The Wages of Continuity: Health Policy Under the SNP

2016 ◽  
Vol 25 (1) ◽  
pp. 28-44 ◽  
Author(s):  
Scott L. Greer ◽  
Iain Wilson ◽  
Peter D. Donnelly

In government, the SNP has accentuated stability, public provision, and integration in health care and focused energy and patience in neglected ‘Cinderella’ policy areas such as mental health, public health, and health inequalities. This approach is not dissimilar to the policies of previous devolved Scottish governments. It makes Scotland an unusual kind of NHS system- one with stability and long-term focus on issues that are not obvious political winners. The SNP's successes in health come from building on, holding firm to, and developing this distinctively Scottish style of health policy.

Author(s):  
Simeon J Zuercher ◽  
Philipp Kerksieck ◽  
Christine Adamus ◽  
Christian Burr ◽  
Anja I Lehmann ◽  
...  

Background: The swift spread of SARS-CoV-2 provides a challenge worldwide. As a consequence of restrictive public health measures like isolation, quarantine, and community containment, the provision of mental health services is a major challenge. Evidence from past virus epidemics and the current SARS-CoV-2 outbreak indicate high prevalence rates of mental health problems (MHP) as short- and long-term consequences. However, a broader picture of MHP among different populations is still lacking. Methods: We conducted a rapid review on MHP prevalence rates published since 2000, during and after epidemics, including the general public, health care workers, and survivors. Any quantitative articles reporting on MHP rates were included. Out of 2855 articles screened, a total of 74 were included in this review. Results: Most original studies on MHP were conducted in China in the context of SARS-CoV-1, and reported on anxiety, depression, post-traumatic stress symptoms/disorder, general psychiatric morbidity, and psychological symptoms. The MHP rates across studies, populations, and epidemics vary substantially. While some studies show high and persistent rates of MHP in populations directly affected by isolation, quarantine, threat of infection, infection, or life-threatening symptoms (e.g. health care workers), other studies report minor effects. Furthermore, even less affected populations (e.g. distant to epidemic epicenter, no contact history with suspected or confirmed cases) can show high rates of MHP. Discussion: MHP vary largely across countries and risk-groups in reviewed studies. The results call attention to potentially high MHP during epidemics. Individuals affected directly by an epidemic might be at a higher risk of short or even long-term mental health impairments. This study delivers insights stemming from a wide range of psychiatric instruments and questionnaires. The results call for the use of validated and standardized instruments, reference norms, and pre-post measurements to better understand the magnitude of the MHP during and after the epidemics. Nevertheless, emerging MHP should be considered during epidemics including the provision of access to mental health care to mitigate potential mental impairments.


2021 ◽  
Vol In Press (In Press) ◽  
Author(s):  
John Chukwuma Oyem ◽  
Patrick Chukwuyenum Ichipi-Ifukor ◽  
Chukubueze Caleb Obi-Ojinika

Context: The outbreak of the highly infectious COVID-19 has led to a global public health and economic crisis, especially in developing countries. Due to the global burden and spread and the high mortality rate of the virus, as well as an inadequate mental health care system in Nigeria, inhabitants often experience fear, depression, and anxiety that, if left unaddressed, may lead to long-term consequences. Although depression was a concerning issue in Nigeria before COVID-19, the pandemic has caused a surge in depression cases. This review highlighted the possible causes of depression among Nigerians during the COVID-19 pandemic and identified potential mitigating interventions to prevent depression. Evidence Acquisition: We searched PubMed for the articles published from January 2019 to September 2020 using the terms of “depression”, “COVID-19”, and “Nigeria”. The articles resulting from these searches and the relevant references cited in those articles were reviewed. Results: Nigerians are likely to fall into depression due to the challenges and limitations affecting the economy and development of Nigeria. Conclusions: During the COVID-19 struggle, providing sound mental health services for individuals is imperative to maintain nations’ mental health for a more rapid recovery across various measures of societal well-being post-COVID-19.


Author(s):  
Richard J. Bonnie ◽  
Heather Zelle

This chapter explores ethical issues in mental health policy from a public health perspective, with a focus on the United States. Ethical discourse about mental health treatment has typically focused on paradigmatic concepts of individual autonomy, competence, paternalism, and appropriate justifications for overriding individual decision-making and restricting individual liberty. This chapter focuses on overarching ethical challenges in mental health policy at the population level—enhancing access of persons with mental illness to preventive services and community supports, and facilitating their successful community integration. Achieving these goals can reduce the need for coercion and ameliorate the social burden and stigma of mental illness. Shifting ethical discourse to the population level is an important step in the continuing transformation of mental health care and policy in the twenty-first century.


