Purpose: The purpose of this study was to clarify the relationship and experiences of occupational health nurses (OHNs) and related departments in project development of mental health care for primary treatment in the...Purpose: The purpose of this study was to clarify the relationship and experiences of occupational health nurses (OHNs) and related departments in project development of mental health care for primary treatment in the Japanese occupational health setting. Method: A total of 235 OHNs who are members of the Japan Academy of Occupational Health Nursing were sent an anonymous self-administered questionnaire survey. The questionnaire included items on the following: the OHN’s background, whether the OHN had experience in project development, the communication between the associated departments, the Japanese version of the Work Engagement Scale (UWES-J), occupational assessments, workplace assessments, and the Transtheoretical Model (TTM) for health promotion in companies and the OHN’s working environment. We performed logistic regression analysis to examine the relationship between experience and these harmonious relationships with other associated departments. Result: Responses from 61 OHNs (valid response rate: 25.9%) were analyzed. The mean number of years of service as an OHN was 18.9, and 82% of respondents had experience in project development. The logistic analysis further revealed that OHNs who had experience in project development of mental health care usually had a harmonious relationship with other associated departments. Conclusion: To promote mental health care for workers, OHNs have the capability to create individual and workplace assessments, enhance their work engagement, and make further improvements to their working environment. .展开更多
Background: Further strategies are needed to deal with the high losses to suicide. New modalities should be explored within the context of suicide prevention. Aim: The aim of the study was to evaluate participants’ e...Background: Further strategies are needed to deal with the high losses to suicide. New modalities should be explored within the context of suicide prevention. Aim: The aim of the study was to evaluate participants’ experiences of a web based program for mental health care staff, including its potential clinical relevance. Methods: Nineteen participants participated in five focus groups. Data was analyzed using content analysis. Results: The analysis showed participants’ experiences of the program’s contents and format (“Web Based Modules”, “Discussion Groups”) and practical value (“Clinical Relevance and Use”, “Effects on Communication and Climate”). Conclusions: The program partly increased awareness about risk factors and the importance of inquiring about suicide ideation/plans and documenting suicide assessments. Experiences of the clinical value were varying and may be increased through potential enhancements.展开更多
We review the past, present and future state of mental health care in the Kingdom of Saudi Arabia (KSA). The past is reviewed prior to the modern era, discussing early explanations and treatments for mental health ill...We review the past, present and future state of mental health care in the Kingdom of Saudi Arabia (KSA). The past is reviewed prior to the modern era, discussing early explanations and treatments for mental health illness up through the establishment of the first mental hospital in the 1950s, tracking advances in mental health care over the past 60 years. The present is explored in terms of the current need for mental health care based on the prevalence of mental health problems in KSA. We also discuss the role of the family in caring for the needs of the mentally ill today. Finally, we look forward into the future, discuss the current education system that will produce the next generation of mental health professionals, examine areas of mental health care that need improvement, and provide a research agenda to guide the continued development of the mental health care system in KSA. Our goal is to present a blue print for the development of a state-of-the-art mental health that may serve as a model for other countries in the Middle East, while taking into account the political, cultural and religious factors that are unique to this region of the world.展开更多
BACKGROUND: There is little consensus as to the effects of insurance expansion on emergency department(ED) utilization for mental health purposes. We aimed to study the race specifi c association between the dependent...BACKGROUND: There is little consensus as to the effects of insurance expansion on emergency department(ED) utilization for mental health purposes. We aimed to study the race specifi c association between the dependent coverage provision of the Affordable Care Act(ACA) and changes in young adults' usage of emergency department services for psychiatric diagnoses.METHODS: We utilized a Quasi-Experimental analysis of ED use in California from 2009–2011 for behavioral health diagnoses of individuals aged 19 to 31 years. Analysis used a difference-indifferences approach comparing those targeted by the ACA dependent provision(19–25 years) and those who were not(27 to 31 years), evaluating changes in ED visit rates per 1 000 in California. Primary outcomes measured included the quarterly ED visit rates with any psychiatric diagnosis. Subgroups were analyzed for differences based on race and gender.RESULTS: The ACA dependent provision was associated with 0.05 per 1 000 people fewer psychiatric ED visits among the treatment group(19–25 years) compared to the control group(27–31 years). Hispanics and Asian/Pacific Islanders were the only racial subgroups who did not see this significant reduction and were the only racial subgroups that did not see significant gains in the proportion of psychiatric ED visits covered by private insurance.CONCLUSION: The ACA dependent provision was associated with a modest reduction in the growth rate of ED use for psychiatric reasons, however, racial disparities in the effect of this provision exist for patients of Hispanic and Asian/Pacifi c Islander racial groups.展开更多
