scholarly journals Technology Enabled Clinical Care (TECC): Protocol for a Prospective Longitudinal Cohort Study of Smartphone-Augmented Mental Health Treatment (Preprint)

2020 ◽  
Author(s):  
Natali Rauseo-Ricupero ◽  
John Torous
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Dialectical Behavior Therapy ◽  
Underserved Populations ◽  
Clinical Care ◽  
Clinical Severity ◽  
Psychotic Symptoms ◽  
Study Results ◽  
Prospective Longitudinal

BACKGROUND Even before COVID-19, there has been an urgent need to expand access to and quality of mental health care. This paper introduces an 8-week treatment protocol to realize that vision—Technology Enabled Clinical Care (TECC). TECC offers innovation in clinical assessment, monitoring, and interventions for mental health. TECC uses the mindLAMP app to enable digital phenotyping, clinical communication, and smartphone-based exercises that will augment in-person or telehealth virtual visits. TECC exposes participants to an array of evidence-based treatments (cognitive behavioral therapy, dialectical behavior therapy, acceptance and commitment therapy) introduced through clinical sessions and then practiced through interactive activities provided through a smartphone app called mindLAMP. OBJECTIVE TECC will test the feasibility of providing technology-enabled mental health care within an outpatient clinic; explore the practicality for providing this care to individuals with limited English proficiency; and track anxiety, depression, and mood symptoms for participants to measure the effectiveness of the TECC design. METHODS The TECC study will assess the acceptability and efficacy of this care model in 50 participants as compared to an age- and gender-matched cohort of patients presenting with similar clinical severity of depression, anxiety, or psychotic symptoms. Participants will be recruited from clinics in the Metro Boston area. Aspects of TECC will be conducted in both Spanish and English to ensure wide access to care for multiple populations. RESULTS The results of the TECC study will be used to support or adapt this model of care and create training resources to ensure its dissemination. The study results will be posted on ClinicalTrials.gov, with primary outcomes related to changes in mood, anxiety, and stress, and secondary outcomes related to engagement, alliance, and satisfaction. CONCLUSIONS TECC combines new digital mental health technology with updated clinical protocols and workflows designed to ensure patients can benefit from innovation in digital mental health. Supporting multiple languages, TECC is designed to ensure digital health equity and highlights how mobile health can bridge, not expand, gaps in care for underserved populations. INTERNATIONAL REGISTERED REPORT PRR1-10.2196/23771

scholarly journals International Interprofessional Collaborative Office Rounds (iiCOR): Addressing Children's Developmental, Behavioral, and Emotional Health Using Distance Technology

2021 ◽  
Vol 9 ◽  
Author(s):  
Jennifer S. H. Kiing ◽  
Heidi M. Feldman ◽  
Chris Ladish ◽  
Roopa Srinivasan ◽  
Craig L. Donnelly ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Health Care Services ◽  
Best Practice ◽  
Emotional Health ◽  
Clinical Care ◽  
Learning Technology ◽  
Cultural Variation ◽  
Co Morbidity

Developmental, behavioral, and emotional issues are highly prevalent among children across the globe. Among children living in low- and middle-income countries, these conditions are leading contributors to the global burden of disease. A lack of skilled professionals limits developmental and mental health care services to affected children globally. Collaborative Office Rounds are interprofessional groups that meet regularly to discuss actual cases from the participants' practices using a non-hierarchical, peer-mentoring approach. In 2017, International Interprofessional Collaborative Office Rounds was launched with several goals: to improve the knowledge and skills of practicing child health professionals in high and low resourced settings regarding developmental and mental health care, to support trainees and clinicians in caring for these children, and to promote best practice in diagnosis and management of these conditions. Five nodes, each comprised of 3–4 different sites with an interprofessional team, from 8 countries in North America, Africa, Asia, and South America met monthly via videoconferencing. This report describes and evaluates the first 2 years' experience. Baseline surveys from participants (N = 141) found that 13 disciplines were represented. Qualitative analysis of 51 discussed cases, revealed that all cases were highly complex. More than half of the cases (N = 26) discussed children with autism or traits of autism and almost all (N = 49) had three or more themes discussed. Frequently occurring themes included social determinants of health (N = 31), psychiatric co-morbidity (N = 31), aggression and self-injury (N = 25), differences with the healthcare provider (N = 17), cultural variation in accepting diagnosis or treatment (N = 19), and guidance on gender and sexuality issues (N = 8). Participants generally sought recommendations on next steps in clinical care or management. A survey of participants after year 1 (N = 47) revealed that 87% (N = 41) had expectations that were completely or mostly met by the program. Our experience of regular meetings of interprofessional groups from different countries using distance-learning technology allowed participants to share on overlapping challenges, meet continuing educational needs while learning about different approaches in high- and low-resourced settings. International Interprofessional Collaborative Office Rounds may prove a useful strategy for increasing the work force capacity for addressing developmental, behavioral, and emotional conditions worldwide. More systematic studies are needed.

