Urgent Need for Improved Mental Health Care and a More Collaborative Model of Care

Community-based Shared Mental Health Care: A Model of Collaboration?

Australian Journal of Primary Health ◽

10.1071/py06027 ◽

2006 ◽

Vol 12 (2) ◽

pp. 90 ◽

Cited By ~ 4

Author(s):

Helen Keleher

Keyword(s):

Mental Health ◽

Health Care ◽

Mental Health Care ◽

Model Of Care ◽

Policy And Practice ◽

Community Based ◽

Collaborative Model ◽

Health Care Practices ◽

Practice Models ◽

Working Together

Shared mental health care is being developed as a community-based model of service delivery that is described as a collaborative model with the intention to shift cultures of general practice from simple referral models to stronger models of collaboration. This article examines the degree to which community-based shared mental health care can be considered a collaborative model of care, and the implications for policy and practice and for consumers recovering from depression and related disorders. Victorian-based research informs the discussion, together with literature that discusses shared mental health care. Overall, the literature supports the view that there are positive outcomes of shared primary mental health care, including continuity of care for consumers and enhanced skills for general practitioners. However, features of collaborations such as inter-disciplinary trust, working together, shared planning or sharing of resources are weak in shared mental health care, suggesting that current practice models are working at a level of cooperation rather than true collaboration. The conceptualising of shared mental health care practices in terms of the theory of par partnerships and collaborations can only inform and strengthen the foundations of shared mental health care.

Download Full-text

“Psychosomatic consultation in the workplace” – a new model of care at the interface of company-supported mental health care and consultation-liaison psychosomatics: design of a mixed methods implementation study

BMC Public Health ◽

10.1186/1471-2458-12-780 ◽

2012 ◽

Vol 12 (1) ◽

Cited By ~ 11

Author(s):

Eva Rothermund ◽

Reinhold Kilian ◽

Michael Hoelzer ◽

Dorothea Mayer ◽

Daniel Mauss ◽

...

Keyword(s):

Mental Health ◽

Health Care ◽

Mixed Methods ◽

Mental Health Care ◽

Implementation Study ◽

Model Of Care ◽

New Model

Download Full-text

Primary Mental Health Care Part 1: A Critical Review of the Irish System

10.53902/jpssr.2021.01.000508 ◽

2021 ◽

Vol 1 (2) ◽

Author(s):

Smith L

Keyword(s):

Mental Health ◽

Health Care ◽

Mental Health Care ◽

Best Practice ◽

Model Of Care ◽

Eligibility Criteria ◽

The Public ◽

Primary Mental Health Care ◽

Evolving System ◽

Care Counselling

Primary mental health care is an evolving system, in need of regular revision and requiring innovative and creative adjustments in order to provide the public with an easily accessible and appropriate level and type of service, based on best practice and evidence. This paper is the first in a series of three exploring primary mental health care. The Irish model of care, ‘Counselling in Primary Care’, is presented as well as a number of short-comings associated with that model. The short-comings include eligibility criteria governing access, limitations of service as well as waiting lists; and the medicalization of service delivery.

Download Full-text

Evaluation of a nurse practitioner-led extended hours mental health liaison nurse service based in the emergency department

Australian Health Review ◽

10.1071/ah14100 ◽

2015 ◽

Vol 39 (1) ◽

pp. 1 ◽

Cited By ~ 15

Author(s):

Timothy Wand ◽

Natalie D'Abrew ◽

Catherine Barnett ◽

Louise Acret ◽

Kathryn White

Keyword(s):

Mental Health ◽

Health Care ◽

Emergency Department ◽

Mental Health Care ◽

Nurse Practitioner ◽

Medical Staff ◽

Health Problems ◽

Successful Implementation ◽

Model Of Care ◽

Liaison Nurse

Objective To evaluate a nurse practitioner (NP)-led extended hours mental health liaison nurse (MHLN) service based in the emergency department (ED) of an inner city teaching hospital in Sydney and to explicate a model of care that is transferable across a broad range of ED settings, both in metropolitan and rural contexts. Methods This mixed-methods evaluation encompassed descriptive data on ED mental health presentations, quantifying waiting times for MHLN involvement and interviews with MHLN team members at the commencement of the evaluation and 12 months later. Interviews were also conducted with a snapshot of ED patients, and a sample of ED and psychiatry staff. Results The expanded MHLN service was rapidly incorporated into the ED structure, enthusiastically endorsed by ED patients and highly valued by staff and the organisation. The MHLN team saw 55% of referred patients within the first hour of arrival (frequently before medical assessment), thereby initiating and expediting co-ordination of care at an early stage of the ED process. Conclusions An NP-led extended hours MHLN team based in the ED provides prompt and effective access to specialised mental health care for people with ‘undifferentiated health problems’, and removes a significant workload from nursing and medical staff. Embedding the NP-led MHLN service within the ED structure was pivotal to the success and sustainability of this model of care. What is known about the topic? Mental health liaison nurse (MHLN) services have existed in emergency departments (EDs) in Australia and internationally for many years. However, there is great variation in the way these services are structured and no standardised model of care has been explicated. What does this paper add? Findings from this evaluation indicate that a nurse practitioner-led extended hours MHLN service integrated within the ED team structure provides prompt access to specialised mental health care to people with undifferentiated health problems, and removes a significant workload from ED nursing and medical staff. What are the implications for practitioners? Mental health nurse-led service provision based in the ED is a safe, flexible and effective method of enhancing access to health care that is adaptable to broad range of settings. ED ownership of this model of care is pivotal to the successful implementation and sustainability of MHLN services.