<strong>Background:</strong> Negative and stigmatizing attitudes and behaviours towards people with mental health problems have the potential to lead to a lack of access to care, under-treatment, social ma...<strong>Background:</strong> Negative and stigmatizing attitudes and behaviours towards people with mental health problems have the potential to lead to a lack of access to care, under-treatment, social marginalization, and can undermine the relationship between the patient and provider. The study aimed to measure attitude of healthcare professionals towards mental illness. <strong>Methods: </strong>Across sectional descriptive study was conducted over one month from April to May 2019 at Ras Al khaimah medical and health Science University and affiliated health care facilities. Mental Illness Clinicians’ Attitudes Scale version 4 Questionnaire was used to collect data from participants after obtaining their informed consent with assured confidentiality. <strong>Results:</strong> The study included 113 health care professionals. The mean score of attitude of health care professionals towards mental illness was 57.8 ± 10.8 out of 96. Negative attitudes were reported about the dangerousness, respect and suspicion over recovery of people with mental health problems, interactions with them in clinical practice, and fear of disclosure to colleagues or friends about mental health problems and confidence in capabilities of assessing mental health problems in primary care. The significant positive attitude was found among participants who were university faculty than those who worked in hospitals and Primary care centres (P = 0.04). Health care professionals who were university faculty and have reported more than 10 years of experience as health professionals reported significantly higher mean scores (P < 0.05). Neither age nor gender, or nationality appeared to be related to overall attitudinal responses towards mental illness. <strong>Conclusion:</strong> Educational programs might be useful to raise awareness towards the stigmatizing attitudes towards mental health and mental illnesses.展开更多
Background: There is an increased interest in developing better and more accurate methods to recognize and manage mental health problems in primary care settings. Abbreviated screening instruments for mental distress ...Background: There is an increased interest in developing better and more accurate methods to recognize and manage mental health problems in primary care settings. Abbreviated screening instruments for mental distress are useful tools for research and clinical practice. The present study seeks to investigate whether only a few questionnaire items from the Self-Reporting- Questionnaire-10 (SRQ-10) can be a robust method in the screening for Mental Distress in Primary Health care. Methods: We compared the screening accuracy of a short, five-item (SRQ-5) version of the SRQ-10 with that of the SRQ-20, General Health Questionnaire 12 (GHQ-12) using the DSM-IV axis as a gold standard and analyzed its performance in different diagnostic entities. We also assessed the correlation, sensitivity and specificity between the 4 instruments. All the instruments were administered to 400 primary health care attendees. Results: The estimated prevalence of mental distress was 13.6% in the study sample (Depression 11%, anxiety disorders 1.8%). The SRQ-5 was highly correlated to SRQ-10 (0.923, p < 0.001), SRQ-20 (0.764, p < 0.001) and only moderately correlated to GHQ-12 (0.417, p < 0.001). The SRQ-5 had high properties for identifying mental distress. The AUC for overall mental distress was 0.925 while that for depression and anxiety were 0.915 and 0.849 respectively. Conclusion: This validation showed that in moving from SRQ with 10 or 20 items to one with merely 5 items, we do not seem to lose the screening prowess of the instrument. The SRQ-5 represents a simplified and less time-consuming screening instrument with strong performance characteristics. We therefore recommend it for inclusion into existing patient assessment protocols, thus enhancing case finding at primary health care level.展开更多
A global disparity exists between the burden of mental ill-health and the resources available to address this issue.Common mental disorders,such as mild-to-moderate depression,anxiety disorders and post-traumatic stre...A global disparity exists between the burden of mental ill-health and the resources available to address this issue.Common mental disorders,such as mild-to-moderate depression,anxiety disorders and post-traumatic stress disorder,are associated with a significant decline in health and functioning and contribute significantly to the overall burden of disease.In view of a shortage of mental health professionals in most low-and middle-income countries,task sharing(task shifting)can make an important contribution to improving access to mental health services.Task sharing involves non-specialists in the delivery of health care.The use of lay health workers is premised on the assumption that the shorter training required for non professionals will allow