Author(s):  
Diana Hart

All countries are faced with the problem of the prevention and control of non-communicable diseases (NCD): implement prevention strategies eff ectively, keep up the momentum with long term benefi ts at the individual and the population level, at the same time tackling hea lth inequalities. Th e aff ordability of therapy and care including innovative therapies is going to be one of the key public health priorities in the years to come. Germany has taken in the prevention and control of NCDs. Germany’s health system has a long history of guaranteeing access to high-quality treatment through universal health care coverage. Th r ough their membership people are entitled to prevention and care services maintaining and restoring their health as well as long term follow-up. Like in many other countries general life expectancy has been increasing steadily in Germany. Currently, the average life expectancy is 83 and 79 years in women and men, respectively. Th e other side of the coin is that population aging is strongly associated with a growing burden of disease from NCDs. Already over 70 percent of all deaths in Germany are caused by four disease entities: cardiovascular disease, cancer, chronic respiratory disease and diabetes. Th ese diseases all share four common risk factors: smoking, alcohol abuse, lack of physical activity and overweight. At the same time, more and more people become long term survivors of disease due to improved therapy and care. Th e German Government and public health decision makers are aware of the need for action and have responded by initiating and implementing a wide spectrum of activities. One instrument by strengthening primary prevention is the Prevention Health Care Act. Its overarching aim is to prevent NCDs before they can manifest themselves by strengthening primary prevention and health promotion in diff erent sett ings. One of the main emphasis of the Prevention Health Care Act is the occupational health promotion at the workplace.


2021 ◽  
pp. 135581962199749
Author(s):  
Veronica Toffolutti ◽  
David Stuckler ◽  
Martin McKee ◽  
Ineke Wolsey ◽  
Judith Chapman ◽  
...  

Objective Patients with a combination of long-term physical health problems can face barriers in obtaining appropriate treatment for co-existing mental health problems. This paper evaluates the impact of integrating the improving access to psychological therapies services (IAPT) model with services addressing physical health problems. We ask whether such services can reduce secondary health care utilization costs and improve the employment prospects of those so affected. Methods We used a stepped-wedge design of two cohorts of a total of 1,096 patients with depression and/or anxiety and comorbid long-term physical health conditions from three counties within the Thames Valley from March to August 2017. Panels were balanced. Difference-in-difference models were employed in an intention-to-treat analysis. Results The new Integrated-IAPT was associated with a decrease of 6.15 (95% CI: −6.84 to −5.45) [4.83 (95% CI: −5.47 to −4.19]) points in the Patient Health Questionnaire-9 [generalized anxiety disorder-7] and £360 (95% CI: –£559 to –£162) in terms of secondary health care utilization costs per person in the first three months of treatment. The Integrated-IAPT was also associated with an 8.44% (95% CI: 1.93% to 14.9%) increased probability that those who were unemployed transitioned to employment. Conclusions Mental health treatment in care model with Integrated-IAPT seems to have significantly reduced secondary health care utilization costs among persons with long-term physical health conditions and increased their probability of employment.


2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
◽  

Abstract The workshop has the aim to help developing and strengthening policies for Public Mental Health and support experience sharing platform for Public Mental Health policy development. Mental health policy defines the vision for the future mental health of the national population and internationally. The WHOs developed three recommendations for the development of mental health policy, strategic plans and for organizing services which are to deinstitutionalise mental health care; to integrate mental health into general health care; and to develop community mental health services. For each this aim a situational analysis and needs assessment is recommended as first step. Therefore, this workshop consists of four talks in the development of mental health policies at the regional and national level. First, the process of population consultations and participatory research is described (Felix Sisenop). Participatory research enables exchanging experiences, results and key challenges in Public Mental Health. Participatory research can contribute greatly in empowering people to discuss and deal with mental health issues and therefore is a step towards a more involved and active general public. Second, a policy development at the regional level is described (Elvira Mauz). On behalf of the federal ministry of health the Robert Koch Institute as the German public health institute is currently developing a concept for a national Mental Health Surveillance (MHS). In the talk objectives, framework model and work processes are presented. The MHS should systematically gather, process and analyze primary and secondary data, thus an integrating and monitoring system is working. Third, the Public Mental Health policy in Malta will be described (John Cachia) Over the last 7 years CMH Malta developed a strategic framework for the mental health with the input of patients, families, service providers, NGOs and civil society. The Maltese National Mental Health Strategy 2020-2030 was published in July 2019. This strategy will be described in the Talk. Fourth presenter (Ignas Rubikas) will introduce the national perspective on development of Lithuanian mental health policy addressing major public mental health challenges of suicide prevention, alcohol control policies and mental health promotion in a broader context of national mental health care. Key messages Participatory research in Public Mental Health is an approach to involve the population in policy development. Development of mental health policies can benefit from sharing experiences and lessons learned on a national and regional levels.


1996 ◽  
Vol 12 (4) ◽  
pp. 644-656
Author(s):  
Richard E. Peschel ◽  
Enid Peschel

AbstractConsumerism is a growing phenomenon in U.S. health care, yet its exercise is still inhibited by powerful forces within the medical community. Despite the neuroscientific framework that stresses the commonalities between mental and physical illness, consumerism is even more problematic and difficult in mental health care than in other areas of health care. People with severe mental illness and their advocates must contend with limited public understanding of neurobiological disorders, poor definitions of effective treatment, and a paucity of outcome data, especially from prospective randomized and long-term studies. The only clear way for consumerism to grow in mental health care is for its advocates to align themselves with the neuroscientific revolution and to demand that effective and equitable treatment programs be created based on the documented evidence of the physical nature of neurobiological disorders.


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