Community Involvement and Adolescent Mental Health: Moderating Effects of Race/Ethnicity and Neighborhood Disadvantage

ERIC Educational Resources Information Center

Hull, Pamela; Kilbourne, Barbara; Reece, Michelle; Husaini, Baqar

2008-01-01

Social development and stress process theories suggest that participation in one's community can function as a protective factor for mental health, especially for youth from socioeconomically disadvantaged areas. However, the effects of community involvement on adolescent mental health could vary across racial/ethnic groups and levels of…

[Mental Health Promotion Among the Chronic Disabled Population in the Community].

PubMed

Huang, Hui-Chuan; Wang, Li-Hua; Chang, Hsiu-Ju

2015-08-01

Societal ageing and the rising prevalence of chronic disease are important causes that underlie the growth in the number of disabled individuals. The disease-induced psychological distress experienced by this population not only decreases quality of life but also increases demand for healthcare. The healthcare policy for the disabled population currently focuses on community healthcare. Therefore, developing appropriate programs to promote mental health among the disabled population in community settings is a critical issue. The present paper reviews current mental health promotion initiatives that target the disabled population in the community and addresses mental healthcare issues that are prevalent among the chronically disabled; strategies of mental health promotion that use music therapy, reminiscence therapy, and horticultural therapy; and the roles and responsibilities of community professionals in mental healthcare. We offer these perspectives as a reference to promote mental health and to establish holistic community healthcare for chronically disabled individuals.

Asian Community Mental Health Services at 35: a pioneering ethnic organization (1973-2008).

PubMed

Vu, Catherine M; Schwartz, Sara L; Austin, Michael J

2011-01-01

Asian Community Mental Health Services is a nonprofit organization that delivers mental health services to primarily Asian and Pacific Islander communities. From its early beginnings and over its 35-year history, the agency has had to overcome numerous challenges, including gaining legitimacy as a culturally specific nonprofit, combating stigma surrounding mental health issues within the Asian Pacific Islander community, building resources to fund service delivery, and developing an educated and culturally sensitive workforce. The history of the organization highlights the multiple challenges and rewards of developing a culturally specific nonprofit in an urban area as well as the important role that internal operations play in relation to nonprofit expansion and growth.

Perceptions of the community on the pricing of community mental health services.

PubMed

Ogden, J R; Ogden, D T

1992-01-01

In the past few years there has been a decrease in governmental support of Community Mental Health centers. Because of this, there has been some concern, on the part of Community Mental Health professionals, as to the overall impact of this decreased governmental support. Research has been conducted that speculates on how best to handle this mini-crisis. One article suggests moving to an overall marketing approach to help combat this dollar support decline (Day and Ford 1988). Others provide methods for surveying Community Mental Health users (Ludke, Curry & Saywell 1983). William Winston (1988) suggests an overall psychographic segmentation approach to developing market targets. There has also been research detailing promotional methods for expanded marketing coverage (Moldenhauer 1988), however little has been written defining the pricing impact on Community Mental Health services. This study addresses the perceptions of Community Mental Health Center users toward the price variable of the marketing mix.

Development of Community Based Rehabilitation in Pakistan: Bringing Mental Handicap into Focus.

ERIC Educational Resources Information Center

Miles, M.

1998-01-01

Reviews the history of services for people with mental disabilities in Pakistan, with emphasis on the development of outreach projects based on principles of community-based rehabilitation. Strategies are suggested that build on existing realities and strengths of families and communities. Promising examples from Bangladesh are cited. (Author/DB)

Community Based Training Centers for the Vocational Transitioning of Students with Mental Retardation.

ERIC Educational Resources Information Center

Craft, Robert D.; Martch, Theodore

The Douglas Education Service District, Winston Dillard School District, and the Special Education Department at Douglas High School in Winston, Oregon, developed a community-based education program that emphasizes ongoing job training for students with mental disabilities and the development of competitive employment in the community. The program…

Community Mental Health: Issues for Social Work Practice and Education.

ERIC Educational Resources Information Center

Katz, Arthur J., Ed.

Articles by social work educators on some of the critical issues in community mental health are presented. Examined are some conceptual and program developments related to coordination, continuity of care, and the use of teams in planning and service delivery for community mental health (Lawrence K. Berg). The issue of civil commitment to and…

Melding Infant Mental Health and Multisystemic Therapy Approaches to Community-Based Treatment

ERIC Educational Resources Information Center

Willoughby, Jay C.; Carubia, Beau A.; Murgolo, Marisa A.; Carter, Debbie R.; Frankel, Karen A.

2013-01-01

A recent partnership between the Irving Harris Program in Child Development and Infant Mental Health and the Community Based Psychiatry Program at University of Colorado Hospital joined two different approaches to child mental health treatment: infant mental health and multisystemic therapy (MST). This article illustrates the compatibility of…

Violent Extremism, Community-Based Violence Prevention, and Mental Health Professionals.

PubMed

Weine, Stevan M; Stone, Andrew; Saeed, Aliya; Shanfield, Stephen; Beahrs, John; Gutman, Alisa; Mihajlovic, Aida

2017-01-01

New community-based initiatives being developed to address violent extremism in the United States are utilizing mental health services and leadership. This article reviews current approaches to preventing violent extremism, the contribution that mental illness and psychosocial problems can make to violent extremism, and the rationale for integrating mental health strategies into preventing violent extremism. The authors describe a community-based targeted violence prevention model and the potential roles of mental health professionals. This model consists of a multidisciplinary team that assesses at-risk individuals with comprehensive threat and behavioral evaluations, arranges for ongoing support and treatment, conducts follow-up evaluations, and offers outreach, education, and resources for communities. This model would enable mental health professionals in local communities to play key roles in preventing violent extremism through their practice and leadership.

24 CFR 582.5 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-04-01

...). The term nonprofit organization also includes a community mental health center established as a public... appropriate services, including health care, mental health treatment, alcohol and other substance abuse... ASSISTANT SECRETARY FOR COMMUNITY PLANNING AND DEVELOPMENT, DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT...

How community physical, structural, and social stressors relate to mental health in the urban slums of Accra, Ghana.

PubMed

Greif, Meredith J; Nii-Amoo Dodoo, F

2015-05-01

Urban health in developing counties is a major public health challenge. It has become increasingly evident that the dialog must expand to include mental health outcomes, and to shift focus to the facets of the urban environment that shape them. Population-based research is necessary, as empirical findings linking the urban environment and mental health have primarily derived from developed countries, and may not be generalizable to developing countries. Thus, the current study assesses the prevalence of mental health problems (i.e., depression, perceived powerlessness), as well as their community-based predictors (i.e., crime, disorder, poverty, poor sanitation, local social capital and cohesion), among a sample of 690 residents in three poor urban communities in Accra, Ghana. It uncovers that residents in poor urban communities in developing countries suffer from mental health problems as a result of local stressors, which include not only physical and structural factors but social ones. Social capital and social cohesion show complex, often unhealthy, relationships with mental health, suggesting considerable drawbacks in making social capital a key focus among policymakers. Copyright © 2015. Published by Elsevier Ltd.

Improving the mental health of rural New South Wales communities facing drought and other adversities.

PubMed

Hart, Craig Richard; Berry, Helen Louise; Tonna, Anne Maree

2011-10-01

NSW has just experienced its worst drought in a century. As years passed with insufficient rain, drought-related mental health problems became evident on farms. Our objective is to describe how, in response, the Rural Adversity Mental Health Program was introduced in 2007 to raise awareness of drought-related mental health needs and help address these needs in rural and remote NSW. The program has since expanded to include other forms of rural adversity, including recent floods. Rural NSW. DESIGN, PARTICIPANTS, INTERVENTIONS: Designed around community development principles, health, local service networks and partner agencies collaborated to promote mental health, education and early intervention. Strategies included raising mental health literacy, organising community social events and disseminating drought-related information. Priority areas were Aboriginal communities, older farmers, young people, women, primary health care and substance use. Over 3000 people received mental health literacy training in the four years of operation from 2007 to 2010. Stakeholders collaborated to conduct hundreds of mental health-related events attended by thousands of people. A free rural mental health support telephone line provided crisis help and referral to rural mental health-related services. Drought affected mental health in rural NSW. A community development model was accepted and considered effective in helping communities build capacity and resilience in the face of chronic drought-related hardship. Given the scale, complexity and significance of drought impacts and rural adjustment, and the threats posed by climate change, a long-term approach to funding such programs would be appropriate. © 2011 The Authors. Australian Journal of Rural Health © National Rural Health Alliance Inc.

Community mental health nursing: keeping pace with care delivery?

PubMed

Henderson, Julie; Willis, Eileen; Walter, Bonnie; Toffoli, Luisa

2008-06-01

The National Mental Health Strategy has been associated with the movement of service delivery into the community, creating greater demand for community services. The literature suggests that the closure of psychiatric beds and earlier discharge from inpatient services, have contributed to an intensification of the workload of community mental health nurses. This paper reports findings from the first stage of an action research project to develop a workload equalization tool for community mental health nurses. The study presents data from focus groups conducted with South Australian community mental health nurses to identify issues that impact upon their workload. Four themes were identified, relating to staffing and workforce issues, clients' characteristics or needs, regional issues, and the impact of the health-care system. The data show that the workload of community mental health nurses is increased by the greater complexity of needs of community mental health clients. Service change has also resulted in poor integration between inpatient and community services and tension between generic case management and specialist roles resulting in nurses undertaking tasks for other case managers. These issues, along with difficulties in recruiting and retaining staff, have led to the intensification of community mental health work and a crisis response to care with less time for targeted interventions.

Citizenship, Community Mental Health, and the Common Good.

PubMed

Atterbury, Kendall; Rowe, Michael

2017-07-01

In this article, we address the issue of community mental health and the common good via an applied theory of citizenship to support the social inclusion, empowerment, and inclusion of persons diagnosed with psychiatric disorders. We begin by discussing citizenship, and the concept of the common good, in regard to historical conceptions of citizenship, including the historical exclusion of women, people of color, persons with mental illness, and others. We then review the development of our citizenship framework in response to the limitations of even the most innovative community mental health interventions, specifically the practice of mental health outreach to persons who are homeless. We review findings from three citizenship research studies - a community-level intervention, an individual- and group-level intervention, and development of an individual instrument of citizenship - along with brief comments on current citizenship research. We conclude with a discussion of the challenges of realizing both the individual and collective potential of, and challenges to, the citizenship framework in relation to current and future community mental health systems of care. Copyright © 2017 John Wiley & Sons, Ltd. Copyright © 2017 John Wiley & Sons, Ltd.

THE COMMUNITY COLLEGE IN MENTAL HEALTH TRAINING, REPORT OF A CONFERENCE TO EXPLORE THE ROLE OF THE COMMUNITY COLLEGE IN COLLEGE INSTITUTIONAL RESEARCH WORKERS (2D, PACIFIC GROVE, CALIFORNIA, MARCH 10-12, 1966).

ERIC Educational Resources Information Center

PENNINGROTH, PAUL W.

A CONFERENCE SPONSORED BY THE SOUTHERN REGIONAL EDUCATION BOARD AND THE NATIONAL INSTITUTE OF MENTAL HEALTH WAS HELD IN APRIL 1966, TO (1) PROVIDE OPPORTUNITY FOR COMMUNITY COLLEGE AND MENTAL HEALTH LEADERS TO CONSIDER SIGNIFICANT ISSUES IN THE TRAINING OF MENTAL HEALTH WORKERS, (2) PROVIDE INFORMATION ABOUT DEVELOPMENTS AND CURRENT PROGRAMS IN…

Expanded School Mental Health Services: Development of the Southeastern School Behavioral Health Community

ERIC Educational Resources Information Center

Weist, Mark D.; Stevens, Robert; Headley-Greenlaw, June; Miller, Elaine; Fletcher, Lee; Collier, Tristan; Arnau, Penny; Urbanski, Jan; Jenkins, June; Diana, David

2018-01-01

This article reviews the development of the Southeastern School Behavioral Health Community (SSBHC), which began in 2013 to bring coherence to the school behavioral health (SBH) agenda in South Carolina and has since expanded to become a regional effort in the southeastern United States. The term SBH is used to convey community mental health…

Disaster mental health preparedness in the community: A systematic review study

PubMed Central

Roudini, Juliet; Khankeh, Hamid Reza; Witruk, Evelin

2017-01-01

The objective of this study was to perform a systematic review of articles that cover aspects of disaster mental health preparedness. This assessment was done by a thorough review and summary of the available studies which provided a considerable background and amplified the gaps in knowledge about community mental health preparedness. By this systematic review, we tried to identify available concept of community mental health preparedness and related tools that communities and individuals will need to prepare for natural disasters. We found there is a lack of mental health preparedness in the majority of countries; valid and reliable tools and context-bound programs should be developed based on the experiences and perceptions of the community. PMID:28680695

Community Mental Health Services in Latin America for People with Severe Mental Disorders

PubMed Central

Minoletti, Alberto; Galea, Sandro; Susser, Ezra

2013-01-01

Mental disorders are highly prevalent in Latin American countries and exact a serious emotional toll, yet investment in public mental health remains insufficient. Most countries of the region have developed national and local initiatives to improve delivery of mental health services over the last 22 years, following the technical leadership of the Pan American Health Organization/World Health Organization (PAHO/WHO). It is especially notable that PAHO/WHO facilitated the development of national policies and plans, as well as local programs, to deliver specialized community care for persons with severe mental disorders. Nevertheless, at present, the majority of Latin American countries maintain a model of services for severe mental disorders based primarily on psychiatric hospitals that consume most of the national mental health budget. To accelerate the pace of change, this article emphasizes the need to develop cross-country regional initiatives that promote mental health service development, focusing on severe mental disorders. As one specific example, the authors describe work with RedeAmericas, which has brought together an interdisciplinary group of international investigators to research regional approaches and train a new generation of leaders in public mental health. More generally, four regional strategies are proposed to complement the work of PAHO/ WHO in Latin America: 1) to develop multi-country studies on community services, 2) to study new strategies and interventions in countries with more advanced mental health services, 3) to strengthen advocacy groups by cross-country interchange, and 4) to develop a network of well-trained leaders to catalyze progress across the region. PMID:25339792

'Our community is the worst': the influence of cultural beliefs on stigma, relationships with family and help-seeking in three ethnic communities in London.

PubMed

Shefer, Guy; Rose, Diana; Nellums, Laura; Thornicroft, Graham; Henderson, Claire; Evans-Lacko, Sara

2013-09-01

Existing knowledge about the cultural beliefs of black and minority ethnic (BME) communities in the UK regarding stigma and mental illness is limited. Data were collected in 10 focus groups, five with service users and five with laypersons, from BME communities in London. Thematic analysis identified that cultural beliefs regarding mental illness reflect four different voices present within the BME communities. The study revealed that cultural beliefs influencing both relationships with family and, consequently, help-seeking for individuals with mental illness must be considered in the development of anti-stigma interventions and when engaging communities around mental health.

Exploring the role of ethnic media and the community readiness to combat stigma attached to mental illness among Vietnamese immigrants: the pilot project Tam An (Inner Peace in Vietnamese).

PubMed

Han, Meekyung; Cao, Lien; Anton, Karen

2015-01-01

Vietnamese Americans are at high risk for developing mental health disorders due to multiple risk factors such as trauma and acculturative stress. However, the utilization of mental health services has been low. The pilot project Tam An was implemented to raise mental health awareness by engaging community resources in the Vietnamese population. Informed by the Community Readiness Model and through local ethnic media sources, messages to destigmatize mental health and promote the willingness to initiate mental health treatment were presented. Using an exploratory perspective, findings from focus group data suggest that the project improved the community's stage of readiness.

[Community inclusion as a human right and medical necessity for individuals with serious mental illnesses].

PubMed

Salzer, Mark S

2017-09-01

Community inclusion refers to equal opportunities for people to participate in the community and willingness to welcome and active community attitude. The opportunity to participate in the community is both a medical necessity and a rights issue. This concept provides a novel theoretical framework for the advancement of mental health policies, programs, and global practices that enable the development of the well-being and health of people with mental disorders. Eleven fundamentals for promoting community inclusion of individuals with serious mental illnesses that are supported by key conceptual, theoretical, and research evidence. These fundamentals reflect beliefs and schemas that need to be present to truly prioritize and facilitate inclusion, intervention strategies and achieve the most impactful objectives that were expected. The greater inclusion, greater community participation, which includes work, education, religion and spiritual participation, and other domains associated with having a life that makes sense, all of which generates physical, cognitive and mental benefts for anyone, disregarding the presence or absence of a mental disorder. The concept of community inclusion offers a transformative next step in the delivery of mental health services that clearly articulates community participation in meaningful areas as the target for promoting full health and wellness.

Community psychiatric care: from libertarianism to coercion. Moral panic and mental health policy in Britain.

PubMed

Holloway, F

1996-08-01

This article discusses recent developments in mental health policy in Britain, focusing on the move towards compulsory supervision of mentally ill people in the community. It is argued that the desire for compulsion reflects moral panic rather than rational appraisal of the undoubted problems with community mental health care. Alternative strategies involving education of the patient and cares, the deployment of psychological treatments of psychosis and an emphasis on the negotiation of treatment plans, are advocated.

Development of project wings home visits, a mental health intervention for Latino families using community-based participatory research.

PubMed

Garcia, Carolyn; Hermann, Denise; Bartels, Anna; Matamoros, Pablo; Dick-Olson, Linda; Guerra de Patino, Janeth

2012-11-01

As the Latino population in the United States experiences rapid growth, the well-being of Latino adolescents is a growing concern because of their high rates of mental health problems. Latino adolescents have higher rates of mental health problems than their peers, including depressive symptoms, suicide attempts, and violence. Sophisticated, realistic health promotion efforts are needed to reduce these risk behaviors and enhance protective factors. Parents and schools can be key protective factors, or assets, in adolescents' lives. This article details the steps undertaken to develop Project Wings Home Visits, a collaborative school-based, community-linked mental health promotion intervention for Latino adolescents and their families. Core to the intervention is the use of a community health worker model to provide home-based outreach and education to parents of Latino adolescents. The intervention was developed using a community-based participatory research approach that involved the cooperation of a community health care system, a public high school, and a university. Our process demonstrates the benefits, strengths, and challenges of using community-based participatory research in creating and implementing health promotion interventions.

The concept of stigma in mental illness as applied to Haitian Americans.

PubMed

Dieujuste, Colette

2016-06-01

To report on the analysis of the concept of the stigma of mental illness within the Haitian American community. Mental illness is a highly stigmatized condition within certain communities making it challenging for individuals to seek effective treatment. The consequences of such stigma can have lifelong corollaries for the individuals, the families and the communities. The concept of stigma is not fully developed in nursing; clarity of the concept of stigma of mental illness is still needed in the nursing literature. In order to assist patients in accessing mental health services, the concept of stigma must first be clarified. The method used for this concept analysis was that of Walker and Avant. Five attributes were identified, creating the following definition: labelling, stereotype, negative attitude, emotional response, and discrimination. The antecedents for stigma of mental illness are lack of knowledge about mental illness, emotional state and cultural beliefs and values. The origins of stigmatization of mental illness among Haitian Americans need to be understood. Mental health illnesses are stigmatized within the Haitian culture, which presents as a barrier to accessing help for many Haitian American women suffering from mental illness. The defining attributes can be used to develop tools to help clinicians identify patients being stigmatized. Once stigma is recognized, nurses can develop strategies and policies that can mitigate the effects of stigmatization of mental illness among this patient population. Further research is essential to examine the ways in which this concept impacts the Haitian American community, as well as effective strategies to help minimize its effects. © 2016 International Council of Nurses.

Developing mental health services in Nigeria : the impact of a community-based mental health awareness programme.

PubMed

Eaton, Julian; Agomoh, Ahamefula O

2008-07-01

This grass-roots level mental health awareness programme considerably increased use of community-based mental health services in a part of Nigeria where knowledge about treatability of mental illness was limited. The benefits of the programme were sustained for a significant period after the initial awareness programme. In order for attitude changes to be reinforced, similar awareness programmes must be repeated at regular intervals.

Step-Up: Promoting Youth Mental Health and Development in Inner-City High Schools

PubMed Central

Pardo, Gisselle; Conover, Kelly; Gopalan, Geetha; McKay, Mary

2011-01-01

African American and Latino youth who reside in inner-city communities are at heightened risk for compromised mental health, as their neighborhoods are too often associated with serious stressors, including elevated rates of poverty, substance abuse, community violence, as well as scarce youth-supportive resources, and mental health care options. Many aspects of disadvantaged urban contexts have the potential to thwart successful youth development. Adolescents with elevated mental health needs may experience impaired judgment, poor problem-solving skills, and conflictual interpersonal relationships, resulting in unsafe sexual behavior and drug use. However, mental health services are frequently avoided by urban adolescents who could gain substantial benefit from care. Thus, the development of culturally sensitive, contextually relevant and effective services for urban, low-income African American and Latino adolescents is critical. Given the complexity of the mental health and social needs of urban youth, novel approaches to service delivery may need to consider individual (i.e., motivation to succeed in the future), family (i.e., adult support within and outside of the family), and community-level (i.e., work and school opportunities) clinical components. Step-Up, a high school-based mental health service delivery model has been developed to bolster key family, youth and school processes related to youth mental health and positive youth development. Step-Up (1) intervenes with urban minority adolescents across inner-city ecological domains; (2) addresses multiple levels (school, family and community) in order to target youth mental health difficulties; and (3) provides opportunities for increasing youth social problem-solving and life skills. Further, Step-Up integrates existing theory-driven, evidence-based interventions. This article describes Step-Up clinical goals, theoretical influences, as well as components and key features, and presents preliminary data on youth engagement for two cohorts of students. PMID:23564983

Step-Up: Promoting Youth Mental Health and Development in Inner-City High Schools.

PubMed

Alicea, Stacey; Pardo, Gisselle; Conover, Kelly; Gopalan, Geetha; McKay, Mary

2012-06-01

African American and Latino youth who reside in inner-city communities are at heightened risk for compromised mental health, as their neighborhoods are too often associated with serious stressors, including elevated rates of poverty, substance abuse, community violence, as well as scarce youth-supportive resources, and mental health care options. Many aspects of disadvantaged urban contexts have the potential to thwart successful youth development. Adolescents with elevated mental health needs may experience impaired judgment, poor problem-solving skills, and conflictual interpersonal relationships, resulting in unsafe sexual behavior and drug use. However, mental health services are frequently avoided by urban adolescents who could gain substantial benefit from care. Thus, the development of culturally sensitive, contextually relevant and effective services for urban, low-income African American and Latino adolescents is critical. Given the complexity of the mental health and social needs of urban youth, novel approaches to service delivery may need to consider individual (i.e., motivation to succeed in the future), family (i.e., adult support within and outside of the family), and community-level (i.e., work and school opportunities) clinical components. Step-Up, a high school-based mental health service delivery model has been developed to bolster key family, youth and school processes related to youth mental health and positive youth development. Step-Up (1) intervenes with urban minority adolescents across inner-city ecological domains; (2) addresses multiple levels (school, family and community) in order to target youth mental health difficulties; and (3) provides opportunities for increasing youth social problem-solving and life skills. Further, Step-Up integrates existing theory-driven, evidence-based interventions. This article describes Step-Up clinical goals, theoretical influences, as well as components and key features, and presents preliminary data on youth engagement for two cohorts of students.

Mapping the terrain: A conceptual schema for a mental health medication support service in community pharmacy

PubMed Central

Scahill, Shane; Fowler, Jane L; Hattingh, H Laetitia; Kelly, Fiona; Wheeler, Amanda J

2015-01-01

Objective: Mental health–related problems pose a serious issue for primary care, and community pharmacy could make a significant contribution, but there is a dearth of information. Methods: This article reports synthesis of the literature on mental health interventions across a range of pharmacy models, and pharmacy services in contexts beyond mental health. To best inform the design of a community pharmacy medication support intervention for mental health consumers, the literature was reported as a conceptual schema and subsequent recommendations for development, implementation and evaluation of the service. A broad conceptualisation was taken in this review. In addition to mental health and community pharmacy literature, policy/initiatives, organisational culture and change management principles, and evaluative processes were reviewed. Key words were selected and literature reviews undertaken using EMBASE, PubMed, CINAHL and Web of Science. Results: Recommendations were made around: medication support intervention design, consumer recruitment, implementation in community pharmacy and evaluation. Surprisingly, there is a scarce literature relating to mental health interventions in community pharmacy. Even so, findings from other pharmacy models and broader medicines management for chronic illness can inform development of a medication support service for mental health consumers. Key learnings include the need to expand medicines management beyond adherence with respect to both intervention design and evaluation. Conclusion: The conceptual framework is grounded in the need for programmes to be embedded within pharmacies that are part of the health system as a whole. PMID:26770802

Mental health in the Solomon Islands: developing reforms and partnerships.

PubMed

Ryan, Brigid; Orotaloa, Paul; Araitewa, Stephen; Gaoifa, Daniel; Moreen, John; Kiloe, Edwin; Same, William; Goding, Margaret; Ng, Chee

2015-12-01

The Solomon Islands face significant shortages and geographical imbalances in the distribution of skilled health workers and resources, which severely impact the delivery of mental health services. The government's Integrated Mental Health Service has emphasised the importance of greater community ownership and involvement in community-based mental health care, and of moving from centralised services to increased local and accessible care. From 2012 to 2014, the Solomon Islands Integrated Mental Health service worked with Asia-Australia Mental Health to build workforce capacity and deliver sustainable community mental health programs. Supported by the Australian Aid Program's Public Sector Linkages Program, this project shared resources and fostered links between public sector agencies in Australia, Fiji and the Solomon Islands. Key learning points from the collaboration included the critical need to establish partnerships with community stakeholders, the importance of sustaining a well-functioning mental health team, and optimising the strengths of the local resources in the Solomon Islands. Through this project, national policies, promotion and service delivery were strengthened, through the exchange of experiences and mobilisation of north-south (Australia-Solomon Islands) and south-south (Solomon Islands-other Pacific nations) technical expertise. This project demonstrates the potential for international partnerships to contribute to the development of culturally-appropriate and integrated mental health services. © The Royal Australian and New Zealand College of Psychiatrists 2015.

Some implications of a community mental health model for developing countries.

PubMed

Mehryar, A; Khajavi, F

The aim of this paper is to call attention to certain problems facing many developing countries which are bound to lead to further difficulties in psychosocial adjustment. Almost all these problems are inherent in the process of socioeconomic change, urbanization, and industrialization. These changes may not only lead to an increase in the rate of mental illness, but because of their impact on the basic family structure and living conditions, will result in a reduced tolerance of deviation on the part of the community. Moreover, the spread of public education and mass media is also likely to lead to a change in the expectations and attitudes of developing nations making it no longer possible to endure psychological suffering as part of one's destiny. Even the improvement of public health services leading to reduction of infant mortality and a rise in life expectancy may lead to a gross increase in demands for mental health services by the very young and the aged sections of the population. It is the contention of this paper that a community mental health model, with certain modifications to fit the local culture, will best serve the increasing mental health needs of developing nations. Of particular relevance are such aspects of the model as population and prevention orientation, community involvement, extension of prefessional resources through consultation, utilization of non-professional manpower, continuity and comprehensiveness of care as well as an open systems conceptualization of the whole process of the organization and delivery of mental health services. The latter approach will help bring about an integration of mental health services within the wider framework of human service agencies, e.g., public health, general and adult education, family planning, and community development.

A decade of peace: Mental health issues and service developments in the Solomon Islands since 2003.

PubMed

Maukera, Rex; Blignault, Ilse

2015-12-01

To describe the impact on mental health and psychosocial wellbeing of the armed conflict that occurred in the Solomon Islands from 1998-2003 and the subsequent political unrest and natural disasters, and the developments in mental health services since 2003. A literature and document review was conducted, supplemented by the written reflections of senior staff in the Solomon Islands Mental Health Service. Conflict and natural disaster have had a significant impact on the mental health and functioning of individuals, families and communities. National health system reform has been accompanied by the reorientation of the mental health services from custodial care to care in the community and greater emphasis on mental health promotion and prevention. The dedication of the small group of Solomon Islands mental health professionals, supported by local health service managers and external donors, has been a major strength. However, they face significant challenges. Continued investment in mental health, including the treatment and prevention of mental and substance use disorders, is essential for mental health and development outcomes. All development stakeholders, including civil society, government, academic and research institutions, and development partners, have a role to play. © The Royal Australian and New Zealand College of Psychiatrists 2015.

Building community resilience through mental health infrastructure and training in post-Katrina New Orleans.

PubMed

Springgate, Benjamin F; Wennerstrom, Ashley; Meyers, Diana; Allen, Charles E; Vannoy, Steven D; Bentham, Wayne; Wells, Kenneth B

2011-01-01

To describe a disaster recovery model focused on developing mental health services and capacity-building within a disparities-focused, community-academic participatory partnership framework. Community-based participatory, partnered training and services delivery intervention in a post-disaster setting. Post-Katrina Greater New Orleans community. More than 400 community providers from more than 70 health and social services agencies participated in the trainings. Partnered development of a training and services delivery program involving physicians, therapists, community health workers, and other clinical and non-clinical personnel to improve access and quality of care for mental health services in a post-disaster setting. Services delivery (outreach, education, screening, referral, direct treatment); training delivery; satisfaction and feedback related to training; partnered development of training products. Clinical services in the form of outreach, education, screening, referral and treatment were provided in excess of 110,000 service units. More than 400 trainees participated in training, and provided feedback that led to evolution of training curricula and training products, to meet evolving community needs over time. Participant satisfaction with training generally scored very highly. This paper describes a participatory, health-focused model of community recovery that began with addressing emerging, unmet mental health needs using a disparities-conscious partnership framework as one of the principle mechanisms for intervention. Population mental health needs were addressed by investment in infrastructure and services capacity among small and medium sized non-profit organizations working in disaster-impacted, low resource settings.

Co-production as an approach to developing stakeholder partnerships to reduce mental health inequalities: an evaluation of a pilot service.

PubMed

Lwembe, Saumu; Green, Stuart A; Chigwende, Jennifer; Ojwang, Tom; Dennis, Ruth

2017-01-01

Aim This study aimed to evaluate a pilot cross-sector initiative - bringing together public health, a community group, primary mental health teams and patients - in using co-production approaches to deliver a mental health service to meet the needs of the black and minority ethnic communities. Black and minority ethnic communities continue to face inequalities in mental health service access and provision. They are under-represented in low-level interventions as they are less likely to be referred, and more likely to disengage from mainstream mental health services. Effective models that lead to improved access and better outcomes are yet to be established. It has long been recognised that to be effective, services need to be more culturally competent, which may be achieved through a co-production approach. This study aimed to evaluate the role of co-production in the development of a novel community mental health service for black and minority ethnic service users. Qualitative research methods, including semi-structured interviews and focus groups, were used to collect data to examine the use of co-production methods in designing and delivering an improved mental health service. Findings Twenty-five patients enrolled into the study; of these, 10 were signposted for more intensive psychological support. A 75% retention rate was recorded (higher than is generally the case for black and minority ethnic service users). Early indications are that the project has helped overcome barriers to accessing mental health services. Although small scale, this study highlights an alternative model that, if explored and developed further, could lead to delivery of patient-centred services to improve access and patient experience within mental health services, particularly for black and minority ethnic communities.

Neighbourhood influences on mental health in master planned estates: a qualitative study of resident perspectives.

PubMed

Francis, Jacinta; Giles-Corti, Billie; Wood, Lisa; Knuiman, Matthew

2014-12-01

Neighbourhood characteristics have been linked to a range of health outcomes, including mental health. Despite the growth of master planned estates (MPEs) within Australia, few studies have investigated the physical and social correlates of mental health in residents of new housing developments. Methods This study aimed to identify the facilitators of, and barriers to, mentally healthy neighbourhoods using focus groups with residents of MPEs in metropolitan Perth, Western Australia. Focus group interviews were analysed using qualitative research software package QSR NVivo. Results and Conclusions Results suggest that mental health is strongly influenced by a sense of community and security, as well as an aesthetically pleasing environment. Residents of MPEs may experience a strong sense of community due to similarities in life-stage and the community building efforts of property developers. Expanding population size, social exclusion, and insufficient services may negatively affect the mental health of residents in MPEs. SO WHAT?: Identifying correlates of mentally healthy neighbourhoods may help urban planners design residential areas that promote healthy living.

Teaching and Training Relevant Community Skills to Mentally Retarded Persons.

ERIC Educational Resources Information Center

Matson, Johnny L.

1988-01-01

Reviews some of the major developments in teaching and training relevant community skills to mentally retarded persons. The following adaptive skills are discussed: (1) toilet use and bed wetting; (2) eating, dressing, and personal hygiene; (3) community survival; and (4) vocational and social skills. (BJV)

NIMH Prototype Management Information System for Community Mental Health Centers

PubMed Central

Wurster, Cecil R.; Goodman, John D.

1980-01-01

Various approaches to centralized support of computer applications in health care are described. The NIMH project to develop a prototype Management Information System (MIS) for community mental health centers is presented and discussed as a centralized development of an automated data processing system for multiple user organizations. The NIMH program is summarized, the prototype MIS is characterized, and steps taken to provide for the differing needs of the mental health centers are highlighted.

Community beliefs about causes and risks for mental disorders: a mental health literacy survey in a rural area of Maharashtra, India.

PubMed

Kermode, Michelle; Bowen, Kathryn; Arole, Shoba; Joag, Kaustubh; Jorm, Anthony F

2010-11-01

Explanations for mental disorders in India can be influenced by biomedicine, systems of traditional medicine and supernatural beliefs. Community beliefs about causes of mental distress influence help-seeking behaviours. This study aimed to assess local knowledge and understanding of causes and risks for mental disorders in a rural area of Maharashtra, and to assess the prevalence of possible common mental disorders. A cross-sectional mental health literacy survey was undertaken in late 2007. A questionnaire was administered to 240 systematically sampled community members and 60 village health workers (VHWs). Participants were presented with two vignettes describing people experiencing symptoms of mental disorders (depression, psychosis); they were asked about the causes of the problems and the vulnerabilities of community sub-groups. Additionally, the General Health Questionnaire (GHQ12) was administered to assess prevalence of possible common mental disorders. The most commonly acknowledged causes of the problems were a range of socioeconomic factors. Supernatural and biological explanations were not widely endorsed. Women, the unemployed and the poor were judged as more likely to develop mental disorders, while both young and older people were perceived to be less vulnerable. Results of the GHQ12 indicated that 27% had a possible common mental disorder and that the elderly were at increased risk, contrary to community perceptions. Enhancing mental health literacy of both VHWs and community members using approaches that are sensitive to local conceptualizations of mental health and illness will contribute to improved treatment and care for people with mental disorders. Further investigation of mental health among the elderly in this community is indicated.

Gerald Caplan: A Tribute to the Originator of Mental Health Consultation

ERIC Educational Resources Information Center

Erchul, William P.

2009-01-01

Gerald Caplan (1917-2008), world-renowned child and community psychiatrist, was the originator of the modern practice of mental health consultation. In addition to consultation, Caplan developed and refined many conceptual models and methods for practice for use in community mental health, psychology, and education. This tribute article focuses on…

Weathering the Cuts: A Delphi Survey on Surviving Cutbacks in Community Mental Health.

ERIC Educational Resources Information Center

Goplerud, Eric N.; Walfish, Steven

Although the major locus of mental health care in the United States is in community agencies, funding cutbacks threaten the services those agencies provide. To assist human service managers in developing guidelines and concrete action strategies for dealing with financial problems, 106 mental health professionals (e.g., agency directors, technical…

Community perceptions of mental distress in a post-conflict setting: a qualitative study in Burundi.

PubMed

Familiar, Itziar; Sharma, Sonali; Ndayisaba, Herman; Munyentwari, Norbert; Sibomana, Seleus; Bass, Judith K

2013-01-01

There is scant documentation of the mental health characteristics of low-income communities recovering from armed conflict. To prepare for quantitative health surveys and health service planning in Burundi, we implemented a qualitative study to explore concepts related to mental distress and coping among adults. Mental distress was defined as problems related to feelings, thinking, behaviour and physical stress. Using free listing and key informant interviews with a range of community members, we triangulated data to identify salient issues. Thirty-eight free list respondents and 23 key informants were interviewed in 5 rural communities in Burundi using 2 interview guides from the WHO Toolkit for Mental Health Assessment in Humanitarian Settings. Based on these interviews, we identified four locally defined idioms/terms relating to mental distress: ihahamuka (anxiety spectrum illnesses), ukutiyemera (a mix of depression and anxiety-like syndrome), akabonge (depression/grief-like syndrome) and kwamana ubwoba burengeje (anxiety-like syndrome). Mental distress terms were perceived as important problems impacting community development. Affected individuals sought help from several sources within the community, including community leaders and traditional healers. We discuss how local expressions of distress can be used to tailor health research and service integration from the bottom up.

Contextualizing mental health: gendered experiences in a Mumbai slum.

PubMed

Parkar, Shubhangi R; Fernandes, Johnson; Weiss, Mitchell G

2003-12-01

Urban mental health programmes in developing countries remain in their infancy. To serve low-income communities, research needs to consider the impact of common life experience in slums, including poverty, bad living conditions, unemployment, and crowding. Our study in the Malavani slum of Mumbai examines afflictions of the city affecting the emotional well-being and mental health of women and men with respect to gender. This is a topic for which mental health studies have been lacking, and for which psychiatric assumptions based on middle-class clinical experience may be most tenuous. This study employs ethnographic methods to show how environmental and social contexts interact in shaping local experience with reference to common mental health problems. Focusing on the social and environmental context of the mental health of communities, rather than psychiatric disorders affecting individuals, findings are broadly applicable and sorely needed to guide the development of locally appropriate community mental health programmes. Identified afflictions affecting mental health include not only access to health care, but also sanitation, addictions, criminality, domestic violence, and the so-called bar-girl culture. Although effective clinical interventions are required for mental health services to treat psychiatric disorders, they cannot directly affect the conditions of urban slums that impair mental health.

Community Attitude and Associated Factors towards People with Mental Illness among Residents of Worabe Town, Silte Zone, Southern Nation's Nationalities and People's Region, Ethiopia.

PubMed

Bedaso, Asres; Yeneabat, Tebikew; Yohannis, Zegeye; Bedasso, Kufa; Feyera, Fetuma

2016-01-01

Mental illnesses worldwide are accompanied by another pandemic, that of stigma and discrimination. Public understanding about mental illnesses and attitudes towards people with mental illness play a paramount role in the prevention and treatment of mental illness and the rehabilitation of people with mental illness. To assess community attitude and associated factors towards people with mental illness. Community based cross-sectional study was conducted from April 28 to May 28, 2014. Quantitative data were collected through interview from 435 adults selected using simple random sampling. Data were collected using community attitude towards mentally ill (CAMI) tool to assess community attitude towards people with mental illness and associated factors. Multiple linear regression analysis was performed to identify predictors of community attitude towards people with mental illness and the level of significance association was determined by beta with 95% confidence interval and P less than 0.05. The highest mean score was on social restrictiveness subscale (31.55±5.62). Farmers had more socially restrictive view (β = 0.291, CI [0.09, 0.49]) and have less humanistic view towards mentally ill (β = 0.193, CI [-0.36, -0.03]). Having mental health information had significantly less socially restrictive (β = -0.59, CI [-1.13, -0.05]) and less authoritarian (β = -0.10, CI [-1.11, -0.06]) view towards mentally ill but respondents who are at university or college level reported to be more socially restrictive (β = 0.298, CI [0.059, 0.54]). Respondents whose age is above 48 years old had significantly less view of community mental health ideology (β = -0.59, CI [-1.09, -0.08]). Residents of Worabe town were highly socially restrictive but less authoritarian. There was high level of negative attitude towards people with mental illness along all the subscales with relative variation indicating a need to develop strategies to change negative attitude attached to mental illness in Worabe town at community level.

Art and mental health in Samoa.

PubMed

Ryan, Brigid; Goding, Margaret; Fenner, Patricia; Percival, Steven; Percival, Wendy; Latai, Leua; Petaia, Lisi; Pulotu-Endemann, Fuimaono Karl; Parkin, Ian; Tuitama, George; Ng, Chee

2015-12-01

To pilot an art and mental health project with Samoan and Australian stakeholders. The aim of this project was to provide a voice through the medium of art for people experiencing mental illness, and to improve the public understanding in Samoa of mental illness and trauma. Over 12 months, a series of innovative workshops were held with Samoan and Australian stakeholders, followed by an art exhibition. These workshops developed strategies to support the promotion and understanding of mental health in Samoa. Key stakeholders from both art making and mental health services were engaged in activities to explore the possibility of collaboration in the Apia community. The project was able to identify the existing resources and community support for the arts and mental health projects, to design a series of activities aimed to promote and maintain health in the community, and to pilot these programs with five key organizations. This project demonstrates the potential for art and mental health projects to contribute to both improving mental health and to lowering the personal and social costs of mental ill health for communities in Samoa. © The Royal Australian and New Zealand College of Psychiatrists 2015.

Community perspectives on post-Katrina mental health recovery in New Orleans.

PubMed

Meyers, Diana; Allien, Charles E; Dunn, Donisha; Wennerstrom, Ashley; Springgate, Benjamin F

2011-01-01

Disaster-affected communities may face prolonged challenges to community-wide mental health recovery due to limitations in local resources, infrastructure, and leadership. REACH NOLA, an umbrella non-profit organization comprising academic institutions and community-based agencies, sought to promote community recovery, increase mental health service delivery capacity, and develop local leadership in post-Katrina New Orleans through its Mental Health infrastructure and Training Project (MHIT). The project offered local health service providers training and follow-up support for implementing evidence-based and new approaches to mental health service delivery. This commentary shares the perspectives of three community leaders who co-directed MHIT. They describe the genesis of MHIT, the experience of each agency in adopting leadership roles in addressing post-disaster needs, challenges and growth opportunities, and then overarching lessons learned concerning leadership in a prolonged crisis. These lessons may be relevant to community agencies addressing hurricane recovery in other areas of the Gulf States as well as to inform long-term disaster recovery efforts elsewhere.

Mental health as an advocacy priority in the lesbian, gay, bisexual, and transgender communities.

PubMed

Pandya, Anand

2014-05-01

This column reviews the evolution of lesbian, gay, bisexual, and transgender (LGBT) mental health advocacy in relation to modern mental health advocacy efforts. In addition to developments in organized psychiatry (e.g., American Psychiatric Association's LGBT caucus), grassroots LGBT community initiatives are playing an important role (e.g., Trevor Project providing crisis intervention/suicide prevention services to LGBT youth, face-to-face mental health services in LGBT community centers). Studies have found that LGBT individuals are at increased risk for mental health problems (e.g., depression, anxiety, substance misuse, suicidal ideation, self-harm). Mental health advocacy in the LGBT community has been slowed by the long-standing association of the concept of homosexuality with psychopathology in mainstream psychiatry (e.g., homosexuality was only removed from the DSM in 1973, ego dystonic homosexuality still appears in the ICD-10). However, positive developments in LGBT mental health advocacy have been fostered by the proposed minority stress model (i.e., that elevated risk of mental illness in LGBT individuals is a consequence of a hostile stressful environment). A particularly encouraging initiative is the It Gets Better Project, in which thousands of videos, some by prominent individuals, have been posted online to send a message of hope to LGBT youth facing harassment and low self-esteem.

Developing a mental health care plan in a low resource setting: the theory of change approach.

PubMed

Hailemariam, Maji; Fekadu, Abebaw; Selamu, Medhin; Alem, Atalay; Medhin, Girmay; Giorgis, Tedla Wolde; DeSilva, Mary; Breuer, Erica

2015-09-28

Scaling up mental healthcare through integration into primary care remains the main strategy to address the extensive unmet mental health need in low-income countries. For integrated care to achieve its goal, a clear understanding of the organisational processes that can promote and hinder the integration and delivery of mental health care is essential. Theory of Change (ToC), a method employed in the planning, implementation and evaluation of complex community initiatives, is an innovative approach that has the potential to assist in the development of a comprehensive mental health care plan (MHCP), which can inform the delivery of integrated care. We used the ToC approach to develop a MHCP in a rural district in Ethiopia. The work was part of a cross-country study, the Programme for Improving Mental Health Care (PRIME) which focuses on developing evidence on the integration of mental health in to primary care. An iterative ToC development process was undertaken involving multiple workshops with stakeholders from diverse backgrounds that included representatives from the community, faith and traditional healers, community associations, non-governmental organisations, Zonal, Regional and Federal level government offices, higher education institutions, social work and mental health specialists (psychiatrists and psychiatric nurses). The objective of this study is to report the process of implementing the ToC approach in developing mental health care plan. A total of 46 persons participated in four ToC workshops. Four critical path dimensions were identified: community, health facility, administrative and higher level care organisation. The ToC participants were actively engaged in the process and the ToC encouraged strong commitment among participants. Key opportunities and barriers to implementation and how to overcome these were suggested. During the workshops, a map incorporating the key agreed outcomes and outcome indicators was developed and finalized later. The ToC approach was found to be an important component in the development of the MHCP and to encourage broad political support for the integration of mental health services into primary care. The method may have broader applicability in planning complex health interventions in low resource settings.

The ARC organizational and community intervention strategy for implementing evidence-based children's mental health treatments.

PubMed

Glisson, Charles; Schoenwald, Sonja K

2005-12-01

This paper reviews the implications of organizational and community intervention research for the implementation of effective mental health treatments in usual community practice settings. The paper describes an organizational and community intervention model named ARC for Availability, Responsiveness and Continuity, that was designed to support the improvement of social and mental health services for children. The ARC model incorporates intervention components from organizational development, interorganizational domain development, the diffusion of innovation, and technology transfer that target social, strategic, and technological factors in effective children's services. This paper also describes a current NIMH-funded study that is using the ARC intervention model to support the implementation of an evidence-based treatment, Multisystemic Therapy (MST), for delinquent youth in extremely rural, impoverished communities in the Appalachian Mountains of East Tennessee.

Application of a model for the development of a mental health service delivery collaboration between police and the health service.

PubMed

Laing, Robert; Halsey, Rebecca; Donohue, David; Newman, Claire; Cashin, Andrew

2009-05-01

Changing societal trends have revealed an increased prevalence of mental illness and diminished health resources from which to offer services. This has lead to a need to develop new and more efficient police and health service models of practice. Services offered by the police department in the management of mental health crisis in the community are essential in minimising the risk of individuals with mental health problems causing harm to themselves or a member of the public. In addressing the difficulties associated with police playing an important role in the management of mental health crisis in the community, but having little training in mental health issues, this paper discusses a proposed innovation for New South Wales police in Australia through the development of a Crisis Intervention Team model.

Beyond the biomedical: community resources for mental health care in rural Ethiopia.

PubMed

Selamu, Medhin; Asher, Laura; Hanlon, Charlotte; Medhin, Girmay; Hailemariam, Maji; Patel, Vikram; Thornicroft, Graham; Fekadu, Abebaw

2015-01-01

The focus of discussion in addressing the treatment gap is often on biomedical services. However, community resources can benefit health service scale-up in resource-constrained settings. These assets can be captured systematically through resource mapping, a method used in social action research. Resource mapping can be informative in developing complex mental health interventions, particularly in settings with limited formal mental health resources. We employed resource mapping within the Programme for Improving Mental Health Care (PRIME), to systematically gather information on community assets that can support integration of mental healthcare into primary care in rural Ethiopia. A semi-structured instrument was administered to key informants. Community resources were identified for all 58 sub-districts of the study district. The potential utility of these resources for the provision of mental healthcare in the district was considered. The district is rich in community resources: There are over 150 traditional healers, 164 churches and mosques, and 401 religious groups. There were on average 5 eddir groups (traditional funeral associations) per sub-district. Social associations and 51 micro-finance institutions were also identified. On average, two traditional bars were found in each sub-district. The eight health centres and 58 satellite clinics staffed by Health Extension Workers (HEWs) represented all the biomedical health services in the district. In addition the Health Development Army (HDA) are community volunteers who support health promotion and prevention activities. The plan for mental healthcare integration in this district was informed by the resource mapping. Community and religious leaders, HEWs, and HDA may have roles in awareness-raising, detection and referral of people with mental illness, improving access to medical care, supporting treatment adherence, and protecting human rights. The diversity of community structures will be used to support rehabilitation and social reintegration. Alcohol use was identified as a target disorder for community-level intervention.

Beyond the Biomedical: Community Resources for Mental Health Care in Rural Ethiopia

PubMed Central

Selamu, Medhin; Asher, Laura; Hanlon, Charlotte; Medhin, Girmay; Hailemariam, Maji; Patel, Vikram; Thornicroft, Graham; Fekadu, Abebaw

2015-01-01

Background The focus of discussion in addressing the treatment gap is often on biomedical services. However, community resources can benefit health service scale-up in resource-constrained settings. These assets can be captured systematically through resource mapping, a method used in social action research. Resource mapping can be informative in developing complex mental health interventions, particularly in settings with limited formal mental health resources. Method We employed resource mapping within the Programme for Improving Mental Health Care (PRIME), to systematically gather information on community assets that can support integration of mental healthcare into primary care in rural Ethiopia. A semi-structured instrument was administered to key informants. Community resources were identified for all 58 sub-districts of the study district. The potential utility of these resources for the provision of mental healthcare in the district was considered. Results The district is rich in community resources: There are over 150 traditional healers, 164 churches and mosques, and 401 religious groups. There were on average 5 eddir groups (traditional funeral associations) per sub-district. Social associations and 51 micro-finance institutions were also identified. On average, two traditional bars were found in each sub-district. The eight health centres and 58 satellite clinics staffed by Health Extension Workers (HEWs) represented all the biomedical health services in the district. In addition the Health Development Army (HDA) are community volunteers who support health promotion and prevention activities. Discussion The plan for mental healthcare integration in this district was informed by the resource mapping. Community and religious leaders, HEWs, and HDA may have roles in awareness-raising, detection and referral of people with mental illness, improving access to medical care, supporting treatment adherence, and protecting human rights. The diversity of community structures will be used to support rehabilitation and social reintegration. Alcohol use was identified as a target disorder for community-level intervention. PMID:25962075

Understanding Latino Parents' Child Mental Health Literacy: Todos a bordo/All Aboard

ERIC Educational Resources Information Center

Umpierre, Mari; Meyers, Laura V.; Ortiz, Aida; Paulino, Angela; Rodriguez, Anita Rivera; Miranda, Ana; Rodriguez, Raquel; Kranes, Stephanie; McKay, Mary M.

2015-01-01

Objective: This article describes Phase 1 of a pilot that aims to develop, implement, and test an intervention to educate and simultaneously engage highly stressed Latino parents in child mental health services. A team of Spanish-speaking academic and community co-investigators developed the intervention using a community-based participatory…

Experiences in Rural Mental Health. IX: Measuring and Monitoring Stress in Communities.

ERIC Educational Resources Information Center

Miller, Francis T.; And Others

Based on a North Carolina feasibility study (1967-73) which focused on development of a pattern for providing comprehensive mental health services to rural people, this guide deals with measuring and monitoring stress in the community. Emphasizing the "proactive" efforts developed in a stress model for Vance and Franklin counties, this…

A Strategic Planning Model for Community Mental Health Centers.

ERIC Educational Resources Information Center

Del Pizzo, Les; And Others

1987-01-01

Describes a strategic plan developed at a community mental health center, the Summit Center for Human Development, to deal with its own survival while public demand increases, and federal and state programs are cut back. Examines current and prospective services and outlines directions for enhancing the mandated and optional services provided…

The Resource Team: an innovative service delivery support model for mental health services.

PubMed

O'Sullivan, Julie; Powell, Jacinta; Gibbon, Peter; Emmerson, Brett

2009-04-01

This paper outlines the development of the Resource Team, an innovative service delivery model supporting clinical services at the Inner North Brisbane Mental Health Service, Royal Brisbane and Women's Hospital Health Service District. The team aims to provide a base for specialist mental health support staff, improve knowledge management and support the development of meaningful community partnerships. Development of the team included a literature review and consultation with internal and external stakeholders. From this, the objectives, roles and functions of the team were clarified and disseminated to stakeholders. The team currently encompasses 12 positions and has initiated a number of programs and service developments. These include improved IT management of clinical resources and the development of partnerships with the community and non-government sectors. The Resource Team effectively coordinates specialist clinical support positions, addresses knowledge management issues and facilitates meaningful engagement with the community and non-government sectors. The model could easily be applied in other mental health and general health services.

Lessons Learned From a Community-Based Participatory Research Mental Health Promotion Program for American Indian Youth.

PubMed

Langdon, Sarah E; Golden, Shannon L; Arnold, Elizabeth Mayfield; Maynor, Rhonda F; Bryant, Alfred; Freeman, V Kay; Bell, Ronny A

2016-05-01

Background American Indian (AI) youth have the highest rates of suicide among racial/ethnic minority groups in the United States. Community-based strategies are essential to address this issue, and community-based participatory research (CBPR) offers a model to engage AI communities in mental health promotion programming. Objectives This article describes successes and challenges of a CBPR, mixed-method project, The Lumbee Rite of Passage (LROP), an academic-community partnership to develop and implement a suicide prevention program for Lumbee AI youth in North Carolina. Method LROP was conducted in two phases to (1) understand knowledge and perceptions of existing mental health resources and (2) develop, implement, and evaluate a cultural enrichment program as a means of suicide prevention. Discussion/Results LROP implemented an effective community-academic partnership by (1) identifying and understanding community contexts, (2) maintaining equitable partnerships, and (3) implementing a culturally tailored research design targeting multilevel changes to support mental health. Strategies formed from the partnership alleviated challenges in each of these key CBPR concept areas. Conclusions LROP highlights how a CBPR approach contributes to positive outcomes and identifies opportunities for future collaboration in a tribal community. Using culturally appropriate CBPR strategies is critical to achieving sustainable, effective programs to improve mental health of AI youth. © 2016 Society for Public Health Education.

Empowerment of women and mental health promotion: a qualitative study in rural Maharashtra, India

PubMed Central

Kermode, Michelle; Herrman, Helen; Arole, Rajanikant; White, Joshua; Premkumar, Ramaswamy; Patel, Vikram

2007-01-01

Background The global burden of mental illness is high and opportunities for promoting mental health are neglected in most parts of the world. Many people affected by mental illness live in developing countries, where treatment and care options are limited. In this context, primary health care (PHC) programs can indirectly promote mental health by addressing its determinants i.e. by enhancing social unity, minimising discrimination and generating income opportunities. The objectives of this study were to: 1. Describe concepts of mental health and beliefs about determinants of mental health and illness among women involved with a PHC project in rural Maharashtra, India; 2. Identify perceived mental health problems in this community, specifically depression, suicide and violence, their perceived causes, and existing and potential community strategies to respond to them and; 3. Investigate the impact of the PHC program on individual and community factors associated with mental health Method We undertook qualitative in-depth interviews with 32 women associated with the PHC project regarding: their concepts of mental health and its determinants; suicide, depression and violence; and the perceived impact of the PHC project on the determinants of mental health. The interviews were taped, transcribed, translated and thematically analysed. Results Mental health and illness were understood by these women to be the product of cultural and socio-economic factors. Mental health was commonly conceptualised as an absence of stress and the commonest stressors were conflict with husbands and mother-in-laws, domestic violence and poverty. Links between empowerment of women through income generation and education, reduction of discrimination based on caste and sex, and promotion of individual and community mental health were recognised. However, mental health problems such as suicide and violence were well-described by participants. Conclusion While it is essential that affordable, accessible, appropriate treatments and systems of referral and care are available for people with mental illness in developing country settings, the promotion of mental health by addressing its determinants is another potential strategy for reducing the burden of mental illness for individuals and communities in these settings. PMID:17761003

Empowerment of women and mental health promotion: a qualitative study in rural Maharashtra, India.

PubMed

Kermode, Michelle; Herrman, Helen; Arole, Rajanikant; White, Joshua; Premkumar, Ramaswamy; Patel, Vikram

2007-08-31

The global burden of mental illness is high and opportunities for promoting mental health are neglected in most parts of the world. Many people affected by mental illness live in developing countries, where treatment and care options are limited. In this context, primary health care (PHC) programs can indirectly promote mental health by addressing its determinants i.e. by enhancing social unity, minimising discrimination and generating income opportunities. The objectives of this study were to: 1. Describe concepts of mental health and beliefs about determinants of mental health and illness among women involved with a PHC project in rural Maharashtra, India; 2. Identify perceived mental health problems in this community, specifically depression, suicide and violence, their perceived causes, and existing and potential community strategies to respond to them and; 3. Investigate the impact of the PHC program on individual and community factors associated with mental health We undertook qualitative in-depth interviews with 32 women associated with the PHC project regarding: their concepts of mental health and its determinants; suicide, depression and violence; and the perceived impact of the PHC project on the determinants of mental health. The interviews were taped, transcribed, translated and thematically analysed. Mental health and illness were understood by these women to be the product of cultural and socio-economic factors. Mental health was commonly conceptualised as an absence of stress and the commonest stressors were conflict with husbands and mother-in-laws, domestic violence and poverty. Links between empowerment of women through income generation and education, reduction of discrimination based on caste and sex, and promotion of individual and community mental health were recognised. However, mental health problems such as suicide and violence were well-described by participants. While it is essential that affordable, accessible, appropriate treatments and systems of referral and care are available for people with mental illness in developing country settings, the promotion of mental health by addressing its determinants is another potential strategy for reducing the burden of mental illness for individuals and communities in these settings.

Barriers and Facilitators of a Healthy Lifestyle Among Persons with Serious and Persistent Mental Illness: Perspectives of Community Mental Health Providers

PubMed Central

McKibbin, Christine L.; Kitchen, Katherine A.; Wykes, Thomas L.; Lee, Aaron A.

2014-01-01

The investigators used qualitative methods to examine perspectives of community mental health professionals on obesity management in adults with serious mental illness. Data from 5 focus groups were subjected to constant comparison analysis and grounded theory. Results showed that influences at individual, social, community, and societal levels impact development and maintenance of obesity. Mental health providers desired a collaborative relationship with providers of health promotion program staff. They also believed that frequent, group-based health promotion should include participation incentives for adults with SMI and should occur over durations of at least 6-months to achieve improved health outcomes for this population. PMID:24129587

A Student-Centered Mental Health Virtual Community Needs and Features: A Focus Group Study.

PubMed

El Morr, Christo; Maule, Catherine; Ashfaq, Iqra; Ritvo, Paul; Ahmad, Farah

2017-01-01

Mental health is a pervasive challenge in the population and especially for university/college students on campuses across North America. Anxiety, stress and depression are on the rise and a scalable, economically sound innovation is essential to address these mental health challenges. The research team has conducted 8 focus groups in April to May 2016 in order to elicit perspectives of students at York University about their online activities and the development of an online mindfulness based Mental Health Virtual Community. This paper explains the main results of the qualitative analysis pertaining to the challenges and benefits of an online mindfulness based Mental Health Virtual Community.

RedeAmericas: building research capacity in young leaders for sustainable growth in community mental health services in Latin America.

PubMed

Yang, L; Pratt, C; Valencia, E; Conover, S; Fernández, R; Burrone, M S; Cavalcanti, M T; Lovisi, G; Rojas, G; Alvarado, R; Galea, S; Price, L N; Susser, E

2017-01-01

The purpose of this paper is to describe the development and initial accomplishments of a training program of young leaders in community mental health research as part of a Latin American initiative known as RedeAmericas. RedeAmericas was one of five regional 'Hubs' funded by the National Institute of Mental Health (NIMH) to improve community mental health care and build mental health research capacity in low- and middle-income countries. It included investigators in six Latin American cities - Santiago, Chile; Medellín, Colombia; Rio de Janeiro, Brazil; and Córdoba, Neuquén, and Buenos Aires in Argentina - working together with a team affiliated with the Global Mental Health program at Columbia University in New York City. One component of RedeAmericas was a capacity-building effort that included an Awardee program for early career researchers in the mental health field. We review the aims of this component, how it developed, and what was learned that would be useful for future capacity-building efforts, and also comment on future prospects for maintaining this type of effort.

Mental health care reforms in Asia: the urgency of now: building a recovery-oriented, community mental health service in china.

PubMed

Tse, Samson; Ran, Mao-Sheng; Huang, Yueqin; Zhu, Shimin

2013-07-01

For the first time in history, China has a mental health legal framework. People in China can now expect a better life and more accessible, better-quality health care services for their loved ones. Development of a community mental health service (CMHS) is at a crossroads. In this new column on mental health reforms in Asia, the authors review the current state of the CMHS in China and propose four strategic directions for future development: building on the strengths of the "686 Project," the 2004 initiative that launched China's mental health reform; improving professional skills of the mental health workforce, especially for a recovery approach; empowering families and caregivers to support individuals with severe mental illness; and using information and communications technology to promote self-help and reduce the stigma associated with psychiatric disorders.

Current Issues in Mental Retardation and Human Development: Selected Papers from the 1970 Staff Development Conferences of the President's Committee on Mental Retardation (Washington, D.C., 1971).

ERIC Educational Resources Information Center

Stedman, Donald J., Ed.

Six papers discuss some of the current issues in the field of mental retardation and human development. Epidemiology of mental retardation from a sociological and clinical point of view is analyzed by Jane R. Mercer, based on studies of mental retardation in the community in Pomona, California. The role of genetics and intra-uterine diagnosis of…

Perceived community participation in tsunami recovery efforts and the mental health of tsunami-affected mothers: findings from a study in rural Sri Lanka.

PubMed

Wickrama, K A S; Wickrama, T

2011-09-01

The 2004 tsunami seriously affected millions of families in several developing countries by destroying their livelihoods, houses and communities, subsequently damaging social and physical resources. Disaster studies have documented that both post-traumatic stress disorder (PTSD) and depression develop during the first six months following disaster exposure for the majority of those afflicted. and Using data from 325 tsunami-affected families living in southern Sri Lanka, the current study investigates whether community social resources such as residents' perceived community participation in tsunami recovery efforts reduce mental health risks (PTSD and depressive symptoms) of tsunami-affected mothers. The analysis is based on structural equation modelling. and The findings of structural equation modelling supports the main hypothesis that residents' perceived community participation directly and indirectly (through collective family functioning and mental health service use) reduces mental health risks (both PTSD and depressive symptoms) of tsunami-affected mothers after controlling for pre-tsunami family adversities. In addition, the results show that residents' perceived community participation buffers the influence of trauma exposure on PTSD symptom levels of mothers. The identification of specific social and family processes that relate to mental health can be useful for post-disaster interventions and recovery programmes.

Transitional Support for Adults with Severe Mental Illness: Critical Time Intervention and Its Roots in Assertive Community Treatment

ERIC Educational Resources Information Center

Herman, Daniel B.

2014-01-01

Professional social workers and other mental health providers have for many years been involved in delivering treatment and support services focused on the needs of adults with severe mental illnesses living in the community. While some models have evolved largely through practice experience, others have developed through research paradigms in…

Primary Prevention Approaches to the Development of Mental Health Services for Ethnic Minorities: A Challenge to Social Work Education and Practice.

