming majority (83%,n=39,800) attended the region’s tertiary mental health facility. A substantial proportion (30%,n=14,440) had primary physical illness, while 18%,n=8606, had primary neurologic disorders. The commonest physical comorbidity was hypertension (4%) and diabetes (2%). A significant proportion of the populace with mental disorders appeared not to be accessing mental health care services, even when it is available. Meaningful efforts to improve access to mental health services in the northeast region of Nigeria will require successful integration of mental health into primary and general medical services.

scholarly journals The distribution of mental health services within NHS trusts

1994 ◽  
Vol 18 (8) ◽  
pp. 469-471
Author(s):  
Judy Harrison
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Services ◽  
Health Services ◽  
Health Care Services ◽  
Significant Proportion ◽  
Acute Hospital ◽  
Care Services ◽  
Community Trust ◽  
Using Data

From April 1994, over 95% of health care services will be provided by NHS trusts. Mental Health services have a choice of remaining within the acute hospital trust or forming part or all of a community trust. Using data from trust directories, the distribution of mental health services within the first three trust waves is described. Forty per cent of acute hospital trusts currently do not include mental health services. Unlike other specialities, a significant proportion of mental health services are choosing to form specialist mental health trusts. The implications of the alternative trust arrangements for psychiatry are discussed.

Demographic and psychiatric predictors of engagement in psychotherapy services conducted via clinical video telehealth

2018 ◽  
Vol 26 (1-2) ◽  
pp. 113-118
Author(s):  
Lisa M Valentine ◽  
Shannon D Donofry ◽  
Minden B Sexton
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Services ◽  
Health Services ◽  
Mental Health Care ◽  
Health Care Services ◽  
Mental Health Problems ◽  
Future Research ◽  
Health Administration ◽  
Symptom Profile

IntroductionMilitary veterans are at high risk for developing mental health problems. Unfortunately, veterans have relatively low rates of engagement in mental health services compared with non-veterans. In order to address barriers to mental health care services, the Veteran’s Health Administration (VHA) has implemented clinical video telehealth (CVT). Although the effectiveness of this technology appears promising, there is limited research evaluating rates of engagement in CVT mental health services or what factors may predict premature attrition from mental health care delivered via this format.MethodsThe present study aimed to investigate treatment engagement among veterans enrolled in psychotherapy delivered via CVT, as well as to explore the effects of various demographic and clinical characteristics on these outcomes. Participants were 250 veterans with consults placed to the CVT clinic at a large Midwestern VHA. To evaluate characteristics related to therapy retention, demographic and symptom profile information was gathered from a subset of 93 participants who attended at least one CVT psychotherapy appointment.ResultsResults indicated there were no significant demographic differences between veterans who attended at least one CVT appointment and those who did not attend at least one session. Demographic variables were not related to the number of CVT visits attended. Regarding psychological characteristics, veterans with anxiety disorders attended fewer CVT appointments overall than veterans with mood disorders and attendance at CVT was negatively correlated with anxiety severity.DiscussionThese findings have potential implications for providers working in CVT clinics as well as for future research in this area.

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