Telepsychiatry in India – Where Do We Stand? A Comparative Review between Global and Indian Telepsychiatry Programs

PubMed Central

Naskar, Subrata; Victor, Robin; Das, Himabrata; Nath, Kamal

2017-01-01

A wide discrepancy exists in India between the existing mental healthcare repertoire and the alarmingly high burden of individuals requiring immediate attention from requisite mental healthcare services. Providing equitable mental healthcare across a vast country characterized by profound cultural variations and territorial caveats has remained a major public health concern. Against this gloomy backdrop, the emergence of distant communications technology offers solace and optimism as an ingenious approach to bridge the existing gap between clients and mental health professionals. Using inexpensive equipment and basic technical knowhow, telepsychiatry expands the scope of the discipline to distant and hazy suburbs and villages from its urban centers of excellence. The current academic endeavor intends to perform a systematic review of relevant literature from India as well as from other countries. The various models of telepsychiatry-both asynchronous and synchronous models-in practice have been elaborated on with a focus on effectiveness, feasibility and acceptability of this latest modality. A sincere attempt to chronicle the remarkable journey of telepsychiatry in India, beginning in the dawn of the 21st century to the current Indian scenario, has been made. The legal and ethical issues, along with a few words of caution and contemplation, have been briefly touched on. A set of recommendations has been provided with the hope that policy makers and administrators in the domain of mental health may benefit from them. It is anticipated that telepsychiatry will be adequately utilized in India to tackle the raging menace of inadequate mental healthcare services. PMID:28615754

Developing Indicators for the Child and Youth Mental Health System in Ontario.

PubMed

Yang, Julie; Kurdyak, Paul; Guttmann, Astrid

2016-01-01

When the Government of Ontario launched a comprehensive mental health and addictions strategy, the Institute for Clinical Evaluative Sciences (ICES) was tasked with developing a scorecard for ongoing monitoring of the child and youth mental health system. Using existing administrative and survey-based healthcare and education data, researchers at ICES developed a scorecard consisting of 25 indicators that described at-risk populations, child and youth mental healthcare and relevant outcomes. This scorecard is the first in Canada to report on performance indicators for the child and youth mental health system and provides a model for monitoring child and youth mental health using routinely collected administrative data.

Technology in Mental Health: Creating New Knowledge and Inventing the Future of Services.

PubMed

Ben-Zeev, Dror

2017-02-01

The mental health services now in place are intrinsically linked with the technology that has been at our disposal for decades of research and practice. Advancements in Web, mobile, sensor, and informatics technology can do more than serve as tools to enhance existing models of care. Novel technologies can help us better understand the very nature of mental illness and revise our fundamental assumptions about the structure, boundaries, and modalities of mental health treatment. Recognizing the unprecedented opportunities new technology offers to improve the outcomes of people with mental illness, Psychiatric Services announces a new column on technology and mental health.

Communication skills in psychiatry training.

PubMed

Ditton-Phare, Philippa; Halpin, Sean; Sandhu, Harsimrat; Kelly, Brian; Vamos, Marina; Outram, Sue; Bylund, Carma L; Levin, Tomer; Kissane, David; Cohen, Martin; Loughland, Carmel

2015-08-01

Mental health clinicians can experience problems communicating distressing diagnostic information to patients and their families, especially about severe mental illnesses such as schizophrenia. Evidence suggests that interpersonal communication skills can be effectively taught, as has been demonstrated in the specialty of oncology. However, very little literature exists with respect to interpersonal communication skills training for psychiatry. This paper provides an overview of the communication skills training literature. The report reveals significant gaps exist and highlights the need for advanced communication skills training for mental health clinicians, particularly about communicating a diagnosis and/or prognosis of schizophrenia. A new communication skills training framework for psychiatry is described, based on that used in oncology as a model. This model promotes applied skills and processes that are easily adapted for use in psychiatry, providing an effective platform for the development of similar training programs for psychiatric clinical practice. © The Royal Australian and New Zealand College of Psychiatrists 2015.

Visualizations and Mental Models - The Educational Implications of GEOWALL

NASA Astrophysics Data System (ADS)

Rapp, D.; Kendeou, P.

2003-12-01

Work in the earth sciences has outlined many of the faulty beliefs that students possess concerning particular geological systems and processes. Evidence from educational and cognitive psychology has demonstrated that students often have difficulty overcoming their na‹ve beliefs about science. Prior knowledge is often remarkably resistant to change, particularly when students' existing mental models for geological principles may be faulty or inaccurate. Figuring out how to help students revise their mental models to include appropriate information is a major challenge. Up until this point, research has tended to focus on whether 2-dimensional computer visualizations are useful tools for helping students develop scientifically correct models. Research suggests that when students are given the opportunity to use dynamic computer-based visualizations, they are more likely to recall the learned information, and are more likely to transfer that knowledge to novel settings. Unfortunately, 2-dimensional visualization systems are often inadequate representations of the material that educators would like students to learn. For example, a 2-dimensional image of the Earth's surface does not adequately convey particular features that are critical for visualizing the geological environment. This may limit the models that students can construct following these visualizations. GEOWALL is a stereo projection system that has attempted to address this issue. It can display multidimensional static geologic images and dynamic geologic animations in a 3-dimensional format. Our current research examines whether multidimensional visualization systems such as GEOWALL may facilitate learning by helping students to develop more complex mental models. This talk will address some of the cognitive issues that influence the construction of mental models, and the difficulty of updating existing mental models. We will also discuss our current work that seeks to examine whether GEOWALL is an effective tool for helping students to learn geological information (and potentially restructure their na‹ve conceptions of geologic principles).

Building Coalitions To Provide HIV Legal Advocacy Services: Utilizing Existing Disability Models. AIDS Technical Report, No. 5.

ERIC Educational Resources Information Center

Harvey, David C.; Ardinger, Robert S.

This technical report is part of a series on AIDS/HIV (Acquired Immune Deficiency Syndrome/Human Immunodeficiency Virus) and is intended to help link various legal advocacy organizations providing services to persons with mental illness or developmental disabilities. This report discusses strategies to utilize existing disability models for…

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.

Collaborative Care in Schools: Enhancing Integration and Impact in Youth Mental Health

ERIC Educational Resources Information Center

Lyon, Aaron R.; Whitaker, Kelly; French, William P.; Richardson, Laura P.; Wasse, Jessica Knaster; McCauley, Elizabeth

2016-01-01

Collaborative care (CC) is an innovative approach to integrated mental health service delivery that focuses on reducing access barriers, improving service quality and lowering health care expenditures. A large body of evidence supports the effectiveness of CC models with adults and, increasingly, for youth. Although existing studies examining…

Mental Health Services in NCAA Division I Athletics: A Survey of Head ATCs.

PubMed

Sudano, Laura E; Miles, Christopher M

There is a growing awareness of the importance of mental health care in National Collegiate Athletic Association (NCAA) student-athletes; however, there is a lack of literature on mental health resources in collegiate settings. Identifying current practices can set the stage to improve the delivery of care. There is great variability in resources and current practices and no "standard of care" exists. Observational, quantitative. Level 5. One hundred twenty-seven (36% response rate) head athletic trainers at Division I NCAA member colleges completed a web-based survey. Questions assessed several aspects of mental health clinicians, perception of care coordination, and screening. Seventy-two percent of respondents noted that counseling took place in a counseling center, and 20.5% of respondents indicated that they had a mental health provider who worked in the athletic training room. Mental health clinician credentials included marriage and family therapist, psychologist, clinical social worker, and psychiatrist. The majority of athletic trainers (ATCs) noted that they are satisfied with the feedback from the mental health provider about the student-athletes' mental health (57.3%) and believe that they would be able to provide better care to student-athletes if mental health services occurred onsite in the training room (46.4%). Fewer than half (43%) indicated that they use screening instruments to assess for mental health disorders. There is wide variability on how mental health services are provided to NCAA Division 1 student-athletes. Some mental health care providers are located offsite, while some provide care in the training room setting. Also, there are inconsistencies in the use of standardized screening tools for mental health evaluation. There is no standard collaborative or integrated care delivery model for student-athletes. Opportunities exist for standardization through integrated care models and increased use of validated screening tools to deliver comprehensive care to student-athletes.

The Impact of Secondary School Students' Preconceptions on the Evolution of their Mental Models of the Greenhouse effect and Global Warming

NASA Astrophysics Data System (ADS)

Reinfried, Sibylle; Tempelmann, Sebastian

2014-01-01

This paper provides a video-based learning process study that investigates the kinds of mental models of the atmospheric greenhouse effect 13-year-old learners have and how these mental models change with a learning environment, which is optimised in regard to instructional psychology. The objective of this explorative study was to observe and analyse the learners' learning pathways according to their previous knowledge in detail and to understand the mental model formation processes associated with them more precisely. For the analysis of the learning pathways, drawings, texts, video and interview transcripts from 12 students were studied using qualitative methods. The learning pathways pursued by the learners significantly depend on their domain-specific previous knowledge. The learners' preconceptions could be typified based on specific characteristics, whereby three preconception types could be formed. The 'isolated pieces of knowledge' type of learners, who have very little or no previous knowledge about the greenhouse effect, build new mental models that are close to the target model. 'Reduced heat output' type of learners, who have previous knowledge that indicates compliances with central ideas of the normative model, reconstruct their knowledge by reorganising and interpreting their existing knowledge structures. 'Increasing heat input' type of learners, whose previous knowledge consists of subjective worldly knowledge, which has a greater personal explanatory value than the information from the learning environment, have more difficulties changing their mental models. They have to fundamentally reconstruct their mental models.

The Transcultural Wellness Center: rehabilitation and recovery in Asian and Pacific Islander mental health care.

PubMed

Cameron, Rebecca P; Ton, Hendry; Yang, Cynthia; Endriga, Marya C; Lan, Mei-Fang; Koike, Alan K

2008-01-01

Asian and Pacific Islander Americans (APIAs) are a diverse group, representing many cultures of origin, a range of immigration experiences, and varying access to economic and other resources. Despite stereotypes such as the "model minority" and cultural values that stigmatize mental illness and complicate mental health help-seeking, APIAs' psychiatric rehabilitation and recovery needs are significant. These needs are inadequately treated within existing systems of care. Passage of California's Mental Health Services Act (MHSA) in 2004 created the opportunity for Sacramento County to fund a full-service mental health clinic designed to meet the needs of the APIA community. The process by which this clinic, the Transcultural Wellness Center, was conceptualized, advocated for, and launched is described. This clinic is considered a best practice model within the MHSA system redesign effort.

THE STUDY OF THE UNIVERSITY AS A MODEL FOR COMMUNITY MENTAL HEALTH.

ERIC Educational Resources Information Center

BERNS, ROBERT S.

ASPECTS OF COMMUNITY MENTAL HEALTH WITHIN THE STRUCTURE OF THE UNIVERSITY AND THE ROLE OF THE COMMUNITY PSYCHIATRIST ARE EXPLORED. THE PSYCHIATRIST CAN OFFER DIRECTION AND INSIGHT IN DECISION-MAKING AND PROBLEM SOLVING OF THE CONFLICTS EXISTING BETWEEN STUDENTS AND ADMINISTRATORS. IN DOING THIS, THE PSYCHIATRIST MUST VIEW GROUP PROBLEMS IN TERMS…

Temporal patterns of mental model convergence: implications for distributed teams interacting in electronic collaboration spaces.

PubMed

McComb, Sara; Kennedy, Deanna; Perryman, Rebecca; Warner, Norman; Letsky, Michael

2010-04-01

Our objective is to capture temporal patterns in mental model convergence processes and differences in these patterns between distributed teams using an electronic collaboration space and face-to-face teams with no interface. Distributed teams, as sociotechnical systems, collaborate via technology to work on their task. The way in which they process information to inform their mental models may be examined via team communication and may unfold differently than it does in face-to-face teams. We conducted our analysis on 32 three-member teams working on a planning task. Half of the teams worked as distributed teams in an electronic collaboration space, and the other half worked face-to-face without an interface. Using event history analysis, we found temporal interdependencies among the initial convergence points of the multiple mental models we examined. Furthermore, the timing of mental model convergence and the onset of task work discussions were related to team performance. Differences existed in the temporal patterns of convergence and task work discussions across conditions. Distributed teams interacting via an electronic interface and face-to-face teams with no interface converged on multiple mental models, but their communication patterns differed. In particular, distributed teams with an electronic interface required less overall communication, converged on all mental models later in their life cycles, and exhibited more linear cognitive processes than did face-to-face teams interacting verbally. Managers need unique strategies for facilitating communication and mental model convergence depending on teams' degrees of collocation and access to an interface, which in turn will enhance team performance.

Overcoming roadblocks: current and emerging reimbursement strategies for integrated mental health services in primary care.

PubMed

O'Donnell, Allison N; Williams, Mark; Kilbourne, Amy M

2013-12-01

The Chronic Care Model (CCM) has been shown to improve medical and psychiatric outcomes for persons with mental disorders in primary care settings, and has been proposed as a model to integrate mental health care in the patient-centered medical home under healthcare reform. However, the CCM has not been widely implemented in primary care settings, primarily because of a lack of a comprehensive reimbursement strategy to compensate providers for day-to-day provision of its core components, including care management and provider decision support. Drawing upon the existing literature and regulatory guidelines, we provide a critical analysis of challenges and opportunities in reimbursing CCM components under the current fee-for-service system, and describe an emerging financial model involving bundled payments to support core CCM components to integrate mental health treatment into primary care settings. Ultimately, for the CCM to be used and sustained over time to integrate physical and mental health care, effective reimbursement models will need to be negotiated across payers and providers. Such payments should provide sufficient support for primary care providers to implement practice redesigns around core CCM components, including care management, measurement-based care, and mental health specialist consultation.

Legal capacity of persons with disabilities in Ethiopia: The need to reform existing legal frameworks.

PubMed

Marishet, Mohammed Hamza

The Convention on the Rights of Persons with Disabilities (CRPD) prohibited deprivation legal capacity of persons with disability based on assessment of mental capacity. The assertion is that, persons with disabilities shall exercise their legal capacity in all aspects of life without any restrictions that are based on mental incapacity (such as, unsoundness of mind, deficit in mental capacity, dotage, etc. This approach signifies a shift from substituted decision making, where another person act on behalf of persons with mental disabilities, to supported decision making where the person with mental disability is assisted in decision making. The rationale for the move lies on the recognition that the right to legal capacity embodies the inherent meaning of what it meant to be human. Without legal capacity a person cannot exercise all other rights and entitlements. Accordingly, States parties to CRPD are required to reform domestic legislations that are based on substituted decision making model and recognize full legal capacity of persons with disabilities in line with supported decision making model. As a Sate party to CRPD, Ethiopia assumed the same obligation. Nonetheless, in its initial report to the Committee on CRPD, the country denies existence of legislation that restricts legal capacity on the grounds of mental incapacity. This research found out that there are restrictions imposed on legal capacity of persons with disabilities on the basis of mental incapacity/disability. The research analyzed the approach employed to restrict legal capacity under the existing legal frameworks of Ethiopia vis-à-vis supported decision-making regime under CRPD. The research is doctrinal and, as such, limited to content analysis of general and specific legal capacity laws of the country (such as, marriage, divorce, will, work and employment, political participation, access to justice and others). Copyright © 2017 Elsevier Ltd. All rights reserved.

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.

42 CFR 51d.5 - How is an emergency determined to exist?

Code of Federal Regulations, 2014 CFR

2014-10-01

... Section 51d.5 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES GRANTS MENTAL...? (a) In making a decision as to whether a mental health or substance abuse emergency exists for... mental health and/or substance abuse services are overwhelmed or unable to meet the existing mental...

42 CFR 51d.5 - How is an emergency determined to exist?

Code of Federal Regulations, 2012 CFR

2012-10-01

... Section 51d.5 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES GRANTS MENTAL...? (a) In making a decision as to whether a mental health or substance abuse emergency exists for... mental health and/or substance abuse services are overwhelmed or unable to meet the existing mental...

42 CFR 51d.5 - How is an emergency determined to exist?

Code of Federal Regulations, 2011 CFR

2011-10-01

... Section 51d.5 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES GRANTS MENTAL...? (a) In making a decision as to whether a mental health or substance abuse emergency exists for... mental health and/or substance abuse services are overwhelmed or unable to meet the existing mental...

42 CFR 51d.5 - How is an emergency determined to exist?

Code of Federal Regulations, 2013 CFR

2013-10-01

... Section 51d.5 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES GRANTS MENTAL...? (a) In making a decision as to whether a mental health or substance abuse emergency exists for... mental health and/or substance abuse services are overwhelmed or unable to meet the existing mental...

A Statewide Key Informant Survey and Social Indicators Analysis.

ERIC Educational Resources Information Center

Fleischer, Mitchell

This needs assessment study of mental health needs of the elderly in Pennsylvania used a three-part approach. These parts were a review of existing data sources, an extensive key informant study, and a review of service delivery models. A recent study found a prevalence rate for mental illness in the elderly of 12.8%, more than 5% lower than the…

Human resources and models of mental healthcare integration into primary and community care in India: Case studies of 72 programmes

PubMed Central

Maheedhariah, Meera S.; Ghani, Sarah; Raja, Anusha; Patel, Vikram

2017-01-01

Background Given the scarcity of specialist mental healthcare in India, diverse community mental healthcare models have evolved. This study explores and compares Indian models of mental healthcare delivered by primary-level workers (PHW), and health workers’ roles within these. We aim to describe current service delivery to identify feasible and acceptable models with potential for scaling up. Methods Seventy two programmes (governmental and non-governmental) across 12 states were visited. 246 PHWs, coordinators, leaders, specialists and other staff were interviewed to understand the programme structure, the model of mental health delivery and health workers’ roles. Data were analysed using framework analysis. Results Programmes were categorised using an existing framework of collaborative and non-collaborative models of primary mental healthcare. A new model was identified: the specialist community model, whereby PHWs are trained within specialist programmes to provide community support and treatment for those with severe mental disorders. Most collaborative and specialist community models used lay health workers rather than doctors. Both these models used care managers. PHWs and care managers received support often through multiple specialist and non-specialist organisations from voluntary and government sectors. Many projects still use a simple yet ineffective model of training without supervision (training and identification/referral models). Discussion and conclusion Indian models differ significantly to those in high-income countries—there are less professional PHWs used across all models. There is also intensive specialist involvement particularly in the community outreach and collaborative care models. Excessive reliance on specialists inhibits their scalability, though they may be useful in targeted interventions for severe mental disorders. We propose a revised framework of models based on our findings. The current priorities are to evaluate the comparative effectiveness, cost-effectiveness and scalability of these models in resource-limited settings both in India and in other low- and middle- income countries. PMID:28582445

The association between childhood maltreatment, mental health problems, and aggression in justice-involved boys.

PubMed

Hoeve, Machteld; Colins, Olivier F; Mulder, Eva A; Loeber, Rolf; Stams, Geert Jan J M; Vermeiren, Robert R J M

2015-01-01

The link between childhood maltreatment and adolescent aggression is well documented; yet, studies examining potential mechanisms that explain this association are limited. In the present study, we tested the association between childhood maltreatment and adolescent aggression in boys in juvenile justice facilities (N = 767) and examined the contribution of mental health problems to this relationship. Data on childhood maltreatment, mental health problems, and aggression were collected by means of self-report measures and structural equation models were used to test mediation models. We found that mental health problems mediated the link between maltreatment and aggression. Results demonstrated different pathways depending on the type of aggression examined. The association between childhood maltreatment and reactive aggression was fully mediated by a variety of mental health problems and for proactive aggression the association was partially mediated by mental health problems. We also found that reactive and proactive aggression partially mediated the association between maltreatment and mental health problems. These findings suggest that a transactional model may best explain the negative effects of childhood trauma on mental health problems and (in particular reactive) aggression. In addition, our findings add to the existing evidence that reactive and proactive aggression have different etiological pathways. © 2015 Wiley Periodicals, Inc.

Conceptualizing Culturally Infused Engagement and Its Measurement for Ethnic Minority and Immigrant Children and Families

PubMed Central

Pottick, Kathleen J.; Chen, Yun

2017-01-01

Despite the central role culture plays in racial and ethnic disparities in mental health among ethnic minority and immigrant children and families, existing measures of engagement in mental health services have failed to integrate culturally specific factors that shape these families' engagement with mental health services. To illustrate this gap, the authors systematically review 119 existing instruments that measure the multi-dimensional and developmental process of engagement for ethnic minority and immigrant children and families. The review is anchored in a new integrated conceptualization of engagement, the culturally infused engagement model. The review assesses culturally relevant cognitive, attitudinal, and behavioral mechanisms of engagement from the stages of problem recognition and help seeking to treatment participation that can help illuminate the gaps. Existing measures examined four central domains pertinent to the process of engagement for ethnic minority and immigrant children and families: (a) expressions of mental distress and illness, (b) causal explanations of mental distress and illness, (c) beliefs about mental distress and illness, and (d) beliefs and experiences of seeking help. The findings highlight the variety of tools that are used to measure behavioral and attitudinal dimensions of engagement, showing the limitations of their application for ethnic minority and immigrant children and families. The review proposes directions for promising research methodologies to help intervention scientists and clinicians improve engagement and service delivery and reduce disparities among ethnic minority and immigrant children and families at large, and recommends practical applications for training, program planning, and policymaking. PMID:28275923

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.

[Prevention of mental disorders].

PubMed

Riedel-Heller, Steffi; Gühne, Uta

2013-12-01

Investment in prevention is a major public health requirement. Mental disorders are common and are associated with severe consequences. They are a major target for prevention. Based on vulnerabilitiy-stress-models the theoretical background for prevention in mental disorders is outlined. Effective strategies for children, adolescents, adults and individuals in old age do exist. Results regarding the prevention of depres-sion and psychoses are outlined and risk groups which require current actions are determined. Current activities towards a national prevention strategy in Germany are discussed. © Georg Thieme Verlag KG Stuttgart · New York.

Better together? a naturalistic qualitative study of inter-professional working in collaborative care for co-morbid depression and physical health problems.

PubMed

Knowles, Sarah E; Chew-Graham, Carolyn; Coupe, Nia; Adeyemi, Isabel; Keyworth, Chris; Thampy, Harish; Coventry, Peter A

2013-09-20

Mental-physical multi-morbidities pose challenges for primary care services that traditionally focus on single diseases. Collaborative care models encourage inter-professional working to deliver better care for patients with multiple chronic conditions, such as depression and long-term physical health problems. Successive trials from the United States have shown that collaborative care effectively improves depression outcomes, even in people with long-term conditions (LTCs), but little is known about how to implement collaborative care in the United Kingdom. The aim of the study was to explore the extent to which collaborative care was implemented in a naturalistic National Health Service setting. A naturalistic pilot study of collaborative care was undertaken in North West England. Primary care mental health professionals from IAPT (Increasing Access to Psychological Therapies) services and general practice nurses were trained to collaboratively identify and manage patients with co-morbid depression and long-term conditions. Qualitative interviews were performed with health professionals at the beginning and end of the pilot phase. Normalization Process Theory guided analysis. Health professionals adopted limited elements of the collaborative care model in practice. Although benefits of co-location in primary care practices were reported, including reduced stigma of accessing mental health treatment and greater ease of disposal for identified patients, existing norms around the division of mental and physical health work in primary care were maintained, limiting integration of the mental health practitioners into the practice setting. Neither the mental health practitioners nor the practice nurses perceived benefits to joint management of patients. Established divisions between mental and physical health may pose particular challenges for multi-morbidity service delivery models such as collaborative care. Future work should explore patient perspectives about whether greater inter-professional working enhances experiences of care. The study demonstrates that research into implementation of novel treatments must consider how the introduction of innovation can be balanced with the need for integration into existing practice.

Better together? a naturalistic qualitative study of inter-professional working in collaborative care for co-morbid depression and physical health problems

PubMed Central

2013-01-01

Background Mental-physical multi-morbidities pose challenges for primary care services that traditionally focus on single diseases. Collaborative care models encourage inter-professional working to deliver better care for patients with multiple chronic conditions, such as depression and long-term physical health problems. Successive trials from the United States have shown that collaborative care effectively improves depression outcomes, even in people with long-term conditions (LTCs), but little is known about how to implement collaborative care in the United Kingdom. The aim of the study was to explore the extent to which collaborative care was implemented in a naturalistic National Health Service setting. Methods A naturalistic pilot study of collaborative care was undertaken in North West England. Primary care mental health professionals from IAPT (Increasing Access to Psychological Therapies) services and general practice nurses were trained to collaboratively identify and manage patients with co-morbid depression and long-term conditions. Qualitative interviews were performed with health professionals at the beginning and end of the pilot phase. Normalization Process Theory guided analysis. Results Health professionals adopted limited elements of the collaborative care model in practice. Although benefits of co-location in primary care practices were reported, including reduced stigma of accessing mental health treatment and greater ease of disposal for identified patients, existing norms around the division of mental and physical health work in primary care were maintained, limiting integration of the mental health practitioners into the practice setting. Neither the mental health practitioners nor the practice nurses perceived benefits to joint management of patients. Conclusions Established divisions between mental and physical health may pose particular challenges for multi-morbidity service delivery models such as collaborative care. Future work should explore patient perspectives about whether greater inter-professional working enhances experiences of care. The study demonstrates that research into implementation of novel treatments must consider how the introduction of innovation can be balanced with the need for integration into existing practice. PMID:24053257

Racial and ethnic disparities in mental illness stigma.

PubMed

Rao, Deepa; Feinglass, Joseph; Corrigan, Patrick

2007-12-01

The present study sought to examine whether racial/ethnic differences exist in stigmatizing attitudes towards people with mental illness among community college students. Multiple regression models were used to investigate racial/ethnic differences in students' perceived dangerousness and desire for segregation from persons with mental illness both before and after participation in an antistigma intervention. At baseline, African Americans and Asians perceived people with mental illness as more dangerous and wanted more segregation than Caucasians, and Latinos perceived people with mental illness as less dangerous and wanted less segregation than Caucasians. Similar patterns emerged postintervention, except that Asians' perceptions changed significantly such that they tended to perceive people with mental illness as least dangerous of all the racial/ethnic groups. These findings suggest that racial/ethnic background may help to shape mental illness stigma, and that targeting antistigma interventions to racial/ethnic background of participants may be helpful.

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.

Interagency collaboration models for people with mental ill health in contact with the police: a systematic scoping review

PubMed Central

Scantlebury, Arabella; Booth, Alison; MacBryde, Jillian Catherine; Scott, William J; Wright, Kath

2018-01-01

Objective To identify existing evidence on interagency collaboration between law enforcement, emergency services, statutory services and third sector agencies regarding people with mental ill health. Design Systematic scoping review. Scoping reviews map particular research areas to identify research gaps. Data sources and eligibility ASSIA, CENTRAL, the Cochrane Library databases, Criminal Justice Abstracts, ERIC, Embase, MEDLINE, PsycINFO, PROSPERO and Social Care Online and Social Sciences Citation Index were searched up to 2017, as were grey literature and hand searches. Eligible articles were empirical evaluations or descriptions of models of interagency collaboration between the police and other agencies. Study appraisal and synthesis Screening and data extraction were undertaken independently by two researchers. Arksey’s framework was used to collate and map included studies. Results One hundred and twenty-five studies were included. The majority of articles were of descriptions of models (28%), mixed methods evaluations of models (18%) and single service evaluations (14%). The most frequently reported outcomes (52%) were ‘organisational or service level outcomes’ (eg, arrest rates). Most articles (53%) focused on adults with mental ill health, whereas others focused on adult offenders with mental ill health (17.4%). Thirteen models of interagency collaboration were described, each involving between 2 and 13 agencies. Frequently reported models were ‘prearrest diversion’ of people with mental ill health (34%), ‘coresponse’ involving joint response by police officers paired with mental health professionals (28.6%) and ‘jail diversion’ following arrest (23.8%). Conclusions We identified 13 different interagency collaboration models catering for a range of mental health-related interactions. All but one of these models involved the police and mental health services or professionals. Several models have sufficient literature to warrant full systematic reviews of their effectiveness, whereas others need robust evaluation, by randomised controlled trial where appropriate. Future evaluations should focus on health-related outcomes and the impact on key stakeholders. PMID:29588323

Interagency collaboration models for people with mental ill health in contact with the police: a systematic scoping review.

PubMed

Parker, Adwoa; Scantlebury, Arabella; Booth, Alison; MacBryde, Jillian Catherine; Scott, William J; Wright, Kath; McDaid, Catriona

2018-03-27

To identify existing evidence on interagency collaboration between law enforcement, emergency services, statutory services and third sector agencies regarding people with mental ill health. Systematic scoping review. Scoping reviews map particular research areas to identify research gaps. ASSIA, CENTRAL, the Cochrane Library databases, Criminal Justice Abstracts, ERIC, Embase, MEDLINE, PsycINFO, PROSPERO and Social Care Online and Social Sciences Citation Index were searched up to 2017, as were grey literature and hand searches. Eligible articles were empirical evaluations or descriptions of models of interagency collaboration between the police and other agencies. Screening and data extraction were undertaken independently by two researchers. Arksey's framework was used to collate and map included studies. One hundred and twenty-five studies were included. The majority of articles were of descriptions of models (28%), mixed methods evaluations of models (18%) and single service evaluations (14%). The most frequently reported outcomes (52%) were 'organisational or service level outcomes' (eg, arrest rates). Most articles (53%) focused on adults with mental ill health, whereas others focused on adult offenders with mental ill health (17.4%). Thirteen models of interagency collaboration were described, each involving between 2 and 13 agencies. Frequently reported models were 'prearrest diversion' of people with mental ill health (34%), 'coresponse' involving joint response by police officers paired with mental health professionals (28.6%) and 'jail diversion' following arrest (23.8%). We identified 13 different interagency collaboration models catering for a range of mental health-related interactions. All but one of these models involved the police and mental health services or professionals. Several models have sufficient literature to warrant full systematic reviews of their effectiveness, whereas others need robust evaluation, by randomised controlled trial where appropriate. Future evaluations should focus on health-related outcomes and the impact on key stakeholders. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Supporting Children in Mastering Temporal Relations of Stories: The TERENCE Learning Approach

ERIC Educational Resources Information Center

Di Mascio, Tania; Gennari, Rosella; Melonio, Alessandra; Tarantino, Laura

2016-01-01

Though temporal reasoning is a key factor for text comprehension, existing proposals for visualizing temporal information and temporal connectives proves to be inadequate for children, not only for their levels of abstraction and detail, but also because they rely on pre-existing mental models of time and temporal connectives, while in the case of…

An evaluation of computerized adaptive testing for general psychological distress: combining GHQ-12 and Affectometer-2 in an item bank for public mental health research.

