Psykologer i kommunen: En kartlegging av tjenester for barn og unge med psykiske vansker

2021 ◽  
Vol 58 (6) ◽  
Keyword(s):  
Mental Health ◽  
Health Services ◽  
Children And Adolescents ◽  
Service Providers ◽  
Population Level ◽  
Clinical Psychologist ◽  
Service Users ◽  
Individual Level ◽  
Specialist Services ◽  
Common Problems

Background: Frontline mental health services for children and adolescents are receiving increased attention, and all Norwegian municipalities were required to hire a clinical psychologist by 2020. However, we know little about what role clinical psychologists have taken in frontline services in terms of the content of their service or how they differ from other frontline practitioners. Objective: The objective was to investigate what types of problems children and adolescents who receive help from frontline psychologists have, what type of help is being offered, what improvements are needed, and how the services provided by psychologists differ from those of other frontline service providers. Method: The current study is based on reports from 139 psychologists and 587 other professionals working with children and adolescents in frontline services. Results: The psychologists report emotional struggles and challenging life situations to be the most common problems among their service users. Most of the interventions delivered by psychologists are provided at individual level rather than at group or population level. Compared with other frontline practitioners, psychologists more often include parents in sessions with children and adolescents. Both psychologists and other professionals report a need for increased collaboration across services. Implications: The results suggest that improvements could involve strengthening collaboration between frontline and specialist services.

Barriers and Supports Experienced by Pacific Peoples in Aotearoa New Zealand’s Mental Health Services

2021 ◽  
pp. 002202212110398
Author(s):  
Christina Fa’alogo-Lilo ◽  
Claire Cartwright
Keyword(s):  
Mental Health ◽  
New Zealand ◽  
Mental Health Services ◽  
Health Services ◽  
Cultural Values ◽  
Mental Health Problems ◽  
Service Providers ◽  
Health Problems ◽  
Service Users ◽  
The Family

As with minority groups internationally, Pacific peoples in New Zealand (Pasifika) experience higher rates of mental health problems than the general population, and are less likely to access mental health services. This study investigated the barriers and supports for Pasifika accessing and using mental health services with participation of 25 Pasifika (10 service-providers, 11 ex-service-users, and 4 ex-service-users/providers) in order to gain their key informant perspectives. A Pasifika-appropriate Talanoa approach was used to guide the data-collection process and the qualitative data were analyzed using thematic analysis. Barriers included stigma among Pasifika regarding mental health problems, commitment to finding solutions within the family, and both mistrust and lack of knowledge of services. Within the services, non-Pasifika providers often lacked understanding of the collectivist cultural values and practices of Pasifika, including spiritual beliefs. They were more likely to use services if the providers were respectful of Pasifika practices and paid attention to developing relationships in a culturally appropriate way. This included involvement of the Pasifika family, when possible. Service-users often benefited from contact with Pasifika providers within mainstream services. These results support previous cross-cultural research that indicates the importance of offering evaluation and intervention services grounded in an understanding and respect for the cultural significance and meaning of mental health problems for the person, the family, and their community. While efforts are made to address these issues in New Zealand, change is slow and ongoing cultural training for service-providers along with psychoeducation for Pasifika about mental health services is strongly desirable.

scholarly journals Perspectives of Health Service Providers on Barriers to Accessing Perinatal Mental Health Services in Karnataka, India: a Qualitative Study

2020 ◽  
Author(s):  
Debarati Mukherjee ◽  
Nolita Dolcy ◽  
Daisy A John ◽  
Maithili Karthik ◽  
Swapnil A Gadhave ◽  
...  
Keyword(s):  
Mental Health ◽  
Risk Factors ◽  
Mental Health Services ◽  
Health Services ◽  
Service Providers ◽  
Maternal Mental Health ◽  
Perinatal Mental Health ◽  
Frontline Workers ◽  
Individual Level ◽  
Health Service Providers

Abstract Background: Poor maternal mental health is a major public health concern since it adversely impacts both maternal and child health outcomes. This study aimed to document the barriers to utilizing perinatal mental health services in Karnataka, India, and to determine its relationship with risk factors of poor maternal mental health in this context. Methods: Qualitative research methods using in-depth interviews were conducted on twenty-one local stakeholders who represented health service providers in various capacities: mental health specialists (n = 4), gynaecologists (n = 2), government officials from the Department of Health and Family Welfare (n = 2), and Department of Women and Child Development (n = 2), senior state consultant to United Nations Children’s Fund (n = 1), and frontline workers (n = 10). Data were analysed using a thematic framework analysis approach. Results: We identified multiple barriers to service utilization operating at the levels of the health system, community, family, and the individual. Health-system level barriers included lack of a universal screening mechanism, poor infrastructure, poor training of frontline workers on mental health issues, and inadequate time for counselling and treatment. Community-level barriers included stigma and misconceptions, leading to a lack of social support. Family and individual level barriers included the financial burden of availing services, lack of family and partner support, and lack of empowerment and motivation in the woman to seek services. Family and individual level barriers interacted with risk factors of poor maternal mental health. Based on this evidence and drawing from the literature, we propose a contextualised, stepped-care model for universal screening, detection, referral, and treatment of women with perinatal mental health conditions for Karnataka that is integrated with the reproductive, maternal, and child health (RMNCH) program in primary care settings. Conclusions: The framework developed in this study suggests that addressing the identified barriers would potentially increase uptake of available services, create awareness about and demand for high-quality mental health services, reduce the risk factors of poor maternal mental health, and eventually improve our understanding of its true burden in the state of Karnataka. This is essential for proper implementation, monitoring, and evaluation of programs relevant to perinatal mental health.