ERIC Educational Resources Information Center

Miller, Samuel O., Ed.; And Others

This monograph contains articles on mental health needs, experiences, and preventive social work programs in ethnic minority communities. An overview by Gwenelle Styles O'Neal reviews factors that influence the mental health of ethnic minorities and explores family and community support networks for alleviating stress. Susan Bellinger examines…

Trends in Mental Health and Substance Abuse Services at the Nation’s Community Health Centers: 1998–2003

PubMed Central

Druss, Benjamin G.; Bornemann, Thomas; Fry-Johnson, Yvonne W.; McCombs, Harriet G.; Politzer, Robert M.; Rust, George

2008-01-01

Objective. We examined trends in delivery of mental health and substance abuse services at the nation’s community health centers. Methods. Analyses used data from the Health Resources and Services Administration (HRSA), Bureau of Primary Care’s (BPHC) 1998 and 2003 Uniform Data System, merged with county-level data. Results. Between 1998 and 2003, the number of patients diagnosed with a mental health/substance abuse disorder in community health centers increased from 210 000 to 800 000. There was an increase in the number of patients per specialty mental health/substance abuse treatment provider and a decline in the mean number of patient visits, from 7.3 visits per patient to 3.5 by 2003. Although most community health centers had some on-site mental health/substance abuse services, centers without on-site services were more likely to be located in counties with fewer mental health/substance abuse clinicians, psychiatric emergency rooms, and inpatient hospitals. Conclusions. Community health centers are playing an increasingly central role in providing mental health/substance abuse treatment services in the United States. It is critical both to ensure that these centers have adequate resources for providing mental health/substance abuse care and that they develop effective linkages with mental health/substance abuse clinicians in the communities they serve. PMID:18687596

Trends in Mental Health and Substance Abuse Services at the Nation’s Community Health Centers: 1998–2003

PubMed Central

Druss, Benjamin G.; Bornemann, Thomas; Fry-Johnson, Yvonne W.; McCombs, Harriet G.; Politzer, Robert M.; Rust, George

2006-01-01

Objective. We examined trends in delivery of mental health and substance abuse services at the nation’s community health centers. Methods. Analyses used data from the Health Resources and Services Administration (HRSA), Bureau of Primary Care’s (BPHC) 1998 and 2003 Uniform Data System, merged with county-level data. Results. Between 1998 and 2003, the number of patients diagnosed with a mental health/substance abuse disorder in community health centers increased from 210 000 to 800 000. There was an increase in the number of patients per specialty mental health/substance abuse treatment provider and a decline in the mean number of patient visits, from 7.3 visits per patient to 3.5 by 2003. Although most community health centers had some on-site mental health/substance abuse services, centers without on-site services were more likely to be located in counties with fewer mental health/substance abuse clinicians, psychiatric emergency rooms, and inpatient hospitals. Conclusions. Community health centers are playing an increasingly central role in providing mental health/substance abuse treatment services in the United States. It is critical both to ensure that these centers have adequate resources for providing mental health/substance abuse care and that they develop effective linkages with mental health/substance abuse clinicians in the communities they serve. PMID:17008573

Mental health academics in rural and remote Australia.

PubMed

Pierce, David; Little, Fiona; Bennett-Levy, James; Isaacs, Anton N; Bridgman, Heather; Lutkin, Sarah J; Carey, Timothy A; Schlicht, Kate G; McCabe-Gusta, Zita P; Martin, Elizabeth; Martinez, Lee A

2016-01-01

The significant impact of mental ill health in rural and remote Australia has been well documented. Included among innovative approaches undertaken to address this issue has been the Mental Health Academic (MHA) project, established in 2007. Funded by the Australian Government (Department of Health), this project was established as a component of the University Departments of Rural Health (UDRH) program. All 11 UDRHs appointed an MHA. Although widely geographically dispersed, the MHAs have collaborated in various ways. The MHA project encompasses a range of activities addressing four key performance indicators. These activities, undertaken in rural and remote Australia, aimed to increase access to mental health services, promote awareness of mental health issues, support students undertaking mental health training and improve health professionals' capacity to recognise and address mental health issues. MHAs were strategically placed within the UDRHs across the country, ensuring an established academic base for the MHAs' work was available immediately. Close association with each local rural community was recognised as important. For most MHAs this was facilitated by having an established clinical role in their local community and actively engaging with the community in which they worked. In common with other rural health initiatives, some difficulties were experienced in the recruitment of suitable MHAs, especially in more remote locations. The genesis of this article was a national meeting of the MHAs in 2014, to identify and map the different types of activities MHAs had undertaken in their regions. These activities were analysed and categorised by the MHAs. These categories have been used as a guiding framework for this article. The challenge to increase community access to mental health services was addressed by (i) initiatives to address specific access barriers, (ii) supporting recruitment and retention of rural mental health staff, (iii) developing the skills of the existing workforce and (iv) developing innovative approaches to student placements. Strategies to promote awareness of mental health issues included workshops in rural and remote communities, specific suicide prevention initiatives and targeted initiatives to support the mental health needs of Indigenous Australians. The need for collaboration between the widely dispersed MHAs was identified as important to bridge the rural divide, to promote project cohesiveness and ensure new ideas in an emerging setting are readily shared and to provide professional support for one another as mental health academics are often isolated from academic colleagues with similar mental health interests. The MHA project suggests that an integrated approach can be taken to address the common difficulties of community awareness raising of mental health issues, increasing access to mental health services, workforce recruitment and retention (access), and skill development of existing health professionals (access and awareness). To address the specific needs and circumstances of their community, MHAs have customised their activities. As in other rural initiatives, one size was found not to fit all. The triad of flexibility, diversity and connectedness (both to local community and other MHAs) describes the response identified as appropriate by the MHAs. The breadth of the MHA role to provide university sponsored educational activities outside traditional student teaching meant that the broader health workforce benefited from access to mental health training that would not otherwise have occurred. Provision of these additional educational opportunities addressed not only the need for increased education regarding mental health but also reduced the barriers commonly faced by rural health professionals in accessing quality professional development.

Integrating Journalism Into Health Promotion: Creating and Disseminating Community Narratives.

PubMed

Brown, Louis D; Berryhill, Joseph C; Jones, Eric C

2018-06-01

Media coverage of mental health and other social issues often relies on episodic narratives that suggest individualistic causes and solutions, while reinforcing negative stereotypes. Community narratives can provide empowering alternatives, serving as media advocacy tools used to shape the policy debate on a social issue. This article provides health promotion researchers and practitioners with guidance on how to develop and disseminate community narratives to broaden awareness of social issues and build support for particular programs and policy solutions. To exemplify the community narrative development process and highlight important considerations, this article examines a narrative from a mental health consumer-run organization. In the narrative, people with mental health problems help one another while operating a nonprofit organization, thereby countering stigmatizing media portrayals of people with mental illness as dangerous and incompetent. The community narrative frame supports the use of consumer-run organizations, which are not well-known and receive little funding despite evidence of effectiveness. The article concludes by reviewing challenges to disseminating community narratives, such as creating a product of interest to media outlets, and potential solutions, such as engaging media representatives through community health partnerships and using social media to draw attention to the narratives.

The Partnered Research Center for Quality Care: Developing Infrastructure to Support Community-partnered Participatory Research in Mental Health

PubMed Central

Lizaola, Elizabeth; Schraiber, Ron; Braslow, Joel; Kataoka, Sheryl; Springgate, Benjamin F.; Wells, Kenneth B.; Jones, Loretta

2013-01-01

Evidence-based programs have been shown to improve functioning and mental health outcomes, especially for vulnerable populations. However, these populations face numerous barriers to accessing care including lack of resources and stigma surrounding mental health issues. In order to improve mental health outcomes and reduce health disparities, it is essential to identify methods for reaching such populations with unmet need. A promising strategy for reducing barriers and improving access to care is Community Partnered Participatory Research (CPPR). Given the power of this methodology to transform the impact of research in resource-poor communities, we developed an NIMH-funded Center, the Partnered Research Center for Quality Care, to support partnerships in developing, implementing, and evaluating mental health services research and programs. Guided by a CPPR framework, center investigators, both community and academic, collaborated in all phases of research with the goal of establishing trust, building capacity, increasing buy-in, and improving the sustainability of interventions and programs. They engaged in two-way capacity-building, which afforded the opportunity for practical problems to be raised and innovative solutions to be developed. This article discusses the development and design of the Partnered Research Center for Quality Care and provides examples of partnerships that have been formed and the work that has been conducted as a result. PMID:22352082

"Tension" in South Asian women: developing a measure of common mental disorder using participatory methods.

PubMed

Karasz, Alison; Patel, Viraj; Kabita, Mahbhooba; Shimu, Parvin

2013-01-01

Although common mental disorder (CMD) is highly prevalent among South Asian immigrant women, they rarely seek mental treatment. This may be owing in part to the lack of conceptual synchrony between medical models of mental disorder and the social models of distress common in South Asian communities. Furthermore, common mental health screening and diagnostic measures may not adequately capture distress in this group. Community-based participatory research (CBPR) is ideally suited to help address measurement issues in CMD as well as to develop culturally appropriate treatment models. To use participatory methods to identify an appropriate, culturally specific mental health syndrome and develop an instrument to measure this syndrome. We formed a partnership between researchers, clinicians, and community members. The partnership selected a culturally specific model of emotional distress/illness, "tension," as a focus for further study. Partners developed a scale to measure Tension and tested the new scale on 162 Bangladeshi immigrant women living in the Bronx. The 24-item "Tension Scale" had high internal consistency (α = 0.83). On bivariate analysis, the scale significantly correlated in the expected direction with depressed as measured by the Patient Health Questionnaire (PHQ-2), age, education, self-rated health, having seen a physician in the past year, and other variables. Using participatory techniques, we created a new measure designed to assess CMD in an isolated immigrant group. The new measure shows excellent psychometric properties and will be helpful in the implementation of a community-based, culturally synchronous intervention for depression. We describe a useful strategy for the rapid development and field testing of culturally appropriate measures of mental distress and disorder.

Covering Intensive Community-Based Child Mental Health Services under Medicaid. A Series of Issue Briefs.

ERIC Educational Resources Information Center

Koyanagi, Chris; Semansky, Rafael

This set of seven issue briefs considers six important community-based services for children with serious mental or emotional disorders that some states provide as mandated rehabilitation services under the federal Medicaid law. The materials are designed to help state policymakers develop appropriate rules for covering community-based services…

What? Another Form? The Process of Measuring and Comparing Service Utilization in a Community Mental Health Program Model.

ERIC Educational Resources Information Center

Dewa, Carolyn S.; Horgan, Salinda; Russell, Marc; Keates, Jane

2001-01-01

Describes experiences in developing a multi-program economic evaluation and costing study of Assertive Community Treatment (ACT), a widely studied community mental health treatment model. The project description shows how the worlds of research and service delivery can collaborate to come to symbiotic resolutions. (Author/SLD)

Community Attitude and Associated Factors towards People with Mental Illness among Residents of Worabe Town, Silte Zone, Southern Nation’s Nationalities and People’s Region, Ethiopia

PubMed Central

Bedasso, Kufa; Feyera, Fetuma

2016-01-01

Background Mental illnesses worldwide are accompanied by another pandemic, that of stigma and discrimination. Public understanding about mental illnesses and attitudes towards people with mental illness play a paramount role in the prevention and treatment of mental illness and the rehabilitation of people with mental illness. Objective To assess community attitude and associated factors towards people with mental illness. Methods Community based cross-sectional study was conducted from April 28 to May 28, 2014. Quantitative data were collected through interview from 435 adults selected using simple random sampling. Data were collected using community attitude towards mentally ill (CAMI) tool to assess community attitude towards people with mental illness and associated factors. Multiple linear regression analysis was performed to identify predictors of community attitude towards people with mental illness and the level of significance association was determined by beta with 95% confidence interval and P less than 0.05. Results The highest mean score was on social restrictiveness subscale (31.55±5.62). Farmers had more socially restrictive view (β = 0.291, CI [0.09, 0.49]) and have less humanistic view towards mentally ill (β = 0.193, CI [-0.36, -0.03]). Having mental health information had significantly less socially restrictive (β = -0.59, CI [-1.13, -0.05]) and less authoritarian (β = -0.10, CI [-1.11, -0.06]) view towards mentally ill but respondents who are at university or college level reported to be more socially restrictive (β = 0.298, CI [0.059, 0.54]). Respondents whose age is above 48 years old had significantly less view of community mental health ideology (β = -0.59, CI [-1.09, -0.08]). Conclusion and Recommendation Residents of Worabe town were highly socially restrictive but less authoritarian. There was high level of negative attitude towards people with mental illness along all the subscales with relative variation indicating a need to develop strategies to change negative attitude attached to mental illness in Worabe town at community level. PMID:26930591

Developing a culturally appropriate mental health care service for Samoa.

PubMed

Enoka, Matamua Iokapeta Sina; Tenari, Aliilelei; Sili, Tupou; Peteru, Latama; Tago, Pisaina; Blignault, Ilse

2013-06-01

Mental Health Care Services are part of the National Health Services for Samoa. Their function is to provide mental health care services to the population of Samoa, which numbers 180,000 people. However, like many other countries in the Pacific region, mental health is considered a low priority. The mental health budget allocation barely covers the operation of mental health care services. More broadly, there is a lack of political awareness about mental health care services and mental health rarely becomes an issue of deliberation in the political arena. This article outlines the recent development of mental health care services in Samoa, including the Mental Health Policy 2006 and Mental Health Act 2007. It tells the story of the successful integration of aiga (family) as an active partner in the provision of care, and the development of the Aiga model utilizing Samoan cultural values to promote culturally appropriate family-focused community mental health care for Samoa. Mental Health Care Services today encompass both clinical and family-focused community mental health care services. The work is largely nurse-led. Much has been achieved over the past 25 years. Increased recognition by government and increased resourcing are necessary to meet the future health care needs of the Samoan people. Copyright © 2012 Wiley Publishing Asia Pty Ltd.

A 17-Month Review of the Care Model, Service Structure, and Design of THRIVE, a Community Mental Health Initiative in Northern Singapore.

PubMed

Cheang, K M; Cheok, C C S

2015-12-01

Effective delivery of psychiatric care requires the development of a range of services. The existing Singapore health care system provides a comprehensive range of psychiatric services based in restructured hospitals. The Ministry of Health Community Mental Health Masterplan (2012-2017) aims to build novel services for the community. This Masterplan envisions the development of ASCATs (Assessment Shared Care Teams) and COMITs (Community Intervention Teams) to build the capacity and capability for psychiatric care to be delivered outside the hospital in the community. A community mental health plan comprising a fast access clinic, internet-delivered self-help and building a community network of providers was devised for the North of Singapore through the THRIVE (Total Health Rich In Vitality and Energy) programme. This article provides an introduction to the care model, service structure and design of the THRIVE, and reviews its milestones and achievements from its inception in August 2012 until December 2013.

42 CFR 483.130 - PASARR determination criteria.

Code of Federal Regulations, 2011 CFR

2011-10-01

... criteria. (a) Basis for determinations. Determinations made by the State mental health or mental... determinations by category. Advance group determinations by category developed by the State mental health or... records, physician's evaluations, election of hospice status, records of community mental health centers...

Community care for people who are homeless and mentally ill.

PubMed

Drury, Lin J

2003-05-01

This qualitative longitudinal study documents the experiences of 60 people who are homeless and mentally ill from their state mental hospital discharge through their first two years in community housing. The study explores the personal, cultural, and environmental contexts of life for adults who are homeless and mentally ill and examines the interaction between an individual's needs and community resources. The research identifies forces that perpetuate homelessness and traces the struggles that people who are homeless and mentally ill encounter during the transition from the streets to stable housing. The findings describe a culturally based pattern of mutual avoidance between homeless mentally ill clients and caregivers, which limits delivery of services to the population. Recommendations include development of alternative systems of care delivery, expansion of educational experiences with underserved populations, and increased funding for service or research with people who are homeless and mentally ill.

Promoting Mental Health and Preventing Mental Illness in General Practice.

PubMed

Thomas, Steve; Jenkins, Rachel; Burch, Tony; Calamos Nasir, Laura; Fisher, Brian; Giotaki, Gina; Gnani, Shamini; Hertel, Lise; Marks, Marina; Mathers, Nigel; Millington-Sanders, Catherine; Morris, David; Ruprah-Shah, Baljeet; Stange, Kurt; Thomas, Paul; White, Robert; Wright, Fiona

2016-01-01

This paper calls for the routine integration of mental health promotion and prevention into UK General Practice in order to reduce the burden of mental and physical disorders and the ensuing pressure on General Practice. The proposals & the resulting document (https://ethicscharity.files.wordpress.com/2015/09/rcgp_keymsg_150925_v5.pdf) arise from an expert 'Think Tank' convened by the London Journal of Primary Care, Educational Trust for Health Improvement through Cognitive Strategies (ETHICS Foundation) and the Royal College of General Practitioners. It makes 12 recommendations for General Practice: (1) Mental health promotion and prevention are too important to wait. (2) Work with your community to map risk factors, resources and assets. (3) Good health care, medicine and best practice are biopsychosocial rather than purely physical. (4) Integrate mental health promotion and prevention into your daily work. (5) Boost resilience in your community through approaches such as community development. (6) Identify people at increased risk of mental disorder for support and screening. (7) Support early intervention for people of all ages with signs of illness. (8) Maintain your biopsychosocial skills. (9) Ensure good communication, interdisciplinary team working and inter-sectoral working with other staff, teams and agencies. (10) Lead by example, taking action to promote the resilience of the general practice workforce. (11) Ensure mental health is appropriately included in the strategic agenda for your 'cluster' of General Practices, at the Clinical Commissioning Groups, and the Health and Wellbeing Board. (12) Be aware of national mental health strategies and localise them, including action to destigmatise mental illness within the context of community development.

A Framework for Classifying Online Mental Health-Related Communities With an Interest in Depression.

PubMed

Saha, Budhaditya; Nguyen, Thin; Phung, Dinh; Venkatesh, Svetha

2016-07-01

Mental illness has a deep impact on individuals, families, and by extension, society as a whole. Social networks allow individuals with mental disorders to communicate with others sufferers via online communities, providing an invaluable resource for studies on textual signs of psychological health problems. Mental disorders often occur in combinations, e.g., a patient with an anxiety disorder may also develop depression. This co-occurring mental health condition provides the focus for our work on classifying online communities with an interest in depression. For this, we have crawled a large body of 620 000 posts made by 80 000 users in 247 online communities. We have extracted the topics and psycholinguistic features expressed in the posts, using these as inputs to our model. Following a machine learning technique, we have formulated a joint modeling framework in order to classify mental health-related co-occurring online communities from these features. Finally, we performed empirical validation of the model on the crawled dataset where our model outperforms recent state-of-the-art baselines.

Mental health community based funding: Ohio's experience in revising its funding allocation methodology.

PubMed

Seiber, Eric E; Sweeney, Helen Anne; Partridge, Jamie; Dembe, Allard E; Jones, Holly

2012-10-01

Over the past 20 years, states have increasingly moved away from centrally financed, state-operated facilities to financing models built around community-based service delivery mechanisms. This paper identifies four important broad factors to consider when developing a funding formula to allocate state funding for community mental health services to local boards in an equitable manner, based on local community need: (1) funding factors used by other states; (2) state specific legislative requirements; (3) data availability; and (4) local variation of factors in the funding formula. These considerations are illustrated with the recent experience of Ohio using available evidence and data sources to develop a new community-based allocation formula. We discuss opportunities for implementing changes in formula based mental health funding related to Medicaid expansions for low income adults scheduled to go into effect under the new Patient Protection and Affordable Care Act.

Community pharmacists' experiences in mental illness and addictions care: a qualitative study.

PubMed

Murphy, Andrea L; Phelan, Heather; Haslam, Scott; Martin-Misener, Ruth; Kutcher, Stan P; Gardner, David M

2016-01-28

Community pharmacists are accessible health care professionals who encounter people with lived experience of mental illness and addictions in daily practice. Although some existing research supports that community pharmacists' interventions result in improved patient mental health outcomes, gaps in knowledge regarding the pharmacists' experiences with service provision to this population remain. Improving knowledge regarding the pharmacists' experiences with mental illness and addictions service provision can facilitate a better understanding of their perspectives and be used to inform the development and implementation of interventions delivered by community pharmacists for people with lived experience of mental illness and addictions in communities. We conducted a qualitative study using a directed content analysis and the Theoretical Domains Framework as part of our underlying theory of behaviour change and our analytic framework for theme development. The Theoretical Domains Framework facilitates understanding of behaviours of health care professionals and implementation challenges and opportunities for interventions in health care. Thematic analysis co-occurred throughout the process of the directed content analysis. We recruited community pharmacists, with experience dispensing psychotropics, at a minimum, through multiple mechanisms (e.g., professional associations) in a convenience sampling approach. Potential participants were offered the option of focus groups or interviews. Data were collected from one focus group and two interviews involving six pharmacists. Theoretical Domains Framework coding was primarily weighted in two domains: social/professional role and identity and environmental context and resources. We identified five main themes in the experiences of pharmacists in mental illness and addictions care: competing interests, demands, and time; relationships, rapport, and trust; stigma; collaboration and triage; and role expectations and clarity. Pharmacists are not practicing to their full scope of practice in mental illness and addictions care for several reasons including limitations within the work environment and lack of structures and processes in place to be fully engaged as health care professionals. More research and policy work are needed to examine better integration of pharmacists as members of the mental health care team in communities.

Focus Group in Community Mental Health Research: Need for Adaption.

PubMed

Zupančič, Vesna; Pahor, Majda; Kogovšek, Tina

2018-04-27

The article presents an analysis of the use of focus groups in researching community mental health users, starting with the reasons for using them, their implementation in mental health service users' research, and the adaptations of focus group use when researching the experiences of users. Based on personal research experience and a review of scientific publications in the Google Scholar, Web of Science, ProQuest, EBSCOhost, and Scopus databases, 20 articles published between 2010 and 2016 were selected for targeted content analysis. A checklist for reporting on the use of focus groups with community mental health service users, aiming to improve the comparability, verifiability and validity was developed. Adaptations of the implementation of focus groups in relation to participants' characteristics were suggested. Focus groups are not only useful as a scientific research technique, but also for ensuring service users' participation in decision-making in community mental health and evaluating the quality of the mental health system and services .

[Expanding the boundaries of clinics. Development of a community mental health program for children and teenagers from a rights perspective in the City of Buenos Aires].

PubMed

Barcala, Alejandra; Torricelli, Flavia

2013-01-01

There are forms of severe suffering in contemporary life that are not accommodated within the mechanisms offered by the mental health care system or that are not described on diagnostics handbooks, which need an appropriate response. This paper deals with the development of a community mental health program that provided care to children and teenagers with severe mental disorders and with a significant subjective suffering in the City of Buenos Aires from 2006 until the beginning of 2012. Pursuant to international standards in force in terms of mental health and human rights, this community, collective and territorial mental health practice suggested an inter-discipline and cross-sector approach that took into consideration the multi-dimension of social health determiners to provide comprehensive care. In order to offer a reply to fragmentation and the repeated traumas to which a large number of these children and teenagers have been exposed to, the program designed individual clinical-community strategies for each child or teenager, based on a network of continuous and reliable institutional supports. Conceived from a psychoanalytical approach, this praxis intended to benefit subjectification processes and the building of social bonds aiming at preventing the growing trends of administering medication and admitting children and teenagers as patients in mental health facilities.

Worldwide child and adolescent mental health begins with awareness: a preliminary assessment in nine countries.

PubMed

Hoven, Christina W; Doan, Thao; Musa, George J; Jaliashvili, Tea; Duarte, Cristiane S; Ovuga, Emilio; Ismayilov, Fuad; Rohde, Luis A; Dmitrieva, Tatjana; Du, Yasong; Yeghiyan, Maruke; Din, Amira Seif El; Apter, Alan; Mandell, Donald J

2008-06-01

To temper untoward mental health outcomes in children and adolescents, the World Psychiatric Association's Presidential Global Child Mental Health Programme, in collaboration with the WHO and the International Association of Child and Adolescent Psychiatry and Allied Professionals, established a Child Mental Health Awareness Task Force headed by Sam Tyano. Its task was to develop methodologies to increase awareness among policy-makers, community leaders, health professionals, teachers, parents, and children. Based on a prior comprehensive international search for effective techniques for information dissemination, an awareness manual was written for use by health professionals in diverse communities so as to guide the design and implementation of location specific awareness campaigns. We assessed the children, parents and teachers both before and after the campaign to determine changes in knowledge, attitudes and understanding of mental health. The school-based studies were conducted in selected communities in nine countries on five different continents distinguished by their different languages, cultures and their differing levels of economic development: Armenia, Azerbaijan, Brazil, China, Egypt, Georgia, Israel, Russia, and Uganda. In the six sites that completed all assessments, indicators of positive change in awareness of child mental health were identified, and results demonstrated an increased willingness to discuss emotional problems freely. These data support the utility of collaborating with schools so as to foster better child mental health in such under-resourced communities.

Enabling occupational participation and social inclusion for people recovering from mental ill-health through community gardening.

PubMed

Whatley, Elise; Fortune, Tracy; Williams, Anne E

2015-12-01

There is a need for mental health practitioners to understand how inclusive environments that enable participation can be developed. This paper presents the findings from an ethnographic exploration of Mind 'Sprout', a supported community garden situated in inner-city Melbourne. The study explored how this community development project created a socially inclusive environment, and enabled occupational participation among people recovering from mental ill-health. Consistent with the ethos of ethnography, data were collected through participant observation and asking questions of people as they participated at 'Sprout'. Six individual interviews and review of organisational documents were also conducted. Qualitative analysis was used to identify the understandings of how the Sprout community was created and experienced by its members. Three interrelated themes were revealed: Sprout community garden enabled social inclusion and occupational participation by creating community, creating a flexible environment that supports participation and creating a learning environment. The way Sprout operated enabled its members to participate together in occupation and to interact socially within the garden community and beyond as part of the local community. Sprout has developed a philosophy of active participation. The findings point to the opportunities that community development projects offer for creating environments that enable participation and social inclusion. They also suggest that an opportunity exists for occupational therapists to broaden their practise by leading or collaborating in these projects. © 2015 Occupational Therapy Australia.

A Community-Engaged Research Approach to Improve Mental Health Among Latina Immigrants: ALMA Photovoice.

PubMed

Perez, Georgina; Della Valle, Pamela; Paraghamian, Sarah; Page, Rachel; Ochoa, Janet; Palomo, Fabiana; Suarez, Emilia; Thrasher, Angela; Tran, Anh N; Corbie-Smith, Giselle

2016-05-01

Recent Latina immigrants are at increased risk of poor mental health due to stressors associated with adapting to life in the United States. Existing social and health care policies often do not adequately address the mental health concerns of new Latino populations. Amigas Latinas Motivando el Alma, a community-partnered research project, seeks to improve immigrant Latinas' mental health outcomes. Using Photovoice methodology, promotoras (lay health advisors) reflected on community factors affecting mental health through photography and guided discussion. Discussions were audio-recorded, transcribed, and coded using content analysis to identify salient themes. Promotoras reviewed codes to develop themes that they presented in community forums to reach local policy makers and to increase community awareness. These forums included an exhibit of the promotoras' photographs and discussion of action steps to address community concerns. Themes included transitioning to life in the United States, parenting, education, and combating racism. Nearly 150 stakeholders attended the community forums and proposed responses to promotoras' photographic themes. Our findings suggest that Photovoice provides an opportunity for Latinas and the larger community to identify issues that they find most important and to explore avenues for action and change by creating sustainable partnerships between the community and forum attendees. © 2015 Society for Public Health Education.

Barriers to Integrating Mental Health Services in Community-Based Primary Care Settings in Mexico City: A Qualitative Analysis.

PubMed

Martinez, William; Galván, Jorge; Saavedra, Nayelhi; Berenzon, Shoshana

2017-05-01

Despite the high prevalence of mental disorders in Mexico, minimal mental health services are available and there are large gaps in mental health treatment. Community-based primary care settings are often the first contact between patients and the health system and thus could serve as important settings for assessing and treating mental disorders. However, no formal assessment has been undertaken regarding the feasibility of implementing these services in Mexico. Before tools are developed to undertake such an assessment, a more nuanced understanding of the microprocesses affecting mental health service delivery must be acquired. A qualitative study used semistructured interviews to gather information from 25 staff in 19 community-based primary care clinics in Mexico City. Semistructured interviews were analyzed by using the meaning categorization method. In a second phase of coding, emerging themes were compared with an established typology of barriers to health care access. Primary care staff reported a number of significant barriers to implementing mental health services in primary care clinics, an already fragile and underfunded system. Barriers included the following broad thematic categories: service issues, language and cultural issues, care recipient characteristics, and issues with lack of knowledge. Results indicate that the implementation of mental health services in primary care clinics in Mexico will be difficult. However, the information in this study can help inform the integration of mental health into community-based primary care in Mexico through the development of adequate evaluative tools to assess the feasibility and progress of integrating these services.

Understanding Latino Parents' Child Mental Health Literacy: Todos a bordo/All Aboard

PubMed Central

Umpierre, Mari; Meyers, Laura V.; Ortiz, Aida; Paulino, Angela; Rodriguez, Anita Rivera; Miranda, Ana; Rodriguez, Raquel; Kranes, Stephanie; McKay, Mary M.

2015-01-01

Objective This article describes Phase 1 of a pilot that aims to develop, implement, and test an intervention to educate and simultaneously engage highly stressed Latino parents in child mental health services. A team of Spanish-speaking academic and community co-investigators developed the intervention using a community-based participatory research approach and qualitative methods. Method Through focus groups, the team identified parents' knowledge gaps and their health communication preferences. Results Latino parents from urban communities need and welcome child mental health literacy interventions that integrate printed materials with videos, preferably in their native language, combined with guidance from professionals. Conclusion A 3-minute video in Spanish that integrates education entertainment strategies and a culturally relevant format was produced as part of the intervention to educate and simultaneously engage highly stressed Latino parents in child mental health care. It is anticipated that the intervention will positively impact service use among this group. PMID:26412954

Rel8: demonstrating the feasibility of delivering an 8-week social skills program in a public mental health setting.

PubMed

Wauchope, Bronwyn; Terlich, Alissa; Lee, Stuart

2016-06-01

As community mental health services integrate recovery-oriented practices, treatments that focus on skills development and social integration are desirable. This study aimed to examine the feasibility of implementing "Rel8", an 8-week social skills training group adapted to suit a public community mental health setting. A retrospective audit was conducted of quantitative and qualitative data from four groups run between 2011 and 2013. Pre- and post-group measures were collected, assessing self-rated friendships and confidence with social skills and clinician-rated social skill performance. Qualitative feedback about group participation was also collected through use of a developed questionnaire. Analysis revealed significant improvements in participants' confidence with their social skills following group participation, with a trend also found for improved social skill performance. "Rel8", an adapted 8-week social skills training group, is a feasible program in the context of community mental health services. The program added to the recovery-centred practice of the community mental health service while also adding to the diversity of clinician skills for psychosocial-oriented practice. © The Royal Australian and New Zealand College of Psychiatrists 2015.

Client Violence toward Social Workers: The Role of Management in Community Mental Health Programs.

ERIC Educational Resources Information Center

Spencer, Patricia C.; Munch, Shari

2003-01-01

Examines job-related, client-perpetrated threats or physical violence against social workers in general, and community outreach mental health professionals in particular. Highlights the critical role of supervisors and administrators in developing proactive prevention and postincident response policies and procedures that create an organizational…

24 CFR 582.100 - Program component descriptions.

Code of Federal Regulations, 2010 CFR

2010-04-01

... organizations. A sponsor may be a private, nonprofit organization or a community mental health agency... Development (Continued) OFFICE OF ASSISTANT SECRETARY FOR COMMUNITY PLANNING AND DEVELOPMENT, DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT COMMUNITY FACILITIES SHELTER PLUS CARE Assistance Provided § 582.100 Program...

Promoting Mental Health and Preventing Mental Illness in General Practice

PubMed Central

Thomas, Steve; Jenkins, Rachel; Burch, Tony; Calamos Nasir, Laura; Fisher, Brian; Giotaki, Gina; Gnani, Shamini; Hertel, Lise; Marks, Marina; Mathers, Nigel; Millington-Sanders, Catherine; Morris, David; Ruprah-Shah, Baljeet; Stange, Kurt; Thomas, Paul; White, Robert; Wright, Fiona

2016-01-01

Abstract This paper calls for the routine integration of mental health promotion and prevention into UK General Practice in order to reduce the burden of mental and physical disorders and the ensuing pressure on General Practice. The proposals & the resulting document (https://ethicscharity.files.wordpress.com/2015/09/rcgp_keymsg_150925_v5.pdf) arise from an expert ‘Think Tank’ convened by the London Journal of Primary Care, Educational Trust for Health Improvement through Cognitive Strategies (ETHICS Foundation) and the Royal College of General Practitioners. It makes 12 recommendations for General Practice: (1) Mental health promotion and prevention are too important to wait. (2) Work with your community to map risk factors, resources and assets. (3) Good health care, medicine and best practice are biopsychosocial rather than purely physical. (4) Integrate mental health promotion and prevention into your daily work. (5) Boost resilience in your community through approaches such as community development. (6) Identify people at increased risk of mental disorder for support and screening. (7) Support early intervention for people of all ages with signs of illness. (8) Maintain your biopsychosocial skills. (9) Ensure good communication, interdisciplinary team working and inter-sectoral working with other staff, teams and agencies. (10) Lead by example, taking action to promote the resilience of the general practice workforce. (11) Ensure mental health is appropriately included in the strategic agenda for your ‘cluster’ of General Practices, at the Clinical Commissioning Groups, and the Health and Wellbeing Board. (12) Be aware of national mental health strategies and localise them, including action to destigmatise mental illness within the context of community development. PMID:28250821

“Tension” in South Asian Women: Developing a Measure of Common Mental Disorder Using Participatory Methods

PubMed Central

Karasz, Alison; Patel, Viraj; Kabita, Mahbhooba; Shimu, Parvin

2015-01-01

Background Though common mental disorder (CMD) is highly prevalent among South Asian immigrant women, they rarely seek mental treatment. This may be due in part to the lack of conceptual synchrony between medical models of mental disorder and the social models of distress common in South Asian communities. Furthermore, common mental health screening and diagnostic measures may not adequately capture distress in this group. CBPR is ideally suited to help address measurement issues in CMD as well as develop culturally appropriate treatment models. Objectives To use participatory methods to identify an appropriate, culturally specific mental health syndrome and develop an instrument to measure this syndrome. Methods We formed a partnership between researchers, clinicians, and community members. The partnership selected a culturally specific model of emotional distress/ illness, “Tension,” as a focus for further study. Partners developed a scale to measure Tension and tested the new scale on 162 Bangladeshi immigrant women living in the Bronx. Results The 24-item “Tension Scale” had high internal consistency (alpha =0.83). In bivariate analysis, the scale significantly correlated in the expected direction with depressed as measured by the PHQ-2, age, education, self-rated health, having seen a physician in the past year, and other variables. Conclusions Using participatory techniques, we created a new measure designed to assess common mental disorder in an isolated immigrant group. The new measure shows excellent psychometric properties and will be helpful in the implementation of a community-based, culturally synchronous intervention for depression. We describe a useful strategy for the rapid development and field testing of culturally appropriate measures of mental distress and disorder. PMID:24375184

Telemental Health Training, Team Building, and Workforce Development in Cultural Context: The Hawaii Experience.

PubMed

Alicata, Daniel; Schroepfer, Amanda; Unten, Tim; Agoha, Ruby; Helm, Susana; Fukuda, Michael; Ulrich, Daniel; Michels, Stanton

2016-04-01

The goal of the University of Hawaii (UH) child and adolescent psychiatry telemental health (TMH) program is to train child and adolescent psychiatry fellows to provide behavioral health services for the children of Hawaii and the Pacific Islands in the cultural context of their rural communities using interactive videoteleconferencing (IVTC). The training experience balances learning objectives with community service. Learning objectives include: Understanding mental health disparities in rural communities, leveraging community resources in ongoing treatment, providing culturally effective care, and improving health care access and delivery through TMH service research and evaluation. We describe the UH experience. Several UH faculty are experienced with IVTC technology. They are triple-board trained, are recognized for their research in program evaluation and mental health disparities, and are committed to serving Hawaii's rural communities. We demonstrate the role of TMH in linking children and their families living in rural communities with multiple mental health treatment providers. The service-learning curriculum and a unique collaboration with Mayo Clinic provide the opportunity to examine the role of TMH in global service, and training, education, and research. TMH provides direct services to patients and consultation on Hawaii Island and Maui County. The collaboration with the Mayo Clinic brings further consultation in complex diagnostics, pharmacogenomics, and cross-cultural psychiatry. A curriculum provides trainees experience with IVTC with the goal of potential recruitment to underserved rural communities. The TMH program at UH is unique in its team building and workforce development by joining multiple entities through IVTC and translating expertise from the Mayo Clinic to rural communities, and strengthening collaboration with local child and adolescent psychiatrists, and primary care and other mental health providers. The UH psychiatry program is a model program to develop an expert mental health workforce in cultural context for children living in rural communities.

A COMMUNITY MENTAL HEALTH PROFESSIONAL DEVELOPMENT MODEL FOR THE EXPANSION OF REFLECTIVE PRACTICE AND SUPERVISION: EVALUATION OF A PILOT TRAINING SERIES FOR INFANT MENTAL HEALTH PROFESSIONALS.

PubMed

Shea, Sarah E; Goldberg, Sheryl; Weatherston, Deborah J

2016-11-01

The Michigan Association for Infant Mental Health identified a need for reflective supervision training for infant mental health (IMH) specialists providing home-based services to highly vulnerable infants and their families. Findings indicate that this pilot of an IMH community mental health professional development model was successful, as measured by the participants' increased capacity to apply reflective practice and supervisory knowledge and skills. Furthermore, IMH clinicians demonstrated an increase in the frequency of their use of reflective practice skills, and their supervisors demonstrated an increase in their sense of self-efficacy regarding reflective supervisory tasks. Finally, the evaluation included a successful pilot of new measures designed to measure reflective practice, contributing to the growing body of research in the area of reflective supervision. © 2016 Michigan Association for Infant Mental Health.

Implementing a Mentally Healthy Schools Framework Based on the Population Wide Act-Belong-Commit Mental Health Promotion Campaign: A Process Evaluation

ERIC Educational Resources Information Center

Anwar-McHenry, Julia; Donovan, Robert John; Nicholas, Amberlee; Kerrigan, Simone; Francas, Stephanie; Phan, Tina

2016-01-01

Purpose: Mentally Healthy WA developed and implemented the Mentally Healthy Schools Framework in 2010 in response to demand from schools wanting to promote the community-based Act-Belong-Commit mental health promotion message within a school setting. Schools are an important setting for mental health promotion, therefore, the Framework encourages…

A cultural critique of community psychiatry in India.

PubMed

Jain, Sumeet; Jadhav, Sushrut

2008-01-01

This article is the first comprehensive cultural critique of India's official community mental health policy and program. Data are based on a literature review of published papers, conference proceedings, analyses of official policy and popular media, interviews with key Indian mental health professionals, and fieldwork in Kanpur district, Uttar Pradesh (2004-2006). The authors demonstrate how three influences have shaped community psychiatry in India: a cultural asymmetry between health professionals and the wider society, psychiatry's search for both professional and social legitimacy, and WHO policies that have provided the overall direction to the development of services. Taken together, the consequences are that rural community voices have been edited out. The authors hypothesize that community psychiatry in India is a bureaucratic and culturally incongruent endeavor that increases the divide between psychiatry and local rural communities. Such a claim requires sustained ethnographic fieldwork to reveal the dynamics of the gap between community and professional experiences. The development of culturally sensitive psychiatric theory and clinical services is essential to improve the mental health of rural citizens who place their trust in India's biomedical network.

A mental health training program for community health workers in India: impact on knowledge and attitudes

PubMed Central

2011-01-01

Background Unmet needs for mental health treatment in low income countries are pervasive. If mental health is to be effectively integrated into primary health care in low income countries like India then grass-roots workers need to acquire relevant knowledge and skills to be able to recognise, refer and support people experiencing mental disorders in their own communities. This study aims to provide a mental health training intervention to community health workers in Bangalore Rural District, Karnataka, India, and to evaluate the impact of this training on mental health literacy. Methods A pre-test post-test study design was undertaken with assessment of mental health literacy at three time points; baseline, completion of the training, and three month follow-up. Mental health literacy was assessed using the interviewer-administered Mental Health Literacy Survey. The training intervention was a four day course based on a facilitator's manual developed specifically for community health workers in India. Results 70 community health workers from Doddaballapur, Bangalore Rural District were recuited for the study. The training course improved participants' ability to recognize a mental disorder in a vignette, and reduced participants' faith in unhelpful and potentially harmful pharmacological interventions. There was evidence of a minor reduction in stigmatizing attitudes, and it was unclear if the training resulted in a change in participants' faith in recovery following treatment. Conclusion The findings from this study indicate that the training course demonstrated potential to be an effective way to improve some aspects of mental health literacy, and highlights strategies for strengthening the training course. PMID:21819562

Retention challenge facing Australia's rural community mental health services: Service managers' perspectives.

PubMed

Cosgrave, Catherine; Hussain, Rafat; Maple, Myfanwy

2015-10-01

This paper aims to contribute to the development of a more sustainable Australian rural community mental health workforce by comparing the findings from a literature search investigating impacting factors on retention with the experiences of community mental health service managers running services in rural Australia. Semi-structured interviews. Public health sector, rural New South Wales. Five community mental health managers, running services in rural Australia. Interviews were undertaken as a pilot for a broader qualitative study investigating factors influencing the decision to stay or leave among community mental health professionals working in rural positions. The purpose of undertaking this pilot study was to test for validity and relevance of the retention phenomena and help inform the research design for the main study. Three key retention focussed themes were identified: (i) Staffing is a persistent challenge; (ii) Small remote towns pose the biggest challenge; and (iii) The decision to stay or leave is complex and multifactorial. The findings of this pilot study support previous research and contribute to the understanding of influences on retention among health professionals working in rural community mental health services. Importantly, those who have worked for several years in rural positions hold important information through which to explore factors that impact retention in rural and remote regions. © 2015 National Rural Health Alliance Inc.

Comparing the mental health literacy of Chinese people in Australia, China, Hong Kong and Taiwan: Implications for mental health promotion.

PubMed

Wong, Daniel Fu Keung; Cheng, Chi-Wei; Zhuang, Xiao Yu; Ng, Ting Kin; Pan, Shu-Man; He, Xuesong; Poon, Ada

2017-10-01

Using data of 200, 522, 572, and 287 Chinese from Australia, China, Hong Kong and Taiwan respectively, this study aimed at comparing the mental health literacy of Chinese people from different communities, and between Chinese communities and the Australian general public. The participants were asked questions that assessed their recognition of depression and schizophrenia. Compared with the Australians, much lower percentages of Chinese in the four Chinese communities could correctly identify depression and early schizophrenia. Commonalities in the preference for 'psychiatrist', 'psychologist', 'Chinese medical doctor', and 'Chinese traditional healer', a lack of knowledge of medications, and a higher likelihood of endorsement of traditional Chinese medicines were found among the four Chinese communities. Differences in the preference for 'general practitioner' and 'social worker', and a higher percentage of endorsement of herbal medicines were observed among the different Chinese communities. Cultural factors such as Chinese perceptions of mental illness, and socio-contextual factors such as differences in mental health care system in the four communities were offered to explain these commonalities and differences. Mental health promotion programmes for Chinese people may need to consider the above-mentioned cultural and socio-contextual factors so that specific promotion programmes can be developed. Copyright © 2017 Elsevier B.V. All rights reserved.

Changing needs and new perspectives for psychiatry and mental health services in Korea.

PubMed

Park, Jong-Ik; Kim, Yong Sik

2006-01-01

Although western psychiatry was introduced more than one hundred years ago, the history of Korean psychiatry actually began with the foundation of the Cho-sun Neuropsychiatric Association (formerly Korean Neuropsychiatric Association) in 1945. Since the initiation of Korean national economic development plan in 1960s, the number of mental institutions grew gradually but a large portion of patients suffering from psychosis and alcohol dependence still remained in the asylum. Rapid industrialization in the 80's brought about family disintegration and breakdown of the social support system, resulting in displacement of mentally ill persons outside of the family. In 1995, the Mental Health Law was enacted and with the introduction of the concept of community mental health, construction of many mental health centers commenced. Korea faces important tasks of further developing local community mental health and predicting and resolving the mental health problems related to the issues of rapid aging society, transformation in family structure, foreign laborers, and North Korean refugees. Such tasks must be met through refined mental health policy plans, effective allocation of mental health-related human resources and funding, and fostering of social concern and consensus about the issues of mental health.

Integrating Mental Health and HIV Services in Zimbabwean Communities: A Nurse and Community-led Approach to Reach the Most Vulnerable.

PubMed

Duffy, Malia; Sharer, Melissa; Cornman, Helen; Pearson, Jennifer; Pitorak, Heather; Fullem, Andrew

Alcohol use and depression negatively impact adherence, retention in care, and HIV progression, and people living with HIV (PLWH) have disproportionately higher depression rates. In developing countries, more than 76% of people with mental health issues receive no treatment. We hypothesized that stepped-care mental health/HIV integration provided by multiple service professionals in Zimbabwe would be acceptable and feasible. A three-phase mixed-method design was used with a longitudinal cohort of 325 nurses, community health workers, and traditional medicine practitioners in nine communities. During Phase 3, 312 PLWH were screened by nurses for mental health symptoms; 28% were positive. Of 59 PLWH screened for harmful alcohol and substance use, 36% were positive. Community health workers and traditional medicine practitioners screened 123 PLWH; 54% were positive for mental health symptoms and 29% were positive for alcohol and substance abuse. Findings indicated that stepped-care was acceptable and feasible for all provider types. Copyright © 2015 The Authors. Published by Elsevier Inc. All rights reserved.

Toward Family and Community: Mental Retardation Services in Massachusetts, New England, and the United States.

ERIC Educational Resources Information Center

Braddock, David; Hemp, Richard

1997-01-01

Current trends in mental retardation services in Massachusetts were investigated using the New England region, the state of Michigan, and the United States as comparative frames of reference. Massachusetts' movement toward reducing reliance on state institutions, reallocating funding, and developing community services and family support is…

Mental health research, ethics and multiculturalism.

PubMed

Bailes, Marion J; Minas, I Harry; Klimidis, Steven

2006-01-01

In this paper we examine ethical issues relevant to conducting mental health research with refugees and immigrant communities that have cultural orientations and social organisation that are substantially different to those of the broader Australian community, and we relate these issues to NH&MRC Guidelines. We describe the development and conduct of a mental health research project carried out recently in Melbourne with the Somali community, focusing on ethical principles involved, and relating these to the NH&MRC National Statement on Ethical Conduct in Research Involving Humans, and the NH&MRC document Values and Ethics: Guidelines for Ethical Conduct in Aboriginal and Torres Strait Islander Health Research. The experience of conducting mental health research with the Somali community highlights the fact that the principles of inclusion and benefit enunciated in the NH&MRC document Values and Ethics are particularly pertinent when conducting research with refugees and immigrant communities that are culturally distant to those of the broader Australian community. These principles inform issues of research design and consent, as well as guiding respectful engagement with the participating community and communication of the research findings.

Neurotechnology: expanding opportunities for funding at the National Institute of Mental Health.

PubMed

Huerta, M F; Curvey, M F; Koslow, S H

1994-10-01

The National Institute of Mental Health recognizes the importance that creative development of technology and methodology play in brain and behavioral science research. This institute is making major efforts to support such development through specific initiatives, like the Human Brain Project. In addition, this Institute is actively building bridges between business and academic research communities to make optical use of funds for the research and development of commercially viable technologies relevant to all aspects of the Institute's mission through the Small Business Innovation Research and Small Business Technology Transfer Programs. Together, these efforts will culminate in a more vigorous scientific enterprise, and ultimately benefit the entire mental health community and society.

Developing Quality Indicators for Family Support Services in Community Team-Based Mental Health Care

PubMed Central

Olin, S. Serene; Kutash, Krista; Pollock, Michele; Burns, Barbara J.; Kuppinger, Anne; Craig, Nancy; Purdy, Frances; Armusewicz, Kelsey; Wisdom, Jennifer; Hoagwood, Kimberly E.

2013-01-01

Quality indicators for programs integrating parent-delivered family support services for children’s mental health have not been systematically developed. Increasing emphasis on accountability under the Affordable Care Act highlights the importance of quality-benchmarking efforts. Using a modified Delphi approach, quality indicators were developed for both program level and family support specialist level practices. These indicators were pilot tested with 21 community-based mental health programs. Psychometric properties of these indicators are reported; variations in program and family support specialist performance suggest the utility of these indicators as tools to guide policies and practices in organizations that integrate parent-delivered family support service components. PMID:23709287

Using an intervention mapping framework to develop an online mental health continuing education program for pharmacy staff.

PubMed

Wheeler, Amanda; Fowler, Jane; Hattingh, Laetitia

2013-01-01

Current mental health policy in Australia recognizes that ongoing mental health workforce development is crucial to mental health care reform. Community pharmacy staff are well placed to assist people with mental illness living in the community; however, staff require the knowledge and skills to do this competently and effectively. This article presents the systematic planning and development process and content of an education and training program for community pharmacy staff, using a program planning approach called intervention mapping. The intervention mapping framework was used to guide development of an online continuing education program. Interviews with mental health consumers and carers (n = 285) and key stakeholders (n = 15), and a survey of pharmacy staff (n = 504) informed the needs assessment. Program objectives were identified specifying required attitudes, knowledge, skills, and confidence. These objectives were aligned with an education technique and delivery strategy. This was followed by development of an education program and comprehensive evaluation plan. The program was piloted face to face with 24 participants and then translated into an online program comprising eight 30-minute modules for pharmacists, 4 of which were also used for support staff. The evaluation plan provided for online participants (n ≅ 500) to be randomized into intervention (immediate access) or control groups (delayed training access). It included pre- and posttraining questionnaires and a reflective learning questionnaire for pharmacy staff and telephone interviews post pharmacy visit for consumers and carers. An online education program was developed to address mental health knowledge, attitudes, confidence, and skills required by pharmacy staff to work effectively with mental health consumers and carers. Intervention mapping provides a systematic and rigorous approach that can be used to develop a quality continuing education program for the health workforce. Copyright © 2013 The Alliance for Continuing Education in the Health Professions, the Society for Academic Continuing Medical Education, and the Council on CME, Association for Hospital Medical Education.

42 CFR 483.130 - PASARR determination criteria.

Code of Federal Regulations, 2012 CFR

2012-10-01

... criteria. (a) Basis for determinations. Determinations made by the State mental health or intellectual... determinations by category. Advance group determinations by category developed by the State mental health or... records, physician's evaluations, election of hospice status, records of community mental health centers...

42 CFR 483.130 - PASARR determination criteria.

Code of Federal Regulations, 2013 CFR

2013-10-01

... criteria. (a) Basis for determinations. Determinations made by the State mental health or intellectual... determinations by category. Advance group determinations by category developed by the State mental health or... records, physician's evaluations, election of hospice status, records of community mental health centers...

Using participatory methods to enhance patient-centred mental health care in a federally qualified community health center serving a Mexican American farmworker community.

PubMed

Ingram, Maia; Schachter, Ken A; Guernsey de Zapien, Jill; Herman, Patricia M; Carvajal, Scott C

2015-12-01

Mexican American farmworkers experience high rates of mental health conditions; however, it is difficult for them to access care. Patient-centred care is a systems-wide approach to improving the delivery of services for diverse populations in the primary care setting. We describe the application of community-based participatory research methods to assess and address gaps in perceptions of mental health care between providers and migrant workers living in a US-Mexico Border community. A federally qualified health centre (FQHC) serving a community of approximately 60 000 agricultural workers who live in Yuma County and harvest vegetables during the winter season. We conducted patient focus groups (n = 64) and FQHC staff interviews (n = 16) to explore attributes and dimensions of patient-centred mental health care. Patients and staff both prioritized increased access to mental health care and patient-centred care, while patients were more concerned with interpersonal care and providers with coordination of care. All participants stressed the relationship between life events and mental health and the centrality of family in care. Patients also emphasized the importance of a good attitude, the ability to solve problems, positive family relationships and reliance on faith. Patients suggested that the FQHC inform patients about mental health resources, provide community informational talks to address stigma, and offer support groups. The participatory approach of this qualitative study resulted in a wealth of data regarding patient preferences that will enable the FQHC to develop protocols and training to provide patient-centred mental health-care services for their community. © 2014 John Wiley & Sons Ltd.

Prevention and control of mental illnesses and mental health: National Action Plan for NCD Prevention, Control and Health Promotion in Pakistan.

PubMed

Nishtar, Sania; Minhas, Fareed A; Ahmed, Ashfaq; Badar, Asma; Mohamud, Khalif Bile

2004-12-01

As part of the National Action Plan for Non-communicable Disease Prevention, Control and Health Promotion in Pakistan (NAP-NCD), mental illnesses have been grouped alongside non-communicable diseases (NCD) within a combined strategic framework in order to synchronize public health actions. The systematic approach for mental illnesses is centred on safeguarding the rights of the mentally ill, reducing stigma and discrimination, and de-institutionalisation and rehabilitation of the mentally ill in the community outlining roles of healthcare providers, the community, legislators and policy makers. The approach has implications for support functions in a number of areas including policy building, manpower and material development and research. Priority action areas for mental health as part of NAP-NCD include the integration of surveillance of mental illnesses in a comprehensive population-based NCD surveillance system; creating awareness about mental health as part of an integrated NCD behavioural change communication strategy; integration of mental health with primary healthcare; the development of sustainable public health infrastructure to support community mental health initiatives; building capacity of the health system in support of prevention and control activities; effective implementation of existing legislation and harmonizing working relationships with law enforcing agencies. NAP-NCD also stresses on the need to integrate mental health into health services as part of a sustainable and integrated medical education programme for all categories of healthcare providers and the availability of essential psychotropic drugs at all healthcare levels. It lays emphasis on protecting the interests of special groups such as prisoners, refugees and displaced persons, women, children and individuals with disabilities. Furthermore, it promotes need-based research for contemporary mental health issues.

An Exploration of the Effect of Community Engagement in Research on Perceived Outcomes of Partnered Mental Health Services Projects*

PubMed Central

Khodyakov, Dmitry; Stockdale, Susan; Jones, Felica; Ohito, Elizabeth; Jones, Andrea; Lizaola, Elizabeth; Mango, Joseph

2011-01-01

Mental health research projects address sensitive issues for vulnerable populations and are implemented in complex environments. Community-Based Participatory Research approaches are recommended for health research on vulnerable populations, but little is known about how variation in participation affects outcomes of partnered research projects. We developed a conceptual model demonstrating the impact of community engagement in research on outcomes of partnered projects. We collected data on key constructs from community and academic leaders of 21 sampled partnered research projects in two cycles of an NIMH research center. We conducted empirical analyses to test the model. Our findings suggest that community engagement in research is positively associated with perceived professional development, as well as political and community impact. PMID:22582144

A Taxonomy of Community Living Skills.

ERIC Educational Resources Information Center

Dever, Richard B.

1989-01-01

Described is the "Taxonomy of Community Living Skills," a guide for curriculum developers. Experts (n=59) in mental retardation were surveyed to assess the taxonomy's coherence, appropriateness, completeness, etc. Responses to the model's five domains (personal maintenance and development, homemaking and community life, vocational,…

An innovative community organizing campaign to improve mental health and wellbeing among Pacific Island youth in South Auckland, New Zealand.

PubMed

Han, Hahrie; Nicholas, Alexandra; Aimer, Margaret; Gray, Jonathon

2015-12-01

To examine whether being an organizer in a community organizing program improves personal agency and self-reported mental health outcomes among low-income Pacific Island youth in Auckland, New Zealand. Counties Manukau Health initiated a community organizing campaign led and run by Pacific Island youth. We used interviews, focus groups and pre- and post-campaign surveys to examine changes among 30 youths as a result of the campaign. Ten youths completed both pre- and post-campaign surveys. Eleven youths participated in focus groups, and four in interviews. Overall, youths reported an increased sense of agency and improvements to their mental health. Community organizing has potential as a preventive approach to improving mental health and developing agency over health among disempowered populations. © The Royal Australian and New Zealand College of Psychiatrists 2015.

VA Community Mental Health Service Providers' Utilization of and Attitudes toward Telemental Health Care: The Gatekeeper's Perspective

ERIC Educational Resources Information Center

Jameson, John Paul; Farmer, Mary Sue; Head, Katharine J.; Fortney, John; Teal, Cayla R.

2011-01-01

Context: Mental health (MH) providers in community-based outpatient clinics (CBOCs) are important stakeholders in the development of the Veterans Health Administration (VA) telemental health (TMH) system, but their perceptions of these technologies have not been systematically examined. Purpose: The purpose of this study was to investigate the…

Staffing Systems of Care for Children and Families: A Report of the Southern Human Resource Development Consortium for Mental Health on Workforce Issues Related to Community-Based Service Delivery for Children and Adolescents with Serious Emotional Disturbance/Mental Illness and Their Families.

ERIC Educational Resources Information Center

Pires, Sheila A.

This report describes the results of a regional needs assessment of workforce issues related to the delivery of community-based services for children and adolescents with serious emotional disturbance or mental illness and their families in a region comprising 12 southern states. The assessment involved a survey of key stakeholders, principally…

Housing choice and control, housing quality, and control over professional support as contributors to the subjective quality of life and community adaptation of people with severe mental illness.

PubMed

Nelson, Geoffrey; Sylvestre, John; Aubry, Tim; George, Lindsey; Trainor, John

2007-03-01

This research examined two premises of supported housing: (a) that consumer choice/control over housing and support and the quality of housing are important contributors to the subjective quality of life and adaptation to community living of people with mental illness, and (b) that apartments provide mental health consumers with more choice/control over housing and support than group living arrangements. To test these two hypotheses, we collected data from participants with mental illness housed through a government initiative in Ontario, Canada. A total of 130 participants completed a baseline interview, and 91 of those participants also completed a follow-up interview 9-months later. Support was found for both hypotheses. The results were discussed in terms of the paradigm of supported housing, previous research, and implications for housing policy and program development in the community mental health sector.

Plague Doctors in the HIV/AIDS Epidemic: Mental Health Professionals and the "San Francisco Model," 1981-1990.

PubMed

Blair, Thomas R

2016-01-01

Psychiatrists, psychologists, and other mental health professionals were among the first and most crucial responders to HIV/AIDS. Given an epidemic in which behavior and identity played fundamental roles, mental health professionals were uniquely positioned to conduct social research to explain the existence and spread of disease; to develop clinical understanding of psychological aspects of HIV/AIDS as they emerged; and to collaborate with affected communities to promote education and behavioral change. This study examines the roles of mental health professionals as "plague doctors" in San Francisco's response to HIV/AIDS, in the early years of the epidemic. Among the many collaborations and projects that distinguished the "San Francisco model" of response to this plague, bathhouse-based epidemiology, consult-liaison psychiatry, and community partnerships for counseling and education are examined in detail as illustrations of the epidemic-changing engagement of the mental health community.

The Role of Communities in Mental Health Care in Low- and Middle-Income Countries: A Meta-Review of Components and Competencies.

PubMed

Kohrt, Brandon A; Asher, Laura; Bhardwaj, Anvita; Fazel, Mina; Jordans, Mark J D; Mutamba, Byamah B; Nadkarni, Abhijit; Pedersen, Gloria A; Singla, Daisy R; Patel, Vikram

2018-06-16

Community-based mental health services are emphasized in the World Health Organization’s Mental Health Action Plan , the World Bank’s Disease Control Priorities , and the Action Plan of the World Psychiatric Association. There is increasing evidence for effectiveness of mental health interventions delivered by non-specialists in community platforms in low- and middle-income countries (LMIC). However, the role of community components has yet to be summarized. Our objective was to map community interventions in LMIC, identify competencies for community-based providers, and highlight research gaps. Using a review-of-reviews strategy, we identified 23 reviews for the narrative synthesis. Motivations to employ community components included greater accessibility and acceptability compared to healthcare facilities, greater clinical effectiveness through ongoing contact and use of trusted local providers, family involvement, and economic benefits. Locations included homes, schools, and refugee camps, as well as technology-aided delivery. Activities included awareness raising, psychoeducation, skills training, rehabilitation, and psychological treatments. There was substantial variation in the degree to which community components were integrated with primary care services. Addressing gaps in current practice will require assuring collaboration with service users, utilizing implementation science methods, creating tools to facilitate community services and evaluate competencies of providers, and developing standardized reporting for community-based programs.

An Exploration of Factors that Effect the Implementation of Peer Support Services in Community Mental Health Settings.

PubMed

Mancini, Michael A

2018-02-01

This study explored the integration of peer services into community mental health settings through qualitative interviews with peer-providers and non-peer mental health workers. Results show peer job satisfaction was contingent upon role clarity, autonomy, and acceptance by non-peer coworkers. Mental health workers reported the need for organizational support for peer services and guidance about how to utilize peers, negotiate their professional boundaries and accommodate their mental health needs. Effective peer integration requires organizational readiness, staff preparation and clear policies and procedures. Consultation from consumer-based organizations, enhanced professional competencies, and professional development and career advancement opportunities for peers represent important resources.

People with mental disabilities negotiating life in the risk society: a theoretical approach.

PubMed

Eriksson, B G; Hummelvoll, J K

2008-10-01

Risk assessment and risk management owing to the potential threat from people with serious mental disorders living in the local community have been given much attention in psychiatric and mental healthcare research. Research connected to risks associated with living in the community for people with mental disabilities has also been published. This paper focuses on the situation of people with mental health problems and disabilities from a quite different perspective. In the light of the societal change towards what has been named the 'risk society', the consequences for vulnerable groups, especially people with mental disabilities, are discussed. Furthermore, the purpose is to shed light on how structural factors, like the process of individualization and 'de-population' of societal institutions, are affecting the living conditions for people with mental disabilities - positively as well as negatively. The importance of trust in the risk society is highlighted, but also the important role that the local community might play in relation to people with mental disabilities. Finally, some potentialities and new roles that this development towards a risk society and increased individualization paradoxically can open up for people with mental disabilities are outlined.

Assertive outreach handbook will aid mental health staff in maintaining client engagement.

PubMed

Gregory, Nathan; Macpherson, Rob

The model of assertive outreach is one of the most internationally researched areas of community mental healthcare. An assertive outreach team at a mental health trust developed a handbook on the model, involving contributions from service users, carers, local clinicians and the voluntary sector. This article outlines the process of developing the handbook, summarises its content and user feedback.

The Components of Resilience--Perceptions of an Australian Rural Community

ERIC Educational Resources Information Center

Buikstra, Elizabeth; Ross, Helen; King, Christine A.; Baker, Peter G.; Hegney, Desley; McLachlan, Kathryn; Rogers-Clark, Cath

2010-01-01

Resilience, of individuals, is a well-established concept in the psychology/mental health literatures, but has been little explored in relation to communities. Related theory in the community development and social impact assessment literature provides insight into qualities and assets of communities that enable them to develop effectively or to…

Community Psychiatric Rehabilitation in Israel.

ERIC Educational Resources Information Center

Levy, Amihay; Neumann, Micha

1988-01-01

This paper describes the development of community-based rehabilitation services for persons with mental illness in Israel. It focuses on occupational, social, and residential community psychiatric rehabilitation services. The paper argues that service development has been slow and out of step with the philosophy and objectives of community…

Mental health research and evaluation in multicultural Australia: developing a culture of inclusion.

PubMed

Minas, Harry; Kakuma, Ritsuko; Too, Lay San; Vayani, Hamza; Orapeleng, Sharon; Prasad-Ildes, Rita; Turner, Greg; Procter, Nicholas; Oehm, Daryl

2013-10-07

Cultural and linguistic diversity is a core feature of the Australian population and a valued element of national identity. The proportion of the population that will be overseas-born is projected to be 32% by 2050. While a very active process of mental health system reform has been occurring for more than two decades - at national and state and territory levels - the challenges presented by cultural and linguistic diversity have not been effectively met. A key area in which this is particularly an issue is in the collection, analysis and reporting of mental health data that reflect the reality of population diversity. The purpose of this study was to examine: what is known about the mental health of immigrant and refugee communities in Australia; whether Australian mental health research pays adequate attention to the fact of cultural and linguistic diversity in the Australian population; and whether national mental health data collections support evidence-informed mental health policy and practice and mental health reform in multicultural Australia. The study consisted of three components - a brief review of what is known about mental health in, and mental health service use by, immigrant and refugee communities; an examination of national data collections to determine the extent to which relevant cultural variables are included in the collections; and an examination of Australian research to determine the extent to which immigrant and refugee communities are included as participants in such research. The review of Australian research on mental health of immigrant and refugee communities and their patterns of mental health service use generated findings that are highly variable. The work is fragmented and usually small-scale. There are multiple studies of some immigrant and refugee communities and there are no studies of others. Although there is a broadly consistent pattern of lower rates of utilisation of specialist public mental health services by immigrants and refugees the absence of adequate population epidemiological data prevents judgments about whether the observed patterns constitute under-utilisation. There are virtually no data on quality of service outcomes. The examination of national data collections revealed multiple gaps in these data collections. The review of papers published in four key Australian journals to determine whether immigrants and refugees are included in mental health research studies revealed a high rate (9.1%) of specific exclusion from studies (usually due to low English fluency) and a much higher rate of general neglect of the issue of population diversity in study design and reporting. While there are many positive statements of policy intent in relation to immigrant and refugee communities in national mental health policies and strategies there is virtually no reporting by Commonwealth or State and Territory governments of whether policies that are relevant to immigrant and refugee communities are effectively implemented. It is not possible, on the basis of the data collected, to determine whether immigrant and refugee communities are benefiting from the mental health system reforms that are being actively carried out. The majority of Australian mental health research does not adequately include immigrant and refugee samples. On the basis of the findings of this study eight strategies have been recommended that will contribute to the development of a culture of inclusion of all Australians in the national mental health research enterprise.