PubMed

Stochl, Jan; Böhnke, Jan R; Pickett, Kate E; Croudace, Tim J

2016-05-20

Recent developments in psychometric modeling and technology allow pooling well-validated items from existing instruments into larger item banks and their deployment through methods of computerized adaptive testing (CAT). Use of item response theory-based bifactor methods and integrative data analysis overcomes barriers in cross-instrument comparison. This paper presents the joint calibration of an item bank for researchers keen to investigate population variations in general psychological distress (GPD). Multidimensional item response theory was used on existing health survey data from the Scottish Health Education Population Survey (n = 766) to calibrate an item bank consisting of pooled items from the short common mental disorder screen (GHQ-12) and the Affectometer-2 (a measure of "general happiness"). Computer simulation was used to evaluate usefulness and efficacy of its adaptive administration. A bifactor model capturing variation across a continuum of population distress (while controlling for artefacts due to item wording) was supported. The numbers of items for different required reliabilities in adaptive administration demonstrated promising efficacy of the proposed item bank. Psychometric modeling of the common dimension captured by more than one instrument offers the potential of adaptive testing for GPD using individually sequenced combinations of existing survey items. The potential for linking other item sets with alternative candidate measures of positive mental health is discussed since an optimal item bank may require even more items than these.

Mental health service utilization of Somali adolescents: religion, community, and school as gateways to healing.

PubMed

Ellis, B Heidi; Lincoln, Alisa K; Charney, Meredith E; Ford-Paz, Rebecca; Benson, Molly; Strunin, Lee

2010-11-01

This mixed-method study examines the utility of the Gateway Provider Model (GPM) in understanding service utilization and pathways to help for Somali refugee adolescents. Somali adolescents living in the Northeastern United States, and their caregivers, were interviewed. Results revealed low rates of use of mental health services. However other sources of help, such as religious and school personnel, were accessed more frequently. The GPM provides a helpful model for understanding refugee youth access to services, and an elaborated model is presented showing how existing pathways to help could be built upon to improve refugee youth access to services.

Mental health and positive change among Japanese mothers of children with intellectual disabilities: Roles of sense of coherence and social capital.

PubMed

Kimura, Miyako; Yamazaki, Yoshihiko

2016-12-01

We investigated predictors of mental health and positive change among mothers of children with intellectual disabilities in Japan based on the concept of the Double ABCX model. We used variables of having a child with autism spectrum disorder (ASD) and dissatisfaction with systems as stressors, availability of social support and social capital (SC) as existing resources, sense of coherence (SOC) as appraisal of the stressor, and mental health and positive change as adaptation. A self-administered questionnaire was distributed to 10 intellectual disability-oriented special needs schools in Tokyo, and obtained 613 responses from mothers of children under age 20 attending these schools. The results showed that our Double ABCX model explained 46.0% of the variance in mothers' mental health and 38.9% of the variance in positive change. The most powerful predictor of this model was SOC, and SC may be directly and indirectly related to maternal mental health and positive change through mothers' SOC. Increasing opportunity for interaction between neighbors and family of children with disabilities may be one effective way to enhance SOC through SC. Since maternal SOC, SC, mental health, and positive change were significantly correlated with each other, synergy among these elements could be expected. Copyright © 2016 Elsevier Ltd. All rights reserved.

From Conceptual Frameworks to Mental Models for Astronomy: Students' Perceptions

ERIC Educational Resources Information Center

Pundak, David; Liberman, Ido; Shacham, Miri

2017-01-01

Considerable debate exists among discipline-based astronomy education researchers about how students change their perceptions in science and astronomy. The study questioned the development of astronomical models among students in institutions of higher education by examining how college students change their initial conceptual frameworks and…

Components of Implicit Stigma against Mental Illness among Chinese Students

PubMed Central

Wang, Xiaogang; Huang, Xiting; Jackson, Todd; Chen, Ruijun

2012-01-01

Although some research has examined negative automatic aspects of attitudes toward mental illness via relatively indirect measures among Western samples, it is unclear whether negative attitudes can be automatically activated in individuals from non-Western countries. This study attempted to validate results from Western samples with Chinese college students. We first examined the three-component model of implicit stigma (negative cognition, negative affect, and discriminatory tendencies) toward mental illness with the Single Category Implicit Association Test (SC-IAT). We also explored the relationship between explicit and implicit stigma among 56 Chinese university college students. In the three separate SC-IATs and the combined SC-IAT, automatic associations between mental illness and negative descriptors were stronger relative to those with positive descriptors and the implicit effect of cognitive and affective SC-IATs were significant. Explicit and implicit measures of stigma toward mental illness were unrelated. In our sample, women's overall attitudes toward mental illness were more negative than men's were, but no gender differences were found for explicit measures. These findings suggested that implicit stigma toward mental illness exists in Chinese students, and provide some support for the three-component model of implicit stigma toward mental illness. Future studies that focus on automatic components of stigmatization and stigma-reduction in China are warranted. PMID:23029366

Mind matters: A meta-analysis on parental mentalization and sensitivity as predictors of infant-parent attachment.

PubMed

Zeegers, Moniek A J; Colonnesi, Cristina; Stams, Geert-Jan J M; Meins, Elizabeth

2017-12-01

Major developments in attachment research over the past 2 decades have introduced parental mentalization as a predictor of infant-parent attachment security. Parental mentalization is the degree to which parents show frequent, coherent, or appropriate appreciation of their infants' internal states. The present study examined the triangular relations between parental mentalization, parental sensitivity, and attachment security. A total of 20 effect sizes (N = 974) on the relation between parental mentalization and attachment, 82 effect sizes (N = 6,664) on the relation between sensitivity and attachment, and 24 effect sizes (N = 2,029) on the relation between mentalization and sensitivity were subjected to multilevel meta-analyses. The results showed a pooled correlation of r = .30 between parental mentalization and infant attachment security, and rs of .25 for the correlations between sensitivity and attachment security, and between parental mentalization and sensitivity. A meta-analytic structural equation model was performed to examine the combined effects of mentalization and sensitivity as predictors of infant attachment. Together, the predictors explained 12% of the variance in attachment security. After controlling for the effect of sensitivity, the relation between parental mentalization and attachment remained, r = .24; the relation between sensitivity and attachment remained after controlling for parental mentalization, r = .19. Sensitivity also mediated the relation between parental mentalization and attachment security, r = .07, suggesting that mentalization exerts both direct and indirect influences on attachment security. The results imply that parental mentalization should be incorporated into existing models that map the predictors of infant-parent attachment. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Stigma and intellectual disability: potential application of mental illness research.

PubMed

Ditchman, Nicole; Werner, Shirli; Kosyluk, Kristin; Jones, Nev; Elg, Brianna; Corrigan, Patrick W

2013-05-01

Individuals with intellectual disabilities (ID) and individuals with mental illness are consistently found to be among the most socially excluded populations and continue to face substantial health, housing, and employment disparities due to stigma. Although this has spurred extensive research efforts and theoretical advancements in the study of stigma toward mental illness, the stigma of ID has received only limited attention. In this article we explore the application of mental illness stigma research for ID. We carefully reviewed the existing research on mental illness stigma as a foundation for a parallel summary of the empirical literature on attitudes and stigma related to ID. Based on our review, there has not been a systematic approach to the study of stigma toward ID. However, multilevel conceptual models of stigma have received much attention in the mental illness literature. These models have been used to inform targeted interventions and have application to the study of the stigma process for individuals with ID. Nonetheless, there are indeed key differences between-as well as substantial variability within-the ID and mental illness populations that must be considered. Stigma is an issue of social justice impacting the lives of individuals with ID, yet there remains virtually no systematic framework applied to the understanding of the stigma process for this group. Future research can draw on the stigma models developed in the mental illness literature to guide more rigorous research efforts and ultimately the development of effective, multilevel stigma-change strategies for ID.

The role of provider supply and organization in reducing racial/ethnic disparities in mental health care in the U.S

PubMed Central

Cook, Benjamin Lê; Doksum, Teresa; Chen, Chih-nan; Carle, Adam; Alegría, Margarita

2013-01-01

Racial and ethnic disparities in mental health care access in the United States are well documented. Prior studies highlight the importance of individual and community factors such as health insurance coverage, language and cultural barriers, and socioeconomic differences, though these factors fail to explain the extent of measured disparities. A critical factor in mental health care access is a local area’s organization and supply of mental health care providers. However, it is unclear how geographic differences in provider organization and supply impact racial/ethnic disparities. The present study is the first analysis of a nationally representative U.S. sample to identify contextual factors (county-level provider organization and supply, as well as socioeconomic characteristics) associated with use of mental health care services and how these factors differ across racial/ethnic groups. Hierarchical logistic models were used to examine racial/ethnic differences in the association of county-level provider organization (health maintenance organization (HMO) penetration) and supply (density of specialty mental health providers and existence of a community mental health center) with any use of mental health services and specialty mental health services. Models controlled for individual- and county-level socio-demographic and mental health characteristics. Increased county-level supply of mental health care providers was significantly associated with greater use of any mental health services and any specialty care, and these positive associations were greater for Latinos and African-Americans compared to non-Latino Whites. Expanding the mental health care workforce holds promise for reducing racial/ethnic disparities in mental health care access. Policymakers should consider that increasing the management of mental health care may not only decrease expenditures, but also provide a potential lever for reducing mental health care disparities between social groups. PMID:23466259

A model of succession planning for mental health nurse practitioners.

PubMed

Hampel, Sally; Procter, Nicholas; Deuter, Kate

2010-08-01

This paper reviews current literature on succession planning for mental health nurse practitioners (NPs) and discusses a model of succession planning that is underpinned by principals of leadership development, workforce participation and client engagement. The paper identifies succession planning as a means of managing a present and future workforce, while simultaneously addressing individual and organizational learning and practice development needs. A discussion of the processes attendant upon sustainable succession planning - collegial support, career planning and development, information exchange, capacity building, and mentoring is framed within the potential interrelationships between existing NP, developing NP and service directors and/or team managers. Done effectively and in partnership with wider clinical services, succession planning has the potential to build NP leadership development and leadership transition more broadly within mental health services.

Implementing street triage: a qualitative study of collaboration between police and mental health services.

PubMed

Horspool, Kimberley; Drabble, Sarah J; O'Cathain, Alicia

2016-09-07

Street Triage is a collaborative service between mental health workers and police which aims to improve the emergency response to individuals experiencing crisis, but peer reviewed evidence of the effectiveness of these services is limited. We examined the design and potential impact of two services, along with factors that hindered and facilitated the implementation of the services. We conducted 14 semi-structured interviews with mental health and police stakeholders with experience of a Street Triage service in two locations of the UK. Framework analysis identified themes related to key aspects of the Street Triage service, perceived benefits of Street Triage, and ways in which the service could be developed in the future. Stakeholders endorsed the Street Triage services which utilised different operating models. These models had several components including a joint response vehicle or a mental health worker in a police control room. Operating models were developed with consideration of the local geographical and population density. The ability to make referrals to the existing mental health service was perceived as key to the success of the service yet there was evidence to suggest Street Triage had the potential to increase pressure on already stretched mental health and police services. Identifying staff with skills and experience for Street Triage work was important, and their joint response resulted in shared decision making which was less risk averse for the police and regarded as in the interest of patient care by mental health professionals. Collaboration during Street Triage improved the understanding of roles and responsibilities in the 'other' agency and led to the development of local information sharing agreements. Views about the future direction of the service focused on expansion of Street Triage to address other shared priorities such as frequent users of police and mental health services, and a reduction in the police involvement in crisis response. The Street Triage service received strong support from stakeholders involved in it. Referral to existing health services is a key function of Street Triage, and its impact on referral behaviour requires rigorous evaluation. Street Triage may result in improvement to collaborative working but competing demands for resources within mental health and police services presented challenges for implementation.

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 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.

Implementing a new governance model.

PubMed

Stanley-Clarke, Nicky; Sanders, Jackie; Munford, Robyn

2016-05-16

Purpose - The purpose of this paper is to discuss the lessons learnt from the process of implementing a new model of governance within Living Well, a New Zealand statutory mental health agency. Design/methodology/approach - It presents the findings from an organisational case study that involved qualitative interviews, meeting observations and document analysis. Archetype theory provided the analytical framework for the research enabling an analysis of both the formal structures and informal value systems that influenced the implementation of the governance model. Findings - The research found that the move to a new governance model did not proceed as planned. It highlighted the importance of staff commitment, the complexity of adopting a new philosophical approach and the undue influence of key personalities as key determining factors in the implementation process. The findings suggest that planners and managers within statutory mental health agencies need to consider the implications of any proposed governance change on existing roles and relationships, thinking strategically about how to secure professional commitment to change. Practical implications - There are ongoing pressures within statutory mental health agencies to improve the efficiency and effectiveness of organisational structures and systems. This paper has implications for how planners and managers think about the process of implementing new governance models within the statutory mental health environment in order to increase the likelihood of sustaining and embedding new approaches to service delivery. Originality/value - The paper presents insights into the process of implementing new governance models within a statutory mental health agency in New Zealand that has relevance for other jurisdictions.

Racial/ethnic differences in perception of need for mental health treatment in a US national sample.

PubMed

Breslau, Joshua; Cefalu, Matthew; Wong, Eunice C; Burnam, M Audrey; Hunter, Gerald P; Florez, Karen R; Collins, Rebecca L

2017-08-01

To resolve contradictory evidence regarding racial/ethnic differences in perceived need for mental health treatment in the USA using a large and diverse epidemiologic sample. Samples from 6 years of a repeated cross-sectional survey of the US civilian non-institutionalized population were combined (N = 232,723). Perceived need was compared across three non-Hispanic groups (whites, blacks and Asian-Americans) and two Hispanic groups (English interviewees and Spanish interviewees). Logistic regression models were used to test for variation across groups in the relationship between severity of mental illness and perceived need for treatment. Adjusting statistically for demographic and socioeconomic characteristics and for severity of mental illness, perceived need was less common in all racial/ethnic minority groups compared to whites. The prevalence difference (relative to whites) was smallest among Hispanics interviewed in English, -5.8% (95% CI -6.5, -5.2%), and largest among Hispanics interviewed in Spanish, -11.2% (95% CI -12.4, -10.0%). Perceived need was significantly less common among all minority racial/ethnic groups at each level of severity. In particular, among those with serious mental illness, the largest prevalence differences (relative to whites) were among Asian-Americans, -23.3% (95% CI -34.9, -11.7%) and Hispanics interviewed in Spanish, 32.6% (95% CI -48.0, -17.2%). This study resolves the contradiction in empirical evidence regarding the existence of racial/ethnic differences in perception of need for mental health treatment; differences exist across the range of severity of mental illness and among those with no mental illness. These differences should be taken into account in an effort to reduce mental health-care disparities.

Racial/ethnic differences in perception of need for mental health treatment in a US national sample

PubMed Central

Breslau, Joshua; Cefalu, Matthew; Wong, Eunice C.; Burnam, M. Audrey; Hunter, Gerald P.; Florez, Karen R.; Collins, Rebecca L.

2017-01-01

Purpose To resolve contradictory evidence regarding racial/ethnic differences in perceived need for mental health treatment in the USA using a large and diverse epidemiologic sample. Methods Samples from 6 years of a repeated cross-sectional survey of the US civilian non-institutionalized population were combined (N = 232,723). Perceived need was compared across three non-Hispanic groups (whites, blacks and Asian-Americans) and two Hispanic groups (English interviewees and Spanish interviewees). Logistic regression models were used to test for variation across groups in the relationship between severity of mental illness and perceived need for treatment. Results Adjusting statistically for demographic and socioeconomic characteristics and for severity of mental illness, perceived need was less common in all racial/ethnic minority groups compared to whites. The prevalence difference (relative to whites) was smallest among Hispanics interviewed in English, −5.8% (95% CI −6.5, −5.2%), and largest among Hispanics interviewed in Spanish, - 11.2% (95% CI −12.4, −10.0%). Perceived need was significantly less common among all minority racial/ethnic groups at each level of severity. In particular, among those with serious mental illness, the largest prevalence differences (relative to whites) were among Asian-Americans, −23.3% (95% CI −34.9, −11.7%) and Hispanics interviewed in Spanish, 32.6% (95% CI −48.0, −17.2%). Conclusions This study resolves the contradiction in empirical evidence regarding the existence of racial/ethnic differences in perception of need for mental health treatment; differences exist across the range of severity of mental illness and among those with no mental illness. These differences should be taken into account in an effort to reduce mental health-care disparities. PMID:28550518

The demand for ambulatory mental health services from specialty providers.

PubMed Central

Horgan, C M

1986-01-01

A two-part model is used to examine the demand for ambulatory mental health services in the specialty sector. In the first equation, the probability of having a mental health visit is estimated. In the second part of the model, variations in levels of use expressed in terms of visits and expenditures are examined in turn, with each of these equations conditional on positive utilization of mental health services. In the second part of the model, users are additionally grouped into those with and without out-of-pocket payment for services. This specification accounts for special characteristics regarding the utilization of ambulatory mental health services: (1) a large part of the population does not use these services; (2) of those who use services, the distribution of use is highly skewed; and (3) a large number of users have zero out-of-pocket expenditures. Cost-sharing does indeed matter in the demand for ambulatory mental health services from specialty providers; however, the decision to use mental health services is affected by the level of cost-sharing to a lesser degree than is the decision regarding the level of use of services. The results also show that price is only one of several important factors in determining the demand for services. The lack of significance of family income and of being female is notable. Evidence is presented for the existence of bandwagon effects. The importance of Medicaid in the probability of use equations is noted. PMID:3721874

Serum 25-Hydroxyvitamin D Concentrations and Indicators of Mental Health: An Analysis of the Canadian Health Measures Survey.

PubMed

Chu, Filmer; Ohinmaa, Arto; Klarenbach, Scott; Wong, Zing-Wae; Veugelers, Paul

2017-10-13

The main function of vitamin D is calcium homeostasis. However, emerging evidence has correlated adequate serum 25-hydroxyvitamin D (25(OH)D) concentrations with better mental health. The objective of this study is to investigate the association of serum 25(OH)D concentrations with indicators of mental health such as depression, anxiety, and stress. Associations of serum 25(OH)D concentrations with four indicators of mental health were examined using ordered logistic regression models with increasing specificity that account for demographics, socio-economic status, and health. Margin effects are used to determine the probability of the average adult Canadian being in the best mental health state by groupings of serum 25(OH)D concentrations. A robust association between serum 25(OH)D concentrations and the indicators of mental health were observed. In the fully adjusted ordered logistic model, an average Canadian appeared more likely to experience better mental health when serum 25(OH)D concentrations were higher. This study adds to the weight of the existence of an association between vitamin D status and mental health, but, as this study is cross sectional, it does not establish causality. Due to the low risk of harm from toxicity and the relative modest costs of vitamin D supplements, more research to establish the effectiveness and causality of this relationship is recommended.

The influence of culture on immigrant women's mental health care experiences from the perspectives of health care providers.

PubMed

O'Mahony, Joyce Maureen; Donnelly, Tam Truong

2007-05-01

It is well documented that serious mental health problems such as depression, schizophrenia, and post migration stress disorders exist among immigrant women. Informed by Kleinman's explanatory model, this qualitative exploratory study was conducted with seven health care providers who provided mental health services to immigrant women. Analysis of the data revealed that (a) immigrant women face many difficulties when accessing mental health care services due to cultural differences, social stigma, and unfamiliarity with Western biomedicine, (b) spiritual beliefs and practices that influence immigrant women's mental health care practices, and (c) the health care provider-client relationship, which exerts great influence on how immigrant women seek mental health care. The study also revealed that cultural background exerts both positive and negative influences on how immigrant women seek mental health care. We suggest that although cultural knowledge and practices influence immigrant women's coping choices and strategies, awareness of social and economic differences among diverse groups of immigrant women is necessary to improve the accessibility of mental health care for immigrant women.

Scanning of speechless comics changes spatial biases in mental model construction.

PubMed

Román, Antonio; Flumini, Andrea; Santiago, Julio

2018-08-05

The mental representation of both time and number shows lateral spatial biases, which can be affected by habitual reading and writing direction. However, this effect is in place before children begin to read. One potential early cause is the experiences of looking at picture books together with a carer, as those images also follow the directionality of the script. What is the underlying mechanism for this effect? In the present study, we test the possibility that such experiences induce spatial biases in mental model construction, a mechanism which is a good candidate to induce the biases observed with numbers and times. We presented a speechless comic in either standard (left-to-right) or mirror-reversed (right-to-left) form to adult Spanish participants. We then asked them to draw the scene depicted by sentences like 'the square is between the cross and the circle'. The position of the lateral objects in these drawings reveals the spatial biases at work when building mental models in working memory. Under conditions of highly consistent directionality, the mirror comic changed pre-existing lateral biases. Processes of mental model construction in working memory stand as a potential mechanism for the generation of spatial biases for time and number.This article is part of the theme issue 'Varieties of abstract concepts: development, use and representation in the brain'. © 2018 The Author(s).

Managing risk: clinical decision-making in mental health services.

PubMed

Muir-Cochrane, Eimear; Gerace, Adam; Mosel, Krista; O'Kane, Debra; Barkway, Patricia; Curren, David; Oster, Candice

2011-01-01

Risk assessment and management is a major component of contemporary mental health practice. Risk assessment in health care exists within contemporary perspectives of management and risk aversive practices in health care. This has led to much discussion about the best approach to assessing possible risks posed by people with mental health problems. In addition, researchers and commentators have expressed concern that clinical practice is being dominated by managerial models of risk management at the expense of meeting the patient's health and social care needs. The purpose of the present study is to investigate the risk assessment practices of a multidisciplinary mental health service. Findings indicate that mental health professionals draw on both managerial and therapeutic approaches to risk management, integrating these approaches into their clinical practice. Rather than being dominated by managerial concerns regarding risk, the participants demonstrate professional autonomy and concern for the needs of their clients.

Contested understandings of recovery in mental health.

PubMed

McCabe, Rhiannah; Whittington, Richard; Cramond, Laura; Perkins, Elizabeth

2018-05-17

The concept of recovery is contested throughout the existing literature and in mental health services. Little research exists that gives voice to service user perspectives of recovery. This paper explores how service users in two recovery oriented services run by the National Health Service in North West England talked about recovery and what it meant to them. 14 service users accessing these services took part in semi-structured qualitative interviews focusing on the concept of recovery. Data were analysed using an interpretive phenomenological analysis approach. Service users talked about recovery as a dynamic, day to day process as well as an outcome; specifically related to being discharged from inpatient settings. A number of factors including relationships and medication were cited to have the potential to make or break recovery. The study highlights the continued dominance of the biomedical model in mental health services. Service users appear to have internalised staff and services' understanding of recovery perhaps unsurprisingly given the power differential in these relationships. Implications for clinical practice are explored.

Experiencing stigma as a nurse with mental illness.

PubMed

Peterson, A L

2017-06-01

WHAT IS KNOWN ON THE SUBJECT?: Stigma involves connecting individuals with a particular label to negative characteristics; this is based not on the stigmatized condition itself, but cultural reactions to it. Stigma exists towards nurses with mental illness. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: This paper offers a first-person account of experiencing stigma as a nurse with a mental illness. This paper incorporates the existing literature to offer a broader cultural perspective on the experiences of a nurse with a mental illness. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Nurses are likely to encounter a nurse with a mental illness at some point in their practice. Nurses' reactions towards colleagues with mental illness can have significant implications for those colleague(s)' wellbeing. Nurses with mental illness will have to navigate their person and professional journey while giving consideration to the attitudes of their nursing peers and leaders. Limited research has been done on the stigma faced by nurses with mental illness from their nursing peers. Mental illness is not generally considered acceptable within the context of nursing culture, so when nurses do experience mental illness, their experiences in a professional context may be influenced by stereotypes, particularly those relating to dangerousness. Using autoethnography as a research method, the author examines her own subjective experiences of stigma as a nurse with a mental illness, and draws upon existing literature on stigma, deviance and the phenomenon of mental illness in nurses to analyse broader cultural implications for nursing. Assessment of suitability to return to work arises throughout the narratives, and consideration is given to the way that risk assessment by nursing leaders is impacted by negative stereotypes that surround mental illness. © 2017 John Wiley & Sons Ltd.

Defining Quality of Life in the Children of Parents with Severe Mental Illness: A Preliminary Stakeholder-Led Model

PubMed Central

Bee, Penny; Berzins, Kathryn; Calam, Rachel; Pryjmachuk, Steven; Abel, Kathryn M.

2013-01-01

Severe parental mental illness poses a challenge to quality of life (QoL) in a substantial number of children and adolescents, and improving the lives of these children is of urgent political and public health concern. This study used a bottom-up qualitative approach to develop a new stakeholder-led model of quality of life relevant to this population. Qualitative data were collected from 19 individuals participating in focus groups or individual interviews. Participants comprised 8 clinical academics, health and social care professionals or voluntary agency representatives; 5 parents and 6 young people (aged 13–18 yrs) with lived experience of severe parental mental illness. Data underwent inductive thematic analysis for the purposes of informing a population-specific quality of life model. Fifty nine individual themes were identified and grouped into 11 key ‘meta-themes’. Mapping each meta-theme against existing child-centred quality of life concepts revealed a multi-dimensional model that endorsed, to a greater or lesser degree, the core domains of generic quality of life models. Three new population-specific priorities were also observed: i) the alleviation of parental mental health symptoms, ii) improved problem-based coping skills and iii) increased mental health literacy. The identification of these priorities raises questions regarding the validity of generic quality of life measures to monitor the effectiveness of services for families and children affected by severe mental illness. New, age-appropriate instruments that better reflect the life priorities and unique challenges faced by the children of parents with severe mental illness may need to be developed. Challenges then remain in augmenting and adapting service design and delivery mechanisms better to meet these needs. Future child and adult mental health services need to work seamlessly alongside statutory education and social care services and a growing number of relevant third sector providers to address fully the quality of life priorities of these vulnerable families. PMID:24040050

Defining quality of life in the children of parents with severe mental illness: a preliminary stakeholder-led model.

PubMed

Bee, Penny; Berzins, Kathryn; Calam, Rachel; Pryjmachuk, Steven; Abel, Kathryn M

2013-01-01

Severe parental mental illness poses a challenge to quality of life (QoL) in a substantial number of children and adolescents, and improving the lives of these children is of urgent political and public health concern. This study used a bottom-up qualitative approach to develop a new stakeholder-led model of quality of life relevant to this population. Qualitative data were collected from 19 individuals participating in focus groups or individual interviews. Participants comprised 8 clinical academics, health and social care professionals or voluntary agency representatives; 5 parents and 6 young people (aged 13-18 yrs) with lived experience of severe parental mental illness. Data underwent inductive thematic analysis for the purposes of informing a population-specific quality of life model. Fifty nine individual themes were identified and grouped into 11 key 'meta-themes'. Mapping each meta-theme against existing child-centred quality of life concepts revealed a multi-dimensional model that endorsed, to a greater or lesser degree, the core domains of generic quality of life models. Three new population-specific priorities were also observed: i) the alleviation of parental mental health symptoms, ii) improved problem-based coping skills and iii) increased mental health literacy. The identification of these priorities raises questions regarding the validity of generic quality of life measures to monitor the effectiveness of services for families and children affected by severe mental illness. New, age-appropriate instruments that better reflect the life priorities and unique challenges faced by the children of parents with severe mental illness may need to be developed. Challenges then remain in augmenting and adapting service design and delivery mechanisms better to meet these needs. Future child and adult mental health services need to work seamlessly alongside statutory education and social care services and a growing number of relevant third sector providers to address fully the quality of life priorities of these vulnerable families.

Shared mental models of integrated care: aligning multiple stakeholder perspectives.

PubMed

Evans, Jenna M; Baker, G Ross

2012-01-01

Health service organizations and professionals are under increasing pressure to work together to deliver integrated patient care. A common understanding of integration strategies may facilitate the delivery of integrated care across inter-organizational and inter-professional boundaries. This paper aims to build a framework for exploring and potentially aligning multiple stakeholder perspectives of systems integration. The authors draw from the literature on shared mental models, strategic management and change, framing, stakeholder management, and systems theory to develop a new construct, Mental Models of Integrated Care (MMIC), which consists of three types of mental models, i.e. integration-task, system-role, and integration-belief. The MMIC construct encompasses many of the known barriers and enablers to integrating care while also providing a comprehensive, theory-based framework of psychological factors that may influence inter-organizational and inter-professional relations. While the existing literature on integration focuses on optimizing structures and processes, the MMIC construct emphasizes the convergence and divergence of stakeholders' knowledge and beliefs, and how these underlying cognitions influence interactions (or lack thereof) across the continuum of care. MMIC may help to: explain what differentiates effective from ineffective integration initiatives; determine system readiness to integrate; diagnose integration problems; and develop interventions for enhancing integrative processes and ultimately the delivery of integrated care. Global interest and ongoing challenges in integrating care underline the need for research on the mental models that characterize the behaviors of actors within health systems; the proposed framework offers a starting point for applying a cognitive perspective to health systems integration.

The PII Solution to Mental Healthcare Delivery: Prevention, Intervention, and Integration.