Daily ward process in inpatient mental health care

2019 ◽  
pp. 187-192
Author(s):  
Katalin Walsby ◽  
Caroline Attard
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Clinical Care ◽  
Therapeutic Relationships ◽  
Inpatient Mental Health ◽  
Safe Environments

This chapter describes regular daily processes within the inpatient mental health ward that form the backbone of the ward’s functioning and underpin the ability of wards to provide therapeutic and safe environments. Precisely because acute inpatient wards can be unpredictable, with changing circumstances generating unremitting challenges to patients, carers, and staff, these daily processes, such as handover, medication, and mealtimes, are crucial to help create a sense of structure as well as safe clinical care. These processes must be followed if inpatient psychiatric wards are going to be able to provide an environment that allows the development of enabling and therapeutic relationships for patients, carers, and staff themselves.

scholarly journals COVID-19 mental health care toolkit: an international collaborative effort by Early Career Psychiatrists section

2020 ◽  
Vol 33 (5) ◽  
pp. e100270
Author(s):  
Frances Adiukwu ◽  
Laura Orsolini ◽  
Drita Gashi Bytyçi ◽  
Samer El Hayek ◽  
Jairo M Gonzalez-Diaz ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Clinical Care ◽  
Outpatient Setting ◽  
Early Career ◽  
Collaborative Effort ◽  
Risk Patients ◽  
International Research Team ◽  
Health Field

The collaborative effort of an international research team from the Early Career Psychiatrists section of the World Psychiatry Association has brought about an easy-to-use, quick and stepwise mental health care toolkit for the identification and appropriate referral of those in need of mental health care during the pandemic. This simple guide can be applied in the general outpatient setting and is catered for all healthcare professionals, regardless of their expertise within the mental health field with minimal training. It is our hope that by incorporating this toolkit into our daily clinical care during the pandemic for high-risk patients and patients with non-specific complaints, we will be able to bridge the mental health gap present in our society.

Listening to patients' needs to improve their subjective quality of life

2005 ◽  
Vol 35 (11) ◽  
pp. 1655-1665 ◽  
Author(s):  
ANTONIO LASALVIA ◽  
CHIARA BONETTO ◽  
FRANCESCA MALCHIODI ◽  
GIOVANNI SALVI ◽  
ALBERTO PARABIAGHI ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Mental Health Professionals ◽  
Subjective Quality ◽  
Subjective Quality Of Life ◽  
Community Based ◽  
Prospective Longitudinal

Background. Subjective quality of life has gained a crucial role as a global measure of outcome in mental health care. This study aimed to investigate the impact of meeting needs for care, as assessed by both patients and mental health professionals, to improve the subjective quality of life in a sample of patients receiving community-based psychiatric care.Method. The study was conducted using a 4-year prospective longitudinal design. A cohort of patients from the South-Verona Community-based Mental Health Service (CMHS) was assessed at baseline and follow-up using, among other social and clinical measures, the Camberwell Assessment of Need (both staff and patient versions) and the Lancashire Quality of Life Profile. Predictors of changes of subjective quality of life were explored using block-stratified multiple regression procedures.Results. Improvement in patients' clinical conditions as well as the reduction in patient-rated unmet needs in the social domain predicted an increase in subjective quality of life over 4 years; changes in staff-rated needs did not show any association with changes in subjective quality of life.Conclusions. Meeting self-perceived social needs, beyond symptoms reduction, seems to be of particular importance for ensuring a better quality of life for people with mental disorders. If the main goal of mental health care is to improve the quality of life of users, a policy of actively addressing patient-rated needs should be implemented.

