scholarly journals Development and Evaluation of a Web-Based Resource for Suicidal Thoughts: NowMattersNow.org (Preprint)

2018 ◽  
Author(s):  
Ursula Whiteside ◽  
Julie Richards ◽  
David Huh ◽  
Rianna Hidalgo ◽  
Rebecca Nordhauser ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
User Experience ◽  
Health Care Providers ◽  
Negative Emotions ◽  
Care Providers ◽  
Suicidal Thoughts ◽  
Web Based ◽  
Experience Survey ◽  
Suicidal Patients

BACKGROUND Nearly half of people who die by suicide see a health care provider in the month before their death. With the release of new care guidelines, detection of suicidal patients will likely increase. Providers need access to suicide-specific resources that can be used as part of immediate, brief interventions with a suicidal patient. Web-based suicide prevention resources have the potential to address this need. OBJECTIVE This study aimed to describe the development of the NowMattersNow.org website as a resource for individuals with suicidal thoughts and to evaluate the utility of the site via user experience surveys. METHODS NowMattersNow.org is an online video-based free public resource that provides evidence-based teachings, examples, and resources for managing suicidal thoughts and intense emotions focused largely around skills from dialectical behavior therapy. Developed with assistance from mental health consumers, it is intended to address gaps in access to services for suicidal patients in health care systems. Visitors stay an average of a minute and a half on the website. From March 2015 to December 2017, a user experience survey measured self-reported changes on a 1 (not at all) to 5 (completely overwhelming) scale regarding intensity of suicidal thoughts and negative emotions while on the website. Longitudinal regression analyses using generalized estimating equations evaluated the magnitude and statistical significance of user-reported changes in suicidal ideation and negative emotion. In secondary analyses, user-reported changes specific to subgroups, including men aged 36 to 64 years, mental health care providers, and other health care providers were evaluated. RESULTS During the period of analysis, there were 138,386 unique website visitors. We analyzed surveys (N=3670) collected during that time. Subsamples included men aged 36 to 64 years (n=512), mental health providers (n=460), and other health care providers (n=308). A total of 28% (1028/3670) of survey completers rated their suicidal thoughts as a 5 or “completely overwhelming” when they entered the website. We observed significant reductions in self-reported intensity of suicidal thoughts (–0.21, P<.001) and negative emotions (–0.32, P<.001), including decreases for users with the most severe suicidal thoughts (–6.4%, P<.001), most severe negative emotions (–10.9%, P<.001), and for middle-aged men (–0.13, P<001). Results remained significant after controlling for length of visit to website (before the survey) and technology type (mobile, desktop, and tablet). CONCLUSIONS Survey respondents reported measurable reductions in intensity of suicidal thoughts and emotions, including those rating their suicidal thoughts as completely or almost completely overwhelming and among middle-aged men. Although results from this user-experience survey administered at one point in time to a convenience sample of users must be interpreted with caution, results provide preliminary support for the potential effectiveness of the NowMattersNow.org website as a tool for short-term management of suicidal thoughts and negative emotions.

Organisational impact of the National Disability Insurance Scheme transition on mental health care providers: the experience in the Australian Capital Territory

2018 ◽  
Vol 26 (6) ◽  
pp. 590-594 ◽  
Author(s):  
Mary Anne Furst ◽  
Jose A Salinas-Perez ◽  
Luis Salvador-Carulla
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Health Care Providers ◽  
Service Provision ◽  
Care Providers ◽  
Australian Capital Territory ◽  
Insurance Scheme ◽  
Mental Health Care Providers ◽  
The Impact

Objectives: Concerns raised about the appropriateness of the National Disability Insurance Scheme (NDIS) in Australia for people with mental illness have not been given full weight due to a perceived lack of available evidence. In the Australian Capital Territory (ACT), one of the pilot sites of the Scheme, mental health care providers across all relevant sectors who were interviewed for a local Atlas of Mental Health Care described the impact of the scheme on their service provision. Methods: All mental health care providers from every sector in the ACT were contacted. The participation rate was 92%. We used the Description and Evaluation of Services and Directories for Long Term Care to assess all service provision at the local level. Results: Around one-third of services interviewed lacked funding stability for longer than 12 months. Nine of the 12 services who commented on the impact of the NDIS expressed deep concern over problems in planning and other issues. Conclusions: The transition to NDIS has had a major impact on ACT service providers. The ACT was a best-case scenario as it was one of the NDIS pilot sites.

scholarly journals Use and Effects of Patient Access to Medical Records in General Practice Through a Personal Health Record in the Netherlands: Protocol for a Mixed-Methods Study

10.2196/10193 ◽  
2018 ◽  
Vol 7 (9) ◽  
pp. e10193 ◽  
Author(s):  
Maria MT Vreugdenhil ◽  
Rudolf B Kool ◽  
Kees van Boven ◽  
Willem JJ Assendelft ◽  
Jan AM Kremer
Keyword(s):  
Health Care ◽  
General Practice ◽  
Health Care Providers ◽  
Personal Health Record ◽  
Mixed Methods Study ◽  
Personal Health ◽  
Care Providers ◽  
Group Discussions ◽  
Web Based ◽  
Staff Level