Mental health research and evaluation in multicultural Australia: developing a culture of inclusion

PubMed Central

2013-01-01

Introduction Cultural and linguistic diversity is a core feature of the Australian population and a valued element of national identity. The proportion of the population that will be overseas-born is projected to be 32% by 2050. While a very active process of mental health system reform has been occurring for more than two decades - at national and state and territory levels - the challenges presented by cultural and linguistic diversity have not been effectively met. A key area in which this is particularly an issue is in the collection, analysis and reporting of mental health data that reflect the reality of population diversity. The purpose of this study was to examine: what is known about the mental health of immigrant and refugee communities in Australia; whether Australian mental health research pays adequate attention to the fact of cultural and linguistic diversity in the Australian population; and whether national mental health data collections support evidence-informed mental health policy and practice and mental health reform in multicultural Australia. Methods The study consisted of three components – a brief review of what is known about mental health in, and mental health service use by, immigrant and refugee communities; an examination of national data collections to determine the extent to which relevant cultural variables are included in the collections; and an examination of Australian research to determine the extent to which immigrant and refugee communities are included as participants in such research. Results The review of Australian research on mental health of immigrant and refugee communities and their patterns of mental health service use generated findings that are highly variable. The work is fragmented and usually small-scale. There are multiple studies of some immigrant and refugee communities and there are no studies of others. Although there is a broadly consistent pattern of lower rates of utilisation of specialist public mental health services by immigrants and refugees the absence of adequate population epidemiological data prevents judgments about whether the observed patterns constitute under-utilisation. There are virtually no data on quality of service outcomes. The examination of national data collections revealed multiple gaps in these data collections. The review of papers published in four key Australian journals to determine whether immigrants and refugees are included in mental health research studies revealed a high rate (9.1%) of specific exclusion from studies (usually due to low English fluency) and a much higher rate of general neglect of the issue of population diversity in study design and reporting. Conclusions While there are many positive statements of policy intent in relation to immigrant and refugee communities in national mental health policies and strategies there is virtually no reporting by Commonwealth or State and Territory governments of whether policies that are relevant to immigrant and refugee communities are effectively implemented. It is not possible, on the basis of the data collected, to determine whether immigrant and refugee communities are benefiting from the mental health system reforms that are being actively carried out. The majority of Australian mental health research does not adequately include immigrant and refugee samples. On the basis of the findings of this study eight strategies have been recommended that will contribute to the development of a culture of inclusion of all Australians in the national mental health research enterprise. PMID:24093216

24 CFR 576.56 - Homeless assistance and participation.

Code of Federal Regulations, 2010 CFR

2010-04-01

... treatment, mental health treatment, counseling, supervision, and other services essential for achieving... Development (Continued) OFFICE OF ASSISTANT SECRETARY FOR COMMUNITY PLANNING AND DEVELOPMENT, DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT COMMUNITY FACILITIES EMERGENCY SHELTER GRANTS PROGRAM: STEWART B. McKINNEY...

[(Community) psychiatry, a parenthesis?].

PubMed

Bucheron, Bastien

2015-01-01

Beyond an a priori antagonism between these two notions, alienism and mental health cultivate analogies as to the place to which they assign mental health. Is community psychiatry not therefore simply a parenthesis in the history of psychiatry? The question is raised therefore regarding the place given to subjectivity and complexity. What must be done to ensure that this parenthesis of community psychiatry does not close? It is perhaps a case of making use of the tools which institutional psychotherapy has developed to keep the community psychiatry spirit alive. Copyright © 2015. Published by Elsevier Masson SAS.

Parental Mental Illness. Building Community Systems for Young Children.

ERIC Educational Resources Information Center

Hendrick, Victoria; Daly, Kathleen

Families are the principal influence on development in the first years of life, so the mental health of parents is an issue that affects every child in California. The most common mental health concerns facing parents involve stress and anxiety. These needs can be addressed through public health messages that de-stigmatize mental illness and…

Interventions to increase use of services; Mental Health Awareness in Nigeria.

PubMed

Eaton, Julian; Nwefoh, Emeka; Okafor, Godwin; Onyeonoro, Ugochukwu; Nwaubani, Kenneth; Henderson, Claire

2017-01-01

Mental health services in Nigeria consist mainly of large government psychiatric hospitals and there are very few mental health professionals to serve the large population of the country. However, more recently, community mental health services, which have been shown to improve access to care and clinical outcomes are beginning to develop in some locations. Despite efforts to promote more accessible services, low levels of knowledge about effective treatment of mental disorders means that even where these services are available, a very small proportion of people utilise these services. Therefore interventions to increase service use are an essential component of health system. This intervention was designed to increase use of a mental health services through the work of community-based Village Health Workers. Fifteen Village Health Workers in each Local Government Area (district) were selected and trained to create mental health awareness in communities. Their function also include identification and referral of persons with mental illness to trained mental health nurses in the clinics. Attendance data prior to and after intervention were collected and compared. The incident rate for initial period of intervention is five times higher than the baseline rate (95% CI; 3.42-7.56; p < 0.001) though this diminished in the long term, levelling off above initial baseline. This study demonstrated that addition of awareness raising using volunteers in communities as part of health programme implementation can increase services use by a population. Mechanisms such as informing populations of the existence of a service which they were previously lacking; explanation of causation of mental illness and achieving community leaders' support for a new service can make investment in services more efficient by increasing attendance.

Experiencing Community: Perspectives of Individuals Diagnosed as Having Serious Mental Illness

PubMed Central

Bromley, Elizabeth; Gabrielian, Sonya; Brekke, Benjamin; Pahwa, Rohini; Daly, Kathleen A.; Brekke, John S.; Braslow, Joel T.

2013-01-01

Objective Community integration is recognized as a crucial component of recovery from serious mental illness. Although the construct of community integration can be measured with structured instruments, little is known about the subjective and experiential meaning of community and community involvement for persons with serious mental illness. Methods In 2010, 30 individuals with serious mental illness treated in two public mental health clinics completed semistructured interviews that elicited the places and people that they associate with the experience of community and the larger meaning of community in their lives. Results Participants described four experiences as integral to their concepts of community: receiving help, minimizing risk, avoiding stigma, and giving back. Participants looked for communities that provide reliable support, and they described the need to manage community contact in order to protect themselves and others from their symptoms and from discrimination. Most participants experienced communities centered on mental health treatment or mentally ill peers as providing opportunities for positive engagement. Conclusions The experience of having a serious mental illness shapes preferences for and perceptions of community in pervasive ways. Participants describe community involvement not as a means to move away from illness experiences and identities but as a process that is substantially influenced by them. Mental health communities may help individuals with serious mental illness to both manage their illness and recognize and enjoy a sense of community. The findings indicate the need for further research on the relationship between community integration and outcome in serious mental illness. PMID:23545784

Community Psychology and Community Mental Health: A Call for Reengagement.

PubMed

Townley, Greg; Brown, Molly; Sylvestre, John

2018-03-01

Community psychology is rooted in community mental health research and practice and has made important contributions to this field. Yet, in the decades since its inception, community psychology has reduced its focus on promoting mental health, well-being, and liberation of individuals with serious mental illnesses. This special issue endeavors to highlight current efforts in community mental health from our field and related disciplines and point to future directions for reengagement in this area. The issue includes 12 articles authored by diverse stakeholder groups. Following a review of the state of community mental health scholarship in the field's two primary journals since 1973, the remaining articles center on four thematic areas: (a) the community experience of individuals with serious mental illness; (b) the utility of a participatory and cross-cultural lens in our engagement with community mental health; (c) Housing First implementation, evaluation, and dissemination; and (d) emerging or under-examined topics. In reflection, we conclude with a series of challenges for community psychologists involved in future, transformative, movements in community mental health. © Society for Community Research and Action 2018.

Community beliefs about treatments and outcomes of mental disorders: a mental health literacy survey in a rural area of Maharashtra, India.

PubMed

Kermode, M; Bowen, K; Arole, S; Joag, K; Jorm, A F

2009-07-01

Mental health remains a neglected issue in most developing countries, especially in rural areas where access to effective mental health services is limited. The integration of mental health into primary health care is being promoted as a strategy to address this problem. Consequently, there is an urgent need to enhance mental health awareness among communities, and to provide mental health training for primary healthcare staff. In order to do this effectively, it is important to understand and take account of local views on mental health and illness. As such, a mental health literacy (MHL) assessment was undertaken in a poor, rural area of Maharashtra, India to inform the development of a mental health training programme. A cross-sectional MHL survey was undertaken in late 2007. Data were collected from 240 systematically sampled community members and 60 purposively sampled village health workers (VHWs) using an interviewer-administered questionnaire. Participants were presented with two vignettes describing people experiencing symptoms of mental disorders (depression, psychosis), and were asked to name the problems, and to identify the treatments and people that were most likely to be helpful (or otherwise), and the likely outcomes for people with such problems. Most participants recognized that the people in the vignettes were experiencing a mental health problem. 'Depression' was the most common label for the problems experienced in the depression vignette, and 'a mind/brain problem' was the most common label in the case of the psychosis vignette. Socio-economic interventions provided by family, friends and neighbours were considered to be most helpful. Local VHWs and doctors were also viewed as potentially helpful, but psychiatrists less so. Approximately half of the sample thought that dealing with the problem alone would be helpful. Special diets, tonics, appetite stimulants and sleeping pills were also strongly endorsed, but awareness of psychiatric medications was negligible. The findings from this study highlight the need to enhance MHL in this community. Additionally, there is a need to build the capacity of the primary healthcare staff, including the VHWs, so that they are equipped to provide an effective local response for people experiencing mental health problems.

Local suffering and the global discourse of mental health and human rights: An ethnographic study of responses to mental illness in rural Ghana

PubMed Central

Read, Ursula M; Adiibokah, Edward; Nyame, Solomon

2009-01-01

Background The Global Movement for Mental Health has brought renewed attention to the neglect of people with mental illness within health policy worldwide. The maltreatment of the mentally ill in many low-income countries is widely reported within psychiatric hospitals, informal healing centres, and family homes. International agencies have called for the development of legislation and policy to address these abuses. However such initiatives exemplify a top-down approach to promoting human rights which historically has had limited impact at the level of those living with mental illness and their families. Methods This research forms part of a longitudinal anthropological study of people with severe mental illness in rural Ghana. Visits were made to over 40 households with a family member with mental illness, as well as churches, shrines, hospitals and clinics. Ethnographic methods included observation, conversation, semi-structured interviews and focus group discussions with people with mental illness, carers, healers, health workers and community members. Results Chaining and beating of the mentally ill was found to be commonplace in homes and treatment centres in the communities studied, as well as with-holding of food ('fasting'). However responses to mental illness were embedded within spiritual and moral perspectives and such treatment provoked little sanction at the local level. Families struggled to provide care for severely mentally ill relatives with very little support from formal health services. Psychiatric services were difficult to access, particularly in rural communities, and also seen to have limitations in their effectiveness. Traditional and faith healers remained highly popular despite the routine maltreatment of the mentally ill in their facilities. Conclusion Efforts to promote the human rights of those with mental illness must engage with the experiences of mental illness within communities affected in order to grasp how these may underpin the use of practices such as mechanical restraint. Interventions which operate at the local level with those living with mental illness within rural communities, as well as family members and healers, may have greater potential to effect change in the treatment of the mentally ill than legislation or investment in services alone. PMID:19825191

Local suffering and the global discourse of mental health and human rights: an ethnographic study of responses to mental illness in rural Ghana.

PubMed

Read, Ursula M; Adiibokah, Edward; Nyame, Solomon

2009-10-14

The Global Movement for Mental Health has brought renewed attention to the neglect of people with mental illness within health policy worldwide. The maltreatment of the mentally ill in many low-income countries is widely reported within psychiatric hospitals, informal healing centres, and family homes. International agencies have called for the development of legislation and policy to address these abuses. However such initiatives exemplify a top-down approach to promoting human rights which historically has had limited impact at the level of those living with mental illness and their families. This research forms part of a longitudinal anthropological study of people with severe mental illness in rural Ghana. Visits were made to over 40 households with a family member with mental illness, as well as churches, shrines, hospitals and clinics. Ethnographic methods included observation, conversation, semi-structured interviews and focus group discussions with people with mental illness, carers, healers, health workers and community members. Chaining and beating of the mentally ill was found to be commonplace in homes and treatment centres in the communities studied, as well as with-holding of food ('fasting'). However responses to mental illness were embedded within spiritual and moral perspectives and such treatment provoked little sanction at the local level. Families struggled to provide care for severely mentally ill relatives with very little support from formal health services. Psychiatric services were difficult to access, particularly in rural communities, and also seen to have limitations in their effectiveness. Traditional and faith healers remained highly popular despite the routine maltreatment of the mentally ill in their facilities. Efforts to promote the human rights of those with mental illness must engage with the experiences of mental illness within communities affected in order to grasp how these may underpin the use of practices such as mechanical restraint. Interventions which operate at the local level with those living with mental illness within rural communities, as well as family members and healers, may have greater potential to effect change in the treatment of the mentally ill than legislation or investment in services alone.

Disaster Mental Health and Positive Psychology: An Afterward to the Special Issue.

PubMed

Southwick, Steven M; Satodiya, Ritvij; Pietrzak, Robert H

2016-12-01

The articles in this Special Issue are devoted to integrating the fields of disaster mental health and positive psychology. Their focus on resilience building, individual and community preparation, meaning making, and posttraumatic growth represents an important new development in disaster mental health. The overarching goal of this effort is to inform strategies to help both individuals-including children, adolescent, adult disaster survivors, and relief workers-and communities prepare for, respond to, recover from, and possibly even grow stronger in the face of adversity. To achieve this goal, this body of literature suggests that it is important for disaster mental health workers to partner with community leaders, organizations, and the population at large to understand community vulnerabilities, take advantage of existing strengths, and respect cultural factors implicated in disaster recovery. It further suggests that an effective community-based approach to disaster recovery will make psychosocial support and skill-building programs available to large numbers of survivors, which is critical for responding to future national and international disasters. Continued high-quality research that is comprehensive and considers not only relevant psychological, social, cultural, and biological factors but also interrelations between individuals, organizations and communities is needed to advance this relatively new and important direction of the disaster mental health field. © 2016 Wiley Periodicals, Inc.

Community strengthening and mental health system linking after flooding in two informal human settlements in Peru: a model for small-scale disaster response.

PubMed

Contreras, C; Aguilar, M; Eappen, B; Guzmán, C; Carrasco, P; Millones, A K; Galea, J T

2018-01-01

Mental health is an important factor in responding to natural disasters. Observations of unmet mental health needs motivated the subsequent development of a community-based mental health intervention following one such disaster affecting Peru in 2017. Two informal human settlements on the outskirts of Lima were selected for a mental health intervention that included: (1) screening for depression and domestic violence, (2) children's activities to strengthen social and emotional skills and diminish stress, (3) participatory theater activities to support conflict resolution and community resilience, and (4) community health worker (CHW) accompaniment to government health services. A total of 129 people were screened across both conditions, of whom 12/116 (10%) presented with depression and 21/58 (36%) reported domestic violence. 27 unique individuals were identified with at least one problem. Thirteen people (48%) initially accepted CHW accompaniment to government-provided services. This intervention provides a model for a small-scale response to disasters that can effectively and acceptably identify individuals in need of mental health services and link them to a health system that may otherwise remain inaccessible.

Dangerousness and mental health policy.

PubMed

Hewitt, J L

2008-04-01

Mental health policy development in the UK has become increasingly dominated by the assumed need to prevent violence and alleviate public concerns about the dangers of the mentally ill living in the community. Risk management has become the expected focus of contemporary mental health services, and responsibility has increasingly been devolved to individual service professionals when systems fail to prevent violence. This paper analyses the development of mental health legislation and its impact on services users and mental health professionals at the micro level of service delivery. Historical precedence, media influence and public opinion are explored, and the reification of risk is questioned in practical and ethical terms. The government's newest proposals for compulsory treatment in the community are discussed in terms of practical efficacy and therapeutic impact. Dangerousness is far from being an objectively observable phenomenon arising from clinical pathology, but is a formulation of what is partially knowable through social analysis and unknowable by virtue of its situation in individual psychic motivation. Risk assessment can therefore never be completely accurate, and the solution of a 'better safe than sorry' approach to mental health policy is ethically and pragmatically flawed.

The Clubhouse Model of Community Support for Adults with Mental Illness: An Emerging Opportunity for Social Work Education.

ERIC Educational Resources Information Center

Jackson, Robert L.; And Others

1996-01-01

As an approach to serving adults with mental illness, the Clubhouse Model, developed during the 1950s and 1960s, is particularly suitable for social workers. Clubhouse communities provide support for a full range of daily needs and a participatory environment designed to promote recovery from social isolation and deprivation. Social workers'…

Leisure Activities for Retarded Children. A Task Analysis Approach. Integrating Trainable Mentally Retarded Children Through Community Education. ESEA Title IV, Part C.

ERIC Educational Resources Information Center

Minneapolis Public Schools, Minn.

Designed to meet the need of trainable mentally retarded persons for recreation skill training and for opportunities to experience leisure/social skill development in a community setting, the packet provides task analysis information on 114 activities. Information is provided on behavioral objectives, basic skills required, materials and…

A Proposal to the Massachusetts Board of Regional Community Colleges for a New Occupational Program.

ERIC Educational Resources Information Center

Viaux, Frederic B.

The development of a Mental Health Technology Program at Middlesex Community College is proposed. The 2-year program would train the student to become a middle-level generalist in the field of mental health with special abilities as a communicator. On successfully completing the program, the student would receive an Associate Degree in Mental…

Effects of a Program to Improve Mental Health Literacy for Married Immigrant Women in Korea.

PubMed

Choi, Yun-Jung

2017-08-01

This study aimed to develop and evaluate a mental health improvement program for the acculturative stress and mental health literacy of married immigrant women using bilingual gatekeepers. Bilingual gatekeepers were recruited from multicultural centers and trained to provide 8-week structured mental health improvement services to the women in the experimental group using a mental health improvement guidebook developed by the authors in 8 different languages. The program was effective in improving mental health and mental health literacy scores as well as reducing the degree of acculturative stress. This study offers a model of effective mental healthcare for multicultural communities. Copyright © 2017 Elsevier Inc. All rights reserved.

REFLECTIVE PRACTICE IN ORGANIZATIONAL LEARNING, CULTURAL SELF-UNDERSTANDING, AND COMMUNITY SELF-STRENGTHENING.

PubMed

Sparrow, Joshua

2016-11-01

The infant mental health field can amplify its effects when it extends its purview beyond the dyad to the larger contexts in which infants and adult caregivers interact and develop over time. Within health, mental health, education, and other human service organizations, the quality of relationships is a critical variable in the individual-level outcomes that such organizations seek. The goals of this work and the means for accomplishing them are highly dependent on human qualities and interactions that are shaped by organizational processes. In communities, too, processes that shape relationships also strongly influence child-, family-, and community-level outcomes. The Touchpoints approach to reflective practice can guide relational processes among professionals, parents, and infants in organizations and communities that influence these outcomes. © 2016 Michigan Association for Infant Mental Health.

Working Towards Open and Inclusive Support of Mental Health in Academia

NASA Astrophysics Data System (ADS)

Black, T. E.

2017-12-01

Mental health issues among academics have historically been dismissed as being inherent to the academic culture. While this culture is starting to shift toward more open recognition of these issues, progress toward addressing them lags. I will share a graduate student-focused perspective on some causes and effects of mental health issues in academia, and offer some actionable ideas for improvement. The stereotypical graduate school experience is conducive to the development of mental health issues. Financial stresses, balancing research, teaching, and degree commitments, and managing significant non-academic life events can be detrimental to student health without an adequate system of support. The limited recognition of and support for mental health issues in academia comes at great cost not only to individual health, but to the scientific community. Who do we exclude when we do not fully support individuals with mental health concerns? There are many anecdotes of scientists leaving academia for the sake of their mental health; it is plausible that many, anticipating potential mental health concerns or the factors that drive them, do not pursue academia at all. How can we support those in academia who experience mental health concerns? We can start by ensuring that everyone in our community has access to appropriate resources. This may look like providing new community members with clear information about the mental health services and resources that are available to the community, or advocating for better resources where they are lacking. It is important, however, to address the potential causes of mental health issues as well as the symptoms. While exact factors depend strongly on individuals, we should work to establish more flexible community standards and protocols that can accommodate the various life circumstances that we may encounter. Such actions would help to drive a broader culture shift toward recognizing and destigmatizing mental health issues.

Can a pharmacy intervention improve the metabolic risks of mental health patients? Evaluation of a novel collaborative service.

PubMed

Maulavizada, Husna; Emmerton, Lynne; Hattingh, Hendrika Laetitia

2016-04-26

The pressure on healthcare services worldwide has driven the incorporation of disease state management services within community pharmacies in developed countries. Pharmacists are recognised as the most accessible healthcare professionals, and the incorporation of these services facilitates patient care. In Australia, the opportunity to manage pharmacy patients with mental illness has been underutilised, despite the existence of service models for other chronic conditions. This paper is an independent evaluation of a novel service developed by a community pharmacy in Perth, Western Australia. The service represents collaboration between a nurse practitioner and community pharmacy staff in the management of mental health patients with metabolic risks. We applied practice service standards for Australian community pharmacies to develop an evaluation framework for this novel service. This was followed by semi-structured interviews with staff members at the study pharmacy to explore service processes and procedures. Descriptive analysis of interviews was supplemented with analysis of patients' biometric data. All data were evaluated against the developed framework. The evaluation framework comprised 13 process, 5 outcomes, and 11 quality indicators. Interview data from eight staff members and biometric data from 20 community-dwelling mental health patients taking antipsychotics were evaluated against the framework. Predominantly, patients were managed by the pharmacy's nurse practitioner, with medication management provided by pharmacists. Patients' biometric measurements comprised weight, blood pressure, blood glucose levels, lipid profiles and management of obesity, smoking, hypertension and diabetes. Positive outcomes observed in the patient data included weight loss, smoking cessation, and improved blood pressure, blood glucose and lipid levels. The developed framework allowed effective evaluation of the service, and may be applicable to other pharmacy services. The metabolic clinic met key process, quality and outcomes indicators. The positive patient outcomes may assist in securing further funding.

Mental Health Research and Practice in Minority Communities: Development of Culturally Sensitive Training Programs.

ERIC Educational Resources Information Center

Miranda, Manuel R., Ed.; Kitano, Harry H. L., Ed.

Ten studies concerned with developing culturally sensitive programs for mental health treatment of American minority groups are presented. Chapters 1-5 discuss variables to be considered when creating such programs. Work in cross-cultural settings has raised questions about the validity of some of the newly developed psychiatric diagnostic…

Enhancing Schools’ Capacity to Support Children in Poverty: An Ecological Model of School-Based Mental Health Services

PubMed Central

Frazier, Stacy L.; Atkins, Marc S.; Schoenwald, Sonja K.; Glisson, Charles

2013-01-01

School based mental health services for children in poverty can capitalize on schools’ inherent capacity to support development and bridge home and neighborhood ecologies. We propose an ecological model informed by public health and organizational theories to refocus school based services in poor communities on the core function of schools to promote learning. We describe how coalescing mental health resources around school goals includes a focus on universal programming, mobilizing indigenous school and community resources, and supporting core teaching technologies. We suggest an iterative research–practice approach to program adaptation and implementation as a means toward advancing science and developing healthy children. PMID:18581225

Supporting patients with mental illness: Deconstructing barriers to community pharmacist access.

PubMed

Calogero, Samantha; Caley, Charles F

To discuss the barriers faced by individuals with mental health conditions attempting to access their community pharmacists and to propose solutions toward deconstructing those barriers. Given the prevalence of mental illness and the frequency at which psychotropic medications are dispensed, community pharmacists have a daily opportunity to engage patients with mental illness and be active participants in community-based mental health care. Yet multiple barriers affect patient access to community pharmacists. Some barriers, such as heavy dispensing workload, can be considered as "external" to the pharmacist. Other barriers, such as negative attitudes about mental illness, are considered to be "internal." Research about mental illness stigma in pharmacy often reports that community pharmacists are uncomfortable with, or have little time for, mental health patients. Patients also report experiencing stigma from pharmacists and pharmacy staff. Expanded efforts are needed by the pharmacy profession to deconstruct barriers that patients with mental illness are faced with in community pharmacy, especially related to stigma. Specifically, these efforts should include critically evaluating and addressing the quality of didactic and experiential opportunities in psychiatric pharmacotherapy for pharmacy students, transforming the physical layout of community pharmacies to offer true counseling privacy, educating community pharmacists and pharmacy staff about mental illness, and educating patients about what to expect from community pharmacists. There are opportunities for community pharmacy to improve its impact on mental health treatment outcomes by resolving mental illness stigma and other barriers that prevent patients with mental illness from accessing their community pharmacist. Copyright © 2017 American Pharmacists Association®. Published by Elsevier Inc. All rights reserved.

Shared decision making in Swedish community mental health services - an evaluation of three self-reporting instruments.

PubMed

Rosenberg, David; Schön, Ulla-Karin; Nyholm, Maria; Grim, Katarina; Svedberg, Petra

2017-04-01

Despite the potential impact of shared decision making on users satisfaction with care and quality in health care decisions, there is a lack of knowledge and skills regarding how to work with shared decision making among health care providers. The aim of this study was to evaluate the psychometric properties of three instruments that measure varied dimensions of shared decision making, based on self-reports by clients, in a Swedish community mental health context. The study sample consisted of 121 clients with experience of community mental health care, and involved in a wide range of decisions regarding both social support and treatment. The questionnaires were examined for face and content validity, internal consistency, test-retest reliability and construct validity. The instruments displayed good face and content validity, satisfactory internal consistency and a moderate to good level of stability in test-retest reliability with fair to moderate construct correlations, in a sample of clients with serious mental illness and experience of community mental health services in Sweden. The questionnaires are considered to be relevant to the decision making process, user-friendly and appropriate in a Swedish community mental health care context. They functioned well in settings where non-medical decisions, regarding social and support services, are the primary focus. The use of instruments that measure various dimensions of the self-reported experience of clients, can be a key factor in developing knowledge of how best to implement shared decision making in mental health services.

StreetWise: developing a serious game to support forensic mental health service users' preparation for discharge: a feasibility study.

PubMed

Reynolds, L M; Davies, J P; Mann, B; Tulloch, S; Nidsjo, A; Hodge, P; Maiden, N; Simpson, A

2017-05-01

WHAT IS KNOWN ON THE SUBJECT?: Serious gaming can support learning and development. The use of serious games for skills development and the rehearsal of the management of events that cannot be replicated in real life is well established. Few serious games have been used in mental health services, and none in forensic mental health care. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: How a serious game may be coproduced by forensic mental health service users and game developers The acceptability of the therapeutic use of serious gaming by forensic mental health service users and providers. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Computer games may be used by practitioners in their therapeutic work with forensic mental health service users. Mental health nurses to use serious games to creatively and safely bridge the gap for service users between receiving care in controlled environments and living more independent in the community. Introduction Assessment of users' skills and confidence to safely respond to risky community-based situations underpins discharge planning. Serious games have been used for skills development, and this study trialled their use in forensic mental health services. Aim The aim was to develop and test the acceptability and usability of an innovative serious game to support forensic mental health service users' preparation for discharge. Method A prototype serious game was developed by service users and researchers. Acceptability and usability testing was undertaken and service providers interviewed about the acceptability of serious gaming for forensic mental health services. Result A prototype game was produced and successfully trialled by service users. However, both service users and providers identified that work needed to be done to develop and test a game with greater complexity. Discussion The acceptability and usability of using serious games to support service users to develop skills needed for successful discharge was demonstrated. Implications for practice Mental health practitioners may use gaming to support their practice and work innovatively with other professions such as game developers to create new ways of working in forensic mental health services. © 2016 John Wiley & Sons Ltd.

Exploring the relationship between stigma and help-seeking for mental illness in African-descended faith communities in the UK.

PubMed

Mantovani, Nadia; Pizzolati, Micol; Edge, Dawn

2017-06-01

Stigma related to mental illness affects all ethnic groups, contributing to the production and maintenance of mental illness and restricting access to care and support. However, stigma is especially prevalent in minority communities, thus potentially increasing ethnically based disparities. Little is known of the links between stigma and help-seeking for mental illness in African-descended populations in the UK. Building on the evidence that faith-based organizations (FBOs) can aid the development of effective public health strategies, this qualitative study used semi-structured interviews with faith groups to explore the complex ways in which stigma influences help-seeking for mental illness in African-descended communities. A thematic approach to data analysis was applied to the entire data set. Twenty-six men and women who had varying levels of involvement with Christian FBOs in south London were interviewed (e.g. six faith leaders, thirteen 'active members' and seven 'regular attendees'). Key factors influencing help-seeking behaviour were as follows: beliefs about the causes of mental illness; 'silencing' of mental illness resulting from heightened levels of ideological stigma; and stigma (re)production and maintenance at community level. Individuals with a diagnosis of mental illness were likely to experience a triple jeopardy in terms of stigma. 'One-size-fits-all' approaches cannot effectively meet the needs of diverse populations. To ensure that services are more congruent with their needs, health and care organizations should enable service users, families and community members to become active creators of interventions to remove barriers to help-seeking for mental illness. © 2016 The Authors. Health Expectations Published by John Wiley & Sons Ltd.

The Systematic Medical Appraisal, Referral and Treatment (SMART) Mental Health Project: Development and Testing of Electronic Decision Support System and Formative Research to Understand Perceptions about Mental Health in Rural India

PubMed Central

Maulik, Pallab K; Tewari, Abha; Devarapalli, Siddhardha; Kallakuri, Sudha; Patel, Anushka

2016-01-01

Introduction Common mental disorders (CMD) such as depression, suicidal risk and emotional/medically unexplained complaints affect a large number of people in India, but few receive appropriate care. Key reasons for this include few trained mental health professionals and stigma associated with mental health. A potential approach to address poor access to care is by training village healthcare workers in providing basic mental health care, and harnessing India’s vast mobile network to support such workers using mobile-based applications. We propose an intervention to implement such an approach that incorporates the use of mobile-based electronic decision support systems (EDSS) to provide mental health services for CMD, combined with a community-based anti-stigma campaign. This will be implemented and evaluated across 42 villages in Andhra Pradesh, a south Indian state. This paper discusses the development and testing of the EDSS, and the formative research that informed the anti-stigma campaign. Materials and Methods The development of the EDSS used an iterative process that was validated against clinical diagnosis. A mixed methods approach tested the user acceptability of the EDSS. Focus group discussions and in-depth interviews provided community-level perceptions about mental health. This study involved 3 villages and one primary health centre. Results The EDSS application was found to be acceptable, but some modifications were needed. The community lacked adequate knowledge about CMD and its treatment and there was stigma associated with mental illness. Faith and traditional healers were considered to be important mental health service providers. Discussion A number of barriers and facilitators were identified in implementing the intervention analysed in a framework using Andersen’s behavioural model of health services use. Conclusion The findings assisted with refining the intervention prior to large-scale implementation and evaluation. PMID:27732652

The Systematic Medical Appraisal, Referral and Treatment (SMART) Mental Health Project: Development and Testing of Electronic Decision Support System and Formative Research to Understand Perceptions about Mental Health in Rural India.

PubMed

Maulik, Pallab K; Tewari, Abha; Devarapalli, Siddhardha; Kallakuri, Sudha; Patel, Anushka

2016-01-01

Common mental disorders (CMD) such as depression, suicidal risk and emotional/medically unexplained complaints affect a large number of people in India, but few receive appropriate care. Key reasons for this include few trained mental health professionals and stigma associated with mental health. A potential approach to address poor access to care is by training village healthcare workers in providing basic mental health care, and harnessing India's vast mobile network to support such workers using mobile-based applications. We propose an intervention to implement such an approach that incorporates the use of mobile-based electronic decision support systems (EDSS) to provide mental health services for CMD, combined with a community-based anti-stigma campaign. This will be implemented and evaluated across 42 villages in Andhra Pradesh, a south Indian state. This paper discusses the development and testing of the EDSS, and the formative research that informed the anti-stigma campaign. The development of the EDSS used an iterative process that was validated against clinical diagnosis. A mixed methods approach tested the user acceptability of the EDSS. Focus group discussions and in-depth interviews provided community-level perceptions about mental health. This study involved 3 villages and one primary health centre. The EDSS application was found to be acceptable, but some modifications were needed. The community lacked adequate knowledge about CMD and its treatment and there was stigma associated with mental illness. Faith and traditional healers were considered to be important mental health service providers. A number of barriers and facilitators were identified in implementing the intervention analysed in a framework using Andersen's behavioural model of health services use. The findings assisted with refining the intervention prior to large-scale implementation and evaluation.

Cultural Competence in Counseling the Muslim Patient: Implications for Mental Health.

PubMed

Rassool, G Hussein

2015-10-01

Given the rapidly growing population of Muslims in Western societies, it is imperative to develop a better understanding of the mental health needs and concerns of this community. Muslim religious beliefs have an impact on the mental health of individuals, families and communities. The lack of understanding of the interplay between religious influences on health or sickness behaviors can have a significant effect upon the delivery of nursing practice. The Muslim community is experiencing social exclusion (social exclusion correlates with mental health problems) related to their cultural and religious identity. In addition, the emergence of radical extremism and the resulting media coverage have magnified this problem. Misunderstanding the worldview of the patient can lead to ethical dilemmas, practice problems, and problems in communication. Often, Muslim individuals are stigmatized and families are rejected and isolated for their association with mental health problems, addiction and suicide. There are indicators that Muslims experience mental ill health, but that they either are unidentified by mainstream mental health services or present late to the services. The aims of the paper are to examine the religious and cultural influences on mental health beliefs of Muslims, and provide an understanding of mental health problems, and its implications in counseling and spiritual interventions. Copyright © 2015 Elsevier Inc. All rights reserved.

The Georgia Feasibility Study: The Development of Alternative Community Services for the Current Residents of Georgia Retardation Center and the Southwest Developmental Center at Bainbridge.

ERIC Educational Resources Information Center

Bradley, Valerie J.; And Others

The report explores the feasibility of placing 565 severely mentally retarded residents of the Georgia Retardation Center and Southwestern Developmental Center at Bainbridge, Georgia, in alternative community living and daytime arrangements. The seven mental retardation service areas which had placed most of these residents were the focus of…

Research protocol: a realist synthesis of contestability in community-based mental health markets.

PubMed

Durham, Jo; Bains, Amara

2015-03-25

In most developed nations, there has been a shift from public services to a marketisation of public goods and services - representing a significant reform process aiming to transform the way in which community-based human services, such as health, are delivered and consumed. For services, this means developing the capacity to adapt and innovate in response to changing circumstances to achieve quality. The availability of rigorous research to demonstrate whether a market approach and contestability, in particular, is a coherent reform process is largely absent. Contestability operates on the premise that better procurement processes allow more providers to enter the market and compete for contracts. This is expected to create stimulus for greater efficiencies, innovation and improved service delivery to consumers. There is limited understanding, however, about how community-based providers morph and re-configure in response to the opportunities posed by contestability. This study focuses on the effect of a contestability policy on the community-managed mental health sector. A realist review will be undertaken to understand how and why the introduction of contestability into a previously incontestable market influences the ways in which community-based mental health providers respond to contestability. The review will investigate those circumstances that shape organisational response and generate outcomes through activating mechanisms. An early scoping has helped to formulate the initial program theory. A realist synthesis will be undertaken to identify relevant journal articles and grey literature. Data will be extracted in relation to the emerging contextual factors, mechanisms and outcomes and their configurations. The analysis will seek patterns and regularities in these configurations across the extracted data and will focus on addressing our theory-based questions. Increasingly, community-based mental health markets are moving to contestability models. Rigorous research is needed to understand how such markets work and in what contexts. The knowledge gained from this study in community-based mental health will provide valuable lessons in how contestability works, in what circumstances and who benefits when. The results of the proposed research will be useful to policy-makers and may be applicable in other contexts beyond the community-based mental health sector. PROSPERO CRD42015016808.

Survey of northern informal and formal mental health practitioners

PubMed Central

O'Neill, Linda; George, Serena; Sebok, Stefanie

2013-01-01

Background This survey is part of a multi-year research study on informal and formal mental health support in northern Canada involving the use of qualitative and quantitative data collection and analysis methods in an effort to better understand mental health in a northern context. Objective The main objective of the 3-year study was to document the situation of formal and informal helpers in providing mental health support in isolated northern communities in northern British Columbia, northern Alberta, Yukon, Northwest Territories and Nunavut. The intent of developing a survey was to include more participants in the research and access those working in small communities who would be concerned regarding confidentiality and anonymity due to their high profile within smaller populations. Design Based on the in-depth interviews from the qualitative phase of the project, the research team developed a survey that reflected the main themes found in the initial qualitative analysis. The on-line survey consisted of 26 questions, looking at basic demographic information and presenting lists of possible challenges, supports and client mental health issues for participants to prioritise. Results Thirty-two participants identified various challenges, supports and client issues relevant to their mental health support work. A vast majority of the respondents felt prepared for northern practice and had some level of formal education. Supports for longevity included team collaboration, knowledgeable supervisors, managers, leaders and more opportunities for formal education, specific training and continuity of care to support clients. Conclusion For northern-based research in small communities, the development of a survey allowed more participants to join the larger study in a way that protected their identity and confidentiality. The results from the survey emphasise the need for team collaboration, interdisciplinary practice and working with community strengths as a way to sustain mental health support workers in the North. PMID:23984276

Significance of mental health legislation for successful primary care for mental health and community mental health services: A review.

PubMed

Ayano, Getinet

2018-03-29

 Mental health legislation (MHL) is required to ensure a regulatory framework for mental health services and other providers of treatment and care, and to ensure that the public and people with a mental illness are afforded protection from the often-devastating consequences of mental illness.  To provide an overview of evidence on the significance of MHL for successful primary care for mental health and community mental health servicesMethod: A qualitative review of the literature on the significance of MHL for successful primary care for mental health and community mental health services was conducted.  In many countries, especially in those who have no MHL, people do not have access to basic mental health care and treatment they require. One of the major aims of MHL is that all people with mental disorders should be provided with treatment based on the integration of mental health care services into the primary healthcare (PHC). In addition, MHL plays a crucial role in community integration of persons with mental disorders, the provision of care of high quality, the improvement of access to care at community level. Community-based mental health care further improves access to mental healthcare within the city, to have better health and mental health outcomes, and better quality of life, increase acceptability, reduce associated social stigma and human rights abuse, prevent chronicity and physical health comorbidity will likely to be detected early and managed.  Mental health legislation plays a crucial role in community integration of persons with mental disorders, integration of mental health at primary health care, the provision of care of high quality and the improvement of access to care at community level. It is vital and essential to have MHL for every country.

Development and community-based validation of eight item banks to assess mental health.

PubMed

Batterham, Philip J; Sunderland, Matthew; Carragher, Natacha; Calear, Alison L

2016-09-30

There is a need for precise but brief screening of mental health problems in a range of settings. The development of item banks to assess depression and anxiety has resulted in new adaptive and static screeners that accurately assess severity of symptoms. However, expansion to a wider array of mental health problems is required. The current study developed item banks for eight mental health problems: social anxiety disorder, panic disorder, post-traumatic stress disorder, obsessive-compulsive disorder, adult attention-deficit hyperactivity disorder, drug use, psychosis and suicidality. The item banks were calibrated in a population-based Australian adult sample (N=3175) by administering large item pools (45-75 items) and excluding items on the basis of local dependence or measurement non-invariance. Item Response Theory parameters were estimated for each item bank using a two-parameter graded response model. Each bank consisted of 19-47 items, demonstrating excellent fit and precision across a range of -1 to 3 standard deviations from the mean. No previous study has developed such a broad range of mental health item banks. The calibrated item banks will form the basis of a new system of static and adaptive measures to screen for a broad array of mental health problems in the community. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Curriculum Development and Discursive Practices: Building a Training Culture around Dual Diagnosis.

ERIC Educational Resources Information Center

Goldsmith, Steve

Dual diagnosis of comorbid substance abuse and mental disorder is currently presenting great difficulties across Australia's health and community service sectors. Historically, mental health professionals have received relatively little formal education or training in substance abuse issues. A new curriculum on dual diagnosis was developed and…

Treating the untreated: applying a community-based, culturally sensitive psychiatric intervention to confined and physically restrained mentally ill individuals in Bali, Indonesia.

PubMed

Suryani, Luh Ketut; Lesmana, Cokorda Bagus Jaya; Tiliopoulos, Niko

2011-11-01

This study identified, mapped and treated the clinical features of mentally ill people, who had been isolated and restrained by family and community members as a result of a functional failure of the traditional medical, hospital-based mental health model currently practiced in Indonesia. A 10-month epidemiological population survey was carried out in Karangasem regency of Bali, Indonesia. A total of 404,591 individuals were clinically interviewed, of which 895 individuals with mental health problems were identified, with 23 satisfying criteria of physical restraint and confinement. Of the latter, twenty were males; age range was 19-69 years, all diagnosed by the researchers with schizophrenia-spectrum disorder (ICD-10 diagnostic criteria). Duration of restraint ranged from 3 months to 30 years (mean = 8.1 years, SD = 8.3 years). Through the application of a holistic intervention model, all patients exhibited a remarkable recovery within 19 months of treatment. We conclude that the development of a community-based, culturally sensitive and respectful mental health model can serve as an optimum promoter of positive mental health outcomes.

Utilization of the Behavior Change Wheel framework to develop a model to improve cardiometabolic screening for people with severe mental illness.

PubMed

Mangurian, Christina; Niu, Grace C; Schillinger, Dean; Newcomer, John W; Dilley, James; Handley, Margaret A

2017-11-14

Individuals with severe mental illness (e.g., schizophrenia, bipolar disorder) die 10-25 years earlier than the general population, primarily from premature cardiovascular disease (CVD). Contributing factors are complex, but include systemic-related factors of poorly integrated primary care and mental health services. Although evidence-based models exist for integrating mental health care into primary care settings, the evidence base for integrating medical care into specialty mental health settings is limited. Such models are referred to as "reverse" integration. In this paper, we describe the application of an implementation science framework in designing a model to improve CVD outcomes for individuals with severe mental illness (SMI) who receive services in a community mental health setting. Using principles from the theory of planned behavior, focus groups were conducted to understand stakeholder perspectives of barriers to CVD risk factor screening and treatment identify potential target behaviors. We then applied results to the overarching Behavior Change Wheel framework, a systematic and theory-driven approach that incorporates the COM-B model (capability, opportunity, motivation, and behavior), to build an intervention to improve CVD risk factor screening and treatment for people with SMI. Following a stepped approach from the Behavior Change Wheel framework, a model to deliver primary preventive care for people that use community mental health settings as their de facto health home was developed. The CRANIUM (cardiometabolic risk assessment and treatment through a novel integration model for underserved populations with mental illness) model focuses on engaging community psychiatrists to expand their scope of practice to become responsible for CVD risk, with significant clinical decision support. The CRANIUM model was designed by integrating behavioral change theory and implementation theory. CRANIUM is feasible to implement, is highly acceptable to, and targets provider behavior change, and is replicable and efficient for helping to integrate primary preventive care services in community mental health settings. CRANIUM can be scaled up to increase CVD preventive care delivery and ultimately improve health outcomes among people with SMI served within a public mental health care system.

Relationships, environment, and the brain: how emerging research is changing what we know about the impact of families on human development.

PubMed

Patterson, Jo Ellen; Vakili, Susanna

2014-03-01

Recent research is providing family therapists with new information about the complex interaction between an individual's biological makeup and his/her social and physical environment. Family and social relationships, particularly during sensitive periods early in life, can affect a child's biological foundation. Additionally, stress during the early years can have a lasting effect on an individual's physical and mental health and contribute to the onset of severe mental illness. Community programs have been developed to intervene early with families who have an at-risk child to prevent or minimize the onset of mental illness including providing partnerships with at-risk mothers of infants to shape attachment relationships. Programs are also developing individual and family interventions to prevent the onset of psychosis. Practicing family therapists can incorporate emerging neuroscience and early intervention research and leverage the growing base of community programs to enhance the effectiveness and sustainability of mental health outcomes for clients. Additionally, family therapy education programs should broaden student training to incorporate the growing body of information about how family relationships affect individual mental health development. © 2013 FPI, Inc.

The Continued Development and Practice of School Psychology in Singapore: Using REACH as an Illustration

ERIC Educational Resources Information Center

Ooi, Yoon Phaik; Ang, Rebecca P.; Ibrahim, Noor Haslinda; Koh, Delphine; Lee, Poh Yin; Ong, Lue Ping; Wong, Geraldine; Fung, Daniel S. S.

2014-01-01

School psychology in Singapore gained greater prominence with the development of the National Mental Health Blueprint in 2007 that included a focus on children and adolescents. A partnership between the Ministry of Health and the Ministry of Education was formed to develop a community mental health pilot program called 'Response, Early…

Community Mental Health as a Population-based Mental Health Approach.

PubMed

Yuxuan Cai, Stefanie; Shuen Sheng Fung, Daniel

2016-01-01

Mental health services for youths in Singapore were challenged by accessibility and resource constraints. A community-based mental health program working with schools and other partners was developed to address the population needs. To describe the formation of a community-based mental health program and evaluate the program in terms of its outcome and the satisfaction of the users of this program. Based on needs analyses, a community multidisciplinary team was set up in 15 schools to pilot a new model of care for youths. Implemented progressively over five years, networks of teams were divided into four geographic zones. Each zone had clusters of 10 to 15 schools. These teams worked closely with school counselors. Teams were supported by a psychiatrist and a resident. Interventions were focused on empowering school-based personnel to work with students and families, with the support of the teams. 4,184 students were served of whom 10% were seen by the school counselors and supported by the community team. Only 0.15% required referral to tertiary services. Outcome measured by counselor and teacher ratings showed improvements in the Clinical Global Impression scale and Strengths and Difficulties Questionnaire. These included reductions in conduct problems, emotional problems, hyperactive behaviors and peer problems. Furthermore, prosocial behavior also significantly improved. Preliminary cost effectiveness analyses suggest that community treatments are superior to clinic interventions.

Bridging Mental Health and Education in Urban Elementary Schools: Participatory Research to Inform Intervention Development

ERIC Educational Resources Information Center

Cappella, Elise; Jackson, Daisy R.; Bilal, Caroline; Hamre, Bridget K.; Soule, Carles

2011-01-01

Guided by participatory research and implementation science, we conducted a two-phase study to contextualize a school mental health intervention for its implementation settings. Drawing from research and existing programs, we created a teacher consultation and coaching intervention delivered by indigenous school and community mental health…

EFFECTS OF A COMPREHENSIVE OPPORTUNITY PROGRAM ON THE DEVELOPMENT OF EDUCABLE MENTALLY RETARDED CHILDREN.

ERIC Educational Resources Information Center

SMITH, LLOYD L.; STROUD, JAMES B.

THIS STUDY INVESTIGATED THE EFFECTS UPON EDUCABLE MENTALLY RETARDED CHILDREN OF A COMPREHENSIVE OPPORTUNITY PROGRAM EMBRACING NOT ONLY GOOD INSTRUCTION, BUT ALSO PSYCHOTHERAPY, A GOOD MENTAL-HYGIENE ATMOSPHERE, AND WHOLESOME AND EFFECTIVE HUMAN RELATIONSHIPS IN SCHOOL, HOME, AND COMMUNITY. THE MAJOR OBJECTIVES WERE--(1) TO SELECT AND/OR DEVELOP…

Community Perceptions of Mental Illness in Jharkhand, India.

PubMed

Sangeeta, S J; Mathew, K J

2017-09-01

Understanding and perceptions about mental illness vary among individuals based on their experience with the illness or their contact with the people affected by it. These may be further influenced by the individuals' sociocultural background. This study aimed to understand the differences in the beliefs about, understanding of, and explanations for mental illness between different population groups of Jharkhand, India. During July 2014 to February 2016, we recruited the following 3 groups of individuals aged between 18 and 60 years: individuals with mental illness (group 1, n = 240), relatives of individuals with mental illness (group 2, n = 240), and the general public (group 3, n = 240). Qualitative and quantitative findings were combined in this study, and participants were asked about their beliefs about, understanding of, and explanations about mental illness. Individuals with mental illness and their relatives shared similar beliefs whereas the general public held a different opinion in various domains. There were significant differences among all groups in their understanding of various aspects of mental illnesses including the definition, causes, signs and symptoms, treatment, and outcomes. Individuals' perception towards different aspects of mental illness varies, despite they are sharing the same sociocultural milieu. Differences in beliefs, understanding, and explanations may lead to conflicts in treatment goals and expectations, and hamper the intervention strategies that promote mental health and patient care. Focused strategies to develop uniformity in beliefs and explanations about various aspects of mental illness may help to develop collaboration with different community groups that may in turn help in developing effective interventions and treatment.

Developing preventive mental health interventions for refugee families in resettlement.

PubMed

Weine, Stevan Merrill

2011-09-01

In refugee resettlement, positive psychosocial outcomes for youth and adults depend to a great extent on their families. Yet refugee families find few empirically based services geared toward them. Preventive mental health interventions that aim to stop, lessen, or delay possible negative individual mental health and behavioral sequelae through improving family and community protective resources in resettled refugee families are needed. This paper describes 8 characteristics that preventive mental health interventions should address to meet the needs of refugee families, including: Feasibility, Acceptability, Culturally Tailored, Multilevel, Time Focused, Prosaicness, Effectiveness, and Adaptability. To address these 8 characteristics in the complex environment of refugee resettlement requires modifying the process of developmental research through incorporating innovative mental health services research strategies, including: resilience framework, community collaboration, mixed methods with focused ethnography, and the comprehensive dynamic trial. A preventive intervention development cycle for refugee families is proposed based on a program of research on refugees and migrants using these services research strategies. Furthering preventive mental health for refugee families also requires new policy directives, multisystemic partnerships, and research training. 2011 © FPI, Inc.

Developing Preventive Mental Health Interventions for Refugee Families in Resettlement

PubMed Central

WEINE, STEVAN MERRILL

2014-01-01

In refugee resettlement, positive psychosocial outcomes for youth and adults depend to a great extent on their families. Yet refugee families find few empirically based services geared toward them. Preventive mental health interventions that aim to stop, lessen, or delay possible negative individual mental health and behavioral sequelae through improving family and community protective resources in resettled refugee families are needed. This paper describes 8 characteristics that preventive mental health interventions should address to meet the needs of refugee families, including: Feasibility, Acceptability, Culturally Tailored, Multilevel, Time Focused, Prosaicness, Effectiveness, and Adaptability. To address these 8 characteristics in the complex environment of refugee resettlement requires modifying the process of developmental research through incorporating innovative mental health services research strategies, including: resilience framework, community collaboration, mixed methods with focused ethnography, and the comprehensive dynamic trial. A preventive intervention development cycle for refugee families is proposed based on a program of research on refugees and migrants using these services research strategies. Furthering preventive mental health for refugee families also requires new policy directives, multisystemic partnerships, and research training. PMID:21884078

Prevalence of Children's Mental Health Problems and the Effectiveness of Population-Level Family Interventions.

PubMed

Kato, Noriko; Yanagawa, Toshihiko; Fujiwara, Takeo; Morawska, Alina

2015-01-01

The prevalence of mental health problems among children and adolescents is of growing importance. Intervening in children's mental health early in life has been shown to be more effective than trying to resolve these problems when children are older. With respect to prevention activities in community settings, the prevalence of problems should be estimated, and the required level of services should be delivered. The prevalence of children's mental health disorders has been reported for many countries. Preventive intervention has emphasized optimizing the environment. Because parents are the primary influence on their children's development, considerable attention has been placed on the development of parent training to strengthen parenting skills. However, a public-health approach is necessary to confirm that the benefits of parent-training interventions lead to an impact at the societal level. This literature review clarifies that the prevalence of mental health problems is measured at the national level in many countries and that population-level parenting interventions can lower the prevalence of mental health problems among children in the community.

Prevalence of Children’s Mental Health Problems and the Effectiveness of Population-Level Family Interventions

PubMed Central

Kato, Noriko; Yanagawa, Toshihiko; Fujiwara, Takeo; Morawska, Alina

2015-01-01

The prevalence of mental health problems among children and adolescents is of growing importance. Intervening in children’s mental health early in life has been shown to be more effective than trying to resolve these problems when children are older. With respect to prevention activities in community settings, the prevalence of problems should be estimated, and the required level of services should be delivered. The prevalence of children’s mental health disorders has been reported for many countries. Preventive intervention has emphasized optimizing the environment. Because parents are the primary influence on their children’s development, considerable attention has been placed on the development of parent training to strengthen parenting skills. However, a public-health approach is necessary to confirm that the benefits of parent-training interventions lead to an impact at the societal level. This literature review clarifies that the prevalence of mental health problems is measured at the national level in many countries and that population-level parenting interventions can lower the prevalence of mental health problems among children in the community. PMID:26250791

[Awareness and attitude toward suicide in community mental health professionals and hospital workers].

PubMed

Kim, Soung Nam; Lee, Kang Sook; Lee, Seon Young; Yu, Jae Hee; Hong, A Rum

2009-05-01

The purpose of this study was to evaluate community mental health professionals and hospital workers attitude and awareness towards suicide. This study investigated 264 community mental health professionals and 228 hospital workers. SOQs (Suicidal Opinion Questionnaires) were used from July 2007 to September 2007. After a factor analysis for the attitude towards suicide, the items on ethics, mental illness, religion, risk, and motivation were included in the subsequent analysis. There were significant differences in the attitude towards suicide according to religion, age, educational background, the marriage status, the economic position, and different professional licenses. Hospital workers' view was different from the community workers'. The hospital workers judged that suicide was due to mental illness, and suicide was high for the people in a special environment and who lacked motivation, which caused them to fall in a dangerous situation. For the lower educational group, they thought that suicide was attributable to mental illness. The awareness for suicide was significantly higher in the group with a postgraduate education, unmarried people, mental health professionals and the persons who had concern and experience with suicide. The factors that had an influence on the awareness of suicide were the items of mental illness, religion, risk and motivational factors. This study suggested that the factors to increase the awareness and attitude for suicide were the experience of increased education and case management of suicide. Therefore, education dealing with suicide and reinforcement of crisis management programs should be developed.

Community perceptions of mental health needs: a qualitative study in the Solomon Islands

PubMed Central

Blignault, Ilse; Bunde-Birouste, Anne; Ritchie, Jan; Silove, Derrick; Zwi, Anthony B

2009-01-01

Background Psychosocial and mental health needs in the aftermath of conflict and disaster have attracted substantial attention. In the Solomon Islands, the conceptualisation of mental health, for several decades regarded by policy makers as primarily a health issue, has broadened and been incorporated into the national development and social policy agendas, reflecting recognition of the impact of conflict and rapid social change on the psychosocial wellbeing of the community as a whole. We sought to understand how mental health and psychosocial wellbeing were seen at the community level, the extent to which these issues were identified as being associated with periods of 'tension', violence and instability, and the availability of traditional approaches and Ministry of Health services to address these problems. Methods This article reports the findings of qualitative research conducted in a rural district on the island of Guadalcanal in the Solomon Islands. Key informant interviews were conducted with community leaders, and focus groups were held with women, men and young people. Wellbeing was defined broadly. Results Problems of common concern included excessive alcohol and marijuana use, interpersonal violence and abuse, teenage pregnancy, and lack of respect and cooperation. Troubled individuals and their families sought help for mental problems from various sources including chiefs, church leaders and traditional healers and, less often, trauma support workers, health clinic staff and police. Substance-related problems presented special challenges, as there were no traditional solutions at the individual or community level. Severe mental illness was also a challenge, with few aware that a community mental health service existed. Contrary to our expectations, conflict-related trauma was not identified as a major problem by the community who were more concerned about the economic and social sequelae of the conflict. Conclusion Communities identify and are responding to a wide range of mental health challenges; the health system generally can do more to learn about how this is being done, and build more comprehensive services and policy on this foundation. The findings underscore the need to promote awareness of those services which are available, to extend mental health care beyond urban centres to rural villages where the majority of the population live, and to promote community input to policy so as to ensure that it 'fits' the context. PMID:19284638

FBO LEADERS’ PERCEPTIONS OF THE PSYCHO-SOCIAL CONTEXTS IN RURAL LATINOS

PubMed Central

VACCA, RAFFAELE; WIENS, BRENDA; LOE, EMILY; LAFLAM, MELODY; PÉREZ, AWILDA; LOCKE, BARBARA

2016-01-01

LATINOS COMPRISE THE LARGEST MINORITY RURAL POPULATION IN THE U.S. AND THEY ARE OFTEN EXPOSED TO ADVERSE SOCIAL HEALTH DETERMINANTS THAT CAN DETRIMENTALLY AFFECT THEIR MENTAL HEALTH. GUIDED BY THE CBPR PRINCIPLES, THIS STUDY AIMED TO DESCRIBE FBO LEADERS’ PERCEPTIONS OF THE CONTEXTS AFFECTING MENTAL WELL-BEING AND POTENTIAL APPROACHES TO MENTAL HEALTH PROMOTION IN RURAL, LATINO IMMIGRANTS. THIS IS A DESCRIPTIVE, QUALITATIVE ARM OF A LARGER STUDY IN WHICH COMMUNITY-ACADEMIC MEMBERS HAVE PARTNERED TO DEVELOP A CULTURALLY TAILORED MENTAL HEALTH PROMOTION INTERVENTION AMONG RURAL LATINOS. FBO’S LEADERS (N=15), FROM DIFFERENT DENOMINATIONS IN NORTH FLORIDA, WERE INTERVIEWED UNTIL SATURATION WAS REACHED. FBO LEADERS REMARKED THAT IN ADDITION TO RELIGIOSITY, WHICH LATINOS ALREADY HAVE, MORE COMMUNITY BUILDING AND INVOLVEMENT IS NECESSARY TO THE PROMOTION OF MENTAL HEALTH. PMID:26818929

Objective community integration of mental health consumers living in supported housing and of others in the community.

PubMed

Yanos, Philip T; Stefancic, Ana; Tsemberis, Sam

2012-01-01

Housing programs for people with severe mental illnesses aim to maximize community integration. However, little is known about how the community integration of mental health consumers living in supported housing compares with that of other community residents in the socially disadvantaged communities where supported housing is often located. The purpose of this study was to examine predictors of objective community integration of mental health consumers living in supported housing and of other persons living in the same communities. Participants were 124 adults (60 mental health consumers and 64 other community residents) residing in designated zip codes in the Bronx, New York. Participants were administered measures of psychiatric symptoms, substance use, physical community integration (participation in local activities), social integration (interactions with community members), and citizenship (political activism or volunteering). Mental health consumers living in supported independent housing had significantly lower scores on indicators of objective community integration than other community members. However, differences were relatively small. Among mental health consumers, African-American race, education, and length of time in current residence were associated with better community integration. Findings suggest that mental health consumers living in supported housing may not achieve levels of objective community integration that are comparable with other community members; however, psychiatric factors did not account for this difference. Length of time in neighborhoods appears to be an important factor in facilitating social integration.

Engaging cultural resources to promote mental health in Dutch LSES neighborhoods: study of a community-based participatory media project.

PubMed

Knibbe, Mare; de Vries, Marten; Horstman, Klasien

2017-06-01

Community-based participatory media projects form a promising new strategy for mental health promotion that can help address the mental health-gap identified by the World Health Organization. (2008b) mhGAP, Mental Health Gap Action Programme: Scaling Up Care for Mental, Neurological and Substance Use Disorders. World Health Organization, Geneva. In this article we present an ethnographic study about a participatory media project that was developed to promote mental health in selected Dutch low socio-economic status neighborhoods. Through narrowcastings (group film viewings), participant observation and interviews we mapped the ways in which the media project effected and facilitated the collective sense-making process of the audience with regard to sources of stress impacting mental health and opportunities for action. These determinants of mental health are shaped by cultural dimensions, since the cultural context shapes everyday experiences of stress as well as the resources and skills to manage them. Our analysis shows that the media project engaged cultural resources to challenge stressful social scripts. We conclude that more attention should be paid to cultural narratives in a community to understand how health promotion strategies can support social resilience. © The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

The role of community mental health nurses caring for people with schizophrenia in Taiwan: a substantive grounded theory.

PubMed

Huang, Xuan-Yi; Yen, Wen-Jiuan; Liu, Shwu-Jiuan; Lin, Chouh-Jiuan

2008-03-01

The aim was to develop a practice theory that can be used to guide the direction of community nursing practice to help clients with schizophrenia and those who care for them. Substantive grounded theory was developed through use of grounded theory method of Strauss and Corbin. Two groups of participants in Taiwan were selected using theoretical sampling: one group consisted of community mental health nurses and the other group was clients with schizophrenia and those who cared for them. The number of participants in each group was determined by theoretical saturation. Semi-structured one-to-one in-depth interviews and unstructured non-participant observation were utilized for data collection. Data analysis involved three stages: open, axial and selective coding. During the process of coding and analysis, both inductive and deductive thinking were utilized and the constant comparative analysis process continued until data saturation occurred. To establish trustworthiness, the four criteria of credibility, transferability, dependability and confirmability were followed along with field trial, audit trial, member check and peer debriefing for reliability and validity. A substantive grounded theory, the role of community mental health nurses caring for people with schizophrenia in Taiwan, was developed through utilization of grounded theory method of Strauss and Corbin. In this paper, results and discussion focus on causal conditions, context, intervening conditions, consequences and phenomenon. The theory is the first to contribute knowledge about the field of mental health home visiting services in Taiwan to provide guidance for the delivery of quality care to assist people in the community with schizophrenia and their carers.

Three models of community mental health services In low-income countries

PubMed Central

2011-01-01

Objective To compare and contrast three models of community mental health services in low-income settings. Data Sources/Study Setting Primary and secondary data collected before, during, and after site visits to mental health programs in Nigeria, the Philippines, and India. Study Design Qualitative case study methodology. Data Collection Data were collected through interviews and observations during site visits to the programs, as well as from reviews of documentary evidence. Principal Findings A set of narrative topics and program indicators were used to compare and contrast three community mental health programs in low-income countries. This allowed us to identify a diversity of service delivery models, common challenges, and the strengths and weaknesses of each program. More definitive evaluations will require the establishment of data collection methods and information systems that provide data about the clinical and social outcomes of clients, as well as their use of services. Conclusions Community mental health programs in low-income countries face a number of challenges. Using a case study methodology developed for this purpose, it is possible to compare programs and begin to assess the effectiveness of diverse service delivery models. PMID:21266051

Tailored tobacco dependence support for mental health patients: a model for inpatient and community services.

PubMed

Parker, Camilla; McNeill, Ann; Ratschen, Elena

2012-12-01

Although smoking prevalence among people with severe mental illness is high, it remains largely unaddressed. This pragmatic pilot project aimed to develop and implement a tailored tobacco dependence service in mental health settings and to assess its impact, as well as barriers and facilitators to implementation. An integrative service model, spanning acute, rehabilitation and community services, including the design of tailored instruments and referral pathways, delivered by two mental health professionals. Four adult acute and two rehabilitation wards (129 beds), and the community recovery team (2038 cases) of the United Kingdom's largest Mental Health Trust. Audit of smoking information in patient notes; service uptake; quit attempts; smoking cessation and reduction; qualitative data on implementation barriers/facilitators. A total of 110 patients attended at least one support session: 53 inpatients (23% of inpatient smokers) and 57 community (of unknown number of community smokers, as recording of smoking status is not mandatory). Thirty-four of these (31%) made a quit attempt; 17 (15%) stopped smoking and 29 (26%) reduced cigarette consumption by up to 50% at the final contact. Barriers to service implementation related to: (i) trust policy, systems and procedures, (ii) staff knowledge and attitudes and (iii) illness-related factors. Despite the strong anti-smoking climate in the United Kingdom, including a law requiring smoke-free policies in mental health settings, establishing a smoking cessation treatment service for people with mental illness proved difficult, due to complex systemic barriers. However, there is clearly a demand, by patients, for such a service. © 2012 The Authors, Addiction © 2012 Society for the Study of Addiction.