scholarly journals Online Training Program Improves Providers’ Spiritual Competencies in Mental Health Care

2020 ◽  
Author(s):  
Michelle Pearce ◽  
Kenneth Pargament ◽  
Holly Oxhandler ◽  
Cassandra Vieten ◽  
Serena Wong
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Training Program ◽  
Professional Training ◽  
Graduate Training ◽  
Clinical Care ◽  
Online Training ◽  
Knowledge And Skills ◽  
Spiritual Competency

Background: We designed the online Spiritual Competency Training in Mental Health (SCT-MH) program to train providers across mental health fields in basic religious and spiritual (RS) competencies. The goal was to help address the professional training gap in RS aspects of multicultural diversity and integration. We hypothesized that providers completing the program would demonstrate an increase in attitudes, knowledge, and skills relevant to RS issues in mental health care. Methods: The SCT-MH program, offered online through the edX platform, consists of 8 hours of multi-media content. 169 participants across a broad range of mental health disciplines completed a pre- and post-training survey, which evaluated their spiritual competency using measures assessing their attitudes, knowledge, and skills in the intersection of RS and mental health. We also collected qualitative data to evaluate participants’ levels of satisfaction with the content and format of the program. Results: Participants showed significantly increased spiritual competency in all measures of attitudes, knowledge, and skills following their participation in the course. Participants reported high satisfaction with both the content and the online format of the training program, and a decrease in perceived barriers to integrating RS in practice.Conclusions: These results demonstrate that a brief, novel online training program can help address the current gap between the clinical need and professional requirements for spiritual competency and the general lack of graduate training in this area of multiculturalism. Suggestions for how this program and others like it can be integrated into graduate education and impact clinical care are discussed.

scholarly journals T91. THE POSITIVE AND NEGATIVE SYNDROME SCALE SUPERIOR TO A SELF-REPORT QUESTIONNAIRE IN THE PHARMACOTHERAPY MONITORING AND OUTCOME SURVEY

2020 ◽  
Vol 46 (Supplement_1) ◽  
pp. S266-S266
Author(s):  
Annegien Bartels-Velthuis ◽  
Koen Ties ◽  
Ellen Visser ◽  
Johan Arends ◽  
Marieke Pijnenborg ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Self Report ◽  
Psychotic Symptoms ◽  
Positive Symptoms ◽  
Data Set ◽  
Syndrome Scale ◽  
Outcome Monitoring ◽  
Negative Syndrome

Abstract Background Aiming to improve the quality of care for patients with a psychotic disorder, the ongoing Pharmacotherapy Monitoring Outcome Survey (PHAMOUS) started in 2006 in four large mental health care organizations in the Northern Netherlands, by adding it to the at that time mandatory Routine Outcome Monitoring program. However, since the cuts in the financial budgets for mental health care, research nurses are increasingly experiencing time-pressure in the assessments. The Positive and Negative Syndrome Scale (PANSS), part of the assessment, is a time-consuming interview, taking approximately 30 minutes. Therefore, we developed and validated a short self-report questionnaire assessing positive psychotic symptoms, the Brief Positive Symptoms Questionnaire (BPSQ). Methods The BPSQ was added to PHAMOUS and filled in once by patients in four mental health care institutions in 2017 and 2018. The BPSQ consists of nine items and takes about 2–3 minutes to complete. It was validated against the PANSS positive scale and two items of the Health of the Nations Outcome Scale (HoNOS), with item 6 assessing the problems that patients experience due to hallucinations and delusions and item 8 assessing further mental and behavioural problems. Results BPSQ data were obtained from n=287 patients (mean age 47.1 years, 67.6% male). The PANSS was assessed in n=244 and HoNOS data were available for n=156 patients. Scores of one patient were considered unreliable and thus removed from the data set. The BPSQ had a Cronbach’s alpha of .81. Spearman’s correlation coefficient of the BPSQ and the PANSS positive scale was significant (ρ(243) = .63, p < .05). Correlations between the BPSQ and HoNOS items 6 and 8 were significant (ρ(155) = .488, p < .05 and ρ(155) = .251, p < .05 respectively). Post hoc analysis showed that the more severely psychotic the patients were, the less the BPSQ and the PANSS positive scale were corresponding. Discussion Given the medium correlation of the BPSQ with the PANSS positive scale and the low concurrent validity with the two relevant HoNOS items, we argue that the widely used and validated PANSS is indispensable in the PHAMOUS assessment of positive symptoms in a chronic population with psychotic disorders. Replication of this study in first-episode psychotic patients is recommended.