Background In the Dutch health care system, general practitioners hold a central position. They store information from all health care providers who are involved with their patients in their electronic health records. Web-based access to the summary record in general practice through a personal health record (PHR) may increase patients’ insight into their medical conditions and help them to be involved in their care. Objective We describe the protocol that we will use to investigate the utilization of patients’ digital access to the summary of their medical records in general practice through a PHR and its effects on the involvement of patients in their care. Methods We will conduct a multilevel mixed-methods study in which the PHR and Web-based access to the summary record will be offered for 6 months to a random sample of 500 polypharmacy patients, 500 parents of children aged <4 years, and 500 adults who do not belong to the former two groups. At the patient level, a controlled before-after study will be conducted using surveys, and concurrently, qualitative data will be collected from focus group discussions, think-aloud observations, and semistructured interviews. At the general practice staff (GP staff) level, focus group discussions will be conducted at baseline and Q-methodology inquiries at the end of the study period. The primary outcomes at the patient level are barriers and facilitators for using the PHR and summary records and changes in taking an active role in decision making and care management and medication adherence. Outcomes at the GP staff level are attitudes before and opinions after the implementation of the intervention. Patient characteristics and changes in outcomes related to patient involvement during the study period will be compared between the users and nonusers of the intervention using chi-square tests and t tests. A thematic content analysis of the qualitative data will be performed, and the results will be used to interpret quantitative findings. Results Enrollment was completed in May 2017 and the possibility to view GP records through the PHR was implemented in December 2017. Data analysis is currently underway and the first results are expected to be submitted for publication in autumn 2019. Conclusions We expect that the findings of this study will be useful to health care providers and health care organizations that consider introducing the use of PHR and Web-based access to records and to those who have recently started using these. Trial Registration Netherlands Trial Registry NTR6395; http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=6395 (Archived by WebCite at http://www.webcitation.org/71nc8jzwM) Registered Report Identifier RR1-10.2196/10193

scholarly journals Impact of mental health and addiction NIMHANS ECHO on primary care physicians: study from a rural state of India

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S157-S157
Author(s):  
Shabinabegam A M Sheth ◽  
Bhavya Bairy ◽  
Aurobind Ganesh ◽  
Sumi Jain ◽  
Prabhat Chand ◽  
...  
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Health Care ◽  
Primary Health Care ◽  
Health Care Providers ◽  
Mental Health Problems ◽  
Health Problems ◽  
Care Providers ◽  
Primary Health ◽  
Secondary Outcomes

AimsAs per National Mental Health Survey-2015-16, 83 out of 100 people having mental health problems do not have access to care in India. Further, primary health care providers (PCPs) have not been adequately trained in the screening, diagnosis, and initial management of common mental health conditions. There is thus a need to train health care providers at the State level to incorporate mental health into primary health care. In this paper, we report the findings of a collaborative project between the National Institute of Mental Health and Neuro Sciences (NIMHANS) Bangalore India, and the state of Chhattisgarh incorporating mental health into primary care and addressing urban-rural disparities through tele-mentoring.MethodWe assessed the impact of the NIMHANS Extended Community Health Care Outcome (ECHO), an online, blended training program on participants' knowledge and competence (primary outcome) and commitment, satisfaction, and performance (Secondary outcomes) using Moore's evaluation framework. Primary and secondary outcomes were determined through a pre-post evaluation, assessment of trainee participation in the quarterly tele ECHO clinic as well as periodic assignments, respectively.ResultOver ten months of the NIMHANS ECHO program, there was a significant improvement in the participants' knowledge post-ECHO (p < 0.05, t = −3.52). Self-efficacy in diagnosis and management of mental health problems approached significance; p < 0.001. Increased engagement in tele-ECHO sessions was associated with better performance for declarative and procedural knowledge. The attrition rate was low (5 out of 30 dropped out), and satisfaction ratings of the course were high across all fields. The participants reported a 10- fold increase in the number of patients with mental health problems they had seen, following the training. A statistically significant increase in the number of psychotropic drugs prescribed post ECHO with t = −3.295, p = 0.01.ConclusionThe outcomes indicate that the NIMHANS ECHO with high participant commitment is a model with capacity building potential in mental health and addiction for remote and rural areas by leveraging technology. This model has the potential to be expanded to other states in the country in providing mental health care to persons in need of care.

The determination of data collection tools that can measure and document the cooperation of local health care providers

2020 ◽  
Author(s):  
Beáta Erika Nagy ◽  
Róza Oláh ◽  
Erika Zombor ◽  
Péter Boris ◽  
Anna Szabina Szele
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Health Care Providers ◽  
Health Improvement ◽  
Local Health ◽  
Care Providers ◽  
Structured Interviews ◽  
Daily Work ◽  
Local Health Care ◽  
Institutional Relations

Abstract Background The overall objective of the study is to improve the mental health of the age group below 18 years through the investigation of the intra-and inter-sectoral cooperation between local suppliers and to make the intensity and quality of collaborations measurable. In this paper, based on Hungarian and international literature, we aim at describing the current and future optimal cooperation between the members of the mental health care system and examine the possibilities for documenting and measuring cooperation. Methods Semi-structured interviews were recorded with the leaders or representatives of 12 public educational institutions, six social and six health institutions involvement of the relevant experts (N = 24). Results The function of the institutions belonging to these systems, as well as the daily work of the professionals working there, have a significant impact on the mental health of children in either positive or negative directions. After exploring the current situation, the cooperation of local suppliers and inter-institutional relations can highly increase the mental health improvement of the youth. Conclusion According to the results, the developing progress can be more effective through organising the different forms of care, sectors and professionals together to achieve a common goal.

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