an increase in the provision of required care without the need for an increase in resources and will strengthen and scale-up sustainable health systems.The need for low-tech support in the management of conunon mental disorders is widespread,and the core resource is humans trained to identify and treat those requiring mental health care.There is a strong evidence base for the effectiveness of task sharing in psychotherapy,and talk therapies,e.g.cognitive behavioral therapy,can easily be delegated to non-specialists,including non-specialist health workers,peer helpers and lay people.A(cost-)effective model of mental health care in low-resource settings as well as in high-income countries may include the medical school-based training of some psychiatrists and clinical psychologists in the treatment of referred patients with serious mental illness.These professional mental health specialists would also be trainers and supervisors of non-specialist health workers who would identify common mental health disorders and provide psychotherapy to people with these conditions in a community-based setting.Community-based generalism including task sharing rather than centralized specialism may be capable of preventing and treating many common mental disorders with minor financial expenditure.展开更多
Mental health care has moved from hospital settings to community mental health settings, and there is a need to explore the perceptions of patient safety among registered nurses working in this field. Patient safety i...Mental health care has moved from hospital settings to community mental health settings, and there is a need to explore the perceptions of patient safety among registered nurses working in this field. Patient safety is to include everyone and to be the goal in all aspects of health care. The aim of the study was to explore registered nurses’ perceptions of patient safety in community mental health settings for people with serious mental illness. The study was qualitative and descriptive in nature and interviews were carried out during spring 2012, with seven registered nurses working in community mental health settings for people with serious mental illness in five municipalities in the middle of Sweden. The sampling was purposive and data were analysed using qualitative content analysis. The findings showed that the registered nurses understood patient safety as providing support to people with serious mental illness in regaining and maintaining health through good treatment and respecting self-determination and avoiding coercion. The terms of daily living in small community mental health settings within the a large community health care organization, communication, sufficient knowledge of psychiatric disabilities among people in the residents’ network, and national laws and regulations, all had implications for patient safety. The registered nurses perceived patient safety as involving a wide range of issues that in other areas of care are more often discussed in terms of quality of care. Determining the boundaries of patient safety in community mental health settings for people with serious mental illness can be a first step in establishing workable routines that ensure safe patient care.展开更多
Objective: The aim of this study is to investigate the association between mental health treatment patterns and risk of injuries among a Western Australian male birth cohort. Method: A population-based birth-cohort of...Objective: The aim of this study is to investigate the association between mental health treatment patterns and risk of injuries among a Western Australian male birth cohort. Method: A population-based birth-cohort of males born between 1980 and 1984 in Western Australia was followed up using linked health data. Results: Participants with mental health conditions were at an increased risk of injury. Those with a continuous mental health treatment pattern without interruption or window periods had lower risk of injury compared to those with treatment interruption or window periods. The adjusted incidence rate ratios (95% confidence interval) for injury among participants: 1) without a mental condition, 2) with a previous mental condition, 3) with a mental condition in the last four years and without interruption in their mental health treatment, and 4) with a mental condition in the last four years with interruptions in mental health service, were 0.38 (0.35 - 0.40), 0.77 (0.71 - 083), 1.0 (reference group) and 2.06 (1.72 - 2.47) respectively. Conclusion: Increasing resources for mental health services and enabling sufficient continuous mental health services and follow-up may reduce the risk of injury among populations with mental health conditions.展开更多
Malawi is located in the southern part of Africa with a population of more than 16 million people. The country is ravaged with HIV and AIDS epidemic of which the prevalence rate is at 14%. The people who have HIV/AIDS...Malawi is located in the southern part of Africa with a population of more than 16 million people. The country is ravaged with HIV and AIDS epidemic of which the prevalence rate is at 14%. The people who have HIV/AIDS are also affected by mental and psychological disorders. Nevertheless, very little is known about mental health care of people who have HIV and AIDS in Malawi. We did literature search using AJOL, Proquest, PsychINFO, Google Scholar and HINARI search engines and the search yielded scanty (12) research studies on the mental health of people with HIV and AIDS that were conducted in Malawi between 2006-2014. Twelve (12) studies that were reviewed focused on prevalence of mental disorders among people who have HIV and AIDS;nurses’ knowledge and skills for providing mental health care to people living with HIV and AIDS (PLWHA);perceived risk of HIV infection among people who have mental health problems;substance abuse and HIV/AIDS issues and awareness of interaction between HIV/AIDS and Mental health. In conclusion, the review shows that people with HIV infection are also affected by mental health problems such as depression and substance abuse. They receive some mental health care in general settings at ART clinics because mental health care is integrated into general health care delivery system. Therefore, it is necessary that health professionals who are generalists should be equipped with adequate knowledge and skills for providing mental health care to care to people with HIV and AIDS.展开更多