PubMed

King, Mira A

In this essay, the author proposes a new, integrated model for mental healthcare delivery called the PII solution, which builds on the successes of federal government programs and state initiatives. The PII solution includes prevention, intervention, and integration. As a community-centered approach, PII leverages existing programs in concert with new approaches to meet the diverse needs of patients with the spectrum of mental health disorders, from low risk to high risk. The PII solution can be applied to any subgroup in society to create a comprehensive plan to combat mental illness. In this essay, the author uses the PII solution to (a) build upon public-private partnership initiatives that have reduced emergency department utilization and costs for behavioral health patients, (b) improve law enforcement's proficiency in identifying and deescalating situations involving potentially violent individuals with a serious mental illness, and (c) advocate for increased social responsibility of providers to ensure that mentally ill patients are receiving the right care in the right setting.

Common mental disorder and obesity: insight from four repeat measures over 19 years: prospective Whitehall II cohort study.

PubMed

Kivimäki, Mika; Lawlor, Debbie A; Singh-Manoux, Archana; Batty, G David; Ferrie, Jane E; Shipley, Martin J; Nabi, Hermann; Sabia, Séverine; Marmot, Michael G; Jokela, Markus

2009-10-06

To examine potential reciprocal associations between common mental disorders and obesity, and to assess whether dose-response relations exist. Prospective cohort study with four measures of common mental disorders and obesity over 19 years (Whitehall II study). Civil service departments in London. 4363 adults (28% female, mean age 44 years at baseline). Common mental disorder defined as general health questionnaire "caseness;" overweight and obesity based on Word Health Organization definitions. In models adjusted for age, sex, and body mass index at baseline, odds ratios for obesity at the fourth screening were 1.33 (95% confidence interval 1.00 to 1.77), 1.64 (1.13 to 2.36), and 2.01 (1.21 to 3.34) for participants with common mental disorder at one, two, or three preceding screenings compared with people free from common mental disorder (P for trend<0.001). The corresponding mean differences in body mass index at the most recent screening were 0.20, 0.31, and 0.50 (P for trend<0.001). These associations remained after adjustment for baseline characteristics related to mental health and exclusion of participants who were obese at baseline. In addition, obesity predicted future risk of common mental disorder, again with evidence of a dose-response relation (P for trend=0.02, multivariable model). However, this association was lost when people with common mental disorder at baseline were excluded (P for trend=0.33). These findings suggest that in British adults the direction of association between common mental disorders and obesity is from common mental disorder to increased future risk of obesity. This association is cumulative such that people with chronic or repeat episodes of common mental disorder are particularly at risk of weight gain.

Investing in mental health and well-being: findings from the DataPrev project

PubMed Central

Mcdaid, David; Park, A-La

2011-01-01

A systematic review was conducted to determine the extent to which an economic case has been made in high-income countries for investment in interventions to promote mental health and well-being. We focused on areas of interest to the DataPrev project: early years and parenting interventions, actions set in schools and workplaces and measures targeted at older people. Economic evaluations had to have some focus on promotion of mental health and well-being and/or primary prevention of poor mental health through health-related means. Studies preventing exacerbations in existing mental health problems were excluded, with the exception of support for parents with mental health problems, which might indirectly affect the mental health of their children. Overall 47 studies were identified. There was considerable variability in their quality, with a variety of outcome measures and different perspectives: societal, public purse, employer or health system used, making policy comparisons difficult. Caution must therefore be exercised in interpreting results, but the case for investment in parenting and health visitor-related programmes appears most strong, especially when impacts beyond the health sector are taken into account. In the workplace an economic return on investment in a number of comprehensive workplace health promotion programmes and stress management projects (largely in the USA) was reported, while group-based exercise and psychosocial interventions are of potential benefit to older people. Many gaps remain; a key first step would be to make more use of the existence evidence base on effectiveness and model mid- to long-term costs and benefits of action in different contexts and settings. PMID:22079932

Integrating mental health into primary care in Nigeria: report of a demonstration project using the mental health gap action programme intervention guide.

PubMed

Gureje, Oye; Abdulmalik, Jibril; Kola, Lola; Musa, Emmanuel; Yasamy, Mohammad Taghi; Adebayo, Kazeem

2015-06-21

The World Mental Health Surveys conducted by the World Health Organization (WHO) have shown that huge treatment gaps for severe mental disorders exist in both developed and developing countries. This gap is greatest in low and middle income countries (LMICs). Efforts to scale up mental health services in LMICs have to contend with the paucity of mental health professionals and health facilities providing specialist services for mental, neurological and substance use (MNS) disorders. A pragmatic solution is to improve access to care through the facilities that exist closest to the community, via a task-shifting strategy. This study describes a pilot implementation program to integrate mental health services into primary health care in Nigeria. The program was implemented over 18 months in 8 selected local government areas (LGAs) in Osun state of Nigeria, using the WHO Mental Health Gap Action Programme Intervention Guide (mhGAP-IG), which had been contextualized for the local setting. A well supervised cascade training model was utilized, with Master Trainers providing training for the Facilitators, who in turn conducted several rounds of training for front-line primary health care workers. The first set of trainings by the Facilitators was supervised and mentored by the Master Trainers and refresher trainings were provided after 9 months. A total of 198 primary care workers, from 68 primary care clinics, drawn from 8 LGAs with a combined population of 966,714 were trained in the detection and management of four MNS conditions: moderate to severe major depression, psychosis, epilepsy, and alcohol use disorders, using the mhGAP-IG. Following training, there was a marked improvement in the knowledge and skills of the health workers and there was also a significant increase in the numbers of persons identified and treated for MNS disorders, and in the number of referrals. Even though substantial retention of gained knowledge was observed nine months after the initial training, some level of decay had occurred supporting the need for a refresher training. It is feasible to scale up mental health services in primary care settings in Nigeria, using the mhGAP-IG and a well-supervised cascade-training model. This format of training is pragmatic, cost-effective and holds promise, especially in settings where there are few specialists.

Breaking through the Glass Ceiling: Consumers in Mental Health Organisations' Hierarchies.

PubMed

Scholz, Brett; Bocking, Julia; Happell, Brenda

2017-05-01

Contemporary mental health policies call for consumers to be engaged in all levels of mental health service planning, implementation, and delivery. Critical approaches to traditional healthcare hierarchies can effectively challenge barriers to better engagement with consumers in mental health organisations. This qualitative exploratory study analyses how particular strategies for consumer leadership facilitate or hinder relationships between consumers and mental health services, and how these strategies influence hierarchical structures. Fourteen participants from a range of mental health organisations were interviewed. These interviews were analysed using thematic analytic and discursive psychological techniques. The findings highlight several benefits of having consumers within mental health organisational hierarchies, and elaborate on ways that employees within mental health services can support integration of consumers into existing hierarchies. Specific barriers to consumers in hierarchies are discussed, including a lack of clarity of structures and roles within hierarchies, and resistance to consumers reaching the highest levels of leadership within organisations. Alternative hierarchical models which privilege consumers' control over resources and power are also discussed. Mental health organisations are encouraged to integrate consumer leaders into their hierarchical structures to improve their organisational offerings, their reputation, and their service innovation.

Formal Analysis of Self-Efficacy in Job Interviewee’s Mental State Model

NASA Astrophysics Data System (ADS)

Ajoge, N. S.; Aziz, A. A.; Yusof, S. A. Mohd

2017-08-01

This paper presents a formal analysis approach for self-efficacy model of interviewee’s mental state during a job interview session. Self-efficacy is a construct that has been hypothesised to combine with motivation and interviewee anxiety to define state influence of interviewees. The conceptual model was built based on psychological theories and models related to self-efficacy. A number of well-known relations between events and the course of self-efficacy are summarized from the literature and it is shown that the proposed model exhibits those patterns. In addition, this formal model has been mathematically analysed to find out which stable situations exist. Finally, it is pointed out how this model can be used in a software agent or robot-based platform. Such platform can provide an interview coaching approach where support to the user is provided based on their individual metal state during interview sessions.

Place and provision: mapping mental health advocacy services in London.

PubMed

Foley, Ronan; Platzer, Hazel

2007-02-01

The National Health Service (NHS) Executive for London carried out an investigation in 2002 as part of their wider mental health strategy to establish whether existing mental health advocacy provision in the city was meeting need. The project took a two-part approach, with an emphasis on, (a) mapping the provision of advocacy services and, (b) cartographic mapping of service location and catchments. Data were collected through a detailed questionnaire with service providers in collaboration with the Greater London Mental Health Advocacy Network (GLMHAN) and additional health and government sources. The service mapping identified some key statistics on funding, caseloads and models of service provision with an additional emphasis on coverage, capacity, and funding stability. The questionnaire was augmented by interviews and focus groups with commissioners, service providers and service users and identified differing perspectives and problems, which informed the different perspectives of each of these groups. The cartographic mapping exercise demonstrated a spatially-even provision of mental health advocacy services across the city with each borough being served by at least one local service as well as by London wide specialist schemes. However, at local level, no one borough had the full range of specialist provision to match local demographic need. Ultimately the research assisted the Advisory Group in providing commissioning agencies with clear information on the current status of city-wide mental health advocacy services, and on gaps in existing advocacy provision alongside previously unconsidered geographical and service dimensions of that provision.

The role of provider supply and organization in reducing racial/ethnic disparities in mental health care in the U.S.

PubMed

Cook, Benjamin Lê; Doksum, Teresa; Chen, Chih-Nan; Carle, Adam; Alegría, Margarita

2013-05-01

Racial and ethnic disparities in mental health care access in the United States are well documented. Prior studies highlight the importance of individual and community factors such as health insurance coverage, language and cultural barriers, and socioeconomic differences, though these factors fail to explain the extent of measured disparities. A critical factor in mental health care access is a local area's organization and supply of mental health care providers. However, it is unclear how geographic differences in provider organization and supply impact racial/ethnic disparities. The present study is the first analysis of a nationally representative U.S. sample to identify contextual factors (county-level provider organization and supply, as well as socioeconomic characteristics) associated with use of mental health care services and how these factors differ across racial/ethnic groups. Hierarchical logistic models were used to examine racial/ethnic differences in the association of county-level provider organization (health maintenance organization (HMO) penetration) and supply (density of specialty mental health providers and existence of a community mental health center) with any use of mental health services and specialty mental health services. Models controlled for individual- and county-level socio-demographic and mental health characteristics. Increased county-level supply of mental health care providers was significantly associated with greater use of any mental health services and any specialty care, and these positive associations were greater for Latinos and African-Americans compared to non-Latino Whites. Expanding the mental health care workforce holds promise for reducing racial/ethnic disparities in mental health care access. Policymakers should consider that increasing the management of mental health care may not only decrease expenditures, but also provide a potential lever for reducing mental health care disparities between social groups. Copyright © 2013 Elsevier Ltd. All rights reserved.

Strategies for Working with Asian Americans in Mental Health: Community Members' Policy Perspectives and Recommendations.

PubMed

Weng, Suzie S; Spaulding-Givens, Jennifer

2017-09-01

This qualitative study used snowball sampling of individuals known to provide informal assistance to Asian American community members with their mental health problems in a locality in the South where there has been an exponential increase of the Asian American population. The major themes found include: (1) the existence of cultural, language, knowledge, and transportation barriers and the importance of policy in addressing them; (2) the impact of the model minority myth and the need for inclusive policymaking; and (3) the unique service and policy needs of immigrants. Findings demonstrate the importance and value of including diverse Asian American individuals in mental health policymaking efforts.

The office of student wellness: innovating to improve student mental health.

PubMed

Seritan, Andreea L; Rai, Gurmeet; Servis, Mark; Pomeroy, Claire

2015-02-01

Despite increasing mental health needs among medical students, few models for effective preventive student wellness programs exist. This paper describes a novel approach developed at the University of California (UC) Davis School of Medicine: the Office of Student Wellness (OSW). Improved access and mental health service utilization have been documented, with over half of all students receiving support and clinical care. UC Davis student satisfaction mean scores on the Association of American Medical Colleges Graduation Questionnaire wellness questions have reached or exceeded national average over the last 4 years, since the OSW was founded. This program may serve as a blueprint for other medical schools in developing effective student wellness programs.

A social marketing approach to changing mental health practices directed at youth and adolescents.

PubMed

Andreason, Alan R

2004-01-01

The mental health problems of children are of increasing social concern. Many best practices have been developed but often not implemented. Social marketing has been suggested as an innovative, useful approach to this challenge-along with others in the health care field. However, much confusion exists over what the approach entails, where it has been applied and how it can be adapted to significant social challenges such as changing mental health practices directed at youth and adolescents. This article defines key terms, offers historical perspective and provides a specific approach and set of models to implement an effective social marketing strategy in a range of contexts.

Using dictionaries to study the mental lexicon.

PubMed

Anshen, F; Aronoff, M

The notion of a mental lexicon has its historical roots in practical reference dictionaries. The distributional analysis of dictionaries provides one means of investigating the structure of the mental lexicon. We review our earlier work with dictionaries, based on a three-way horserace model of lexical access and production, and then present the most recent results of our ongoing analysis of the Oxford English Dictionary, Second Edition on CD-ROM, which traces changes in productivity over time of the English suffixes -ment and -ity, both of which originate in French borrowings. Our results lead us to question the validity of automatic analogy from a set of existing words as the driving force behind morphological productivity. Copyright 1999 Academic Press.

The Centre for International Mental Health Approach to Mental Health System Development

PubMed Central

Minas, Harry

2012-01-01

Although mental disorders are a major public health problem, the development of mental health services has been a low priority everywhere, particularly in low- and middle-income countries. Recent years have seen a growing understanding of the importance of population mental health and increased attention to the need to developmental health systems for responding to population mental health service needs. In countries and regions where mental health services are all but nonexistent, and in postconflict and postdisaster settings, there are many impediments to establishing or scaling up mental health services. It is frequently necessary to act simultaneously on multiple fronts: generating local evidence that will inform decision makers; developing a policy framework; securing investment; determining the most appropriate service model for the context; training and supporting mental health workers; establishing or expanding existing services; putting in place systems for monitoring and evaluation; and strengthening leadership and governance capabilities. This article presents the approach of the Centre for International Mental Health in the Melbourne School of Population Health to mental health system development, and illustrates the way in which the elements of the program are integrated by giving a brief case example from Sri Lanka. (harv rev psychiatry 2012;20:37–46.) PMID:22335181

The enduring mental health impact of the September 11th terrorist attacks: challenges and lessons learned.

PubMed

Ozbay, Fatih; Auf der Heyde, Tanja; Reissman, Dori; Sharma, Vansh

2013-09-01

The authors review the existing literature on the mental health impact of the September 11th attacks and the implications for disaster mental health clinicians and policy makers. The authors discuss the demographic characteristics of those affected and the state of mental health needs and existing mental health delivery services; the nature of the disaster and primary impacts on lives, infrastructure, and socioeconomic factors; the acute aftermath in the days and weeks after the attacks; the persistent mental health impact and evolution of services of the postacute aftermath; and the implications for future disaster mental health practitioners and policy makers. Copyright © 2013 Elsevier Inc. All rights reserved.

Explanations of illness experiences among community mental health patients: an argument for the use of an ethnographic interview method in routine clinical care.

PubMed

Owiti, John A; Palinski, Andrea; Ajaz, Ali; Ascoli, Micol; De Jongh, Bertine; Bhui, Kamaldeep S

2015-02-01

Cultural variations in perceptions of mental distress are important issues for healthcare. They can affect communication between patients and professionals and may be a root cause for misdiagnosis, patient disengagement, and disparities in access, outcomes and overall experiences of treatment by patients. Taking into account patients' explanatory models (EMs) of mental distress is fundamental to patient-centred care, and improved outcomes. This paper reports on the outcomes from the Cultural Consultation Service, commissioned in an inner-city London borough. We used a narrative-based ethnographic method of assessment, in which community mental health patients referred for a cultural consultation were interviewed using Barts Explanatory Model Inventory and Checklist (BEMI) to assess the EMs of their mental distress. Patients mainly attributed the causes and consequences of their mental distress to emotional and psychological factors, which were inextricably linked to existing social concerns and interpersonal issues. Desired solutions mainly focused on treatment, social, and systemic interventions. We found that using BEMI could contribute to a comprehensive assessment in routine care and can be used by professionals within a short timeframe and with minimal training. Ethnographic assessment method captures patients' EMs and illness experiences, opening the way for patient-centred interventions and potentially better outcomes and experiences.

Post-traumatic stress disorder associated with natural and human-made disasters in the World Mental Health Surveys

PubMed Central

Bromet, E. J.; Atwoli, L.; Kawakami, N.; Navarro-Mateu, F.; Piotrowski, P.; King, A. J.; Aguilar-Gaxiola, S.; Alonso, J.; Bunting, B.; Demyttenaere, K.; Florescu, S.; de Girolamo, G.; Gluzman, S.; Haro, J. M.; de Jonge, P.; Karam, E. G.; Lee, S.; Kovess-Masfety, V.; Medina-Mora, M. E.; Mneimneh, Z.; Pennell, B.-E.; Posada-Villa, J.; Salmerón, D.; Takeshima, T.; Kessler, R. C.

2017-01-01

Background Research on post-traumatic stress disorder (PTSD) following natural and human-made disasters has been undertaken for more than three decades. Although PTSD prevalence estimates vary widely, most are in the 20–40% range in disaster-focused studies but considerably lower (3–5%) in the few general population epidemiological surveys that evaluated disaster-related PTSD as part of a broader clinical assessment. The World Mental Health (WMH) Surveys provide an opportunity to examine disaster-related PTSD in representative general population surveys across a much wider range of sites than in previous studies. Method Although disaster-related PTSD was evaluated in 18 WMH surveys, only six in high-income countries had enough respondents for a risk factor analysis. Predictors considered were socio-demographics, disaster characteristics, and pre-disaster vulnerability factors (childhood family adversities, prior traumatic experiences, and prior mental disorders). Results Disaster-related PTSD prevalence was 0.0–3.8% among adult (ages 18+) WMH respondents and was significantly related to high education, serious injury or death of someone close, forced displacement from home, and pre-existing vulnerabilities (prior childhood family adversities, other traumas, and mental disorders). Of PTSD cases 44.5% were among the 5% of respondents classified by the model as having highest PTSD risk. Conclusion Disaster-related PTSD is uncommon in high-income WMH countries. Risk factors are consistent with prior research: severity of exposure, history of prior stress exposure, and pre-existing mental disorders. The high concentration of PTSD among respondents with high predicted risk in our model supports the focus of screening assessments that identify disaster survivors most in need of preventive interventions. PMID:27573281

Post-traumatic stress disorder associated with natural and human-made disasters in the World Mental Health Surveys.

PubMed

Bromet, E J; Atwoli, L; Kawakami, N; Navarro-Mateu, F; Piotrowski, P; King, A J; Aguilar-Gaxiola, S; Alonso, J; Bunting, B; Demyttenaere, K; Florescu, S; de Girolamo, G; Gluzman, S; Haro, J M; de Jonge, P; Karam, E G; Lee, S; Kovess-Masfety, V; Medina-Mora, M E; Mneimneh, Z; Pennell, B-E; Posada-Villa, J; Salmerón, D; Takeshima, T; Kessler, R C

2017-01-01

Research on post-traumatic stress disorder (PTSD) following natural and human-made disasters has been undertaken for more than three decades. Although PTSD prevalence estimates vary widely, most are in the 20-40% range in disaster-focused studies but considerably lower (3-5%) in the few general population epidemiological surveys that evaluated disaster-related PTSD as part of a broader clinical assessment. The World Mental Health (WMH) Surveys provide an opportunity to examine disaster-related PTSD in representative general population surveys across a much wider range of sites than in previous studies. Although disaster-related PTSD was evaluated in 18 WMH surveys, only six in high-income countries had enough respondents for a risk factor analysis. Predictors considered were socio-demographics, disaster characteristics, and pre-disaster vulnerability factors (childhood family adversities, prior traumatic experiences, and prior mental disorders). Disaster-related PTSD prevalence was 0.0-3.8% among adult (ages 18+) WMH respondents and was significantly related to high education, serious injury or death of someone close, forced displacement from home, and pre-existing vulnerabilities (prior childhood family adversities, other traumas, and mental disorders). Of PTSD cases 44.5% were among the 5% of respondents classified by the model as having highest PTSD risk. Disaster-related PTSD is uncommon in high-income WMH countries. Risk factors are consistent with prior research: severity of exposure, history of prior stress exposure, and pre-existing mental disorders. The high concentration of PTSD among respondents with high predicted risk in our model supports the focus of screening assessments that identify disaster survivors most in need of preventive interventions.

A stepped-care model of post-disaster child and adolescent mental health service provision.

PubMed

McDermott, Brett M; Cobham, Vanessa E

2014-01-01

From a global perspective, natural disasters are common events. Published research highlights that a significant minority of exposed children and adolescents develop disaster-related mental health syndromes and associated functional impairment. Consistent with the considerable unmet need of children and adolescents with regard to psychopathology, there is strong evidence that many children and adolescents with post-disaster mental health presentations are not receiving adequate interventions. To critique existing child and adolescent mental health services (CAMHS) models of care and the capacity of such models to deal with any post-disaster surge in clinical demand. Further, to detail an innovative service response; a child and adolescent stepped-care service provision model. A narrative review of traditional CAMHS is presented. Important elements of a disaster response - individual versus community recovery, public health approaches, capacity for promotion and prevention and service reach are discussed and compared with the CAMHS approach. Difficulties with traditional models of care are highlighted across all levels of intervention; from the ability to provide preventative initiatives to the capacity to provide intense specialised posttraumatic stress disorder interventions. In response, our over-arching stepped-care model is advocated. The general response is discussed and details of the three tiers of the model are provided: Tier 1 communication strategy, Tier 2 parent effectiveness and teacher training, and Tier 3 screening linked to trauma-focused cognitive behavioural therapy. In this paper, we argue that traditional CAMHS are not an appropriate model of care to meet the clinical needs of this group in the post-disaster setting. We conclude with suggestions how improved post-disaster child and adolescent mental health outcomes can be achieved by applying an innovative service approach.

Teacher consultation and coaching within mental health practice: classroom and child effects in urban elementary schools.

PubMed

Cappella, Elise; Hamre, Bridget K; Kim, Ha Yeon; Henry, David B; Frazier, Stacy L; Atkins, Marc S; Schoenwald, Sonja K

2012-08-01

To examine effects of a teacher consultation and coaching program delivered by school and community mental health professionals on change in observed classroom interactions and child functioning across one school year. Thirty-six classrooms within 5 urban elementary schools (87% Latino, 11% Black) were randomly assigned to intervention (training + consultation/coaching) and control (training only) conditions. Classroom and child outcomes (n = 364; 43% girls) were assessed in the fall and spring. Random effects regression models showed main effects of intervention on teacher-student relationship closeness, academic self-concept, and peer victimization. Results of multiple regression models showed levels of observed teacher emotional support in the fall moderated intervention impact on emotional support at the end of the school year. Results suggest teacher consultation and coaching can be integrated within existing mental health activities in urban schools and impact classroom effectiveness and child adaptation across multiple domains. © 2012 American Psychological Association

Involving mental health service users in suicide-related research: a qualitative inquiry model.

PubMed

Lees, David; Procter, Nicholas; Fassett, Denise; Handley, Christine

2016-03-01

To describe the research model developed and successfully deployed as part of a multi-method qualitative study investigating suicidal service-users' experiences of mental health nursing care. Quality mental health care is essential to limiting the occurrence and burden of suicide, however there is a lack of relevant research informing practice in this context. Research utilising first-person accounts of suicidality is of particular importance to expanding the existing evidence base. However, conducting ethical research to support this imperative is challenging. The model discussed here illustrates specific and more generally applicable principles for qualitative research regarding sensitive topics and involving potentially vulnerable service-users. Researching into mental health service users with first-person experience of suicidality requires stakeholder and institutional support, researcher competency, and participant recruitment, consent, confidentiality, support and protection. Research with service users into their experiences of sensitive issues such as suicidality can result in rich and valuable data, and may also provide positive experiences of collaboration and inclusivity. If challenges are not met, objectification and marginalisation of service-users may be reinforced, and limitations in the evidence base and service provision may be perpetuated.

The Workload Curve: Subjective Mental Workload.

PubMed

Estes, Steven

2015-11-01

In this paper I begin looking for evidence of a subjective workload curve. Results from subjective mental workload assessments are often interpreted linearly. However, I hypothesized that ratings of subjective mental workload increase nonlinearly with unitary increases in working memory load. Two studies were conducted. In the first, the participant provided ratings of the mental difficulty of a series of digit span recall tasks. In the second study, participants provided ratings of mental difficulty associated with recall of visual patterns. The results of the second study were then examined using a mathematical model of working memory. An S curve, predicted a priori, was found in the results of both the digit span and visual pattern studies. A mathematical model showed a tight fit between workload ratings and levels of working memory activation. This effort provides good initial evidence for the existence of a workload curve. The results support further study in applied settings and other facets of workload (e.g., temporal workload). Measures of subjective workload are used across a wide variety of domains and applications. These results bear on their interpretation, particularly as they relate to workload thresholds. © 2015, Human Factors and Ergonomics Society.

Trends in non-help-seeking for mental disorders in Germany between 1997-1999 and 2009-2012: a repeated cross-sectional study.

PubMed

Brandstetter, Susanne; Dodoo-Schittko, Frank; Speerforck, Sven; Apfelbacher, Christian; Grabe, Hans-Jörgen; Jacobi, Frank; Hapke, Ulfert; Schomerus, Georg; Baumeister, Sebastian E

2017-08-01

This study sought to examine trends in non-help-seeking for mental disorders among persons with a prevalent mental disorder (12-month prevalence) in Germany between 1997-1999 and 2009-2012. We examined data from 1909 persons aged 18-65 years who participated in two independent, repeated cross-sectional surveys (German National Interview and Examination Study 1997-1999, German Health Interview and Examination Survey for Adults 2009-2012) conducted 12 years apart. Prevalent mental disorders (12-month prevalence) were determined using the Composite International Diagnostic Interview, which included information on lifetime help-seeking for mental health problems. Correlates of self-reported help-seeking were analyzed according to Andersen's Behavioral Model. Multivariable Poisson regression models were used to assess time trends in the directly standardized and model-adjusted prevalence of non-help-seeking across strata of socio-economic and clinical variables. The proportion of people with a prevalent mental disorder who have never sought help in their lifetime decreased significantly from 62% (95% CI 58.7-64.7) to 57% (95% CI 52.2-60.9) between 1997-1999 and 2009-2012 in adults aged 18-65 years in Germany. Downward trends in non-help-seeking occurred in all investigated strata and reached statistical significance in women, in people who were living alone, people with medium educational level, people living in middle-sized communities, people with non-statutory health insurance, smokers, and people with co-existing somatic conditions. Despite a downward trend over the course of 12 years, a large proportion of people suffering from mental disorders are still not seeking treatment in Germany. Further efforts to increase uptake of help-seeking for mental disorders in hard-to-reach groups are warranted to continue this trend.

Building flexibility and managing complexity in community mental health: lessons learned in a large urban centre.

PubMed

Stergiopoulos, Vicky; Saab, Dima; Francombe Pridham, Kate; Aery, Anjana; Nakhost, Arash

2018-01-24

Across many jurisdictions, adults with complex mental health and social needs face challenges accessing appropriate supports due to system fragmentation and strict eligibility criteria of existing services. To support this underserviced population, Toronto's local health authority launched two novel community mental health models in 2014, inspired by Flexible Assertive Community Team principles. This study explores service user and provider perspectives on the acceptability of these services, and lessons learned during early implementation. We purposively sampled 49 stakeholders (staff, physicians, service users, health systems stakeholders) and conducted 17 semi-structured qualitative interviews and 5 focus groups between October 23, 2014 and March 2, 2015, exploring stakeholder perspectives on the newly launched team based models, as well as activities and strategies employed to support early implementation. Interviews and focus groups were audio recorded, transcribed verbatim and analyzed using thematic analysis. Findings revealed wide-ranging endorsement for the two team-based models' success in engaging the target population of adults with complex service needs. Implementation strengths included the broad recognition of existing service gaps, the use of interdisciplinary teams and experienced service providers, broad partnerships and collaboration among various service sectors, training and team building activities. Emerging challenges included lack of complementary support services such as suitable housing, organizational contexts reluctant to embrace change and risk associated with complexity, as well as limited service provider and organizational capacity to deliver evidence-based interventions. Findings identified implementation drivers at the practitioner, program, and system levels, specific to the implementation of community mental health interventions for adults with complex health and social needs. These can inform future efforts to address the health and support needs of this vulnerable population.

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.

Linking Obesity Prevention and Mental Health Promotion to Address Health Disparities.

PubMed

Claydon, Elizabeth; Austin, Anna; Smith, Megan V

2016-05-01

Considerable racial health disparities exist, especially in mental health and obesity. However, few approaches exist to address obesity and mental health simultaneously in minority groups. An intervention to address mental health in a low-income, minority group of urban mothers was designed using results from a needs assessment. Participating women were asked to rank their top health concerns and personal goals. Along with mental health concerns and basic needs, the majority of mothers desired assistance with improving their physical well-being. These results are surprising, but lend credence to creating interventions that aim to address both mental health and obesity concerns simultaneously.

Pain Catastrophizing and Its Relationship with Health Outcomes: Does Pain Intensity Matter?

PubMed Central

García-Palacios, Azucena; Botella, Cristina; Ribera-Canudas, Maria Victoria

2017-01-01

Pain catastrophizing is known to contribute to physical and mental functioning, even when controlling for the effect of pain intensity. However, research has yet to explore whether the strength of the relationship between pain catastrophizing and pain-related outcomes varies across pain intensity levels (i.e., moderation). If this was the case, it would have important implications for existing models of pain and current interventions. The present investigation explored whether pain intensity moderates the relationship between pain catastrophizing and pain-related outcomes. Participants were 254 patients (62% women) with heterogeneous chronic pain. Patients completed a measure of pain intensity, pain interference, pain catastrophizing, and physical and mental health. Pain intensity moderated the relationship between pain catastrophizing and pain interference and between pain catastrophizing and physical health status. Specifically, the strength of the correlation between pain catastrophizing and these outcomes decreased considerably as pain intensity increased. In contrast, pain intensity did not moderate the relationship between pain catastrophizing and mental health. Study findings provide a new insight into the role of pain intensity (i.e., moderator) in the relationship between pain catastrophizing and various pain-related outcomes, which might help develop existent models of pain. Clinical implications are discussed in the context of personalized therapy. PMID:28348506

Health-related quality of life among adults 65 years and older in the United States, 2011-2012: a multilevel small area estimation approach.