Financing Community Services for Persons with Disabilities: State Agency and Community Provider Perspectives.

ERIC Educational Resources Information Center

Hemp, Richard

1992-01-01

This serial issue summarizes findings from a survey of 20 state mental retardation and developmental disabilities agencies and 93 community based providers on developing and financing community services. The survey queried respondents concerning: (1) which models or strategies for financing community services have been most effective; (2) what…

Highlighting the Way Forward: A Review of Community Mental Health Research and Practice Published in AJCP and JCP.

PubMed

Townley, Greg; Terry, Rachel

2018-03-01

Articles published in the two most prominent journals of community psychology in North America, the American Journal of Community Psychology (AJCP) and Journal of Community Psychology (JCP), provide a clear indicator of trends in community research and practice. An examination of community psychology's history and scholarship suggests that the field has reduced its emphasis on promoting mental health, well-being, and liberation of individuals with serious mental illnesses over the past several decades. To further investigate this claim, the current review presents an analysis of articles relevant to community mental health (N = 307) published in the American Journal of Community Psychology (AJCP) and Journal of Community Psychology (JCP) from 1973 to 2015. The review focuses on article characteristics (e.g., type of article and methods employed), author characteristics, topic areas, and theoretical frameworks. Results document a downward trend in published articles from the mid-1980s to mid-2000s, with a substantial increase in published work between 2006 and 2015. A majority of articles were empirical and employed quantitative methods. The most frequent topic area was community mental health centers and services (n = 49), but the past three decades demonstrate a clear shift away from mental health service provision to address pressing social issues that impact community mental health, particularly homelessness (n = 42) and community integration of adults with serious mental illnesses (n = 40). Findings reflect both the past and present state of community psychology and suggest promising directions for re-engaging with community mental health and fostering well-being, inclusion, and liberation of adults experiencing serious mental health challenges. © Society for Community Research and Action 2017.

Self-Disclosure and Spiritual Well-Being in Pastors Seeking Professional Psychological Help.

PubMed

Salwen, Erik D; Underwood, Lee A; Dy-Liacco, Gabriel S; Arveson, Kathleen R

2017-01-01

Pastoral mental health is a topic that has only rarely been researched empirically in the psychological literature, yet a pastor's mental health can have a significant impact on churches, communities, and even nations (Royal and Thompson, Journal of Psychology and Christianity, 31 (3), 195-204, 2012). One of the thoughts prompting this research is that evangelical pastors might be expected to resist the findings of psychological research and lack understanding of specific mental illnesses they are potentially facing. Combined with historical and cultural dynamics that could influence resistance to professional psychological help, evangelical pastors have personal, internal factors that could also strengthen resistance, including the researched issues of self-disclosure flexibility and spiritual well-being. A correlational research design with multivariate regression was used to determine potentially significant or predictive relationships between the relevant factors. Among evangelical seminary students ( N  = 251) preparing for parish-based pastoral ministry, this research determined that no significant relationship, predictive or otherwise, existed between self-disclosure flexibility, spiritual well-being, and attitudes toward seeking professional psychological help. Implications include a shift in focus toward external factors influencing pastors' help-seeking attitudes, such as the need for the mental health community to develop connections with evangelical pastors and the development of more support for Christian mental health professionals in the larger evangelical community.

Demand and access to mental health services: a qualitative formative study in Nepal

PubMed Central

2014-01-01

Background Nepal is experiencing a significant ‘treatment gap’ in mental health care. People with mental disorders do not always receive appropriate treatment due to a range of structural and individual issues, including stigma and poverty. The PRIME (Programme for Improving Mental Health Care) programme has developed a mental health care plan to address this issue in Nepal and four other low and middle income countries. This study aims to inform the development of this comprehensive care plan by investigating the perceptions of stakeholders at different levels of the care system in the district of Chitwan in southern Nepal: health professionals, lay workers and community members. It focuses specifically on issues of demand and access to care, and aims to identify barriers and potential solutions for reaching people with priority mental disorders. Methods This qualitative study consisted of key informant interviews (33) and focus group discussions (83 participants in 9 groups) at community and health facility levels. Data were analysed using a framework analysis approach. Results As well as pragmatic barriers at the health facility level, mental health stigma and certain cultural norms were found to reduce access and demand for services. Respondents perceived the lack of awareness about mental health problems to be a major problem underlying this, even among those with high levels of education or status. They proposed strategies to improve awareness, such as channelling education through trusted and respected community figures, and responding to the need for openness or privacy in educational programmes, depending on the issue at hand. Adapting to local perceptions of stigmatised treatments emerged as another key strategy to improve demand. Conclusions This study identifies barriers to accessing care in Nepal that reach beyond the health facility and into the social fabric of the community. Stakeholders in PRIME’s integrated care plan advocate strategic awareness raising initiatives to improve the reach of integrated services in this low-income setting. PMID:25084826

Demand and access to mental health services: a qualitative formative study in Nepal.

PubMed

Brenman, Natassia F; Luitel, Nagendra P; Mall, Sumaya; Jordans, Mark J D

2014-08-02

Nepal is experiencing a significant 'treatment gap' in mental health care. People with mental disorders do not always receive appropriate treatment due to a range of structural and individual issues, including stigma and poverty. The PRIME (Programme for Improving Mental Health Care) programme has developed a mental health care plan to address this issue in Nepal and four other low and middle income countries. This study aims to inform the development of this comprehensive care plan by investigating the perceptions of stakeholders at different levels of the care system in the district of Chitwan in southern Nepal: health professionals, lay workers and community members. It focuses specifically on issues of demand and access to care, and aims to identify barriers and potential solutions for reaching people with priority mental disorders. This qualitative study consisted of key informant interviews (33) and focus group discussions (83 participants in 9 groups) at community and health facility levels. Data were analysed using a framework analysis approach. As well as pragmatic barriers at the health facility level, mental health stigma and certain cultural norms were found to reduce access and demand for services. Respondents perceived the lack of awareness about mental health problems to be a major problem underlying this, even among those with high levels of education or status. They proposed strategies to improve awareness, such as channelling education through trusted and respected community figures, and responding to the need for openness or privacy in educational programmes, depending on the issue at hand. Adapting to local perceptions of stigmatised treatments emerged as another key strategy to improve demand. This study identifies barriers to accessing care in Nepal that reach beyond the health facility and into the social fabric of the community. Stakeholders in PRIME's integrated care plan advocate strategic awareness raising initiatives to improve the reach of integrated services in this low-income setting.

Educable Mentally Handicapped: Curriculum Guide.

ERIC Educational Resources Information Center

Alberta Dept. of Education, Edmonton.

The curriculum guide outlines objectives, strategies, and materials for developing academic, daily living, and vocational skills in educable mentally retarded students. An introductory section explains that the curriculum incorporates a community focus, parental involvement, developmental sequencing, and prescriptive teaching. Guidelines to…

The effectiveness of an integrated collaborative care model vs. a shifted outpatient collaborative care model on community functioning, residential stability, and health service use among homeless adults with mental illness: a quasi-experimental study.

PubMed

Stergiopoulos, Vicky; Schuler, Andrée; Nisenbaum, Rosane; deRuiter, Wayne; Guimond, Tim; Wasylenki, Donald; Hoch, Jeffrey S; Hwang, Stephen W; Rouleau, Katherine; Dewa, Carolyn

2015-08-28

Although a growing number of collaborative mental health care models have been developed, targeting specific populations, few studies have utilized such interventions among homeless populations. This quasi-experimental study compared the outcomes of two shelter-based collaborative mental health care models for men experiencing homelessness and mental illness: (1) an integrated multidisciplinary collaborative care (IMCC) model and (2) a less resource intensive shifted outpatient collaborative care (SOCC) model. In total 142 participants, 70 from IMCC and 72 from SOCC were enrolled and followed for 12 months. Outcome measures included community functioning, residential stability, and health service use. Multivariate regression models were used to compare study arms with respect to change in community functioning, residential stability, and health service use outcomes over time and to identify baseline demographic, clinical or homelessness variables associated with observed changes in these domains. We observed improvements in both programs over time on measures of community functioning, residential stability, hospitalizations, emergency department visits and community physician visits, with no significant differences between groups over time on these outcome measures. Our findings suggest that shelter-based collaborative mental health care models may be effective for individuals experiencing homelessness and mental illness. Future studies should seek to confirm these findings and examine the cost effectiveness of collaborative care models for this population.

Children's Mental Health in D.C.: The Mismatch between Need and Treatment. Data Snapshot

ERIC Educational Resources Information Center

DC Action for Children, 2012

2012-01-01

Child well-being is important for community and economic development in the city. Young children with strong mental health are prepared to develop crucial skills that help build the basis of a prosperous and sustainable society. When DC ensures the healthy development of members of the next generation, they will pay that back through productivity…

Assessing Students with Serious Mental Health and Behavioral Problems: Clinical Assessment for Educators.

ERIC Educational Resources Information Center

Hansen, Jo-Ida C.; Conlon, Amy L.

The current intervention trend for many of the mental health and behavioral problems faced by today's youth is an integrative approach that involves the community, families, and schools. Clinical assessment for serious mental health and behavioral problems can be an important component in the development of school-based screening programs. The…

The Texas Children's Medication Algorithm Project: Revision of the Algorithm for Pharmacotherapy of Attention-Deficit/Hyperactivity Disorder

ERIC Educational Resources Information Center

Pliszka, Steven R.; Crismon, M. Lynn; Hughes, Carroll W.; Corners, C. Keith; Emslie, Graham J.; Jensen, Peter S.; McCracken, James T.; Swanson, James M.; Lopez, Molly

2006-01-01

Objective: In 1998, the Texas Department of Mental Health and Mental Retardation developed algorithms for medication treatment of attention-deficit/hyperactivity disorder (ADHD). Advances in the psychopharmacology of ADHD and results of a feasibility study of algorithm use in community mental health centers caused the algorithm to be modified and…

Tackling community integration in mental health home visit integration in Finland.

PubMed

Raitakari, Suvi; Haahtela, Riikka; Juhila, Kirsi

2016-09-01

Integration - and its synonym inclusion - is emphasised in the western welfare states and in the European Union in particular. Integration is also a central topic in the social sciences and in current mental health and homelessness research and practice. As mental healthcare has shifted from psychiatric hospitals to the community, it has inevitably become involved with housing and integration issues. This article explores how community integration is understood and tackled in mental health floating support services (FSSs) and, more precisely, in service user-practitioner home visit interaction. The aim, through shedding light on how the idea of integration is present and discussed in front-line mental health practices, is to offer a 'template' on how we might, in a systematic and reflective way, develop community integration research and practice. The analysis is based on ethnomethodological and micro-sociological interaction research. The research settings are two FSSs located in a large Finnish city. The data contain 24 audio-recorded and transcribed home visits conducted in 2011 and 2012 with 16 different service users. The study shows how the participants in service user-practitioner interaction give meaning to community integration and make decisions about how it should (or should not) be enhanced in each individual case. This activity is called community integration work in action. Community integration work in action is based on various dimensions of integration: getting out of the house, participating in group activities and getting along with those involved in one's life and working life. Additionally, the analysis demonstrates how community integration work is accomplished by discursive devices (resistance, positioning, excuses and justifications, delicacy and advice-giving). The article concludes that community integration is about interaction: it is not only service users' individual challenge but also a social challenge, our challenge. © 2015 John Wiley & Sons Ltd.

Objective Community Integration of Mental Health Consumers Living in Supported Housing and of Others in the Community

PubMed Central

Yanos, Philip T.; Stefancic, Ana; Tsemberis, Sam

2015-01-01

Objective Housing programs for people with severe mental illnesses aim to maximize community integration. However, little is known about how the community integration of mental health consumers living in supported housing compares with that of other community residents in the socially disadvantaged communities where supported housing is often located. The purpose of this study was to examine predictors of objective community integration of mental health consumers living in supported housing and of other persons living in the same communities. Methods Participants were 124 adults (60 mental health consumers and 64 other community residents) residing in designated zip codes in the Bronx, New York. Participants were administered measures of psychiatric symptoms, substance use, physical community integration (participation in local activities), social integration (interactions with community members), and citizenship (political activism or volunteering). Results Mental health consumers living in supported independent housing had significantly lower scores on indicators of objective community integration than other community members. However, differences were relatively small. Among mental health consumers, African-American race, education, and length of time in current residence were associated with better community integration. Conclusions Findings suggest that mental health consumers living in supported housing may not achieve levels of objective community integration that are comparable with other community members; however, psychiatric factors did not account for this difference. Length of time in neighborhoods appears to be an important factor in facilitating social integration. PMID:22549530

Psychological Community Integration of Individuals With Serious Mental Illness.

PubMed

Pahwa, Rohini; Kriegel, Liat

2018-06-01

As different facets of community integration as well as psychological and social integration are important dimensions of recovery for individuals with serious mental illness (SMI). The primary aim of the study was to explore psychological integration for individuals with SMI into the mental health and mainstream (i.e., non-mental health) communities and its association with their social integration into both communities. The study used self-report and egocentric social network data from 60 individuals with SMI receiving community-based mental health services. The primary findings indicated that social integration connected to service providers was associated with psychological integration in both mental health and mainstream communities. Our data suggest that in addition to providing services, providers are doing something meaningful to impact their clients' lives well beyond mental health services. The study supports a bifurcated conceptualization of psychological integration and provides a more complex understanding of the community integration concept.

Police and mental health clinician partnership in response to mental health crisis: A qualitative study.

PubMed

McKenna, Brian; Furness, Trentham; Oakes, Jane; Brown, Steve

2015-10-01

Police officers as first responders to acute mental health crisis in the community, commonly transport people in mental health crisis to a hospital emergency department. However, emergency departments are not the optimal environments to provide assessment and care to those experiencing mental health crises. In 2012, the Northern Police and Clinician Emergency Response (NPACER) team combining police and mental health clinicians was created to reduce behavioural escalation and provide better outcomes for people with mental health needs through diversion to appropriate mental health and community services. The aim of this study was to describe the perceptions of major stakeholders on the ability of the team to reduce behavioural escalation and improve the service utilization of people in mental health crisis. Responses of a purposive sample of 17 people (carer or consumer advisors, mental health or emergency department staff, and police or ambulance officers) who had knowledge of, or had interfaced with, the NPACER were thematically analyzed after one-to-one semistructured interviews. Themes emerged about the challenge created by a stand-alone police response, with the collaborative strengths of the NPACER (communication, information sharing, and knowledge/skill development) seen as the solution. Themes on improvements in service utilization were revealed at the point of community contact, in police stations, transition through the emergency department, and admission to acute inpatient units. The NPACER enabled emergency department diversion, direct access to inpatient mental health services, reduced police officer 'down-time', improved interagency collaboration and knowledge transfer, and improvements in service utilization and transition. © 2015 Australian College of Mental Health Nurses Inc.

Islamic representation and urban space in Banda Aceh: Linking the social and spatial

NASA Astrophysics Data System (ADS)

Istiqamah; Herlily

2018-03-01

Post conflict and tsunami; the city of Banda Aceh is experiencing a massive development as an effort to represent an Islamic city. Some strategic points have been chosen by the municipality to build architectural objects that are considered to represent Islam in the urban space. The issue of such representational practice is the development of neglecting the activities of local communities as users of urban public spaces. The purpose of this design study is to provide an alternative to the urban design of Banda Aceh to represent Islam that is not moving from physical development but by involving community activities. Establish and rediscover the relationship between Islam and urban life in Banda Aceh. This design study uses mental maps of 50 inhabitants of Banda Aceh city of various ages who live in 10 villages around the city center. We use mental maps as a tool to read the daily activities of the community and determine the familiar urban territory with the community. The results of this study will be used to form a Muslim community and present community activities to represent Islam in the urban space.

Promoting Health and Behavioral Health Equity in California.

PubMed

Mishra, Meenoo; Lupi, Monica Valdes; Miller, Wm Jahmal; Nolfo, Tamu

2016-01-01

Behavioral health disparities are not usually considered part of the same system of health disparities. However, the California Department of Public Health focused its health equity strategies on reducing behavioral health disparities through its California Statewide Plan to Promote Health and Mental Health Equity. This statewide plan was developed through a community-wide stakeholder engagement and outreach process. In addition, the California Reducing Disparities Project is a prevention and early intervention effort to reduce mental health disparities in underserved populations. This strategic plan represents the voice of several racial/ethnic communities, such as African American, Asian and Pacific Islander, Latino, Native American, as well as lesbian, gay, bisexual, transgender, and queer and questioning communities in California, through 5 strategic planning workgroups. The workgroups were composed of a broad range of stakeholders, including community leaders, mental health care providers, consumer and family members, individuals with lived experience, and academia. This case example highlights the various efforts of California's Office of Health Equity in eliminating behavioral health disparities and promoting mental health equity, as well as discusses the unique statutory and regulatory role of the Office of Health Equity's deputy director.

The effect of a community mental health training program for multidisciplinary staff.

PubMed

Yang, Bing Xiang; Stone, Teresa E; Davis, Scott A

2018-06-01

Primary health workers play a critical role in providing health education to people with mental disorders. In China community health workers working with people with mental health problems lack experience and training in this area. Additionally, coordination between hospital and community staff is not well established. The aim of this study was to provide an interdisciplinary community mental health training program and to evaluate the effect of the training on staff knowledge about mental health and confidence in their roles. A three-day community mental health training program was offered specifically for interdisciplinary mental health professionals. Using a one-group pre-test post-test design, participants completed a self-assessment of mental health concepts and program evaluation which included asking participants to rate their satisfaction using a five-point Likert scale and to respond to open-ended questions. Forty-eight participants including health professionals from colleges, hospital and community health centers were recruited. Only 8.7% of participants had ever received community mental health training. Post-test evaluation demonstrated improvements in knowledge, and most participants were very satisfied with the program. The findings indicate that this brief interdisciplinary training program had a positive effect in improving knowledge about community mental health concepts and confidence in dealing with people with mental health disorders for multidisciplinary staff working in primary health care areas. Copyright © 2017 Elsevier Inc. All rights reserved.

Geographic Access to Specialty Mental Health Care Across High- and Low-Income US Communities.

PubMed

Cummings, Janet R; Allen, Lindsay; Clennon, Julie; Ji, Xu; Druss, Benjamin G

2017-05-01

With the future of the Affordable Care Act and Medicaid program unclear, it is critical to examine the geographic availability of specialty mental health treatment resources that serve low-income populations across local communities. To examine the geographic availability of community-based specialty mental health treatment resources and how these resources are distributed by community socioeconomic status. Measures of the availability of specialty mental health treatment resources were derived using national data for 31 836 zip code tabulation areas from 2013 to 2015. Analyses examined the association between community socioeconomic status (assessed by median household income quartiles) and resource availability using logistic regressions. Models controlled for zip code tabulation area-level demographic characteristics and state indicators. Dichotomous indicators for whether a zip code tabulation area had any (1) outpatient mental health treatment facility (more than nine-tenths of which offer payment arrangements for low-income populations), (2) office-based practice of mental health specialist physician(s), (3) office-based practice of nonphysician mental health professionals (eg, therapists), and (4) mental health facility or office-based practice (ie, any community-based resource). Of the 31 836 zip code tabulation areas in the study, more than four-tenths (3382 of 7959 [42.5%]) of communities in the highest income quartile (mean income, $81 207) had any community-based mental health treatment resource vs 23.1% of communities (1841 of 7959) in the lowest income quartile (mean income, $30 534) (adjusted odds ratio, 1.74; 95% CI, 1.50-2.03). When examining the distribution of mental health professionals, 25.3% of the communities (2014 of 7959) in the highest income quartile had a mental health specialist physician practice vs 8.0% (637 of 7959) of those in the lowest income quartile (adjusted odds ratio, 3.04; 95% CI, 2.53-3.66). Similarly, 35.1% of the communities (2792 of 7959) in the highest income quartile had a nonphysician mental health professional practice vs 12.9% (1029 of 7959) of those in the lowest income quartile (adjusted odds ratio, 2.77; 95%, 2.35-3.26). In contrast, outpatient mental health treatment facilities were less likely to be located in the communities in the highest vs lowest income quartiles (12.9% [1025 of 7959] vs 16.5% [1317 of 7959]; adjusted odds ratio, 0.43; 95% CI, 0.37-0.51). More than seven-tenths of the lowest income communities with any resource (71.5% [1317 of 1841]) had an outpatient mental health treatment facility. Mental health treatment facilities are more likely to be located in poorer communities, whereas office-based practices of mental health professionals are more likely to be located in higher-income communities. These findings indicate that mental health treatment facilities constitute the backbone of the specialty mental health treatment infrastructure in low-income communities. Policies are needed to support and expand available resources for this critical infrastructure.

Using systems of care to reduce incarceration of youth with serious mental illness.

PubMed

Erickson, Chris D

2012-06-01

Youth with serious mental illness come into contact with juvenile justice more than 3 times as often as other youth, obliging communities to expend substantial resources on adjudicating and incarcerating many who, with proper treatment, could remain in the community for a fraction of the cost. Incarceration is relatively ineffective at remediating behaviors associated with untreated serious mental illness and may worsen some youths' symptoms and long-term prognoses. Systems of care represent a useful model for creating systems change to reduce incarceration of these youth. This paper identifies the systemic factors that contribute to the inappropriate incarceration of youth with serious mental illness, including those who have committed non-violent offenses or were detained due to lack of available treatment. It describes the progress of on-going efforts to address this problem including wraparound and diversion programs and others utilizing elements of systems of care. The utility of systems of care principles for increasing access to community-based mental health care for youth with serious mental illness is illustrated and a number of recommendations for developing collaborations with juvenile justice to further reduce the inappropriate incarceration of these youth are offered.

Mental health promotion in a school community by using the results from the Well-being Profile: an action research project.

PubMed

Puolakka, Kristiina; Haapasalo-Pesu, Kirsi-Maria; Konu, Anne; Astedt-Kurki, Päivi; Paavilainen, Eija

2014-01-01

This article presents an action research project as a method to combine science and practical expertise in order to develop the practices of the health care system. The project aimed at developing mental health promotion in the school community in general and at finding tools for timely help when mental health is at risk. The underlying idea is that mental health is an integral part of health and by promoting general well-being it is also possible to promote and ensure mental health at school. The study was conducted in a Finnish lower secondary school of 446 pupils where the pupils are aged between 12 and 15 years. The initial survey was conducted using the School Well-being Profile, a tool developed by Anne Konu. A well-being questionnaire was used to identify the areas in need of improvement, providing the basis for planning and implementing development measures together with the local actors. The instrument proved to be a usable way of collecting feedback of the well-being of the school environment. As a result of the action research project, the school's physical conditions and social relationships improved and appropriate practices for future problem situations were set.

Cultural translation of refugee trauma: Cultural idioms of distress among Somali refugees in displacement.

PubMed

Im, Hyojin; Ferguson, Aidan; Hunter, Margaret

2017-01-01

Westernized approaches to mental health care often place limited emphasis on refugees' own experiences and cultural explanations of symptoms and distress. In order to effectively assess community mental health needs and develop interventions grounded in local needs, mental health programs need to be informed by an understanding of cultural features of mental health, including cultural idioms of distress (CIDs). The current study aims to explore CIDs among Somali refugees displaced in Kenya to understand mental health needs in cultural context and serve the community in a culturally responsive and sensitive manner. This research was conducted as a two-phase qualitative study. First, key informant interviews with Somali mental health stakeholders generated a list of 7 common Somali CIDs: buufis, buqsanaan, welwel, murug, qaracan, jinn, and waali. Typologies of each CID were further explored through four focus group interviews with Somali community members. The findings from a template analysis revealed Somali lay beliefs on how trauma and daily stressors are experienced and discussed in the form of CIDs and how each term is utilized and understood in attributing symptoms to associated causes. This study highlights the need to incorporate colloquial terms in mental health assessment and to adopt a culturally relevant framework to encourage wider utilization of services and religious/spiritual support systems.

Building a Network of Services: 1963-1971. Final Report: Greater Cleveland Mental Retardation Development Project.

ERIC Educational Resources Information Center

Buckman, Rilma Oxley

The final report documents the Greater Cleveland Mental Retardation Development Project, a 5-year demonstration project concerned with solving such problems as how a community can provide all the services and programs needed by the retarded and their families, ensure successful and appropriate employment, and staff and finance such programs.…

Developing a Curriculum for Human Service Workers. Career Education for Mental Health Workers. Occasional Paper Series, No. 6.

ERIC Educational Resources Information Center

Slater, Arthur L.; Gordon, Katherine K.

Based on an educational needs assessment, a project designed a community college curriculum to develop the competencies of human service workers for the changing mental health service delivery system. The curriculum prepares workers to meet future service needs such as pre-discharge preparation of patients, outreach, aftercare, community…

Therapeutic friendliness and the development of therapeutic leverage by mental health nurses in community rehabilitation settings.

PubMed

Gardner, Andrew

2010-01-01

In a world dominated by technology and driven by fiscal policy emphasis, the therapeutic relationship as a healing modality is still a central theme to mental health nurses (MHN) in their everyday work. This research, as part of a PhD program, used a constructivist grounded theory approach to explore the process of therapeutic relationships and professional boundaries. The current paper outlines how therapeutic friendliness provides a connection for the therapeutic relationship to develop but in doing so requires a balancing of the therapeutic relationship and constant maintenance of the professional boundary. The authors also discuss how community mental health nurses (CMHN) invest in the therapeutic relationship in order to develop a therapeutic alliance and how the alliance between the CMHN and the client facilitates the use of therapeutic leverage applied by the CMHN as part of the therapeutic process.

Rural Mental Health Ecology: A Framework for Engaging with Mental Health Social Capital in Rural Communities.

PubMed

Wilson, Rhonda L; Wilson, G Glenn; Usher, Kim

2015-09-01

The mental health of people in rural communities is influenced by the robustness of the mental health ecosystem within each community. Theoretical approaches such as social ecology and social capital are useful when applied to the practical context of promoting environmental conditions which maximise mental health helping capital to enhance resilience and reduce vulnerably as a buffer for mental illness. This paper explores the ecological conditions that affect the mental health and illness of people in rural communities. It proposes a new mental health social ecology framework that makes full use of the locally available unique social capital that is sufficiently flexible to facilitate mental health helping capital best suited to mental health service delivery for rural people in an Australian context.

Costs and Benefits of Policy-Oriented Community Research: A Case Study.

ERIC Educational Resources Information Center

Brand, Stephen; Moore, Thom

Recent developments in the social policy literature suggest a growing overlap in community and social policy interests and methods. This combination of community and policy interests is illustrated by tracing successive steps of the Illinois Residential Life Survey in order to support programming decisions about community mental health in a…

An Ecological-Transactional Understanding of Community Violence: Theoretical Perspectives.

ERIC Educational Resources Information Center

Overstreet, Stacy; Mazza, James

2003-01-01

Community violence has emerged as a major risk factor for the development of mental health problems in children and adolescents. The goal of this article is to present an ecological-transactional model of community violence as a conceptual framework for understanding the existing literature and for guiding future research on community violence…

Beasts of burden or organised cooperation: the story of a mental health team in remote, Indigenous Australia.

PubMed

Hunter, Ernest; Onnis, Leigh-Ann; Santhanam-Martin, Radhika; Skalicky, Judy; Gynther, Bruce; Dyer, Geraldine

2013-12-01

This paper aims to describe the growth of a regionally-based mental health team providing services to remote Indigenous communities in far north Queensland. By drawing on their experience, the authors are able to identify factors supporting the development and sustained capacity of integrated mental health teams, working in challenging remote settings.

A Randomized Controlled Trial of Cognitive-Behavioral Treatment for Posttraumatic Stress Disorder in Severe Mental Illness

ERIC Educational Resources Information Center

Mueser, Kim T.; Rosenberg, Stanley D.; Xie, Haiyi; Jankowski, M. Kay; Bolton, Elisa E.; Lu, Weili; Hamblen, Jessica L.; Rosenberg, Harriet J.; McHugo, Gregory J.; Wolfe, Rosemarie

2008-01-01

A cognitive-behavioral therapy (CBT) program for posttraumatic stress disorder (PTSD) was developed to address its high prevalence in persons with severe mental illness receiving treatment at community mental health centers. CBT was compared with treatment as usual (TAU) in a randomized controlled trial with 108 clients with PTSD and either major…

Reclaiming Joy: Pilot Evaluation of a Mental Health Peer Support Program for Older Adults Who Receive Medicaid

ERIC Educational Resources Information Center

Chapin, Rosemary K.; Sergeant, Julie F.; Landry, Sarah; Leedahl, Skye N.; Rachlin, Roxanne; Koenig, Terry; Graham, Annette

2013-01-01

Purpose: Stigma and lack of access to providers create barriers to mental health treatment for older adults living in the community. In order to address these barriers, we developed and evaluated a peer support intervention for older adults receiving Medicaid services. Design and Methods: Reclaiming Joy is a mental health intervention that pairs…

Mental health and social service needs for mental health service users in Japan: a cross-sectional survey of client- and staff-perceived needs.

PubMed

Miyamoto, Yuki; Hashimoto-Koichi, Rieko; Akiyama, Miki; Takamura, Soichi

2015-01-01

The appropriate utilization of community services by people with mental health difficulties is becoming increasingly important in Japan. The aim of the present study was to describe service needs, as perceived by people with mental health difficulties living in the community and their service providers. We analyzed the difference between two necessity ratings using paired data in order to determine implications related to needs assessment for mental health services. This cross-sectional study used two self-reported questionnaires, with one questionnaire administered to mental health service users living in the community and another questionnaire to staff members providing services to those users at community service facilities. The study was conducted in psychiatric social rehabilitation facilities for people with mental health difficulties in Japan. The paired client and staff responses rated needs for each kind of mental health and social service independently. The 19 services listed in the questionnaire included counseling and healthcare, housing, renting, daily living, and employment. Overall, 246 individuals with mental health difficulties were asked to participate in this study, and after excluding invalid responses, 188 client-staff response dyads (76.4% of recruited people, 83.6% of people who gave consent) were analyzed in this study. A Wilcoxon matched-pairs signed rank test was used to compare the perceived needs, and weighted and unweighted Kappa statistics were calculated to assess rating agreement within client-staff dyads. Over 75% of participants in our study, who were people with mental health difficulties living in the community, regarded each type of mental health service as "somewhat necessary," or "absolutely necessary" to live in their community. Most clients and staff rated healthcare facilities with 24/7 crisis consultation services as necessary. Agreement between client and staff ratings of perceived needs for services was low (Kappa = .02 to .26). Services regarding housing, renting a place to live, and advocacy had the same tendency in that clients perceived a higher need when compared to staff perceptions (p < .01). It is essential for the service providers to identify the services that each user needs, engage in dialogue, and involve clients in service planning and development.

Witness for Wellness: preliminary findings from a community-academic participatory research mental health initiative.

PubMed

Bluthenthal, Ricky N; Jones, Loretta; Fackler-Lowrie, Nicole; Ellison, Marcia; Booker, Theodore; Jones, Felica; McDaniel, Sharon; Moini, Moraya; Williams, Kamau R; Klap, Ruth; Koegel, Paul; Wells, Kenneth B

2006-01-01

Quality improvement programs promoting depression screening and appropriate treatment can significantly reduce racial and ethnic disparities in mental-health care and outcomes. However, promoting the adoption of quality-improvement strategies requires more than the simple knowledge of their potential benefits. To better understand depression issues in racial and ethnic minority communities and to discover, refine, and promote the adoption of evidence-based interventions in these communities, a collaborative academic-community participatory partnership was developed and introduced through a community-based depression conference. This partnership was based on the community-influenced model used by Healthy African-American Families, a community-based agency in south Los Angeles, and the Partners in Care model developed at the UCLA/RAND NIMH Health Services Research Center. The integrated model is described in this paper as well as the activities and preliminary results based on multimethod program evaluation techniques. We found that combining the two models was feasible. Significant improvements in depression identification, knowledge about treatment options, and availability of treatment providers were observed among conference participants. In addition, the conference reinforced in the participants the importance of community mobilization for addressing depression and mental health issues in the community. Although the project is relatively new and ongoing, already substantial gains in community activities in the area of depression have been observed. In addition, new applications of this integrated model are underway in the areas of diabetes and substance abuse. Continued monitoring of this project should help refine the model as well as assist in the identification of process and outcome measures for such efforts.

A balanced psychology and a full life.

PubMed Central

Seligman, Martin E P; Parks, Acacia C; Steen, Tracy

2004-01-01

Psychology since World War II has been largely devoted to repairing weakness and understanding suffering. Towards that end, we have made considerable gains. We have a classification of mental illness that allows international collaboration, and through this collaboration we have developed effective psychotherapeutic or pharmacological treatments for 14 major mental disorders. However, while building a strong science and practice of treating mental illness, we largely forgot about everyday well-being. Is the absence of mental illness and suffering sufficient to let individuals and communities flourish? Were all disabling conditions to disappear, what would make life worth living? Those committed to a science of positive psychology can draw on the effective research methods developed to understand and treat mental illness. Results from a new randomized, placebo-controlled study demonstrate that people are happier and less depressed three months after completing exercises targeting positive emotion. The ultimate goal of positive psychology is to make people happier by understanding and building positive emotion, gratification and meaning. Towards this end, we must supplement what we know about treating illness and repairing damage with knowledge about nurturing well-being in individuals and communities. PMID:15347529

Thailand mental health country profile.

PubMed

Siriwanarangsan, Porntep; Liknapichitkul, Dusit; Khandelwal, Sudhir K

2004-01-01

Thailand, a constitutional monarchy, has undergone a rapid shift in its demography and economy in last two decades. This has put a great burden on the health services, including mental health care of the country. The current emphasis of the Ministry of Public Health is to change its role from health care provider to policymaker and regulator of standards, and to provide technical support to health facilities under its jurisdiction as well as in the private sector. The Department of Mental Health, established in 1994, has laid down a mental health policy that aims to promote mental health care within the community with the help of people's participation in health programmes. Focus has been placed on developing suitable and efficient technology by seeking cooperation both within and outside the Ministry of Public Health. Consequently, the Department of Mental Health has been receiving increasing budgetary allocations. Since there is a paucity of trained manpower, the emphasis is being laid on the utilization of general health care for mental health care. Some of the specific interventions are community services, prison services, psychiatric rehabilitation, and use of media in mental health operations. There have been active efforts towards international cooperation for developing technologies for specific programmes. Private and non-governmental organizations are supported and encouraged to provide mental health care to the marginalized sections of society. Efforts have also been made by the Department of Mental Health to inspect and raise the efficiency of its operations to result in quality service.

Challenges and Opportunities for Implementing Integrated Mental Health Care: A District Level Situation Analysis from Five Low- and Middle-Income Countries

PubMed Central

Hanlon, Charlotte; Luitel, Nagendra P.; Kathree, Tasneem; Murhar, Vaibhav; Shrivasta, Sanjay; Medhin, Girmay; Ssebunnya, Joshua; Fekadu, Abebaw; Shidhaye, Rahul; Petersen, Inge; Jordans, Mark; Kigozi, Fred; Thornicroft, Graham; Patel, Vikram; Tomlinson, Mark; Lund, Crick; Breuer, Erica; De Silva, Mary; Prince, Martin

2014-01-01

Background Little is known about how to tailor implementation of mental health services in low- and middle-income countries (LMICs) to the diverse settings encountered within and between countries. In this paper we compare the baseline context, challenges and opportunities in districts in five LMICs (Ethiopia, India, Nepal, South Africa and Uganda) participating in the PRogramme for Improving Mental health carE (PRIME). The purpose was to inform development and implementation of a comprehensive district plan to integrate mental health into primary care. Methods A situation analysis tool was developed for the study, drawing on existing tools and expert consensus. Cross-sectional information obtained was largely in the public domain in all five districts. Results The PRIME study districts face substantial contextual and health system challenges many of which are common across sites. Reliable information on existing treatment coverage for mental disorders was unavailable. Particularly in the low-income countries, many health service organisational requirements for mental health care were absent, including specialist mental health professionals to support the service and reliable supplies of medication. Across all sites, community mental health literacy was low and there were no models of multi-sectoral working or collaborations with traditional or religious healers. Nonetheless health system opportunities were apparent. In each district there was potential to apply existing models of care for tuberculosis and HIV or non-communicable disorders, which have established mechanisms for detection of drop-out from care, outreach and adherence support. The extensive networks of community-based health workers and volunteers in most districts provide further opportunities to expand mental health care. Conclusions The low level of baseline health system preparedness across sites underlines that interventions at the levels of health care organisation, health facility and community will all be essential for sustainable delivery of quality mental health care integrated into primary care. PMID:24558389

Child Community Mental Health Services in Asia Pacific and Singapore’s REACH Model

PubMed Central

Lim, Choon Guan; Loh, Hannah; Renjan, Vidhya; Tan, Jason; Fung, Daniel

2017-01-01

In recent decades, there have been concerted efforts to improve mental health services for youths alongside the challenges of rising healthcare costs and increasing demand for mental health needs. One important phenomenon is the shift from traditional clinic-based care to community-based mental health services to improve accessibility to services and provide patient-centred care. In this article, we discuss the child and adolescent community mental health efforts within the Asia-Pacific region. We also discuss Singapore’s community and school-based mental health service, known as the Response, Early Intervention and Assessment in Community Mental Health (REACH). This article discusses how REACH has evolved over the years in response to the changing needs of youths in Singapore. Finally, we discuss the current challenges and future directions for youth mental health care. PMID:28984830

Using Geospatial Research Methods to Examine Resource Accessibility and Availability as it Relates to Community Participation of Individuals with Serious Mental Illnesses.

PubMed

Townley, Greg; Brusilovskiy, Eugene; Snethen, Gretchen; Salzer, Mark S

2018-03-01

Greater community participation among individuals with serious mental illnesses is associated with better psychosocial and health outcomes. Typically, studies examining community participation have utilized self-report measures and been conducted in limited settings. The introduction of methodological advances to examining community participation of individuals with serious mental illnesses has the potential to advance the science of community mental health research and invigorate the work of community psychologists in this area. This study employed an innovative geospatial approach to examine the relationship between community participation and resource accessibility (i.e., proximity) and availability (i.e., concentration) among 294 individuals utilizing community mental health services throughout the United States. Findings suggest small but significant associations between community participation and the accessibility and availability of resources needed for participation. Furthermore, findings demonstrate the importance of car access for individuals residing in both urban and non-urban settings. The methods and results presented in this study have implications for community mental health research and services and provide an illustration of ways that geospatial methodologies can be used to investigate environmental factors that impact community inclusion and participation of individuals with serious mental illnesses. © Society for Community Research and Action 2017.

Deinstitutionalization: Its Impact on Community Mental Health Centers and the Seriously Mentally Ill

ERIC Educational Resources Information Center

Kliewer, Stephen P.; McNally Melissa; Trippany, Robyn L.

2009-01-01

Deinstitutionalization has had a significant impact on the mental health system, including the client, the agency, and the counselor. For clients with serious mental illness, learning to live in a community setting poses challenges that are often difficult to overcome. Community mental health agencies must respond to these specific needs, thus…

Do socio-economic factors, elderly population size and service development factors influence the development of specialist mental health programs for older people?

PubMed

Shah, Ajit

2008-12-01

Despite the increase in the proportion of older people in the population, little is known about factors that facilitate the development of specialist mental health services for older people. The relationship between the presence of specialist mental health programs for older people and elderly population size, proportion of older people in the population, gross national domestic product (GDP), and various parameters of health funding, mental health funding and mental health service provision was examined in an ecological study using data from the World Health Organization. The presence of specialist mental health programs for older people was significantly associated with higher GDP, higher expenditure on healthcare and mental healthcare, the presence of a national mental health policy and a national mental health program, the availability of mental health care in primary care and the community, and higher density of psychiatric beds, psychiatrists, psychiatric nurses, psychologists and social workers. The challenge will be to persuade policy-makers in low and medium income countries, where the increase in the elderly population is most rapid, to develop specialist mental health services for older people.

Development of a measure of sense of community for individuals with serious mental illness residing in community settings.

PubMed

Townley, Greg; Kloos, Bret

2009-03-03

The psychological sense of community is one of the most commonly investigated constructs in community psychology. Sense of community may be particularly important for individuals with serious mental illness (SMI) because they often face societal barriers to participation in community living, including stigma and discrimination. To date, no published studies have investigated the psychometric qualities of sense of community measures among individuals with SMI. The current study tested a series of confirmatory factor analyses using the Brief Sense of Community Index (BSCI, Long & Perkins, 2003) in a sample of 416 persons with SMI living in community settings to suggest a model of sense of community for individuals with SMI and other disabilities. The resulting scale, the Brief Sense of Community Index- Disability (BSCI-D), demonstrated good model fit and construct validity. Implications are discussed for how this scale may be used in research investigating community integration and adaptive functioning in community settings.

Development of a measure of sense of community for individuals with serious mental illness residing in community settings

PubMed Central

Townley, Greg; Kloos, Bret

2008-01-01

The psychological sense of community is one of the most commonly investigated constructs in community psychology. Sense of community may be particularly important for individuals with serious mental illness (SMI) because they often face societal barriers to participation in community living, including stigma and discrimination. To date, no published studies have investigated the psychometric qualities of sense of community measures among individuals with SMI. The current study tested a series of confirmatory factor analyses using the Brief Sense of Community Index (BSCI, Long & Perkins, 2003) in a sample of 416 persons with SMI living in community settings to suggest a model of sense of community for individuals with SMI and other disabilities. The resulting scale, the Brief Sense of Community Index- Disability (BSCI-D), demonstrated good model fit and construct validity. Implications are discussed for how this scale may be used in research investigating community integration and adaptive functioning in community settings. PMID:19305637

Strengths amidst vulnerabilities: the paradox of resistance in a mining-affected community in Guatemala.

PubMed

Caxaj, C Susana; Berman, Helene; Ray, Susan L; Restoule, Jean-Paul; Varcoe, Coleen

2014-11-01

The influence of large-scale mining on the psychosocial wellbeing and mental health of diverse Indigenous communities has attracted increased attention. In previous reports, we have discussed the influence of a gold mining operation on the health of a community in the Western highlands of Guatemala. Here, we discuss the community strengths, and acts of resistance of this community, that is, community processes that promoted mental health amidst this context. Using an anti-colonial narrative methodology that incorporated participatory action research principles, we developed a research design in collaboration with community leaders and participants. Data collection involved focus groups, individual interviews and photo-sharing with 54 men and women between the ages of 18 and 67. Data analysis was guided by iterative and ongoing conversations with participants and McCormack's narrative lenses. Study findings revealed key mechanisms and sources of resistance, including a shared cultural identity, a spiritual knowing and being, 'defending our rights, defending our territory,' and, speaking truth to power. These overlapping strengths were identified by participants as key protective factors in facing challenges and adversity. Yet ultimately, these same strengths were often the most eroded or endangered due the influence of large-scale mining operations in the region. These community strengths and acts of resistance reveal important priorities for promoting mental health and wellbeing for populations impacted by large-scale mining operations. Mental health practitioners must attend to both the strengths and parallel vulnerabilities that may be occasioned by large-scale projects of this nature.

Integrating mental health into chronic care in South Africa: the development of a district mental healthcare plan

PubMed Central

Petersen, Inge; Fairall, Lara; Bhana, Arvin; Kathree, Tasneem; Selohilwe, One; Brooke-Sumner, Carrie; Faris, Gill; Breuer, Erica; Sibanyoni, Nomvula; Lund, Crick; Patel, Vikram

2016-01-01

Background In South Africa, the escalating prevalence of chronic illness and its high comorbidity with mental disorders bring to the fore the need for integrating mental health into chronic care at district level. Aims To develop a district mental healthcare plan (MHCP) in South Africa that integrates mental healthcare for depression, alcohol use disorders and schizophrenia into chronic care. Method Mixed methods using a situation analysis, qualitative key informant interviews, theory of change workshops and piloting of the plan in one health facility informed the development of the MHCP. Results Collaborative care packages for the three conditions were developed to enable integration at the organisational, facility and community levels, supported by a human resource mix and implementation tools. Potential barriers to the feasibility of implementation at scale were identified. Conclusions The plan leverages resources and systems availed by the emerging chronic care service delivery platform for the integration of mental health. This strengthens the potential for future scale up. PMID:26447176

Working atmosphere, job satisfaction and individual characteristics of community mental health professionals in integrated care.

PubMed

Goetz, Katja; Kleine-Budde, Katja; Bramesfeld, Anke; Stegbauer, Constance

2018-03-01

Working requirements of community mental healthcare professionals in integrated care are complex. There is a lack of research concerning the relation of job satisfaction, working atmosphere and individual characteristics. For the current study, a survey evaluating job satisfaction and working atmosphere of mental healthcare professionals in integrated care was performed. About 321 community mental healthcare professionals were included in the survey; the response rate was 59.5%. The professional background of community mental healthcare professionals included nursing, social work and psychology. Community mental healthcare professionals reported the highest satisfaction with colleagues and the lowest satisfaction with income. Moreover, it could be shown that more responsibility, more recognition and more variety in job tasks lead to an increase of overall job satisfaction. Healthcare for mentally ill patients in the community setting is complex and requires well-structured care with appropriate responsibilities within the team. A co-operative relationship among colleagues as well as clearly defined responsibilities seem to be the key for the job satisfaction of community mental healthcare professionals in integrated care. © 2017 John Wiley & Sons Ltd.

Rural Community Psychology: Applications and Challenges.

ERIC Educational Resources Information Center

Bailey, Bruce E.; And Others

Rural areas have fewer health services and are proportionally underrepresented in practicing mental health professionals. For community psychology to meet the needs of rural populations, new training approaches for community psychologists will need to be developed. New areas of prevention and intervention will require roles and functions different…

Treatment of Individuals with Borderline Personality Disorder Using Dialectical Behavior Therapy in a Community Mental Health Setting: Clinical Application and a Preliminary Investigation

ERIC Educational Resources Information Center

Ben-Porath, Denise D.; Peterson, Gregory A.; Smee, Jacqueline

2004-01-01

This article describes an effort to implement and examine dialectical behavior therapy's (DBT) effectiveness in a community mental health setting. Modifications made to address unique aspects of community mental health settings are described. Barriers encountered in implementation of DBT treatment in community mental health settings, such as staff…

Epidemiological study of mental morbidity in an urban slum community in India for the development of a community mental health programme.

PubMed

Silvanus, V; Subramanian, P

2012-03-01

A crossectional field study was carried out in an urban slum in order to assess the prevalence and nature of mental morbidity and identify stressors in the community. A face to face interview was conducted with the help of a questionnaire. The interview consisted of three sections as follows: Data identifying the informant by age, sex, marital status, education, occupation, age at marriage, number of members, children and monthly income. General Health Questionnaire (GHQ) 5- item version used as a screening instrument to assess the present mental health status of the informant and data of past illnesses in self or family and questions framed to elicit perceptions regarding mental illness, alcoholism, their causation and treatment. The subjects who scored above 2 ie 3,4,and 5 in the GHQ were requested to follow up at the Mental Health OPD and subjected to a standardized psychiatric interview by a Psychiatrist. The Diagnostic and Statistical Manual Third Revised (DSM 3 R) criteria were used for diagnosis. After the interview and examination, the appropriate treatment was instituted. A total of 443 individuals were screened. The overall prevalence rate of mental illness in the community was 61 per thousand. It is estimated that the case rate ranges from 38 to 84 per thousand within 95% confidence limits. The overall severity ranged from mild to severe morbidity. The prevalence of severe mental morbidity which includes psychosis, depressive illness, mental retardation was 22.5 per thousand. Neurosis (63.31%) especially Major Depression and Adjustment disorder, Psychosis (10.00%), Somatization disorder (6.66%) and Psychiatric symptoms secondary to physical illness were the major groups of illness. Women were found to have more mental health problems than men. The morbidity pattern also differs significantly with the gender. Neurosis was seen more among the female subjects. There was a significant association of mental health problems with low educational status, unemployment and large family size. Financial problems, marital conflicts, interpersonal conflicts and housing problems were the major stressors as perceived by the respondents. There exists significant mental health problems in the community which can be due to deleterious sociocultural factors and we recommend the integration of mental health care with general health care.

[A Long Way Home: The Current State of Care Provided by Family Caregivers and Public Health Nurses to Persons With Mental Illness in the Community].

PubMed

Huang, Yu-Chu; Wang, Yu-Hui

2015-08-01

According to Taiwan's Health and Welfare Ministry statistics, Taiwan had a total of 122,538 people who were officially registered as mentally disabled at the end of December 2013. Worldwide, schizophrenia ranks as the sixth most burdensome disease in terms of total expenditures. The present paper uses the two actual care stories of the families of mental illness patients and compares and contrasts these with the community mental illness care models used in other countries. The hospital-based psychiatric and community-based mental illness care that is practiced in Taiwan presents dilemmas and has long focused on "disease-orientated care" rather than holistic care. The gap between institutional and community mental rehabilitation services in Taiwan are examined. We recommend that policy makers create an open space for mental illness family caregivers and public health nurses to engage in dialogue in order to effectively integrate the care resources available to community mental illness patients and to break down the care barriers that currently separate community mental illness patients, family caregivers, and public health nurses.

Partnering with mental health providers: a guide for services researchers.

PubMed

Frounfelker, Rochelle L; Ben-Zeev, Dror; Kaiser, Susan M; O'Neill, Sheila; Reedy, William; Drake, Robert E

2012-10-01

There is a 20-year delay between the development of effective interventions for individuals with severe mental illness and widespread adoption in public mental health care settings. Academic-provider collaborations can shorten this gap, but establishing and maintaining partnerships entail significant challenges. This paper identifies potential barriers to academic-provider research collaborations and provides guidelines to overcome these obstacles. Authors from an academic institution and community mental health organization outline the components of their long-standing partnership, and discuss the lessons learned that were instrumental in establishing the collaborative model. Results Realistic resource allocation and training, a thorough understanding of the service model and consumer characteristics, systemic and bidirectional communication and concrete plans for post-project continuation are necessary at all project phases. A shared decision-making framework is essential for effective academic institution and community mental health agency collaborations and can facilitate long-term sustainability of novel interventions.

From tragedy to triumph: a segue to community building for children and families.

PubMed

Steves, Laura; Blevins, Ted

2005-01-01

In 2000, more than 60 nonprofit agencies, health care providers, government officials, and community advocates in Tarrant County, Texas, came together to work for systemic change in the mental health care system. The coalition, known as the Mental Health Connection, began working toward a "No Wrong Door" approach to mental health services, which required aggressive coordination between federal, private, and nonprofit resources. The result is a five- to six-year plan for implementation of a new systems of care model for children with severe emotional disturbances and their families. The Mental Health Connection also focuses on legislative advocacy to bring about necessary policy changes at the local, state, and federal levels. Finally, the coalition focuses on developing sustainable revenue streams that will allow the new systems to remain in place once the group accomplishes the initial mission of the Mental Health Connection.

The centrality of social ties to climate migration and mental health.

PubMed

Torres, Jacqueline M; Casey, Joan A

2017-07-06

Climate change-related hazards and disasters, known to adversely impact physical and mental health outcomes, are also expected to result in human migration above current levels. Environmentally-motivated migration and displacement may lead to the disruption of existing social ties, with potentially adverse consequences for mobile populations as well as their family members who remain in places of origin. We propose that the disruption of social ties is a key mechanism by which climate-related migration may negatively impact mental health, in particular. Existing social ties may provide social and material resources that buffer mental health stressors related to both prolonged and acute climate events. Preparation for such events may also strengthen these same ties and protect mental health. Communities may leverage social ties, first to mitigate climate change, and second, to adapt and rebuild post-disaster in communities of origin. Additionally, social ties can inform migration decisions and destinations. For example, scholars have found that the drought-motivated adaptive migration of West African Fulbe herders only occurred because of the long-term development of social networks between migrants and non-migrants through trade and seasonal grazing. On the other hand, social ties do not always benefit mental health. Some migrants, including those from poor regions or communities with no formal safety net, may face considerable burden to provide financial and emotional resources to family members who remain in countries of origin. In destination communities, migrants often face significant social marginalization. Therefore, policies and programs that aim to maintain ongoing social ties among migrants and their family and community members may be critically important in efforts to enhance population resilience and adaptation to climate change and to improve mental health outcomes. Several online platforms, like Refugee Start Force, serve to integrate refugees by connecting migrants directly to people and services in destination communities. These efforts may increasingly draw upon novel technologies to support and maintain social networks in the context of population mobility due to climatic and other factors.

Materialistic Thinking and Its Mental-Hygienic Implications among Students of Budapest Business School

ERIC Educational Resources Information Center

Gombás, Judit

2015-01-01

Previous research with extrinsic ("materialistic") and intrinsic ("non-materialistic") life goals suggest that intrinsic aspirations (e.g. relationships, community service, personal development) are associated with a better functioning, mentally and physically more healthy personality. In this survey 198 undergraduate students…

Anthropology, brokerage, and collaboration in the development of a Tongan public psychiatry: Local lessons for global mental health.

PubMed

Poltorak, Mike

2016-12-01

The Global Mental Health (GMH) movement has raised questions of the translatability of psychiatric concepts and the challenges of community engagement. In Tonga, the local psychiatrist Dr Puloka successfully established a publicly accessible psychiatry that has improved admission rates for serious mental illnesses and addressed some of the stigma attached to diagnosis. On the basis of historical analysis and ethnographic fieldwork with healers, doctors, and patients since 1998, this article offers an ethnographic contextualization of the development and reception of Puloka's three key interventions during the 1990s: (a) collaboration with traditional healers; (b) translation of psychiatric diagnoses into local cultural concepts; and (c) encouraging freedom of movement and legal appeal to involuntary admission. Dr Puloka's use of medical anthropological and transcultural psychiatry research informed a community-engaged brokerage between the implications of psychiatric nosologies and local needs that can address some of the challenges of the Global Mental Health movement.

Taoism and its impact on mental health of the Chinese communities.

PubMed

Yip, Kam-shing

2004-03-01

Spirituality and religious coping is an important and rapidly expanding field in recent years. For the Chinese, traditional Taoism may still have a strong impact on the mental health of Chinese people. Taoistic concepts of mental health stress the transcendence from self and secularity, the dynamic revertism of nature, integration with nature and the pursuit of the infinite. Compared with western concepts of mental health, Taoism advocates self-transcendence, integration with the Law of Nature, inaction and infinite frame of reference instead of social attainment, self-development, progressive endeavor and personal interpretation. By means of a case illustration, the writer tries to describe its impacts on help-seeking, stress and coping, and the meaning of life of a Chinese family. Its generalization to different types of Chinese communities is also discussed.

Psychiatric care in the Middle East: a "mental health supermarket" in the town of Lod.

PubMed

Shaked, Ginette; Renert, Noa; Mahuda, Israela; Strous, Rael D

2004-01-01

It is often in times of political tension and hostilities that community mental health care is neglected. We describe a novel and creative community mental health program where a combination of professional mental health workers and an innovative mental health system network combine to provide a remarkably successful and tension free mental health care arrangement in an area of high political and intergroup hostility. The system, termed the "mental health supermarket," encompasses multi-component rehabilitation, hospital liaison and interagency collaborative care. The framework succeeds in settling fears and insecurities between various communities as well as catering to a fragmented and lower income community, while introducing an element of self-determination in personal mental health care.

Urban and non-urban differences in community living and participation among individuals with serious mental illnesses.

PubMed

Townley, Greg; Brusilovskiy, Eugene; Salzer, Mark S

2017-03-01

Despite a wealth of studies examining the relationship between urbanicity (i.e., living in an urban area) and psychological distress, there is a paucity of research examining the relationship between urbanicity, community living, and community participation of adults with serious mental illnesses. This study addresses this knowledge gap by assessing urban and non-urban differences in community participation, sense of community, mental health stigma, and perceptions of the neighborhood environment among individuals with serious mental illnesses living independently throughout the United States. A total of 300 individuals with serious mental illnesses recruited from 21 outpatient mental health service organizations in 15 states completed a phone survey about their community living and participation experiences. Urbanicity was examined at two spatial scales (block group and county), and independent-samples t-tests were employed to assess urban and non-urban differences in community living and participation variables. Levels of community participation and perceptions of neighborhood quality and crime were higher in urban block groups; sense of community was higher in urban counties; and perceptions of mental health stigma were higher in non-urban counties. Results inform the methodological literature on best practices for assessing urbanicity, as well as interventions aimed at increasing community participation and improving aspects of the built and social environment that affect individuals who experience mental health distress. Copyright © 2017 Elsevier Ltd. All rights reserved.

Developing a Community-Academic Partnership to Improve Recognition and Treatment of Depression in Underserved African American and White Elders

PubMed Central

Dobransky-Fasiska, Deborah; Brown, Charlotte; Pincus, Harold A.; Nowalk, Mary P.; Wieland, Melissa; Parker, Lisa S.; Cruz, Mario; McMurray, Michelle L.; Mulsant, Benoit; Reynolds, Charles F.

2011-01-01

Objective Reducing mental health disparities among underserved populations, particularly African American elders, is an important public health priority. The authors describe the process and challenges of developing a community/academic research partnership to address these disparities. Methods The authors are using a Community-Based Participatory Research approach to gain access to underserved populations in need of depression treatment. The authors identify six stages: 1) Collaborating to Secure Funding; 2) Building a Communications Platform and Research Infrastructure; 3) Fostering Enduring Relationships; 4) Assessing Needs/Educating about Research Process; 5) Initiating Specific Collaborative Projects (meeting mutual needs/interests); and 6) Maintaining a Sustainable and Productive Partnership. Data from a needs assessment developed collaboratively by researchers and community agencies facilitated agreement on mutual research goals, while strengthening the partnership. Results A community/academic-based partnership with a solid research infrastructure has been established and maintained for 3 years. Using the results of a needs assessment, the working partnership prioritized and launched several projects. Through interviews and questionnaires, community partners identified best practices for researchers working in the community. Future research and interventional projects have been developed, including plans for sustainability that will eventually shift more responsibility from the academic institution to the community agencies. Conclusions To reach underserved populations by developing and implementing models of more effective mental health treatment, it is vital to engage community agencies offering services to this population. A successful partnership requires “cultural humility,” collaborative efforts, and the development of flexible protocols to accommodate diverse communities. PMID:20104053

Development of Mental Health Indicators in Korea

PubMed Central

Han, Hyeree; Ahn, Dong Hyun; Song, Jinhee; Hwang, Tae Yeon

2012-01-01

Objective Promoting mental health and preventing mental health problems are important tasks for international organizations and nations. Such goals entail the establishment of active information networks and effective systems and indicators to assess the mental health of populations. This being said, there is a need in Korea develop ways to measure the state of mental health in Korea. Methods This paper reviews the mental health indicator development policies and practices of seven organizations, countries, and regions: WHO, OECD, EU, United States, Australia, UK, and Scotland. Using Delphi method, we conducted two surveys of mental health indicators for experts in the field of mental health. The survey questionnaire included 5 domains: mental health status, mental health factor, mental health system, mental health service, and quality of mental health services. We considered 124 potential mental health indicators out of more than 600 from indicators of international organizations and foreign countries. Results We obtained the top 30 mental health indicators from the surveys. Among them, 10 indicators belong to the mental health system. The most important five mental health indicators are suicide rate, rate of increase in mental disorder treatment, burden caused by mental disorders, adequacy of identifying problems of mental health projects and deriving solutions, and annual prevalence of mental disorders. Conclusion Our study provides information about the process for indicator development and the use of survey results to measure the mental health status of the Korean population. The aim of mental health indicator development is to improve the mental health system by better grasping the current situation. We suggest these mental health indicators can monitor progress in efforts to implement reform policies, provide community services, and involve users, families and other stakeholders in mental health promotion, prevention, care and rehabilitation. PMID:23251193

[Status of the discussion regarding cost-effectiveness of community psychiatry and inpatient psychiatry].

PubMed

Brenner, H D

1995-01-01

In the current climate of escalating health care costs and shrinking resources, higher priority is also being given to the relation between costs and benefits of reform efforts and further developments of existing service delivery systems in the field of mental health. Some proponents of community psychiatry have predicted in a pointed manner that a change in the allocation of resources in favor of community-based care would dramatically decrease the need for hospital beds, cost half as much and be clinically at least as efficacious as inpatient treatment. The author gives careful consideration to these postulates based on today's available literature and on his own experiences in Mannheim and in Bern. He presents an array of newer findings which places them in perspective and to some extent contradicts them as well. Recent studies on the effects of an expansion of outpatient treatment programs on the overall mental health delivery system suggest that in areas with already reasonably developed community services its further enhancement rarely has an effect on the number of admissions to and length of hospital stays. In addition, the postulate that community care is considerably less costly only holds if in- and outpatient facilities are not considered to be integral parts of a comprehensive system of mental health care which both serve different purposes. Accordingly, the question of the effectiveness of treatment must also be discussed very distinctively. Although a network of well-functioning community-based services is (not yet) a veritable alternative, it can by all means, however, serve as a useful counterpart to the intensive treatment offered in modern mental institutions.(ABSTRACT TRUNCATED AT 250 WORDS)

Redesigning community mental health services for urban children: Supporting schooling to promote mental health.

PubMed

Atkins, Marc S; Shernoff, Elisa S; Frazier, Stacy L; Schoenwald, Sonja K; Cappella, Elise; Marinez-Lora, Ane; Mehta, Tara G; Lakind, Davielle; Cua, Grace; Bhaumik, Runa; Bhaumik, Dulal

2015-10-01

This study examined a school- and home-based mental health service model, Links to Learning, focused on empirical predictors of learning as primary goals for services in high-poverty urban communities. Teacher key opinion leaders were identified through sociometric surveys and trained, with mental health providers and parent advocates, on evidence-based practices to enhance children's learning. Teacher key opinion leaders and mental health providers cofacilitated professional development sessions for classroom teachers to disseminate 2 universal (Good Behavior Game, peer-assisted learning) and 2 targeted (Good News Notes, Daily Report Card) interventions. Group-based and home-based family education and support were delivered by mental health providers and parent advocates for children in kindergarten through 4th grade diagnosed with 1 or more disruptive behavior disorders. Services were Medicaid-funded through 4 social service agencies (N = 17 providers) in 7 schools (N = 136 teachers, 171 children) in a 2 (Links to Learning vs. services as usual) × 6 (pre- and posttests for 3 years) longitudinal design with random assignment of schools to conditions. Services as usual consisted of supported referral to a nearby social service agency. Mixed effects regression models indicated significant positive effects of Links to Learning on mental health service use, classroom observations of academic engagement, teacher report of academic competence and social skills, and parent report of social skills. Nonsignificant between-groups effects were found on teacher and parent report of problem behaviors, daily hassles, and curriculum-based measures. Effects were strongest for young children, girls, and children with fewer symptoms. Community mental health services targeting empirical predictors of learning can improve school and home behavior for children living in high-poverty urban communities. (c) 2015 APA, all rights reserved).

Learning and change in a community mental health setting.

PubMed

Mancini, Michael A; Miner, Craig S

2013-10-01

This article offers methodological reflections and lessons learned from a three-year university-community partnership that used participatory action research methods to develop and evaluate a model for learning and change. Communities of practice were used to facilitate the translation of recovery-oriented and evidence-based programs into everyday practice at a community mental health agency. Four lessons were drawn from this project. First, the processes of learning and organizational change are complex, slow, and multifaceted. Second, development of leaders and champions is vital to sustained implementation in an era of restricted resources. Third, it is important to have the agency's values, mission, policies, and procedures align with the principles and practices of recovery and integrated treatment. And fourth, effective learning of evidence-based practices is influenced by organizational culture and climate. These four lessons are expanded upon and situated within the broader literature and implications for future research are discussed.

Emergent Approaches to Mental Health Problems. The Century Psychology Series.

ERIC Educational Resources Information Center

Cowen, Emory L., Ed.; And Others

Innovative approaches to mental health problems are described. Conceptualizations about the following areas are outlined: psychiatry, the universe, and the community; theoretical malaise and community mental health; the relation of conceptual models to manpower needs; and mental health manpower and institutional change. Community programs and new…

Can urban regeneration programmes assist coping and recovery for people with mental illness? Suggestions from a qualitative case study.