Aim: To verify the epidemiological profile of patients enrolled in the Mental Health Program at a Family Health Unit, as well as the most prevalent disorders, age and comorbidities. Methods: After analyzing the medica...Aim: To verify the epidemiological profile of patients enrolled in the Mental Health Program at a Family Health Unit, as well as the most prevalent disorders, age and comorbidities. Methods: After analyzing the medical records, the following variables were obtained: diagnosis of mental health status, gender, age group, associated comorbidities and medication in use. Results: There was a prevalence of 61.3% in women and 38.7% in men;patients aged 30 to 39 years were the most affected (22.6%);the most common disorders were epilepsy (36%), depression (14%), anxiety disorder (8.6%) and schizophrenia (8.6%);the most common comorbidities were systemic arterial hypertension (30%) and insomnia (15%) and the most commonly used psychotropic drugs were amitriptyline, carbamazepine and phenobarbital (10.2% each). Conclusion: There was a high prevalence of females, mainly at 30 to 39 years old and the most prevalent diagnoses were epilepsy, depression and anxiety disorder. About medications, antidepressants and anticonvulsants were the most prescribed.展开更多
The purpose of this study was to describe women’s experiences with gender violence and the impact on mental health. The research was a qualitative observational study. Participants were n = 72 women clients of (02) P...The purpose of this study was to describe women’s experiences with gender violence and the impact on mental health. The research was a qualitative observational study. Participants were n = 72 women clients of (02) Primary Health Centers at the University of Carabobo-Venezuela. The technique to gather the information was focus group discussion (FGD). The interpretation of data was an analytical process based on Mayring’s approach. The principal findings showed that, women clients of primary health centers experienced different levels of violence in everyday life. Physical violence was the most frequent abuse reported by victims. Death threats were the most frequent conduct used by the partners in terms of psychological violence. Women expressed being under the control of a dominant partner without physical aggression or threats, but they felt a lack of autonomy. Additionally, women who experienced different levels of abuse specified some symptoms that could suggest an impact on mental health. In conclusion, women naturalized dominance and control because they understood this kind of abuse as normal behavior between relationship partners.展开更多
Some research acknowledges engagement in creative and literary activities as constructively impacting rehabilitation and recovery. Nevertheless, there is a deficit of literature describing experiences of participation...Some research acknowledges engagement in creative and literary activities as constructively impacting rehabilitation and recovery. Nevertheless, there is a deficit of literature describing experiences of participation in literary activities. This study examined how members of a non-profit association for mental health, with experiences of mental problems or illnesses, experienced group-based literary activities facilitated of a bi-disciplinary research team during one semester. This study held a constructive/naturalistic design and used a qualitative methodology with a latent analysis to describe how participants experienced literary activities (creative writing, reading and conversations about published and own written poetry and prose texts). Both individual and focus-group interviews were performed early 2014. Despite previous negative experiences, the findings showed that the participants perceived the literary activities empowering. Four categories were created: Presumptions of personal literacy, leadership role, participants’ role, and literacy development. These were abstracted and interpreted into three themes: Identifying a reading and writing self-image, challenging and redefining one’s reading and writing identity, and strengthening one’s intellectual and humanistic capacity. Literary activities seemed to positively change the participants’ attitudes towards writing and reading, and also enhanced their literacy skills. We argue that literacy skills are interconnected with health literacy. Involvement of literary activities into rehabilitation in mental health practice may be beneficial for some groups, and merits further studies.展开更多