PubMed

Lin, Yu-Hsiu; McLain, Alexander C; Probst, Janice C; Bennett, Kevin J; Qureshi, Zaina P; Eberth, Jan M

2017-01-01

The purpose of this study was to develop county-level estimates of poor health-related quality of life (HRQOL) among aged 65 years and older U.S. adults and to identify spatial clusters of poor HRQOL using a multilevel, poststratification approach. Multilevel, random-intercept models were fit to HRQOL data (two domains: physical health and mental health) from the 2011-2012 Behavioral Risk Factor Surveillance System. Using a poststratification, small area estimation approach, we generated county-level probabilities of having poor HRQOL for each domain in U.S. adults aged 65 and older, and validated our model-based estimates against state and county direct estimates. County-level estimates of poor HRQOL in the United States ranged from 18.07% to 44.81% for physical health and 14.77% to 37.86% for mental health. Correlations between model-based and direct estimates were higher for physical than mental HRQOL. Counties located in the Arkansas, Kentucky, and Mississippi exhibited the worst physical HRQOL scores, but this pattern did not hold for mental HRQOL, which had the highest probability of mentally unhealthy days in Illinois, Indiana, and Vermont. Substantial geographic variation in physical and mental HRQOL scores exists among older U.S. adults. State and local policy makers should consider these local conditions in targeting interventions and policies to counties with high levels of poor HRQOL scores. Copyright © 2016 Elsevier Inc. All rights reserved.

Unobtrusive Monitoring of Spaceflight Team Functioning

NASA Technical Reports Server (NTRS)

Maidel, Veronica; Stanton, Jeffrey M.

2010-01-01

This document contains a literature review suggesting that research on industrial performance monitoring has limited value in assessing, understanding, and predicting team functioning in the context of space flight missions. The review indicates that a more relevant area of research explores the effectiveness of teams and how team effectiveness may be predicted through the elicitation of individual and team mental models. Note that the mental models referred to in this literature typically reflect a shared operational understanding of a mission setting such as the cockpit controls and navigational indicators on a flight deck. In principle, however, mental models also exist pertaining to the status of interpersonal relations on a team, collective beliefs about leadership, success in coordination, and other aspects of team behavior and cognition. Pursuing this idea, the second part of this document provides an overview of available off-the-shelf products that might assist in extraction of mental models and elicitation of emotions based on an analysis of communicative texts among mission personnel. The search for text analysis software or tools revealed no available tools to enable extraction of mental models automatically, relying only on collected communication text. Nonetheless, using existing software to analyze how a team is functioning may be relevant for selection or training, when human experts are immediately available to analyze and act on the findings. Alternatively, if output can be sent to the ground periodically and analyzed by experts on the ground, then these software packages might be employed during missions as well. A demonstration of two text analysis software applications is presented. Another possibility explored in this document is the option of collecting biometric and proxemic measures such as keystroke dynamics and interpersonal distance in order to expose various individual or dyadic states that may be indicators or predictors of certain elements of team functioning. This document summarizes interviews conducted with personnel currently involved in observing or monitoring astronauts or who are in charge of technology that allows communication and monitoring. The objective of these interviews was to elicit their perspectives on monitoring team performance during long-duration missions and the feasibility of potential automatic non-obtrusive monitoring systems. Finally, in the last section, the report describes several priority areas for research that can help transform team mental models, biometrics, and/or proxemics into workable systems for unobtrusive monitoring of space flight team effectiveness. Conclusions from this work suggest that unobtrusive monitoring of space flight personnel is likely to be a valuable future tool for assessing team functioning, but that several research gaps must be filled before prototype systems can be developed for this purpose.

[Implementing models of cross-sectoral mental health care (integrated health care, regional psychiatry budget) in Germany: systematic literature review].

PubMed

Schmid, Petra; Steinert, Tilman; Borbé, Raoul

2013-11-01

Cross-sectoral integrated health-care and the regional psychiatry budget are two models of cross-sectoral health care (comprising in-patient and out-patient care) in Germany. Both models of financing were created in order to overcome the so-called fragmentation in German health care. The regional psychiatry budget is a specific solution for psychiatric services whereas integrated health care models can be developed for all areas of health care. The purpose of this overview is to elucidate both the current state of implementation of these models and the results of evaluation research. Systematic literature review, additional manual search. 28 journal articles and 38 websites referring to 21 projects were identified. The projects are highly heterogenuous in terms of size, included populations and services, aims, and steering-function (concerning the different pathways of care). The projects yield innovative models of mental health care capable of competing with the co-existing traditional financing systems of in-patient and out-patient services. The future of mental health care organisation in Germany is currently open and under political discussion. © Georg Thieme Verlag KG Stuttgart · New York.

Gaps and Barriers in Services for Children in State Mental Health Plans

ERIC Educational Resources Information Center

Gould, Sara R.; Beals-Erickson, Sarah E.; Roberts, Michael C.

2012-01-01

Significant gaps exist in children's mental healthcare, and barriers prevent access to existing services. Current federal initiatives call for state governmental agencies to recognize and resolve deficits in their systems of care. Previous work has acknowledged some of the problems in meeting the mental health needs of children within a system of…

Dual diagnosis: co-existence of drug, alcohol and mental health problems.

PubMed

Manley, David

The Department of Health (DoH) published a set of good practice implementation guidelines on dual diagnosis in May 2002. This guidance suggests that in order to improve the prognosis for clients who have mental health problems and who drink or take drugs problematically, mental health and substance misuse services should adopt an integrated service model. There is a considerable amount of American-based research supporting this approach, but little evidence from the UK researchers demonstrating its application in the UK. This article offers an example of a service that has been developed in the city of Nottingham and argues that this client group will be served most effectively if mental health services support specialist dual-diagnosis resources. Integrated care pathways for this client group can be developed and led by specialist clinicians acting as consultants to mental health services (DoH, 2002a). This consultancy role within mental health services enhances the links needed between substance misuse and mental health services. As a result, specialist dual-diagnosis teams are best placed to increase positive prognoses for clients by ensuring evidence-based substance misuse skills are utilized and adapted by mental health teams to ensure fully integrated care coordination.

Revising explanatory models to accommodate anomalous genetic phenomena: Problem solving in the context of discovery

NASA Astrophysics Data System (ADS)

Hafner, Robert; Stewart, Jim

Past problem-solving research has provided a basis for helping students structure their knowledge and apply appropriate problem-solving strategies to solve problems for which their knowledge (or mental models) of scientific phenomena is adequate (model-using problem solving). This research examines how problem solving in the domain of Mendelian genetics proceeds in situations where solvers' mental models are insufficient to solve problems at hand (model-revising problem solving). Such situations require solvers to use existing models to recognize anomalous data and to revise those models to accommodate the data. The study was conducted in the context of 9-week high school genetics course and addressed: the heuristics charactenstic of successful model-revising problem solving: the nature of the model revisions, made by students as well as the nature of model development across problem types; and the basis upon which solvers decide that a revised model is sufficient (that t has both predictive and explanatory power).

Mental health and inequity: a human rights approach to inequality, discrimination, and mental disability.

PubMed

Burns, Jonathan Kenneth

2009-01-01

Mental disability and mental health care have been neglected in the discourse around health, human rights, and equality. This is perplexing as mental disabilities are pervasive, affecting approximately 8% of the world population. Furthermore, the experience of persons with mental disability is one characterized by multiple interlinked levels of inequality and discrimination within society. Efforts directed toward achieving formal equality should not stand alone without similar efforts to achieve substantive equality for persons with mental disabilities. Structural factors such as poverty, inequality, homelessness, and discrimination contribute to risk for mental disability and impact negatively on the course and outcome of such disabilities. A human rights approach to mental disability means affirming the full personhood of those with mental disabilities by respecting their inherent dignity, their individual autonomy and independence, and their freedom to make their own choices. A rights-based approach requires us to examine and transform the language, terminology, and models of mental disability that have previously prevailed especially within health discourse. Such an approach also requires us to examine the multiple ways in which inequality and discrimination characterize the lives of persons with mental disabilities and to formulate a response based on a human rights framework. In this article, I examine issues of terminology, models of understanding mental disability, and the implications of international treaties such as the United Nations Convention on the Rights of Persons with Disabilities for our response to the inequalities and discrimination that exist within society--both within and outside the health care system. Finally, while acknowledging that health care professionals have a role to play as advocates for equality, non-discrimination, and justice, I argue that it is persons with mental disabilities themselves who have the right to exercise agency in their own lives and who, consequently, should be at the center of advocacy movements and the setting of the advocacy agenda.

How would mental health parity affect the marginal price of care?

PubMed Central

Zuvekas, S H; Banthin, J S; Selden, T M

2001-01-01

OBJECTIVE: To determine the impact of parity in mental health benefits on the marginal prices that consumers face for mental health treatment. DATA SOURCES/DATA COLLECTION: We used detailed information on health plan benefits for a nationally representative sample of the privately insured population under age 65 taken from the 1987 National Medical Expenditure Survey (Edwards and Berlin 1989). The survey was carefully aged and reweighted to represent 1995 population and coverage characteristics. STUDY DESIGN: We computed marginal out-of-pocket costs from the cost-sharing benefits described by policy booklets under current coverage and under parity for various mental health treatment expenditure levels using the MEDSIM health care microsimulation model developed by researchers at the Agency for Healthcare Research and Quality. Descriptive analyses and two-limit Tobit regression models are used to examine how insurance generosity varies across individuals by demographic and socioeconomic characteristics. Our analyses are limited to a description of how parity would change the marginal incentives faced by consumers under their existing plan's cost-sharing arrangements for mental and physical health care. We do not attempt to simulate how parity might affect the level of benefits, including whether benefits are offered at all, or the level of managed care that affects the actual benefits that plan members receive. Rather, we focus only on the nominal benefits described in their policy booklets. PRINCIPAL FINDINGS: Our results show that as of 1995 parity coverage would substantially reduce the share of mental health expenditures that consumers would pay at the margin under their existing plan's cost-sharing provisions, with larger changes for outpatient care than for inpatient care. Because current mental health coverage generally becomes less generous as expenditures rise, while coverage for other medical care becomes more generous (due to stop-loss provisions), the difference in incentives between current mental health coverage and the assumed parity coverage widens as total expenditure grows. We also find that the impact of parity on marginal incentives would vary greatly across the privately insured population. CONCLUSIONS: Based on the large variation in the impact of parity on marginal incentives across the population under current plan cost-sharing arrangements, changes in the demand for mental health treatment will likely also vary across the population. PMID:11221816

Developing an ACT-R Model of Mental Manipulation

DTIC Science & Technology

2000-05-01

entire test. However, from the verbal protocol and existing literature ( Biederman , 1987 ), it was clear that subjects had a tendency to break images into...Associates. Anderson, J.R. (1993). Rules of the mind. Lawrence Erlbaum Associates. Biederman , I. ( 1987 ). Recognition by components: A theory of human

Chronic Pain and Mental Health Disorders: Shared Neural Mechanisms, Epidemiology, and Treatment.

PubMed

Hooten, W Michael

2016-07-01

Chronic pain and mental health disorders are common in the general population, and epidemiological studies suggest that a bidirectional relationship exists between these 2 conditions. The observations from functional imaging studies suggest that this bidirectional relationship is due in part to shared neural mechanisms. In addition to depression, anxiety, and substance use disorders, individuals with chronic pain are at risk of other mental health problems including suicide and cigarette smoking and many have sustained sexual violence. Within the broader biopsychosocial model of pain, the fear-avoidance model explains how behavioral factors affect the temporal course of chronic pain and provides the framework for an array of efficacious behavioral interventions including cognitive-behavioral therapy, acceptance-based therapies, and multidisciplinary pain rehabilitation. Concomitant pain and mental health disorders often complicate pharmacological management, but several drug classes, including serotonin-norepinephrine reuptake inhibitors, tricyclic antidepressants, and anticonvulsants, have efficacy for both conditions and should be considered first-line treatment agents. Copyright © 2016 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.

Personality disorders and the DSM-5: Scientific and extra-scientific factors in the maintenance of the status quo.

PubMed

Gøtzsche-Astrup, Oluf; Moskowitz, Andrew

2016-02-01

The aim of this study was to review and discuss the evidence for dimensional classification of personality disorders and the historical and sociological bases of psychiatric nosology and research. Categorical and dimensional conceptualisations of personality disorder are reviewed, with a focus on the Diagnostic and Statistical Manual of Mental Disorders-system's categorisation and the Five-Factor Model of personality. This frames the events leading up to the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition, personality disorder debacle, where the implementation of a hybrid model was blocked in a last-minute intervention by the American Psychiatric Association Board of Trustees. Explanations for these events are discussed, including the existence of invisible colleges of researchers and the fear of risking a 'scientific revolution' in psychiatry. A failure to recognise extra-scientific factors at work in classification of mental illness can have a profound and long-lasting influence on psychiatric nosology. In the end it was not scientific factors that led to the failure of the hybrid model of personality disorders, but opposing forces within the mental health community in general and the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition, Task Force in particular. Substantial evidence has accrued over the past decades in support of a dimensional model of personality disorders. The events surrounding the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition, Personality and Personality Disorders Work Group show the difficulties in reconciling two different worldviews with a hybrid model. They also indicate the future of a psychiatric nosology that will be increasingly concerned with dimensional classification of mental illness. As such, the road is paved for more substantial changes to personality disorder classification in the International Classification of Diseases, 11th Revision, in 2017. © The Royal Australian and New Zealand College of Psychiatrists 2015.

Nobody's Really Ever Asked Me Why: Anxiety as a Barrier to School Success

ERIC Educational Resources Information Center

Kratt, Diane M.

2016-01-01

Children's mental health can be a barrier to school success. School-based mental health services exist and research has shown positive results with the implementation of them. However, students spend the majority of their school time with a teacher and very little research exists on the role of a teacher in regards to students with mental health…

Predicting the mental health of college students with psychological capital.

PubMed

Selvaraj, Priscilla Rose; Bhat, Christine Suniti

2018-06-01

Behavioral health treatment is grounded in the medical model with language of deficits and problems, rather than resources and strengths. With developments in the field of positive psychology, re-focusing on well-being rather than illness is possible. The primary purpose of this study was to examine relationships and predictions that exist between levels of mental health in college students, i.e., flourishing, moderate mental health, and languishing, and psychological capital (PsyCap). For this cross-sectional, exploratory study survey method was used for data collection and for analyses of results a series of descriptive, correlation, ANOVA, and multiple regression analyses were done. Results indicated that developing positive psychological strengths such as hope, efficacy, resilience, and optimism (acronym HERO) within college students significantly increased their positive mental health. Based on the predictive nature of PsyCap, mental health professionals may engage more in creating programs incorporating PsyCap development intervention for college students. Implications for counseling and programmatic services for college students are presented along with suggestions for future research.

Community perceptions of mental illness in rural Uganda: An analysis of existing challenges facing the Bwindi Mental Health Programme.

PubMed

Shah, Arya; Wheeler, Lydia; Sessions, Kristen; Kuule, Yusufu; Agaba, Edwin; Merry, Stephen P

2017-10-11

To assess community perceptions of mental illness in the Bwindi Community Hospital (BCH) catchment area: to recognise beliefs about the causes and the treatments for mental illness. To provide community data to staff at BCH as they work to develop more effective community mental health programmes. A shortage of mental health providers in Uganda has prompted research into community-based task-sharing models for the provision of mental health services in underserved communities. Six focus group discussions, with a total of 54 community members (50% male, n = 27; mean age + s.d. [39.9 + 10.9 years]) from the BCH catchment area, were conducted to assess community member and stakeholder perceptions of mental illness and belief in the feasibility of community-based programming. Qualitative study of data through thematic analysis was conducted to assess the presence of commonly occurring perceptions. Qualitative thematic analysis revealed two major themes: (1) belief that any given patient's metal illness results from either an intrinsic or an extrinsic cause and (2) belief in a need to determine treatment of mental illness based on the believed cause. As BCH designs community-based mental health services, our findings provide support for the need for further education of community members and training of community health workers to address and integrate the above-stated beliefs regarding mental illness.

Community perceptions of mental illness in rural Uganda: An analysis of existing challenges facing the Bwindi Mental Health Programme

PubMed Central

2017-01-01

Objectives To assess community perceptions of mental illness in the Bwindi Community Hospital (BCH) catchment area: to recognise beliefs about the causes and the treatments for mental illness. To provide community data to staff at BCH as they work to develop more effective community mental health programmes. Background A shortage of mental health providers in Uganda has prompted research into community-based task-sharing models for the provision of mental health services in underserved communities. Methods Six focus group discussions, with a total of 54 community members (50% male, n = 27; mean age + s.d. [39.9 + 10.9 years]) from the BCH catchment area, were conducted to assess community member and stakeholder perceptions of mental illness and belief in the feasibility of community-based programming. Qualitative study of data through thematic analysis was conducted to assess the presence of commonly occurring perceptions. Results Qualitative thematic analysis revealed two major themes: (1) belief that any given patient’s metal illness results from either an intrinsic or an extrinsic cause and (2) belief in a need to determine treatment of mental illness based on the believed cause. Conclusion As BCH designs community-based mental health services, our findings provide support for the need for further education of community members and training of community health workers to address and integrate the above-stated beliefs regarding mental illness. PMID:29041798

Measuring cognition in teams: a cross-domain review.

PubMed

Wildman, Jessica L; Salas, Eduardo; Scott, Charles P R

2014-08-01

The purpose of this article is twofold: to provide a critical cross-domain evaluation of team cognition measurement options and to provide novice researchers with practical guidance when selecting a measurement method. A vast selection of measurement approaches exist for measuring team cognition constructs including team mental models, transactive memory systems, team situation awareness, strategic consensus, and cognitive processes. Empirical studies and theoretical articles were reviewed to identify all of the existing approaches for measuring team cognition. These approaches were evaluated based on theoretical perspective assumed, constructs studied, resources required, level of obtrusiveness, internal consistency reliability, and predictive validity. The evaluations suggest that all existing methods are viable options from the point of view of reliability and validity, and that there are potential opportunities for cross-domain use. For example, methods traditionally used only to measure mental models may be useful for examining transactive memory and situation awareness. The selection of team cognition measures requires researchers to answer several key questions regarding the theoretical nature of team cognition and the practical feasibility of each method. We provide novice researchers with guidance regarding how to begin the search for a team cognition measure and suggest several new ideas regarding future measurement research. We provide (1) a broad overview and evaluation of existing team cognition measurement methods, (2) suggestions for new uses of those methods across research domains, and (3) critical guidance for novice researchers looking to measure team cognition.

Telepsychiatry: Promise, potential, and challenges

PubMed Central

Malhotra, Savita; Chakrabarti, Subho; Shah, Ruchita

2013-01-01

Despite the high prevalence and potentially disabling consequences of mental disorders, specialized mental health services are extremely deficient, leading to the so-called ‘Mental Health Gap’. Moreover, the services are concentrated in the urban areas, further worsening the rural-urban and tertiary primary care divide. Strengthening of and expanding the existing human resources and infrastructure, and integrating mental health into primary care appear to be the two major solutions. However, both the strategies are riddled with logistic difficulties and have a long gestation period. In such a scenario, telepsychiatry or e-mental health, defined as the use of information and communication technology to provide or support psychiatric services across distances, appears to be a promising answer. Due to its enormous potential, a review of the existing literature becomes imperative. An extensive search of literature was carried out and has been presented to delineate the modes of communication, acceptability and satisfaction, reliability, outcomes, cost-effectiveness, and legal and ethical challenges related to telepsychiatry. Telepsychiatry has been applied for direct patient care (diagnosis and management), consultation, and training, education, and research purposes. Both real-time, live interaction (synchronous) and store–forward (asynchronous) types of technologies have been used for these purposes. A growing amount of literature shows that training, supervision, and consultation by specialists to primary care physicians through telepsychiatry has several advantages. In this background, we have further focused on the models of telepsychiatry best suited for India, considering that mental health care can be integrated into primary care and taken to the doorstep of patients in the community. PMID:23441027

The role of global traditional and complementary systems of medicine in the treatment of mental health disorders.

PubMed

Gureje, Oye; Nortje, Gareth; Makanjuola, Victor; Oladeji, Bibilola D; Seedat, Soraya; Jenkins, Rachel

2015-02-01

Traditional and complementary systems of medicine include a broad range of practices, which are commonly embedded in cultural milieus and reflect community beliefs, experiences, religion, and spirituality. Two major components of this system are discernible: complementary alternative medicine and traditional medicine, with different clientele and correlates of patronage. Evidence from around the world suggests that a traditional or complementary system of medicine is commonly used by a large number of people with mental illness. Practitioners of traditional medicine in low-income and middle-income countries fill a major gap in mental health service delivery. Although some overlap exists in the diagnostic approaches of traditional and complementary systems of medicine and conventional biomedicine, some major differences exist, largely in the understanding of the nature and cause of mental disorders. Treatments used by providers of traditional and complementary systems of medicine, especially traditional and faith healers in low-income and middle-income countries, might sometimes fail to meet widespread understandings of human rights and humane care. Nevertheless, collaborative engagement between traditional and complementary systems of medicine and conventional biomedicine might be possible in the care of people with mental illness. The best model to bring about that collaboration will need to be established by the needs of the extant mental health system in a country. Research is needed to provide an empirical basis for the feasibility of such collaboration, to clearly delineate its boundaries, and to test its effectiveness in bringing about improved patient outcomes. Copyright © 2015 Elsevier Ltd. All rights reserved.

Application of Neurolinguistic Programming for Treatment and Relapse Prevention of Addictive Behaviors.

ERIC Educational Resources Information Center

Sandhu, Daya Singh

The dilemma of relapse exists for a number of addictive behaviors, and mental health authorities agree that keeping addictive behaviors off permanently is much more difficult than treating the behaviors initially. Several relapse prevention models have been posited and environmental, physiological, behavioral, cognitive, and affective factors have…

Research and partnerships with schools.

PubMed

Svirydzenka, Nadzeya; Aitken, Jill; Dogra, Nisha

2016-08-01

Despite the quantity of research on child and adolescent mental health being done in schools, little output has focused on the practical aspects of recruiting schools and students into a study. Furthermore, there is limited knowledge on how to develop and sustain productive and mutually beneficial partnerships with schools after the project finishes. A large study examining prevalence of mental health problems in young people involving nine schools is used as an example for the procedure of recruitment and carrying out a research project, while developing and sustaining partnerships with schools. While recruiting the schools, a three-stage model was developed that corresponded closely to the school's needs and existing demands. The suggested procedure for the study, thus, closely reflected the varying existing cultures of participating schools. Partnerships, developed as a result of the project, were used in developing further projects and interventions for promoting good mental health in schools. Rather than a blanket research recruitment and procedural approach with an end to school involvement at the end of the project, the paper advocates for a deeper understanding of the schools' internal culture for improved recruitment and study outcomes. Developed partnerships, when sustained past the completion of research, prove to be a useful tool in applying the findings in promoting good mental health in schools and continuing research further.

Common mental disorders and the built environment in Santiago, Chile.

PubMed

Araya, Ricardo; Montgomery, Alan; Rojas, Graciela; Fritsch, Rosemarie; Solis, Jaime; Signorelli, Andres; Lewis, Glyn

2007-05-01

There is growing research interest in the influence of the built environment on mental disorders. To estimate the variation in the prevalence of common mental disorders attributable to individuals and the built environment of geographical sectors where they live. A sample of 3870 adults (response rate 90%) clustered in 248 geographical sectors participated in a household cross-sectional survey in Santiago, Chile. Independently rated contextual measures of the built environment were obtained. The Clinical Interview Schedule was used to estimate the prevalence of common mental disorders. There was a significant association between the quality of the built environment of small geographical sectors and the presence of common mental disorders among its residents. The better the quality of the built environment, the lower the scores for psychiatric symptoms; however, only a small proportion of the variation in common mental disorder existed at sector level, after adjusting for individual factors. Findings from our study, using a contextual assessment of the quality of the built environment and multilevel modelling in the analysis, suggest these associations may be more marked in non-Western settings with more homogeneous geographical sectors.

Neighborhoods and Mental Health: Exploring Ethnic Density, Poverty, and Social Cohesion among Asian Americans and Latinos

PubMed Central

Hong, Seunghye; Zhang, Wei; Walton, Emily

2014-01-01

This study examines the associations of neighborhood ethnic density and poverty with social cohesion and self-rated mental health among Asian Americans and Latinos. Path analysis is employed to analyze data from the 2002–2003 National Latino and Asian American Study (NLAAS) and the 2000 U.S. Census (N=2095 Asian Americans living in N=259 neighborhoods; N=2554 Latinos living in N=317 neighborhoods). Findings reveal that neighborhood ethnic density relates to poor mental health in both groups. Social cohesion partially mediates that structural relationship, but is positively related to ethnic density among Latinos and negatively related to ethnic density among Asian Americans. Although higher neighborhood poverty is negatively associated with mental health for both groups, the relationship does not hold in the path models after accounting for social cohesion and covariates. Furthermore, social cohesion fully mediates the association between neighborhood poverty and mental health among Latinos. This study highlights the necessity of reconceptualizing existing theories of social relationships to reflect complex and nuanced mechanisms linking neighborhood structure and mental health for diverse racial and ethnic groups. PMID:24769491

The United Nations Convention on the Rights of Persons with Disabilities: a new approach to decision-making in mental health law.

PubMed

Morrissey, Fiona

2012-12-01

The UN Convention on the Rights of Persons with Disabilities (CRPD) requires us to engage in new approaches to decision-making in mental health law. The reclassification of mental health rights to the realm of disability rights is an important step towards equal treatment for persons with psychosocial disabilities. Law reformers worldwide are beginning to consider the implications of the provisions. Legislators will be required to understand the underlying philosophy of the CRPD to realise the rights set out in it. The CRPD possesses a number of innovative provisions which can transform decision-making in the mental health context. Article 12 provides a new conceptualisation of persons with disabilities and their capacity to participate by requiring support to exercise legal capacity. While good practice exists, the provision has yet to be fully implemented by many State Parties. This article discusses the impact of the CRPD on mental health law, legal capacity law and describes examples of supported decision-making models for mental health care.

The paradox of mental health: over-treatment and under-recognition.

PubMed

2013-01-01

The PLOS Medicine editors discuss the paradox of mental health, where over-diagnosis and treatment of some mental health issues exists alongside profound under-recognition of mental health conditions in the developing world.

Mental health selection and income support dynamics: multiple spell discrete-time survival analyses of welfare receipt.

PubMed

Kiely, Kim M; Butterworth, Peter

2014-04-01

The higher occurrence of common psychiatric disorders among welfare recipients has been attributed to health selection, social causation and underlying vulnerability. The aims of this study were to test for the selection effects of mental health problems on entry and re-entry to working-age welfare payments in respect to single parenthood, unemployment and disability. Nationally representative longitudinal data were drawn from the Household Income and Labour Dynamics in Australia survey. Multiple spell discrete-time survival analyses were conducted using multinomial logistic regression models to test if pre-existing mental health problems predicted transitions to welfare. Analyses were stratified by sex and multivariate adjusted for mental health problems, father's occupation, socioeconomic position, marital status, employment history, smoking status and alcohol consumption, physical function and financial hardship. All covariates were modelled as either lagged effects or when a respondent was first observed to be at risk of income support. Mental health problems were associated with increased risk of entry and re-entry to disability, unemployment and single parenting payments for women, and disability and unemployment payments for men. These associations were attenuated but remained significant after adjusting for contemporaneous risk factors. Although we do not control for reciprocal causation, our findings are consistent with a health selection hypothesis and indicate that mental illness may be a contributing factor to later receipt of different types of welfare payments. We argue that mental health warrants consideration in the design and targeting of social and economic policies.

Bringing urban governance back in: Neighborhood conflicts and depression.

PubMed

Fu, Qiang

2018-01-01

Urban governance and its impact on contentious politics have received remarkably little attention in existing studies on mental health. Drawing on a measure of neighborhood conflicts developed in a survey of thirty-nine urban neighborhoods in Guangzhou, China, this article investigates the potential link between urban governance and mental health. Net of sociodemographic, relational, and environmental measures, it finds that among residents' conflicts with different entities of urban governance, only those with local/grassroots governments are significantly associated with more depressive symptoms. Moreover, these subgroups of government-oriented conflicts associated with more depressive symptoms are related to neighborhood planning and communal properties, reflecting a dilemma in the Chinese model of urban governance. By offering a relational interpretation of neighborhood conflicts, this study not only challenges the previous view that community building in China improves mental health, but calls attention to the significance of urban governance in research on mental health. Copyright © 2017 Elsevier Ltd. All rights reserved.

Single-channel EEG-based mental fatigue detection based on deep belief network.

PubMed

Pinyi Li; Wenhui Jiang; Fei Su

2016-08-01

Mental fatigue has a pernicious influence on road and work place safety as well as a negative symptom of many acute and chronic illnesses, since the ability of concentrating, responding and judging quickly decreases during the fatigue or drowsiness stage. Electroencephalography (EEG) has been proven to be a robust physiological indicator of human cognitive state over the last few decades. But most existing EEG-based fatigue detection methods have poor performance in accuracy. This paper proposed a single-channel EEG-based mental fatigue detection method based on Deep Belief Network (DBN). The fused nonliear features from specified sub-bands and dynamic analysis, a total of 21 features are extracted as the input of the DBN to discriminate three classes of mental state including alert, slight fatigue and severe fatigue. Experimental results show the good performance of the proposed model comparing with those state-of-art methods.