PubMed

Whitley, Rob; Prince, Martin

2006-03-01

Researchers and policy-makers are increasingly recognizing that urban socio-environmental conditions can affect the development and course of numerous health problems. The aim of this paper is to investigate the impact an urban regeneration programme can have on everyday functioning, coping and recovery for people with a mental illness. We were also interested in discerning which component parts of the regeneration are the most important in positively affecting people with mental illness. These questions were explored through an in-depth qualitative case study of the Gospel Oak neighbourhood in London, which recently underwent an intensive urban regeneration programme. Interviews and focus groups were conducted with residents living with a mental illness (n = 16). Relevant participant observation was also conducted. Participants reported that interventions that improved community safety were by far the most important in affecting everyday coping and functioning. Interventions that improved the quantity and quality of shared community facilities had a positive, but milder effect on mental health. Component parts that appeared to have little effect included environmental landscaping and greater community involvement in decision-making processes. Most participants reported that their mental illness was a consequence of severe insults over the life-span, for example childhood neglect or family breakdown. Thus, the regeneration was seen as something that could assist coping, but not something that could significantly contribute to complete recovery. Our results thus suggest that urban regeneration can have a mild impact on people with mental illness, but this appears to be outweighed by life-span experience of severe individual-level risk factors. That said, some of our findings converge with other studies indicating that community safety and community facilities can play a role in positively affecting mental health. Further ethnographic and epidemiological research is necessary to explore these two factors.

Calmer Life: A Hybrid Effectiveness-implementation Trial for Late-life Anxiety Conducted in Low-income, Mental Health-Underserved Communities.

PubMed

Shrestha, Srijana; Wilson, Nancy; Kunik, Mark E; Wagener, Paula; Amspoker, Amber B; Barrera, Terri; Freshour, Jessica; Kraus-Schuman, Cynthia; Bavineau, Jane; Turner, Maria; Stanley, Melinda A

2017-05-01

Anxiety is common among older adults and is associated with multiple negative outcomes. Late-life anxiety is usually unrecognized by providers and undertreated, although evidence supports the effectiveness of psychosocial treatment. Access to mental health care is especially poor among African American seniors. New treatment models are needed to expand the reach of mental health care to minority elders. Our article outlines a study designed to test the effectiveness and implementation potential of Calmer Life (CL), a community-based, person-centered, flexible and culturally tailored intervention for late-life anxiety and worry, offered in low-income, mental health-underserved and predominantly African American communities. CL is skills-based, but also includes resource counseling and an option to integrate religion/spirituality. The study population includes individuals 50 years of age and older who are experiencing high levels of worry. The program was developed in the context of a community-academic partnership with organizations that provide services for seniors in underserved communities, and it trains nontraditional community providers to deliver the intervention. Study progress to date, challenges, and lessons learned are discussed. Data collection is ongoing, and study findings will be available in late 2017. CL will offer valuable information to help expand the reach of anxiety treatment among minority seniors living in underserved neighborhoods.

Incentives in financing mental health care in Austria.

PubMed

Zechmeister, Ingrid; Oesterle, August; Denk, Peter; Katschnig, Heinz

2002-09-01

In Austria, financing health care -and even more so mental health care- is characterized by a mix of federal and provincial responsibilities, lack of uniformity in service provision and service providers, and diverse funding arrangements. The division between financing structures for health care and social care makes the situation even more complex. This state of affairs results in various, partly counterproductive and sometimes paradoxical financial incentives and disincentives for the providers, recipients and financiers of mental health services. In several provinces of Austria, recent reform plans in mental health care have focused strongly on establishing community-based and patient-oriented mental health care. One of the main challenges in implementing this new policy is the re-allocation of resources. The authors hypothesize that the existing structure of mental health care financing, with its incentives and disincentives, constitutes an obstacle to patient-oriented community-based mental health care. Analyzing the characteristics of the overall mental health care financing system in one Austrian province, Lower Austria, will provide a better understanding of actor-relationships and inherent incentives and highlight implications for the process of deinstitutionalization. The authors used an analytical framework based on the principal-agent theory, empirical evidence, and information on financial, organizational and legal structures to identify the characteristics of actor-relationships and the position of single actors within the system. The article shows how incentives are linked to existing constellations of actors involved in mental health care financing and identifies significant power relations. As a consequence, incentives and disincentives within the financing system result in hospital- centered and supply-oriented mental health care in Lower Austria. The current system of financing mental health care provides an obstacle to the provision of patient-oriented and community-based mental care. This is due to existing constellations and power relations among the actors where, most importantly, patients are the weakest party in the patient-payer-provider triangle. Balancing power relations will be a significant prerequisite for alternative financing systems. IMPLICATIONS FOR HEALTH POLICIES AND FURTHER RESEARCH: If a community and needs-based mental health care system is to be established in Austria, the financing structures have to be changed accordingly. Applying a principal-agent framework is useful for identifying key aspects in mental health care financing in relation to the provision of services. Further research is needed to help develop alternative financing mechanisms that support community-based and patient-oriented mental health care systems.

Context matters: community characteristics and mental health among war-affected youth in Sierra Leone.

PubMed

Betancourt, Theresa S; McBain, Ryan; Newnham, Elizabeth A; Brennan, Robert T

2014-03-01

Worldwide, over one billion children and adolescents live in war-affected settings. At present, only limited research has investigated linkages between disrupted social ecology and adverse mental health outcomes among war-affected youth. In this study, we examine three community-level characteristics - social disorder and collective efficacy within the community, as reported by caregivers, and perceived stigma as reported by youth - in relation to externalizing behaviors and internalizing symptoms among male and female former child soldiers in postconflict Sierra Leone. A total of 243 former child soldiers (30% female, mean age at baseline: 16.6 years) and their primary caregivers participated in interviews in 2004 and 2008, as part of a larger prospective cohort study of war-affected youth in Sierra Leone. Two-point growth models were estimated to examine the relationship between community-level characteristics and externalizing and internalizing outcomes across the time points. Both social disorder within the community, reported by caregivers, and perceived stigma, reported by youth, positively covaried with youths' externalizing and internalizing scores - indicating that higher levels of each at baseline and follow-up were associated with higher levels of mental health problems at both time points (p < .05). The relationship between collective efficacy and mental health outcomes was nonsignificant (p > .05). This study offers a rare glimpse into the role that the postconflict social context plays in shaping the mental health among former child soldiers. Results indicate that both social disorder and perceived stigma within the community demonstrate an important relationship to externalizing and internalizing problems among adolescent ex-combatants. Moreover, these relationships persisted over a 4-year period of follow-up. These results underscore the importance of the postconflict social environment and the need to develop postconflict interventions that address community-level processes in addition to the needs of families and individuals. © 2013 The Authors. Journal of Child Psychology and Psychiatry © 2013 Association for Child and Adolescent Mental Health.

The patient experience in community mental health services for older people: a concept mapping approach to support the development of a new quality measure.

PubMed

Wilberforce, Mark; Batten, Eric; Challis, David; Davies, Linda; Kelly, Michael P; Roberts, Chris

2018-06-18

The patient experience is a crucial part of the measurement of service quality. However, instruments to evaluate experiential quality in the community mental health care of older adults are lacking. Before designing a new instrument, clarity is needed about what is to be measured, and how care experiences are articulated by patients. The study aimed to construct a framework to describe older patients' experience of community mental health and social care. Concept mapping blends structured qualitative data collection with quantitative analysis in a mixed method approach. Five activities were undertaken. Patients first identified sentences describing the care experience; a card-sort exercise then grouped these thematically; multidimensional analysis portrayed these data in a map of clusters; interpretation was by patient advisers; finally a new questionnaire was designed. The research involved 22 older people with mental health problems and 29 mental health practitioners, from one region of England. Sixty-seven statements were identified that described the care experience. Analysis of card sort data revealed seven clusters, which were interpreted by patient advisers to the study as: personal qualities and relationships; communication problems; feeling powerless; in-and-out care; bureaucracy; focus on life, not just mental health; and continuity of care. These themes and the component statements were used as a foundation for later work, developing a new measure of the care experience in mental health services for older people. Concept mapping has many strengths as an empirical and participant-driven means for underpinning new measurement instruments. A group of older people identified 67 candidate statements that could act as questionnaire items grouped within seven themes. Future research will establish the psychometric properties of the new measure.

A mental health first aid training program for Australian Aboriginal and Torres Strait Islander peoples: description and initial evaluation.

PubMed

Kanowski, Len G; Jorm, Anthony F; Hart, Laura M

2009-06-03

Mental Health First Aid (MHFA) training was developed in Australia to teach members of the public how to give initial help to someone developing a mental health problem or in a mental health crisis situation. However, this type of training requires adaptation for specific cultural groups in the community. This paper describes the adaptation of the program to create an Australian Aboriginal and Torres Strait Islander Mental Health First Aid (AMHFA) course and presents an initial evaluation of its uptake and acceptability. To evaluate the program, two types of data were collected: (1) quantitative data on uptake of the course (number of Instructors trained and courses subsequently run by these Instructors); (2) qualitative data on strengths, weaknesses and recommendations for the future derived from interviews with program staff and focus groups with Instructors and community participants. 199 Aboriginal people were trained as Instructors in a five day Instructor Training Course. With sufficient time following training, the majority of these Instructors subsequently ran 14-hour AMHFA courses for Aboriginal people in their community. Instructors were more likely to run courses if they had prior teaching experience and if there was post-course contact with one of the Trainers of Instructors. Analysis of qualitative data indicated that the Instructor Training Course and the AMHFA course are culturally appropriate, empowering for Aboriginal people, and provided information that was seen as highly relevant and important in assisting Aboriginal people with a mental illness. There were a number of recommendations for improvements. The AMHFA program is culturally appropriate and acceptable to Aboriginal people. Further work is needed to refine the course and to evaluate its impact on help provided to Aboriginal people with mental health problems.

The mental health consumer movement and peer providers in Israel.

PubMed

Moran, G S

2018-04-16

Self-help peer-support groups in Israel emerged in the 1980s and, over time, dynamically interacted and co-developed with the statutory mental health (MH) system. In this editorial, I outline historical milestones of how the evolution of the Israeli mental health system was influenced by the consumer movement. A brief depiction of the consumer movement history. At first, consumers operated outside of the mainstream MH system. Gradually, consumer groups and institutional personnel joined efforts towards community integration and enhancement of quality of life, pushing forward a person-centered recovery orientation. In turn, some administrators and key stakeholders in rehabilitation community services grew to value the impact of knowledge-by-experience in contemporary mental health care. In this context, over the past decade, peer roles were developed in the mental health system, including consumer-providers in community services and peer specialists in inpatient psychiatric hospitals. The insertion of peer roles into the mainstream MH system is far-reaching, including the placement of a peer-project coordinator within the ministry of health. I describe the unique contribution of peers, as experts-by-experience, to mainstream professional knowledge and practice. I also highlight the potential challenges involved when peer models of care are added to traditional medical models of care. The Israeli case demonstrates how the consumer movement can play an active role in MH systems and be acknowledged and recognised as a partner for changing policy, practice and reshaping formal institutions. In addition, they play a vital role in the development of peer-support services.

Shared decision-making in mental health care-A user perspective on decisional needs in community-based services.

PubMed

Grim, Katarina; Rosenberg, David; Svedberg, Petra; Schön, Ulla-Karin

2016-01-01

Shared decision-making (SDM) is an emergent research topic in the field of mental health care and is considered to be a central component of a recovery-oriented system. Despite the evidence suggesting the benefits of this change in the power relationship between users and practitioners, the method has not been widely implemented in clinical practice. The objective of this study was to investigate decisional and information needs among users with mental illness as a prerequisite for the development of a decision support tool aimed at supporting SDM in community-based mental health services in Sweden. Three semi-structured focus group interviews were conducted with 22 adult users with mental illness. The transcribed interviews were analyzed using a directed content analysis. This method was used to develop an in-depth understanding of the decisional process as well as to validate and conceptually extend Elwyn et al.'s model of SDM. The model Elwyn et al. have created for SDM in somatic care fits well for mental health services, both in terms of process and content. However, the results also suggest an extension of the model because decisions related to mental illness are often complex and involve a number of life domains. Issues related to social context and individual recovery point to the need for a preparation phase focused on establishing cooperation and mutual understanding as well as a clear follow-up phase that allows for feedback and adjustments to the decision-making process. The current study contributes to a deeper understanding of decisional and information needs among users of community-based mental health services that may reduce barriers to participation in decision-making. The results also shed light on attitudinal, relationship-based, and cognitive factors that are important to consider in adapting SDM in the mental health system.

Mental health consumer parents' recommendations for designing psychoeducation interventions for their minor children.

PubMed

Riebschleger, Joanne; Onaga, Esther; Tableman, Betty; Bybee, Deborah

2014-09-01

This research explores consumer parents' recommendations for developing psychoeducation programs for their minor children. Data were drawn from a purposive sample of 3 focus groups of parent consumers of a community mental health agency. The research question was: "What do consumer parents recommend for developing psychoeducation programs for their minor children?" Parents recommended content foci of mental illness, recovery, heritability, stigma, and coping. The next step is youth psychoeducation intervention development and evaluation. Parents, youth, and professionals should be included in the program planning. (PsycINFO Database Record (c) 2014 APA, all rights reserved).

Fronto-Parietal Subnetworks Flexibility Compensates For Cognitive Decline Due To Mental Fatigue.

PubMed

Taya, Fumihiko; Dimitriadis, Stavros I; Dragomir, Andrei; Lim, Julian; Sun, Yu; Wong, Kian Foong; Thakor, Nitish V; Bezerianos, Anastasios

2018-04-24

Fronto-parietal subnetworks were revealed to compensate for cognitive decline due to mental fatigue by community structure analysis. Here, we investigate changes in topology of subnetworks of resting-state fMRI networks due to mental fatigue induced by prolonged performance of a cognitively demanding task, and their associations with cognitive decline. As it is well established that brain networks have modular organization, community structure analyses can provide valuable information about mesoscale network organization and serve as a bridge between standard fMRI approaches and brain connectomics that quantify the topology of whole brain networks. We developed inter- and intramodule network metrics to quantify topological characteristics of subnetworks, based on our hypothesis that mental fatigue would impact on functional relationships of subnetworks. Functional networks were constructed with wavelet correlation and a data-driven thresholding scheme based on orthogonal minimum spanning trees, which allowed detection of communities with weak connections. A change from pre- to posttask runs was found for the intermodule density between the frontal and the temporal subnetworks. Seven inter- or intramodule network metrics, mostly at the frontal or the parietal subnetworks, showed significant predictive power of individual cognitive decline, while the network metrics for the whole network were less effective in the predictions. Our results suggest that the control-type fronto-parietal networks have a flexible topological architecture to compensate for declining cognitive ability due to mental fatigue. This community structure analysis provides valuable insight into connectivity dynamics under different cognitive states including mental fatigue. © 2018 Wiley Periodicals, Inc.

Climate change and mental health: a causal pathways framework.

PubMed

Berry, Helen Louise; Bowen, Kathryn; Kjellstrom, Tord

2010-04-01

Climate change will bring more frequent, long lasting and severe adverse weather events and these changes will affect mental health. We propose an explanatory framework to enhance consideration of how these effects may operate and to encourage debate about this important aspect of the health impacts of climate change. Literature review. Climate change may affect mental health directly by exposing people to trauma. It may also affect mental health indirectly, by affecting (1) physical health (for example, extreme heat exposure causes heat exhaustion in vulnerable people, and associated mental health consequences) and (2) community wellbeing. Within community, wellbeing is a sub-process in which climate change erodes physical environments which, in turn, damage social environments. Vulnerable people and places, especially in low-income countries, will be particularly badly affected. Different aspects of climate change may affect mental health through direct and indirect pathways, leading to serious mental health problems, possibly including increased suicide mortality. We propose that it is helpful to integrate these pathways in an explanatory framework, which may assist in developing public health policy, practice and research.

Drought and its effect on mental health--how GPs can help.

PubMed

Sartore, Gina-Maree; Kelly, Brian; Stain, Helen J

2007-12-01

Drought has been a major stressor affecting rural New South Wales communities since late 2001. While much is known about the effects on mental health of acute natural disasters, there is less research available on the effect to communities of chronic natural disasters. Of great concern for Australian rural communities is that independent of drought, the rate of suicide for some groups is higher in rural than urban communities, while access to mental health services is less. This article explores how general practitioners can identify and respond to the drought related mental health needs of farming residents. Limited availability of mental health services to rural communities increases reliance on GPs for mental health care. Residents of farming communities report experiencing substantial distress in relation to the drought. The local GP is a key source of consultation, advice and treatment. Early intervention is a critical task in improving the mental health of rural communities. Early intervention provided by GPs will be enhanced through: working closely with other community agencies to promote early effective intervention for mental health problems, improve access to advice and initial consultation, and facilitate urgent consultation when needed; increasing access to services for farmers and responding promptly to needs; and utilising the support of rural organisational workers.

The burden of mental, neurological, and substance use disorders in China and India: a systematic analysis of community representative epidemiological studies.

PubMed

Charlson, Fiona J; Baxter, Amanda J; Cheng, Hui G; Shidhaye, Rahul; Whiteford, Harvey A

2016-07-23

China and India jointly account for 38% of the world population, so understanding the burden attributed to mental, neurological, and substance use disorders within these two countries is essential. As part of the Lancet/Lancet Psychiatry China-India Mental Health Alliance Series, we aim to provide estimates of the burden of mental, neurological, and substance use disorders for China and India from the Global Burden of Disease Study 2013 (GBD 2013). In this systematic analysis for community representative epidemiological studies, we conducted systematic reviews in line with PRISMA guidelines for community representative epidemiological studies. We extracted estimates of prevalence, incidence, remission and duration, and mortality along with associated uncertainty intervals from GBD 2013. Using these data as primary inputs, DisMod-MR 2.0, a Bayesian meta-regression instrument, used a log rate and incidence-prevalence-mortality mathematical model to develop internally consistent epidemiological models. Disability-adjusted life-year (DALY) changes between 1990 and 2013 were decomposed to quantify change attributable to population growth and ageing. We projected DALYs from 2013 to 2025 for mental, neurological, and substance use disorders using United Nations population data. Around a third of global DALYs attributable to mental, neurological, and substance use disorders were found in China and India (66 million DALYs), a number greater than all developed countries combined (50 million DALYs). Disease burden profiles differed; India showed similarities with other developing countries (around 50% of DALYs attributable to non-communicable disease), whereas China more closely resembled developed countries (around 80% of DALYs attributable to non-communicable disease). The overall population growth in India explains a greater proportion of the increase in mental, neurological, and substance use disorder burden from 1990 to 2013 (44%) than in China (20%). The burden of mental, neurological, and substance use disorders is estimated to increase by 10% in China and 23% in India between 2013 and 2025. The current and projected burden of mental, neurological, and substance use disorders in China and India warrants the urgent prioritisation of programmes focused on targeted prevention, early identification, and effective treatment. China Medical Board, Bill & Melinda Gates Foundation. Copyright © 2016 Elsevier Ltd. All rights reserved.

Community Engagement in a complex intervention to improve access to primary mental health care for hard-to-reach groups.

PubMed

Lamb, Jonathan; Dowrick, Christopher; Burroughs, Heather; Beatty, Susan; Edwards, Suzanne; Bristow, Kate; Clarke, Pam; Hammond, Jonathan; Waheed, Waquas; Gabbay, Mark; Gask, Linda

2015-12-01

Despite the availability of effective evidence-based treatments for depression and anxiety, many 'harder-to-reach' social and patient groups experience difficulties accessing treatment. We developed a complex intervention, the AMP (Improving Access to Mental Health in Primary Care) programme, which combined community engagement (CE), tailored (individual and group) psychosocial interventions and primary care involvement. To develop and evaluate a model for community engagement component of the complex intervention. This paper focuses on the development of relationships between stakeholders, their engagement with the issue of access to mental health and with the programme through the CE model. Our evaluation draws on process data, qualitative interviews and focus groups, brought together through framework analysis to evaluate the issues and challenges encountered. A case study of the South Asian community project carried out in Longsight in Greater Manchester, United Kingdom. Complex problems require multiple local stakeholders to work in concert. Assets based approaches implicitly make demands on scarce time and resources. Community development approaches have many benefits, but perceptions of open-ended investment are a barrier. The time-limited nature of a CE intervention provides an impetus to 'do it now', allowing stakeholders to negotiate their investment over time and accommodating their wider commitments. Both tangible outcomes and recognition of process benefits were vital in maintaining involvement. CE interventions can play a key role in improving accessibility and acceptability by engaging patients, the public and practitioners in research and in the local service ecology. © 2014 John Wiley & Sons Ltd.

Implementation of a mental health medication management intervention in Australian community pharmacies: Facilitators and challenges.

PubMed

Hattingh, H Laetitia; Kelly, Fiona; Fowler, Jane; Wheeler, Amanda J

Community pharmacists are in an ideal position to promote and provide mental health medication management services. However, formalised or structured pharmacy services to support consumers with mental health conditions are scarce. Australian mental health consumers indicated a need for targeted community pharmacy mental health services which presented an opportunity to develop an intervention that were integrated with remunerated professional services. The study aimed to pilot a mental health medication management intervention in Australian community pharmacies. Pharmacists worked in partnership with consumers, carers and mental health workers over three to six months to set and support achievement of individual goals related to medicines use, physical health and mental wellbeing. This paper provides a comparison of community pharmacies that successfully delivered the intervention with those that did not and identifies facilitators and challenges to service implementation. One hundred pharmacies opted to pilot the delivery of the intervention in three Australian states (Queensland, Western Australia and northern New South Wales). Of those, 55 successfully delivered the intervention (completers) whilst 45 were unsuccessful (non-completers). A mixed methods approach, including quantitative pharmacy surveys and qualitative semi-structured interviews, was used to gather data from participating pharmacies. Following intervention development, 142 pharmacists and 21 pharmacy support staff attended training workshops, received resource kits and ongoing support from consumer and pharmacist mentors throughout intervention implementation. Baseline quantitative data was collected from each pharmacy on staff profile, volume of medicines dispensed, the range of professional services delivered and relationships with health professionals. At the completion of the study participants were invited to complete an online exit survey and take part in a semi-structured interview that explored their experiences of intervention implementation and delivery. Twenty-nine staff members from completer pharmacies returned exit surveys and interviews were conducted with 30 staff from completer and non-completer pharmacies. Descriptive analyses of quantitative data and thematic analyses of qualitative data were used to compare completers and non-completers. Baseline similarities included numbers of general and mental health prescriptions dispensed and established professional services. However, there was greater prevalence of diabetes management, opioid substitution services, and relationships with mental health services in completer pharmacies. Key facilitators for completers included pharmacy owner/manager support, staff buy-in and involvement, intervention flexibility, recruitment immediately following training, integration of intervention with existing services, changes to workflow, and regular consumer contact. Key barriers for both groups included lack of pharmacy owner/manager support or staff buy-in, time constraints, privacy limitations and pilot project associated paperwork. Insights into factors that underpinned successful intervention implementation and delivery should inform effective strategies for similar future studies and allocation of pharmacy mental health service delivery resources. Copyright © 2017 Elsevier Inc. All rights reserved.

Mental Health Services in a Rural Area: The Integrated Relationship between State Hospital and Community Mental Health Centers. Notes from the Field.

ERIC Educational Resources Information Center

Bittle, Ronald G.

1988-01-01

Describes "linkage agreement" system between Illinois community mental health centers and Anna Mental Health and Developmental Center serving 28 rural counties. Agreements specify responsibilities of community centers and hospital staff regarding referrals, client treatment, and discharge. Describes improvements over previous…

Factors that influence Asian communities' access to mental health care.

PubMed

Wynaden, Dianne; Chapman, Rose; Orb, Angelica; McGowan, Sunita; Zeeman, Zenith; Yeak, SiewHo

2005-06-01

This paper presents the findings of a qualitative study to identify factors that influence Asian communities' access to mental health care and how mental health care is delivered to them. Semistructured interviews were completed with Asian community members/leaders and health-care professionals. Content analysis identified major themes. Participants also completed a demographic data sheet. The research aimed to provide health professionals with an increased understanding of the values and beliefs held by people from Asian communities regarding the cause and treatment of mental illness. Data analysis identified six main themes that influenced Asian communities' access to mental health care and how mental health care is delivered to them. They were: shame and stigma; causes of mental illness; family reputation; hiding up; seeking help; and lack of collaboration. The findings highlighted that people from Asian communities are unwilling to access help from mainstream services because of their beliefs, and that stigma and shame are key factors that influence this reluctance. The findings also highlight that the mental health needs of refugee women are significant, and that they comprise a vulnerable group within Australian society.

Improving Care for Depression & Suicide Risk in Adolescents: Innovative Strategies for Bringing Treatments to Community Settings

PubMed Central

Asarnow, Joan Rosenbaum; Miranda, Jeanne

2015-01-01

This article reviews the literature on interventions and services for depression and suicide prevention among adolescents, with the goals of placing this science within the context of current changing health care environments and highlighting innovative models for improving health and mental health. We examine the: challenges and opportunities offered by new initiatives and legislation designed to transform the U.S. health and mental healthcare systems; summarize knowledge regarding the treatment of depression and suicidality/self-harm in adolescents; and describe innovative models for partnering with health systems and communities. This review demonstrates that treatment models and service delivery strategies are currently available for increasing evidence-based care, particularly for depression, and concludes with recommendations for future research and quality improvement initiatives aimed at inspiring additional efforts to put science to work, bridge science and community practice, and develop strategies for partnering with communities to improve care, mental health, and well-being among adolescents. PMID:24437432

Participatory Action Research in Public Mental Health and a School of Nursing: Qualitative Findings from an Academic-Community Partnership

PubMed Central

Mahone, Irma H.; Farrell, Sarah P.; Hinton, Ivora; Johnson, Robert; Moody, David; Rifkin, Karen; Moore, Kenneth; Becker, Marcia; Barker, Margaret

2011-01-01

Summary An academic-community partnership between a school of nursing (SON) at a public university (the University of Virginia, or UVA) and a public mental health clinic developed around a shared goal of finding an acceptable shared decision making (SDM) intervention targeting medication use by persons with serious mental illness. The planning meetings of the academic-community partnership were recorded and analyzed. Issues under the partnership process included 1) clinic values and priorities, 2) research agenda, 3) ground rules, and 4) communication. Issues under the SDM content included: 1) barriers, 2) information exchange, 3) positive aspects of shared decision making, and 4) technology. Using participatory-action research (PAR), the community clinic was able to raise questions and concerns throughout the process, be actively involved in research activities (such as identifying stakeholders and co-leading focus groups), participate in the reflective activities on the impact of SDM on practice and policy, and feel ownership of the SDM intervention. PMID:22163075

How Service Learning Addresses the Mental Health Needs of Students in Urban Schools

ERIC Educational Resources Information Center

Wilczenski, Felicia L.; Cook, Amy L.

2009-01-01

Service learning promotes social-emotional and academic development through active engagement in community activities. It empowers students to think beyond themselves and to develop a commitment to serve others. In so doing, service learning builds connections with school and community that are critically important in urban settings. This paper…

A Case for Expanded School-Community Partnerships in Support of Positive Youth Development

ERIC Educational Resources Information Center

Anderson-Butcher, Dawn; Stetler, E. Gwyn; Midle, Theresa

2006-01-01

This article discusses the results of two studies exploring the status of partnerships between schools and community organizations. In the first study, 90 teachers, administrators, and support service staff reported that the most common type of partnership involved youth development organizations, mental health providers, parents and residents,…

Stigmatization of people with mental illness among inhabitants of a rural community in northern Nigeria.

PubMed

Audu, Ishaq A; Idris, Suleiman H; Olisah, Victor O; Sheikh, Taiwo L

2013-02-01

Despite the fact that mental illness is a common problem in society, people's perception of the mentally ill and community attitude towards them is still rather poor, making their rehabilitation and reintegration into society an uphill task. To examine the stigmatization of people with mental illness within a rural community and identify the socio-demographic variables involved. A cross-sectional descriptive study using a multi-stage random sampling technique to obtain data through an interviewer-administered questionnaire to 325 adult inhabitants of a rural community in Nigeria. The results showed widespread ignorance about causation, mode of transmission and remedies available for mental illness, with only 0.9% of respondents attributing mental illness to brain disease. The others attributed it to spiritual attack, punishment for evil doing and illicit psychoactive substance use, among other things. Negative views about the mentally ill were also widely expressed resulting in discriminatory practices. Stigmatization of people with mental illness is still rampant in our community. There is a need for adequate public education about the causes and mode of transmission of mental illness and the treatment options available in the community.

Developing a logic model for youth mental health: participatory research with a refugee community in Beirut

PubMed Central

Afifi, Rema A; Makhoul, Jihad; El Hajj, Taghreed; Nakkash, Rima T

2011-01-01

Although logic models are now touted as an important component of health promotion planning, implementation and evaluation, there are few published manuscripts that describe the process of logic model development, and fewer which do so with community involvement, despite the increasing emphasis on participatory research. This paper describes a process leading to the development of a logic model for a youth mental health promotion intervention using a participatory approach in a Palestinian refugee camp in Beirut, Lebanon. First, a needs assessment, including quantitative and qualitative data collection was carried out with children, parents and teachers. The second phase was identification of a priority health issue and analysis of determinants. The final phase in the construction of the logic model involved development of an intervention. The process was iterative and resulted in a more grounded depiction of the pathways of influence informed by evidence. Constructing a logic model with community input ensured that the intervention was more relevant to community needs, feasible for implementation and more likely to be sustainable. PMID:21278370

Cultural Psychiatry: A Spotlight on the Experience of Clinical Social Workers' Encounter with Jewish Ultra-Orthodox Mental Health Clients.

PubMed

Freund, Anat; Band-Winterstein, Tova

2017-07-01

Community is a complex issue, especially in two particular populations overlap: Haredi society, which embraces cultural codes common to closed communities, and the mental health population characterized by its own unique needs. The present study explores the encounter experience of social workers with the cultural perceptions of mental health clients in the Haredi community in light of Community Cultural Psychiatry. A qualitative-phenomenological approach was adopted. In-depth semi-structured interviews were conducted with 27 social workers, mental health professionals, who are in contact with ultra-Orthodox Jewish clients. Three major themes emerged from the data analysis: (1) Exclusion vs. grace and compassion. (2) Mental health: A professional or cultural arena? (3) Mental health help-seeking changing processes. This study shows that the attitude in the Haredi community toward mental health therapy undergoes a process of change. It is important to strengthen this process, together with preserving existing community informal structures of help.

Decentralizing provision of mental health care in Sri Lanka.

PubMed

Fernando, Neil; Suveendran, Thirupathy; de Silva, Chithramalee

2017-04-01

In the past, mental health services in Sri Lanka were limited to tertiary-care institutions, resulting in a large treatment gap. Starting in 2000, significant efforts have been made to reconfigure service provision and to integrate mental health services with primary health care. This approach was supported by significant political commitment to establishing island-wide decentralized mental health care in the wake of the 2004 tsunami. Various initiatives were consolidated in The mental health policy of Sri Lanka 2005-2015, which called for implementation of a comprehensive community-based, decentralized service structure. The main objectives of the policy were to provide mental health services of good quality at primary, secondary and tertiary levels; to ensure the active involvement of communities, families and service users; to make mental health services culturally appropriate and evidence based; and to protect the human rights and dignity of all people with mental health disorders. Significant improvements have been made and new cadres of mental health workers have been introduced. Trained medical officers (mental health) now provide outpatient care, domiciliary care, mental health promotion in schools, and community mental health education. Community psychiatric nurses have also been trained and deployed to supervise treatment adherence in the home and provide mental health education to patients, their family members and the wider community. A total of 4367 mental health volunteers are supporting care and raising mental health literacy in the community. Despite these important achievements, more improvements are needed to provide more timely intervention, combat myths and stigma, and further decentralize care provision. These, and other challenges, will be targeted in the new mental health policy for 2017-2026.

Depression, a Hidden Mental Health Disparity in an Asian Indian Immigrant Community.

PubMed

Roberts, Lisa R; Mann, Semran K; Montgomery, Susanne B

2015-12-23

Cultural influences are deeply rooted, and continue to affect the lives of Asian-Indian (AI) immigrants living in Western culture. Emerging literature suggests the powerful nature of traditions and culture on the lives, mental and physical health of AI immigrants, particularly women. The purpose of this study was to explore depression among AI women in Central California (CC). This mixed-methods research was conducted in collaboration with the CC Punjabi community and the support of local religious leaders. All interviews were conducted in Punjabi and English. Whenever possible we utilized validated scales aligned with emerging themes from the qualitative data, which also provided contextualization to survey responses. In all we conducted 11 key informant interviews, four focus groups (n = 47) and a rigorously developed anonymous survey (n = 350). Social dynamics and traditional expectations including gendered roles significantly affected mental health among women participants. Subgroups along the lines of language choice (Punjabi vs. English) experience and report depression differently in part due to the highly stigmatized nature of mental health issues in this model minority community. The findings of this study highlight the importance of utilizing mixed methods to access hard to reach populations regarding sensitive topics such as mental health.

Depression, a Hidden Mental Health Disparity in an Asian Indian Immigrant Community

PubMed Central

Roberts, Lisa R.; Mann, Semran K.; Montgomery, Susanne B.

2015-01-01

Cultural influences are deeply rooted, and continue to affect the lives of Asian-Indian (AI) immigrants living in Western culture. Emerging literature suggests the powerful nature of traditions and culture on the lives, mental and physical health of AI immigrants, particularly women. The purpose of this study was to explore depression among AI women in Central California (CC). This mixed-methods research was conducted in collaboration with the CC Punjabi community and the support of local religious leaders. All interviews were conducted in Punjabi and English. Whenever possible we utilized validated scales aligned with emerging themes from the qualitative data, which also provided contextualization to survey responses. In all we conducted 11 key informant interviews, four focus groups (n = 47) and a rigorously developed anonymous survey (n = 350). Social dynamics and traditional expectations including gendered roles significantly affected mental health among women participants. Subgroups along the lines of language choice (Punjabi vs. English) experience and report depression differently in part due to the highly stigmatized nature of mental health issues in this model minority community. The findings of this study highlight the importance of utilizing mixed methods to access hard to reach populations regarding sensitive topics such as mental health. PMID:26703654

Collaborating With an Urban Community to Develop an HIV and AIDS Prevention Program for Black Youth and Families

ERIC Educational Resources Information Center

Baptiste, Donna R.; Paikoff, Roberta L.; McKay, Mary McKernan; Madison-Boyd, Sybil; Coleman, Doris; Bell, Carl

2005-01-01

This article describes a collaboration between academic researchers and residents of a low-income, inner-city community to develop and deliver an HIV and AIDS prevention program for Black youth. The Chicago HIV Prevention and Adolescent Mental Health Project (CHAMP) Program was developed and implemented to decrease HIV and AIDS risk exposure among…

Miniconsultation on the Mental and Physical Health Problems of Black Women.

ERIC Educational Resources Information Center

Black Women's Community Development Foundation, Inc., Washington, DC.

The Black Women's Community Development Foundation (BWCDF) examined the mental and physical health issues confronting black women. BWCDF chose to examine these issues through a "miniconsultation," a gathering of some 60 health care professionals, sociologists, educators and others who for two days comprehensively shared their…

Organizational Growth and Change: The Life Cycle of a Community Mental Health Center.

ERIC Educational Resources Information Center

Messal, Judith L.

1980-01-01

Organizations go through life cycles that affect their behavior. Growth models often relate to leadership. In a study of one mental health center's development, growth is related to funding. If funding remains diversified and productivity is kept high, growth of a mature organization remains manageable. (JAC)

Roles of community helpers in using the Medicare Part D benefit

PubMed Central

Hensley, Melissa A.

2013-01-01

Objectives To examine the experiences of low-income Part D beneficiaries with mental illness and their use of community helpers to access prescription medicines. Methods Individual semi-structured interviews were conducted with 26 Medicare beneficiaries with mental illness in community settings. The transcripts were analyzed for content related to community help-seeking and attitudes toward family and professional helpers. Results Medicare Part D beneficiaries with mental illness used the assistance of community helpers extensively. Pharmacists, nurses, community mental health case managers, and family members assisted beneficiaries with understanding their benefit plans and interpreting paperwork from plans and government agencies. Community helpers also assisted with tasks related to medication adherence. Mental health consumers appreciated the help that they received from family members and professionals. Conclusion This group of Medicare beneficiaries would have experienced difficulty in using their benefits and obtaining their medication without considerable help from professionals and family members in the community. PMID:21317520

Exploring an increased role for Australian community pharmacy in mental health professional service delivery: evaluation of the literature.

PubMed

Hattingh, H Laetitia; Scahill, Shane; Fowler, Jane L; Wheeler, Amanda J

2016-12-01

Australian general practitioners primarily treat mental health problems by prescribing medication dispensed by community pharmacists. Pharmacists therefore have regular interactions with mental health consumers and carers. This narrative review explored the potential role of community pharmacy in mental health services. Medline, CINAHL, ProQuest, Emerald, PsycINFO, Science Direct, PubMed, Web of Knowledge and IPA were utilised. The Cochrane Library as well as grey literature and "lay" search engines such as GoogleScholar were also searched. Four systematic reviews and ten community pharmacy randomised controlled trials were identified. Various relevant reviews outlining the impact of community pharmacy based disease state or medicines management services were also identified. International studies involving professional service interventions for mental health consumers could be contextualised for the Australian setting. Australian studies of pharmacy professional services for chronic physical health conditions provided further guidance for the expansion of community pharmacy mental health professional services.

A review of protective factors and causal mechanisms that enhance the mental health of Indigenous Circumpolar youth.

PubMed

MacDonald, Joanna Petrasek; Ford, James D; Willox, Ashlee Cunsolo; Ross, Nancy A

2013-12-09

To review the protective factors and causal mechanisms which promote and enhance Indigenous youth mental health in the Circumpolar North. A systematic literature review of peer-reviewed English-language research was conducted to systematically examine the protective factors and causal mechanisms which promote and enhance Indigenous youth mental health in the Circumpolar North. This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, with elements of a realist review. From 160 records identified in the initial search of 3 databases, 15 met the inclusion criteria and were retained for full review. Data were extracted using a codebook to organize and synthesize relevant information from the articles. More than 40 protective factors at the individual, family, and community levels were identified as enhancing Indigenous youth mental health. These included practicing and holding traditional knowledge and skills, the desire to be useful and to contribute meaningfully to one's community, having positive role models, and believing in one's self. Broadly, protective factors at the family and community levels were identified as positively creating and impacting one's social environment, which interacts with factors at the individual level to enhance resilience. An emphasis on the roles of cultural and land-based activities, history, and language, as well as on the importance of social and family supports, also emerged throughout the literature. More than 40 protective factors at the individual, family, and community levels were identified as enhancing Indigenous youth mental health. These included practicing and holding traditional knowledge and skills, the desire to be useful and to contribute meaningfully to one's community, having positive role models, and believing in one's self. Broadly, protective factors at the family and community levels were identified as positively creating and impacting one's social environment, which interacts with factors at the individual level to enhance resilience. An emphasis on the roles of cultural and land-based activities, history, and language, as well as on the importance of social and family supports, also emerged throughout the literature. Healthy communities and families foster and support youth who are resilient to mental health challenges and able to adapt and cope with multiple stressors, be they social, economic, or environmental. Creating opportunities and environments where youth can successfully navigate challenges and enhance their resilience can in turn contribute to fostering healthy Circumpolar communities. Looking at the role of new social media in the way youth communicate and interact is one way of understanding how to create such opportunities. Youth perspectives of mental health programmes are crucial to developing appropriate mental health support and meaningful engagement of youth can inform locally appropriate and culturally relevant mental health resources, programmes and community resilience strategies.

A review of protective factors and causal mechanisms that enhance the mental health of Indigenous Circumpolar youth

PubMed Central

MacDonald, Joanna Petrasek; Ford, James D.; Willox, Ashlee Cunsolo; Ross, Nancy A.

2013-01-01

Objectives To review the protective factors and causal mechanisms which promote and enhance Indigenous youth mental health in the Circumpolar North. Study design A systematic literature review of peer-reviewed English-language research was conducted to systematically examine the protective factors and causal mechanisms which promote and enhance Indigenous youth mental health in the Circumpolar North. Methods This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, with elements of a realist review. From 160 records identified in the initial search of 3 databases, 15 met the inclusion criteria and were retained for full review. Data were extracted using a codebook to organize and synthesize relevant information from the articles. Results More than 40 protective factors at the individual, family, and community levels were identified as enhancing Indigenous youth mental health. These included practicing and holding traditional knowledge and skills, the desire to be useful and to contribute meaningfully to one's community, having positive role models, and believing in one's self. Broadly, protective factors at the family and community levels were identified as positively creating and impacting one's social environment, which interacts with factors at the individual level to enhance resilience. An emphasis on the roles of cultural and land-based activities, history, and language, as well as on the importance of social and family supports, also emerged throughout the literature. More than 40 protective factors at the individual, family, and community levels were identified as enhancing Indigenous youth mental health. These included practicing and holding traditional knowledge and skills, the desire to be useful and to contribute meaningfully to one's community, having positive role models, and believing in one's self. Broadly, protective factors at the family and community levels were identified as positively creating and impacting one's social environment, which interacts with factors at the individual level to enhance resilience. An emphasis on the roles of cultural and land-based activities, history, and language, as well as on the importance of social and family supports, also emerged throughout the literature. Conclusions Healthy communities and families foster and support youth who are resilient to mental health challenges and able to adapt and cope with multiple stressors, be they social, economic, or environmental. Creating opportunities and environments where youth can successfully navigate challenges and enhance their resilience can in turn contribute to fostering healthy Circumpolar communities. Looking at the role of new social media in the way youth communicate and interact is one way of understanding how to create such opportunities. Youth perspectives of mental health programmes are crucial to developing appropriate mental health support and meaningful engagement of youth can inform locally appropriate and culturally relevant mental health resources, programmes and community resilience strategies. PMID:24350066

Mental health and addictions capacity building for community health centres in Ontario.

PubMed

Khenti, Akwatu; Thomas, Fiona C; Mohamoud, Sirad; Diaz, Pablo; Vaccarino, Oriana; Dunbar, Kate; Sapag, Jaime C

2017-10-01

In recent years, there has been increased recognition in Canada of the need to strengthen mental health services in primary health care (PHC). Collaborative models, including partnerships between PHC and specialized mental health care providers, have emerged as effective ways for improving access to mental health care and strengthening clinical capacity. Primary health care physicians and other health professionals are well positioned to facilitate the early detection of mental disorders and provide appropriate treatment and follow-up care, helping to tackle stigma toward mental health problems in the process. This 4-year mental health and addiction capacity-building initiative for PHC addressed competency needs at the individual, interprofessional, and organizational levels. The program included 5 key components: a needs assessment; interprofessional education; mentoring; development of organizational mental health and addiction action plans for each participating community health centre; and creation of an advanced resource manual to support holistic and culturally competent collaborative mental health care. A comprehensive evaluation framework using a mixed-methods approach was applied from the initiation of the program. A total of 184 health workers in 10 community health centres in Ontario participated in the program, including physicians, nurses, social workers, and administrative staff. Evaluation findings demonstrated high satisfaction with the training, improved competencies, and individual behavioural and organizational changes. By building capacity to integrate holistic and culturally appropriate care, this competency-based program is a promising model with strong potential to be adapted and scaled up for PHC organizations nationally and internationally. Copyright© the College of Family Physicians of Canada.

Transformational leadership moderates the relationship between emotional exhaustion and turnover intention among community mental health providers.

PubMed

Green, Amy E; Miller, Elizabeth A; Aarons, Gregory A

2013-08-01

Public sector mental health care providers are at high risk for burnout and emotional exhaustion which negatively affect job performance and client satisfaction with services. Few studies have examined ways to reduce these associations, but transformational leadership may have a positive effect. We examine the relationships between transformational leadership, emotional exhaustion, and turnover intention in a sample of 388 community mental health providers. Emotional exhaustion was positively related to turnover intention, and transformational leadership was negatively related to both emotional exhaustion and turnover intention. Transformational leadership moderated the relationship between emotional exhaustion and turnover intention, indicating that having a transformational leader may buffer the effects of providers' emotional exhaustion on turnover intention. Investing in transformational leadership development for supervisors could reduce emotional exhaustion and turnover among public sector mental health providers.

Transformational Leadership Moderates the Relationship between Emotional Exhaustion and Turnover Intention among Community Mental Health Providers

PubMed Central

Green, Amy E.; Miller, Elizabeth A.; Aarons, Gregory A.

2014-01-01

Public sector mental health care providers are at high risk for burnout and emotional exhaustion which negatively affect job performance and client satisfaction with services. Few studies have examined ways to reduce these associations, but transformational leadership may have a positive effect. We examine the relationships between transformational leadership, emotional exhaustion, and turnover intention in a sample of 388 community mental health providers. Emotional exhaustion was positively related to turnover intention, and transformational leadership was negatively related to both emotional exhaustion and turnover intention. Transformational leadership moderated the relationship between emotional exhaustion and turnover intention, indicating that having a transformational leader may buffer the effects of providers’ emotional exhaustion on turnover intention. Investing in transformational leadership development for supervisors could reduce emotional exhaustion and turnover among public sector mental health providers. PMID:22052429

A Sexual Assault Primary Prevention Model with Diverse Urban Youth

ERIC Educational Resources Information Center

Smothers, Melissa Kraemer; Smothers, D. Brian

2011-01-01

In this study, a nonprofit community mental health clinic developed a socioecological model of sexual abuse prevention that was implemented in a public school. The goal of the program was to promote and create community change within individuals and the school community by reducing tolerance of sexual violence and sexual harassment. Participants…

Community Residences for Mentally Retarded People: A Study of Seven Community Residences.

ERIC Educational Resources Information Center

Wehbring, Kurt; Ogren, Ciele

The report describes the distinctive characteristics and styles of seven community residences for retarded children or adults and provides a comparative analysis with emphasis on common themes of successful group homes. The homes are compared in terms of original initiation of the residence; the development of the residence; operations (such as…

Does social capital reduce child behavior problems? Results from the Great East Japan Earthquake follow-up for Children Study.

PubMed

Yagi, Junko; Fujiwara, Takeo; Yambe, Takehito; Okuyama, Makiko; Kawachi, Ichiro; Sakai, Akio

2016-08-01

We sought to investigate the association between social capital and child behavior problems in Iwate prefecture, Japan, in the aftermath of the 2011 Great East Japan Earthquake. Children and their caregivers were recruited from four nursery schools in coastal areas affected by the tsunami, as well as one in an unaffected inland area (N = 94). We assessed the following via caregiver questionnaire: perceptions of social capital in the community, child behavior problems (Child Behavior Checklist, Strength and Difficulty Questionnaire), post-traumatic stress disorder (PTSD) symptoms, child's exposure to trauma (e.g. loss of family members), and caregiver's mental health (Impact of Event Scale-R for PTSD symptoms; K6 for general mental health). We collected details on trauma exposure by interviewing child participants. Structural equation modeling was used to assess whether the association between social capital and child behavior problems was mediated by caregiver's mental health status. Children of caregivers who perceived higher community social capital (trust and mutual aid) showed fewer PTSD symptoms. Furthermore, caregiver's mental health mediated the association between social trust and child PTSD symptoms. Social capital had no direct impact on child behavior problems. Community social capital was indirectly associated (via caregiver mental health status) with child behavior problems following exposure to disaster. Community development to boost social capital among caregivers may help to prevent child behavior problems.

Research and organizational issues for the implementation of family work in community psychiatric services.

PubMed

Jones, Adrian; Scannell, Tony

2002-04-01

The need for evidence-based practice (EBP) to guide and develop mental health services remains fundamental for modern services. Aim. To discuss issues that impact upon implementation of EBP and practice development using family work (FW) as an example. A selection of the FW literature was reviewed drawing on sources including the Cochrane Library, Cinahl and Medline. Keywords used were FW, community mental health team and research design. Centralized policy initiatives and guidelines that are themselves guided by evidence of randomized controlled trials predominantly risk alienating practitioners and clients/carers. Family work has some demonstrable clinical benefits although models differ and the active therapeutic agent remains unclear. Its adoption into routine care is also hindered by a productivity management outlook that seeks to maximize stretched resources and whose values are likely to be internalized by practitioners. The dichotomous position of previous research and practice development make implementation of EBP difficult and highlights the need for strategic planning that embraces both factors. The current drive to increase EBP requires a bi-directional process of influence that allows individual practitioners and clients/carers to become producers of evidence and not simply recipients. The authors support wider adoption of case study research designs to reflect the unpredictable nature of mental health care. Adoption of assertive community treatment models within community services is most likely to promote the excellence management model and accommodate EBP such as FW.

Establishing evidence-informed core intervention competencies in psychological first aid for public health personnel.

PubMed

Parker, Cindy L; Everly, George S; Barnett, Daniel J; Links, Jonathan M

2006-01-01

A full-scale public health response to disasters must attend to both the physical and mental health needs of affected communities. Public health preparedness efforts can be greatly expanded to address the latter set of needs, particularly in light of the high ratio of psychological to physical casualties that often rapidly overwhelms existing mental health response resources in a large-scale emergency. Psychological first aid--the provision of basic psychological care in the short term aftermath of a traumatic event--is a mental health response skill set that public health personnel can readily acquire with proper training. The application of psychological first aid by public health workers can significantly augment front-line community-based mental health responses during the crisis phase of an event. To help achieve this augmented response, we have developed a set of psychological first aid intervention competencies for public health personnel. These competencies, empirically grounded and based on best practice models and consensus statements from leading mental health organizations, represent a necessary step for developing a public health workforce that can better respond to the psychological needs of impacted populations in disasters.

Ethical issues in perinatal mental health research.

PubMed

Brandon, Anna R; Shivakumar, Geetha; Lee, Simon Craddock; Inrig, Stephen J; Sadler, John Z

2009-11-01

To review the background of current ethical standards for the conduct of perinatal mental health research and describe the ethical challenges in this research domain. Current literature reflects a growing sentiment in the scientific community that having no information regarding the impact of psychiatric treatment on the mother and developing fetus/infant poses dangers that may exceed the risks involved in research. However, without sufficient consensus across the scientific community, both regulatory bodies and perinatal researchers find themselves without a framework for decision making that satisfactorily limits the risks and facilitates the benefits of participation of pregnant and lactating women in clinical research. Psychiatric research in perinatal mental health is critically important as it enables clinicians and patients to participate in informed decision-making concerning treatment for psychiatric disorders. Specific areas of concern include fetal safety, maternal risk, the therapeutic misconception, commercial interests, forensic/legal issues, the informed consent process, and study design. Developing guidelines that address ethical challenges and include the views and concerns of multiple stakeholders could improve the access of perinatal women to the benefits of participation in mental health research in addition to providing evidence-based mental healthcare for this subpopulation.

Generational attitudes of rural mental health nurses.

PubMed

Crowther, Andrew; Kemp, Michael

2009-04-01

To determine how attitudes of rural mental health nurses differ across generations. Survey. Mental health services in rural New South Wales. Practising mental health nurses. Survey responses. Survey response rate 44%. A total of 89 mental health nurses, clustered in inpatient units and community health centres, responded. Of these nurses, 4 were veterans, 52 baby boomers, 17 Generation X and 5 Generation Y. There are significant differences in how mental health nurses from different generations view their work, and in what is expected from managers. Managers need to modify traditional working styles, allowing greater flexibility of employment. They must also accept lower staff retention rates, and facilitate the development of younger staff.

Defining effective community support for long-term psychiatric patients according to behavioural principles.

PubMed

Evans, I M; Moltzen, N L

2000-08-01

The purpose of this article is to define the characteristics of effective support in community mental health settings for patients with serious and persistent mental illness. A broad literature providing empirical evidence on competent caregiver behaviours and styles is selectively reviewed. Relevant findings from family caregiver research and studies of social environments that enhance skill development in people with intellectual disabilities are incorporated, within a cognitive-behavioural framework. Six important domains are identified which represent positive caregiver styles: acceptance, creating a positive atmosphere, expectations of change, responsiveness, normalisation and educativeness. The characteristics hypothesised to be critical for caregivers and support workers are defined in a general way that can allow for individualisation according to the goals of the programs and the cultural priorities of staff and patients. Further empirical validation of these characteristics would enable community mental health services to provide more specialised clinical treatments.

Development and pilot testing of a mental healthcare plan in Nepal

PubMed Central

Jordans, M. J. D.; Luitel, N. P.; Pokhrel, P.; Patel, V.

2016-01-01

Background Mental health service delivery models that are grounded in the local context are needed to address the substantial treatment gap in low- and middle-income countries. Aims To present the development, and content, of a mental healthcare plan (MHCP) in Nepal and assess initial feasibility. Method A mixed methods formative study was conducted. Routine monitoring and evaluation data, including client flow and reports of satisfaction, were obtained from patients (n = 135) during the pilot-testing phase in two health facilities. Results The resulting MHCP consists of 12 packages, divided over community, health facility and organisation platforms. Service implementation data support the real-life applicability of the MHCP, with reasonable treatment uptake. Key barriers were identified and addressed, namely dissatisfaction with privacy, perceived burden among health workers and high drop-out rates. Conclusions The MHCP follows a collaborative care model encompassing community and primary healthcare interventions. PMID:26447173

It's a goal!: Basing a community psychiatric nursing service in a local football stadium.

PubMed

Pringle, Alan; Sayers, Pete

2004-09-01

This paper describes the development of a community mental health project in a local football stadium. Funded for three years by the Laureus Foundation's 'Sport for Good' initiative, the project provides mental health promotion and mental health awareness input targeted initially at young men, a group who are often very difficult to engage in this type work. Using group interventions and utilising football as a metaphor, the project helps young men address issues around depression, self-esteem and inclusion, and addresses the subject of suicide which remains the second biggest cause of death in young men in Britain. The paper describes the development of the project, the structure of the groups and the evaluation of the first two groups to complete the process. The work takes place in the Moss Rose stadium, home of Macclesfield Town, a team in the English Football League.

Development and pilot testing of a mental healthcare plan in Nepal.

PubMed

Jordans, M J D; Luitel, N P; Pokhrel, P; Patel, V

2016-01-01

Mental health service delivery models that are grounded in the local context are needed to address the substantial treatment gap in low- and middle-income countries. To present the development, and content, of a mental healthcare plan (MHCP) in Nepal and assess initial feasibility. A mixed methods formative study was conducted. Routine monitoring and evaluation data, including client flow and reports of satisfaction, were obtained from patients (n = 135) during the pilot-testing phase in two health facilities. The resulting MHCP consists of 12 packages, divided over community, health facility and organisation platforms. Service implementation data support the real-life applicability of the MHCP, with reasonable treatment uptake. Key barriers were identified and addressed, namely dissatisfaction with privacy, perceived burden among health workers and high drop-out rates. The MHCP follows a collaborative care model encompassing community and primary healthcare interventions. © The Royal College of Psychiatrists 2016.

Setting Up a Mental Health Clinic in the Heart of Rural Africa.

PubMed

Enow, Humphrey; Thalitaya, Madhusudan Deepak; Mbatia, Wallace; Kirpekar, Sheetal

2015-09-01

The World Health Organization defines health as a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity (WHO 1948). In Africa, mental health issues often come last on the list of priorities for policy-makers & people's attitudes towards mental illness are strongly influenced by traditional beliefs in supernatural causes/remedies. The massive burden attributed to mental illness in these communities, poses a huge moral, cultural/economic challenge and requires a concerted and integrated approach involving policy makers, mental health Practitioners, the general public, service users and their families and other stake holders to reverse the trend. Improving community awareness of mental illness. Change the negative perception of mental illness by the community. Providing a screening/referral pathway for mental illnesses. Providing supervision of patient care. Promote community participation on issues regarding mental health with a view to challenge existing traditional attitudes and beliefs, reduce stigma and promote health seeking behaviour.

Individual- and community-level determinants of Inuit youth mental wellness.

PubMed

Gray, Andrew Paul; Richer, Faisca; Harper, Sam

2016-10-20

Following the onset of intensive colonial intervention and rapid social change in the lives of Inuit people, youth in Nunavik have experienced high rates of mental health problems and suicide. Inuit people describe a broad range of contextual influences on mental wellness based on lived experience, but most epidemiological studies have focused on individual risk factors and pathologies. This study aimed to assess the influence of multiple determinants of mental wellness among Inuit youth in Nunavik, including culturally meaningful activities, housing and community social characteristics. Mental wellness was measured in the form of two primary outcomes: self-esteem and suicidal ideation. Using cross-sectional data from the 2004 Nunavik Inuit Health Survey and multilevel regression modelling, we estimated associations between these two outcomes and various independent individual- and community-level explanatory factors among Inuit youth. All variables were selected to reflect Inuit perspectives on determinants of mental wellness. The study design and interpretation of results were validated with Inuit community representatives. Pride in Inuit identity, traditional activities, community-level social support and community-level socio-economic status were found to be protective. Barriers to participating in traditional activities, household crowding and high community rates of violence were risk factors. These findings support Inuit perspectives, expand the scope of epidemiological analysis of Inuit mental wellness and reinforce the need for locally informed, community-wide approaches to mental wellness promotion for Inuit youth.

Systematic review of mental health and well-being outcomes following community-based obesity prevention interventions among adolescents

PubMed Central

Hoare, Erin; Fuller-Tyszkiewicz, Matthew; Skouteris, Helen; Millar, Lynne; Nichols, Melanie; Allender, Steven

2015-01-01

Objectives This paper aimed to systematically evaluate the mental health and well-being outcomes observed in previous community-based obesity prevention interventions in adolescent populations. Setting Systematic review of literature from database inception to October 2014. Articles were sourced from CINAHL, Global Health, Health Source: Nursing and Academic Edition, MEDLINE, PsycARTICLES and PsycINFO, all of which were accessed through EBSCOhost. The Cochrane Database was also searched to identify all eligible articles. PRISMA guidelines were followed and search terms and search strategy ensured all possible studies were identified for review. Participants Intervention studies were eligible for inclusion if they were: focused on overweight or obesity prevention, community-based, targeted adolescents (aged 10–19 years), reported a mental health or well-being measure, and included a comparison or control group. Studies that focused on specific adolescent groups or were treatment interventions were excluded from review. Quality of evidence was assessed using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) guidelines. Primary and secondary outcome measures Primary outcomes were measures of mental health and well-being, including diagnostic and symptomatic measures. Secondary outcomes included adiposity or weight-related measures. Results Seven studies met the inclusion criteria; one reported anxiety/depressive outcomes, two reported on self-perception well-being measures such as self-esteem and self-efficacy, and four studies reported outcomes of quality of life. Positive mental health outcomes demonstrated that following obesity prevention, interventions included a decrease in anxiety and improved health-related quality of life. Quality of evidence was graded as very low. Conclusions Although positive outcomes for mental health and well-being do exist, controlled evaluations of community-based obesity prevention interventions have not often included mental health measures (n=7). It is recommended that future interventions incorporate mental health and well-being measures to identify any potential mechanisms influencing adolescent weight-related outcomes, and equally to ensure interventions are not causing harm to adolescent mental health. PMID:25564145

Community mental health care in India.

PubMed

Padmavati, R

2005-04-01

Recent times are witnessing methods in the various forms of community care for the mentally ill in India. Non-governmental organizations (NGO) play a pivotal role in filling the gap in the existing mental health services in India and the substantial need for these services. Various strategies that have been employed in community care have attempted to utilize existing community resources for implementation. Informal manpower resources incorporated with specialist psychiatric care and integrated with existing health care facilities have been general strategies. While the feasibility and cost-effectiveness of the NGO operated community outreach programs for the mentally ill have been demonstrated, various factors are seen to influence the planning and execution of such programs. This paper elucidates some critical factors that would need to be considered in community mental health care in India.

To explore the efficacy of community rehabilitation for facilitating daily function among patients with mental illness.

PubMed

Cheng, Jui-Fen; Chen, Chung-Ying; Lin, Mei-Chu; Huang, Xuan-Yi

2018-04-17

To explore the efficacy of community rehabilitation for facilitating daily function among patients with mental illness. A quasi-experimental design was used. Two hundred and sixty-four participants completed a daily living function scale questionnaire and provided disease-related information. Community rehabilitation was shown to be efficient in helping to stabilize mental illness and enhance daily function. Daily function had a significant and positive correlation with disease stability. Community rehabilitation for patients with mental illness can effectively stabilize and prevent disability among those with mental illness. © 2018 Wiley Periodicals, Inc.

Community Determinants of Latinos’ Use of Mental Health Services

PubMed Central

Aguilera, Adrian; Regeser López, Steven

2014-01-01

Objective This study examined the role of community in understanding Latino adults’ (18–64 years of age) use of community mental health services. Methods Service utilization data from the Los Angeles County Department of Mental Health were analyzed from 2003 in two service provider areas. Demographic data, including foreign-born status, language, education, and income for the Latino population, were obtained from the 2000 U.S. Census. The study sample consisted of 4,133 consumers of mental health services in 413 census tracts from an established immigrant community and 4,156 consumers of mental health services in 204 census tracts from a recent immigrant community. Negative binomial regression analyses were conducted to examine associations between locales, community characteristics, and use of services. Results Community of residence and foreign-born status were significantly associated with Latinos’ service use. Latinos from the established immigrant community were more likely to use services than Latinos from the recent immigrant community. Across both communities, census tracts with a higher percentage of foreign-born noncitizen residents showed lower service use. Within the established immigrant community, as income levels increased there was little change in utilization. In contrast, in the recent immigrant community, as income levels increased utilization rates increased as well (β=.001, p<.001). Conclusions The findings point out the importance of locale and community determinants in understanding Latinos’ use of public mental health services. PMID:18378840

Effects of mental health benefits legislation: a community guide systematic review.

PubMed

Sipe, Theresa Ann; Finnie, Ramona K C; Knopf, John A; Qu, Shuli; Reynolds, Jeffrey A; Thota, Anilkrishna B; Hahn, Robert A; Goetzel, Ron Z; Hennessy, Kevin D; McKnight-Eily, Lela R; Chapman, Daniel P; Anderson, Clinton W; Azrin, Susan; Abraido-Lanza, Ana F; Gelenberg, Alan J; Vernon-Smiley, Mary E; Nease, Donald E

2015-06-01

Health insurance benefits for mental health services typically have paid less than benefits for physical health services, resulting in potential underutilization or financial burden for people with mental health conditions. Mental health benefits legislation was introduced to improve financial protection (i.e., decrease financial burden) and to increase access to, and use of, mental health services. This systematic review was conducted to determine the effectiveness of mental health benefits legislation, including executive orders, in improving mental health. Methods developed for the Guide to Community Preventive Services were used to identify, evaluate, and analyze available evidence. The evidence included studies published or reported from 1965 to March 2011 with at least one of the following outcomes: access to care, financial protection, appropriate utilization, quality of care, diagnosis of mental illness, morbidity and mortality, and quality of life. Analyses were conducted in 2012. Thirty eligible studies were identified in 37 papers. Implementation of mental health benefits legislation was associated with financial protection (decreased out-of-pocket costs) and appropriate utilization of services. Among studies examining the impact of legislation strength, most found larger positive effects for comprehensive parity legislation or policies than for less-comprehensive ones. Few studies assessed other mental health outcomes. Evidence indicates that mental health benefits legislation, particularly comprehensive parity legislation, is effective in improving financial protection and increasing appropriate utilization of mental health services for people with mental health conditions. Evidence was limited for other mental health outcomes. Published by Elsevier Inc.

Violence, mental health and violence risk factors among women in the general population: an0020epidemiology study based on two national household surveys in the UK

PubMed Central

2013-01-01

Background Females who perpetrated violence in the community have important mental health and public protection implications. There is a dearth of research in this area. This study investigated the prevalence of psychiatric morbidity, personality disorders as well as victim characteristics and violence risk factors of women in the community who self-reported violence against others. Methods The study sample consisted of 8,275 community women aged 16–74 years obtained from the 2000 and 2007 UK national psychiatric morbidity surveys. Self report incidences of violence, personality disorders and the presence of psychiatric symptoms were assessed by interviews and/or established structured psychiatric assessment protocols. Results Weighted prevalence of female violence, which primarily involved partners and friends, was 5.5% in 2000 and 5.1% in 2007. Violence-prone women also had significantly higher prevalence of common mental disorders and comorbidity (adjusted odds ratio 3.3 and 2.9 respectively) than non-violent women. Multivariate analyses identified eight significant risk factors that characterized violence prone women: young age, residing in social-assisted housing, presence of early conduct problems, victim of domestic violence, self-harming, excessive drinking and past criminal justice involvements. Conclusion A higher prevalence of common mental disorders and some types of personality disorder was found among violence prone women compared to their non-violence prone counterparts. The identified violence risk factors could be used to develop a quick and easily administered rating tool suitable for use by non-mental health trained frontline workers such as police and social support workers in the community to identify violence-prone women. Mental health and support services then can be provided to them for mental health care and violence prevention purposes. PMID:24165544

The impact of a community mental health initiative on outcomes for offenders with a serious mental disorder.