Download Full-text

To what extent could acute general psychiatric day care reduce inpatient admissions?

Journal of Hospital Administration ◽

10.5430/jha.v2n2p105 ◽

2013 ◽

Vol 2 (2) ◽

pp. 105

Author(s):

Thomas W. Kallert ◽

Andrea Howardová ◽

Jiri Raboch ◽

Stefan Priebe ◽

Andrzej Kiejna ◽

...

Keyword(s):

Mental Health ◽

Health Care ◽

Mental Health Service ◽

Health Service ◽

Mental Health Care ◽

Day Care ◽

Calculation Methods ◽

Model Of Care ◽

Eligibility Criteria ◽

Site Specific

Background: Percentage reduction of inpatient admissions by acute general psychiatric day care in individual facilities (i.e. feasibility rate of acute day care) seems to be an important parameter for service planning. Previously reported feasibility rates showed significant variation, however, and were based on eligibility criteria defined for randomized controlled trials. This paper aims to perform an in-depth exploration of the calculation method of these feasibility rates, to propose different calculation methods expanding research definitions to the reality of service provision, and to analyze the association between the availability of residential services in regional mental health service systems and these rates. Methods: Data from the randomization process of the European Day Hospital Evaluation (EDEN) study in which a total of 1117 patients were included in five sites provided the basis to calculate site-specific and overall rates of patients for whom this mode of treatment might be adequate. Sensitivity analyses were carried out by varying the selection of patients’ eligibility criteria and thus calculating different feasibility estimates. Data on the regional mental health care systems were collected by use of the European Service Mapping Schedule. Results: The use of four different calculation methods showed that site-specific feasibility rates of acute day care for general psychiatric patients varied from 13.8% to 25.7% up to 44.1% to 79.0%. Overall rates varied from 17.3% up to 67.7%, respectively. The high values were calculated under a scenario where the current acute day care model of care is enhanced to manage more complicated patients than currently treated under existing acute day care models. In three out of the four calculation methods higher rates were calculated for sites which demonstrated higher figures of residential services, and thus were less advanced in their process of deinstitutionalization. Conclusions: In order to determine the capacity of day hospitals as an alternative to acute psychiatric hospital care, mental health care planning must clearly decide on the eligibility criteria of patients to be treated in these facilities. Guided by such definitions, treatment concepts and professional qualifications of the staff in these facilities need to be adapted. The finding that less de-institutionalized regions may benefit most from a transition to acute day care as a means for promoting the transition to a community model of care for otherwise institutionalized patients must be assessed in more detail. Comprehensive research exploring the impact of all regional mental health service configuration characteristics on the concept of acute day care is needed.

Download Full-text

The Collaborative Model of Mental Health Care for Older Iowans

Research in Gerontological Nursing ◽

10.3928/19404921-20100603-99 ◽

2010 ◽

Vol 3 (3) ◽

pp. 200-208 ◽

Cited By ~ 6

Author(s):

Brian P. Kaskie ◽

Kathleen C. Buckwalter

Keyword(s):

Mental Health ◽

Health Care ◽

Mental Health Care ◽

Collaborative Model

Download Full-text

A Tribute to the Late William J. Curran

The Journal of Law Medicine & Ethics ◽

10.1017/s1073110500004058 ◽

1996 ◽

Vol 24 (3) ◽

pp. 274-275

Author(s):

O. Lawrence ◽

J.D. Gostin

Keyword(s):

Mental Health ◽

Health Care ◽

Mental Illness ◽

United Nations ◽

Mental Health Care ◽

Harvard University ◽

Legal Medicine ◽

General Assembly ◽

International Institute ◽

University Professor

In the summer of 1979, a group of experts on law, medicine, and ethics assembled in Siracusa, Sicily, under the auspices of the International Commission of Jurists and the International Institute of Higher Studies in Criminal Science, to draft guidelines on the rights of persons with mental illness. Sitting across the table from me was a quiet, proud man of distinctive intelligence, William J. Curran, Frances Glessner Lee Professor of Legal Medicine at Harvard University. Professor Curran was one of the principal drafters of those guidelines. Many years later in 1991, after several subsequent re-drafts by United Nations (U.N.) Rapporteur Erica-Irene Daes, the text was adopted by the U.N. General Assembly as the Principles for the Protection of Persons with Mental Illness and for the Improvement of Mental Health Care. This was the kind of remarkable achievement in the field of law and medicine that Professor Curran repeated throughout his distinguished career.

Download Full-text