Background: There is a lack of reliable epidemiological data on prevalence and comorbidity rates of mental disorders in the migrant population in Germany. Despite existing national and international data on the extent...Background: There is a lack of reliable epidemiological data on prevalence and comorbidity rates of mental disorders in the migrant population in Germany. Despite existing national and international data on the extent of psychosocial burdens in migrant populations the prevalence among the study population remains unclear. The aim of this study was to collect prevalence data for the largest migrant population in Germany-individuals with Turkish migration backgrounds—using a culturally and linguistically sensitive approach. Methods: The study employs a cross-sectional design. The multi-centre study (Hamburg, Berlin) is based on a sample of individuals with Turkish migration backgrounds living in the two cities stratified by age, gender, and education. The study programme consists of three phases: 1) a qualitative focus group to collect information on how to increase the participation rate of the target population as a minority group in Germany;2) a translation phase to create culture and linguistic sensitive versions of the assessment tools (e.g., the Composite International Diagnostic Interview (CIDI) for Turkish speaking individuals;and 3) a baseline community study to assess the lifetime, 12-month and four-week prevalence and comorbidity rates of mental disorder, health care utilization and help-seeking behaviour in individuals of Turkish migration backgrounds living in Germany. Discussion: The study provides important data on the lifetime prevalence of mental disorders and health care utilization of individuals with Turkish migration backgrounds. Furthermore, the study is an important step towards gaining a better understanding of potential barriers to participation, creating resources for difficult-to- reach minorities, and understanding the need for assessing mental disorders in migrant populations. These results can offer a starting point for the initiation of the necessary structural changes for mental health care services and policies for groups with migration backgrounds.展开更多
文摘Purpose: The purpose of this study was to clarify the relationship and experiences of occupational health nurses (OHNs) and related departments in project development of mental health care for primary treatment in the Japanese occupational health setting. Method: A total of 235 OHNs who are members of the Japan Academy of Occupational Health Nursing were sent an anonymous self-administered questionnaire survey. The questionnaire included items on the following: the OHN’s background, whether the OHN had experience in project development, the communication between the associated departments, the Japanese version of the Work Engagement Scale (UWES-J), occupational assessments, workplace assessments, and the Transtheoretical Model (TTM) for health promotion in companies and the OHN’s working environment. We performed logistic regression analysis to examine the relationship between experience and these harmonious relationships with other associated departments. Result: Responses from 61 OHNs (valid response rate: 25.9%) were analyzed. The mean number of years of service as an OHN was 18.9, and 82% of respondents had experience in project development. The logistic analysis further revealed that OHNs who had experience in project development of mental health care usually had a harmonious relationship with other associated departments. Conclusion: To promote mental health care for workers, OHNs have the capability to create individual and workplace assessments, enhance their work engagement, and make further improvements to their working environment. .
文摘Background: Further strategies are needed to deal with the high losses to suicide. New modalities should be explored within the context of suicide prevention. Aim: The aim of the study was to evaluate participants’ experiences of a web based program for mental health care staff, including its potential clinical relevance. Methods: Nineteen participants participated in five focus groups. Data was analyzed using content analysis. Results: The analysis showed participants’ experiences of the program’s contents and format (“Web Based Modules”, “Discussion Groups”) and practical value (“Clinical Relevance and Use”, “Effects on Communication and Climate”). Conclusions: The program partly increased awareness about risk factors and the importance of inquiring about suicide ideation/plans and documenting suicide assessments. Experiences of the clinical value were varying and may be increased through potential enhancements.
文摘We review the past, present and future state of mental health care in the Kingdom of Saudi Arabia (KSA). The past is reviewed prior to the modern era, discussing early explanations and treatments for mental health illness up through the establishment of the first mental hospital in the 1950s, tracking advances in mental health care over the past 60 years. The present is explored in terms of the current need for mental health care based on the prevalence of mental health problems in KSA. We also discuss the role of the family in caring for the needs of the mentally ill today. Finally, we look forward into the future, discuss the current education system that will produce the next generation of mental health professionals, examine areas of mental health care that need improvement, and provide a research agenda to guide the continued development of the mental health care system in KSA. Our goal is to present a blue print for the development of a state-of-the-art mental health that may serve as a model for other countries in the Middle East, while taking into account the political, cultural and religious factors that are unique to this region of the world.