scholarly journals “I Can’t Crack the Code”: What Suicide Notes Teach Us about Experiences with Mental Illness and Mental Health Care

2018 ◽  
Vol 64 (2) ◽  
pp. 98-106 ◽  
Author(s):  
Zainab Furqan ◽  
Mark Sinyor ◽  
Ayal Schaffer ◽  
Paul Kurdyak ◽  
Juveria Zaheer
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Illness ◽  
Mental Health Care ◽  
Suicidal Behaviour ◽  
Mental Health Treatment ◽  
Clinical Care ◽  
Personal Agency ◽  
Subjective Experiences ◽  
Suicide Notes

Objective: While mental illness is a risk factor for suicidal behaviour and many suicide decedents receive mental health care prior to death, there is a comparative lack of research that explores their experiences of mental illness and care. Suicide notes offer unique insight into these subjective experiences. Our study explores the following questions: “How are mental illness and mental health care experienced by suicide decedents who leave suicide notes?” and “What role do these experiences play in their paths to suicide?” Method: We used a constructivist grounded theory framework to select a focus of qualitative analysis and engage in line-by-line open coding, axial coding, and theorizing of the data. Our sample is a set of 36 suicide notes that explicitly make mention of mental illness and/or mental health care, purposefully selected from a larger sample of 252 notes. Results: The primary themes from our sample were 1) negotiating personal agency in the context of mental illness, 2) conflict between self and illness, and 3) experiences of mental health treatment leading to hopelessness and self-blame. These experiences with mental illness and mental health care can give rise to exhaustion and a desire to exercise personal agency, contributing to suicidal behaviour. Conclusions and Relevance: This study highlights unique perspectives by suicide decedents, whose voices and experiences may not have been heard otherwise, addressing a critical deficit in existing literature. These insights can potentially enrich clinical care or strengthen existing suicide prevention programs.

Working with Traumatized Immigrants with a ptsd Diagnosis

2017 ◽  
Vol 41 (S1) ◽  
pp. S17-S17
Author(s):  
I.T. Graef-Calliess
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Asylum Seekers ◽  
Depressive Disorders ◽  
Transcultural Psychiatry ◽  
Traumatic Experiences ◽  
Study Results ◽  
Important Host ◽  
Competing Interest

Graef-Calliess Iris (Germany).Germany has always been an important host country for asylum seekers. Although recently an increasing number of investigations about mental health of specific migrant groups have been published in Germany, there is a paucity of research concerning mental health of traumatized asylum seekers. The aim of the presentation is to present study results which describe socio-demographics, types and frequency of traumatic experiences, psychiatric diagnoses, suicidality and time to access to mental health care in traumatized asylum seekers who applied to an outpatient department of a clinical center with high expertise in transcultural psychiatry and psychotherapy in Hannover, Germany. The study shows that most of the traumatized asylum seekers had experienced multiple pre-migratory traumatic events, had unfavorable post-migratory conditions, had PTSD and depressive disorders as diagnoses, and had high suicidality and late access to mental health care. This is indicative of the mental health situation of asylum seekers in Germany in general. Ways of dealing with this challenge for the mental health care system and options for clinical management will be presented.Disclosure of interestThe author has not supplied his declaration of competing interest.

Sign in / Sign up

Export Citation Format

Share Document