Public perceptions of the risks of an unfamiliar technology: The case of using nuclear energy sources for space missions

NASA Astrophysics Data System (ADS)

Maharik, Michael

This thesis addresses the public perception of the risk of a technology not widely known to laypeople. Its aims were (1) to characterize public perceptions of the risk of using nuclear energy in space and decisions related to this risk, and (2) to extend the 'mental model' methodology to studying public perception of unfamiliar, risky technologies. A model of the physical processes capable of creating risks from using nuclear energy sources in space was first constructed. Then, knowledge and beliefs related to this topic were elicited from three different groups of people. The generality of the findings was examined in a constructive replication with environmentally-oriented people. The possibility of involving the public in decision-making processes related to engineering macro-design was then investigated. Finally, a communication regarding these risk processes was developed and evaluated in an experiment comparing it with communications produced by NASA. Although they included large portions of the expert model, people's beliefs also had gaps and misconceptions. Respondents often used scientific terms without a clear understanding of what they meant. Respondents' mental models sometimes contained scattered and inconsistent entries. The impact of pre-existing mental models was clearly seen. Different groups of people had different patterns of knowledge and beliefs. Nevertheless, respondents expressed reasonable and coherent opinions on choices among engineering options. The CMU brochure, derived from the study of readers' existing mental models, provided a better risk communication tool than NASA's material, reflecting primarily experts' perspective. The better performance of subjects reading either brochure generally reflected adding knowledge on issues that they had not previously known, rather than correcting wrong beliefs. The communication study confirmed a hypothesis that improving knowledge on risk processes related to the use of a technology causes a more favorable attitude towards that technology. Recommendations related to the design and targeting of risk communication, and to public participation in decision-making on using new and risky technologies, are derived. Additional studies that will elicit laypeople's definitions of risk related to specific technologies, and link their detailed understanding of risk-development processes to the perceived dimensions of risk, are suggested.

Nonevent stress contributes to mental health disparities based on sexual orientation: evidence from a personal projects analysis.

PubMed

Frost, David M; LeBlanc, Allen J

2014-09-01

This study examined the role of nonevent stress--in the form of frustrated personal project pursuits in the arenas of relationships and work--as a contributing factor to mental health disparities between heterosexual and lesbian, gay, and bisexual (LGB) populations. A purposive sample of 431 LGB (55%) and heterosexually identified (45%) individuals living in the United States and Canada completed the Personal Project Inventory by describing and rating core personal projects they were pursuing. The intensity of perceived barriers to the achievement of relationship- and work-related personal projects served as indicators nonevent stress. Hierarchical linear regression models tested the hypothesis that nonevent stress contributes to the association between sexual orientation and two indicators of mental health: depressive symptoms and psychological well-being. LGB individuals had significantly more depressive symptoms and lower levels of psychological well-being than heterosexuals. Indicators of nonevent stress were significantly associated with mental health outcomes and their inclusion in models attenuated sexual orientation differences in mental health. The critical indirect pathway leading from sexual minority status to mental health occurred via barriers to relationship projects from interpersonal sources. This research suggests that nonevent stress because of structural and interpersonal stigma may contribute to mental health disparities between LGB and heterosexual individuals. The findings have important implications for policy reform around same-sex relationship recognition and workplace discrimination. Future research and clinical work will benefit by expanding existing foci on stress to include nonevent stressors to better understand and address mental health problems, particularly in LGB populations.

Nonevent Stress Contributes to Mental Health Disparities Based on Sexual Orientation: Evidence From a Personal Projects Analysis

PubMed Central

Frost, David M.; LeBlanc, Allen J.

2015-01-01

This study examined the role of nonevent stress—in the form of frustrated personal project pursuits in the arenas of relationships and work—as a contributing factor to mental health disparities between heterosexual and lesbian, gay, and bisexual (LGB) populations. A purposive sample of 431 LGB (55%) and heterosexually identified (45%) individuals living in the United States and Canada completed the Personal Project Inventory by describing and rating core personal projects they were pursuing. The intensity of perceived barriers to the achievement of relationship- and work-related personal projects served as indicators nonevent stress. Hierarchical linear regression models tested the hypothesis that nonevent stress contributes to the association between sexual orientation and two indicators of mental health: depressive symptoms and psychological well-being. LGB individuals had significantly more depressive symptoms and lower levels of psychological well-being than heterosexuals. Indicators of nonevent stress were significantly associated with mental health outcomes and their inclusion in models attenuated sexual orientation differences in mental health. The critical indirect pathway leading from sexual minority status to mental health occurred via barriers to relationship projects from interpersonal sources. This research suggests that nonevent stress because of structural and interpersonal stigma may contribute to mental health disparities between LGB and heterosexual individuals. The findings have important implications for policy reform around same-sex relationship recognition and workplace discrimination. Future research and clinical work will benefit by expanding existing foci on stress to include nonevent stressors to better understand and address mental health problems, particularly in LGB populations. PMID:25265219

Video-conferencing Telehealth Linkage attempts to Schools to Facilitate Mental Health Consultation.

PubMed

McLennan, John D

2018-04-01

Telehealth to schools may be a strategic approach to expand child mental health service delivery, however, there are only a few published examples. This report describes video-conferencing telehealth linkage attempts to schools to facilitate mental health consultation. A series of synchronous video-conferencing linkage strategies were attempted to connect a mental health consultation service to multiple schools in a Canadian setting. Consultation to support the implementation of the Daily Report Card, for students with attentional and behavioural problems, was the core content of this pilot linkage attempt. Synchronous video conference consultations were successfully delivered to six elementary schools across three school districts. Two of three linkage strategies were functional. One used existing health centre-based telehealth units to connect to school-based dedicated tablets with a video collaboration app and reliance on existing school Wi-Fi. A second used existing laptops in both the health and school system linked through a communication platform. A third connection, using 3G/4G hotspots to obviate the need to access school Wi-Fi, was deemed too expensive in this setting. The potential to use existing computer hardware to connect mental health providers and schools could facilitate scale-up. However, it is unknown whether mental health systems and school sectors will invest in such linkages and reorganize core mental health services to be delivered in this way.

Anatomically remote muscle contraction facilitates patellar tendon reflex reinforcement while mental activity does not: a within-participants experimental trial.

PubMed

Passmore, Steven R; Bruno, Paul A

2012-09-07

The Jendrassik maneuver (JM) is a remote facilitation muscular contraction shown to affect amplitude and temporal components of the human stretch reflex. Conflicting theoretical models exist regarding the neurological mechanism related to its ability to reinforce reflex parameters. One mechanism involves the gamma motoneurons of the fusimotor system, which are subject to both physical and mental activity. A second mechanism describes reduced alpha motoneuron presynaptic inhibition, which is not subject to mental activity. In the current study, we determined if mental activity could be used to create a reflex facilitation comparable to a remote muscle contraction. Using a within-participants design, we investigated the relative effect of the JM and a successfully employed mental task (Stroop task) on the amplitude and temporal components of the patellar tendon reflex. We found that the addition of mental activity had no influence on the patellar tendon reflex parameters measured, while the JM provided facilitation (increased reflex amplitude, decreased total reflex time). The findings from this study support the view that the mechanism for the JM is a reduction in presynaptic inhibition of alpha motoneurons as it is influenced by physical and not mental activity.

'What's up, (R)DoC?'--can identifying core dimensions of early functioning help us understand, and then reduce, developmental risk for mental disorders?

PubMed

Sonuga-Barke, Edmund J S

2014-08-01

In the U.S. the National Institute of Mental Health (NIMH), the main funder of mental health research in the world, has recently changed its funding model to promote a radically new perspective for mental health science. This bold, and for some controversial, initiative, termed the Research Diagnostic Criteria (or RDoC for short), intends to shift the focus of research, and eventually clinical practice, away from existing diagnostic categories, as recently updated in the DSM-5, towards 'new ways of classifying psychopathology based on dimensions of observable behavior and neurobiological measures.' This reorientation from discrete categorical disorder manifestations to underlying cross-cutting dimensions of individual functioning has generated considerable debate across the community of mental health researchers and clinicians (with strong views voiced both pro and con). Given its pivotal role in defining the research agenda globally, there is little doubt that this US science funding initiative will also have ramifications for researchers and clinicians worldwide. In this Editorial we focus specifically on the translational potential of the dimensional RDoC approach, properly extended to developmental models of early risk, in terms of its value as a potential driver of early intervention/prevention models; in the current issue of the JCPP this is exemplified by a number of papers thata address the mapping of underlying dimensions of core functioning to disorder risk, providing evidence for their potential predictive power as early markers of later disorder processes. © 2014 The Author. Journal of Child Psychology and Psychiatry. © 2014 Association for Child and Adolescent Mental Health.

Mental State Assessment and Validation Using Personalized Physiological Biometrics

PubMed Central

Patel, Aashish N.; Howard, Michael D.; Roach, Shane M.; Jones, Aaron P.; Bryant, Natalie B.; Robinson, Charles S. H.; Clark, Vincent P.; Pilly, Praveen K.

2018-01-01

Mental state monitoring is a critical component of current and future human-machine interfaces, including semi-autonomous driving and flying, air traffic control, decision aids, training systems, and will soon be integrated into ubiquitous products like cell phones and laptops. Current mental state assessment approaches supply quantitative measures, but their only frame of reference is generic population-level ranges. What is needed are physiological biometrics that are validated in the context of task performance of individuals. Using curated intake experiments, we are able to generate personalized models of three key biometrics as useful indicators of mental state; namely, mental fatigue, stress, and attention. We demonstrate improvements to existing approaches through the introduction of new features. Furthermore, addressing the current limitations in assessing the efficacy of biometrics for individual subjects, we propose and employ a multi-level validation scheme for the biometric models by means of k-fold cross-validation for discrete classification and regression testing for continuous prediction. The paper not only provides a unified pipeline for extracting a comprehensive mental state evaluation from a parsimonious set of sensors (only EEG and ECG), but also demonstrates the use of validation techniques in the absence of empirical data. Furthermore, as an example of the application of these models to novel situations, we evaluate the significance of correlations of personalized biometrics to the dynamic fluctuations of accuracy and reaction time on an unrelated threat detection task using a permutation test. Our results provide a path toward integrating biometrics into augmented human-machine interfaces in a judicious way that can help to maximize task performance.

Mental State Assessment and Validation Using Personalized Physiological Biometrics.

PubMed

Patel, Aashish N; Howard, Michael D; Roach, Shane M; Jones, Aaron P; Bryant, Natalie B; Robinson, Charles S H; Clark, Vincent P; Pilly, Praveen K

2018-01-01

Mental state monitoring is a critical component of current and future human-machine interfaces, including semi-autonomous driving and flying, air traffic control, decision aids, training systems, and will soon be integrated into ubiquitous products like cell phones and laptops. Current mental state assessment approaches supply quantitative measures, but their only frame of reference is generic population-level ranges. What is needed are physiological biometrics that are validated in the context of task performance of individuals. Using curated intake experiments, we are able to generate personalized models of three key biometrics as useful indicators of mental state; namely, mental fatigue, stress, and attention. We demonstrate improvements to existing approaches through the introduction of new features. Furthermore, addressing the current limitations in assessing the efficacy of biometrics for individual subjects, we propose and employ a multi-level validation scheme for the biometric models by means of k -fold cross-validation for discrete classification and regression testing for continuous prediction. The paper not only provides a unified pipeline for extracting a comprehensive mental state evaluation from a parsimonious set of sensors (only EEG and ECG), but also demonstrates the use of validation techniques in the absence of empirical data. Furthermore, as an example of the application of these models to novel situations, we evaluate the significance of correlations of personalized biometrics to the dynamic fluctuations of accuracy and reaction time on an unrelated threat detection task using a permutation test. Our results provide a path toward integrating biometrics into augmented human-machine interfaces in a judicious way that can help to maximize task performance.

Mental Illness in Persons with Mental Retardation: ARC Facts.

ERIC Educational Resources Information Center

Weber, Linda R.; Wimmer, Sharon

This brief factsheet presents information on mental illness in mentally retarded persons. The most prevalent disorders found in this population are schizophrenia, organic brain syndrome, adjustment disorders, personality disorders, depression, and behavioral problems. Few standardized methods of assessment exist for the diagnosis of mental illness…

Medicaid Expansion Under the Affordable Care Act: Potential Changes in Receipt of Mental Health Treatment Among Low-Income Nonelderly Adults With Serious Mental Illness

PubMed Central

Gfroerer, Joe; Kuramoto, S. Janet; Ali, Mir; Woodward, Albert M.; Teich, Judith

2015-01-01

Objectives. We designed this study to examine differences in receipt of mental health treatment between low-income uninsured nonelderly adults with serious mental illness (SMI) who were eligible for Medicaid under the Affordable Care Act (ACA) and their existing Medicaid counterparts. Assessing these differences might estimate the impact of the Medicaid expansion efforts under the ACA on receipt of mental health treatment among uninsured nonelderly adults with SMI. Methods. We examined data from 2000 persons aged 18 to 64 years who participated in the 2008 to 2013 National Survey on Drug Use and Health, had income below 138% of the federal poverty level, met SMI criteria, and either were uninsured (n = 1000) or had Medicaid-only coverage (n = 1000). We defined SMI according to the Alcohol, Drug Abuse, and Mental Health Administration Reorganization Act. We used descriptive analyses and logistic regression modeling. Results. In the 28 states currently expanding Medicaid, the model-adjusted prevalence (MAP) of receiving mental health treatment among Medicaid-only enrollees with SMI (MAP = 71.3%; 95% confidence interval [CI] = 65.74%, 76.29%) was 30.1% greater than their uninsured counterparts (MAP = 54.8%; 95% CI = 48.16%, 61.33%). In the United States, the MAP of receiving mental health treatment among Medicaid-only enrollees with SMI (MAP = 70.4%; 95% CI = 65.67%, 74.70%) was 35.9% higher than their uninsured counterparts (MAP = 51.8%; 95% CI = 46.98%, 56.65%). Conclusions. Estimated increases in receipt of mental health treatment because of enrolling in Medicaid among low-income uninsured adults with SMI might help inform planning and implementation efforts for the Medicaid expansion under the ACA. PMID:25790424

A systematic review of social stress and mental health among transgender and gender non-conforming people in the United States.

PubMed

Valentine, Sarah E; Shipherd, Jillian C

2018-03-28

Transgender and gender non-conforming (TGNC) populations, including those who do not identify with gender binary constructs (man or woman) are increasingly recognized in health care settings. Research on the health of TGNC people is growing, and disparities are often noted. In this review, we examine 77 studies published between January 1, 1997 and March 22, 2017 which reported mental health outcomes in TGNC populations to (a) characterize what is known about mental health outcomes and (b) describe what gaps persist in this literature. In general, depressive symptoms, suicidality, interpersonal trauma exposure, substance use disorders, anxiety, and general distress have been consistently elevated among TGNC adults. We also used the minority stress model as a framework for summarizing existing literature. While no studies included all elements of the Minority Stress Model, this summary gives an overview of which studies have looked at each element. Findings suggest that TGNC people are exposed to a variety of social stressors, including stigma, discrimination, and bias events that contribute to mental health problems. Social support, community connectedness, and effective coping strategies appear beneficial. We argue that routine collection of gender identity data could advance our understanding mental health risk and resilience factors among TGNC populations. Copyright © 2018 Elsevier Ltd. All rights reserved.

Mental health policies in South-East Asia and the public health role of screening instruments for depression.

PubMed

Sharan, Pratap; Sagar, Rajesh; Kumar, Saurabh

2017-04-01

The World Health Organization (WHO) South-East Asia Region, which contributes one quarter of the world's population, has a significant burden due to mental illnesses. Mental health has been a low priority in most countries of the region. Although most of these countries have national mental health policies, implementation at ground level remains a huge challenge. Many countries in the region lack mental health legislation that can safeguard the rights of people with mental illnesses, and governments have allocated low budgets for mental health services. It is imperative that concerned authorities work towards scaling up both financial and human resources for effective delivery of mental health services. Policymakers should facilitate training in the field of mental health and aim towards integrating mental health services with primary health care, to reduce the treatment gap. Steps should also be taken to develop a robust mental health information system that can provide baseline information and insight about existing mental health services and help in prioritization of the mental health needs of the individual countries. Although evidence-based management protocols such as the WHO Mental Health Gap Action Programme (mhGAP) guidelines facilitate training and scaling up of care in resource-limited countries, the identification of mental disorders like depression in such settings remains a challenge. Development and validation of brief psychiatric screening instruments should be prioritized to support such models of care. This paper illustrates an approach towards the development of a new culturally adapted instrument to identify depression that has scope for wider use in the WHO South-East Asia Region.

From neurocognition to community participation in serious mental illness: the intermediary role of dysfunctional attitudes and motivation.

PubMed

Thomas, E C; Luther, L; Zullo, L; Beck, A T; Grant, P M

2017-04-01

Evidence for a relationship between neurocognition and functional outcome in important areas of community living is robust in serious mental illness research. Dysfunctional attitudes (defeatist performance beliefs and asocial beliefs) have been identified as intervening variables in this causal chain. This study seeks to expand upon previous research by longitudinally testing the link between neurocognition and community participation (i.e. time in community-based activity) through dysfunctional attitudes and motivation. Adult outpatients with serious mental illness (N = 175) participated, completing follow-up assessments approximately 6 months after initial assessment. Path analysis tested relationships between baseline neurocognition, emotion perception, functional skills, dysfunctional attitudes, motivation, and outcome (i.e. community participation) at baseline and follow-up. Path models demonstrated two pathways to community participation. The first linked neurocognition and community participation through functional skills, defeatist performance beliefs, and motivation. A second pathway linked asocial beliefs and community participation, via a direct path passing through motivation. Model fit was excellent for models predicting overall community participation at baseline and, importantly, at follow-up. The existence of multiple pathways to community participation in a longitudinal model supports the utility of multi-modal interventions for serious mental illness (i.e. treatment packages that build upon individuals' strengths while addressing the array of obstacles to recovery) that feature dysfunctional attitudes and motivation as treatment targets.

Reconstructing the evolution of mind.

PubMed

Povinelli, D J

1993-05-01

Since Darwin, the idea of intellectual continuity has gripped comparative psychology. Psychological evolution has been viewed as the accumulation of gradual changes over time, resulting in an unbroken chain of mental capacities throughout the diversity of life. Some researchers have even maintained that no fundamental psychological differences exist among species. An alternative model argues that a rather profound new psychology related to mental state attribution may have evolved recently in the primate order. The author explores recent experimental research from chimpanzees, rhesus monkeys, and children that is consistent with this second model of psychological evolution. Drawing on the fields of developmental, comparative, and social psychology, as well as evolutionary and developmental biology, the author outlines a research agenda aimed at reconstructing the evolution of metacognition.

The what, when, and why of implementation frameworks for evidence-based practices in child welfare and child mental health service systems.

PubMed

Hanson, Rochelle F; Self-Brown, Shannon; Rostad, Whitney L; Jackson, Matthew C

2016-03-01

It is widely recognized that children in the child welfare system are particularly vulnerable to the adverse health and mental effects associated with exposure to abuse and neglect, making it imperative to have broad-based availability of evidence-based practices (EBPs) that can prevent child maltreatment and reduce the negative mental health outcomes for youth who are victims. A variety of EBPs exist for reducing child maltreatment risk and addressing the associated negative mental health outcomes, but the reach of these practices is limited. An emerging literature documents factors that can enhance or inhibit the success of EBP implementation in community service agencies, including how the selection of a theory-driven conceptual framework, or model, might facilitate implementation planning by providing guidance for best practices during implementation phases. However, limited research is available to guide decision makers in the selection of implementation frameworks that can boost implementation success for EBPs that focus on preventing child welfare recidivism and serving the mental health needs of maltreated youth. The aims of this conceptual paper are to (1) provide an overview of existing implementation frameworks, beginning with a discussion of definitional issues and the selection criteria for frameworks included in the review; and (2) offer recommendations for practice and policy as applicable for professionals and systems serving victims of child maltreatment and their families. Copyright © 2015 Elsevier Ltd. All rights reserved.

Causal reasoning with forces

PubMed Central

Wolff, Phillip; Barbey, Aron K.

2015-01-01

Causal composition allows people to generate new causal relations by combining existing causal knowledge. We introduce a new computational model of such reasoning, the force theory, which holds that people compose causal relations by simulating the processes that join forces in the world, and compare this theory with the mental model theory (Khemlani et al., 2014) and the causal model theory (Sloman et al., 2009), which explain causal composition on the basis of mental models and structural equations, respectively. In one experiment, the force theory was uniquely able to account for people's ability to compose causal relationships from complex animations of real-world events. In three additional experiments, the force theory did as well as or better than the other two theories in explaining the causal compositions people generated from linguistically presented causal relations. Implications for causal learning and the hierarchical structure of causal knowledge are discussed. PMID:25653611

Probabilistic representation in syllogistic reasoning: A theory to integrate mental models and heuristics.

PubMed

Hattori, Masasi

2016-12-01

This paper presents a new theory of syllogistic reasoning. The proposed model assumes there are probabilistic representations of given signature situations. Instead of conducting an exhaustive search, the model constructs an individual-based "logical" mental representation that expresses the most probable state of affairs, and derives a necessary conclusion that is not inconsistent with the model using heuristics based on informativeness. The model is a unification of previous influential models. Its descriptive validity has been evaluated against existing empirical data and two new experiments, and by qualitative analyses based on previous empirical findings, all of which supported the theory. The model's behavior is also consistent with findings in other areas, including working memory capacity. The results indicate that people assume the probabilities of all target events mentioned in a syllogism to be almost equal, which suggests links between syllogistic reasoning and other areas of cognition. Copyright © 2016 The Author(s). Published by Elsevier B.V. All rights reserved.

A precision medicine approach for psychiatric disease based on repeated symptom scores.

PubMed

Fojo, Anthony T; Musliner, Katherine L; Zandi, Peter P; Zeger, Scott L

2017-12-01

For psychiatric diseases, rich information exists in the serial measurement of mental health symptom scores. We present a precision medicine framework for using the trajectories of multiple symptoms to make personalized predictions about future symptoms and related psychiatric events. Our approach fits a Bayesian hierarchical model that estimates a population-average trajectory for all symptoms and individual deviations from the average trajectory, then fits a second model that uses individual symptom trajectories to estimate the risk of experiencing an event. The fitted models are used to make clinically relevant predictions for new individuals. We demonstrate this approach on data from a study of antipsychotic therapy for schizophrenia, predicting future scores for positive, negative, and general symptoms, and the risk of treatment failure in 522 schizophrenic patients with observations over 8 weeks. While precision medicine has focused largely on genetic and molecular data, the complementary approach we present illustrates that innovative analytic methods for existing data can extend its reach more broadly. The systematic use of repeated measurements of psychiatric symptoms offers the promise of precision medicine in the field of mental health. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

Evaluation of a co-delivered training package for community mental health professionals on service user- and carer-involved care planning.

PubMed

Grundy, A C; Walker, L; Meade, O; Fraser, C; Cree, L; Bee, P; Lovell, K; Callaghan, P

2017-08-01

WHAT IS KNOWN ON THE SUBJECT?: There is consistent evidence that service users and carers feel marginalized in the process of mental health care planning. Mental health professionals have identified ongoing training needs in relation to involving service users and carers in care planning. There is limited research on the acceptability of training packages for mental health professionals which involve service users and carers as co-facilitators. WHAT DOES THIS PAPER ADD TO EXISTING KNOWLEDGE?: A co-produced and co-delivered training package on service user- and carer-involved care planning was acceptable to mental health professionals. Aspects of the training that were particularly valued were the co-production model, small group discussion and the opportunity for reflective practice. The organizational context of care planning may need more consideration in future training models. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Mental health nurses using co-production models of delivering training to other mental health professionals can be confident that such initiatives will be warmly welcomed, acceptable and engaging. On the basis of the results reported here, we encourage mental health nurses to use co-production approaches more often. Further research will show how clinically effective this training is in improving outcomes for service users and carers. Background There is limited evidence for the acceptability of training for mental health professionals on service user- and carer-involved care planning. Aim To investigate the acceptability of a co-delivered, two-day training intervention on service user- and carer-involved care planning. Methods Community mental health professionals were invited to complete the Training Acceptability Rating Scale post-training. Responses to the quantitative items were summarized using descriptive statistics (Miles, ), and qualitative responses were coded using content analysis (Weber, ). Results Of 350 trainees, 310 completed the questionnaire. The trainees rated the training favourably (median overall TARS scores = 56/63; median 'acceptability' score = 34/36; median 'perceived impact' score = 22/27). There were six qualitative themes: the value of the co-production model; time to reflect on practice; delivery preferences; comprehensiveness of content; need to consider organizational context; and emotional response. Discussion The training was found to be acceptable and comprehensive with participants valuing the co-production model. Individual differences were apparent in terms of delivery preferences and emotional reactions. There may be a need to further address the organizational context of care planning in future training. Implications for practice Mental health nurses should use co-production models of continuing professional development training that involve service users and carers as co-facilitators. © 2017 The Authors. Journal of Psychiatric and Mental Health Nursing Published by John Wiley & Sons Ltd.

Barriers to delivering mental health services in Georgia with an economic and financial focus: informing policy and acting on evidence.

PubMed

Sulaberidze, Lela; Green, Stuart; Chikovani, Ivdity; Uchaneishvili, Maia; Gotsadze, George

2018-02-13

Whilst there is recognition that the global burden of disease associated with mental health disorders is significant, the economic resources available, especially in Low and Middle Income Countries, are particularly scarce. Identifying the economic (system) and financial (individual) barriers to delivering mental health services and assessing the opportunities for reform can support the development of strategies for change. A mixed methods study was developed, which engaged with a range of stakeholders from mental health services, including key informants, service managers, healthcare professional and patients and their care-takers. Data generated from interviews and focus groups were analysed using an existing framework that outlines a range of economic and financial barriers to improving mental health practice. In addition, the study utilised health financing and programmatic data. The analysis identified a variety of local economic barriers, including: the inhibition of the diversification of the mental health workforce and services due to inflexible resources; the variable and limited provision of services across the country; and the absence of mechanisms to assess the delivery and quality of existing services. The main financial barriers identified were related to out-of pocket payments for purchasing high quality medications and transportation to access mental health services. Whilst scarcity of financial resources exists in Georgia, as in many other countries, there are clear opportunities to improve the effectiveness of the current mental health programme. Addressing system-wide barriers could enable the delivery of services that aim to meet the needs of patients. The use of existing data to assess the implementation of the mental health programme offers opportunities to benchmark and improve services and to support the appropriate commissioning and reconfiguration of services.

Adjustment Disorders as a Stress-Related Disorder: A Longitudinal Study of the Associations among Stress, Resources, and Mental Health

PubMed Central

Kocalevent, Rüya-Daniela; Mierke, Annett; Danzer, Gerhard; Klapp, Burghard F.

2014-01-01

Objective Adjustment disorders are re-conceptualized in the DSM-5 as a stress-related disorder; however, besides the impact of an identifiable stressor, the specification of a stress concept, remains unclear. This study is the first to examine an existing stress-model from the general population, in patients diagnosed with adjustment disorders, using a longitudinal design. Methods The study sample consisted of 108 patients consecutively admitted for adjustment disorders. Associations of stress perception, emotional distress, resources, and mental health were measured at three time points: the outpatients’ presentation, admission for inpatient treatment, and discharge from the hospital. To evaluate a longitudinal stress model of ADs, we examined whether stress at admission predicted mental health at each of the three time points using multiple linear regressions and structural equation modeling. A series of repeated-measures one-way analyses of variance (rANOVAs) was performed to assess change over time. Results Significant within-participant changes from baseline were observed between hospital admission and discharge with regard to mental health, stress perception, and emotional distress (p<0.001). Stress perception explained nearly half of the total variance (44%) of mental health at baseline; the adjusted R2 increased (0.48), taking emotional distress (i.e., depressive symptoms) into account. The best predictor of mental health at discharge was the level of emotional distress (i.e., anxiety level) at baseline (β = −0.23, R2 corr = 0.56, p<0.001). With a CFI of 0.86 and an NFI of 0.86, the fit indices did not allow for acceptance of the stress-model (Cmin/df = 15.26; RMSEA = 0.21). Conclusions Stress perception is an important predictor in adjustment disorders, and mental health-related treatment goals are dependent on and significantly impacted by stress perception and emotional distress. PMID:24825165

Goal-Driven Autonomy and Robust Architecture for Long-Duration Missions (Year 1: 1 July 2013 - 31 July 2014)

DTIC Science & Technology

2014-09-30

Mental Domain = Ω Goal Management goal change goal input World =Ψ Memory Mission & Goals( ) World Model (-Ψ) Episodic Memory Semantic Memory ...Activations Trace Meta-Level Control Introspective Monitoring Memory Reasoning Trace ( ) Strategies Episodic Memory Metaknowledge Self Model...it is from incorrect or missing memory associations (i.e., indices). Similarly, correct information may exist in the input stream, but may not be

How to make an affiliate model work--a case history.