文摘BACKGROUND: There is little consensus as to the effects of insurance expansion on emergency department(ED) utilization for mental health purposes. We aimed to study the race specifi c association between the dependent coverage provision of the Affordable Care Act(ACA) and changes in young adults' usage of emergency department services for psychiatric diagnoses.METHODS: We utilized a Quasi-Experimental analysis of ED use in California from 2009–2011 for behavioral health diagnoses of individuals aged 19 to 31 years. Analysis used a difference-indifferences approach comparing those targeted by the ACA dependent provision(19–25 years) and those who were not(27 to 31 years), evaluating changes in ED visit rates per 1 000 in California. Primary outcomes measured included the quarterly ED visit rates with any psychiatric diagnosis. Subgroups were analyzed for differences based on race and gender.RESULTS: The ACA dependent provision was associated with 0.05 per 1 000 people fewer psychiatric ED visits among the treatment group(19–25 years) compared to the control group(27–31 years). Hispanics and Asian/Pacific Islanders were the only racial subgroups who did not see this significant reduction and were the only racial subgroups that did not see significant gains in the proportion of psychiatric ED visits covered by private insurance.CONCLUSION: The ACA dependent provision was associated with a modest reduction in the growth rate of ED use for psychiatric reasons, however, racial disparities in the effect of this provision exist for patients of Hispanic and Asian/Pacifi c Islander racial groups.
文摘<strong>Background:</strong> Negative and stigmatizing attitudes and behaviours towards people with mental health problems have the potential to lead to a lack of access to care, under-treatment, social marginalization, and can undermine the relationship between the patient and provider. The study aimed to measure attitude of healthcare professionals towards mental illness. <strong>Methods: </strong>Across sectional descriptive study was conducted over one month from April to May 2019 at Ras Al khaimah medical and health Science University and affiliated health care facilities. Mental Illness Clinicians’ Attitudes Scale version 4 Questionnaire was used to collect data from participants after obtaining their informed consent with assured confidentiality. <strong>Results:</strong> The study included 113 health care professionals. The mean score of attitude of health care professionals towards mental illness was 57.8 ± 10.8 out of 96. Negative attitudes were reported about the dangerousness, respect and suspicion over recovery of people with mental health problems, interactions with them in clinical practice, and fear of disclosure to colleagues or friends about mental health problems and confidence in capabilities of assessing mental health problems in primary care. The significant positive attitude was found among participants who were university faculty than those who worked in hospitals and Primary care centres (P = 0.04). Health care professionals who were university faculty and have reported more than 10 years of experience as health professionals reported significantly higher mean scores (P < 0.05). Neither age nor gender, or nationality appeared to be related to overall attitudinal responses towards mental illness. <strong>Conclusion:</strong> Educational programs might be useful to raise awareness towards the stigmatizing attitudes towards mental health and mental illnesses.
文摘Background: There is an increased interest in developing better and more accurate methods to recognize and manage mental health problems in primary care settings. Abbreviated screening instruments for mental distress are useful tools for research and clinical practice. The present study seeks to investigate whether only a few questionnaire items from the Self-Reporting- Questionnaire-10 (SRQ-10) can be a robust method in the screening for Mental Distress in Primary Health care. Methods: We compared the screening accuracy of a short, five-item (SRQ-5) version of the SRQ-10 with that of the SRQ-20, General Health Questionnaire 12 (GHQ-12) using the DSM-IV axis as a gold standard and analyzed its performance in different diagnostic entities. We also assessed the correlation, sensitivity and specificity between the 4 instruments. All the instruments were administered to 400 primary health care attendees. Results: The estimated prevalence of mental distress was 13.6% in the study sample (Depression 11%, anxiety disorders 1.8%). The SRQ-5 was highly correlated to SRQ-10 (0.923, p < 0.001), SRQ-20 (0.764, p < 0.001) and only moderately correlated to GHQ-12 (0.417, p < 0.001). The SRQ-5 had high properties for identifying mental distress. The AUC for overall mental distress was 0.925 while that for depression and anxiety were 0.915 and 0.849 respectively. Conclusion: This validation showed that in moving from SRQ with 10 or 20 items to one with merely 5 items, we do not seem to lose the screening prowess of the instrument. The SRQ-5 represents a simplified and less time-consuming screening instrument with strong performance characteristics. We therefore recommend it for inclusion into existing patient assessment protocols, thus enhancing case finding at primary health care level.