PubMed

Stewart, Lynn A; Farrell-MacDonald, Shanna; Feeley, Stacey

2017-10-01

The Community Mental Health Initiative (CMHI) is mandated to assist offenders with serious mental disorders in their transition from institutions to the community, but this incorporates different styles of service. An important unanswered question is whether these are equivalent. Our aim was to compare outcomes for different intervention styles within the CMHI, a programme for serious offenders in prison who also have at least one major mental disorder. Our specific research questions were as follows: do outcomes differ according to whether offenders with mental health difficulties receive (1) clinical discharge planning only; (2) community mental health services only; (3) the combined services or (4) none, although meeting criteria for any CMHI service? Survival analyses, controlling for variables with a significant effect on recidivism or return to prison, were used to test for differences in recidivism or return to prison rates between the intervention and no-intervention groups during a fixed follow-up period. Men receiving only community mental health services had a significantly lower risk of returning to custody and of recidivism than men receiving discharge planning alone or no community mental health service at all, even after controlling for potential confounders including age, number of previous imprisonments and number of previous community failures. The advantages were apparent within 3-6 months and sustained for up to 4 years. Provision of specialised community mental health services for higher-risk male offenders with a mental disorder may reduce recidivism in the short and longer term - within 3 months and up to 4 years respectively. Statistical modelling also pointed to the need to include treatment for substance abuse and assistance in identifying stable accommodation and brokerage of community services among the interventions and services. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

The impact of caregivers on the effectiveness of an early community mental health detection and intervention programme in Hong Kong.

PubMed

Pan, Jia-Yan; Ng, Yat-Nam Petrus; Young, Kim-Wan Daniel

2016-12-01

The prevalence rate of mental illness in Chinese communities is high, but Chinese clients tend to underutilize mental health services. Caregivers may play an important role in mental health early detection and intervention, but few studies have investigated their roles in community mental health services. This study compared the effectiveness of an early detection and intervention programme, the Community Mental Health Intervention Project, for two groups in the context of Hong Kong - clients with and without caregivers. A comparison group pre-post-test design was adopted. A total of 170 service users joined this study, including 100 with caregivers and 70 without caregivers. Both groups showed a significant decrease in psychiatric symptoms and increase in community living skills; the group without caregivers indicated a greater reduction in psychiatric symptoms. Different social work intervention components had different predictive effects on these changes. The Community Mental Health Intervention Project is an effective early detection and intervention programme in working with Hong Kong Chinese people who are suspected of having mental health problems, especially for those without caregivers. © 2014 Wiley Publishing Asia Pty Ltd.

System flexibility in the rehabilitation process of mentally disabled persons in a hostel that bridges between the hospital and the community.

PubMed

Baloush-Kleinman, Vered; Schneidman, Michael

2003-01-01

Deinstitutionalization and community mental health services have become the focus of mental health care in the United States, Italy and England, and now in Israel. Tirat Carmel MHC developed an intervention model of organizational change implemented in a rehabilitation hostel. It is an interim service based on graduated transition from maintenance care to a transitional Half-way House, followed by a Transitional Living Skills Center oriented for independent community living. Of 205 rehabilitees who resided in the hostel since the beginning of the project, 138 were discharged to community residential settings: 67 patients were discharged to reinforced community hostels; 27 to sheltered housing and 23 to independent residential quarters; 7 patients were discharged to comprehensive hostels, 3 to old-age homes and 11 returned home to their families. In terms of employment, 79 were placed in sheltered employment facilities, 24 work in the open market and 3 returned to school; 22 work in therapeutic occupational settings and 10 patients discharged to comprehensive hostels and old-age homes are engaged in sheltered employment programs in those settings. The system flexibility model and the rehabilitation processes anchored in normalization supported the relocation of hospitalized psychiatric patients to community-based settings and enabled the rehabilitees to cope with readjustment to community life.

Supporting mental health in South African HIV-affected communities: primary health care professionals’ understandings and responses

PubMed Central

Burgess, Rochelle Ann

2015-01-01

How do practitioners respond to the mental distress of HIV-affected women and communities? And do their understandings of patients’ distress matter? The World Health Organization (WHO) along with advocates from the Movement for Global Mental Health (MGMH) champion a primary mental health care model to address burgeoning mental health needs in resource-poor HIV-affected settings. Whilst a minority of studies have begun to explore interventions to target this group of women, there is a dearth of studies that explore the broader contexts that will likely shape service outcomes, such as health sector dynamics and competing definitions of mental ill-health. This study reports on an in-depth case study of primary mental health services in a rural HIV-affected community in Northern KwaZulu-Natal. Health professionals identified as the frontline staff working within the primary mental health care model (n = 14) were interviewed. Grounded thematic analysis of interview data highlighted that practitioners employed a critical and socially anchored framework for understanding their patients’ needs. Poverty, gender and family relationships were identified as intersecting factors driving HIV-affected patients’ mental distress. In a divergence from existing evidence, practitioner efforts to act on their understandings of patient needs prioritized social responses over biomedical ones. To achieve this whilst working within a primary mental health care model, practitioners employed a series of modifications to services to increase their ability to target the sociostructural realities facing HIV-affected women with mental health issues. This article suggests that beyond attention to the crucial issues of funding and human resources that face primary mental health care, attention must also be paid to promoting the development of policies that provide practitioners with increased and more consistent opportunities to address the complex social realities that frame the mental distress of HIV-affected women. PMID:25161270

[The challenge of inclusion in mental health: an analysis of a community center and its work with social bonds].

PubMed

Ardila-Gómez, Sara; Hartfiel, María Isabel; Fernández, Marina A; Ares Lavalle, Guadalupe; Borelli, Mariana; Stolkiner, Alicia

2016-01-01

Social inclusion is a key component of transformations in mental health care, because it takes into account the benefits of community life for both those with mental illness and the other members of the community. In order to understand the scope of inclusion within mental health, 45 participants of a community center linked to a psychiatric hospital discharge program which explicitly seeks to provide social inclusion were interviewed. The possible changes in social relationships between users and other community members based in their sustained daily interactions in the community center were explored. Results suggest that the building of social bonds, as part of informal support networks, is one of the benefits of attending the community center. Positive changes in ideas regarding people with "mental illness" were also observed, although these ideas seemed to be more connected to the notion of integration than to social inclusion.

Community mental health nurses' and compassion: an interpretative approach.

PubMed

Barron, K; Deery, R; Sloan, G

2017-05-01

WHAT IS KNOWN ON THE SUBJECT?: The concept of compassion is well documented in the healthcare literature but has received limited attention in mental health nursing. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: Mental health nurses struggle with defining compassion. The study, with its limitations, brings greater clarity to the meaning of compassion for community mental health nurses and NHS organizations. Mental health nurses need time to reflect on their provision of compassionate care. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: The study has shown that compassion is important for NHS healthcare management, frontline mental health nurses and policy-makers in UK, and there is potential for sharing practice and vision across NHS organisations. Mental health nurses could benefit from training to facilitate their understanding of compassionate practices. Emphasis should be placed on the importance of self-compassion and how this can be nurtured from the secure base of clinical supervision. Introduction There is increasing emphasis in policy, research and practice in the UK and internationally on the importance of caring in health care. Compassion needs to be at the core of all healthcare professionals' practice. Recently, health care has received negative attention through media and government reports which cite a lack of compassion in care. Rationale The concept of compassion has received limited attention in community mental health nursing. Aim Based on data taken from semi-structured interviews with community mental health nurses, this paper aims to describe interpretations and perspectives of compassion to gain insight and development of its meaning. Method A naturalistic, interpretive approach was taken to the study. Semi-structured interviews with nine mental health nurses were analysed using Burnard's 14-step model of thematic analysis. Findings The research illuminates the complexity of compassion and how its practice impacts on emotional responses and relationships with self, patients, colleagues and the employing organization. Participants identified difficulties engaging with compassionate practice whilst recognizing it as a driving force underpinning provision of care. Implications for practice Mental health nurses need to be supported to work towards a greater understanding of compassionate care for clinical practice and the need for self-compassion. © 2017 John Wiley & Sons Ltd.

Examining the psychological sense of community for individuals with serious mental illness residing in supported housing environments.

PubMed

Townley, Greg; Kloos, Bret

2011-08-01

The psychological sense of community is an important aspect of community life; yet, it remains largely unexamined among individuals with serious mental illness (SMI). Sense of community represents the strength of bonding among community members; and this social phenomenon likely impacts the process by which individuals with SMI integrate into community life. The current study examined sense of community (SOC) for individuals with SMI by assessing the relationships between neighborhood experiences, unique factors related to SMI (e.g., mental illness diagnosis), and sense of community in the neighborhood. Participants were 402 residents of supported housing programs who used mental health services in South Carolina. Hierarchical linear regression was utilized to determine which components of community life helped to explain variability in sense of community. In total, 214 participants reported that it is very important for them to feel a sense of community in their neighborhoods. Neighbor relations, neighborhood safety, neighborhood satisfaction, neighborhood tolerance for mental illness, and housing site type emerged as significant explanatory variables of sense of community. These findings have implications for interventions aimed at enhancing SOC and community integration for individuals with SMI.

Development and Validation of an Individualism-Collectivism Scale

DTIC Science & Technology

1984-07-01

different parts of the world, and came to a similar conclusion: mental illness is more frequent in socially disintegrated communities and among people...neighborhood, people who have lost their parents at an early age, and individuals in unhappy marriages are more prone to some kinds of mental illness than...problems. Social Problems and Social Support Besides mental health , social problem in a society may also be affected by the presence or absence of social

Voting pattern of mental patients in a community state hospital.

PubMed

Klein, M M; Grossman, S A

1967-06-01

The voting pattern of mental patients in a community-based state hospital was studied. Patients were polled on the New York City mayoralty race. A comparison to the vote of the general population revealed that the hospital sample vote resembled most closely the election results of the hospital district. The results highlight the advantage of community-centered mental health facilities, which undertake the treatment and rehabilitation of mental patients under conditions that maintain ties with family and community.

The Mental Testing Community and Validity: A Prehistory.

ERIC Educational Resources Information Center

von Mayrhauser, Richard T.

1992-01-01

Examines accuracy evaluation in published testing programs of the following: J. M. Cattell; C. Spearman; A. Binet; L. M. Terman; R. M. Yerkes; E. L. Thorndike; and W. D. Scott. Developing community and consensus on testing required convergence between theorists and practitioners. (SLD)

25 CFR 700.453 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-04-01

... normally found in a community and includes but is not limited to water, sewer and electrical lines, community centers, health centers and clinics, roads, and business establishments. (i) Services means activities relating to human development including, but not limited to, educational and job training, mental...

[Community self-help houses as a form of community social support].

PubMed

Dabrowski, S; Brodniak, W; Gierlacki, J; Welbel, S

1998-01-01

Two forms of community-based social support were introduced by the Polish Mental Health Act--community specialist social help services and community self-help houses--for seriously mentally ill and severely mentally retarded persons. According to the art. 8 community social support should be organized by social help agencies in consultation with psychiatric facilities. Data obtained from the Ministry of Labour and Social Policy indicated that from 21th of January 1995 (when the Mental Health Act was put in force) until 30th of June 1997 social help agencies and non-governmental organizations sponsored by social help agencies have set up 134 community self-help houses with 4103 places. In the middle of last year nearly 3500 persons were using these houses. Most of the houses were located in the following districts: Gdańsk (20), Gorzów (16), Płock (12), Warszawa (8 for 164 persons). Vast majority of them served as day rehabilitation houses, while only a few provided sheltered housing as well. Tentative evaluation of functioning of these houses shows that: operational definition of community self-help house given in the target network of nursing homes and community self-help houses should be modified to include statutory purposes of community social support provided in art.8, selection of the persons using community self-help houses should follow the legal requirement of the Mental Health Act (art. 8), separated rehabilitation programs for mentally ill (psychotic) and mentally retarded persons need to be provided, participation of psychiatric facilities in the organization of the community self-help houses should be increased, functioning of the community self-help houses ought to be supervised by specialists, staff of the community self-help houses need to be systematically trained.

The provision of mental health services in England for people over 65 years of age, 1970-78.

PubMed

Hilton, Claire

2008-09-01

The twentieth century saw an increasing number of people living into old age, and consequently a higher prevalence of age-related chronic degenerative brain disorders. By 1971 the mental hospitals were almost half full with people over 65 years of age. Thus plans to close the mental hospitals meant that the development of community mental health services for older people was a necessity. Although there was a multi-disciplinary focus on the care of older people, the lead in service development was largely taken by psychiatrists, both individually and through the Group for the Psychiatry of Old Age at the Royal College of Psychiatrists.

Communicating: How? A Manual for Mental Health Educators.

ERIC Educational Resources Information Center

National Inst. of Mental Health (DHEW), Rockville, MD.

The Alternatives Project, a 60-week, mass media, mental health education project, had as its goals community education and increased public awareness of mental health facilities in the community. Sponsored by the River Region Mental Health/Mental Retardation Board in Louisville, Kentucky, the program made use of creatively produced, coordinated…

Mental health policy in Eastern Europe: a comparative analysis of seven mental health systems

PubMed Central

2014-01-01

Background The objective of this international comparative study is to describe and compare the mental health policies in seven countries of Eastern Europe that share their common communist history: Bulgaria, the Czech Republic, Hungary, Moldova, Poland, Romania, and Slovakia. Methods The health policy questionnaire was developed and the country-specific information was gathered by local experts. The questionnaire includes both qualitative and quantitative information on various aspects of mental health policy: (1) basic country information (demography, health, and economic indicators), (2) health care financing, (3) mental health services (capacities and utilisation, ownership), (4) health service purchasing (purchasing organisations, contracting, reimbursement of services), and (5) mental health policy (policy documents, legislation, civic society). Results The social and economic transition in the 1990s initiated the process of new mental health policy formulation, adoption of mental health legislation stressing human rights of patients, and a strong call for a pragmatic balance of community and hospital services. In contrast to the development in the Western Europe, the civic society was suppressed and NGOs and similar organizations were practically non-existent or under governmental control. Mental health services are financed from the public health insurance as any other health services. There is no separate budget for mental health. We can observe that the know-how about modern mental health care and about direction of needed reforms is available in documents, policies and programmes. However, this does not mean real implementation. Conclusions The burden of totalitarian history still influences many areas of social and economic life, which also has to be taken into account in mental health policy. We may observe that after twenty years of health reforms and reforms of health reforms, the transition of the mental health systems still continues. In spite of many reform efforts in the past, a balance of community and hospital mental health services has not been achieved in this part of the world yet. PMID:24467832

Measures for Preparing Mentally Handicapped People to Live in the Community.

ERIC Educational Resources Information Center

Aharoni, Chanan

The father of a retarded adult describes the development of a course designed to teach independent living skills to mentally retarded adults living in a group home in Israel. The course included instruction on home management, food preparation, and interpersonal skills. How initial neighborhood opposition diminished is recounted. Difficulties…

The Early Childhood Mental Health Project: Child Care Center Consultation in Action.

ERIC Educational Resources Information Center

Johns, Brian

Based on the view that promoting the emotional wellness of young children and fostering secure, warm relationships between chidren and their teachers are critical to healthy early development, the Jewish Family and Children's Services (JFCS)/Parents Place collaborated with the City and County of San Francisco's Community Mental Health Division and…

Perceptions of Campus Climates for Civic Learning as Predictors of College Students' Mental Health

ERIC Educational Resources Information Center

Mitchell, Joshua J.; Reason, Robert D.; Hemer, Kevin M.; Finley, Ashley

2016-01-01

This study explored whether three broad areas promoted students' mental health: perceptions of the climate related to civic learning, experiences on campus, and civic engagement. Campus climates for civic learning including the development of ethical and moral reasoning and the importance of contributing to community were the strongest predictors…

A Summary of Selected Legislation Relating to the Handicapped, 1963-1967.

ERIC Educational Resources Information Center

Department of Health, Education, and Welfare, Washington, DC.

The 26 major laws enacted between 1963 and 1967 which affected the handicapped are considered. The historical development of four major laws includes the Social Security Act Amendments of 1963, 1964, 1965, and 1967; the Mental Retardation Facilities and Community Mental Health Centers Construction Act of 1963; the Elementary and Secondary…

Recruiting and Retaining Mental Health Professionals to Rural Communities: An Interdisciplinary Course In Appalachia

ERIC Educational Resources Information Center

Meyer, Deborah; Hamel-Lambert, Jane; Tice, Carolyn; Safran, Steven; Bolon, Douglas; Rose-Grippa, Kathleen

2005-01-01

Faculty from 5 disciplines (health administration, nursing, psychology, social work, and special education) collaborated to develop and teach a distance-learning course designed to encourage undergraduate and graduate students to seek mental health services employment in rural areas and to provide the skills, experience, and knowledge necessary…

On-The-Job Training Program, Educable Mentally Retarded. Final Report.

ERIC Educational Resources Information Center

Pocatello School District 25, ID.

School training and vocational services were combined into a program designed to demonstrate that educable mentally retarded students could develop well rounded working habits that would mutually benefit them and the community. On-the-job training was used as a demonstration of the practical use of academic, social, and vocational skills learned…

Early Father Involvement Moderates Biobehavioral Susceptibility to Mental Health Problems in Middle Childhood

ERIC Educational Resources Information Center

Boyce, W. Thomas; Essex, Marilyn J.; Alkon, Abbey; Goldsmith, H. Hill; Kraemer, Helena C.; Kupfer, David J.

2006-01-01

Objective: To study how early father involvement and children's biobehavioral sensitivity to social contexts interactively predict mental health symptoms in middle childhood. Method: Fathers' involvement in infant care and maternal symptoms of depression were prospectively ascertained in a community-based study of child health and development in…

Using Appreciative Inquiry to Facilitate Implementation of the Recovery Model in Mental Health Agencies

ERIC Educational Resources Information Center

Clossey, Laurene; Mehnert, Kevin; Silva, Sara

2011-01-01

This article describes an organizational development tool called appreciative inquiry (AI) and its use in mental health to aid agencies implementing recovery model services. AI is a discursive tool with the power to shift dominant organizational cultures. Its philosophical underpinnings emphasize values consistent with recovery: community,…

The Delivery of Services to Mentally Retarded Persons Living in Rural Areas: Context, Problems and Issues.

ERIC Educational Resources Information Center

Horejsi, Charles R.

Strategies and techniques for developing community-based programs for mentally retarded persons in rural areas must take into consideration local circumstances, resources, and characteristics. Rural norms such as overt racial segregation, social conformity, the importance of church, and the stigma of obtaining human services for personal problems…

District Partners Support Students' Mental Health

ERIC Educational Resources Information Center

Elliot, Laura

2018-01-01

Asheville City Schools and Buncombe County Schools in Asheville, N.C., have partnered with the United Way of Asheville and Buncombe County to develop strategies for responding to the emotional and mental health needs of middle school students in those districts. More than 40 community partners have joined their efforts, which include a focus on…

Prevention of mental handicaps in children in primary health care.

PubMed

Shah, P M

1991-01-01

Some 5-15% of children aged 3 to 15 years in both developing and developed countries suffer from mental handicaps. There may be as many as 10-30 million severely and about 60-80 million mildly or moderately mentally retarded children in the world. The conditions causing mental handicaps are largely preventable through primary health care measures in developing countries. Birth asphyxia and birth trauma are the leading causes of mental handicaps in developing countries where over 1.2 million newborns die each year from moderate or severe asphyxia and an equal number survive with severe morbidity due to brain damage. The other preventable or manageable conditions are: infections such as tuberculous and pyogenic meningitides and encephalopathies associated with measles and whooping cough; severe malnutrition in infancy; hyperbilirubinaemia in the newborn; iodine deficiency; and iron deficiency anaemia in infancy and early childhood. In addition, recent demographic and socioeconomic changes and an increase in the number of working mothers tend to deprive both infants and young children of stimulation for normal development. To improve this situation, the primary health care approach involving families and communities and instilling the spirit of self-care and self-help is indispensable. Mothers and other family members, traditional birth attendants, community health workers, as well as nurse midwives and physicians should be involved in prevention and intervention activities, for which they should be trained and given knowledge and skills about appropriate technologies such as the risk approach, home-based maternal record, partograph, mobilogram (kick count), home-risk card, icterometer, and mouth-to-mask or bag and mask resuscitation of the newborn. Most of these have been field-tested by WHO and can be used in the home, the health centre or day care centres to detect and prevent the above-mentioned conditions which can cause mental handicap.

Becoming an Independent Community Mental Health Center: Perils of the Process

PubMed Central

Adams, Milton S.

1978-01-01

Over the past 12 years, since the inception of the Community Mental Health Center (CMHC) movement, there has been increasing concern that local communities have more input; in fact, that they actually have the opportunity to operate the mental health programs that they deem necessary for their communities.1 Under the Amendments to the Community Mental Health Act (P.L.94-63) 1975, CMHCs were given such options as independence or governance. The whole process of governance presents numerous problems as well as opportunities. An overview of the vicissitudes of this process is presented in this paper. PMID:702582

Building on mental health training for law enforcement: strengthening community partnerships.

PubMed

Campbell, Jorien; Ahalt, Cyrus; Hagar, Randall; Arroyo, William

2017-09-11

Purpose The purpose of this paper is to describe the current state of law enforcement training related to the high number of interactions with persons with mental illness, and to recommend next steps in preparing law enforcement to effectively meet this challenge. Design/methodology/approach The authors reviewed the current literature on relevant law enforcement training programs, focusing primarily on crisis intervention team (CIT) training, and used the case example of California to identify opportunities to improve and enhance law enforcement preparedness for the challenge of responding to persons with mental illness. Findings Broad-based community partnerships working together to develop programs that meet the local needs of both those with mental illness and law enforcement, the availability of mental health treatment centers with no-refusal policies, and a coordinating person or agency to effectively liaise among stakeholders are critical enhancements to CIT training. Originality/value As increasing attention is paid to adverse interactions between police and vulnerable populations, this paper identifies policies that would build on existing training programs to improve police responses to persons with mental illness.

MindMatters, a whole-school approach promoting mental health and wellbeing.

PubMed

Wyn, J; Cahill, H; Holdsworth, R; Rowling, L; Carson, S

2000-08-01

MindMatters is an innovative, national mental health promotion program which provides a framework for mental health promotion in Australian schools. Its objectives are to facilitate exemplary practice in the promotion of whole-school approaches to mental health promotion; develop mental health education resources, curriculum and professional development programs which are appropriate to a wide range of schools, students and learning areas; trial guidelines on mental health and suicide prevention and to encourage the development of partnerships between schools, parents, and community support agencies to promote the mental wellbeing of young people. A team of academics and health education professionals, supported by a reference group of mental health experts, developed MindMatters. The program was piloted in 24 secondary schools, drawn from all educational systems and each State and Territory in Australia. The pilot program was amended and prepared for dissemination nationally. The program provides a framework for mental health promotion in widely differing school settings. The teacher professional development dimension of the program is central to enhancing the role of schools in broad population mental health promotion. Promoting the mental health and wellbeing of all young people is a vital part of the core business of teachers by creating a supportive school environment that is conducive to learning. Teachers need to be comfortable and confident in promoting and teaching for mental health. Specific, targeted interventions, provided within a whole-school framework, address the needs of the minority of students who require additional support.

Reorganization of mental health services: from institutional to community-based models of care.

PubMed

Saraceno, B; Gater, R; Rahman, A; Saeed, K; Eaton, J; Ivbijaro, G; Kidd, M; Dowrick, C; Servili, C; Funk, M K; Underhill, C

2015-09-28

Mental health services in the Eastern Mediterranean Region are predominantly centralized and institutionalized, relying on scarce specialist manpower. This creates a major treatment gap for patients with common and disabling mental disorders and places an unnecessary burden on the individual, their family and society. Six steps for reorganization of mental health services in the Region can be outlined: (1) integrate delivery of interventions for priority mental disorders into primary health care and existing priority programmes; (2) systematically strengthen the capacity of non-specialized health personnel for providing mental health care; (3) scale up community-based services (community outreach teams for defined catchment, supported residential facilities, supported employment and family support); (4) establish mental health services in general hospitals for outpatient and acute inpatient care; (5) progressively reduce the number of long-stay beds in mental hospitals through restricting new admissions; and (6) provide transitional/bridge funding over a period of time to scale up community-based services and downsize mental institutions in parallel.

Conceptualizing community: the experience of mental health consumers.

PubMed

Wong, Yin-Ling Irene; Sands, Roberta G; Solomon, Phyllis L

2010-05-01

In this article we describe a focus group study of the perspectives of diverse groups of mental health consumers on the concept of community. We identify the core domains that constitute the notion of community, and commonalities and differences in the perception of community along the lines of ethnicity and sexual orientation/gender identity. Seven focus groups were conducted with a total of 62 participants. Transcripts were analyzed using the grounded theory approach.Two domains-togetherness and community acceptance-emerged as common to four types of communities that were most frequently mentioned in the focus group discussion. Our findings show that identities other than those associated with mental illness and the role of service user are critical to the understanding of the psychological sense of community among persons with psychiatric disabilities. We suggest that mental health providers empower consumers to expand their "personal communities" beyond that of mental health clients using their diverse identities, and design interventions for addressing the stigma emanating from identities that are discriminated against by the wider society.

Variations in prison mental health services in England and Wales.

PubMed

Forrester, Andrew; Exworthy, Tim; Olumoroti, Olumuyiwa; Sessay, Mohammed; Parrott, Janet; Spencer, Sarah-Jane; Whyte, Sean

2013-01-01

In responding to high levels of psychiatric morbidity amongst prisoners and recognising earlier poor quality prison mental health care, prison mental health in-reach teams have been established in England and Wales over the last decade. They are mostly provided by the National Health Service (NHS), which provides the majority of UK healthcare services. Over the same period, the prison population has grown to record levels, such that prisons in England and Wales now contain almost 90,000 of the world's overall prison population of over 10 million people (roughly the size of Paris or Istanbul). This study provides an overview of mental health in-reach services in prisons in England and Wales, including variations between them, through a telephone survey of senior staff in all prisons and young offender institutions in England and Wales. 73% of prisons took part; of them 13% had no in-reach team at all (usually low security establishments) and the majority of services were run by NHS teams, usually according to a generic community mental health team (CMHT) model rather than other specialist models. Team size was unrelated to prison size. Each nurse covered around 500 prisoners, each doctor over 3700. Many provided few or no healthcare cells and 24-h psychiatric cover (including on-call cover) was uncommon. Despite developments in recent years, mental health in-reach services still fall short of community equivalence and there is wide variation in service arrangements that cannot be explained by prison size or function. The aim of community equivalence has not yet been reached in prison healthcare and a more sophisticated measure of service improvement and standardisation would now be useful to drive and monitor future development. Copyright © 2013 Elsevier Ltd. All rights reserved.

Making A Difference: What Communities Can Do To Prevent Mental Handicap and Promote Lives of Quality. Volume IV: Respected and Responsible Citizens.

ERIC Educational Resources Information Center

Kappel, Bruce

The fourth of five volumes on the means by which Canadian communities can reduce the incidence of mental retardation, minimize existing impairment, and improve the quality of life of the mentally retarded, this booklet focuses on the prevention of mental handicap in adults and ways to accommodate and encourage community participation by the…

A mobile clinic approach to the delivery of community-based mental health services in rural Haiti.

PubMed

Fils-Aimé, J Reginald; Grelotti, David J; Thérosmé, Tatiana; Kaiser, Bonnie N; Raviola, Giuseppe; Alcindor, Yoldie; Severe, Jennifer; Affricot, Emmeline; Boyd, Katherine; Legha, Rupinder; Daimyo, Shin; Engel, Stephanie; Eustache, Eddy

2018-01-01

This study evaluates the use of a mental health mobile clinic to overcome two major challenges to the provision of mental healthcare in resource-limited settings: the shortage of trained specialists; and the need to improve access to safe, effective, and culturally sound care in community settings. Employing task-shifting and supervision, mental healthcare was largely delivered by trained, non-specialist health workers instead of specialists. A retrospective chart review of 318 unduplicated patients assessed and treated during the mobile clinic's first two years (January 2012 to November 2013) was conducted to explore outcomes. These data were supplemented by a quality improvement questionnaire, illustrative case reports, and a qualitative interview with the mobile clinic's lead community health worker. The team evaluated an average of 42 patients per clinic session. The most common mental, neurological, or substance abuse (MNS) disorders were depression and epilepsy. Higher follow-up rates were seen among those with diagnoses of bipolar disorder and neurological conditions, while those with depression or anxiety had lower follow-up rates. Persons with mood disorders who were evaluated on at least two separate occasions using a locally developed depression screening tool experienced a significant reduction in depressive symptoms. The mental health mobile clinic successfully treated a wide range of MNS disorders in rural Haiti and provided care to individuals who previously had no consistent access to mental healthcare. Efforts to address these common barriers to the provision of mental healthcare in resource-limited settings should consider supplementing clinic-based with mobile services.

Hmong mental health needs assessment: a community-based partnership in a small mid-Western community.

PubMed

Collier, Ann Futterman; Munger, Martha; Moua, Yong Kay

2012-03-01

The overall goal of this assessment was to verify the mental health needs of Hmong living in a mid-west community in order clarify the format, content, and feasibility of providing mental health services for Hmong in the future. Using a Community-Based Participatory Research (CBPR) model, we held four focus groups with 36 men, women, adolescents and professionals, all of Hmong descent, as well as interviewed 28 individual medical, mental health, education, and social service providers in the Eau Claire community. Our Hmong sample was frequently unclear about what "mental" health meant, indicating a low level of mental health literacy. Results confirmed that there are significant mental health needs in this refugee and immigrant population. Participants described problems consistent with depression, post-traumatic stress disorder (PTSD), anxiety disorders, somatoform disorders, and severe social stress and acculturation difficulties in every generation. Elder people and male adolescents were described as the most disaffected and in need of immediate services. It will be critical to address mental health literacy before designing future interventions. Treatment suggestions were provided with the intention of removing barriers and incorporating culturally sensitive methodologies, while continuing to work closely with our local mental health providers and Hmong leadership.

Mental health consultant to law enforcement: Secret Service development of a Mental Health Liaison Program.

PubMed

Coggins, M H; Pynchon, M R

1998-01-01

The Mental Health Liaison Program developed and used by the Secret Service is presented as a model for comprehensive, multidimensional interactions between law enforcement and mental health systems, with particular focus on assessing and preventing violent behavior. The structure of the program pairs consultants--psychologists and psychiatrists--with Secret Service field offices to provide (a) consultation regarding risk assessment and case management of individuals who threaten or display inappropriate interest in the President or other protectees; (b) training for agents on risk assessment, mental illness, and mental health care issues; and (c) liaison activities between the Secret Service and the mental health community. Practical benefits to the Secret Service are discussed to encourage more systematic use of broad based psychological and psychiatric consultation to law enforcement, with a goal of enhanced intersystem communication and collaboration. The need for program evaluation and outcome research is discussed in the context of applying the model to improve other mental health and law enforcement systems interactions.

Development and piloting of a plan for integrating mental health in primary care in Sehore district, Madhya Pradesh, India

PubMed Central

Shidhaye, Rahul; Shrivastava, Sanjay; Murhar, Vaibhav; Samudre, Sandesh; Ahuja, Shalini; Ramaswamy, Rohit; Patel, Vikram

2016-01-01

Background The large treatment gap for mental disorders in India underlines the need for integration of mental health in primary care. Aims To operationalise the delivery of the World Health Organization Mental Health Gap Action Plan interventions for priority mental disorders and to design an integrated mental healthcare plan (MHCP) comprising packages of care for primary healthcare in one district. Method Mixed methods were used including theory of change workshops, qualitative research to develop the MHCP and piloting of specific packages of care in a single facility. Results The MHCP comprises three enabling packages: programme management, capacity building and community mobilisation; and four service delivery packages: awareness for mental disorders, identification, treatment and recovery. Challenges were encountered in training primary care workers to improve identification and treatment. Conclusions There are a number of challenges to integrating mental health into primary care, which can be addressed through the injection of new resources and collaborative care models. PMID:26447172

The Mental Health Status of Single-Parent Community College Students in California.

PubMed

Shenoy, Divya P; Lee, Christine; Trieu, Sang Leng

2016-01-01

Single-parenting students face unique challenges that may adversely affect their mental health, which have not been explored in community college settings. The authors conducted secondary analysis of Spring 2013 data from the American College Health Association-National College Health Assessment to examine difficulties facing single-parent community college students and the association between single parenting and negative mental health (depression, self-injury, suicide attempt). Participants were 6,832 California community college students, of whom 309 were single parents. Demographic and mental health data were characterized using univariate descriptive analyses. Bivariate analyses determined whether single parents differed from other students regarding negative mental health or traumatic/difficult events. Finances, family, and relationship difficulties disproportionally affected single parents, who reported nearly twice as many suicide attempts as their counterparts (5.3% vs. 2.7%; p < .0001). Single-parenting students face a higher prevalence of mental health stressors than other community college students.

A prison mental health in-reach model informed by assertive community treatment principles: evaluation of its impact on planning during the pre-release period, community mental health service engagement and reoffending.

PubMed

McKenna, Brian; Skipworth, Jeremy; Tapsell, Rees; Madell, Dominic; Pillai, Krishna; Simpson, Alexander; Cavney, James; Rouse, Paul

2015-12-01

It is well recognised that prisoners with serious mental illness (SMI) are at high risk of poor outcomes on return to the community. Early engagement with mental health services and other community agencies could provide the substrate for reducing risk. To evaluate the impact of implementing an assertive community treatment informed prison in-reach model of care (PMOC) on post-release engagement with community mental health services and on reoffending rates. One hundred and eighty prisoners with SMI released from four prisons in the year before implementation of the PMOC were compared with 170 such prisoners released the year after its implementation. The assertive prison model of care was associated with more pre-release contacts with community mental health services and contacts with some social care agencies in some prisons. There were significantly more post-release community mental health service engagements after implementation of this model (Z = -2.388, p = 0.02). There was a trend towards reduction in reoffending rates after release from some of the prisons (Z =1.82, p = 0.07). Assertive community treatment applied to prisoners with mental health problems was superior to 'treatment as usual', but more work is needed to ensure that agencies will engage prisoners in pre-release care. The fact that the model showed some benefits in the absence of any increase in resources suggests that it may be the model per se that is effective. Copyright © 2014 John Wiley & Sons, Ltd.

Preventing Filipino Mental Health Disparities: Perspectives from Adolescents, Caregivers, Providers, and Advocates

PubMed Central

Javier, Joyce R.; Supan, Jocelyn; Lansang, Anjelica; Beyer, William; Kubicek, Katrina; Palinkas, Lawrence A.

2014-01-01

Filipino Americans are the second largest immigrant population and second largest Asian ethnic group in the U.S. Disparities in youth behavioral health problems and the receipt of mental health services among Filipino youth have been documented previously. However, few studies have elicited perspectives from community stakeholders regarding how to prevent mental health disparities among Filipino youth. The purpose of the current study is to identify intervention strategies for implementing mental health prevention programs among Filipino youth. We conducted semi-structured interviews (n=33) with adolescents, caregivers, advocates, and providers and focus groups (n=18) with adolescents and caregivers. Interviews were audio taped and transcribed verbatim. Transcripts were analyzed using a methodology of “coding consensus, co-occurrence, and comparison” and was rooted in grounded theory. Four recommendations were identified when developing mental health prevention strategies among Filipino populations: address the intergenerational gap between Filipino parents and children, provide evidence-based parenting programs, collaborate with churches in order to overcome stigma associated with mental health, and address mental health needs of parents. Findings highlight the implementation of evidence-based preventive parenting programs in faith settings as a community-identified and culturally appropriate strategy to prevent Filipino youth behavioral health disparities. PMID:25667725

Preventing Filipino Mental Health Disparities: Perspectives from Adolescents, Caregivers, Providers, and Advocates.

PubMed

Javier, Joyce R; Supan, Jocelyn; Lansang, Anjelica; Beyer, William; Kubicek, Katrina; Palinkas, Lawrence A

2014-12-01

Filipino Americans are the second largest immigrant population and second largest Asian ethnic group in the U.S. Disparities in youth behavioral health problems and the receipt of mental health services among Filipino youth have been documented previously. However, few studies have elicited perspectives from community stakeholders regarding how to prevent mental health disparities among Filipino youth. The purpose of the current study is to identify intervention strategies for implementing mental health prevention programs among Filipino youth. We conducted semi-structured interviews (n=33) with adolescents, caregivers, advocates, and providers and focus groups (n=18) with adolescents and caregivers. Interviews were audio taped and transcribed verbatim. Transcripts were analyzed using a methodology of "coding consensus, co-occurrence, and comparison" and was rooted in grounded theory. Four recommendations were identified when developing mental health prevention strategies among Filipino populations: address the intergenerational gap between Filipino parents and children, provide evidence-based parenting programs, collaborate with churches in order to overcome stigma associated with mental health, and address mental health needs of parents. Findings highlight the implementation of evidence-based preventive parenting programs in faith settings as a community-identified and culturally appropriate strategy to prevent Filipino youth behavioral health disparities.

Listening, sharing understanding and facilitating consumer, family and community empowerment through a priority driven partnership in Far North Queensland.

PubMed

Haswell-Elkins, Melissa; Reilly, Lyndon; Fagan, Ruth; Ypinazar, Valmae; Hunter, Ernest; Tsey, Komla; Gibson, Victor; Connolly, Brian; Laliberte, Arlene; Wargent, Rachael; Gibson, Teresa; Saunders, Vicki; McCalman, Janya; Kavanagh, David

2009-08-01

This paper provides an example of a mental health research partnership underpinned by empowerment principles that seeks to foster strength among community organizations to support better outcomes for consumers, families and communities. It aims to raise awareness among researchers and service providers that empowerment approaches to assist communities to address mental health problems are not too difficult to be practical but require long-term commitment and appropriate support. A collaborative research strategy that has become known as the Priority Driven Research (PDR) Partnership emerged through literature review, consultations, Family Wellbeing Program delivery with community groups and activities in two discrete Indigenous communities. Progress to date on three of the four components of the strategy is described. The following key needs were identified in a pilot study and are now being addressed in a research-based implementation phase: (i) gaining two-way understanding of perspectives on mental health and promoting universal awareness; (ii) supporting the empowerment of carers, families, consumers and at-risk groups through existing community organizations to gain greater understanding and control of their situation; (iii) developing pathways of care at the primary health centre level to enable support of social and emotional wellbeing as well as more integrated mental health care; (iv) accessing data to enable an ongoing process of analysis/sharing/planning and monitoring to inform future activity. One of the key learnings to emerge in this project so far is that empowerment through partnership becomes possible when there is a concerted effort to strengthen grassroots community organizations. These include social health teams and men's and women's groups that can engage local people in an action orientation.

The politics of knowledge: implications for understanding and addressing mental health and illness.

PubMed

Jenkins, Emily K

2014-03-01

While knowledge represents a valuable commodity, not all forms of knowledge are afforded equal status. The politics of knowledge, which entails the privileging of particular ways of knowing through linkages between the producers of knowledge and other bearers of authority or influence, represents a powerful force driving knowledge development. Within the health research and practice community, biomedical knowledge (i.e. knowledge pertaining to the biological factors influencing health) has been afforded a privileged position, shaping the health research and practice community's view of health, illness and appropriate intervention. The aim of this study is to spark critical reflection and dialogue surrounding the ways in which the politics of knowledge have constrained progress in addressing mental health and illness, one of today's leading public health issues. I argue that the hegemony of biological knowledge represents an ethical issue as it limits the breadth of knowledge available to support practitioners to 'do good' in terms of addressing mental illness. Given the power and influence inherent within the nursing community, I propose that nurses ought to engage in critical reflection and action in an effort to better situate the health research and practice community to effectively address the mental health of populations. © 2013 John Wiley & Sons Ltd.

Marketing and Community Mental Health Centers.

ERIC Educational Resources Information Center

Ferniany, Isaac W.; Garove, William E.

1983-01-01

Suggests that a marketing approach can be applied to community mental health centers. Marketing is a management orientation of providing services for, not to, patients in a systematic manner, which can help mental health centers improve services, strengthen community image, achieve financial independence and aid in staff recruitment. (Author)

Community Mental Health Model for Campus Mental Health Services.

ERIC Educational Resources Information Center

Banning, James H.

University and college mental health services have historically modeled themselves after a traditional clinic model. Few delivery systems have been influenced by the community mental health model. The major reason for this lack of influence appears to be the "in loco parentis" stance of colleges and universities. A campus mental health service…

Mental health nurses' diabetes care skills - a training needs analysis.

PubMed

Nash, Michael

2009-05-28

This article explores mental health nurses' diabetes training needs. A survey of inpatient and community mental health nurses was undertaken using a 16-item self-reporting questionnaire. Two hundred and twenty questionnaires were sent out and 138 returned, providing a response rate of 63%. Analysis shows that mental health nurses are currently involved in a range of diabetes care activities, however, their knowledge and skills may not be up to date. Mental health nurses also report the growing impact of diabetes care on their workload. Areas of identified training needs include taking blood glucose readings, giving dietary advice, liaison with diabetes nurse specialists and weight management. Mental health services and education providers need to consider developing specific training courses for mental health nurses.

Rebuilding the foundations: major renovations to the mental health component of an undergraduate nursing curriculum.

PubMed

Spence, Deborah; Garrick, Helen; McKay, Marie

2012-10-01

Concerns relating to the adequacy of nurses' preparation for the care of people with mental illness prompted significant revision of the mental health component in a Bachelor of Health Science nursing programme in New Zealand that prepares approximately 200 students per year. Working collaboratively with clinical providers, university staff developed and introduced three courses (equivalent to 450 hours of learning) specifically focused on mental health science, inpatient practice, and primary community mental health practice. This paper provides an overview of the new courses and reports the findings of an appreciative inquiry evaluation of this curriculum innovation. © 2012 The Authors. International Journal of Mental Health Nursing © 2012 Australian College of Mental Health Nurses Inc.

Mental health system in Saudi Arabia: an overview

PubMed Central

Qureshi, Naseem Akhtar; Al-Habeeb, Abdulhameed Abdullah; Koenig, Harold G

2013-01-01

Background There is evidence that mapping mental health systems (MHSs) helps in planning and developing mental health care services for users, families, and other caregivers. The General Administration of Mental Health and Social Services of the Ministry of Health over the past 4 years has sought to streamline the delivery of mental health care services to health consumers in Saudi Arabia. Objective We overview here the outcome of a survey that assessed the Saudi MHS and suggest strategic steps for its further improvement. Method The World Health Organization Assessment Instrument for Mental Health Systems was used systematically to collect information on the Saudi MHS in 2009–2010, 4 years after a baseline assessment. Results Several mental health care milestones, especially provision of inpatient mental health services supported by a ratified Mental Health Act, were achieved during this period. However, community mental health care services are needed to match international trends evident in developed countries. Similarly, a larger well-trained mental health workforce is needed at all levels to meet the ever-increasing demand of Saudi society. Conclusion This updated MHS information, discussed in light of international data, will help guide further development of the MHS in Saudi Arabia in the future, and other countries in the Eastern Mediterranean region may also benefit from Saudi experience. PMID:23966783

Mental Healthcare Delivery in London-Middlesex Ontario - The Next Frontier.

PubMed

Velji, Karima; Links, Paul

2016-01-01

The next frontier for mental healthcare delivery will be focused on three facets of innovation, namely structure, process and outcome. The structure innovation will seek to develop new models of care delivery between the two hospitals and with the community. The process innovation will focus on embedding strategies to adopt a recovery and rehabilitation approach to care delivery. Lastly, the outcome innovation will use system wide quality improvement methods to drive breakthrough performance in mental healthcare.

Informal and formal mental health: preliminary qualitative findings

PubMed Central

O'Neill, Linda; George, Serena; Koehn, Corinne; Shepard, Blythe

2013-01-01

Background Northern-based research on mental health support, no matter the specific profession, helps to inform instruction of new practitioners and practitioners already working in rural or isolated conditions. Understanding the complexities of northern mental health support not only benefits clients and practitioners living in the North, but also helps prepare psychologists and counsellors preparing to work in other countries with large rural and isolated populations. The qualitative phase is part of a multi-year research study on informal and formal mental health support in northern Canada involving the use of qualitative and quantitative data collection and analysis methods. Objective The main objective of the qualitative phase interviews was to document in-depth the situation of formal and informal helpers in providing mental health support in isolated northern communities in northern British Columbia, northern Alberta, Yukon and Northwest Territories (NWT). The intent of in-depth interviews was to collect descriptive information on the unique working conditions of northern helping practitioners for the development of a survey and subsequent community action plans for helping practitioner support. Design Twenty participants in northern BC, Yukon and NWT participated in narrative interviews. Consensual qualitative research (CQR) was used in the analysis completed by 7 researchers. The principal researcher and research associate then worked through all 7 analyses, defining common categories and themes, and using selections from each researcher in order to ensure that everyone's analysis was represented in the final consensual summary. Results The preliminary results include 7 main categories consisting of various themes. Defining elements of northern practice included the need for generalist knowledge and cultural sensitivity. The task of working with and negotiating membership in community was identified as essential for northern mental health support. The need for revised codes of ethics relevant to the reality of northern work was a major category, as was insight on how to best sustain northern practice. Conclusion Many of the practitioners who participated in this study have found ways to overcome the biggest challenges of northern practice, yet the limitations of small populations and lack of resources in small communities to adequately address mental health support were identified as existing. Empowering communities by building community capacity to educate, supervise and support formal and informal mental health workers may be the best approach to overcoming the lack of external resources. PMID:23977648

Informal and formal mental health: preliminary qualitative findings.

PubMed

O'Neill, Linda; George, Serena; Koehn, Corinne; Shepard, Blythe

2013-01-01

Northern-based research on mental health support, no matter the specific profession, helps to inform instruction of new practitioners and practitioners already working in rural or isolated conditions. Understanding the complexities of northern mental health support not only benefits clients and practitioners living in the North, but also helps prepare psychologists and counsellors preparing to work in other countries with large rural and isolated populations. The qualitative phase is part of a multi-year research study on informal and formal mental health support in northern Canada involving the use of qualitative and quantitative data collection and analysis methods. The main objective of the qualitative phase interviews was to document in-depth the situation of formal and informal helpers in providing mental health support in isolated northern communities in northern British Columbia, northern Alberta, Yukon and Northwest Territories (NWT). The intent of in-depth interviews was to collect descriptive information on the unique working conditions of northern helping practitioners for the development of a survey and subsequent community action plans for helping practitioner support. Twenty participants in northern BC, Yukon and NWT participated in narrative interviews. Consensual qualitative research (CQR) was used in the analysis completed by 7 researchers. The principal researcher and research associate then worked through all 7 analyses, defining common categories and themes, and using selections from each researcher in order to ensure that everyone's analysis was represented in the final consensual summary. The preliminary results include 7 main categories consisting of various themes. Defining elements of northern practice included the need for generalist knowledge and cultural sensitivity. The task of working with and negotiating membership in community was identified as essential for northern mental health support. The need for revised codes of ethics relevant to the reality of northern work was a major category, as was insight on how to best sustain northern practice. Many of the practitioners who participated in this study have found ways to overcome the biggest challenges of northern practice, yet the limitations of small populations and lack of resources in small communities to adequately address mental health support were identified as existing. Empowering communities by building community capacity to educate, supervise and support formal and informal mental health workers may be the best approach to overcoming the lack of external resources.

Community-Based Approaches for Individuals with Mental Handicap: An African Experience.

ERIC Educational Resources Information Center

Brouilette, Ron; Mariga, Lilian

This booklet addresses issues concerning community-based rehabilitation (CBR) services for people with mental handicaps, especially in Africa. The first section explains CBR services, with subsections on overcoming exclusion, a definition, normalization and community participation, family participation, CBR and mental handicap projects in Africa,…

The Community Mental Health Center as a Matrix Organization.

ERIC Educational Resources Information Center

White, Stephen L.

1978-01-01

This article briefly reviews the literature on matrix organizational designs and discusses the ways in which the matrix design might be applied to the special features of a community mental health center. The phases of one community mental health center's experience in adopting a matrix organizational structure are described. (Author)

Rebuilding community resilience in a post-war context: developing insight and recommendations - a qualitative study in Northern Sri Lanka.

PubMed

Somasundaram, Daya; Sivayokan, Sambasivamoorthy

2013-01-11

Individuals, families and communities in Northern Sri Lanka have undergone three decades of war trauma, multiple displacements, and loss of family, kin, friends, homes, employment and other valued resources. The objective of the study was understanding common psychosocial problems faced by families and communities, and the associated risk and protective factors, so that practical and effective community based interventions can be recommended to rebuild strengths, adaptation, coping strategies and resilience. This qualitative, ecological study is a psychosocial ethnography in post-war Northern Sri Lanka obtained through participant observation; case studies; key- informant interviews; and focus groups discussions with mental health and psychosocial community workers as well as literature survey of media and organizational reports. Qualitative analysis of the data used ethnography, case studies, phenomenology, grounded theory, hermeneutics and symbolic interactionism techniques. Quantitative data on suicide was collected for Jaffna and Killinochchi districts. Complex mental health and psychosocial problems at the individual, family and community levels in a post-war context were found to impair recovery. These included unresolved grief; individual and collective trauma; insecurity, self-harm and suicides; poverty and unemployment; teenage and unwanted pregnancies; alcoholism; child abuse and neglect; gender based violence and vulnerability including domestic violence, widows and female headed-household, family conflict and separation; physical injuries and handicap; problems specific for children and elderly; abuse and/or neglect of elderly and disabled; anti-social and socially irresponsible behaviour; distrust, hopelessness, and powerlessness. Protective factors included families; female leadership and engagement; cultural and traditional beliefs, practices and rituals; and creative potential in narratives, drama and other arts. Risk factors that were impeding community rehabilitation and recovery included continuing military governance, depletion of social capital particularly lack of trust, hope and socio-economic opportunity structures for development that would engender a sense of collective efficacy. In view of the widespread trauma at the individual, family and collective levels, community based programmes to increase local awareness, knowledge and skills to deal with common mental health and psychosocial issues; and training of community level workers and others in basic mental health and psychosocial problem solving are recommended to rebuild family and community agency and resilience. The use of cultural practices and school based programmes would rekindle community processes.

Rebuilding community resilience in a post-war context: developing insight and recommendations - a qualitative study in Northern Sri Lanka

PubMed Central

2013-01-01

Background Individuals, families and communities in Northern Sri Lanka have undergone three decades of war trauma, multiple displacements, and loss of family, kin, friends, homes, employment and other valued resources. The objective of the study was understanding common psychosocial problems faced by families and communities, and the associated risk and protective factors, so that practical and effective community based interventions can be recommended to rebuild strengths, adaptation, coping strategies and resilience. Methods This qualitative, ecological study is a psychosocial ethnography in post-war Northern Sri Lanka obtained through participant observation; case studies; key- informant interviews; and focus groups discussions with mental health and psychosocial community workers as well as literature survey of media and organizational reports. Qualitative analysis of the data used ethnography, case studies, phenomenology, grounded theory, hermeneutics and symbolic interactionism techniques. Quantitative data on suicide was collected for Jaffna and Killinochchi districts. Results Complex mental health and psychosocial problems at the individual, family and community levels in a post-war context were found to impair recovery. These included unresolved grief; individual and collective trauma; insecurity, self-harm and suicides; poverty and unemployment; teenage and unwanted pregnancies; alcoholism; child abuse and neglect; gender based violence and vulnerability including domestic violence, widows and female headed-household, family conflict and separation; physical injuries and handicap; problems specific for children and elderly; abuse and/or neglect of elderly and disabled; anti-social and socially irresponsible behaviour; distrust, hopelessness, and powerlessness. Protective factors included families; female leadership and engagement; cultural and traditional beliefs, practices and rituals; and creative potential in narratives, drama and other arts. Risk factors that were impeding community rehabilitation and recovery included continuing military governance, depletion of social capital particularly lack of trust, hope and socio-economic opportunity structures for development that would engender a sense of collective efficacy. Conclusions In view of the widespread trauma at the individual, family and collective levels, community based programmes to increase local awareness, knowledge and skills to deal with common mental health and psychosocial issues; and training of community level workers and others in basic mental health and psychosocial problem solving are recommended to rebuild family and community agency and resilience. The use of cultural practices and school based programmes would rekindle community processes. PMID:23305538

Attitudes toward the mentally ill among community health-related personnel in South Korea.

PubMed

Jung, Wook; Choi, Eunkyung; Yu, Jaehak; Park, Doo-Heum; Ryu, Seung-Ho; Ha, Jee Hyun

2017-01-01

Prejudice and negative attitudes toward mental illness are major obstacles in the rehabilitation and functional recovery of patients. The objective of this study was to evaluate the attitudes of health-related personnel toward mentally ill patients in a local urban community in South Korea. In total, 401 participants (men, 132; women, 269; mean age, 37.3 ± 9.5 years) were recruited. The participants were health-related personnel in a district of Seoul, who were recruited from three different workplaces: a local administration office, a public health center, and a community welfare center. Sociodemographic data were gathered, and the community attitudes toward the mentally ill (CAMI) inventory were administered. Comparisons of the CAMI subscales were conducted among participants using statistical analysis. Community welfare center workers showed more authoritarianism and social restriction and less community mental health ideology than the other two groups. Among the demographic variables, a shorter working career, higher education, female gender, and younger age were also related to a more negative attitude toward mentally ill patients. Community health-related personnel who have contact with patients with mental illness should be encouraged to have a fair, hospitable, and open-minded attitude. It is advisable for these workers to receive interventions such as regular educational programs early in their careers.

The national community mental health care project in Vietnam: a review for future guidance.

PubMed

Ng, Chee Hong; Than, Phong Thai; La, Cuong Duc; Van Than, Quang; Van Dieu, Chu

2011-04-01

The aim of this paper is to review the national community mental health care (CMHC) project in Vietnam and recommend improvements to the model based on findings reported at a national workshop of major service providers, and supplemented by information gathered from site visits and discussions with mental health leaders, professionals and stakeholders in the hospital and community mental health services. Since 2000, the CMHC project has been carried out in all 63 provinces with an overall national district coverage of around 64% and a total registry of 145 160 patients. It demonstrates a commitment by the government to integrate mental health into primary health care, in line with the World Health Organization recommendations, and set up a national community mental health network. Free treatment is provided for patients, mostly with schizophrenia (62.83%) and epilepsy (34.78%), at the local community level, and a national monitoring system is well established. However, the limitations include the lack of project funds, human resources and facilities, treatment scope, and linkages with families and community. A revised model of CMHC that builds on the strengths of existing services is proposed. While progress in community mental health care in Vietnam has been significant, many challenges facing the CMHC project need addressing.

[Co-construction of a program to promote community participation among seniors living with psychosocial issues, with or without mental health problems].

PubMed

Parisien, Manon; Nour, Kareen; Belley, Anne-Marie; Aubin, Ginette; Billette, Véronique; Dallaire, Bernadette

Objectives A significant proportion of Quebec seniors are living with mental health problems or psychosocial issues such as isolation, bereavement, and psychological distress. These people face many forms of exclusion and are likely to have limited social participation. This paper describes the co-construction steps of a program aimed at promoting community participation among this population.Methods A method for the co-construction of innovative practices in health promotion was used to develop a program that is relevant, rigorous and feasible in diverse settings. The process included several steps, notably: need analysis among seniors and practitioners, development of a logical model for the program, preparation of the leader's manual, validation of the manual by experts, and pilot testing of the program among groups of seniors.Results The goal of the Count me in! program is to promote utilization of the resources of the community that can provide seniors living with mental health conditions or psychosocial issues with activities and positive social contact. The intervention is based on the Strength Model. It includes an individual interview, an eight-meeting workshop, visits to community resources, and collective production of media communication.Conclusion A co-construction process allowed the program to be continuously adjusted in response to stakeholders' feedback. The most important lever for the co-construction was the reconciliation of the partners' practical, conceptual, and experiential expertise. However, contextual factors such as the organization and the availability of mental health services for seniors constituted important barriers to the process.

Ahead of the game protocol: a multi-component, community sport-based program targeting prevention, promotion and early intervention for mental health among adolescent males.

PubMed

Vella, Stewart A; Swann, Christian; Batterham, Marijka; Boydell, Katherine M; Eckermann, Simon; Fogarty, Andrea; Hurley, Diarmuid; Liddle, Sarah K; Lonsdale, Chris; Miller, Andrew; Noetel, Michael; Okely, Anthony D; Sanders, Taren; Telenta, Joanne; Deane, Frank P

2018-03-21

There is a recognised need for targeted community-wide mental health strategies and interventions aimed specifically at prevention and early intervention in promoting mental health. Young males are a high need group who hold particularly negative attitudes towards mental health services, and these views are detrimental for early intervention and help-seeking. Organised sports provide a promising context to deliver community-wide mental health strategies and interventions to adolescent males. The aim of the Ahead of the Game program is to test the effectiveness of a multi-component, community-sport based program targeting prevention, promotion and early intervention for mental health among adolescent males. The Ahead of the Game program will be implemented within a sample drawn from community sporting clubs and evaluated using a sample drawn from a matched control community. Four programs are proposed, including two targeting adolescents, one for parents, and one for sports coaches. One adolescent program aims to increase mental health literacy, intentions to seek and/or provide help for mental health, and to decrease stigmatising attitudes. The second adolescent program aims to increase resilience. The goal of the parent program is to increase parental mental health literacy and confidence to provide help. The coach program is intended to increase coaches' supportive behaviours (e.g., autonomy supportive behaviours), and in turn facilitate high-quality motivation and wellbeing among adolescents. Programs will be complemented by a messaging campaign aimed at adolescents to enhance mental health literacy. The effects of the program on adolescent males' psychological distress and wellbeing will also be explored. Organised sports represent a potentially engaging avenue to promote mental health and prevent the onset of mental health problems among adolescent males. The community-based design, with samples drawn from an intervention and a matched control community, enables evaluation of adolescent males' incremental mental health literacy, help-seeking intentions, stigmatising attitudes, motivation, and resilience impacts from the multi-level, multi-component Ahead of the Game program. Notable risks to the study include self-selection bias, the non-randomised design, and the translational nature of the program. However, strengths include extensive community input, as well as the multi-level and multi-component design. Australian New Zealand Clinical Trials Registry ACTRN12617000709347 . Date registered 17 May 2017. Retrospectively registered.

Context matters: Community characteristics and mental health among war-affected youth in Sierra Leone

PubMed Central

Betancourt, Theresa S.; McBain, Ryan; Newnham, Elizabeth A.; Brennan, Robert T.

2013-01-01

Background Worldwide, over one billion children and adolescents live in war-affected settings. At present, only limited research has investigated linkages between disrupted social ecology and adverse mental health outcomes among war-affected youth. In this study, we examine three community-level characteristics—social disorder and collective efficacy within the community, as reported by caregivers, and perceived stigma as reported by youth—in relation to externalizing behaviors and internalizing symptoms among male and female former child soldiers in post-conflict Sierra Leone. Methods 243 former child soldiers (30% female, mean age at baseline: 16.6 years) and their primary caregivers participated in interviews in 2004 and 2008, as part of a larger prospective cohort study of war-affected youth in Sierra Leone. Two-point growth models were estimated to examine the relationship between community-level characteristics and externalizing and internalizing outcomes across the time points. Results Both social disorder within the community, reported by caregivers, and perceived stigma, reported by youth, positively co-varied with youths’ externalizing and internalizing scores—indicating that higher levels of each at baseline and follow-up were associated with higher levels of mental health problems at both time points (p<0.05). The relationship between collective efficacy and mental health outcomes was non-significant (p>0.05). Conclusions This study offers a rare glimpse into the role that the post-conflict social context plays in shaping mental health among former child soldiers. Results indicate that both social disorder and perceived stigma within the community demonstrate an important relationship to externalizing and internalizing problems among adolescent ex-combatants. Moreover, these relationships persisted over a four-year period of follow up. These results underscore the importance of the post-conflict social environment and the need to develop post-conflict interventions that address community-level processes in addition to the needs of the individual. PMID:24102324

Assertive community treatment for elderly people with severe mental illness

PubMed Central

2010-01-01

Background Adults aged 65 and older with severe mental illnesses are a growing segment of the Dutch population. Some of them have a range of serious problems and are also difficult to engage. While assertive community treatment is a common model for treating difficult to engage severe mental illnesses patients, no special form of it is available for the elderly. A special assertive community treatment team for the elderly is developed in Rotterdam, the Netherlands and tested for its effectiveness. Methods We will use a randomized controlled trial design to compare the effects of assertive community treatment for the elderly with those of care as usual. Primary outcome measures will be the number of dropouts, the number of patients engaged in care and patient's psychiatric symptoms, somatic symptoms, and social functioning. Secondary outcome measures are the number of unmet needs, the subjective quality of life and patients' satisfaction. Other secondary outcomes include the number of crisis contacts, rates of voluntary and involuntary admission, and length of stay. Inclusion criteria are aged 65 plus, the presence of a mental disorder, a lack of motivation for treatment and at least four suspected problems with functioning (addiction, somatic problems, daily living activities, housing etc.). If patients meet the inclusion criteria, they will be randomly allocated to either assertive community treatment for the elderly or care as usual. Trained assessors will use mainly observational instruments at the following time points: at baseline, after 9 and 18 months. Discussion This study will help establish whether assertive community treatment for the elderly produces better results than care as usual in elderly people with severe mental illnesses who are difficult to engage. When assertive community treatment for the elderly proves valuable in these respects, it can be tested and implemented more widely, and mechanisms for its effects investigated. Trial Registration The Netherlands National Trial Register NTR1620 PMID:20958958

Assertive community treatment for elderly people with severe mental illness.

PubMed

Stobbe, Jolanda; Mulder, Niels C L; Roosenschoon, Bert-Jan; Depla, Marja; Kroon, Hans

2010-10-19

Adults aged 65 and older with severe mental illnesses are a growing segment of the Dutch population. Some of them have a range of serious problems and are also difficult to engage. While assertive community treatment is a common model for treating difficult to engage severe mental illnesses patients, no special form of it is available for the elderly. A special assertive community treatment team for the elderly is developed in Rotterdam, the Netherlands and tested for its effectiveness. We will use a randomized controlled trial design to compare the effects of assertive community treatment for the elderly with those of care as usual. Primary outcome measures will be the number of dropouts, the number of patients engaged in care and patient's psychiatric symptoms, somatic symptoms, and social functioning. Secondary outcome measures are the number of unmet needs, the subjective quality of life and patients' satisfaction. Other secondary outcomes include the number of crisis contacts, rates of voluntary and involuntary admission, and length of stay. Inclusion criteria are aged 65 plus, the presence of a mental disorder, a lack of motivation for treatment and at least four suspected problems with functioning (addiction, somatic problems, daily living activities, housing etc.). If patients meet the inclusion criteria, they will be randomly allocated to either assertive community treatment for the elderly or care as usual. Trained assessors will use mainly observational instruments at the following time points: at baseline, after 9 and 18 months. This study will help establish whether assertive community treatment for the elderly produces better results than care as usual in elderly people with severe mental illnesses who are difficult to engage. When assertive community treatment for the elderly proves valuable in these respects, it can be tested and implemented more widely, and mechanisms for its effects investigated. The Netherlands National Trial Register NTR1620.

Using the collaborative intervention planning framework to adapt a health-care manager intervention to a new population and provider group to improve the health of people with serious mental illness.