PubMed

Baumgartner, A J; Berns, A; Stedman, T W

1984-01-01

The North Shore Community Mental Health Center has an unusual mental health delivery system. "Out-stationed" staff work in affiliated agencies, yet are employees of the NSCMHC. This service configuration is the result of an arduous planning process which weighed the advantages of several organizational models. On one extreme was a "Centralized" model, wherein one organization was solely responsible for delivering mental health services. On the other extreme was an "Umbrella" model, wherein the organization acted as a fiscal conduit to several service providers. Somewhere in the middle a compromise was found with a "Lead Agency" model. Here, an organization provides the administrative structure, provides some services, and subcontracts the remaining services. The North Shore Community Mental Health Center adapted this system one step further. Rather than subcontracting services, it outstationed CMHC staff to affiliate agencies. United Cerebral Palsy Association of the North Shore is one of the CMHC's affiliates. The service need for family and play therapists resulted in two CMHC therapists being outstationed at UCP. The affiliation agreement between the two organizations specify the responsibilities and roles each have. The hiring process between the two organizations is an example of the duality of the system. Both agencies had interviewing roles, yet the final hiring decision was the affiliate's, since the employee would spend the majority of his/her time outstationed at the affiliate side. Outstationed staff integration to the North Shore Community Mental Health Center presented problems, however. Since these were new staff hired with federal funds, and since their visibility at the Center was minimal, they had some difficulty being identified as Center staff by existing employees.(ABSTRACT TRUNCATED AT 250 WORDS)

Mental Mechanisms for Topics Identification

PubMed Central

2014-01-01

Topics identification (TI) is the process that consists in determining the main themes present in natural language documents. The current TI modeling paradigm aims at acquiring semantic information from statistic properties of large text datasets. We investigate the mental mechanisms responsible for the identification of topics in a single document given existing knowledge. Our main hypothesis is that topics are the result of accumulated neural activation of loosely organized information stored in long-term memory (LTM). We experimentally tested our hypothesis with a computational model that simulates LTM activation. The model assumes activation decay as an unavoidable phenomenon originating from the bioelectric nature of neural systems. Since decay should negatively affect the quality of topics, the model predicts the presence of short-term memory (STM) to keep the focus of attention on a few words, with the expected outcome of restoring quality to a baseline level. Our experiments measured topics quality of over 300 documents with various decay rates and STM capacity. Our results showed that accumulated activation of loosely organized information was an effective mental computational commodity to identify topics. It was furthermore confirmed that rapid decay is detrimental to topics quality but that limited capacity STM restores quality to a baseline level, even exceeding it slightly. PMID:24744775

Which family--what therapy: Maori culture, families and family therapy in New Zealand.

PubMed

Kumar, Shailesh; Dean, Peter; Smith, Barry; Mellsop, Graham W

2012-04-01

New Zealand is a relatively young and small country which has seen steady migration for nearly seven centuries. Despite a long history of rivalry and hostility between Maori and European values, the country has also seen some significant synergism between the two cultures. For the last three decades Asians have also migrated at a significant pace. The country faces the challenge of delivering quality mental health services to such cultures which are bifurcated in being socio-centric (Maori, Pacific Islanders and Asian total 32% combined) or ego-centric (European total 68%). Significant progress has been made in including families of the mentally ill in their treatment and care planning. Legislative requirements have been introduced for the family to be consulted in the treatment of those who are being compelled to receive psychiatric care under the Mental Health Act. Models of family therapy developed through innovation meeting the unique local needs or adaptation of existing models from overseas are being used. An overview of such family therapy modalities is presented.

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.

Teacher Consultation and Coaching within Mental Health Practice: Classroom and Child Effects in Urban Elementary Schools

PubMed Central

Cappella, Elise; Hamre, Bridget K.; Kim, Ha Yeon; Henry, David B.; Frazier, Stacy L.; Atkins, Marc S.; Schoenwald, Sonja K.

2012-01-01

Objective To examine effects of a teacher consultation and coaching program delivered by school and community mental health professionals on change in observed classroom interactions and child functioning across one school year. Method Thirty-six classrooms within five urban elementary schools (87% Latino, 11% Black) were randomly assigned to intervention (training + consultation/coaching) and control (training only) conditions. Classroom and child outcomes (n = 364; 43% girls) were assessed in the fall and spring. Results Random effects regression models showed main effects of intervention on teacher-student relationship closeness, academic self-concept, and peer victimization. Results of multiple regression models showed levels of observed teacher emotional support in the fall moderated intervention impact on emotional support at the end of the school year. Conclusions Results suggest teacher consultation and coaching can be integrated within existing mental health activities in urban schools and impact classroom effectiveness and child adaptation across multiple domains. PMID:22428941

Cost-Effectiveness of Evaluating the New Technologies.

ERIC Educational Resources Information Center

Kastner, Theodore A.

1997-01-01

This commentary on a study comparing use of the brand name drug Depakene with generic valproic acid to control seizures in people with mental retardation focuses on issues of cost-effectiveness. It notes existing guidelines for pharmacoeconomic evaluation and suggests a possible model to include a threshold price (per quality-adjusted life year)…

Effects of Information Status and Uniqueness Status on Referent Management in Discourse Comprehension and Planning

ERIC Educational Resources Information Center

Brocher, Andreas; Chiriacescu, Sofiana Iulia; von Heusinger, Klaus

2018-01-01

In discourse processing, speakers collaborate toward a shared mental model by establishing and recruiting prominence relations between different discourse referents. In this article we investigate to what extent the possibility to infer a referent's existence from preceding context (as indicated by the referent's information status as inferred or…

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…

Unobtrusive Monitoring of Spaceflight Team Functioning. Literature Review and Operational Assessment for NASA Behavioral Health and Performance Element

NASA Technical Reports Server (NTRS)

Maidel, Veronica; Stanton, Jeffrey M.

2010-01-01

This document contains a literature review suggesting that research on industrial performance monitoring has limited value in assessing, understanding, and predicting team functioning in the context of space flight missions. The review indicates that a more relevant area of research explores the effectiveness of teams and how team effectiveness may be predicted through the elicitation of individual and team mental models. Note that the mental models referred to in this literature typically reflect a shared operational understanding of a mission setting such as the cockpit controls and navigational indicators on a flight deck. In principle, however, mental models also exist pertaining to the status of interpersonal relations on a team, collective beliefs about leadership, success in coordination, and other aspects of team behavior and cognition. Pursuing this idea, the second part of this document provides an overview of available off-the-shelf products that might assist in extraction of mental models and elicitation of emotions based on an analysis of communicative texts among mission personnel. The search for text analysis software or tools revealed no available tools to enable extraction of mental models automatically, relying only on collected communication text. Nonetheless, using existing software to analyze how a team is functioning may be relevant for selection or training, when human experts are immediately available to analyze and act on the findings. Alternatively, if output can be sent to the ground periodically and analyzed by experts on the ground, then these software packages might be employed during missions as well. A demonstration of two text analysis software applications is presented. Another possibility explored in this document is the option of collecting biometric and proxemic measures such as keystroke dynamics and interpersonal distance in order to expose various individual or dyadic states that may be indicators or predictors of certain elements of team functioning. This document summarizes interviews conducted with personnel currently involved in observing or monitoring astronauts or who are in charge of technology that allows communication and monitoring. The objective of these interviews was to elicit their perspectives on monitoring team performance during long-duration missions and the feasibility of potential automatic non-obtrusive monitoring systems. Finally, in the last section, the report describes several priority areas for research that can help transform team mental models, biometrics, and/or proxemics into workable systems for unobtrusive monitoring of space flight team effectiveness. Conclusions from this work suggest that unobtrusive monitoring of space flight personnel is likely to be a valuable future tool for assessing team functioning, but that several research gaps must be filled before prototype systems can be developed for this purpose.

Interpersonal polyvictimization and mental health in males.

PubMed

Burns, Carol Rhonda; Lagdon, Susan; Boyda, David; Armour, Cherie

2016-05-01

A consistent conclusion within the extant literature is that victimization and in particular polyvictimization leads to adverse mental health outcomes. A large body of literature exists as it pertains to the association between victimisation and mental health in studies utilising samples of childhood victims, female only victims, and samples of male and female victims; less research exists as it relates to males victims of interpersonal violence. The aim of the current study was therefore to identify profiles of interpersonal victimizations in an exclusively male sample and to assess their differential impact on a number of adverse mental health outcomes. Using data from 14,477 adult males from Wave 2 of the NESARC, we identified interpersonal victimization profiles via Latent Class Analysis. Multinomial Logistic Regression was subsequently utilized to establish risk across mental health disorders. A 4-class solution was optimal. Victimisation profiles showed elevated odds ratios for the presence of mental health disorders; suggesting that multiple life-course victimisation typologies exists, and that victimization is strongly associated with psychopathology. Several additional notable findings are discussed. Copyright © 2016 Elsevier Ltd. All rights reserved.

The Impact of Pre-Existing Mental Health Disorders on the Diagnosis, Treatment and Survival among Lung Cancer Patients in the U.S. Military Health System

PubMed Central

Lin, Jie; McGlynn, Katherine A.; Carter, Corey A.; Nations, Joel A.; Anderson, William F.; Shriver, Craig D.; Zhu, Kangmin

2018-01-01

Background Higher cancer-related mortality has been observed among people with mental health disorders than in the general population. Both delay in diagnosis and inadequate treatment due to health care access have been found to explain the higher mortality. The U.S. Military Health System (MHS), in which all beneficiaries have equal access to health care, provides an ideal system to study this disparity where there are no or minimal barriers to health care access. This study assessed pre-existing mental health disorders and stage at diagnosis, receipt of cancer treatment and overall survival among non-small cell lung cancer (NSCLC) patients in the U.S. MHS. Methods The study used data from the linked database from the Department of Defense’s Central Cancer Registry and the MHS Data Repository (MDR). The study subjects included 5,054 patients with histologically confirmed primary NSCLC diagnosed between 1998 and 2007. Results Patients with a pre-existing mental disorder did not present with more advanced disease at diagnosis than those without. There were no significant differences in receiving cancer treatments between the two groups. However, patients with a mental health disorder had a higher mortality than those without (Adjusted Hazard ratio (HR) =1.11, 95% CI=1.03 to 1.20). Conclusions Poor survival in NSCLC in patients with a pre-existing mental health disorder is not necessarily associated with delay in diagnosis and/or inadequate cancer treatment. Impact This study contributes to the current understanding that health care access is not sufficient to explain the poor survival among NSCLC patients with pre-existing mental health disorder. PMID:27566418

Assessing posttraumatic stress disorder's latent structure in elderly bereaved European trauma survivors: evidence for a five-factor dysphoric and anxious arousal model.

PubMed

Armour, Cherie; O'Connor, Maja; Elklit, Ask; Elhai, Jon D

2013-10-01

The three-factor structure of posttraumatic stress disorder (PTSD) specified by the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, is not supported in the empirical literature. Two alternative four-factor models have received a wealth of empirical support. However, a consensus regarding which is superior has not been reached. A recent five-factor model has been shown to provide superior fit over the existing four-factor models. The present study investigated the fit of the five-factor model against the existing four-factor models and assessed the resultant factors' association with depression in a bereaved European trauma sample (N = 325). The participants were assessed for PTSD via the Harvard Trauma Questionnaire and depression via the Beck Depression Inventory. The five-factor model provided superior fit to the data compared with the existing four-factor models. In the dysphoric arousal model, depression was equally related to both dysphoric arousal and emotional numbing, whereas depression was more related to dysphoric arousal than to anxious arousal.

Predictors of mental health-related acute service utilisation and treatment costs in the 12 months following an acute psychiatric admission.

PubMed

Siskind, Dan; Harris, Meredith; Diminic, Sandra; Carstensen, Georgia; Robinson, Gail; Whiteford, Harvey

2014-11-01

A key step in informing mental health resource allocation is to identify the predictors of service utilisation and costs. This project aims to identify the predictors of mental health-related acute service utilisation and treatment costs in the year following an acute public psychiatric hospital admission. A dataset containing administrative and routinely measured outcome data for 1 year before and after an acute psychiatric admission for 1757 public mental health patients was analysed. Multivariate regression models were developed to identify patient- and treatment-related predictors of four measures of service utilisation or cost: (a) duration of index admission; and, in the year after discharge from the index admission (b) acute psychiatric inpatient bed-days; (c) emergency department (ED) presentations; and (d) total acute mental health service costs. Split-sample cross-validation was used. A diagnosis of psychosis, problems with living conditions and prior acute psychiatric inpatient bed-days predicted a longer duration of index admission, while prior ED presentations and self-harm predicted a shorter duration. A greater number of acute psychiatric inpatient bed-days in the year post-discharge were predicted by psychosis diagnosis, problems with living conditions and prior acute psychiatric inpatient admissions. The number of future ED presentations was predicted by past ED presentations. For total acute care costs, diagnosis of psychosis was the strongest predictor. Illness acuity and prior acute psychiatric inpatient admission also predicted higher costs, while self-harm predicted lower costs. The development of effective models for predicting acute mental health treatment costs using existing administrative data is an essential step towards a workable activity-based funding model for mental health. Future studies would benefit from the inclusion of a wider range of variables, including ethnicity, clinical complexity, cognition, mental health legal status, electroconvulsive therapy, problems with activities of daily living and community contacts. © The Royal Australian and New Zealand College of Psychiatrists 2014.

Unnecessary work tasks and mental health: a prospective analysis of Danish human service workers.

PubMed

Madsen, Ida E H; Tripathi, Manisha; Borritz, Marianne; Rugulies, Reiner

2014-11-01

According to the "stress-as-offense-to-self" perspective, work tasks that are considered unnecessary or unreasonable - so-called "illegitimate work tasks" - are likely to elicit stress-reactions. Previous studies, mostly cross-sectional, have shown that illegitimate tasks are associated with increased self-reported stress, cortisol, and counterproductive work behavior. In this article, we examine the prospective association between unnecessary work tasks, one type of illegitimate work tasks, and mental health among Danish human service workers. Further, we explore whether this association is modified by sex, age, occupational position, and baseline mental health status. The data were obtained from self-administered questionnaires from 1351 Danish human service workers in three waves of data-collection during 1999-2005. We measured unnecessary work tasks by a single item, and assessed mental health using the 5-item mental health inventory from the Short form 36 questionnaire. We analyzed data using multi-level modeling, adjusting for potential confounding by sex, age, cohabitation, occupational position, and baseline mental health. Unnecessary work tasks were prospectively associated with a decreased level of mental health. This association was stronger for employees with poor baseline mental health and tended to be more pronounced among older employees. Among participants with poor baseline mental health, the association was explained by neither psychological demands nor decision latitude. Our findings suggest that the prevention of unnecessary work tasks may benefit employee mental health, particularly among employees with pre-existing mental health problems.

A report on economic studies of Australian mental health issues.

PubMed

Williams, Ruth; Doessel, Darrel

2006-06-01

To report on economic studies of Australian mental health issues. Although the international literature on the economics of mental health issues is increasing, and although many Australian studies exist on one comorbid condition of mental illness, namely substance abuse, there are very few empirical studies by economists of Australia's mental health issues.

Consequences of bullying victimization in childhood and adolescence: A systematic review and meta-analysis

PubMed Central

Moore, Sophie E; Norman, Rosana E; Suetani, Shuichi; Thomas, Hannah J; Sly, Peter D; Scott, James G

2017-01-01

AIM To identify health and psychosocial problems associated with bullying victimization and conduct a meta-analysis summarizing the causal evidence. METHODS A systematic review was conducted using PubMed, EMBASE, ERIC and PsycINFO electronic databases up to 28 February 2015. The study included published longitudinal and cross-sectional articles that examined health and psychosocial consequences of bullying victimization. All meta-analyses were based on quality-effects models. Evidence for causality was assessed using Bradford Hill criteria and the grading system developed by the World Cancer Research Fund. RESULTS Out of 317 articles assessed for eligibility, 165 satisfied the predetermined inclusion criteria for meta-analysis. Statistically significant associations were observed between bullying victimization and a wide range of adverse health and psychosocial problems. The evidence was strongest for causal associations between bullying victimization and mental health problems such as depression, anxiety, poor general health and suicidal ideation and behaviours. Probable causal associations existed between bullying victimization and tobacco and illicit drug use. CONCLUSION Strong evidence exists for a causal relationship between bullying victimization, mental health problems and substance use. Evidence also exists for associations between bullying victimization and other adverse health and psychosocial problems, however, there is insufficient evidence to conclude causality. The strong evidence that bullying victimization is causative of mental illness highlights the need for schools to implement effective interventions to address bullying behaviours. PMID:28401049

Our (Represented) World: A Quantum-Like Object

NASA Astrophysics Data System (ADS)

Lambert-Mogiliansky, Ariane; Dubois, François

It has been suggested that observed cognitive limitations may be an expression of the quantum-like structure of the mind. In this chapter we explore some implications of this hypothesis for learning i.e., for the construction of a representation of the world. For a quantum-like individual, there exists a multiplicity of mentally incompatible (Bohr complementary) but equally valid and complete representations (mental pictures) of the world. The process of learning i.e., of constructing a representation, involves two kinds of operations on the mental picture. The acquisition of new data which is modelled as a preparation procedure and the processing of data which is modelled as an introspective measurement operation. This process is shown not to converge to a single mental picture. Rather, it can evolve forever. We define a concept of entropy to capture relative intrinsic uncertainty. The analysis suggests a new perspective on learning. First, it implies that we must turn to double objectification as in Quantum Mechanics: the cognitive process is the primary object of learning. Second, it suggests that a representation of the world arises as the result of creative interplay between the mind and the environment.

[Models of Mental Health Care for Vulnerable Refugees in the Community].

PubMed

Schellong, Julia; Epple, Franziska; Weidner, Kerstin; Möllering, Andrea

2017-04-01

A non-neglectable portion of people that have fled to Germany have been subjected to expulsion, violence, torture and grave human loss. In some of them, signs of secondary mental problems are obvious. In the light of the efforts at integration, these diseases must not be neglected. Outlined are the federal legal requirements and how the cost coverage, as well as the admission to health care system, is structured. Additionally, 2 exemplary regional models for psychosomatic health care are being introduced: Dresden's "Stepped Care Model for Psychologically Vulnerable Refugees" includes phased offers for prevention and treatment of acute mental crises, as well as somatoform disorders in refugees and their volunteer helpers. The PSZ in Bielefeld unites already existing expertise of social work and trauma therapy to form a shared project and favors, among other things, training courses and the instruction of language mediators. The local circumstances and differences lead to individual, sometimes totally new solutions. Already existing clinical care offers as well as concepts of trauma therapy are focal points for the development of a comprehensive health care provision. Most effective is a combination of medicinal care, psychosocial networking and psychosomatic treatment. For a working health care provision without parallel structures it is indispensible to use expertise in trauma therapy that is already in place. While being very resource-saving psychosomatic centers offer targeted applications in the network of all actors in refugee care especially when combined with well-trained volunteers and language mediators, informed on the issue of trauma. © Georg Thieme Verlag KG Stuttgart · New York.

Mental health response in Haiti in the aftermath of the 2010 earthquake: a case study for building long-term solutions.

PubMed

Raviola, Giuseppe; Eustache, Eddy; Oswald, Catherine; Belkin, Gary S

2012-01-01

Significant challenges exist in providing safe, effective, and culturally sound mental health and psychosocial services when an unforeseen disaster strikes in a low-resource setting. We present here a case study describing the experience of a transnational team in expanding mental health and psychosocial services delivered by two health care organizations, one local (Zanmi Lasante) and one international (Partners in Health), acting collaboratively as part of the emergency response to the 2010 Haiti earthquake. In the year and a half following the earthquake, Zanmi Lasante and Partners in Health provided 20,000 documented individual and group appointments for mental health and psychosocial needs. During the delivery of disaster response services, the collaboration led to the development of a model to guide the expansion and scaling up of community-based mental health services in the Zanmi Lasante health care system over the long-term, with potential for broader scale-up in Haiti. This model identifies key skill packages and implementation rules for developing evidence-based pathways and algorithms for treating common mental disorders. Throughout the collaboration, efforts were made to coordinate planning with multiple organizations interested in supporting the development of mental health programs following the disaster, including national governmental bodies, nongovernmental organizations, universities, foreign academic medical centers, and corporations. The collaborative interventions are framed here in terms of four overarching categories of action: direct service delivery, research, training, and advocacy. This case study exemplifies the role of psychiatrists working in low-resource settings as public health program implementers and as members of multidisciplinary teams.

Employee decision-making about disclosure of a mental disorder at work.

PubMed

Toth, Kate E; Dewa, Carolyn S

2014-12-01

Fear of stigma may lead employees to choose not to disclose a mental disorder in the workplace, thereby limiting help-seeking through workplace accommodation. Research suggests that various factors are considered in making decisions related to disclosure of concealable stigmatizing attributes, yet limited literature explores such decision-making in the context of mental disorder and work. The purpose of this grounded theory study was to develop a model of disclosure specific to mental health issues in a work context. In-depth interviews were conducted with 13 employees of a post-secondary educational institution in Canada. Data were analyzed according to grounded theory methods through processes of open, selective, and theoretical coding. Findings indicated that employees begin from a default position of nondisclosure that is attributable to fear of being stigmatized in the workplace as a result of the mental disorder. In order to move from the default position, employees need a reason to disclose. The decision-making process itself is a risk-benefit analysis, during which employees weigh risks and benefits within the existing context as they assess it. The model identifies that fear of stigmatization is one of the problems with disclosure at work and describes the disclosure decision-making process. Understanding of how employees make decisions about disclosure in the workplace may inform organizational policies, practices, and programs to improve the experiences of individuals diagnosed with a mental disorder at work. The findings suggest possible intervention strategies in education, policy, and culture for reducing stigma of mental disorders in the workplace.

Investigating the Relationships among Stressors, Stress Level, and Mental Symptoms for Infertile Patients: A Structural Equation Modeling Approach.

PubMed

Wang, Jong-Yi; Li, Yi-Shan; Chen, Jen-De; Liang, Wen-Miin; Yang, Tung-Chuan; Lee, Young-Chang; Wang, Chia-Woei

2015-01-01

Patients with infertility are a high risk group in depression and anxiety. However, an existing theoretically and empirically validated model of stressors, stress, and mental symptoms specific for infertile patients is still a void. This study aimed to determine the related factors and their relational structures that affect the level of depressive and anxiety symptoms among infertile patients. A cross-sectional sample of 400 infertility outpatients seeking reproduction treatments in three teaching hospitals across Taiwan participated in the structured questionnaire survey in 2011. The hypothesized model comprising 10 latent variables was tested by Structural Equation Modeling using AMOS 17. Goodness-of-fit indexes, including χ2/DF = 1.871, PGFI = 0.746, PNFI = 0.764, and others, confirmed the modified model fit the data well. Marital stressor, importance of children, guilt-and-blame, and social stressor showed a direct effect on perceived stress. Instead of being a factor of stress, social support was directly and positively related to self-esteem. Perceived stress and self-esteem were the two major mediators for the relationships between stressors and mental symptoms. Increase in social support and self-esteem led to decrease in mental symptoms among the infertile patients. The relational structures were identified and named as the Stressors Stress Symptoms Model, clinically applied to predict anxiety and depression from various stressors. Assessing sources and level of infertility-related stress and implementing culturally-sensitive counseling with an emphasis on positive personal value may assist in preventing the severity of depression and anxiety.

Investigating the Relationships among Stressors, Stress Level, and Mental Symptoms for Infertile Patients: A Structural Equation Modeling Approach

PubMed Central

Wang, Jong-Yi; Liang, Wen-Miin; Yang, Tung-Chuan; Lee, Young-Chang; Wang, Chia-Woei

2015-01-01

Objective Patients with infertility are a high risk group in depression and anxiety. However, an existing theoretically and empirically validated model of stressors, stress, and mental symptoms specific for infertile patients is still a void. This study aimed to determine the related factors and their relational structures that affect the level of depressive and anxiety symptoms among infertile patients. Methods A cross-sectional sample of 400 infertility outpatients seeking reproduction treatments in three teaching hospitals across Taiwan participated in the structured questionnaire survey in 2011. The hypothesized model comprising 10 latent variables was tested by Structural Equation Modeling using AMOS 17. Results Goodness-of-fit indexes, including χ2/DF = 1.871, PGFI = 0.746, PNFI = 0.764, and others, confirmed the modified model fit the data well. Marital stressor, importance of children, guilt-and-blame, and social stressor showed a direct effect on perceived stress. Instead of being a factor of stress, social support was directly and positively related to self-esteem. Perceived stress and self-esteem were the two major mediators for the relationships between stressors and mental symptoms. Increase in social support and self-esteem led to decrease in mental symptoms among the infertile patients. Conclusions The relational structures were identified and named as the Stressors Stress Symptoms Model, clinically applied to predict anxiety and depression from various stressors. Assessing sources and level of infertility-related stress and implementing culturally-sensitive counseling with an emphasis on positive personal value may assist in preventing the severity of depression and anxiety. PMID:26484531

Advancing family-centred care in child and adolescent mental health: a critical review of the literature.

PubMed

MacKean, Gail; Spragins, Wendy; L'Heureux, Laura; Popp, Janice; Wilkes, Chris; Lipton, Harold

2012-01-01

Family-centred care (FCC) is a key factor in increasing health and related system responsiveness to the needs of children and families; unfortunately, it is an unfamiliar service model in children's mental health. This critical review of the literature addresses three key questions: What are the concepts, characteristics and principles of FCC in the context of delivering mental health services to children? What are the enablers, barriers and demonstrated benefits to using a family-centred approach to care in children's mental health? And how can we facilitate moving an FCC model forward in children's mental health? A range of databases was searched for the years 2000–2011, for children ages zero to 18 years. Articles were selected for inclusion if a family-centred approach to care was articulated and the context was the intervention and treatment side of the mental healthcare system. This literature review uncovered a multiplicity of terms and concepts, all closely related to FCC. Two of the most frequently used terms in children's mental health are family centred and family focused, which have important differences, particularly in regard to how the family is viewed. Initial benefits to FCC include improved child and family management skills and function, an increased stability of living situation, improved cost-effectiveness, increased consumer and family satisfaction and improved child and family health and well-being. Significant challenges exist in evaluating FCC because of varying interpretations of its core concepts and applications. Nonetheless, a shared understanding of FCC in a children's mental health context seems possible, and examples can be found of best practices, enablers and strategies, including opportunities for innovative policy change to overcome barriers.

Mental health of transgender youth in care at an adolescent urban community health center: A matched retrospective cohort study

PubMed Central

Reisner, Sari L.; Vetters, Ralph; Leclerc, M; Zaslow, Shayne; Wolfrum, Sarah; Shumer, Daniel; Mimiaga, Matthew J.

2014-01-01

Purpose Transgender youth represent a vulnerable population at risk for negative mental health outcomes including depression, anxiety, self-harm, and suicidality. Limited data exists to compare the mental health of transgender adolescents and emerging adults to cisgender youth accessing community-based clinical services; the current study aimed to fill this gap. Methods A retrospective cohort study of electronic health record (EHR) data from 180 transgender patients age 12–29 years seen between 2002–2011 at a Boston-based community health center was performed. The 106 female-to-male (FTM) and 74 male-to-female (MTF) patients were matched on gender identity, age, visit date, and race/ethnicity to cisgender controls. Mental health outcomes were extracted and analyzed using conditional logistic regression models. Logistic regression models compared FTM to MTF youth on mental health outcomes. Results The sample (n=360) had a mean age of 19.6 (SD=3.0); 43% white, 33% racial/ethnic minority, and 24% race/ethnicity unknown. Compared to cisgender matched controls, transgender youth had a two- to three-fold increased risk of depression, anxiety disorder, suicidal ideation, suicide attempt, self-harm without lethal intent, and both inpatient and outpatient mental health treatment (all p<0.05). No statistically significant differences in mental health outcomes were observed comparing FTM and MTF patients, adjusting for age, race/ethnicity, and hormone use. Conclusions Transgender youth were found to have a disparity in negative mental health outcomes compared to cisgender youth, with equally high burden in FTM and MTF patients. Identifying gender identity differences in clinical settings and providing appropriate services and supports are important steps in addressing this disparity. PMID:25577670

Mental health of transgender youth in care at an adolescent urban community health center: a matched retrospective cohort study.

PubMed

Reisner, Sari L; Vetters, Ralph; Leclerc, M; Zaslow, Shayne; Wolfrum, Sarah; Shumer, Daniel; Mimiaga, Matthew J

2015-03-01

Transgender youth represent a vulnerable population at risk for negative mental health outcomes including depression, anxiety, self-harm, and suicidality. Limited data exist to compare the mental health of transgender adolescents and emerging adults to cisgender youth accessing community-based clinical services; the present study aimed to fill this gap. A retrospective cohort study of electronic health record data from 180 transgender patients aged 12-29 years seen between 2002 and 2011 at a Boston-based community health center was performed. The 106 female-to-male (FTM) and 74 male-to-female (MTF) patients were matched on gender identity, age, visit date, and race/ethnicity to cisgender controls. Mental health outcomes were extracted and analyzed using conditional logistic regression models. Logistic regression models compared FTM with MTF youth on mental health outcomes. The sample (N = 360) had a mean age of 19.6 years (standard deviation, 3.0); 43% white, 33% racial/ethnic minority, and 24% race/ethnicity unknown. Compared with cisgender matched controls, transgender youth had a twofold to threefold increased risk of depression, anxiety disorder, suicidal ideation, suicide attempt, self-harm without lethal intent, and both inpatient and outpatient mental health treatment (all p < .05). No statistically significant differences in mental health outcomes were observed comparing FTM and MTF patients, adjusting for age, race/ethnicity, and hormone use. Transgender youth were found to have a disparity in negative mental health outcomes compared with cisgender youth, with equally high burden in FTM and MTF patients. Identifying gender identity differences in clinical settings and providing appropriate services and supports are important steps in addressing this disparity. Copyright © 2015 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

A call for integrating a mental health perspective into systems of care for abused and neglected infants and young children.

PubMed

Osofsky, Joy D; Lieberman, Alicia F

2011-01-01

A system of care for abused and neglected infants and young children should adopt a comprehensive perspective, with mental health considerations systematically incorporated into policies and decisions affecting children and their families. Children age birth to 5 years have disproportionately high rates of maltreatment, with long-term consequences for their mental and physical health. Research on normal development and developmental psychopathology has shown that early development unfolds in an ecology of transactional influences among biological, interpersonal, and environmental domains. Psychologists should collaborate with other early intervention disciplines to create systems of care based on an ecological-transactional model of development that includes early mental health principles in order to serve the needs of these young children. Didactic courses, practicums, and internships in infant and early childhood mental health should become integral components of undergraduate and graduate curricula in psychology in order to build capacity to achieve this goal. Recommendations are offered for systemic change by integrating infant and early childhood mental health principles into existing systems of care for young children and their families. PsycINFO Database Record (c) 2010 APA, all rights reserved.

Neighborhoods and mental health: exploring ethnic density, poverty, and social cohesion among Asian Americans and Latinos.