文摘A global disparity exists between the burden of mental ill-health and the resources available to address this issue.Common mental disorders,such as mild-to-moderate depression,anxiety disorders and post-traumatic stress disorder,are associated with a significant decline in health and functioning and contribute significantly to the overall burden of disease.In view of a shortage of mental health professionals in most low-and middle-income countries,task sharing(task shifting)can make an important contribution to improving access to mental health services.Task sharing involves non-specialists in the delivery of health care.The use of lay health workers is premised on the assumption that the shorter training required for non professionals will allow an increase in the provision of required care without the need for an increase in resources and will strengthen and scale-up sustainable health systems.The need for low-tech support in the management of conunon mental disorders is widespread,and the core resource is humans trained to identify and treat those requiring mental health care.There is a strong evidence base for the effectiveness of task sharing in psychotherapy,and talk therapies,e.g.cognitive behavioral therapy,can easily be delegated to non-specialists,including non-specialist health workers,peer helpers and lay people.A(cost-)effective model of mental health care in low-resource settings as well as in high-income countries may include the medical school-based training of some psychiatrists and clinical psychologists in the treatment of referred patients with serious mental illness.These professional mental health specialists would also be trainers and supervisors of non-specialist health workers who would identify common mental health disorders and provide psychotherapy to people with these conditions in a community-based setting.Community-based generalism including task sharing rather than centralized specialism may be capable of preventing and treating many common mental disorders with minor financial expenditure.
文摘Mental health care has moved from hospital settings to community mental health settings, and there is a need to explore the perceptions of patient safety among registered nurses working in this field. Patient safety is to include everyone and to be the goal in all aspects of health care. The aim of the study was to explore registered nurses’ perceptions of patient safety in community mental health settings for people with serious mental illness. The study was qualitative and descriptive in nature and interviews were carried out during spring 2012, with seven registered nurses working in community mental health settings for people with serious mental illness in five municipalities in the middle of Sweden. The sampling was purposive and data were analysed using qualitative content analysis. The findings showed that the registered nurses understood patient safety as providing support to people with serious mental illness in regaining and maintaining health through good treatment and respecting self-determination and avoiding coercion. The terms of daily living in small community mental health settings within the a large community health care organization, communication, sufficient knowledge of psychiatric disabilities among people in the residents’ network, and national laws and regulations, all had implications for patient safety. The registered nurses perceived patient safety as involving a wide range of issues that in other areas of care are more often discussed in terms of quality of care. Determining the boundaries of patient safety in community mental health settings for people with serious mental illness can be a first step in establishing workable routines that ensure safe patient care.
文摘Objective: The aim of this study is to investigate the association between mental health treatment patterns and risk of injuries among a Western Australian male birth cohort. Method: A population-based birth-cohort of males born between 1980 and 1984 in Western Australia was followed up using linked health data. Results: Participants with mental health conditions were at an increased risk of injury. Those with a continuous mental health treatment pattern without interruption or window periods had lower risk of injury compared to those with treatment interruption or window periods. The adjusted incidence rate ratios (95% confidence interval) for injury among participants: 1) without a mental condition, 2) with a previous mental condition, 3) with a mental condition in the last four years and without interruption in their mental health treatment, and 4) with a mental condition in the last four years with interruptions in mental health service, were 0.38 (0.35 - 0.40), 0.77 (0.71 - 083), 1.0 (reference group) and 2.06 (1.72 - 2.47) respectively. Conclusion: Increasing resources for mental health services and enabling sufficient continuous mental health services and follow-up may reduce the risk of injury among populations with mental health conditions.
文摘Malawi is located in the southern part of Africa with a population of more than 16 million people. The country is ravaged with HIV and AIDS epidemic of which the prevalence rate is at 14%. The people who have HIV/AIDS are also affected by mental and psychological disorders. Nevertheless, very little is known about mental health care of people who have HIV and AIDS in Malawi. We did literature search using AJOL, Proquest, PsychINFO, Google Scholar and HINARI search engines and the search yielded scanty (12) research studies on the mental health of people with HIV and AIDS that were conducted in Malawi between 2006-2014. Twelve (12) studies that were reviewed focused on prevalence of mental disorders among people who have HIV and AIDS;nurses’ knowledge and skills for providing mental health care to people living with HIV and AIDS (PLWHA);perceived risk of HIV infection among people who have mental health problems;substance abuse and HIV/AIDS issues and awareness of interaction between HIV/AIDS and Mental health. In conclusion, the review shows that people with HIV infection are also affected by mental health problems such as depression and substance abuse. They receive some mental health care in general settings at ART clinics because mental health care is integrated into general health care delivery system. Therefore, it is necessary that health professionals who are generalists should be equipped with adequate knowledge and skills for providing mental health care to care to people with HIV and AIDS.