PubMed

Cabassa, Leopoldo J; Gomes, Arminda P; Meyreles, Quisqueya; Capitelli, Lucia; Younge, Richard; Dragatsi, Dianna; Alvarez, Juana; Manrique, Yamira; Lewis-Fernández, Roberto

2014-11-30

Health-care manager interventions improve the physical health of people with serious mental illness (SMI) and could be widely implemented in public mental health clinics. Local adaptations and customization may be needed to increase the reach of these interventions in the public mental health system and across different racial and ethnic communities. In this study, we describe how we used the collaborative intervention planning framework to customize an existing health-care manager intervention to a new patient population (Hispanics with SMI) and provider group (social workers) to increase its fit with our local community. The study was conducted in partnership with a public mental health clinic that serves predominantly Hispanic clients. A community advisory board (CAB) composed of researchers and potential implementers (e.g., social workers, primary care physicians) used the collaborative intervention planning framework, an approach that combines community-based participatory research principles and intervention mapping (IM) procedures, to inform intervention adaptations. The adaptation process included four steps: fostering collaborations between CAB members; understanding the needs of the local population through a mixed-methods needs assessment, literature reviews, and group discussions; reviewing intervention objectives to identify targets for adaptation; and developing the adapted intervention. The application of this approach enabled the CAB to identify a series of cultural and provider level-adaptations without compromising the core elements of the original health-care manager intervention. Reducing health disparities in people with SMI requires community engagement, particularly when preparing existing interventions to be used with new communities, provider groups, and practice settings. Our study illustrates one approach that can be used to involve community stakeholders in the intervention adaptation process from the very beginning to enhance the transportability of a health-care manager intervention in order to improve the health of people with SMI.

Poverty and mental health in Indonesia.

PubMed

Tampubolon, Gindo; Hanandita, Wulung

2014-04-01

Community and facility studies in developing countries have generally demonstrated an inverse relationship between poverty and mental health. However, recent population-based studies contradict this. In India and Indonesia the poor and non-poor show no difference in mental health. We revisit the relationship between poverty and mental health using a validated measure of depressive symptoms (CES-D) and a new national sample from Indonesia - a country where widespread poverty and deep inequality meet with a neglected mental health service sector. Results from three-level overdispersed Poisson models show that a 1% decrease in per capita household expenditure was associated with a 0.05% increase in CES-D score (depressive symptoms), while using a different indicator (living on less than $2 a day) it was estimated that the poor had a 5% higher CES-D score than the better off. Individual social capital and religiosity were found to be positively associated with mental health while adverse events were negatively associated. These findings provide support for the established view regarding the deleterious association between poverty and mental health in developed and developing countries. Copyright © 2014 Elsevier Ltd. All rights reserved.

Disaster Mental Health and Community-Based Psychological First Aid: Concepts and Education/Training.

PubMed

Jacobs, Gerard A; Gray, Brandon L; Erickson, Sara E; Gonzalez, Elvira D; Quevillon, Randal P

2016-12-01

Any community can experience a disaster, and many traumatic events occur without warning. Psychologists can be an important resource assisting in psychological support for individuals and communities, in preparation for and in response to traumatic events. Disaster mental health and the community-based model of psychological first aid are described. The National Preparedness and Response Science Board has recommended that all mental health professionals be trained in disaster mental health, and that first responders, civic officials, emergency managers, and the general public be trained in community-based psychological first aid. Education and training resources in these two fields are described to assist psychologists and others in preparing themselves to assist their communities in difficult times and to help their communities learn to support one another. © 2016 Wiley Periodicals, Inc.

Opening minds in Canada: background and rationale.

PubMed

Stuart, Heather; Chen, Shu-Ping; Christie, Romie; Dobson, Keith; Kirsh, Bonnie; Knaak, Stephanie; Koller, Michelle; Krupa, Terry; Lauria-Horner, Bianca; Luong, Dorothy; Modgill, Geeta; Patten, Scott B; Pietrus, Mike; Szeto, Andrew; Whitley, Rob

2014-10-01

To summarize the background and rationale of the approach taken by the Mental Health Commission of Canada's Opening Minds (OM) Anti-Stigma Initiative. The approach taken by OM incorporates a grassroots, community development philosophy, has clearly defined target groups, uses contact-based education as the central organizing element across interventions, and has a strong evaluative component, so that best practices can be identified, replicated, and disseminated. Contact-based education occurs when people who have experienced a mental illness share their personal story of recovery and hope. OM has acted as a catalyst to develop partnerships between community groups who are undertaking anti-stigma work and an interdisciplinary team of academic researchers in 5 universities who are evaluating the results of these programs. Building partnerships with existing community programs and promoting systematic evaluation using standardized approaches and instruments have contributed to our understanding of best practices in the field of anti-stigma programming.

Resilience of nurses who work in community mental health workplaces in Palestine.

PubMed

Marie, Mohammad; Hannigan, Ben; Jones, Aled

2017-08-01

People in Palestine live and work in a significantly challenging environment. As a result of these challenges they have developed resilient responses which are embedded in their cultural context. 'Sumud', in particular, is a socio-political concept which refers to ways of surviving in the context of occupation, chronic adversity, lack of resources and limited infrastructure. Nurses' work in Palestine is an under-researched subject and very little is known about how nurses adjust to such challenging environments. To address this gap in the literature this study aimed to explore the resilience of community mental health nurses (CMHNs) who work in Palestine. An interpretive qualitative design was chosen. Fifteen face-to-face interviews were completed with participants. Thirty-two hours of observations of the day-to-day working environment and workplace routines were conducted in two communities' mental health centres. Written documents relating to practical job-related policies were also collected from various workplaces. Thematic analysis was used across all data sources resulting in four main themes, which describe the sources of resilience among CMHNs. These sources are 'Sumud and Islamic cultures', 'Supportive relationships', 'Making use of the available resources', and 'Personal capacity'. The study concludes with a better understanding of resilience in nursing, which draws on wider cultural contexts and social ecological responses. The outcomes from this study will be used to develop the resilience of CMHNs in Palestine. © 2016 The Authors International Journal of Mental Health Nursing published by John Wiley & Sons Australia, Ltd on behalf of Australian College of Mental Health Nurses Inc.

76 FR 17418 - Agency Information Collection Request; 60-Day Public Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2011-03-29

... publicly-funded community mental health and other community-based behavioral health settings. The... (ASPE) and the Substance Abuse and Mental Health Services Administration (SAMHSA) are funding an independent evaluation of the Substance Abuse and Mental Health Services Administration/Center for Mental...

76 FR 17129 - Agency Information Collection Request. 60-Day Public Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2011-03-28

... publicly-funded community mental health and other community-based behavioral health settings. The... (ASPE) and the Substance Abuse and Mental Health Services Administration (SAMHSA) are funding an independent evaluation of the Substance Abuse and Mental Health Services Administration/Center for Mental...

Recidivism of Offenders with Mental Illness Released from Prison to an Intensive Community Treatment Program

ERIC Educational Resources Information Center

Theurer, Gregory; Lovell, David

2008-01-01

An intensive case management treatment program for mentally ill offenders (MIOs) is outlined, and subsequent recidivism of participants is evaluated. Features of the program and its development are discussed. Sixty-four (64) participants released from state prison between 1998 and 2003 were matched with a group of MIOs released earlier on eight…

Kulintja Nganampa Maa-kunpuntjaku (Strengthening Our Thinking): Place-Based Approaches to Mental Health and Wellbeing in Anangu Schools

ERIC Educational Resources Information Center

Osborne, Sam

2013-01-01

MindMatters, implemented by Principals Australia Institute, is a resource and professional development initiative supporting Australian secondary schools in promoting and protecting the mental health and social and emotional wellbeing of members of school communities, preferring a proactive paradigm (Covey, 1989) to the position of "disaster…

Health Service Inpatient Units for People with Intellectual Disabilities and Challenging Behaviour or Mental Health Problems

ERIC Educational Resources Information Center

Mansell, Jim; Ritchie, Fiona; Dyer, Ricinda

2010-01-01

Background: As institutions for people with intellectual disabilities have been replaced with community services, health care provision has developed to provide assessment and treatment, low and medium secure units for people with challenging behaviour or mental health problems. These include both public and private sector provision. Little is…

First and Subsequent Lifetime Alcoholism and Mental Disorders in Suicide Victims With Reference to a Community Sample-the Lundby Study 1947-1997.

PubMed

Holmstrand, Cecilia; Bogren, Mats; Mattisson, Cecilia; Brådvik, Louise

2018-01-01

Background: Suicide victims have been found to frequently suffer from mental disorders, often more than one, and comorbidity has also been found to be a risk factor for suicide. The aim of the present study was to determine the first disorder and possible subsequent disorders in suicide victims during their lifetimes and to compare their development with the development of mental and alcohol use disorders (AUDs) in a community sample. Methods: The Lundby Study is a prospective longitudinal study of mental health in a general population comprising 3,563 subjects, including 68 suicide victims, followed by four field investigations from 1947 to 1997; mortality was monitored up to 2011. Results: AUD was most common as a first diagnosis (26/68, 38.2%) among suicide victims, followed by "depression" (20/68, 29.4%) and "anxiety" (7/68, 10.3%). A predominance of AUD as a first diagnosis was found in the male group, whereas "depression" was the most common first diagnosis in the female group. However, there were very few females with AUD in the Lundby Study. In the whole population, it was more common for someone who started with an AUD to develop a subsequent mental disorder than the other way around. The same was true for AUD in relation to depression. Conclusions: AUD was the most common first mental disorder among male suicide victims and could thus be considered a starting point in the suicidal process. We propose that in addition to detecting and treating depression, it is important to detect and treat AUD vigorously and to be alert for subsequent symptoms of depressive and other mental disorders in suicide prevention efforts.

Community psychiatry: results of a public opinion survey.

PubMed

Lauber, Christoph; Nordt, Carlos; Haker, Helene; Falcato, Luis; Rössler, Wulf

2006-05-01

Mental health authorities must know the public's attitude to community psychiatry when planning community mental health services. However, previous studies have only investigated the impact of demographic variables on the attitude to community psychiatry. To assess the influence of psychological and sociological parameters on the public opinion of community psychiatry in Switzerland. Linear regression analyses of the results of a public opinion survey on a representative population sample in Switzerland (n = 1737). Most respondents have positive attitudes to community psychiatry. In the regression analysis (R2 adjusted = 21.2%), negative emotions towards mentally ill people as depicted in the vignette, great social distance, a positive attitude to restrictions, negative stereotypes, high rigidity and no participation in community activities significantly influenced negative attitudes to community psychiatry. Additionally, other parameters, e.g. contact with mentally ill people and the nationality of the interviewee, have a significant influence. In planning psychiatric community services, general individual traits and emotive issues should be considered because they influence the response towards community psychiatry facilities in the host community.

Impact of postpartum anxiety and depression on child's mental development from two peri-urban communities of Karachi, Pakistan: a quasi-experimental study.

PubMed

Ali, Niloufer Sultan; Mahmud, Sadia; Khan, Asia; Ali, Badar Sabir

2013-10-22

Postpartum anxiety and depression has detrimental effects on the overall mental development of children. This study aims to assess the impact of postpartum anxiety and depression on children's mental development on all sub-scales in a Pakistani population. A quasi-experimental study was conducted in two peri-urban communities of Karachi, a mega city of Pakistan, to assess the impact of postpartum anxiety and depression on children's growth and mental development. A total of 420 women were enrolled, who had given consent out of 651 pregnant women identified, during February 2004 to December 2005. Data for socio-demographic, home environment and family relationship variables were collected between 36 weeks of pregnancy and within 10 days of childbirth. Mother's levels of anxiety and depression were assessed at 1, 2, 6, 12, 18, 24, and 30 months of childbirth. An indigenous, validated screening instrument- Aga Khan University Anxiety and Depression scale was used and diagnostic confirmation was done through a psychologist's interview, based on DSM IV criteria. Children's growth and development was monitored in the same sequence using an Early Childhood Development tool that consists of five subscales; socio emotional, language, cognitive, gross motor and fine motor development. Physical growth was monitored by measuring height and weight of the child. Data was analyzed using SAS 9.2. Multivariable Generalized Estimating Equations (GEE) logistic regression was conducted to identify association of postpartum anxiety and depression with each early childhood development indicator, adjusting for parental and child factors. A significant association of postpartum anxiety and depression with delayed development on all five subscales of children's mental development was found in our study. Interestingly, our study found that higher maternal age had adverse effects on child's emotional whereas positive impact on child's cognitive development. Children's stunting had an adverse impact on all five subscales of children's development. Male children were at higher risk for delayed language and gross motor development relative to female children. Our study found that postpartum anxiety and depression is associated with adverse outcomes regarding children's mental development on all sub-scales. The impact was accentuated by low family income or child's increasing age.

Community engagement: outcomes for occupational therapy students, faculty and clients.

PubMed

Schindler, Victoria P

2014-06-01

Students in health care professions, including occupational therapy, are required to develop knowledge, skills and attitudes in mental health and research. Persons diagnosed with a mental illness, a learning disability or an autism-spectrum disorder desire to achieve goals in higher education and employment. Faculty in health care programmes strives to meet professional goals and accreditation and institution requirements for teaching, service and scholarship. The Bridge Program, a programme based on principles of community engagement, was developed to meet the needs of these three stakeholders. The objective of this paper is to provide programme description and outcomes of the effectiveness of the Bridge Program for all three stakeholders. This uses mixed methods research design including descriptive and quantitative and qualitative one-group pre-test-post-test designs. Instruments consisted of the Occupational Therapy Student and Mental Health Population Scale and the Canadian Occupational Performance Measure. Quantitative results support that graduate occupational therapy students gained research and clinical skills (n = 100; p = .000); clients increased performance and satisfaction toward goals (n = 113; p = .000) and faculty (n = 1) achieved goals related to teaching, service and scholarship. Programmes based on principles of community engagement can address the needs of the community, can provide outcomes that advance knowledge about community practice and can result in benefits for all stakeholders. This paper is limited to generalization and instrumentation and recommends an ongoing evaluation of other community engagement programmes involving all stakeholders in the future research. Copyright © 2014 John Wiley & Sons, Ltd.

Mental health promotion in comprehensive schools.

PubMed

Onnela, A M; Vuokila-Oikkonen, P; Hurtig, T; Ebeling, H

2014-09-01

The purpose of this paper is to describe a participatory action research process on the development of a professional practice model of mental health nurses in mental health promotion in a comprehensive school environment in the city of Oulu, Finland. The developed model is a new method of mental health promotion for mental health nurses working in comprehensive schools. The professional practice model has been developed in workshops together with school staff, interest groups, parents and students. Information gathered from the workshops was analysed using action research methods. Mental health promotion interventions are delivered at three levels: universal, which is an intervention that affects the whole school or community; selective, which is an intervention focusing on a certain group of students; and indicated, which is an individually focused intervention. All interventions are delivered within the school setting, which is a universal setting for all school-aged children. The interventions share the goal of promoting mental health. The purposes of the interventions are enhancing protective factors, reducing risk factors relating to mental health problems and early identification of mental health problems as well as rapid delivery of support or referral to specialized services. The common effect of the interventions on all levels is the increase in the experience of positive mental health. © 2014 John Wiley & Sons Ltd.

75 FR 76006 - Agency Emergency Information Collection Clearance Request for Public Comment

Federal Register 2010, 2011, 2012, 2013, 2014

2010-12-07

... primary care services into publicly funded community mental health and other community-based behavioral... Substance Abuse and Mental Health Administration are funding an independent evaluation of the Substance Abuse and Mental Health Administration/Center for Mental Health Services' (SAMHSA/CMHS) Primary Care...

Tangled up in Blue: Boosting Mental Health Services at Community Colleges

ERIC Educational Resources Information Center

Finkel, Ed

2016-01-01

In a recent survey of 4,000 community college students, half reported experiencing a mental health condition. American College Counseling Association's (ACCA) fifth annual survey of personal and mental health counseling at community colleges provides some data from 159 professionals at two-year colleges in 41 states and Puerto Rico. Among the…

A Phenomenological Study: Community Mental Health Centers Leaders Influence on Clinician Effectiveness

ERIC Educational Resources Information Center

Williams, Beth B.

2011-01-01

Some clinical leaders of community mental health centers are not aware of successful methods for supporting and empowering staff to be more effective, specifically when the staff is experiencing change because of new health information technology. Clinical leaders in community mental health face similar management issues as do other business,…

Integration initiatives for forensic services

PubMed Central

ARBOLEDA-FLÓREZ, JULIO

2003-01-01

Poorly implemented mental health reform policies are often given as reasons for the growth in demands for forensic psychiatric services and the steady increase of mental patients in prison systems. However, in this paper, additional reasons are advanced to explain the growth of forensic psychiatry, such as an expansion in the types of "psychiatric defences" in courts of law; public concerns about violent behaviour attributed to the mentally ill; the community management of paraphilias, especially pedophilia; the development of risk assessment methodologies and the halo of super-specialization. The net result of these developments is that patients who receive a label of "forensic" enter into a mental health ghetto with little connectivity or integration with the general mental health system. The forensic label increases the stigma and decreases opportunities for reintegration and full social recovery. The paper provides guidelines to reverse these trends. PMID:16946932

Pakistan mental health country profile.

PubMed

Karim, Salman; Saeed, Khalid; Rana, Mowaddat Hussain; Mubbashar, Malik Hussain; Jenkins, Rachel

2004-01-01

The Republic of Pakistan is a South East Asian country with a population of over 140.7 million. Its population is fast growing and the majority (70%) live in rural areas with a feudal or tribal value system. The economy is dependent on agriculture and 35% of the population live below the poverty line. Islam is the main religion and 'mental illnesses' are stigmatized and widely perceived to have supernatural causes. The traditional healers along with psychiatric services are the main mental health service providers. The number of trained mental health professionals is small as compared to the population demands and specialist services are virtually non-existent. Lack of data on prevalence of various mental illnesses and monitory constraints are the major hurdles in the development of mental health services. A number of innovative programmes to develop indigenous models of care like the 'Community Mental Health Programme' and 'Schools Mental Health Programme' have been developed. These programmes have been found effective in reducing stigma and increase awareness of mental illness amongst the adults and children living in rural areas. Efforts by the government and mental health professionals have led to the implementation of a 'National Mental Health Policy' and 'Mental Health Act' in 2001. These aim at integrating mental health services with the existing health services, improving mental health care delivery and safeguarding the rights of mentally ill people. A favourable political will and the help of international institutions like the World Health Organization are required to achieve these aims.

A Study of the Community Adjustment of Deinstitutionalized Mentally Retarded Persons. Volume I. Approaches to Defining and Measuring the Community Adjustment of Mentally Retarded Persons: A Review of the Literature.

ERIC Educational Resources Information Center

Freedman, Ruth

The first of a six-volume series on the community adjustment of deinstitutionalized mentally retarded persons examines 28 research studies on community adjustment and proposes a framework for reviewing criterion measures and predictors of adjustment. Summary descriptions of major characteristics of the studies are provided, and matrices listing…

Re-Designing Community Mental Health Services for Urban Children: Supporting Schooling to Promote Mental Health

PubMed Central

Atkins, Marc S.; Shernoff, Elisa S.; Frazier, Stacy L.; Schoenwald, Sonja K.; Cappella, Elise; Marinez-Lora, Ane; Mehta, Tara G.; Lakind, Davielle; Cua, Grace; Bhaumik, Runa; Bhaumik, Dulal

2015-01-01

Objective This study examined a school- and home-based mental health service model, Links to Learning (L2L), focused on empirical predictors of learning as primary goals for services in high poverty urban communities. Method Teacher key opinion leaders (KOLs) were identified through sociometric surveys and trained, with mental health providers (MHPs) and parent advocates (PAs), on evidence-based practices to enhance children’s learning. KOLs and MHPs co-facilitated professional development sessions for classroom teachers to disseminate two universal (Good Behavior Game, Peer Assisted Learning) and two targeted (Good News Notes, Daily Report Card) interventions. Group-based and home-based family education and support were delivered by MHPs and PAs for K-4th grade children diagnosed with one or more disruptive behavior disorder. Services were Medicaid-funded through four social service agencies (N = 17 providers) in seven schools (N = 136 teachers, 171 children) in a two (L2L vs. services-as-usual SAU]) by six (pre- and post-tests for three years) longitudinal design with random assignment of schools to conditions. SAU consisted of supported referral to a nearby social service agency. Results Mixed effects regression models indicated significant positive effects of L2L on mental health service use, classroom observations of academic engagement, teacher report of academic competence and social skills, and parent report of social skills. Nonsignificant between-group effects were found on teacher and parent report of problem behaviors, daily hassles, and curriculum based measures. Effects were strongest for young children, girls, and children with fewer symptoms. Conclusions Community mental health services targeting empirical predictors of learning can improve school and home behavior for children living in high poverty urban communities. PMID:26302252

Variability in community functioning of mothers with serious mental illness.

PubMed

Bybee, Deborah; Mowbray, Carol T; Oyserman, Daphna; Lewandowski, Lisa

2003-01-01

In the post-deinstitutionalization era, everyday community functioning is an important aspect of assessment and treatment of individuals with serious mental illness. The current study focuses on correlates of community functioning among 332 low-income mothers with serious mental illness. Results revealed significant relationships between everyday functioning and a number of demographic, psychiatric, contextual, and mental health treatment variables. Current psychiatric symptoms accounted for the greatest amount of variance and completely mediated the effects of diagnosis and substance abuse history on community functioning; yet contextual variables such as financial worries and social support were also significant predictors, even after controlling for symptoms and other clinical characteristics. Additionally, use of mental health services was a significant moderator of the effect of social stress on community functioning. Implications of results for future research and practice are discussed.

"I cry every day and night, I have my son tied in chains": physical restraint of people with schizophrenia in community settings in Ethiopia.

PubMed

Asher, Laura; Fekadu, Abebaw; Teferra, Solomon; De Silva, Mary; Pathare, Soumitra; Hanlon, Charlotte

2017-07-11

A primary rationale for scaling up mental health services in low and middle-income countries is to address human rights violations, including physical restraint in community settings. The voices of those with intimate experiences of restraint, in particular people with mental illness and their families, are rarely heard. The aim of this study was to understand the experiences of, and reasons for, restraint of people with schizophrenia in community settings in rural Ethiopia in order to develop constructive and scalable interventions. A qualitative study was conducted, involving 15 in-depth interviews and 5 focus group discussions (n = 35) with a purposive sample of people with schizophrenia, their caregivers, community leaders and primary and community health workers in rural Ethiopia. Thematic analysis was used. Most of the participants with schizophrenia and their caregivers had personal experience of the practice of restraint. The main explanations given for restraint were to protect the individual or the community, and to facilitate transportation to health facilities. These reasons were underpinned by a lack of care options, and the consequent heavy family burden and a sense of powerlessness amongst caregivers. Whilst there was pervasive stigma towards people with schizophrenia, lack of awareness about mental illness was not a primary reason for restraint. All types of participants cited increasing access to treatment as the most effective way to reduce the incidence of restraint. Restraint in community settings in rural Ethiopia entails the violation of various human rights, but the underlying human rights issue is one of lack of access to treatment. The scale up of accessible and affordable mental health care may go some way to address the issue of restraint. Clinicaltrials.gov NCT02160249 Registered 3rd June 2014.

The role of child and parental mentalizing for the development of conduct problems over time.

PubMed

Ha, Carolyn; Sharp, Carla; Goodyer, Ian

2011-06-01

The current study aimed to investigate the role of parental and child mentalizing in the development of conduct problems over time in a community sample of 7- to 11-year-olds (N = 659). To measure child mentalizing, children were asked to complete a social vignettes task at baseline as a measure of distorted mentalizing. Parents (primarily mothers) were asked to complete the same task, guessing their child's responses in the social scenarios as a measure of maternal mentalizing. Conduct problems were evaluated using repeated measures from multi-informant (self-, teacher-, and parent-report) questionnaires completed at baseline and 1-year follow-up. As expected, children who had an overly positive mentalizing style were more likely to be reported by teachers as having conduct problems at 1-year follow-up. These findings held when controlling for baseline conduct problems, IQ, SES, and sex. Findings for maternal mentalizing were significant for follow-up parent-report conduct problem symptoms at the bivariate level of analyses, but not at the multivariate level when controlling for baseline conduct problems and age. These findings extend previous reports by providing predictive validity for distorted mentalizing in the development of conduct problems.

Epidemiology of Serious Mental Illness in Malta - Consequences for developing a new psychiatric hospital and community psychiatry.

PubMed

Grech, Anton

2016-09-01

Mental Health Services in Malta are presently at crossroads, because they are in the stage of increasing and strengthening the community services and considering closing the main psychiatric inpatient facility and replacing it with a new hospital. For proper planning of such changes, and ideal approach is that of basing these plans on results of population based epidemiological findings on rate of mental illness and required care. Such studies are strongly recommended, and this approach has already been used in Malta a couple of years ago prior to establishing inpatient care for Eating Disorders. In absence of such studies, this paper proposes ways how to use findings from available research and data to use as basis for such proper service plans.

The Impact of Community Design and Land-Use Choices on Public Health: A Scientific Research Agenda

PubMed Central

Dannenberg, Andrew L.; Jackson, Richard J.; Frumkin, Howard; Schieber, Richard A.; Pratt, Michael; Kochtitzky, Chris; Tilson, Hugh H.

2003-01-01

The design of a community’s built environment influences the physical and mental health of its residents. Because few studies have investigated this relationship, the Centers for Disease Control and Prevention hosted a workshop in May 2002 to help develop a scientific research agenda on these issues. Workshop participants’ areas of expertise included physical activity, injury prevention, air pollution, water quality, urban planning, transportation, architecture, epidemiology, land use, mental health, social capital, housing, and social marketing. This report describes the 37 questions in the resulting research agenda. The next steps are to define priorities and obtain resources. The proposed research will help identify the best practices for designing new communities and revitalizing old ones in ways that promote physical and mental health. PMID:12948970

Design considerations for community mental health management information systems.

PubMed

Lowe, B H; Sugarman, B

1978-01-01

Many community mental health centers are presently faced with the necessity of implementing a management information system. This article offers guidelines for centers dealing with this situation. Whether a center chooses to adapt an existing system or develop one of its own, careful planning prior to the implementation of the system can help ensure that it will meet the needs of the center and operate successfully. The guidelines are organized into the categories of data considerations, people considerations, and system considerations. The first two categories are of general interest, whereas the last category is more technical in nature.

Counseling in Community: Myth or Reality?

ERIC Educational Resources Information Center

Allen, Jackie

This chapter reviews the myths and stories of counseling over the past several decades and proposes that the twenty-first century story of counseling must be counseling in community. This paradigm change will involve counselors joining with mental health professionals, career development specialists, and educators to write the story of…

State mental health policy: Maryland's shared leadership approach to mental health transformation: partnerships that work.

PubMed

Semansky, Rafael M

2012-07-01

In 2005, Maryland received a mental health transformation grant from the Substance Abuse and Mental Health Services Administration. Maryland's transformation efforts have differed from those in other grantee states and have evolved into a shared leadership approach that harnesses the power of leaders from all sectors of the community. This column describes Maryland's reform efforts, focusing in particular on the development of the position of a peer employment specialist to improve placement of consumers in employment. This shared leadership approach has the potential to enhance long-term sustainability of reform initiatives and uses fewer state resources.

The impact of realignment on utilization and cost of community-based mental health services in California.

PubMed

Scheffler, R; Zhang, A; Snowden, L

2001-11-01

Decentralization of California's public mental health system under program realignment has changed the utilization and cost of community-based mental health services. This study examined a sample of 75,951 users, representing 1.5 million adults who visited California's public mental health services during a 6-year period (FY 1988-1990 and FY 1992-1994). Regression analysis was performed to examine cost and utilization reduction over time, across regions, and across psychiatric diagnoses. Overall utilization and cost of community-based mental health services dropped significantly after the implementation of realignment. They were significantly lower for (a) 24-hour services in the urban industrialized Southern Region and (b) outpatient services in the agricultural Central Region of the state. Users diagnosed with mood disorders took a greater portion, but were associated with significantly less treatment and cost than other users in the post-realignment period. When local communities bear the financial risks and rewards, they find more efficient methods of delivering community-based mental health services.

Identification of Important Community Living Skills for Adults with Mental Retardation.

ERIC Educational Resources Information Center

Lovett, David L.; Harris, Mary B.

1987-01-01

Attempted to identify skills important for successful community living of adults with mental retardation. Individuals (N=73) who had significant contact with adults with mental retardation completed questionnaire on academic, leisure, personal, social, and vocational skills frequently taught to persons with mental handicaps. Subjects considered…

The implications of community responses to intimate partner violence in Rwanda

PubMed Central

Seyed-Raeisy, Iran; Burgess, Rochelle; Campbell, Catherine

2018-01-01

Intimate partner violence (IPV) has significant impacts on mental health. Community-focused interventions have shown promising results for addressing IPV in low-income countries, however, little is known about the implications of these interventions for women’s mental wellbeing. This paper analyses data from a community-focused policy intervention in Rwanda collected in 2013–14, including focus group discussions and in-depth interviews with community members (n = 59). Our findings point to three ways in which these community members responded to IPV: (1) reconciling couples experiencing violence, (2) engaging community support through raising cases of IPV during community discussions, (3) navigating resources for women experiencing IPV, including police, social services and legal support. These community responses support women experiencing violence by helping them access available resources and by engaging in community discussions. However, assistance is largely only offered to married women and responses tend to focus exclusively on physical rather than psychological or emotional forms of violence. Drawing on Campbell and Burgess’s (2012) framework for ‘community mental health competence’, we interrogate the potential implications of these responses for the mental wellbeing of women affected by violence. We conclude by drawing attention to the gendered nature of community responses to IPV and the potential impacts this may have for the mental health of women experiencing IPV. PMID:29718961

The implications of community responses to intimate partner violence in Rwanda.

PubMed

Mannell, Jenevieve; Seyed-Raeisy, Iran; Burgess, Rochelle; Campbell, Catherine

2018-01-01

Intimate partner violence (IPV) has significant impacts on mental health. Community-focused interventions have shown promising results for addressing IPV in low-income countries, however, little is known about the implications of these interventions for women's mental wellbeing. This paper analyses data from a community-focused policy intervention in Rwanda collected in 2013-14, including focus group discussions and in-depth interviews with community members (n = 59). Our findings point to three ways in which these community members responded to IPV: (1) reconciling couples experiencing violence, (2) engaging community support through raising cases of IPV during community discussions, (3) navigating resources for women experiencing IPV, including police, social services and legal support. These community responses support women experiencing violence by helping them access available resources and by engaging in community discussions. However, assistance is largely only offered to married women and responses tend to focus exclusively on physical rather than psychological or emotional forms of violence. Drawing on Campbell and Burgess's (2012) framework for 'community mental health competence', we interrogate the potential implications of these responses for the mental wellbeing of women affected by violence. We conclude by drawing attention to the gendered nature of community responses to IPV and the potential impacts this may have for the mental health of women experiencing IPV.

A national evaluation of community-based mental health strategies in Finland.

PubMed

Vähäniemi, Anu; Warwick-Smith, Katja; Hätönen, Heli; Välimäki, Maritta

2018-02-01

High-quality mental health care requires written strategies to set a vision for the future, yet, there is limited systematic information available on the monitoring and evaluation of such strategies. The aim of this nationwide study is to evaluate local mental health strategies in community-based mental health services provided by municipalities. Mental health strategy documents were gathered through an online search and an e-mail survey of the local authorities of all Finnish mainland municipalities (n = 320). Out of 320 municipalities, documents for 129 municipalities (63 documents) were included in the study. The documents obtained (n = 63) were evaluated against the World Health Organization checklist for mental health strategies and policies. Evaluation of the process, operations and content of the documents, against 31 indicators in the checklist. Out of 320 Finnish municipalities, 40% (n = 129) had a mental health strategy document available and 33% (n = 104) had a document that was either in preparation or being updated. In these documents, priorities, targets and activities were clearly described. Nearly all (99%) of the documents suggested a commitment to preventative work, and 89% mentioned a dedication to developing community-based care. The key shortfalls identified were the lack of consideration of human rights (0%), the limited consideration of research (5%) and the lack of financial planning (28%) to successfully execute the plans. Of the documents obtained, 60% covered both mental health and substance abuse issues. This study contributes to the limited evidence base on health care strategy evaluations. Further research is needed to understand the potential impact of policy analysis. © The Author(s) 2017. Published by Oxford University Press in association with the International Society for Quality in Health Care. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

A scenario analysis of the future residential requirements for people with mental health problems in Eindhoven

PubMed Central

2011-01-01

Background Despite large-scale investments in mental health care in the community since the 1990 s, a trend towards reinstitutionalization has been visible since 2002. Since many mental health care providers regard this as an undesirable trend, the question arises: In the coming 5 years, what types of residence should be organized for people with mental health problems? The purpose of this article is to provide mental health care providers, public housing corporations, and local government with guidelines for planning organizational strategy concerning types of residence for people with mental health problems. Methods A scenario analysis was performed in four steps: 1) an exploration of the external environment; 2) the identification of key uncertainties; 3) the development of scenarios; 4) the translation of scenarios into guidelines for planning organizational strategy. To explore the external environment a document study was performed, and 15 semi-structured interviews were conducted. During a workshop, a panel of experts identified two key uncertainties in the external environment, and formulated four scenarios. Results The study resulted in four scenarios: 1) Integrated and independent living in the community with professional care; 2) Responsible healthcare supported by society; 3) Differentiated provision within the walls of the institution; 4) Residence in large-scale institutions but unmet need for care. From the range of aspects within the different scenarios, the panel was able to work out concrete guidelines for planning organizational strategy. Conclusions In the context of residence for people with mental health problems, the focus should be on investment in community care and their re-integration into society. A joint effort is needed to achieve this goal. This study shows that scenario analysis leads to useful guidelines for planning organizational strategy in mental health care. PMID:21211015

Addressing unmet mental health and substance abuse needs: a partnered planning effort between grassroots community agencies, faith-based organizations, service providers, and academic institutions.

PubMed

Wong, Eunice C; Chung, Bowen; Stover, Gabriel; Stockdale, Susan; Jones, Felica; Litt, Paula; Klap, Ruth S; Patel, Kavita; Wells, Kenneth B

2011-01-01

To conduct a process evaluation of the Restoration Center Los Angeles, a community-academic partnered planning effort aimed at holistically addressing the unmet mental health and substance abuse needs of the Los Angeles African American community. Semi-structured interviews with open-ended questions on key domains of partnership effectiveness were conducted with a random stratified sample of participants varying by level of involvement. Eleven partners representing grassroots community agencies, faith-based organizations, service providers, and academic institutions. Common themes identified by an evaluation consultant and partners relating to partnership effectiveness, perceived benefits and costs, and future expectations. Findings underscore the importance of considering the potential issues that may arise with the increasing diversity of partners and perspectives. Many of the challenges and facilitating factors that arise within academic-community partnerships were similarly experienced between the diverse set of community partners. Challenges that affected partnership development between community-to-community partners included differences in expectations regarding the final goal of the project, trust-building, and the distribution of funds. Despite such challenges, partners were able to jointly develop a final set of recommendations for the creation of restoration centers, which was viewed as a major accomplishment. Limited guidance exists on how to navigate differences that arise between community members who have shared identities on some dimensions (eg, African American ethnicity, Los Angeles residence) but divergent identities on other dimensions (eg, formal church affiliation). With increasing diversity of community representation, careful attention needs to be dedicated to not only the development of academic-community partnerships but also community-community partnerships.

In their own words: young people's mental health in drought-affected rural and remote NSW.

PubMed

Carnie, Tracey-Lee; Berry, Helen Louise; Blinkhorn, Susan Audrey; Hart, Craig Richard

2011-10-01

To record the drought-related experiences of young people and to contrast these with their teachers' and other adults' observations. Content analysis of issues and priorities raised in semistructured school-based forums. Rural schools in NSW centres. Young people, their teachers and service providers. Six youth and community forums organised under the Rural Adversity Mental Health Program. Participants welcomed increased community connectedness in response to prolonged drought but reported that drought's mental health impact was mainly negative. Adults observed children's distress, wondering if anyone else noticed it. They witnessed young people worrying about their families, increasingly isolated, at risk of harm, unable to obtain help and facing educational and employment limitations. Young people disclosed many mental health and relationship difficulties at school and at home. They worried about their families, communities and futures and about money and being isolated. Adults and young people reported similar effects of prolonged drought on young people's mental health. But, while adults were more concerned with risks to young people (of harm, abuse, homelessness, problems with the law and constrained opportunities), young people were simply overwhelmed, wanting help for their immediate worries. They sought coordinated support within schools, schools working together, more information about mental health and where to seek help for them and their friends, and support people who understood drought and rural circumstances and on whose discretion they could rely. Mental health programs that are developed in and for metropolitan contexts need to be adapted before being deployed in rural settings. © 2011 The Authors. Australian Journal of Rural Health © National Rural Health Alliance Inc.

Service users' expectations of treatment and support at the Community Mental Health Centre in their recovery.

PubMed

Biringer, Eva; Davidson, Larry; Sundfør, Bengt; Ruud, Torleif; Borg, Marit

2017-09-01

Focus on service users' needs, coping and empowerment, user involvement, and comprehensiveness are supposed to be key elements of the Community Mental Health Centres in Norway. Taking a user-oriented approach means acknowledging the individual's own expectations, aims and hopes. However, studies that have investigated service users' expectations of treatment and support at Community Mental Health Centres are hard to find. The aim of the study was therefore to explore service users' expectations at the start of treatment at a Community Mental Health Centre. Within a collaborative framework, taking a hermeneutic-phenomenological approach, ten service users participated in in-depth interviews about their expectations, hopes and aims for treatment and recovery. The participants sought help due to various mental health issues that had interfered with their lives and created disability and suffering. A data-driven stepwise approach in line with thematic analysis was used. The study was approved by the Norwegian Social Science Data Services. The following four main themes representing participants' expectations at the start of treatment were elicited: hope for recovery, developing understanding, finding tools for coping and receiving counselling and practical assistance. Participants' expectations about treatment were tightly interwoven with their personal aims and hopes for their future life, and expectations were often related to practical and financial problems, the solution of which being deemed necessary to gain a safe basis for recovery in the long run. The transferability of the results may be limited by the small number of participants. The study emphasises how important it is that service users' personal aims and expectations guide the collaborative treatment process. In addition to providing treatment aimed at improving symptoms, Community Mental Health Centres should take a more comprehensive approach than today by providing more support with family issues, social life, education, work and financial issues. © 2016 Nordic College of Caring Science.

Promoting wellbeing and improving access to mental health care through community champions in rural India: the Atmiyata intervention approach.

PubMed

Shields-Zeeman, Laura; Pathare, Soumitra; Walters, Bethany Hipple; Kapadia-Kundu, Nandita; Joag, Kaustubh

2017-01-01

There are limited accounts of community-based interventions for reducing distress or providing support for people with common mental disorders (CMDs) in low and middle-income countries. The recently implemented Atmiyata programme is one such community-based mental health intervention focused on promoting wellness and reducing distress through community volunteers in a rural area in the state of Maharashtra, India. This case study describes the content and the process of implementation of Atmiyata and how community volunteers were trained to become Atmiyata champions and mitras ( friends ). The Atmiyata programme trained Atmiyata champions to provide support and basic counselling to community members with common mental health disorders, facilitate access to mental health care and social benefits, improve community awareness of mental health issues, and to promote well-being. Challenges to implementation included logistical challenges (difficult terrain and weather conditions at the implementation site), content-related challenges (securing social welfare benefits for people with CMDs), and partnership challenges (turnover of public health workers involved in referral chain, resistance from public sector mental health specialists). The case study serves as an example for how such a model can be sustained over time at low cost. The next steps of the programme include evaluation of the impact of the Atmiyata intervention through a pre-post study and adapting the intervention for further scale-up in other settings in India.

Community mental health nurses' perspectives of recovery-oriented practice.

PubMed

Gale, J; Marshall-Lucette, S

2012-05-01

Recovery-oriented practice, an approach aligned towards the service user perspective, has dominated the mental health care arena. Numerous studies have explored service users' accounts of the purpose, meaning and importance of 'recovery'; however, far less is known about healthcare staff confidence in its application to care delivery. A self-efficacy questionnaire and content analysis of nursing course documents were used to investigate a cohort of community mental health nurses' recovery-oriented practice and to determine the extent to which the current continuing professional development curriculum met their educational needs in this regard. Twenty-three community mental health nurses completed a self-efficacy questionnaire and 28 course documents were analysed. The findings revealed high levels of nurses' confidence in their understanding and ability to apply the recovery model and low levels of confidence were found in areas of social inclusion. The content analysis found only one course document that used the whole term 'recovery model'. The findings suggest a gap in the nurses' perceived ability and confidence in recovery-oriented practice with what is taught academically. Hence, nursing education needs to be more explicitly focused on the recovery model and its application to care delivery. © 2011 Blackwell Publishing.

Transformation of children's mental health services: the role of school mental health.

PubMed

Stephan, Sharon Hoover; Weist, Mark; Kataoka, Sheryl; Adelsheim, Steven; Mills, Carrie

2007-10-01

The New Freedom Commission has called for a transformation in the delivery of mental health services in this country. The commission's report and recommendations have highlighted the role of school mental health services in transforming mental health care for children and adolescents. This article examines the intersection of school mental health programs and the commission's recommendations in order to highlight the role of school mental health in the transformation of the child and adolescent mental health system. Schools are uniquely positioned to play a central role in improving access to child mental health services and in supporting mental health and wellness as well as academic functioning of youths. The New Freedom Commission report articulated several goals related to school mental health: reducing stigma, preventing suicide, improving screening and treating co-occurring disorders, and expanding school mental health programs. The authors suggest strategies for change, including demonstrating relevance to schools, developing consensus among stakeholders, enhancing community mental health-school connections, building quality assessment and improvement, and considering the organizational context of schools.

Prevention and mental illness: a new era for a healthier tomorrow.

PubMed

Buck, Steven

2010-07-01

The Department of Mental Health and Substance Abuse Services strives to provide the best possible care for Oklahoma communities through preventative programs and approaches such as QPR, Mental Health First Aid and mental health screenings. All of these techniques have been proven in providing adequate knowledge of risk factors in Oklahoma communities for mental health disorders and help to prevent those predisposed to mental illness from experiencing an onset of the disorder.

Systematic review of mental health and well-being outcomes following community-based obesity prevention interventions among adolescents.

PubMed

Hoare, Erin; Fuller-Tyszkiewicz, Matthew; Skouteris, Helen; Millar, Lynne; Nichols, Melanie; Allender, Steven

2015-01-05

This paper aimed to systematically evaluate the mental health and well-being outcomes observed in previous community-based obesity prevention interventions in adolescent populations. Systematic review of literature from database inception to October 2014. Articles were sourced from CINAHL, Global Health, Health Source: Nursing and Academic Edition, MEDLINE, PsycARTICLES and PsycINFO, all of which were accessed through EBSCOhost. The Cochrane Database was also searched to identify all eligible articles. PRISMA guidelines were followed and search terms and search strategy ensured all possible studies were identified for review. Intervention studies were eligible for inclusion if they were: focused on overweight or obesity prevention, community-based, targeted adolescents (aged 10-19 years), reported a mental health or well-being measure, and included a comparison or control group. Studies that focused on specific adolescent groups or were treatment interventions were excluded from review. Quality of evidence was assessed using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) guidelines. Primary outcomes were measures of mental health and well-being, including diagnostic and symptomatic measures. Secondary outcomes included adiposity or weight-related measures. Seven studies met the inclusion criteria; one reported anxiety/depressive outcomes, two reported on self-perception well-being measures such as self-esteem and self-efficacy, and four studies reported outcomes of quality of life. Positive mental health outcomes demonstrated that following obesity prevention, interventions included a decrease in anxiety and improved health-related quality of life. Quality of evidence was graded as very low. Although positive outcomes for mental health and well-being do exist, controlled evaluations of community-based obesity prevention interventions have not often included mental health measures (n=7). It is recommended that future interventions incorporate mental health and well-being measures to identify any potential mechanisms influencing adolescent weight-related outcomes, and equally to ensure interventions are not causing harm to adolescent mental health. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Community, Public Policy, and Recovery from Mental Illness: Emerging Research and Initiatives.

PubMed

Castillo, Enrico G; Chung, Bowen; Bromley, Elizabeth; Kataoka, Sheryl H; Braslow, Joel T; Essock, Susan M; Young, Alexander S; Greenberg, Jared M; Miranda, Jeanne; Dixon, Lisa B; Wells, Kenneth B

This commentary examines the roles that communities and public policies play in the definition and processes of recovery for adults with mental illness. Policy, clinical, and consumer definitions of recovery are reviewed, which highlight the importance of communities and policies for recovery. This commentary then presents a framework for the relationships between community-level factors, policies, and downstream mental health outcomes, focusing on macroeconomic, housing, and health care policies; adverse exposures such as crime victimization; and neighborhood characteristics such as social capital. Initiatives that address community contexts to improve mental health outcomes are currently under way. Common characteristics of such initiatives and select examples are discussed. This commentary concludes with a discussion of providers', consumers', and other stakeholders' roles in shaping policy reform and community change to facilitate recovery.

The Community Navigator Study: a feasibility randomised controlled trial of an intervention to increase community connections and reduce loneliness for people with complex anxiety or depression.

PubMed

Lloyd-Evans, Brynmor; Bone, Jessica K; Pinfold, Vanessa; Lewis, Glyn; Billings, Jo; Frerichs, Johanna; Fullarton, Kate; Jones, Rebecca; Johnson, Sonia

2017-10-23

Loneliness is associated with poor health outcomes at all ages, including shorter life expectancy and greater risk of developing depression. People with mental health problems are particularly vulnerable to loneliness and, for those with anxiety or depression, loneliness is associated with poorer outcomes. Interventions which support people to utilise existing networks and access new social contact are advocated in policy but there is little evidence regarding their effectiveness. People with mental health problems have potential to benefit from interventions to reduce loneliness, but evidence is needed regarding their feasibility, acceptability and outcomes. An intervention to reduce loneliness for people with anxiety or depression treated in secondary mental health services was developed for this study, which will test the feasibility and acceptability of delivering and evaluating it through a randomised controlled trial. In this feasibility trial, 40 participants with anxiety or depression will be recruited through two secondary mental health services in London and randomised to an intervention (n = 30) or control group (n = 10). The control group will receive standard care and written information about local community resources. The coproduced intervention, developed in this study, includes up to ten sessions with a 'Community Navigator' over a 6-month period. Community Navigators will work with people individually to increase involvement in social activities, with the aim of reducing feelings of loneliness. Data will be collected at baseline and at 6-month follow-up - the end of the intervention period. The acceptability of the intervention and feasibility of participant recruitment and retention will be assessed. Potential primary and secondary outcomes for a future definitive trial will be completed to assess response and completeness, including measures of loneliness, depression and anxiety. Qualitative interviews with participants, staff and other stakeholders will explore experiences of Community Navigator support, the mechanisms by which it may have its effects and suggestions for improving the programme. Our trial will provide preliminary evidence of the feasibility and acceptability of Community Navigator support and of trial procedures for testing this. The results will inform a future definitive randomised controlled trial of this intervention. ISRCTN10771821 . Registered on 3 April 2017.

A Multivariate Analysis of Termination Status in a Rural Community Mental Health Center.

ERIC Educational Resources Information Center

Tutin, Judith; Kessler, Marc

It has been estimated that the most pressing problem in community mental health care clinics is dropout, defined as unilateral termination by the client without therapist approval. To clarify the nature of dropout patients, 133 outpatient records at a rural community mental health center were examined over a one year period. Variables expected to…

Characteristics of Children with Autism Spectrum Disorders Who Received Services through Community Mental Health Centers

ERIC Educational Resources Information Center

Bryson, Stephanie A.; Corrigan, Susan K.; McDonald, Thomas P.; Holmes, Cheryl

2008-01-01

Despite the presence of significant psychiatric comorbidity among children with autism spectrum disorders (ASDs), little research exists on those who receive community-based mental health services. This project examined one year (2004) of data from the database maintained by 26 community mental health centers (CMHCs) in the Midwestern US state of…

Community Mental Health--in an Alternative School, in the Public Schools, and in the Kitchen!

ERIC Educational Resources Information Center

Long, Cindy; Page, John; Hail, Beth; Davis, Tiffany; Mitchell, Len

2003-01-01

Centerstone Community Mental Health, a private nonprofit agency based in Nashville, Tennessee, has responded to community needs by establishing new service programs to address them with whatever funding is available. Three described here are: an alternative school for students who cannot make it in public schools, school-based mental health…

Characteristics of Children with Autistic Spectrum Disorders Served in Comprehensive Community-Based Mental Health Settings

ERIC Educational Resources Information Center

Mandell, David S.; Walrath, Christine M.; Manteuffel, Brigitte; Sgro, Gina; Pinto-Martin, Jennifer

2005-01-01

This study describes the characteristics of children with autistic spectrum disorders (ASD) receiving treatment in community mental health settings. Data from a national community mental health initiative was used to identify children who had received a primary diagnosis of ASD. These children were compared with children with other diagnoses on…

Expanding rural access to mental health care through online postgraduate nurse practitioner education.

PubMed

Kverno, Karan; Kozeniewski, Kate

2016-12-01

Workforce shortages in mental health care are especially relevant to rural communities. People often turn to their primary care providers for mental healthcare services, yet primary care providers indicate that more education is needed to fill this role. Rural primary care nurse practitioners (NPs) are ideal candidates for educational enhancement. Online programs allow NPs to continue living and working in their communities while developing the competencies to provide comprehensive and integrated mental healthcare services. This article presents a review of current online postgraduate psychiatric mental health NP (PMHNP) options. Website descriptions of online PMHNP programs were located using keywords: PMHNP or psychiatric nurse practitioner, postgraduate or post-master's, and distance or online. Across the United States, 15 online postgraduate certificate programs were located that are designed for primary care NPs seeking additional PMHNP specialization. For rural primary care NPs who are ready, willing, and able, a postgraduate PMHNP specialty certificate can be obtained online in as few as three to four semesters. The expected outcome is a cadre of dually credentialed NPs capable of functioning in an integrated role and of increasing rural access to comprehensive mental healthcare services. ©2016 American Association of Nurse Practitioners.

Mental health service delivery: a profile of mental health non-government organisations in south-east Queensland, Australia.

PubMed

Byrne, Louise; Wilson, Michael; Burke, Karena J; Gaskin, Cadeyrn J; Happell, Brenda

2014-05-01

Non-government organisations make a substantial contribution to the provision of mental health services; despite this, there has been little research and evaluation targeted at understanding the role played by these services within the community mental health sector. The aim of the present study was to examine the depth and breadth of services offered by these organisations in south-east Queensland, Australia, across five key aspects of reach and delivery. Representatives from 52 purposively targeted non-government organisations providing mental health services to individuals with significant mental health challenges were interviewed regarding their approach to mental health service provision. The findings indicated a diverse pattern of service frameworks across the sector. The results also suggested a positive approach to the inclusion of consumer participation within the organisations, with most services reporting, at the very least, some form of consumer advocacy within their processes and as part of their services. This paper offers an important first look at the nature of non-government service provision within the mental health sector and highlights the importance of these organisations within the community sector. What is known about the topic? Non-government organisations make a substantial contribution to the multisectorial provision of services to mental health consumers in community settings. Non-government organisations in Australia are well established, with 79.9% of them being in operation for over 10 years. There is an increasing expectation that consumers influence the development, delivery and evaluation of mental health services, especially in the community sector. What does this paper add? This paper provides a profile of non-government organisations in one state in Australia with respect to the services they provide, the consumers they target, the practice frameworks they use, the use of peer workers and consumer participation, the success they have had with obtaining funding and the extent to which they collaborate with other services. What are the implications for practitioners? This paper provides readers with an understanding of the non-government organisations and the services they provide to people with mental health conditions. In addition, the findings provide an opportunity to learn from the experience of non-government organisations in implementing consumer participation initiatives.

Mental hospital reform in Asia: the case of Yuli Veterans Hospital, Taiwan.

PubMed

Lin, Chih-Yuan; Huang, Ai-Ling; Minas, Harry; Cohen, Alex

2009-01-02

Yuli Veterans Hospital (YVH) has been the largest mental hospital for the patients with chronic and severe mental illness in Taiwan for the past 50 years. While this hospital used to be a symbol of hopelessness among patients and their families and an unspoken shame among Taiwan psychiatry and mental health circles it now represents an example of how an old, custodial hospital can be transformed into a very different institution. In this case study we will describe the features of this transformation, which, over the past 20 years, has aimed to help extended stay inpatients with severe mental illness to integrate into the local community of Yuli even though it is not their original home. Using historical documents and oral narratives from Yuli inhabitants, workers and patients of YVH, we will offer a case study of the Yuli model. There are four main components of the Yuli model: holistic medical support, vocational rehabilitation, case management, and the residential program. The four components help patients recover two essential features of their lives: vocational life and ordinary daily routines. As the process of recovery evolves, patients gradually regain inner stability, dignity, self-confidence, and a sense of control. The four components are critical to rebuild the structure and order of life of the patients and are indispensable and interdependent parts of one service package. They operate simultaneously to benefit the patients to the greatest degree possible. There are many challenges to the further development and financial viability of the model of services developed at YVH. There are also important questions concerning the replicability of the Yuli model in other sociocultural and service system contexts. This case study reveals the possibility of transforming a custodial mental hospital into a hospital providing high quality care. Hospital and community are not in opposition. They are part of a continuum of care for the patients. We reinterpret and redefine the boundary and function of hospital and community, and thereby create a new service model, the Yuli Model, to help patients to reintegrate into the community. The Yuli model, which particularly focuses on the needs of people with long-standing illness and prolonged hospital stay, illustrates one approach to linking hospital and community in a creative and constructive manner.

Mental hospital reform in Asia: the case of Yuli Veterans Hospital, Taiwan

PubMed Central

Lin, Chih-Yuan; Huang, Ai-Ling; Minas, Harry; Cohen, Alex

2009-01-01

Background Yuli Veterans Hospital (YVH) has been the largest mental hospital for the patients with chronic and severe mental illness in Taiwan for the past 50 years. While this hospital used to be a symbol of hopelessness among patients and their families and an unspoken shame among Taiwan psychiatry and mental health circles it now represents an example of how an old, custodial hospital can be transformed into a very different institution. In this case study we will describe the features of this transformation, which, over the past 20 years, has aimed to help extended stay inpatients with severe mental illness to integrate into the local community of Yuli even though it is not their original home. Methods Using historical documents and oral narratives from Yuli inhabitants, workers and patients of YVH, we will offer a case study of the Yuli model. Results There are four main components of the Yuli model: holistic medical support, vocational rehabilitation, case management, and the residential program. The four components help patients recover two essential features of their lives: vocational life and ordinary daily routines. As the process of recovery evolves, patients gradually regain inner stability, dignity, self-confidence, and a sense of control. The four components are critical to rebuild the structure and order of life of the patients and are indispensable and interdependent parts of one service package. They operate simultaneously to benefit the patients to the greatest degree possible. Discussion There are many challenges to the further development and financial viability of the model of services developed at YVH. There are also important questions concerning the replicability of the Yuli model in other sociocultural and service system contexts. Conclusion This case study reveals the possibility of transforming a custodial mental hospital into a hospital providing high quality care. Hospital and community are not in opposition. They are part of a continuum of care for the patients. We reinterpret and redefine the boundary and function of hospital and community, and thereby create a new service model, the Yuli Model, to help patients to reintegrate into the community. The Yuli model, which particularly focuses on the needs of people with long-standing illness and prolonged hospital stay, illustrates one approach to linking hospital and community in a creative and constructive manner. PMID:19121218

Social inclusion and mental health.

PubMed

Cobigo, Virginie; Stuart, Heather

2010-09-01

Recent research on approaches to improving social inclusion for people with mental disabilities is reviewed. We describe four approaches (or tools) that can be used to improve social inclusion for people with mental disabilities: legislation, community-based supports and services, antistigma/antidiscrimination initiatives, and system monitoring and evaluation. While legislative solutions are the most prevalent, and provide an important framework to support social inclusion, research shows that their full implementation remains problematic. Community-based supports and services that are person-centered and recovery-oriented hold considerable promise, but they are not widely available nor have they been widely evaluated. Antistigma and antidiscrimination strategies are gaining in popularity and offer important avenues for eliminating social barriers and promoting adequate and equitable access to care. Finally, in the context of the current human rights and evidence-based health paradigms, systematic evidence will be needed to support efforts to promote social inclusion for people with mental disabilities, highlight social inequities, and develop best practice approaches. Tools that promote social inclusion of persons with mental disabilities are available, though not yet implemented in a way to fully realize the goals of current disability discourse.

Career Education for Mental Health Workers. Techniques of Intervention. Human Service Instructional Series. Module No. 4.

ERIC Educational Resources Information Center

Malchon, Margaret J.

This module on techniques of intervention is one of a set of six developed to prepare human services workers for the changing mental health service delivery system. Following notes on the target population (community college students), module length (51 class hours), and suggested class size (15-25 students), the module contains the following…

Randomized Trial of Social Rehabilitation and Integrated Health Care for Older People with Severe Mental Illness

ERIC Educational Resources Information Center

Mueser, Kim T.; Pratt, Sarah I.; Bartels, Stephen J.; Swain, Karin; Forester, Brent; Cather, Corinne; Feldman, James

2010-01-01

Objective: The Helping Older People Experience Success (HOPES) program was developed to improve psychosocial functioning and reduce long-term medical burden in older people with severe mental illness (SMI) living in the community. HOPES includes 1 year of intensive skills training and health management, followed by a 1-year maintenance phase.…

The Application of Behavior Change Theory to Family-Based Services: Improving Parent Empowerment in Children's Mental Health

ERIC Educational Resources Information Center

Olin, S. Serene; Hoagwood, Kimberly E.; Rodriguez, James; Ramos, Belinda; Burton, Geraldine; Penn, Marlene; Crowe, Maura; Radigan, Marleen; Jensen, Peter S.

2010-01-01

We describe the development of a parent empowerment program (PEP) using a community-based participatory research approach. In collaboration with a group of dedicated family advocates working with the Mental Health Association of New York City and state policy makers, academic researchers took an iterative approach to crafting and refining PEP to…

Change Trajectories for the Youth Outcome Questionnaire Self-Report: Identifying Youth at Risk for Treatment Failure

ERIC Educational Resources Information Center

Cannon, Jennifer A. N.; Warren, Jared S.; Nelson, Philip L.; Burlingame, Gary M.

2010-01-01

This study used longitudinal youth outcome data in routine mental health services to test a system for identifying cases at risk for treatment failure. Participants were 2,715 youth (M age = 14) served in outpatient managed care and community mental health settings. Change trajectories were developed using multilevel modeling of archival data.…

Mental Health-Related Stigma and Discrimination in Ghana: Experience of Patients and Their Caregivers.

PubMed

Tawiah, P E; Adongo, P B; Aikins, M

2015-03-01

Mental health is now attracting increased public health attention from health professionals, policy makers and the general population. However, stigma and discrimination usually have enormous negative impact on the patients and their families. This study reports on stigma and discrimination faced by mental health patients and their caregivers in a suburban area of Ghana and the coping strategies used. This is a cross-sectional exploratory study which used both quantitative and qualitative approaches. Two hundred and seventy seven mental health patients were purposively interviewed. Focus group discussions were held with caregivers and in-depth interviews were held with mental health professionals. The quantitative data were analyzed using SPSS and Microsoft Excel(®) whilst the qualitative data were coded and manually analyzed thematically. Mental disorder cuts across all age, sex, education, ethnicity, employment, and marital status. More females were stigmatized than males at the work/employment and educational levels. Various forms of stigma were observed at the economic, psychological and social levels, whilst for discrimination it was only observed at the economic and social levels. Caregivers were also stigmatized and discriminated. The coping strategies adopted by the mental patients and their caregivers were also economic, psychological and social in nature. Mental health patients and their families suffer from stigma and discrimination from the individual, family, work, employment, education to the health level. Thus, community level policy on mental health care needs to be developed and implemented. Furthermore mental health education needs to be intensified at the community level.

Clinicians’ Perspectives on Cognitive Therapy in Community Mental Health Settings: Implications for Training and Implementation

PubMed Central

Gutiérrez-Colina, Ana; Toder, Katherine; Esposito, Gregory; Barg, Frances; Castro, Frank; Beck, Aaron T.; Crits-Christoph, Paul

2012-01-01

Policymakers are investing significant resources in large-scale training and implementation programs for evidence-based psychological treatments (EBPTs) in public mental health systems. However, relatively little research has been conducted to understand factors that may influence the success of efforts to implement EBPTs for adult consumers of mental health services. In a formative investigation during the development of a program to implement cognitive therapy (CT) in a community mental health system, we surveyed and interviewed clinicians and clinical administrators to identify potential influences on CT implementation within their agencies. Four primary themes were identified. Two related to attitudes towards CT: (1) ability to address client needs and issues that are perceived as most central to their presenting problems, and (2) reluctance to fully implement CT. Two themes were relevant to context: (1) agency-level barriers, specifically workload and productivity concerns and reactions to change, and (2) agency-level facilitators, specifically, treatment planning requirements and openness to training. These findings provide information that can be used to develop strategies to facilitate the implementation of CT interventions for clients being treated in public-sector settings. PMID:22426739

Mental health policy in Kenya -an integrated approach to scaling up equitable care for poor populations.

PubMed

Kiima, David; Jenkins, Rachel

2010-06-28

Although most donor and development agency attention is focussed on communicable diseases in Kenya, the importance of non-communicable diseases including mental health and mental illness is increasingly apparent, both in their own right and because of their influence on health, education and social goals. Mental illness is common but the specialist service is extremely sparse and primary care is struggling to cope with major health demands. Non health sectors e.g. education, prisons, police, community development, gender and children, regional administration and local government have significant concerns about mental health, but general health programmes have been surprisingly slow to appreciate the significance of mental health for physical health targets. Despite a people centred post colonial health delivery system, poverty and global social changes have seriously undermined equity. This project sought to meet these challenges, aiming to introduce sustainable mental health policy and implementation across the country, within the context of extremely scarce resources. A multi-faceted and comprehensive programme which combined situation appraisal to inform planning, sustained intersectoral policy dialogue at national and regional level; establishment of a health sector system for coordination, supervision and training of at each level (national, regional, district and primary care); development workshops; production of toolkits, development of guidelines and standards; encouragement of intersectoral liaison at national, regional, district and local levels; public education; and integration of mental health into health management systems. The programme has achieved detailed situation appraisal, epidemiological needs assessment, inclusion of mental health into the health sector reform plans, and into the National Package of Essential Health Interventions, annual operational plans, mental health policy guidelines to accompany the general health policy, tobacco legislation, adaptation of the WHO primary care guidelines for Kenya, primary care training, construction of a quality system of roles and responsibilities, availability of medicines at primary care level, some strengthening of intersectoral liaison with police, prisons and schools, and public education about mental health. The project has demonstrated the importance of using a multi-faceted and comprehensive programme to promote sustainable system change, key elements of which include a focus on the use of rapid appropriate assessment and treatment at primary care level, strengthening the referral system, interministerial and intersectoral liaison, rehabilitation, social inclusion, promotion and advocacy to mobilize community engagement.

Mentally ill persons in the criminal justice system: some perspectives.

PubMed

Lamb, H Richard; Weinberger, Linda E; Gross, Bruce H

2004-01-01

There is an increasing number of severely mentally ill persons in the criminal justice system. This article first discusses the criminalization of persons with severe mental illness and its causes, the role of the police and mental health, and the treatment of mentally ill offenders and its difficulties. The authors then offer recommendations to reduce criminalization by increased coordination between police and mental health professionals, to increase mental health training for police officers, to enhance mental health services after arrest, and to develop more and better community treatment of mentally ill offenders. The necessary components of such treatment are having a treatment philosophy of both theory and practice; having clear goals of treatment; establishing a close liaison between treatment staff and the justice system; understanding the need for structure; having a focus on managing violence; and appreciating the crucial role of case management, appropriate living arrangements, and the role of family members.

Development of a Faith-Based Stress Management Intervention in a Rural African American Community.

PubMed

Bryant, Keneshia; Moore, Todd; Willis, Nathaniel; Hadden, Kristie

2015-01-01

Faith-based mental health interventions developed and implemented using a community-based participatory research (CBPR) approach hold promise for reaching rural African Americans and addressing health disparities. To describe the development, challenges, and lessons learned from the Trinity Life Management, a faith-based stress management intervention in a rural African American faith community. The researchers used a CBPR approach by partnering with the African American faith community to develop a stress management intervention. Development strategies include working with key informants, focus groups, and a community advisory board (CAB). The community identified the key concepts that should be included in a stress management intervention. The faith-based "Trinity Life Management" stress management intervention was developed collaboratively by a CAB and an academic research team. The intervention includes stress management techniques that incorporate Biblical principles and information about the stress-distress-depression continuum.