scholarly journals Supporting mental health service users to stop smoking: findings from a process evaluation of the implementation of smokefree policies into two mental health trusts

2020 ◽  
Author(s):  
Susan E Jones ◽  
S. Mulrine ◽  
H. Clements ◽  
S. Hamilton
Keyword(s):  
Mental Health ◽  
Mental Health Service ◽  
Mental Health Services ◽  
Health Service ◽  
Health Services ◽  
Collective Action ◽  
Process Evaluation ◽  
Service Providers ◽  
Service Users ◽  
Process Data

Abstract Background: Life expectancy is 10-20 years lower among people with a severe mental health disorder. Most of these early deaths are due to chronic conditions, including cardiovascular and respiratory diseases. Smoking is a major risk factor for these conditions and introducing smokefree policies has been recommended to mental health service providers in England by the National Institute for Health and Care Excellence (NICE), in their Public Health Guideline 48: Smoking: acute, maternity and mental health services. This paper reports a process evaluation of introducing these policy recommendations, which were updated in 2013. Aim: To reflect on the process outcomes when introducing smokefree policies in National Health Service (NHS) Trusts providing mental health services in an English region. Method: Process data were collected through semi-structured interviews with staff (n=51), members of partnering organisations (n=5), service users (n=7) and carers (n=2) between November 2016 – April 2017. Normalization Process Theory (NPT) was used to design the data collection tools and analyse the data. A framework approach was taken with the analysis, using the four concepts of NPT: coherence, cognitive participation, collective action and reflexive monitoring. Results: The policy made sense to some staff, patients and carers (coherence) who ‘bought-into’ the idea (cognitive participation) but other participants disagreed. Although smokefree policies were operationalised (collective action), sometimes they were opposed. Progress was made, especially in some units, but continued to be resisted in others. Informal appraisal of progress (reflexive monitoring) presented a varied picture. Conclusion Some progress has been made in terms of changing an entrenched, smoking culture into one that is smokefree on Trust sites across the region. Perseverance and resourcing over the long-term is required to establish a non-smoking culture in on-site provision of mental health services.

scholarly journals Speaking Truth to Power: Mental Health Service Users’ Experiences of Participation in their Diagnosis and Treatment

2020 ◽  
Vol 22 (1) ◽  
pp. 137-156
Author(s):  
Gloria Kirwan
Keyword(s):  
Mental Health ◽  
Mental Health Service ◽  
Mental Health Services ◽  
Health Service ◽  
Health Services ◽  
Service User ◽  
Help Seeking ◽  
Service Providers ◽  
Diagnosis And Treatment ◽  
Service Users

In a qualitative study, long-term mental health service users shared their views on the concept of ‘participation’ as shaped by their personal histories of contact with mental health services in Ireland. Adopting a narrative methodology, the study participants were asked to draw on their experiences with mental health services to illustrate their general views on participation by service users in mental health care contexts.In this study, the research participants recounted positive experiences of participation in which their expressed views regarding their symptoms and treatment needs were incorporated into the service responses they received. The data revealed that service users perceived open and inclusive communication by service providers as an important factor in optimising their ability to participate in help-seeking, diagnosis and treatment plans. However, the study also illuminated the chilling effect on participation when service users’ views were not heeded or acknowledged by service providers. The findings highlight how the failure to include service users’ insights can negatively encroach on service user participation. The service user narratives collected in this study exposed the often uneasy juxtaposition of the service user’s personally held ‘truth’ regarding their lived experience of mental distress versus the powerful system of expert diagnosis and treatment. This article focuses on reporting selective findings from the study regarding participation in the contexts of help-seeking, diagnosis and treatment decisions.

scholarly journals Perspectives of Health Service Providers on Barriers to Accessing Perinatal Mental Health Services in Karnataka, India: A Qualitative Study

2021 ◽  
Author(s):  
Debarati Mukherjee ◽  
Nolita Dolcy ◽  
Daisy A John ◽  
Maithili Karthik ◽  
Swapnil A Gadhave ◽  
...  
Keyword(s):  
Mental Health ◽  
Risk Factors ◽  
Mental Health Services ◽  
Health Services ◽  
Service Providers ◽  
Maternal Mental Health ◽  
Perinatal Mental Health ◽  
Frontline Workers ◽  
Individual Level ◽  
Health Service Providers