PubMed

Hong, Seunghye; Zhang, Wei; Walton, Emily

2014-06-01

This study examines the associations of neighborhood ethnic density and poverty with social cohesion and self-rated mental health among Asian Americans and Latinos. Path analysis is employed to analyze data from the 2002-2003 National Latino and Asian American Study (NLAAS) and the 2000 U.S. Census (N = 2095 Asian Americans living in N = 259 neighborhoods; N = 2554 Latinos living in N = 317 neighborhoods). Findings reveal that neighborhood ethnic density relates to poor mental health in both groups. Social cohesion partially mediates that structural relationship, but is positively related to ethnic density among Latinos and negatively related to ethnic density among Asian Americans. Although higher neighborhood poverty is negatively associated with mental health for both groups, the relationship does not hold in the path models after accounting for social cohesion and covariates. Furthermore, social cohesion fully mediates the association between neighborhood poverty and mental health among Latinos. This study highlights the necessity of reconceptualizing existing theories of social relationships to reflect complex and nuanced mechanisms linking neighborhood structure and mental health for diverse racial and ethnic groups. Copyright © 2014 Elsevier Ltd. All rights reserved.

Mental health status of varenicline and bupropion users during a quit attempt compared to current smokers, other quitters, and non-smokers.

PubMed

Shewale, Anand R; Borse, Mrudula S; Brown, Joshua D; Li, Chenghui

2015-09-01

Varenicline and bupropion are commonly prescribed non-nicotine containing smoking cessation agents. Post-marketing reports suggest an increased incidence of psychiatric disturbances associated with varenicline and bupropion. However, pre-existing psychiatric disorders may confound the association between these smoking cessation agents and psychiatric disturbances. We compared the mental health status of individuals using varenicline or bupropion to that of people quitting without medication, current smokers, and non-smokers while controlling for pre-existing conditions. A cross-sectional design was used. Data were from 2006-2011 Medical Expenditure Panel Survey. Mental health status was assessed using the mental component summary (MCS) from the 12-item Short Form survey (SF-12v2), 2-item Patient Health Questionnaire (PHQ-2), and Kessler 6 Scale (K6). Differences in MCS score were compared using linear regression. Logistic regressions were used to compare positive screenings for depression using PHQ-2 and for psychological distress using K6. Of 578 use episodes, 453 (78.38%) were bupropion and 125 (21.62%) were varenicline. After adjusting for potential confounders, mental health status of varenicline users was not different from current smokers or people who quit smoking without medication, but worse than non-smokers; bupropion was strongly associated with lower mental health status relative to all groups across all three measures. Varenicline was not associated with worse mental health compared to smokers or those who quit without medication, after adjusting for pre-existing psychiatric disorders. Bupropion was associated with worse mental health status than smokers, former smokers who quit without medication, and nonsmokers, even after adjusting for pre-existing psychiatric disorders. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Plate tectonics in the classification of personality disorder: shifting to a dimensional model.

PubMed

Widiger, Thomas A; Trull, Timothy J

2007-01-01

The diagnostic categories of the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders were developed in the spirit of a traditional medical model that considers mental disorders to be qualitatively distinct conditions (see, e.g., American Psychiatric Association, 2000). Work is now beginning on the fifth edition of this influential diagnostic manual. It is perhaps time to consider a fundamental shift in how psychopathology is conceptualized and diagnosed. More specifically, it may be time to consider a shift to a dimensional classification of personality disorder that would help address the failures of the existing diagnostic categories as well as contribute to an integration of the psychiatric diagnostic manual with psychology's research on general personality structure. (c) 2007 APA, all rights reserved

Psychological Construction in the OCC Model of Emotion

PubMed Central

Clore, Gerald L.; Ortony, Andrew

2014-01-01

This article presents six ideas about the construction of emotion: (a) Emotions are more readily distinguished by the situations they signify than by patterns of bodily responses; (b) emotions emerge from, rather than cause, emotional thoughts, feelings, and expressions; (c) the impact of emotions is constrained by the nature of the situations they represent; (d) in the OCC account (the model proposed by Ortony, Clore, and Collins in 1988), appraisals are psychological aspects of situations that distinguish one emotion from another, rather than triggers that elicit emotions; (e) analyses of the affective lexicon indicate that emotion words refer to internal mental states focused on affect; (f) the modularity of emotion, long sought in biology and behavior, exists as mental schemas for interpreting human experience in story, song, drama, and conversation. PMID:25431620

Mental illness in Bwindi, Uganda: Understanding stakeholder perceptions of benefits and barriers to developing a community-based mental health programme.

PubMed

Sessions, Kristen L; Wheeler, Lydia; Shah, Arya; Farrell, Deenah; Agaba, Edwin; Kuule, Yusufu; Merry, Stephen P

2017-11-30

Mental illness has been increasingly recognised as a source of morbidity in low- and middle-income countries and significant treatment gaps exist worldwide. Studies have demonstrated the effectiveness of task sharing through community-based treatment models for addressing international mental health issues. This paper aims to evaluate the perceptions of a wide range of mental health stakeholders in a Ugandan community regarding the benefits and barriers to developing a community-based mental health programme. Bwindi Community Hospital (BCH) in south-west Uganda provides services through a team of community health workers to people in the Kanungu District. Thematic analysis of 13 semi-structured interviews and 6 focus group discussions involving 54 community members and 13 mental health stakeholders within the BCH catchment area. Stakeholders perceived benefits to a community-based compared to a hospital-based programme, including improved patient care, lower costs to patients and improved community understanding of mental illness. They also cited barriers including cost, insufficient workforce and a lack of community readiness. Stakeholders express interest in developing community-based mental health programmes, as they feel that it will address mental health needs in the community and improve community awareness of mental illness. However, they also report that cost is a significant barrier to programme development that will have to be addressed prior to being able to successfully establish such programming. Additionally, many community members expressed unique sociocultural beliefs regarding the nature of mental illness and those suffering from a psychiatric disease.

Of mental models, assumptions and heuristics: The case of acids and acid strength

NASA Astrophysics Data System (ADS)

McClary, Lakeisha Michelle

This study explored what cognitive resources (i.e., units of knowledge necessary to learn) first-semester organic chemistry students used to make decisions about acid strength and how those resources guided the prediction, explanation and justification of trends in acid strength. We were specifically interested in the identifying and characterizing the mental models, assumptions and heuristics that students relied upon to make their decisions, in most cases under time constraints. The views about acids and acid strength were investigated for twenty undergraduate students. Data sources for this study included written responses and individual interviews. The data was analyzed using a qualitative methodology to answer five research questions. Data analysis regarding these research questions was based on existing theoretical frameworks: problem representation (Chi, Feltovich & Glaser, 1981), mental models (Johnson-Laird, 1983); intuitive assumptions (Talanquer, 2006), and heuristics (Evans, 2008). These frameworks were combined to develop the framework from which our data were analyzed. Results indicated that first-semester organic chemistry students' use of cognitive resources was complex and dependent on their understanding of the behavior of acids. Expressed mental models were generated using prior knowledge and assumptions about acids and acid strength; these models were then employed to make decisions. Explicit and implicit features of the compounds in each task mediated participants' attention, which triggered the use of a very limited number of heuristics, or shortcut reasoning strategies. Many students, however, were able to apply more effortful analytic reasoning, though correct trends were predicted infrequently. Most students continued to use their mental models, assumptions and heuristics to explain a given trend in acid strength and to justify their predicted trends, but the tasks influenced a few students to shift from one model to another model. An emergent finding from this project was that the problem representation greatly influenced students' ability to make correct predictions in acid strength. Many students, however, were able to apply more effortful analytic reasoning, though correct trends were predicted infrequently. Most students continued to use their mental models, assumptions and heuristics to explain a given trend in acid strength and to justify their predicted trends, but the tasks influenced a few students to shift from one model to another model. An emergent finding from this project was that the problem representation greatly influenced students' ability to make correct predictions in acid strength.

PERSPECTIVES: Accountability for Mental Health: The Australian Experience.

PubMed

Rosenberg, Sebastian; Salvador-Carulla, Luis

2017-03-01

Australia was one of the first countries to develop a national policy for mental health. A persistent characteristic of all these policies has been their reference to the importance of accountability. What does this mean exactly and have we achieved it? Can Australia tell if anybody is getting better? To review accountability for mental health in Australia and question whether two decades of Australian rhetoric around accountability for mental health has been fulfilled. This paper first considers the concept of accountability and its application to mental health. We then draw on existing literature, reports, and empirical data from national and state governments to illustrate historical and current approaches to accountability for mental health. We provide a content analysis of the most current set of national indicators. The paper also briefly considers some relevant international processes to compare Australia's progress in establishing accountability for mental health. Australia's federated system of government permits competing approaches to accountability, with multiple and overlapping data sets. A clear national approach to accountability for mental health has failed to emerge. Existing data focuses on administrative and health service indicators, failing to reflect broader social factors which reveal quality of life. In spite of twenty years of investment and effort Australia has been described as outcome blind, unable to demonstrate the merit of USD 8bn spent on mental health annually. While it may be prolific, existing administrative data provide little outcomes information against which Australia can genuinely assess the health and welfare of people with a mental illness. International efforts are evolving slowly. Even in high income countries such as Australia, resources for mental health services are constrained. Countries cannot afford to continue to invest in services or programs that fail to demonstrate good outcomes for people with a mental illness or are not value for money. New approaches are needed which ensure that chosen accountability indicators reflect national health and social priorities. Such priorities must be meaningful to a range of stakeholders and the community about the state of mental health. They must drive an agenda of continuous improvement relevant to those most affected by mental disorders. These approaches should be operable in emerging international contexts. Australia must further develop its approach to health accountability in relation to mental health. A limited set of new preferred national mental health indicators should be agreed. These should be tested, both domestically and internationally, for their capacity to inform and drive quality improvement processes in mental health. Existing systems of accountability are not fit for purpose, incapable of firing necessary quality improvement processes. Supported by adequate resources, realistic targets and a culture of openness, new accountability could drive real quality improvement processes for mental health, facilitate jurisdictional comparisons in Australia, and contribute to new efforts to benchmark mental health internationally.

78 FR 22272 - National Institute of Mental Health; Notice of Closed Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2013-04-15

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Institute of Mental... unwarranted invasion of personal privacy. Name of Committee: National Institute of Mental Health Special Emphasis Panel; Leveraging Existing Natural Experiments to Advance the Health of People with Severe Mental...

Real-time mental arithmetic task recognition from EEG signals.

PubMed

Wang, Qiang; Sourina, Olga

2013-03-01

Electroencephalography (EEG)-based monitoring the state of the user's brain functioning and giving her/him the visual/audio/tactile feedback is called neurofeedback technique, and it could allow the user to train the corresponding brain functions. It could provide an alternative way of treatment for some psychological disorders such as attention deficit hyperactivity disorder (ADHD), where concentration function deficit exists, autism spectrum disorder (ASD), or dyscalculia where the difficulty in learning and comprehending the arithmetic exists. In this paper, a novel method for multifractal analysis of EEG signals named generalized Higuchi fractal dimension spectrum (GHFDS) was proposed and applied in mental arithmetic task recognition from EEG signals. Other features such as power spectrum density (PSD), autoregressive model (AR), and statistical features were analyzed as well. The usage of the proposed fractal dimension spectrum of EEG signal in combination with other features improved the mental arithmetic task recognition accuracy in both multi-channel and one-channel subject-dependent algorithms up to 97.87% and 84.15% correspondingly. Based on the channel ranking, four channels were chosen which gave the accuracy up to 97.11%. Reliable real-time neurofeedback system could be implemented based on the algorithms proposed in this paper.

Mental Health and Mental Disorder Recommendation Programs.

PubMed

Ruchiwit, Manyat

2017-12-01

The characteristic differences among the Greater Mekong Subregion (GMS) countries in terms of trade and investment, society and cultural values, medical information and technology, and the living and working environment have become major health problems in terms of mental disorders. The purpose of this article is to identify the gaps in those aspects, to propose mental health and mental disorder recommendation programs, and to recommend policies for policy makers and research investors. A comparative analysis and literature review of existing policy, including overviews of previous research were used to generate a synthesis of the existing knowledge of the mental health and mental disorder recommendation programs. The review results recommend mental health and mental disorder programs for policy makers, research investors, and stakeholders in order to strengthen the directions for implementing these programs in the future. The healthcare provision in each country will not be limited only to its citizens; the healthcare markets and target groups are likely to expand to the neighboring countries in the context of changes in domestic and international factors, which have both positive and negative impacts according to the political, economic, and social situations of the influencing countries.

Mental Health Commissions: making the critical difference to the development and reform of mental health services.

PubMed

Rosen, Alan; Goldbloom, David; McGeorge, Peter

2010-11-01

Several Mental Health Commissions (MHCs) have emerged in developed countries over recent years, often in connection with mental health reform strategies. It is timely to consider the types of MHC which exist in different countries, their characteristics which may contribute to making them more effective, and any possible limitations and concerns raised about them. The emerging literature on MHCs indicates, particularly with the wider types of MHCs, that they may contribute to the substantial enhancement of mental health resources and sustainability of services; mental health reform is much more likely to be implemented properly with an independent monitor such as a MHC which has official influence at the highest levels of government; and they can encourage, champion and monitor the transformation of services into more evidence-based, community-centred, recovery-oriented, consumer, family and human rights-focused mental health services. The advent of MHCs may enhance the resourcing, quality and consistency of distribution of effective clinical practices and crucial support services, and foster more relevant practice-based research. MHC variants can work in different countries and the model can be adapted to state jurisdictions, single state nations and federated systems of government, without duplicating bureaucracies. Achievements and possible limitations are considered.

The Group as Teacher: The Gestalt Peer-Learning Community as a Vehicle for Organisational Healing.

ERIC Educational Resources Information Center

Barber, Paul

The possibility of using a Gestalt-informed peer learning community to facilitate reflective learning and organizational change was explored. A peer learning community model exists that is based on two approaches to working with mental illness--therapeutic community practice (which is based on treating the community group rather than individuals…

Mental Models Held by School Principals Regarding a New System of Evaluating Teachers

ERIC Educational Resources Information Center

Gleissner, Kirsten E.

2017-01-01

In recent years, interest has grown among legislators and educators regarding the use of teacher evaluation as a leverage point for increasing the effectiveness of instruction in schools. Though there is an existing body of knowledge around the attitudes and beliefs held by teachers about their own evaluation experiences, very little information…

Woodcock-Johnson-III, Kaufman Adolescent and Adult Intelligence Test (KAIT), Kaufman Assessment Battery for Children (KABC), and Differential Ability Scales (DAS) support Carroll but not Cattell-Horn.

PubMed

Cucina, Jeffrey M; Howardson, Garett N

2017-08-01

Recently emerging evidence suggests that the dominant structural model of mental abilities-the Cattell-Horn-Carroll (CHC) model-may not adequately account for observed scores for mental abilities batteries, leading scholars to call into question the model's validity. Establishing the robustness of these findings is important since CHC is the foundation for several contemporary mental abilities test batteries, such as the Woodcock-Johnson III (WJ-III). Using confirmatory factor analysis, we investigated CHC's robustness across 4 archival samples of mental abilities test battery data, including the WJ-III, the Kaufman Adolescent & Adult Intelligence Test (KAIT), the Kaufman Assessment Battery for Children (KABC), and the Differential Ability Scales (DAS). We computed omega hierarchical (ωH) and omega subscale (ωS) coefficients for g and the broad factors, which estimated the relationship of composite scores to g and the broad factors, respectively. Across all 4 samples, we found strong evidence for a general ability, g. We additionally found evidence for 3 to 9 residualized, orthogonal broad abilities existing independently of g, many of which also explained reliable variance in test battery scores that cannot be accounted for by g alone. The reliabilities of these broad factors, however, were less than desirable (i.e., <.80) and achieving desirable reliabilities would be practically infeasible (e.g., requiring excessively large numbers of subtests). Our results, and those of CHC critics, are wholly consistent with Carroll's model. Essentially, both g and orthogonal broad abilities are required to explain variance in mental abilities test battery scores, which is consistent with Carroll but not Cattell-Horn. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Engagement processes in model programs for community reentry from prison for people with serious mental illness.

PubMed

Angell, Beth; Matthews, Elizabeth; Barrenger, Stacey; Watson, Amy C; Draine, Jeffrey

2014-01-01

Linking prisoners with mental illness with treatment following release is critical to preventing recidivism, but little research exists to inform efforts to engage them effectively. This presentation compares the engagement process in two model programs, each representing an evidence-based practice for mental health which has been adapted to the context of prison reentry. One model, Forensic Assertive Community Treatment (FACT), emphasizes a long-term wrap-around approach that seeks to maximize continuity of care by concentrating all services within one interdisciplinary team; the other, Critical Time Intervention (CTI), is a time-limited intervention that promotes linkages to outside services and bolsters natural support systems. To compare engagement practices, we analyze data from two qualitative studies, each conducted in a newly developed treatment program serving prisoners with mental illness being discharged from prisons to urban communities. Findings show that the working relationship in reentry services exhibits unique features and is furthered in both programs by the use of practitioner strategies of engagement, including tangible assistance, methods of interacting with consumers, and encouragement of service use via third parties such as families and parole officers. Nevertheless, each program exhibited distinct cultures and rituals of reentry that were associated with fundamental differences in philosophy and differences in resources available to each program. Copyright © 2014 Elsevier Ltd. All rights reserved.

[Strategic planning and mental health policies].

PubMed

Tonini, Nelsi Salete; Kantorski, Luciane Prado

2007-03-01

This article discusses how mental health policies are prioritized in the process of strategic planning of mental health actions within the context of Brazilian psychiatric reform. The theoretical support of strategic planning provide health professionals, particularly those involved in metal health, with elements fir deepening discussions on existing mental health actions and policies.

Individual Factors Predicting Mental Health Court Diversion Outcome

ERIC Educational Resources Information Center

Verhaaff, Ashley; Scott, Hannah

2015-01-01

Objective: This study examined which individual factors predict mental health court diversion outcome among a sample of persons with mental illness participating in a postcharge diversion program. Method: The study employed secondary analysis of existing program records for 419 persons with mental illness in a court diversion program. Results:…

A systematic review of physical activity policy recommendations and interventions for people with mental health problems in Sub-Saharan African countries

PubMed Central

Vancampfort, Davy; Stubbs, Brendon; De Hert, Marc; du Plessis, Christy; Gbiri, Caleb Ademola Omuwa; Kibet, Jepkemoi; Wanyonyi, Nancy; Mugisha, James

2017-01-01

Introduction There is a need for interventions to address the escalating mental health burden in Sub-Saharan Africa (SSA). Implementation of physical activity (PA) within the rehabilitation of people with mental health problems (PMHP) could reduce the burden and facilitate recovery. The objective of the current review was to explore (1) the role of PA within mental health policies of SSA countries, and (2) the current research evidence for PA to improve mental health in SSA. Methods We screened the Mental Health Atlas and MiNDbank for mental health policies in SSA countries and searched PubMed for relevant studies on PA in PMHP in SSA. Results Sixty-nine percent (=33/48) of SSA countries have a dedicated mental health policy. Two of 22 screened mental health policies included broad physical activity recommendations. There is clear evidence for the role of PA in the prevention and rehabilitation of depression in SSA. Conclusion Despite the existing evidence, PA is largely a neglected rehabilitation modality in the mental health care systems of SSA. Continued education of existing staff, training of specialized professionals and integration of PA for mental health in public health awareness programs are needed to initiate and improve PA programs within the mental health care systems of SSA. PMID:28491235

A systematic review of physical activity policy recommendations and interventions for people with mental health problems in Sub-Saharan African countries.

PubMed

Vancampfort, Davy; Stubbs, Brendon; De Hert, Marc; du Plessis, Christy; Gbiri, Caleb Ademola Omuwa; Kibet, Jepkemoi; Wanyonyi, Nancy; Mugisha, James

2017-01-01

There is a need for interventions to address the escalating mental health burden in Sub-Saharan Africa (SSA). Implementation of physical activity (PA) within the rehabilitation of people with mental health problems (PMHP) could reduce the burden and facilitate recovery. The objective of the current review was to explore (1) the role of PA within mental health policies of SSA countries, and (2) the current research evidence for PA to improve mental health in SSA. We screened the Mental Health Atlas and MiNDbank for mental health policies in SSA countries and searched PubMed for relevant studies on PA in PMHP in SSA. Sixty-nine percent (=33/48) of SSA countries have a dedicated mental health policy. Two of 22 screened mental health policies included broad physical activity recommendations. There is clear evidence for the role of PA in the prevention and rehabilitation of depression in SSA. Despite the existing evidence, PA is largely a neglected rehabilitation modality in the mental health care systems of SSA. Continued education of existing staff, training of specialized professionals and integration of PA for mental health in public health awareness programs are needed to initiate and improve PA programs within the mental health care systems of SSA.

Continuous traumatic stress as a mental and physical health challenge: Case studies from South Africa.

PubMed

Kaminer, Debra; Eagle, Gillian; Crawford-Browne, Sarah

2018-07-01

This article discusses the condition of continuous traumatic stress as common on the African continent and in other international settings characterised by very high levels of ongoing violence and threat of community, political or war-related origin. Through consideration of three case studies from South Africa, contexts of continuous traumatic stress are described, and the mental health and physical health effects of living in such contexts are elaborated. Cautions are raised about attempting to transpose existing posttraumatic stress models onto individuals exposed to situations of continuous traumatic stress, and guidelines for optimal interventions with such cases are proposed.

Narrative Exposure Therapy: A Proposed Model to Address Intimate Partner Violence-Related PTSD in Parenting and Pregnant Adolescents.

PubMed

Volpe, Ellen M; Quinn, Camille R; Resch, Kathryn; Sommers, Marilyn S; Wieling, Elizabeth; Cerulli, Catherine

Pregnant and parenting adolescents experience high rates of intimate partner violence (IPV) and its sequelae posttraumatic stress disorder (PTSD) and depression. Narrative exposure therapy (NET) is an innovative intervention that has demonstrated strong preliminary evidence in improving mental health. The specific aims of this article are 3-fold: (1) provide a brief background about IPV-related PTSD and depression among pregnant and parenting adolescents; (2) describe NET's theoretical principles, its therapeutic process, and provide a review of existing evidence; and (3) discuss NET as a potential treatment to address the mental health burden among adolescents experiencing IPV-related PTSD and depression.

Palestinian mothers' perceptions of child mental health problems and services

PubMed Central

THABET, ABDEL AZIZ; EL GAMMAL, HOSSAM; VOSTANIS, PANOS

2006-01-01

The aim of this study was to explore Palestinian mothers' perceptions of child mental health problems and their understanding of their causes; to determine Palestinian mothers' awareness of existing services and sources of help and support; to identify professionals in the community whom Palestinian mothers would consult if their child had mental health problems; and to establish their views on ways of increasing awareness of child mental health issues and services. Checklists exploring the above issues were completed by 249 Palestinian mothers living in refugee camps in the Gaza Strip. Palestinian mothers equally perceived emotional, behavioural and psychotic symptoms as suggestive of mental ill health in childhood. Mothers perceived multiple causes of child mental health problems, including family problems, parental psychiatric illness and social adversity. A substantial proportion (42.6%) had knowledge of local child mental health care services. Overall, mothers preferred Western over traditional types of treatment, and were keen to increase mental health awareness within their society. Despite a different cultural tradition, Palestinian mothers appear open to a range of services and interventions for child mental health problems. As in other non-Western societies, child mental health service provision should be integrated with existing primary health care, schools, and community structures. PMID:16946953

Further examination of predictors of turnover intention among mental health professionals.

PubMed

Yanchus, N J; Periard, D; Osatuke, K

2017-02-01

WHAT IS KNOWN ON THE SUBJECT?: When mental health professionals leave organizations, detrimental effects on quality of patient care occur. Reasons for leaving include incivility, lack of autonomy, perceptions of unfair treatment and feeling psychologically unsafe at work. This paper sought to investigate additional reasons why mental health professionals intend to quit or to cognitively withdraw from their jobs. WHAT DOES THIS PAPER ADD TO EXISTING KNOWLEDGE?: Past research on this topic is limited in its scope and data. Mainly fragmented evidence is available about predictors of job satisfaction and turnover intention (i.e. different mental health occupations examined in separate studies). Only two existing studies that examined broader mental health provider groups were limited by including few workforce settings, small sample sizes and insufficiently rigorous statistical analyses. We examined four occupations (mental health nurses, social workers, psychologists and psychiatrists), each represented through a large sample in multiple settings, all within one large healthcare network with complex patients. Our contribution is finding additional predictors (supervisory support, emotional exhaustion) of job satisfaction/turnover intention. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Organizations can consider using culture change initiatives to increase civility at work; this includes leadership support and role modelling of workplace behaviours. Leaders should monitor staffing levels and high workloads to pre-empt emotional exhaustion, which predicts turnover. Hiring and training supervisors should involve not only technical expertise, but also 'soft skills' necessary for creating civil and supportive work environments. Leaders and managers should use employee feedback data (e.g. organizational surveys) to learn about the workplace environments, and address areas of employees' concern. Introduction Given the global shortage of mental health professionals, high turnover rates within this workforce are concerning. We used United States of America Veterans Health Administration data to add to the limited knowledge about this topic. Aim We examined predictors of turnover intention, or an employee's cognitive withdrawal from their job, in a large sample of direct care mental health professionals, separating among occupations to increase the pragmatic relevance of our findings. Method Survey data from 10 997 mental health employees working in direct patient contact (2432 registered nurses, 3769 social workers, 2520 psychologists and 1276 psychiatrists) were used in a cross-sectional design with structural equation modelling techniques for model testing. Results Job satisfaction was predicted by civility (courteous and respectful workplace behaviours) and supervisory support. Job satisfaction predicted emotional exhaustion which predicted turnover intention. Job satisfaction also directly predicted turnover intention and turnover plans. Discussion Predictors of job satisfaction included civility and supervisory support. Emotional exhaustion predicted turnover intention. Results inform organizational actions to address these work environment characteristics. Implications for practice Organizations can initiate culture changes to improve civility and develop supervisors' 'soft skills' in conjunction with technical expertise. Published 2016. This article is a U.S. Government work and is in the public domain in the USA.

The police-based crisis intervention team (CIT) model: I. Effects on officers' knowledge, attitudes, and skills.

PubMed

Compton, Michael T; Bakeman, Roger; Broussard, Beth; Hankerson-Dyson, Dana; Husbands, Letheshia; Krishan, Shaily; Stewart-Hutto, Tarianna; D'Orio, Barbara M; Oliva, Janet R; Thompson, Nancy J; Watson, Amy C

2014-04-01

Individuals with serious mental illnesses are very likely to interact with police officers. The crisis intervention team (CIT) model is being widely implemented by police departments across the United States to improve officers' responses. However, little research exists on officer-level outcomes. The authors compared officers with or without CIT training on six key constructs related to the CIT model: knowledge about mental illnesses, attitudes about serious mental illnesses and treatments, self-efficacy for deescalating crisis situations and making referrals to mental health services, stigmatizing attitudes, deescalation skills, and referral decisions. The sample included 586 officers, 251 of whom had received the 40-hour CIT training (median of 22 months before the study), from six police departments in Georgia. In-depth, in-person assessments of officers' knowledge, attitudes, and skills were administered. Many measures were linked to two vignettes, in written and video formats, depicting typical police encounters with individuals with psychosis or with suicidality. CIT-trained officers had consistently better scores on knowledge, diverse attitudes about mental illnesses and their treatments, self-efficacy for interacting with someone with psychosis or suicidality, social distance stigma, deescalation skills, and referral decisions. Effect sizes for some measures, including deescalation skills and referral decisions pertaining to psychosis, were substantial (d=.71 and .57, respectively, p<.001). CIT training of police officers resulted in sizable and persisting improvements in diverse aspects of knowledge, attitudes, and skills. Research should now address potential outcomes at the system level and for individuals with whom officers interact.

Does heightened fear of crime lead to poorer mental health in new suburbs, or vice versa?

PubMed

Foster, Sarah; Hooper, Paula; Knuiman, Matthew; Giles-Corti, Billie

2016-11-01

Fear of crime is implicated as a risk factor for poorer mental health, yet few studies have explored whether there is a causal relationship between fear of crime and health, or tested the direction of the relationship. Does, for example, heightened fear of crime lead to poorer mental health, or could poorer mental health exacerbate fear of crime? RESIDE participants in Perth, Australia, completed a questionnaire three years after moving to their neighbourhood (2007-2008, n = 1230), and again four years later (2011-2012, n = 531). The impact of fear of crime on psychological distress (Kessler-6) was examined in SAS using the Proc Mixed procedure (marginal repeated measures model with unrestricted variance pattern). Models controlled for demographics and time, and progressively adjusted for avoidance behaviours (i.e., walking, community participation, social cohesion). This approach was repeated with psychological distress as the independent variable and fear of crime as the outcome. For each increase in one standard deviation (SD) in fear of crime, psychological distress increased by 0.680 (p = 0.0001), however in the reversed models, for each one SD increase in psychological distress, fear of crime increased by 0.152 (p = 0.0001). To help explain these results, temporal order models examined whether baseline values predicted follow-up values. There was a significant association between psychological distress (at baseline) and fear of crime (at follow-up), but no association between fear of crime (at baseline) and psychological distress (at follow-up). The findings suggest a bi-directional relationship exists between fear of crime and mental health, however it appears that higher psychological distress over time leads to higher fear of crime, rather than the reverse. Furthermore, the pathway connecting fear of crime and mental health appears to be direct, rather than via constrained social and physical activities. Copyright © 2016 Elsevier Ltd. All rights reserved.

Virtual environment navigation with look-around mode to explore new real spaces by people who are blind.