文摘Aim: To verify the epidemiological profile of patients enrolled in the Mental Health Program at a Family Health Unit, as well as the most prevalent disorders, age and comorbidities. Methods: After analyzing the medical records, the following variables were obtained: diagnosis of mental health status, gender, age group, associated comorbidities and medication in use. Results: There was a prevalence of 61.3% in women and 38.7% in men;patients aged 30 to 39 years were the most affected (22.6%);the most common disorders were epilepsy (36%), depression (14%), anxiety disorder (8.6%) and schizophrenia (8.6%);the most common comorbidities were systemic arterial hypertension (30%) and insomnia (15%) and the most commonly used psychotropic drugs were amitriptyline, carbamazepine and phenobarbital (10.2% each). Conclusion: There was a high prevalence of females, mainly at 30 to 39 years old and the most prevalent diagnoses were epilepsy, depression and anxiety disorder. About medications, antidepressants and anticonvulsants were the most prescribed.
文摘The purpose of this study was to describe women’s experiences with gender violence and the impact on mental health. The research was a qualitative observational study. Participants were n = 72 women clients of (02) Primary Health Centers at the University of Carabobo-Venezuela. The technique to gather the information was focus group discussion (FGD). The interpretation of data was an analytical process based on Mayring’s approach. The principal findings showed that, women clients of primary health centers experienced different levels of violence in everyday life. Physical violence was the most frequent abuse reported by victims. Death threats were the most frequent conduct used by the partners in terms of psychological violence. Women expressed being under the control of a dominant partner without physical aggression or threats, but they felt a lack of autonomy. Additionally, women who experienced different levels of abuse specified some symptoms that could suggest an impact on mental health. In conclusion, women naturalized dominance and control because they understood this kind of abuse as normal behavior between relationship partners.
文摘Some research acknowledges engagement in creative and literary activities as constructively impacting rehabilitation and recovery. Nevertheless, there is a deficit of literature describing experiences of participation in literary activities. This study examined how members of a non-profit association for mental health, with experiences of mental problems or illnesses, experienced group-based literary activities facilitated of a bi-disciplinary research team during one semester. This study held a constructive/naturalistic design and used a qualitative methodology with a latent analysis to describe how participants experienced literary activities (creative writing, reading and conversations about published and own written poetry and prose texts). Both individual and focus-group interviews were performed early 2014. Despite previous negative experiences, the findings showed that the participants perceived the literary activities empowering. Four categories were created: Presumptions of personal literacy, leadership role, participants’ role, and literacy development. These were abstracted and interpreted into three themes: Identifying a reading and writing self-image, challenging and redefining one’s reading and writing identity, and strengthening one’s intellectual and humanistic capacity. Literary activities seemed to positively change the participants’ attitudes towards writing and reading, and also enhanced their literacy skills. We argue that literacy skills are interconnected with health literacy. Involvement of literary activities into rehabilitation in mental health practice may be beneficial for some groups, and merits further studies.
文摘Background: There is a lack of reliable epidemiological data on prevalence and comorbidity rates of mental disorders in the migrant population in Germany. Despite existing national and international data on the extent of psychosocial burdens in migrant populations the prevalence among the study population remains unclear. The aim of this study was to collect prevalence data for the largest migrant population in Germany-individuals with Turkish migration backgrounds—using a culturally and linguistically sensitive approach. Methods: The study employs a cross-sectional design. The multi-centre study (Hamburg, Berlin) is based on a sample of individuals with Turkish migration backgrounds living in the two cities stratified by age, gender, and education. The study programme consists of three phases: 1) a qualitative focus group to collect information on how to increase the participation rate of the target population as a minority group in Germany;2) a translation phase to create culture and linguistic sensitive versions of the assessment tools (e.g., the Composite International Diagnostic Interview (CIDI) for Turkish speaking individuals;and 3) a baseline community study to assess the lifetime, 12-month and four-week prevalence and comorbidity rates of mental disorder, health care utilization and help-seeking behaviour in individuals of Turkish migration backgrounds living in Germany. Discussion: The study provides important data on the lifetime prevalence of mental disorders and health care utilization of individuals with Turkish migration backgrounds. Furthermore, the study is an important step towards gaining a better understanding of potential barriers to participation, creating resources for difficult-to- reach minorities, and understanding the need for assessing mental disorders in migrant populations. These results can offer a starting point for the initiation of the necessary structural changes for mental health care services and policies for groups with migration backgrounds.