Abstract Background: Poor maternal mental health is a major public health concern since it adversely impacts both maternal and child health outcomes. This study aimed to document the barriers to utilizing perinatal mental health services in Karnataka, India, and to determine its relationship with risk factors of poor maternal mental health in this context. Methods: Qualitative research methods using in-depth interviews were conducted on twenty-one local stakeholders who represented health service providers in various capacities: mental health specialists (n = 4), gynaecologists (n = 2), government officials from the Department of Health and Family Welfare (n = 2), and Department of Women and Child Development (n = 2), senior state consultant to United Nations Children’s Fund (n = 1), and frontline workers (n = 10). Data were analysed using a thematic framework analysis approach. Results: We identified multiple barriers to service utilization operating at the levels of the health system, community, family, and the individual. Health-system level barriers included lack of a universal screening mechanism, poor infrastructure, poor training of frontline workers on mental health issues, and inadequate time for counselling and treatment. Community-level barriers included stigma and misconceptions, leading to a lack of social support. Family and individual level barriers included the financial burden of availing services, lack of family and partner support, and lack of empowerment and motivation in the woman to seek services. Family and individual level barriers interacted with risk factors of poor maternal mental health. Based on this evidence and drawing from the literature, we propose a contextualised, stepped-care model for universal screening, detection, referral, and treatment of women with perinatal mental health conditions for Karnataka that is integrated with the reproductive, maternal, and child health (RMNCH) program in primary care settings. Conclusions: The framework developed in this study suggests that addressing the identified barriers would potentially increase uptake of available services, create awareness about and demand for high-quality mental health services, reduce the risk factors of poor maternal mental health, and eventually improve our understanding of its true burden in the state of Karnataka. This is essential for proper implementation, monitoring, and evaluation of programs relevant to perinatal mental health.

A national survey of offending behaviour amongst intellectually disabled users of mental health services in Ireland

2015 ◽  
Vol 33 (4) ◽  
pp. 207-215 ◽  
Author(s):  
P. Leonard ◽  
A. Morrison ◽  
M. Delany-Warner ◽  
G. J Calvert
Keyword(s):  
Mental Health ◽  
Intellectual Disability ◽  
Mental Health Services ◽  
Health Services ◽  
Service Providers ◽  
Service Users ◽  
Republic Of Ireland ◽  
Disability Service ◽  
The Republic ◽  
Offending Behaviour

BackgroundOffenders with an intellectual disability pose a major challenge to Intellectual Disability Service providers in the Republic of Ireland. This is especially so as no national Forensic Intellectual Disability Service currently exists.The Forensic Intellectual Disability Working Group of the Irish College of Psychiatrists was established in order to take steps to address this issue by establishing the level of need for a Forensic Intellectual Disability Service in Ireland and developing a college position paper.No previous study has been carried out to measure offending behaviour amongst persons with an intellectual disability attending mental health services in Ireland.MethodsA postal survey was undertaken targeting the lead clinicians of all Intellectual Disability Psychiatry, General Adult Psychiatry and Forensic Psychiatry Services in the Republic of Ireland. This survey requested anonymous data regarding service users with an intellectual disability and offending behaviour in this population.ResultsData relating to 431 service users was returned. Those reported to engage in offending behaviour were predominantly young males. Assault was the most common offence type. A significant number of serious offences such as unlawful killing, sexual assault and arson were reported.ConclusionsThere is an urgent need for the development of a Forensic Intellectual Disability Service in the Republic of Ireland. The current efforts of the National Forensic Mental Health Service to establish such a service by the creation of a post of Consultant Forensic Psychiatrist (special interest in intellectual disability) are to be welcomed.

scholarly journals Experiences of mental health service users on their empowerment and social integration in the community

2018 ◽  
Vol 7 (1) ◽  
pp. 165-180 ◽  
Author(s):  
Vasiliki Yotsidi ◽  
Kalliope Kounenou
Keyword(s):  
Mental Health ◽  
Mental Health Service ◽  
Mental Health Services ◽  
Community Mental Health ◽  
Mental Disorders ◽  
Health Service ◽  
Health Services ◽  
Service Providers ◽  
Community Mental Health Services ◽  
Service Users

The transition from institutionalized towards community mental health services demands the evolution from social exclusion to integration practices. Empowerment of people with mental disorders, through their involvement in planning and service provision, prevails as a cutting-edge in such practices. Along these lines, this study adopted a structured bottom-up research methodology to explore the experiences of people with severe mental disorders on nine areas of their community participation. Three focus groups of 18 persons with psychotic disorders who were treated on an out-patient community mental health centre were set up. Qualitative data analysis showed that the areas of treatment, housing, education, and entertainment have turned to be more accessible for mental health service users than those of employment, active citizenship, social relations, social networks and activities in the community. The latter were revealed to still be obstructed by specific personal and social variables, which should be taken into account for community-based treatment to become more responsive and tailor-made. Results are discussed in relation to the role of counselling psychology in improving community mental health services and ensuring that service providers empathize with and respond to individuals' understanding of their condition and what contributes to their care and well-being.

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