Wellness Centre: An Evidence-Guided Approach to Delivering Culturally Relevant Community Psychogeriatric Services for Chinese Elders

PubMed Central

Chan, Kar C.; Sadavoy, Joel

2012-01-01

Ethnic elders are commonly reluctant to access mental health services and their mental health problems are often overlooked and detected late in the course of illness. Prior studies identified major barriers to ethnic seniors accessing appropriate mental health care demonstrating that language and cultural beliefs cannot be ignored if effective mental health services are to be provided to patients from diverse cultural groups. These are particularly important when care is needed by less acculturated immigrant ethnic seniors for whom language barriers are often greatest. Differences in conceptions of mental distress affect ethnic seniors' choice of help-seeking and often discourage or divert aged persons from utilizing mainstream conventional psychiatric care. Despite the extensive need for appropriate service models for ethnic populations, there have been limited data and models to illustrate how these programs can be systematically and effectively integrated within the mainstream mental health service framework. This paper describes an innovative, mainstream, community-based psychogeriatric service delivery model developed for Chinese seniors in Toronto, Canada, aiming at improving their access to care and enhancing earlier mental health problem detection. The important concepts and strategies of designing and operating a culturally acceptable program are illustrated supported by program data and the challenges analyzed. PMID:23762771

Integrating self-help materials into mental health practice.

PubMed

Church, Elizabeth; Cornish, Peter; Callanan, Terrence; Bethune, Cheri

2008-10-01

Patients' mental health issues have become an increasing focus of Canadian family physicians' practices. A self-help approach can help meet this demand, but there are few guidelines for professionals about how to use mental health self-help resources effectively. To aid health professionals in integrating self-help materials into their mental health practices. A resource library of print, audiotape, and videotape self-help materials about common mental health issues was developed for a rural community. The materials were prescreened in order to ensure high quality, and health professionals were given training on how to integrate self-help into their practices. The library was actively used by both health professionals and community members, and most resources were borrowed, particularly the nonprint materials. Health professionals viewed the resources as a way to supplement their mental health practice and reduce demands on their time, as patients generally worked through the resources independently. Some improvements are planned for future implementations of the program, such as providing health professionals with a "prescription pad" of resources and implementing Stages of Change and stepped-care models to maximize the program's effectiveness. Although more evidence is needed regarding the effectiveness of self-help within a family practice context, this program offers a promising way for family physicians to address mild to moderate mental health problems.

The impact of risk management practice upon the implementation of recovery-oriented care in community mental health services: a qualitative investigation.

PubMed

Holley, Jessica; Chambers, Mary; Gillard, Steven

2016-08-01

Recovery-oriented care has become guiding principle for mental health policies and practice in the UK and elsewhere. However, a pre-existing culture of risk management practice may impact upon the provision of recovery-oriented mental health services. To explore how risk management practice impacts upon the implementation of recovery-oriented care within community mental health services. Semi-structured interviews using vignettes were conducted with eight mental health worker and service user dyads. Grounded theory techniques were used to develop explanatory themes. Four themes arose: (1) recovery and positive risk taking; (2) competing frameworks of practice; (3) a hybrid of risk and recovery; (4) real-life recovery in the context of risk. In abstract responses to the vignettes, mental health workers described how they would use a positive-risk taking approach in support of recovery. In practice, this was restricted by a risk-averse culture embedded within services. Mental health workers set conditions with which service users complied to gain some responsibility for recovery. A lack of strategic guidance at policy level and lack of support and guidance at practice level may result in resistance to implementing ROC in the context of RMP. Recommendations are made for policy, training and future research.

A Qualitative Study of the Integration of Arab Muslim Israelis Suffering from Mental Disorders into the Normative Community.

PubMed

Gesser-Edelsburg, Anat; Shbat, Shbat

2017-06-01

This study focuses on the process of the integration of Arab Muslim Israelis suffering from mental disorders into the normative community, addressing perspectives of both people with mental disorders and the community. This qualitative-constructivist study seeks to understand the dynamics of face-to-face meetings by highlighting the participants' points of view. The main themes of the findings included stereotypes and prejudices, gender discrimination, and the effect of face-to-face meetings on integration of people with mental disorders (PMD) into the community. The findings support former studies about the integration of PMD into the normative community, but add a unique finding that females suffer from double discrimination: both as women in a conservative society and as PMD. The study findings indicate a perception of lack of self-efficacy of PMD as a key barrier preventing integration into the community, which also prevents community members and counselors from accepting them or treating them as equals. We recommend on a social marketing campaign to be undertaken with the Arab Muslim community to refute stigmas and prejudices, particulary with double gender discrimination suffered by women with mental disorders in the Muslim community and training of community center counselors who have contact with the PMD population.

COMMUNITY MENTAL HEALTH SERVICES ACT—Five Years of Operation Under the California Law

PubMed Central

Rudin, Edward; McInnes, Robert S.

1963-01-01

The Short-Doyle program represents a small part of the needed response to the base problem of mental illness. However, in the five years since the signing of the original bill, programs receiving aid under the Short-Doyle Act for Community Mental Health Services have made impressive steps toward meeting the need for community mental health services. They have done so under local auspices and working closely with general health and medical programs available locally. PMID:13982995

A Proposal for the Unification of Vermont's Mental Retardation Service System.

ERIC Educational Resources Information Center

Vermont State Dept. of Mental Health, Montpelier. Div. of Mental Retardation.

This planning document proposes that services to Vermonters with mental retardation be unified around the community mental retardation service system, in order to provide community placements for residents of the Brandon Training School (BTS) who are under court order for discharge between 1989 and 1993. The Department of Mental Health plans to…

Effects of Hurricane Hugo: Mental Health Workers and Community Members.

ERIC Educational Resources Information Center

Muzekari, Louis H.; And Others

This paper reports the effects of Hurricane Hugo on mental health workers and indigenous community members. The response and perceptions of mental health staff from the South Carolina Department of Mental Health (Go Teams) from areas unaffected by the hurricane were compared and contrasted with those of a subsequent Hugo Outreach Support Team…

Collaboration with Community Mental Health Service Providers: A Necessity in Contemporary Schools

ERIC Educational Resources Information Center

Villarreal, Victor; Castro-Villarreal, Felicia

2016-01-01

Schools have played an increasingly central role in providing mental health services to youth, but there are limitations to the services that are available through school-based mental health professionals. Thus, collaboration with non-school-based community mental health providers is oftentimes necessary. As collaboration can address limitations…

Citizenship and Community Mental Health Care.

PubMed

Ponce, Allison N; Rowe, Michael

2018-03-01

Citizenship is an approach to supporting the social inclusion and participation in society of people with mental illnesses. It is receiving greater attention in community mental health discourse and literature in parallel with increased awareness of social determinants of health and concern over the continued marginalization of persons with mental illness in the United States. In this article, we review the definition and principles of our citizenship framework with attention to social participation and access to resources as well as rights and responsibilities that society confers on its members. We then discuss our citizenship research at both individual and social-environmental levels, including previous, current, and planned efforts. We also discuss the role of community psychology and psychologists in advancing citizenship and other themes relevant to a citizenship perspective on mental health care and persons with mental illness. © Society for Community Research and Action 2018.

Swedish attitudes towards persons with mental illness.

PubMed

Högberg, Torbjörn; Magnusson, Annabella; Lützén, Kim; Ewalds-Kvist, Béatrice

2012-04-01

Negative and stigmatizing attitudes towards persons with mental illness must be dealt with to facilitate the sufferers' social acceptance. The present study aimed at survey Swedish attitudes towards persons with mental illness related to factors impacting these attitudes. New CAMI-S based on the questionnaire "Community Attitudes to Mental Illness in Sweden" ([CAMI] Taylor & Dear, 1981) was developed with nine behavioral-intention items and thus comprised a total of 29 items. Of 5000 Swedish people, 2391 agreed to complete the questionnaire. Principal component analysis rendered four factors reflecting attitudes towards the mentally ill: Intention to Interact, Fearful and Avoidant, Open-minded and Pro-Integration, as well as Community Mental Health Ideology. The factors were analyzed for trends in attitudes. By MANOVA, the experience of mental illness effects on mind-set towards the sufferers was assessed. By means of logistic regression, demographic factors contributing to positive attitudes towards persons with mental illness residing in the neighborhood were assessed. By New CAMI-S, the Swedish attitudes towards the mentally ill were surveyed and trends in agreement with living next to a person with mental illness were revealed in three out of four factors derived by principal component analysis. Aspects impacting the Swedish attitudes towards persons with mental illness and willingness to have him/her residing in the neighborhood comprised experience of mental illness, female gender, age (31-50 years), born in Scandinavia or outside Europe, only 9 years of compulsory school and accommodation in flat. The New CAMI-S came out as a useful tool to screen Swedish attitudes towards persons with mental illness. Most Swedes were prepared to live next to the mentally ill.

Impact of housing improvement and the socio-physical environment on the mental health of children's carers: a cohort study in Australian Aboriginal communities.

PubMed

Bailie, Ross S; Stevens, Matthew; McDonald, Elizabeth L

2014-05-19

The mental health of carers is an important proximate factor in the causal web linking housing conditions to child health, as well as being important in its own right. Improved understanding of the nature of the relationships between housing conditions, carer mental health and child health outcomes is therefore important for informing the development of housing programs. This paper examines the relationship between the mental health of the carers of young children, housing conditions, and other key factors in the socio-physical environment. This analysis is part of a broader prospective cohort study of children living in Aboriginal communities in the Northern Territory (NT) of Australia at the time of major new community housing programs. Carer's mental health was assessed using two validated scales: the Affect Balance scale and the Brief Screen for Depression. The quality of housing infrastructure was assessed through detailed surveys. Secondary explanatory variables included a range of socio-environmental factors, including validated measures of stressful life events. Hierarchical regression modelling was used to assess associations between outcome and explanatory variables at baseline, and associations between change in housing conditions and change in outcomes between baseline and follow-up. There was no clear or consistent evidence of a causal relationship between the functional state of household infrastructure and the mental health of carers of young children. The strongest and most consistent associations with carer mental health were the measures of negative life events, with a dose-response relationship, and adjusted odds ratio of over 6 for carers in the highest stress exposure category at baseline, and consistent associations in the follow up analysis. The findings highlight the need for housing programs to be supported by social, behavioral and community-wide environmental programs if potential health gains are to be more fully realized, and for rigorous evaluation of such programs for the purpose of informing future housing initiatives.

Global Mental Health in Action: Reducing Disparities One Community at a Time.

PubMed

Bischoff, Richard J; Springer, Paul R; Taylor, Nathan

2017-04-01

There are great disparities in mental health care around the world. Traditional approaches to mental health care have not been found to be transferrable to many parts of the world and are inadequate to address these disparities. Unconventional approaches are needed that match the traditions of care-seeking and care-giving within the communities where they are delivered. The authors review the global mental health literature and discuss how marriage and family therapists are in a particularly good position to have worldwide impact on mental health disparities. Five principles of global mental health are presented along with an example of how these principles are applied through the Reducing Mental Health Disparities One Community at a Time (RD1CT) model. © 2016 American Association for Marriage and Family Therapy.

Community Perception towards Mental Illness among Residents of Gimbi Town, Western Ethiopia

PubMed Central

Benti, Misael; Yohannis, Zegeye; Bedaso, Asres

2016-01-01

Background. Despite the increased burden of mental health problem, little is known about knowledge and perception of the public towards mental health problems in Ethiopia. Methods. Community based cross-sectional study was conducted among selected 845 Gimbi town residents from May 28 to June 28, 2014. Results. Out of the total study participants, 304 (37.3%) were found to have poor perception (a score below mean five semantic differential scales for positive questions and above mean for negative questions) of mental illness. Being above 28 years of age (AOR = 0.48 CI (0.23, 0.78)), private workers (AOR = 0.41 CI (0.19, 0.87)), and lack of mental health information were found to be associated with poor perception of mental illness (AOR = 0.133 CI (0.09, 0.20)). Absence of family history of mental illness was also found to be associated with poor perception of mental illness (AOR = 0.37 CI (0.21, 0.66)). Conclusions. Significant proportions of the community in Gimbi town were found to have poor perception of mental illness. Poor perception is common among old aged, less educated, private workers, those unable to access mental health information, and those with no family history of mental illness. Mental health education on possible causes, treatment options, and possible outcome of treatment to the community is required. PMID:27840817

Health trainer-led motivational intervention plus usual care for people under community supervision compared with usual care alone: a study protocol for a parallel-group pilot randomised controlled trial (STRENGTHEN)

PubMed Central

Thompson, Tom P; Callaghan, Lynne; Hazeldine, Emma; Quinn, Cath; Walker, Samantha; Byng, Richard; Wallace, Gary; Creanor, Siobhan; Green, Colin; Hawton, Annie; Annison, Jill; Sinclair, Julia; Senior, Jane; Taylor, Adrian H

2018-01-01

Introduction People with experience of the criminal justice system typically have worse physical and mental health, lower levels of mental well-being and have less healthy lifestyles than the general population. Health trainers have worked with offenders in the community to provide support for lifestyle change, enhance mental well-being and signpost to appropriate services. There has been no rigorous evaluation of the effectiveness and cost-effectiveness of providing such community support. This study aims to determine the feasibility and acceptability of conducting a randomised trial and delivering a health trainer intervention to people receiving community supervision in the UK. Methods and analysis A multicentre, parallel, two-group randomised controlled trial recruiting 120 participants with 1:1 individual allocation to receive support from a health trainer and usual care or usual care alone, with mixed methods process evaluation. Participants receive community supervision from an offender manager in either a Community Rehabilitation Company or the National Probation Service. If they have served a custodial sentence, then they have to have been released for at least 2 months. The supervision period must have at least 7 months left at recruitment. Participants are interested in receiving support to change diet, physical activity, alcohol use and smoking and/or improve mental well-being. The primary outcome is mental well-being with secondary outcomes related to smoking, physical activity, alcohol consumption and diet. The primary outcome will inform sample size calculations for a definitive trial. Ethics and dissemination The study has been approved by the Health and Care Research Wales Ethics Committee (REC reference 16/WA/0171). Dissemination will include publication of the intervention development process and findings for the stated outcomes, parallel process evaluation and economic evaluation in peer-reviewed journals. Results will also be disseminated to stakeholders and trial participants. Trial registration numbers ISRCTN80475744; Pre-results. PMID:29866736

A social ecological approach to investigating relationships between housing and adaptive functioning for persons with serious mental illness.

PubMed

Kloos, Bret; Shah, Seema

2009-12-01

This paper seeks to advance mental health-housing research regarding which factors of housing and neighborhood environments are critical for adaptive functioning, health, and recovery for persons with serious mental illness (SMI). Housing and neighborhood environments are particularly important for persons with SMI because of the prevalence of poor housing conditions among this population. Most mental health-housing research has been limited by a focus on problems in environments and functioning. The paper seeks to expand the mental health-housing research agenda to consider protective factors that promote community integration and adaptive functioning. We provide an account of how social ecology theory transformed a research program, from examining individual risk factors to investigating the functioning of persons in the contexts of their housing and neighborhood experiences. The resulting housing environment framework-physical aspects of housing and neighborhoods, social environment of neighborhoods, and interpersonal relationships tied to housing-allows for identification of opportunities for health promotion and facilitation of participation in community-based settings. This program of research draws upon several methods to understand the social experience of persons with SMI living in community settings-survey research, qualitative interviews, Geographic Information Systems, participatory research, and visual ethnography. In this paper, we present how social ecology theory was instrumental in the development of new housing environment measures, the selection of appropriate research methods, and framing research questions that are building a new empirical base of knowledge about promoting adaptive functioning, health, and recovery for persons with SMI living in community settings.

Increasing US health plan coverage for exercise programming in community mental health settings for people with serious mental illness: a position statement from the Society of Behavior Medicine and the American College of Sports Medicine.

PubMed

Pratt, Sarah I; Jerome, Gerald J; Schneider, Kristin L; Craft, Lynette L; Buman, Matthew P; Stoutenberg, Mark; Daumit, Gail L; Bartels, Stephen J; Goodrich, David E

2016-09-01

Adults with serious mental illness die more than 10 years earlier than the average American. Premature mortality is due to the high prevalence of preventable diseases including cardiovascular disease and diabetes. Poor lifestyle behaviors including lack of exercise and physical inactivity contribute to the epidemic levels of obesity, diabetes, and cardiovascular disease observed among adults with serious mental illness. Not surprisingly, people with serious mental illness are among the most costly consumers of health services due to increased visits for poorly managed mental and physical health. Recent studies have demonstrated that exercise interventions based on community mental health settings can significantly improve physical and mental health in people with serious mental illness. However, current funding regulations limit the ability of community mental health settings to offer exercise programming services to people with serious mental illness. Policy efforts are needed to improve the dissemination and sustainability of exercise programs for people with serious mental illness.

Morale and job perception of community mental health professionals in Berlin and London.

PubMed

Priebe, Stefan; Fakhoury, Walid K H; Hoffmann, Karin; Powell, Richard A

2005-03-01

Morale and job perception of staff in community mental health care may influence feasibility and quality of care, and some research has suggested particularly high burnout of staff in the community. The aims of this study were to: a) assess morale, i. e. team identity, job satisfaction and burnout, in psychiatrists, community psychiatric nurses and social workers in community mental health care in Berlin and London; b) compare findings between the groups and test whether personal characteristics, place of working and professional group predict morale; and c) explore what tasks, obstacles, skills, enjoyable and stressful aspects interviewees perceived as important in their jobs. In all, 189 mental health professionals (a minimum of 30 in each of the six groups) responded to a postal survey and reported activities per week using pre-formed categories. Perception of professional role was assessed on the Team Identity Scale, job satisfaction on the Minnesota Job Satisfaction Scale, and burnout on the Maslach Burnout Inventory. Seven simple open questions were used to elicit the main tasks, skills that staff did and did not feel competent in, aspects that they did and did not enjoy in their job, and obstacles and factors that caused pressure. Answers were subjected to content analysis using a posteriori formed categories. Weekly activities and morale varied between sites and professional groups. Some mean scores for groups in London exceeded the threshold for a burnout syndrome, and are particularly less favourable for social workers. Working in London predicted higher burnout, lower job satisfaction and lower team identity. Being a psychiatrist predicted higher team identity, whilst being a social worker was associated with higher burnout and lower job satisfaction. Male gender predicted lower burnout and higher team identity. However, professional group and site interacted in predicting burnout and job satisfaction. Psychiatrists in London had much more favourable scores than the other two groups, whilst this did not hold true in Berlin. Answers to open questions revealed universal aspects, such as enjoying direct patient contact and disliking bureaucracy, but also various views that were specific to a site or professional group or both. Burnout remains a problem for some, but not all, professional groups in community mental health care, and social workers in London appear to be a group with particularly low morale. Differences between professional groups depend on the location, and it remains unclear to what extent job-related and general factors impact on the morale of mental health professionals. Answers to open questions reveal general as well as specific aspects of the job perception of the professional groups, some of which may be relevant for service development, training and supervision. More conceptual and methodological work and more extensive studies are required to develop a better understanding of how community mental health professionals perceive their job and how morale may be improved.

Evaluation of Mental Health First Aid training with members of the Vietnamese community in Melbourne, Australia

PubMed Central

Minas, Harry; Colucci, Erminia; Jorm, Anthony F

2009-01-01

Background The aim of this project was to investigate in members of the Vietnamese community in Melbourne the impact of Mental Health First Aid (MHFA) training on attitudes to people with mental illness and on knowledge about mental disorders. Our hypotheses were that at the end of the training participants would have increased knowledge of mental disorders and their treatments, and decreased negative attitudes towards people with mental disorders. Methods Respondents were 114 participants in two-day MHFA training workshops for the Vietnamese community in Melbourne conducted by two qualified MHFA trainers. Participants completed the research questionnaire prior to the commencement of the training (pre-test) and at its completion (post-test). The questionnaires assessed negative attitudes towards people with mental illness (as described in four vignettes), ability to recognise the mental disorders described in the vignettes, and knowledge about how to assist someone with one of these disorders. Responses to open-ended questions were content analysed and coded. To evaluate the effect of the training, answers to the structured questions and to the coded open-ended questions given at pre- and post-test were compared using McNemar tests for dichotomous values and Wilcoxon tests for other scores. Results Between pre- and post-test there was significant improvement in recognition of mental disorders; more targeted and appropriate mental health first aid responses, and reduction in inappropriate first aid responses; and negative attitudes to the people described in the vignettes declined significantly on many items of the stigma scale. Conclusion A two-day, MHFA training course for general members of the Vietnamese community in Melbourne demonstrated significant reductions in stigmatising attitudes, improved knowledge of mental disorders and improved knowledge about appropriate forms of assistance to give to people in the community with mental disorder. There is sufficient evidence to scale up to a population level program for the Vietnamese community, and a need for longitudinal evaluation of such a scaled up program. PMID:19735575

Forensic community mental health nurses' perceptions of statutory community aftercare: implications for practice.

PubMed

Riordan, Sharon; Wix, Stuart; Humphreys, Martin

2005-01-01

The key role played by forensic community mental health nurses in statutory community aftercare for mentally disordered offenders in England and Wales has been successful. The nurses often have the most contact with this patient population, yet paradoxically, have not been asked to express their views about the process. The pivotal role undertaken by this professional group appears to be fundamental to the success of statutory aftercare for this patient group.

Community Support as a Moderator of Postdisaster Mental Health Symptoms in Urban and Nonurban Communities

PubMed Central

West, Jenny S.; Price, Matthew; Gros, Kirstin Stauffacher; Ruggiero, Kenneth J.

2014-01-01

Objective We examined the association between disaster exposure, community support, and mental health outcomes in urban and nonurban participants of Galveston and Chambers counties after Hurricane Ike. The moderating effect of community support was evaluated as a protective factor relative to postdisaster mental health. Methods A representative population-based sample of 157 urban and 714 nonurban adults were interviewed 12 to 17 months after the hurricane about their mental health functioning, disaster exposure, and perceptions of community support. A series of multiple regressions demonstrated that disaster exposure was associated with mental health outcomes for both groups. The strength of the association varied across population samples. Results Community support moderated the association between interpersonal effects of the disaster and posttraumatic stress disorder (PTSD) and depression outcomes in nonurban participants and the association between property damage and PTSD in urban participants. Conclusions Community support played a larger role in reducing PTSD and depression symptoms associated with the interpersonal effects of a disaster in the nonurban sample only. Communities may play a more beneficial role in the recovery process in nonurban areas that have elevated levels of injury or death attributed to a disaster. PMID:24274123

Stigma of mental illness and substance misuse in sub-Saharan African migrants: A qualitative study.

PubMed

McCann, Terence V; Renzaho, Andre; Mugavin, Janette; Lubman, Dan I

2018-06-01

Stigma of mental illness and substance misuse can deter help seeking, especially in immigrants who are often reluctant to seek help early for these issues. The aim of the present study was to explore the stigma experience surrounding mental illness and substance misuse, and its implications for improving help seeking, for youths and parents from sub-Saharan African immigrant communities. A qualitative, descriptive design was used. Individual interviews were undertaken with 28 youths, and focus group discussions were held with 41 parents and community leaders in Melbourne, Australia. The findings indicated that public stigma and self-stigma were common and deterred participants' help seeking within sub-Saharan African communities. There was concern about the consequences of disclosure. Personal shame, fear of community rejection, and being labelled a 'lunatic' deterred help seeking. Programmes are needed to address stigma, promote help seeking, and increase mental health knowledge. Mental health nurses and other clinicians in the mental health and alcohol and other drug fields can make an important contribution. Steps are needed to employ more sub-Saharan African immigrant clinicians to help increase help seeking from their communities. © 2017 Australian College of Mental Health Nurses Inc.

Identification Reduces Stigma of Mental Ill-Health: A Community-Based Study.

PubMed

Kearns, Michelle; Muldoon, Orla T; Msetfi, Rachel M; Surgenor, Paul W G

2018-03-01

The stigma surrounding mental ill-health is an important issue that affects likelihood of diagnosis and uptake of services, as those affected may work to avoid exposure, judgment, or any perceived loss in status associated with their mental ill-health. In this study, we drew upon social identity theory to examine how social group membership might influence the stigma surrounding mental ill-health. Participants from two urban centers in Ireland (N = 626) completed a survey measuring stigma of mental health, perceived social support as well as identification with two different social groups (community and religion). Mediation analysis showed that subjective identification with religious and community groups led to greater perceived social support and consequently lower perceived stigma of mental ill-health. Furthermore, findings indicated that high identification with more than one social group can lead to enhanced social resources, and that identification with a religious group was associated with greater community identification. This study thus extends the evidence base of group identification by demonstrating its relationship with stigma of mental ill-health, while also reinforcing how multiple identities can interact to enhance social resources crucial for well-being. © Society for Community Research and Action 2017.

Student Perceptions of the Impact of Participation in Community College Mental Health Counseling on Retention, Graduation, and Transfer

ERIC Educational Resources Information Center

Quin, Matt Jordan

2017-01-01

This dissertation examined community college transfer students' perceptions of how mental health concerns interfere with academics, the ability to stay in school, graduate, and transfer to a 4-year university. The study also examined if community college transfer students perceive that mental health counseling improves their ability to stay in…

Centralized vs. decentralized child mental health services.

PubMed

Adams, M S

1977-09-01

One of the basic tenets of the Community Mental Health Center movement is that services should be provided in the consumers' community. Various centers across the country have attempted to do this in either a centralized or decentralized fashion. Historically, most health services have been provided centrally, a good example being the traditional general hospital with its centralized medical services. Over the years, some of these services have become decentralized to take the form of local health centers, health maintenance organizations, community clinics, etc, and now various large mental health centers are also being broken down into smaller community units. An example of each type of mental health facility is delineated here.

Mental health service acceptability for the armed forces veteran community.

PubMed

Farrand, P; Jeffs, A; Bloomfield, T; Greenberg, N; Watkins, E; Mullan, E

2018-06-15

Despite developments in mental health services for armed forces veterans and family members, barriers to access associated with poor levels of acceptability regarding service provision remain. Adapting a Step 2 mental health service based on low-intensity cognitive behavioural therapy (CBT) interventions to represent a familiar context and meet the needs of the armed forces veteran community may serve to enhance acceptability and reduce help-seeking barriers. To examine acceptability of a Step 2 low-intensity CBT mental health service adapted for armed forces veterans and family members provided by a UK Armed Forces charity. Qualitative study using individual semi-structured interviews with armed forces veterans and family members of those injured or becoming unwell while serving in the British Armed Forces. Data analysis was undertaken using thematic alongside disconfirming case analysis. Adapting a Step 2 mental health service for armed forces veterans and family members enhanced acceptability and promoted help-seeking. Wider delivery characteristics associated with Step 2 mental health services within the Improving Access to Psychological Therapies (IAPT) programme also contributed to service acceptability. However, limitations of Step 2 mental health service provision were also identified. A Step 2 mental health service adapted for armed forces veterans and family members enhances acceptability and may potentially overcome help-seeking barriers. However, concerns remain regarding ways to accommodate the treatment of post-traumatic stress disorder and provide support for family members.

Screening for mental health risk in high schools: The development of the Youth RADAR.

PubMed

Burns, John R; Rapee, Ronald M

2016-10-01

Epidemiological studies indicate that as many as 1 in 5 young people will develop a mental health problem in any given year. Early detection and intervention are needed to reduce the impact that these conditions have-both for the young person and for the communities in which they live. This study reports the development of a new instrument aimed at helping identify students at risk of developing mental health difficulties. Rather than asking about the presence of symptoms of mental health conditions, the RADAR screening tool assesses a student's balance of risk and protective factors associated with the development of mental health problems. The RADAR was evaluated with a sample of 838 participants in high school Years 7-12. A robust internal factor structure was revealed using exploratory and confirmatory factor analysis. Internal consistency was satisfactory for each subscale, ranging from .73 to .90 while the reliability for the total scale was .91. Retest stability, measured over a 12 month period, was found to be strong (r = .72). Convergent validity was demonstrated with reference to standard measures of depression and behavioral problems. It is concluded that the RADAR is a promising measure for helping mental health professionals and educators decide which students may be at risk of developing mental health problems. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

Professionals' views on mental health service users' education: challenges and support.

PubMed

Nieminen, I; Kaunonen, M

2017-02-01

WHAT IS KNOWN ON THE SUBJECT?: Mental health service users (MHSUs) may experience disruptions in their education. However, education has been shown to have a positive influence on their recovery, potentially offering them broader employment opportunities. The literature suggests that providing support for MHSUs in their educational efforts may be beneficial and is wished for by the service users themselves. However, there is a lack of mental health professionals' views on the topic in the setting of a community mental health centre. WHAT DOES THIS PAPER ADD TO THE EXISTING KNOWLEDGE?: In the perception of mental health professionals, the predominance of disease in the life of MHSUs and their marginalization may form barriers to their success in education. Professionals can support MHSUs in their educational efforts by strengthening the MHSUs' internal resources and creating a supportive environment with professional expertise available. A service user-centred education might further help MHSUs to achieve their educational goals. Our findings confirm previous knowledge of a recovery-oriented approach to supporting MHSUs' education. This study explored the topic from the professionals' perspective in the context of community mental health centres, which is a fresh view in the research literature. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: The findings suggest which types of support professionals perceive to be required for MHSUs to advance their studies. Knowledge of adequate forms of support can be applied in the mental health nursing practice to develop support measures for service users to advance in their studies. All levels of the community mental health centres should be aware of and adopt a recovery-oriented approach. MHSUs and professionals need to have a shared opinion on the definition of recovery orientation. This requires mutual discussion and the more active involvement of MHSUs in the design of their own rehabilitation process. Introduction Studies show the importance of providing support for mental health service users' (MHSUs') education. However, none of these studies explored this support in the community mental health centre setting. The range of MHSUs' educational activities identified in this study varied from participation in courses at the mental health centres to independent studies at different levels of education outside the centres. Aim (1) How do mental health professionals perceive the challenges that may limit service users' potential when they apply for, and complete, their education? (2) How do the professionals describe the methods of rehabilitation aimed at supporting the service users in achieving their educational goals? Method The data were collected from 14 mental health professionals using focus group interviews. Inductive content analysis was then performed. Results Professionals perceive that the predominance of disease and marginalization may be barriers to MHSUs' success in education. Strengthening the MHSUs' internal resources, creating a supportive environment with professional expertise available and service user-centred education appeared to support the MHSUs' educational achievements. Our findings confirm previous knowledge of a recovery-oriented approach to support MHSUs' education. However, professionals' views on this topic in the context of community mental health centres have not been investigated previously. Discussion Professionals perceive that a recovery-oriented approach to rehabilitation may support MHSUs in their educational efforts. Implications for practice A recovery-oriented approach should be adopted by all levels of the community mental health centres. MHSUs and professionals need to have a shared opinion on the definition of recovery orientation. This requires mutual discussion and a more active involvement of MHSUs in the design of their own rehabilitation process. © 2017 John Wiley & Sons Ltd.

WORK INTEREST AS A PREDICTOR OF COMPETITIVE EMPLOYMENT: POLICY IMPLICATIONS FOR PSYCHIATRIC REHABILITATION

PubMed Central

Macias, Cathaleene; DeCarlo, Lawrence T.; Wang, Qi; Frey, Jana; Barreira, Paul

2015-01-01

Consumers with serious mental illness (N=166) enrolling in two community-based mental health programs, a vocational Program of Assertive Community Treatment and a clubhouse certified by the International Center for Clubhouse Development (ICCD), were asked about their interest in work. About one third of the new enrollees expressed no interest in working. Equivalent supported employment services were then offered to all participants in each program. Stated interest in work and receipt of vocational services were statistically significant predictors of whether a person would work and how long it would take to get a job. Two thirds of those interested in work and half of those with no initial interest obtained a competitive job if they received at least one hour of vocational service. Once employed, these two groups held comparable jobs for the same length of time. These findings demonstrate the importance of making vocational services continuously available to all people with serious mental illness, and the viability of integrating these services into routine mental health care. PMID:11577655

Mental health care in prisons and the issue of forensic hospitals in Italy.

PubMed

Peloso, Paolo Francesco; D'Alema, Marco; Fioritti, Angelo

2014-06-01

Mental health (MH) care for Italian prisoners and offenders with mental illness is a paradoxical issue. Theory and practice remained unchanged throughout the 20th century, despite radical changes to general psychiatric care. Until recently, Italy had one of the most advanced National Health Service (NHS)-run community psychiatry care systems and a totally obsolete system of forensic psychiatry managed by criminal justice institutions. Not until 2008, after substantial pressure by public opinion and International Human Rights bodies, did the government approve a major reform transferring health care in prisons and forensic hospitals to the NHS. Forensic hospitals were to be progressively closed, and specialized small-scale facilities were to be developed for discharged offenders with mental illness, along with diversion schemes to ordinary community care. Despite some important achievements, three major problem areas remain: this reform happened without changes to the Criminal Code; regions differ in organization and resources for ordinary psychiatric services; and legal/criminological expertise among NHS MH professionals is limited.

Work interest as a predictor of competitive employment: policy implications for psychiatric rehabilitation.

PubMed

Macias, C; DeCarlo, L T; Wang, Q; Frey, J; Barreira, P

2001-03-01

Consumers with serious mental illness (N = 166) enrolling in two community-based mental health programs, a vocational Program of Assertive Community Treatment and a clubhouse certified by the International Center for Clubhouse Development (ICCD), were asked about their interest in work. About one third of the new enrollees expressed no interest in working. Equivalent supported employment services were then offered to all participants in each program. Stated interest in work and receipt of vocational services were statistically significant predictors of whether a person would work and how long it would take to get a job. Two thirds of those interested in work and half of those with no initial interest obtained a competitive job if they received at least one hour of vocational service. Once employed, these two groups held comparable jobs for the same length of time. These findings demonstrate the importance of making vocational services continuously available to all people with serious mental illness, and the viability of integrating these services into routine mental health care.

Adolescent care. Part 2: communication and referral practices of family physicians caring for adolescents with mental health problems.

PubMed

Maheux, Brigitte; Gilbert, Andrée; Haley, Nancy; Frappier, Jean-Yves

2006-11-01

To document with whom family physicians communicate when evaluating adolescents with mental health problems, to whom they refer these adolescents, and their knowledge and perceptions of the accessibility of mental health services in their communities. Mailed survey completed anonymously. Province of Quebec. All general practitioners who reported seeing at least 10 adolescents weekly (n = 255) among 707 physicians who participated in a larger survey on adolescent mental health care in general practice. Whether family physicians communicated with people (such as parents, teachers, or school nurses) when evaluating adolescents with mental health problems. Number of adolescents referred to mental health services during the last year. Knowledge of mental health services in the community and perception of their accessibility. When asked about the last 5 adolescents seen with symptoms of depression or suicidal thoughts, depending on type of practice, 9% to 19% of physicians reported routinely communicating with parents, and 22% to 32% reported not contacting parents. Between 16% and 43% of physicians referred 5 adolescents or fewer to mental health services during a 12-month period. Most practitioners reported being adequately informed about the mental health services available in their local community clinics. Few physicians knew about services offered by private-practice psychologists, child psychiatrists, or community groups. Respondents perceived mental health services in community clinics (CLSCs) as the most accessible and child psychiatrists as the least accessible services. Few physicians routinely contact parents when evaluating adolescents with serious mental health problems. Collaboration between family physicians and mental health professionals could be improved. The few referrals made to mental health professionals might indicate barriers to mental health services that could mean many adolescents do not receive the care they need. The lack of access to mental health services, notably to child psychiatrists, reported by most respondents could explain why some physicians choose not to refer adolescents.

Native Americans with Diabetes

MedlinePlus

... and address disparities. Promote wellness of the entire community and connect people to local resources, including healthy food, transportation, housing, and mental health care. Develop a coordinated team approach to diabetes ...

A Feasibility Trial of Mental Health First Aid First Nations: Acceptability, Cultural Adaptation, and Preliminary Outcomes.

PubMed

Crooks, Claire V; Lapp, Andrea; Auger, Monique; van der Woerd, Kim; Snowshoe, Angela; Rogers, Billie Jo; Tsuruda, Samantha; Caron, Cassidy

2018-03-25

The Mental Health First Aid First Nations course was adapted from Mental Health First Aid Basic to create a community-based, culturally safe and relevant approach to promoting mental health literacy in First Nations contexts. Over 2.5 days, the course aims to build community capacity by teaching individuals to recognize and respond to mental health crises. This feasibility trial utilized mixed methods to evaluate the acceptability, cultural adaptation, and preliminary effectiveness of MHFAFN. Our approach was grounded in community-based participatory research principles, emphasizing relationship-driven procedures to collecting data and choice for how participants shared their voices. Data included participant interviews (n = 89), and surveys (n = 91) from 10 groups in four provinces. Surveys contained open-ended questions, retrospective pre-post ratings, and a scenario. We utilized data from nine facilitator interviews and 24 facilitator implementation surveys. The different lines of evidence converged to highlight strong acceptability, mixed reactions to the cultural adaptation, and gains in participants' knowledge, mental health first aid skill application, awareness, and self-efficacy, and reductions in stigma beliefs. Beyond promoting individual gains, the course served as a community-wide prevention approach by situating mental health in a colonial context and highlighting local resources and cultural strengths for promoting mental well-being. © 2018 The Authors American Journal of Community Psychology published by Wiley Periodicals, Inc. on behalf of Society for Community Research and Action.

Design-Based Research as an Informal Learning Model for Choral Conductors

ERIC Educational Resources Information Center

Cooper, Naomi

2017-01-01

The number of community choirs continues to grow, and literature endorsing the benefits of choral singing for physical, mental and emotional health and well-being is rapidly expanding, meaning that the professional development of community choral conductors is in the public interest. However, research on choral conductor education remains limited.…

Disparities in Access to Substance Abuse Treatment among People with Intellectual Disabilities and Serious Mental Illness

ERIC Educational Resources Information Center

Slayter, Elspeth M.

2010-01-01

People with intellectual disabilities (ID) have experienced increasing levels of community participation since deinstitutionalization. This freedom has facilitated community inclusion, access to alcohol and drugs, and the potential for developing substance abuse (SA) disorders. People with ID, who are known to have high rates of co-occurring…

An exploratory study of the role of trust in medication management within mental health services.

PubMed

Maidment, Ian D; Brown, Patrick; Calnan, Michael

2011-08-01

To develop understandings of the nature and influence of trust in the safe management of medication within mental health services. Mental health services in the UK. Qualitative methods were applied through focus groups across three different categories of service user--older adult, adults living in the community and forensic services. An inductive thematic analysis was carried out, using the method of constant comparison derived from grounded theory. Participants' views on the key factors influencing trust and the role of trust in safe medication management. The salient factors impacting trust were: the therapeutic relationship; uncertainty and vulnerability; and social control. Users of mental health services may be particularly vulnerable to adverse events and these can damage trust. Safe management of medication is facilitated by trust. However, this trust may be difficult to develop and maintain, exposing service users to adverse events and worsening adherence. Practice and policy should be oriented towards developing trust.

Acceptability and feasibility of using non-specialist health workers to deliver mental health care: Stakeholder perceptions from the PRIME district sites in Ethiopia, India, Nepal, South Africa, and Uganda

PubMed Central

Mendenhall, Emily; De Silva, Mary J.; Hanlon, Charlotte; Petersen, Inge; Shidhaye, Rahul; Jordans, Mark; Luitel, Nagendra; Ssebunnya, Joshua; Fekadu, Abebaw; Patel, Vikram; Tomlinson, Mark; Lund, Crick

2014-01-01

Three-quarters of the global mental health burden exists in low- and middle-income countries (LMICs), yet the lack of mental health services in resource-poor settings is striking. Task-sharing (also, task-shifting), where mental health care is provided by non-specialists, has been proposed to improve access to mental health care in LMICs. This multi-site qualitative study investigates the acceptability and feasibility of task-sharing mental health care in LMICs by examining perceptions of primary care service providers (physicians, nurses, and community health workers), community members, and service users in one district in each of the five countries participating in the PRogramme for Improving Mental health carE (PRIME): Ethiopia, India, Nepal, South Africa, and Uganda. Thirty-six focus group discussions and 164 in-depth interviews were conducted at the pre-implementation stage between February and October 2012 with the objective of developing district level plans to integrate mental health care into primary care. Perceptions of the acceptability and feasibility of task-sharing were evaluated first at the district level in each country through open-coding and then at the cross-country level through a secondary analysis of emergent themes. We found that task-sharing mental health services is perceived to be acceptable and feasible in these LMICs as long as key conditions are met: 1) increased numbers of human resources and better access to medications; 2) ongoing structured supportive supervision at the community and primary care-levels; and 3) adequate training and compensation for health workers involved in task-sharing. Taking into account the socio-cultural context is fundamental for identifying local personnel who can assist in detection of mental illness and facilitate treatment and care as well as training, supervision, and service delivery. By recognizing the systemic challenges and sociocultural nuances that may influence task-sharing mental health care, locally-situated interventions could be more easily planned to provide appropriate and acceptable mental health care in LMICs. PMID:25089962

Acceptability and feasibility of using non-specialist health workers to deliver mental health care: stakeholder perceptions from the PRIME district sites in Ethiopia, India, Nepal, South Africa, and Uganda.

PubMed

Mendenhall, Emily; De Silva, Mary J; Hanlon, Charlotte; Petersen, Inge; Shidhaye, Rahul; Jordans, Mark; Luitel, Nagendra; Ssebunnya, Joshua; Fekadu, Abebaw; Patel, Vikram; Tomlinson, Mark; Lund, Crick

2014-10-01

Three-quarters of the global mental health burden exists in low- and middle-income countries (LMICs), yet the lack of mental health services in resource-poor settings is striking. Task-sharing (also, task-shifting), where mental health care is provided by non-specialists, has been proposed to improve access to mental health care in LMICs. This multi-site qualitative study investigates the acceptability and feasibility of task-sharing mental health care in LMICs by examining perceptions of primary care service providers (physicians, nurses, and community health workers), community members, and service users in one district in each of the five countries participating in the PRogramme for Improving Mental health carE (PRIME): Ethiopia, India, Nepal, South Africa, and Uganda. Thirty-six focus group discussions and 164 in-depth interviews were conducted at the pre-implementation stage between February and October 2012 with the objective of developing district level plans to integrate mental health care into primary care. Perceptions of the acceptability and feasibility of task-sharing were evaluated first at the district level in each country through open-coding and then at the cross-country level through a secondary analysis of emergent themes. We found that task-sharing mental health services is perceived to be acceptable and feasible in these LMICs as long as key conditions are met: 1) increased numbers of human resources and better access to medications; 2) ongoing structured supportive supervision at the community and primary care-levels; and 3) adequate training and compensation for health workers involved in task-sharing. Taking into account the socio-cultural context is fundamental for identifying local personnel who can assist in detection of mental illness and facilitate treatment and care as well as training, supervision, and service delivery. By recognizing the systemic challenges and sociocultural nuances that may influence task-sharing mental health care, locally-situated interventions could be more easily planned to provide appropriate and acceptable mental health care in LMICs. Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.

Becoming a Neighbor: An Examination of the Placement of People with Mental Retardation in Connecticut Communities.

ERIC Educational Resources Information Center

Bradley, Valerie J.; And Others

This study examined the impact of deinstitutionalization of the mentally retarded on their communities, the extent of availability of support services, and the extent to which the Connecticut Department of Mental Retardation assures adequate quality of support services and day programs for people with mental retardation living in community…

Effecting Successful Community Re-Entry: Systems of Care Community Based Mental Health Services

ERIC Educational Resources Information Center

Estes, Rebecca I.; Fette, Claudette; Scaffa, Marjorie E.

2005-01-01

The need for system reform for child and adolescent mental health services, long recognized as a vital issue, continues to challenge mental health professionals. While past legislation has not adequately addressed the issues, the 2003 President's New Freedom Commission may begin to reorient mental health systems toward recovery. Supported by this…

The experience of collective trauma in Australian Indigenous communities.

PubMed

Krieg, Anthea

2009-08-01

The concept of collective trauma has predominantly been applied in the context of natural and human disasters. This paper seeks to explore whether collective trauma offers a respectful way in which to explore and respond to mental health and wellbeing issues for Aboriginal families and communities. A review of the international literature was undertaken in order to determine the elements of collective and mass trauma studies which may have relevance for Indigenous communities in Australia. Findings support the proposition that the patterns of human responses to disasters, particularly in protracted traumas such as war-zones, shows strong parallels to the contemporary patterns of experience and responses articulated by Aboriginal people affected by colonization and its sequelae in Australia. Adopting evidence-informed principles of family and community healing developed internationally in disaster situations may provide helpful ways of conceptualizing and responding in a coordinated way to mental health and wellbeing issues for Indigenous people within Australia.

Community College Student Mental Health: A Comparative Analysis

ERIC Educational Resources Information Center

Katz, Daniel Seth; Davison, Karen

2014-01-01

This study explores community college student mental health by comparing the responses of California community college and traditional university students on the American College Health Association-National College Health Assessment II (ACHA-NCHA II). Using MANOVA, we compared community college and traditional university students, examining…

Mental health among younger and older caregivers of dementia patients.

PubMed

Koyama, Asuka; Matsushita, Masateru; Hashimoto, Mamoru; Fujise, Noboru; Ishikawa, Tomohisa; Tanaka, Hibiki; Hatada, Yutaka; Miyagawa, Yusuke; Hotta, Maki; Ikeda, Manabu

2017-03-01

Caregiver burden in dementia is an important issue, but few studies have examined the mental health of younger and older family caregivers by comparing them with age- and gender-matched community residents. We aimed to compare the mental health of dementia caregivers with that of community residents and to clarify factors related to mental health problems in younger and older caregivers. We studied 104 dementia caregivers; 46 were younger (<65 years) and 58 were older (≥65 years). A total of 104 community residents who were matched for age and gender were selected. We compared depression (Center for Epidemiologic Studies Depression Scale for younger participants; Geriatric Depression Scale for older participants), health-related quality of life (QOL) short-form health survey (SF-8), sleep problems, and suicidal ideation between the caregivers and community residents by age. Behavioural and psychological symptoms of dementia, activities of daily living (ADL), and instrumental ADL were assessed among patients with dementia using the Neuropsychiatric Inventory, Physical Self-Maintenance Scale, and Lawton Instrumental ADL Scale, respectively. According to SF-8 results, both younger and older caregivers had significantly worse mental QOL than community residents (younger caregivers: 46.3 vs community residents: 49.7, P = 0.017; older caregivers: 48.2 vs community residents: 51.1, P = 0.024) but were not more depressive. Sleep problems were significantly more frequent in younger caregivers (39.1%) than in community residents (17.0%) (P = 0.017). Multiple regression analysis revealed that caregivers' deteriorated mental QOL was associated with patients' behavioural and psychological symptoms of dementia in younger caregivers and with dementia patients' instrumental ADL and female gender in older caregivers. Dementia caregivers had a lower mental QOL than community residents. To maintain caregivers' mental QOL, it is necessary to provide younger caregivers with skills or professional interventions for dealing with behavioural and psychological symptoms of dementia, and older caregivers must be offered adequate care support. © 2016 The Authors. Psychogeriatrics © 2016 Japanese Psychogeriatric Society.

Community-partnered evaluation of depression services for clients of community-based agencies in under-resourced communities in Los Angeles.

PubMed

Miranda, Jeanne; Ong, Michael K; Jones, Loretta; Chung, Bowen; Dixon, Elizabeth L; Tang, Lingqi; Gilmore, Jim; Sherbourne, Cathy; Ngo, Victoria K; Stockdale, Susan; Ramos, Esmeralda; Belin, Thomas R; Wells, Kenneth B

2013-10-01

As medical homes are developing under health reform, little is known regarding depression services need and use by diverse safety-net populations in under-resourced communities. For chronic conditions like depression, primary care services may face new opportunities to partner with diverse community service providers, such as those in social service and substance abuse centers, to support a collaborative care model of treating depression. To understand the distribution of need and current burden of services for depression in under-resourced, diverse communities in Los Angeles. Baseline phase of a participatory trial to improve depression services with data from client screening and follow-up surveys. Of 4,440 clients screened from 93 programs (primary care, mental health, substance abuse, homeless, social and other community services) in 50 agencies, 1,322 were depressed according to an eight-item Patient Health Questionnaire (PHQ-8) and gave contact information; 1,246 enrolled and 981 completed surveys. Ninety-three programs, including 17 primary care/public health, 18 mental health, 20 substance abuse, ten homeless services, and 28 social/other community services, participated. Comparisons by setting in 6-month retrospective recall of depression services use. Depression prevalence ranged from 51.9 % in mental health to 17.2 % in social-community programs. Depressed clients used two settings on average to receive depression services; 82 % used any setting. More clients preferred counseling over medication for depression treatment. Need for depression care was high, and a broad range of agencies provide depression care. Although most participants had contact with primary care, most depression services occurred outside of primary care settings, emphasizing the need to coordinate and support the quality of community-based services across diverse community settings.

Impacts of family and community violence exposure on child coping and mental health.

PubMed

Mohammad, Esror Tamim; Shapiro, Ester R; Wainwright, Laurel D; Carter, Alice S

2015-02-01

An ecological stress process model was employed to explore relations between children's exposures to family and community violence and child mental health, and emotionally-regulated coping (ERC) as a protective factor among Latino, European-American, and African-American school-aged children (n = 91; girls, n = 50[54 %]) living in single-parent families who were either homeless and residing in emergency shelters or housed but living in poverty. Mothers reported domestic violence experiences and their child's history of physical/sexual abuse, community violence exposures, and mental health. Children reported on exposure to community violence, internalizing symptoms, and coping. The mental health impacts of multi-level violence exposures and ERC as a moderator of associations between violence exposures and child mental health was tested with structural equation modeling. Family abuse was uniquely associated with PTSD, and community violence with anxiety and aggression. Latent interaction tests revealed that ERC moderated relations between family abuse and anxiety, aggression and PTSD. Emotionally-regulated coping appears to play a protective role for children's mental health in contexts of violence exposure, offering opportunities for intervention and prevention.

The role of non-governmental organizations in the mental health area: differences in understanding.

PubMed

Zupančič, Vesna; Pahor, Majda

2016-12-01

The contribution's aim is highlighting the differences in understanding non-governmental organizations' (NGOs) role in the mental health area within the public support network for patients with mental health problems from various viewpoints, in order to achieve progress in supporting patients with mental health problems in local communities. Qualitative data gathered as a part of a cross-sectional study of NGOs in the support network for patients with mental health problems in two Slovenian health regions (56 local communities), carried out in 2013 and 2014, were used. Qualitative analysis of interviews, focus groups and answers to an open survey question was performed. There are differences in understanding NGOs' role in the support network for patients with mental health problems, which stem from the roles of stakeholders (local community officials, experts, care providers, and patients) within this system and their experience. The actual differences need to be addressed and overcome in order to provide integrated community care. The importance of knowing the current state of NGOs in their life cycle and the socio-chronological context of the local community support network is evident.

Attitudes to people with mental disorders: a mental health literacy survey in a rural area of Maharashtra, India.

PubMed

Kermode, Michelle; Bowen, Kathryn; Arole, Shoba; Pathare, Soumitra; Jorm, Anthony F

2009-12-01

People with mental disorders experience discrimination as a consequence of stigmatising attitudes that are largely socio-culturally constructed. Thus, there is a need to understand local contexts in order to develop effective programs to change such attitudes. We undertook a mental health literacy survey in rural Maharashtra, India, prior to developing a mental health training program for village health workers (VHWs) in a primary health care setting. A cross-sectional mental health literacy survey was undertaken in late 2007, which involved interviewer-administration of a questionnaire to 240 systematically sampled community members, and 60 purposively sampled VHWs. Participants were presented with two vignettes describing people experiencing symptoms of mental disorders (depression, psychosis), and were asked about attitudes towards, and desired social distance from, the people in the vignettes (the latter being a proxy measure for stigma). Linear regression modelling was undertaken to identify predictors of social distance. Although the community was relatively accepting of people with mental disorders, false beliefs and negative attitudes were still evident. Desired social distance was consistently greater for the person depicted in the psychosis vignette compared to the depression vignette. For both vignettes, the main predictor of greater social distance was perceiving the person as dangerous, and the predictors of reduced social distance were being a VHW, and seeing the problem as a sign of personal weakness. For depression, believing the cause to be family tensions also reduced social distance. For psychosis, labelling the disorder as a mind/brain problem, and believing the cause to be lack of control over life or genetic factors increased social distance. The vast majority did not agree that the problems experienced in the vignettes were 'a real medical illness'. Promoting bio-medical explanations for mental disorders in this setting may exacerbate discriminatory attitudes. Provision of contextually relevant mental health training for the VHWs so that they are able to communicate, model and shape more positive attitudes is the next step.

Prevention of mental handicaps in children in primary health care.

PubMed Central

Shah, P. M.

1991-01-01

Some 5-15% of children aged 3 to 15 years in both developing and developed countries suffer from mental handicaps. There may be as many as 10-30 million severely and about 60-80 million mildly or moderately mentally retarded children in the world. The conditions causing mental handicaps are largely preventable through primary health care measures in developing countries. Birth asphyxia and birth trauma are the leading causes of mental handicaps in developing countries where over 1.2 million newborns die each year from moderate or severe asphyxia and an equal number survive with severe morbidity due to brain damage. The other preventable or manageable conditions are: infections such as tuberculous and pyogenic meningitides and encephalopathies associated with measles and whooping cough; severe malnutrition in infancy; hyperbilirubinaemia in the newborn; iodine deficiency; and iron deficiency anaemia in infancy and early childhood. In addition, recent demographic and socioeconomic changes and an increase in the number of working mothers tend to deprive both infants and young children of stimulation for normal development. To improve this situation, the primary health care approach involving families and communities and instilling the spirit of self-care and self-help is indispensable. Mothers and other family members, traditional birth attendants, community health workers, as well as nurse midwives and physicians should be involved in prevention and intervention activities, for which they should be trained and given knowledge and skills about appropriate technologies such as the risk approach, home-based maternal record, partograph, mobilogram (kick count), home-risk card, icterometer, and mouth-to-mask or bag and mask resuscitation of the newborn. Most of these have been field-tested by WHO and can be used in the home, the health centre or day care centres to detect and prevent the above-mentioned conditions which can cause mental handicap. PMID:1786628

A comparison of the effectiveness of three parenting programmes in improving parenting skills, parent mental-well being and children's behaviour when implemented on a large scale in community settings in 18 English local authorities: the parenting early intervention pathfinder (PEIP).

PubMed

Lindsay, Geoff; Strand, Steve; Davis, Hilton

2011-12-30

There is growing evidence that parenting programmes can improve parenting skills and thereby the behaviour of children exhibiting or at risk of developing antisocial behaviour. Given the high prevalence of childhood behaviour problems the task is to develop large scale application of effective programmes. The aim of this study was to evaluate the UK government funded implementation of the Parenting Early Intervention Pathfinder (PEIP). This involved the large scale rolling out of three programmes to parents of children 8-13 years in 18 local authorities (LAs) over a 2 year period. The UK government's Department for Education allocated each programme (Incredible Years, Triple P and Strengthening Families Strengthening Communities) to six LAs which then developed systems to intervene using parenting groups. Implementation fidelity was supported by the training of group facilitators by staff of the appropriate parenting programme supplemented by supervision. Parents completed measures of parenting style, efficacy, satisfaction, and mental well-being, and also child behaviour. A total of 1121 parents completed pre- and post-course measures. There were significant improvements on all measures for each programme; effect sizes (Cohen's d) ranged across the programmes from 0.57 to 0.93 for parenting style; 0.33 to 0.77 for parenting satisfaction and self-efficacy; and from 0.49 to 0.88 for parental mental well-being. Effectiveness varied between programmes: Strengthening Families Strengthening Communities was significantly less effective than both the other two programmes in improving parental efficacy, satisfaction and mental well-being. Improvements in child behaviour were found for all programmes: effect sizes for reduction in conduct problems ranged from -0.44 to -0.71 across programmes, with Strengthening Families Strengthening Communities again having significantly lower reductions than Incredible Years. Evidence-based parenting programmes can be implemented successfully on a large scale in community settings despite the lack of concentrated and sustained support available during a controlled trial.

A comparison of the effectiveness of three parenting programmes in improving parenting skills, parent mental-well being and children's behaviour when implemented on a large scale in community settings in 18 English local authorities: the parenting early intervention pathfinder (PEIP)

PubMed Central

2011-01-01

Background There is growing evidence that parenting programmes can improve parenting skills and thereby the behaviour of children exhibiting or at risk of developing antisocial behaviour. Given the high prevalence of childhood behaviour problems the task is to develop large scale application of effective programmes. The aim of this study was to evaluate the UK government funded implementation of the Parenting Early Intervention Pathfinder (PEIP). This involved the large scale rolling out of three programmes to parents of children 8-13 years in 18 local authorities (LAs) over a 2 year period. Methods The UK government's Department for Education allocated each programme (Incredible Years, Triple P and Strengthening Families Strengthening Communities) to six LAs which then developed systems to intervene using parenting groups. Implementation fidelity was supported by the training of group facilitators by staff of the appropriate parenting programme supplemented by supervision. Parents completed measures of parenting style, efficacy, satisfaction, and mental well-being, and also child behaviour. Results A total of 1121 parents completed pre- and post-course measures. There were significant improvements on all measures for each programme; effect sizes (Cohen's d) ranged across the programmes from 0.57 to 0.93 for parenting style; 0.33 to 0.77 for parenting satisfaction and self-efficacy; and from 0.49 to 0.88 for parental mental well-being. Effectiveness varied between programmes: Strengthening Families Strengthening Communities was significantly less effective than both the other two programmes in improving parental efficacy, satisfaction and mental well-being. Improvements in child behaviour were found for all programmes: effect sizes for reduction in conduct problems ranged from -0.44 to -0.71 across programmes, with Strengthening Families Strengthening Communities again having significantly lower reductions than Incredible Years. Conclusions Evidence-based parenting programmes can be implemented successfully on a large scale in community settings despite the lack of concentrated and sustained support available during a controlled trial. PMID:22208676

Developing a Multiple Caregiver Group for Caregivers of Adolescents With Disruptive Behaviors.

PubMed

Oruche, Ukamaka M; Robb, Sheri L; Aalsma, Matt; Pescosolido, Bernice; Brown-Podgorski, Brittany; Draucker, Claire Burke

2017-12-01

This article describes the development of a 6-week multiple caregiver group intervention for primary caregivers of adolescents diagnosed with Oppositional Defiant Disorder or Conduct Disorder in low-income African American families. The intervention is aimed at increasing the primary caregivers' self-efficacy in managing interactions within the family and especially with child serving educational, mental health, juvenile justice, and child welfare systems. Development of the intervention involved seven iterative activities performed in a collaborative effort between an interdisciplinary academic team, community engagement specialists, members of the targeted population, and clinical partners from a large public mental health system. The intervention development process described in this article can provide guidance for teams that aim to develop new mental health interventions that target specific outcomes in populations with unique needs. Copyright © 2017 Elsevier Inc. All rights reserved.

Toward a Culturally Responsive Model of Mental Health Literacy: Facilitating Help-Seeking Among East Asian Immigrants to North America.

PubMed

Na, Sumin; Ryder, Andrew G; Kirmayer, Laurence J

2016-09-01

Studies have consistently found that East Asian immigrants in North America are less likely to use mental health services even when they experience levels of distress comparable to Euro-Americans. Although cultural factors that may prevent East Asian immigrants from seeking mental health care have been identified, few studies have explored ways to foster appropriate help-seeking and use of mental health services. Recent work on mental health literacy provides a potential framework for strategies to increase appropriate help-seeking and use of services. This paper reviews the literature on help-seeking for mental health problems among East Asian immigrants living in Western countries to critically assess the relevance of the mental health literacy approach as a framework for interventions to improve appropriate use of services. Modifications needed to develop a culturally responsive framework for mental health literacy are identified. © Society for Community Research and Action 2016.

Exploration of experiences in therapeutic groups for patients with severe mental illness: development of the Ferrara group experiences scale (FE- GES).

PubMed

Caruso, Rosangela; Grassi, Luigi; Biancosino, Bruno; Marmai, Luciana; Bonatti, Luciano; Moscara, Maria; Rigatelli, Marco; Carr, Catherine; Priebe, Stefan

2013-10-01

Group therapies are routinely provided for patients with severe mental illness. The factors important to the group experience of patients are still poorly understood and are rarely measured. To support further research and practice, we aimed to develop a questionnaire that captures how patients experience groups within a community mental health context. An initial pool of 39 items was conceptually generated to assess different aspects of group experiences. Items were completed by 166 patients with severe mental illness attending group therapies in community mental health services in Italy. Patients with different psychiatric diagnoses who attended at least 5 group sessions were included. An exploratory factor analysis was used to identify different dimensions of group experiences and to reduce the number of items for each dimension. The resulting questionnaire has five subscales: 1) sharing of emotions and experiences, 2) cognitive improvement, 3) group learning, 4) difficulties in open expression and 5) relationships. Each subscale has 4 items. The scale and sub-scales have good internal consistency. The Ferrara Group Experiences Scale is conceptually derived and assesses dimensions of group experience that are theoretically and practically relevant. It is brief, easy to use and has good psychometric properties. After further validation, the scale may be used for research into patient experiences across different group therapy modalities and for evaluation in routine care.

A Preliminary Investigation into Worry about Mental Health: Development of the Mental Health Anxiety Inventory.

PubMed

Commons, Della; Greenwood, Kenneth Mark; Anderson, Rebecca A

2016-05-01

Worry about physical health is broadly referred to as health anxiety and can range from mild concern to severe or persistent anxiety such as that found in DSM-IV hypochondriasis. While much is known about anxiety regarding physical health, little is known about anxiety regarding mental health. However, recent conceptualizations of health anxiety propose that individuals can experience severe and problematic worry about mental health in similar ways to how people experience extreme worry about physical health. Given the paucity of research in this area, the aim of the current study was to explore anxiety regarding mental health through validation of the Mental Health Anxiety Inventory (MHAI), a modified version of the Short Health Anxiety Inventory. The MHAI, and measures of state anxiety (Depression, Anxiety and Stress Scales-21), trait worry (Penn State Worry Questionnaire), and health anxiety (Short Health Anxiety Inventory) were administered to 104 adult volunteers from the general community. The MHAI demonstrated high internal consistency, acceptable test-retest reliability, and good construct validity when correlated with other measures of anxiety. Results also indicated that participants worried about their mental health and physical health equally, and that almost 9% of participants reported levels of mental health anxiety that were potentially problematic. Preliminary results suggest that a small proportion of adults in the community may experience high levels of mental health anxiety requiring treatment, and that the MHAI, if validated further, could be a useful tool for assessing this form of anxiety.

Review of psychiatric services to mentally disordered offenders around the Pacific Rim.

PubMed

Every-Palmer, Susanna; Brink, Johann; Chern, Tor P; Choi, Wing-Kit; Hern-Yee, Jerome Goh; Green, Bob; Heffernan, Ed; Johnson, Sarah B; Kachaeva, Margarita; Shiina, Akihiro; Walker, David; Wu, Kevin; Wang, Xiaoping; Mellsop, Graham

2014-03-01

This article was commissioned to collate and review forensic psychiatric services provided in a number of key Pacific Rim locations in the hope that it will assist in future dialogue about service development. The Board of the Pacific Rim College of Psychiatrists identified experts in forensic psychiatry from Australia, Canada, China, Hong Kong, Japan, Russia, Singapore, Taiwan, and the US. Each contributor provided an account of issues in their jurisdiction, including mental health services to mentally disordered offenders in prison, competence or fitness to stand trial, legal insanity as a defense at trial, diminished responsibility, and special forensic services available, including forensic hospitals and community forensic mental health services. Responses have been collated and are presented topic by topic and country by country within the body of this review. The availability of mental health screening and psychiatric in-reach or forensic liaison services within prisons differed considerably between countries, as did provisioning of community forensic mental health and rehabilitation services. Diversion of mentally disordered offenders to forensic, state, or hybrid hospitals was common. Legal constructs of criminal responsibility (insanity defense) and fitness to stand trial ("disability") are almost universally recognized, although variably used. Disparities between unmet needs and resourcing available were common themes. The legislative differences between contributing countries with respect to the mental health law and criminal law relating to mentally disordered offenders are relatively subtle. The major differences lie in operationalizing and resourcing forensic services. Copyright © 2013 Wiley Publishing Asia Pty Ltd.