PubMed

Lahav, Orly; Gedalevitz, Hadas; Battersby, Steven; Brown, David; Evett, Lindsay; Merritt, Patrick

2018-05-01

This paper examines the ability of people who are blind to construct a mental map and perform orientation tasks in real space by using Nintendo Wii technologies to explore virtual environments. The participant explores new spaces through haptic and auditory feedback triggered by pointing or walking in the virtual environments and later constructs a mental map, which can be used to navigate in real space. The study included 10 participants who were congenitally or adventitiously blind, divided into experimental and control groups. The research was implemented by using virtual environments exploration and orientation tasks in real spaces, using both qualitative and quantitative methods in its methodology. The results show that the mode of exploration afforded to the experimental group is radically new in orientation and mobility training; as a result 60% of the experimental participants constructed mental maps that were based on map model, compared with only 30% of the control group participants. Using technology that enabled them to explore and to collect spatial information in a way that does not exist in real space influenced the ability of the experimental group to construct a mental map based on the map model. Implications for rehabilitation The virtual cane system for the first time enables people who are blind to explore and collect spatial information via the look-around mode in addition to the walk-around mode. People who are blind prefer to use look-around mode to explore new spaces, as opposed to the walking mode. Although the look-around mode requires users to establish a complex collecting and processing procedure for the spatial data, people who are blind using this mode are able to construct a mental map as a map model. For people who are blind (as for the sighted) construction of a mental map based on map model offers more flexibility in choosing a walking path in a real space, accounting for changes that occur in the space.

Network Approaches to Substance Use and HIV/Hepatitis C Risk among Homeless Youth and Adult Women in the United States: A Review

PubMed Central

Dombrowski, Kirk; Sittner, Kelley; Crawford, Devan; Welch-Lazoritz, Melissa; Habecker, Patrick; Khan, Bilal

2016-01-01

During the United States economic recession of 2008–2011, the number of homeless and unstably housed people in the United States increased considerably. Homeless adult women and unaccompanied homeless youth make up the most marginal segments of this population. Because homeless individuals are a hard to reach population, research into these marginal groups has traditionally been a challenge for researchers interested in substance abuse and mental health. Network analysis techniques and research strategies offer means for dealing with traditional challenges such as missing sampling frames, variation in definitions of homelessness and study inclusion criteria, and enumeration/population estimation procedures. This review focuses on the need for, and recent steps toward, solutions to these problems that involve network science strategies for data collection and analysis. Research from a range of fields is reviewed and organized according to a new stress process framework aimed at understanding how homeless status interacts with issues related to substance abuse and mental health. Three types of network innovation are discussed: network scale-up methods, a network ecology approach to social resources, and the integration of network variables into the proposed stress process model of homeless substance abuse and mental health. By employing network methods and integrating these methods into existing models, research on homeless and unstably housed women and unaccompanied young people can address existing research challenges and promote more effective intervention and care programs. PMID:28042394

Network Approaches to Substance Use and HIV/Hepatitis C Risk among Homeless Youth and Adult Women in the United States: A Review.

PubMed

Dombrowski, Kirk; Sittner, Kelley; Crawford, Devan; Welch-Lazoritz, Melissa; Habecker, Patrick; Khan, Bilal

2016-09-01

During the United States economic recession of 2008-2011, the number of homeless and unstably housed people in the United States increased considerably. Homeless adult women and unaccompanied homeless youth make up the most marginal segments of this population. Because homeless individuals are a hard to reach population, research into these marginal groups has traditionally been a challenge for researchers interested in substance abuse and mental health. Network analysis techniques and research strategies offer means for dealing with traditional challenges such as missing sampling frames, variation in definitions of homelessness and study inclusion criteria, and enumeration/population estimation procedures. This review focuses on the need for, and recent steps toward, solutions to these problems that involve network science strategies for data collection and analysis. Research from a range of fields is reviewed and organized according to a new stress process framework aimed at understanding how homeless status interacts with issues related to substance abuse and mental health. Three types of network innovation are discussed: network scale-up methods, a network ecology approach to social resources, and the integration of network variables into the proposed stress process model of homeless substance abuse and mental health. By employing network methods and integrating these methods into existing models, research on homeless and unstably housed women and unaccompanied young people can address existing research challenges and promote more effective intervention and care programs.

An Evaluation of Understandability of Patient Journey Models in Mental Health.

PubMed

Percival, Jennifer; McGregor, Carolyn

2016-07-28

There is a significant trend toward implementing health information technology to reduce administrative costs and improve patient care. Unfortunately, little awareness exists of the challenges of integrating information systems with existing clinical practice. The systematic integration of clinical processes with information system and health information technology can benefit the patients, staff, and the delivery of care. This paper presents a comparison of the degree of understandability of patient journey models. In particular, the authors demonstrate the value of a relatively new patient journey modeling technique called the Patient Journey Modeling Architecture (PaJMa) when compared with traditional manufacturing based process modeling tools. The paper also presents results from a small pilot case study that compared the usability of 5 modeling approaches in a mental health care environment. Five business process modeling techniques were used to represent a selected patient journey. A mix of both qualitative and quantitative methods was used to evaluate these models. Techniques included a focus group and survey to measure usability of the various models. The preliminary evaluation of the usability of the 5 modeling techniques has shown increased staff understanding of the representation of their processes and activities when presented with the models. Improved individual role identification throughout the models was also observed. The extended version of the PaJMa methodology provided the most clarity of information flows for clinicians. The extended version of PaJMa provided a significant improvement in the ease of interpretation for clinicians and increased the engagement with the modeling process. The use of color and its effectiveness in distinguishing the representation of roles was a key feature of the framework not present in other modeling approaches. Future research should focus on extending the pilot case study to a more diversified group of clinicians and health care support workers.

The experience of hepatitis C treatment for people with a history of mental health problems: An interpretative phenomenological analysis.

PubMed

Ware, K; Davies, J; Rowse, G; Whittaker, S

2015-07-01

This qualitative study explores the experience of hepatitis C virus treatment for people with pre-existing mental health problems within a large city hospital. Four men and four women with pre-existing mental health problems who had received hepatitis C virus treatment took part in semi-structured interviews which were analysed using interpretative phenomenological analysis. A central theme of 'Self, stigma and change' was identified which interlinked with three other main themes of 'Coping and responding to treatment', 'Connectedness to others' and 'The impact of information'. These themes and their sub-themes are discussed in relation to existing literature and clinical practice guidelines. © The Author(s) 2013.

Effects of enhanced foster care on the long-term physical and mental health of foster care alumni.

PubMed

Kessler, Ronald C; Pecora, Peter J; Williams, Jason; Hiripi, Eva; O'Brien, Kirk; English, Diana; White, James; Zerbe, Richard; Downs, A Chris; Plotnick, Robert; Hwang, Irving; Sampson, Nancy A

2008-06-01

Child maltreatment is a significant risk factor for adult mental disorders and physical illnesses. Although the child welfare system routinely places severely abused and/or neglected children in foster care, no controlled studies exist to determine the effectiveness of this intervention in improving the long-term health of maltreated youth. To present results of the first quasi-experimental study, to our knowledge, to evaluate the effects of expanded foster care treatment on the mental and physical health of adult foster care alumni. We used a quasi-experimental design to compare adult outcomes of alumni of a model private foster care program and 2 public programs. The latter alumni were eligible for but not selected by the private program because of limited openings. Propensity score weights based on intake records were adjusted for preplacement between-sample differences. Personal interviews administered 1 to 13 years after leaving foster care assessed the mental and physical health of alumni. A representative sample of 479 adult foster care alumni who were placed in foster care as adolescents (14-18 years of age) between January 1, 1989, and September 30, 1998, in private (n = 111) or public (n = 368) foster care programs in Oregon and Washington. More than 80% of alumni were traced, and 92.2% of those traced were interviewed. Caseworkers in the model program had higher levels of education and salaries, lower caseloads, and access to a wider range of ancillary services (eg, mental health counseling, tutoring, and summer camps) than caseworkers in the public programs. Youth in the model program were in foster care more than 2 years longer than those in the public programs. Private program alumni had significantly fewer mental disorders (major depression, anxiety disorders, and substance use disorders), ulcers, and cardiometabolic disorders, but more respiratory disorders, than did public program alumni. Public sector investment in higher-quality foster care services could substantially improve the long-term mental and physical health of foster care alumni.

Crazy like a fox. Validity and ethics of animal models of human psychiatric disease.

PubMed

Rollin, Michael D H; Rollin, Bernard E

2014-04-01

Animal models of human disease play a central role in modern biomedical science. Developing animal models for human mental illness presents unique practical and philosophical challenges. In this article we argue that (1) existing animal models of psychiatric disease are not valid, (2) attempts to model syndromes are undermined by current nosology, (3) models of symptoms are rife with circular logic and anthropomorphism, (4) any model must make unjustified assumptions about subjective experience, and (5) any model deemed valid would be inherently unethical, for if an animal adequately models human subjective experience, then there is no morally relevant difference between that animal and a human.

The Use of the Position Analysis Questionnaire in Selecting Correlates of Job Performance Among Mentally Retarded Workers

ERIC Educational Resources Information Center

And Others; Townsend, J. William

1974-01-01

The present study investigated the efficiency of various existing measures, mainly psychological tests, for predicting job performance of mentally retarded workers in a sheltered occupational shop. Results indicated that existing measures are predictive of performance on some but not all jobs in a sheltered workshop. (Author)

Mental Health and Social Emotional Programming in Schools: Missing Link or Misappropriation?

ERIC Educational Resources Information Center

Even, Trigg A.; Quast, Heather L.

2017-01-01

While differences of opinion exist on whether mental health services fall within the scope of public education, schools may represent the best opportunity to provide young people with necessary access to mental health care. Professional school counselors are uniquely qualified by training and experience to address the mental health and social…

Inferring a dual-stream model of mentalizing from associative white matter fibres disconnection.

PubMed

Herbet, Guillaume; Lafargue, Gilles; Bonnetblanc, François; Moritz-Gasser, Sylvie; Menjot de Champfleur, Nicolas; Duffau, Hugues

2014-03-01

In the field of cognitive neuroscience, it is increasingly accepted that mentalizing is subserved by a complex frontotemporoparietal cortical network. Some researchers consider that this network can be divided into two distinct but interacting subsystems (the mirror system and the mentalizing system per se), which respectively process low-level, perceptive-based aspects and high-level, inference-based aspects of this sociocognitive function. However, evidence for this type of functional dissociation in a given neuropsychological population is currently lacking and the structural connectivities of the two mentalizing subnetworks have not been established. Here, we studied mentalizing in a large sample of patients (n = 93; 46 females; age range: 18-65 years) who had been resected for diffuse low-grade glioma-a rare tumour that migrates preferentially along associative white matter pathways. This neurological disorder constitutes an ideal pathophysiological model in which to study the functional anatomy of associative pathways. We mapped the location of each patient's resection cavity and residual lesion infiltration onto the Montreal Neurological Institute template brain and then performed multilevel lesion analyses (including conventional voxel-based lesion-symptom mapping and subtraction lesion analyses). Importantly, we estimated each associative pathway's degree of disconnection (i.e. the degree of lesion infiltration) and built specific hypotheses concerning the connective anatomy of the mentalizing subnetworks. As expected, we found that impairments in mentalizing were mainly related to the disruption of right frontoparietal connectivity. More specifically, low-level and high-level mentalizing accuracy were correlated with the degree of disconnection in the arcuate fasciculus and the cingulum, respectively. To the best of our knowledge, our findings constitute the first experimental data on the structural connectivity of the mentalizing network and suggest the existence of a dual-stream hodological system. Our results may lead to a better understanding of disorders that affect social cognition, especially in neuropathological conditions characterized by atypical/aberrant structural connectivity, such as autism spectrum disorders.

Making mental health an integral part of sustainable development: the contribution of a social determinants framework.

PubMed

De Silva, M J

2015-04-01

There have been repeated calls to include mental health in the sustainable development goals (SDGs), arguing that progress in development will not be made without improvements in mental health. Although these calls are starting to gain political traction, currently only a tiny fraction of international development work includes mental health. A social determinants framework may be useful in incorporating mental health into sustainable development because it promotes a multi-sectorial and multi-disciplinary approach which is the corner stone of good development practice. Two approaches are suggested to make mental health a part of sustainable development: (1) integrate mental health into existing development programmes to promote social and economic environments that prevent mental health problems developing; (2) ensure that mental health programmes are better at promoting sustainable development by preventing the negative social and economic consequences of mental illness. Real-world examples of these approaches are provided. To achieve this, the mental health impact of wider development programmes, and the social and economic consequences of mental health interventions, must be evaluated. Development agencies should ensure that they have equity for mental health in all their policies, and investment must be increased for those mental health prevention, promotion and treatment programmes which have the greatest impact on sustainable development. The SDGs bring the promise of a more holistic approach to development. It is now the task of global mental health to demonstrate not just that mental health is an integral part of sustainable development, but that affordable and effective solutions exist which can improve mental health and development more broadly.

Mental Health and Mental Disorder Recommendation Programs

PubMed Central

Ruchiwit, Manyat

2017-01-01

Background: The characteristic differences among the Greater Mekong Subregion (GMS) countries in terms of trade and investment, society and cultural values, medical information and technology, and the living and working environment have become major health problems in terms of mental disorders. The purpose of this article is to identify the gaps in those aspects, to propose mental health and mental disorder recommendation programs, and to recommend policies for policy makers and research investors. Methods: A comparative analysis and literature review of existing policy, including overviews of previous research were used to generate a synthesis of the existing knowledge of the mental health and mental disorder recommendation programs. Results: The review results recommend mental health and mental disorder programs for policy makers, research investors, and stakeholders in order to strengthen the directions for implementing these programs in the future. Conclusion: The healthcare provision in each country will not be limited only to its citizens; the healthcare markets and target groups are likely to expand to the neighboring countries in the context of changes in domestic and international factors, which have both positive and negative impacts according to the political, economic, and social situations of the influencing countries.

Mental Health and Mental Disorder Recommendation Programs

PubMed Central

Ruchiwit, Manyat

2017-01-01

Background: The characteristic differences among the Greater Mekong Subregion (GMS) countries in terms of trade and investment, society and cultural values, medical information and technology, and the living and working environ-ment have become major health problems in terms of mental disorders. The purpose of this article is to identify the gaps in those aspects, to propose mental health and mental disorder recommendation programs, and to recommend policies for policy makers and research investors. Methods: A comparative analysis and literature review of existing policy, including overviews of previous research were used to generate a synthesis of the existing knowledge of the mental health and mental disorder recommendation programs. Results: The review results recommend mental health and mental disorder programs for policy makers, research investors, and stakeholders in order to strengthen the directions for implementing these programs in the future. Conclusion: The healthcare provision in each country will not be limited only to its citizens; the healthcare markets and tar-get groups are likely to expand to the neighboring countries in the context of changes in domestic and international factors, which have both positive and negative impacts according to the political, economic, and social situations of the influencing countries.

Does an immigrant health paradox exist among Asian Americans? Associations of nativity and occupational class with self-rated health and mental disorders

PubMed Central

John, Dolly A.; de Castro, A.B.; Martin, Diane P.; Duran, Bonnie; Takeuchi, David T.

2017-01-01

A robust socioeconomic gradient in health is well-documented, with higher socioeconomic status (SES) associated with better health across the SES spectrum. However, recent studies of U.S. racial/ethnic minorities and immigrants show complex SES-health patterns (e.g., flat gradients), with individuals of low SES having similar or better health than their richer, U.S.-born and more acculturated counterparts, a so-called “epidemiological paradox” or “immigrant health paradox”. To examine whether this exists among Asian Americans, we investigate how nativity and occupational class (white-collar, blue-collar, service, unemployed) are associated with subjective health (self-rated physical health, self-rated mental health) and 12-month DSM-IV mental disorders (any mental disorder, anxiety, depression). We analyzed data from 1530 Asian respondents to the 2002–2003 National Latino and Asian American Study in the labor force using hierarchical multivariate logistic regression models controlling for confounders, subjective social status (SSS), material and psychosocial factors theorized to explain health inequalities. Compared to U.S.-born Asians, immigrants had worse socioeconomic profiles, and controlling for age and gender, increased odds for reporting fair/poor mental health and decreased odds for any DSM-IV mental disorder and anxiety. No strong occupational class-health gradients were found. The foreign-born health-protective effect persisted after controlling for SSS but became nonsignificant after controlling for material and psychosocial factors. Speaking fair/poor English was strongly associated with all outcomes. Material and psychosocial factors were associated with some outcomes – perceived financial need with subjective health, uninsurance with self-rated mental health and depression, social support, discrimination and acculturative stress with all or most DSM-IV outcomes. Our findings caution against using terms like “immigrant health paradox” which oversimplify complex patterns and mask negative outcomes among underserved sub-groups (e.g., speaking fair/poor English, experiencing acculturative stress). We discuss implications for better measurement of SES and health given the absence of a gradient and seemingly contradictory finding of nativity-related differences in self-rated health and DSM-IV mental disorders. PMID:22503561

Does an immigrant health paradox exist among Asian Americans? Associations of nativity and occupational class with self-rated health and mental disorders.

PubMed

John, Dolly A; de Castro, A B; Martin, Diane P; Duran, Bonnie; Takeuchi, David T

2012-12-01

A robust socioeconomic gradient in health is well-documented, with higher socioeconomic status (SES) associated with better health across the SES spectrum. However, recent studies of U.S. racial/ethnic minorities and immigrants show complex SES-health patterns (e.g., flat gradients), with individuals of low SES having similar or better health than their richer, U.S.-born and more acculturated counterparts, a so-called "epidemiological paradox" or "immigrant health paradox". To examine whether this exists among Asian Americans, we investigate how nativity and occupational class (white-collar, blue-collar, service, unemployed) are associated with subjective health (self-rated physical health, self-rated mental health) and 12-month DSM-IV mental disorders (any mental disorder, anxiety, depression). We analyzed data from 1530 Asian respondents to the 2002-2003 National Latino and Asian American Study in the labor force using hierarchical multivariate logistic regression models controlling for confounders, subjective social status (SSS), material and psychosocial factors theorized to explain health inequalities. Compared to U.S.-born Asians, immigrants had worse socioeconomic profiles, and controlling for age and gender, increased odds for reporting fair/poor mental health and decreased odds for any DSM-IV mental disorder and anxiety. No strong occupational class-health gradients were found. The foreign-born health-protective effect persisted after controlling for SSS but became nonsignificant after controlling for material and psychosocial factors. Speaking fair/poor English was strongly associated with all outcomes. Material and psychosocial factors were associated with some outcomes--perceived financial need with subjective health, uninsurance with self-rated mental health and depression, social support, discrimination and acculturative stress with all or most DSM-IV outcomes. Our findings caution against using terms like "immigrant health paradox" which oversimplify complex patterns and mask negative outcomes among underserved sub-groups (e.g., speaking fair/poor English, experiencing acculturative stress). We discuss implications for better measurement of SES and health given the absence of a gradient and seemingly contradictory finding of nativity-related differences in self-rated health and DSM-IV mental disorders. Copyright © 2012 Elsevier Ltd. All rights reserved.

Environmental Quality Index and Childhood Mental Health

EPA Science Inventory

Childhood mental disorders affect between 13%-20% of children in the United States (US) annually and impact the child, family, and community. Literature suggests associations exist between environmental and children’s mental health such as air pollution with autism and ADHD...

Mammography Among Women With Severe Mental Illness: Exploring Disparities Through a Large Retrospective Cohort Study.

PubMed

Thomas, Melanie; James, Monique; Vittinghoff, Eric; Creasman, Jennifer M; Schillinger, Dean; Mangurian, Christina

2018-01-01

This study examined mammogram screening rates among women with severe mental illness by using a socioecological framework. Because it has been shown that people with severe mental illness receive less preventive health care overall, the analysis included psychosocial predictors of mammogram screening rates in a cohort of women with severe mental illness. This retrospective cohort study (N=14,651) used existing statewide data for women ages 48-67 in California with Medicaid insurance who received treatment in the specialty mental health care system. The primary outcome of interest was evidence of breast cancer screening via mammogram. The associations of each predictor of interest with mammogram screening were evaluated by using Poisson models with robust standard errors. Across all demographic and diagnostic categories, rates of breast cancer screening in this cohort of women with severe mental illness fell below the national average. Only 26.3% (3,859/14,651) of women in the cohort received breast cancer screening in the past year. This study replicated previous findings that women with schizophrenia spectrum disorder and those with a comorbid substance use disorder are less likely to receive screening than those with other types of mental illness. In this cohort of women with severe mental illness, evidence of nonpsychiatric health care utilization was strongly associated with breast cancer screening (adjusted risk ratio=3.30, 95% confidence interval=2.61-4.16, p<.001). The findings can inform efforts to improve breast cancer screening among women with severe mental illness, such as targeted outreach to population subsets and colocation of primary care services in mental health treatment settings.

Development and preliminary evaluation of culturally specific web-based intervention for parents of adolescents.

PubMed

Choi, H; Kim, S; Ko, H; Kim, Y; Park, C G

2016-10-01

WHAT IS KNOWN ON THE SUBJECT?: Problematic parent-child relationships have been identified as one of the main predictors of adolescents' mental health problems, but there are few existing interventions that address this issue. The format and delivery method of existing interventions for parents are relatively inaccessible for parents with full-time jobs and families living in rural areas. WHAT DOES THIS PAPER ADD TO EXISTING KNOWLEDGE?: The newly developed 'Stepping Stone' culturally specific web-based intervention, which is intended to help Korean parents of adolescents to acquire both knowledge and communication and conflict management skills, was found to be feasible and well-accepted by parents. This study enabled us to identify areas for improvement in the content and format of the intervention and strategies. This will potentially increase effect sizes for the outcome variables of parents' perception and behaviours. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: This web-based intervention could be delivered across diverse settings, such as schools and community mental health centers, to increase parents' knowledge of adolescent's mental health and allow for early detection of mental health problems. Mental health nurses working in schools may spend a significant amount of time addressing students' mental health issues; thus, this web-based intervention could be a useful resource to share with parents and children. In this way, the mental health nurses could facilitate parental engagement in the intervention and then help them to continue to apply and practice the knowledge and skills obtained through the program. Introduction There is a need for accessible, culturally specific web-based interventions to address parent-child relationships and adolescents' mental health. Aims This study developed and conducted a preliminary evaluation of a 4-week web-based intervention for parents of adolescents aged 11 to 16 years in Korea. Methods We used a two-group, repeated measures, quasi-experimental study design to assess the feasibility of developing and implementing a web-based intervention for parents. Descriptive statistics, chi-square and t tests, and mixed effect modeling were used for data analysis. Results The intervention and 1-month follow-up survey were completed by 47 parents in the intervention group and 46 parents in the attention control (AC) group. The intervention was found to be feasible and well-accepted by parents. Discussion This culturally specific web-based intervention is a useful tool for knowledge dissemination among large numbers of parents. Areas for improvement in the content and format of the intervention and strategies to elicit significant parent-child interactions are provided. Implications for practice and conclusion The intervention could be disseminated in collaboration with mental health nurses working in schools to facilitate parents' participation. © 2016 John Wiley & Sons Ltd.

Experiences of the bereaved in connection with the suicide of young men.

PubMed

Rasmussen, Mette Lyberg; Dieserud, Gudrun

2018-02-06

On average 110 men under 35 years of age take their own lives in Norway each year. Few receive health assistance in the period prior to the suicide, and little research exists on contact with assistance agencies for persons who take their own lives, beyond studies of the number of doctor visits before the death. This study aimed to obtain knowledge of relatives' need for assistance from the health services, both to identify suicide risk and motivate them to seek help in life crises. Sixty-one in-depth interviews with the bereaved next of kin of young men (18-30 years) were analysed using interpretative phenomenological analysis. The bereaved perceived the generally accepted assumption that suicide is attributable to mental illness as an obstacle to identifying suicide risk. Most of the bereaved saw no signs of mental illness before the suicide. The suicide crisis was associated with relational factors. The bereaved who had harboured the thought that a suicide risk existed found that it was not enough to urge the suicidal person to seek health assistance. Improved knowledge of suicide and seeking health assistance were measures that were proposed. The findings challenge the current prevention model. Healthcare personnel as well as the general population should be better informed that mental illness is neither a sufficient nor a necessary factor to explain suicide, even though a higher risk of suicide is associated with some mental disorders.

Mental Health: A Report of the Surgeon General. Executive Summary.

ERIC Educational Resources Information Center

Substance Abuse and Mental Health Services Administration (DHHS/PHS), Rockville, MD. Center for Mental Health Services.

This first Report of the Surgeon General on Mental Health represents the initial step in advancing the notion that mental health is fundamental to general health. It states that a review of research on mental health revealed two findings. First, the efficacy of treatment is well documented, and second, a range of treatment exists for most mental…

An Examination of Mental Health Content in Course Work and Field Experiences in Connecticut Educational Leadership Preparation Programs

ERIC Educational Resources Information Center

Papa, Dorothy P.

2017-01-01

This exploratory mixed method convergent parallel study examined Connecticut Educational leadership preparation programs for the existence of mental health content to learn the extent to which pre-service school leaders are prepared for addressing student mental health. Interviews were conducted with school mental health experts and Connecticut…

Previous Violent Events and Mental Health Outcomes in Guatemala

PubMed Central

Puac-Polanco, Victor D.; Lopez-Soto, Victor A.; Kohn, Robert; Xie, Dawei; Richmond, Therese S.

2015-01-01

Objectives. We analyzed a probability sample of Guatemalans to determine if a relationship exists between previous violent events and development of mental health outcomes in various sociodemographic groups, as well as during and after the Guatemalan Civil War. Methods. We used regression modeling, an interaction test, and complex survey design adjustments to estimate prevalences and test potential relationships between previous violent events and mental health. Results. Many (20.6%) participants experienced at least 1 previous serious violent event. Witnessing someone severely injured or killed was the most common event. Depression was experienced by 4.2% of participants, with 6.5% experiencing anxiety, 6.4% an alcohol-related disorder, and 1.9% posttraumatic stress disorder (PTSD). Persons who experienced violence during the war had 4.3 times the adjusted odds of alcohol-related disorders (P < .05) and 4.0 times the adjusted odds of PTSD (P < .05) compared with the postwar period. Women, indigenous Maya, and urban dwellers had greater odds of experiencing postviolence mental health outcomes. Conclusions. Violence that began during the civil war and continues today has had a significant effect on the mental health of Guatemalans. However, mental health outcomes resulting from violent events decreased in the postwar period, suggesting a nation in recovery. PMID:25713973

A Systematic Review of Interventions to Improve Initiation of Mental Health Care Among Racial-Ethnic Minority Groups.

PubMed

Lee-Tauler, Su Yeon; Eun, John; Corbett, Dawn; Collins, Pamela Y

2018-06-01

The objective of this systematic review was to identify interventions to improve the initiation of mental health care among racial-ethnic minority groups. The authors searched three electronic databases in February 2016 and independently assessed eligibility of 2,065 titles and abstracts on the basis of three criteria: the study design included an intervention, the participants were members of racial-ethnic minority groups and lived in the United States, and the outcome measures included initial access to or attitudes toward mental health care. The qualitative synthesis involved 29 studies. Interventions identified included collaborative care (N=10), psychoeducation (N=7), case management (N=5), colocation of mental health services within existing services (N=4), screening and referral (N=2), and a change in Medicare medication reimbursement policy that served as a natural experiment (N=1). Reduction of disparities in the initiation of antidepressants or psychotherapy was noted in seven interventions (four involving collaborative care, two involving colocation of mental health services, and one involving screening and referral). Five of these disparities-reducing interventions were tested among older adults only. Most (N=23) interventions incorporated adaptations designed to address social or cultural barriers to care. Interventions that used a model of integrated care reduced racial-ethnic disparities in the initiation of mental health care.

Are implicit policy assumptions about climate adaptation trying to push drinking water utilities down an impossible path?

NASA Astrophysics Data System (ADS)

Klasic, M. R.; Ekstrom, J.; Bedsworth, L. W.; Baker, Z.

2017-12-01

Extreme events such as wildfires, droughts, and flooding are projected to be more frequent and intense under a changing climate, increasing challenges to water quality management. To protect and improve public health, drinking water utility managers need to understand and plan for climate change and extreme events. This three year study began with the assumption that improved climate projections were key to advancing climate adaptation at the local level. Through a survey (N = 259) and interviews (N = 61) with California drinking water utility managers during the peak of the state's recent drought, we found that scientific information was not a key barrier hindering adaptation. Instead, we found that managers fell into three distinct mental models based on their interaction with, perceptions, and attitudes, towards scientific information and the future of water in their system. One of the mental models, "modeled futures", is a concept most in line with how climate change scientists talk about the use of information. Drinking water utilities falling into the "modeled future" category tend to be larger systems that have adequate capacity to both receive and use scientific information. Medium and smaller utilities in California, that more often serve rural low income communities, tend to fall into the other two mental models, "whose future" and "no future". We show evidence that there is an implicit presumption that all drinking water utility managers should strive to align with "modeled future" mental models. This presentation questions this assumption as it leaves behind many utilities that need to adapt to climate change (several thousand in California alone), but may not have the technical, financial, managerial, or other capacity to do so. It is clear that no single solution or pathway to drought resilience exists for water utilities, but we argue that a more explicit understanding and definition of what it means to be a resilient drinking water utility is necessary. By highlighting, then questioning, the assumption that all utility managers should strive to have "modeled future" mentalities, this presentation seeks to foster an open dialogue around which pathway or pathways are most feasible for supporting drinking water utility managers planning for climate change.

Predicting the impact of the 2011 conflict in Libya on population mental health: PTSD and depression prevalence and mental health service requirements.

PubMed

Charlson, Fiona J; Steel, Zachary; Degenhardt, Louisa; Chey, Tien; Silove, Derrick; Marnane, Claire; Whiteford, Harvey A

2012-01-01

Mental disorders are likely to be elevated in the Libyan population during the post-conflict period. We estimated cases of severe PTSD and depression and related health service requirements using modelling from existing epidemiological data and current recommended mental health service targets in low and middle income countries (LMIC's). Post-conflict prevalence estimates were derived from models based on a previously conducted systematic review and meta-regression analysis of mental health among populations living in conflict. Political terror ratings and intensity of exposure to traumatic events were used in predictive models. Prevalence of severe cases was applied to chosen populations along with uncertainty ranges. Six populations deemed to be affected by the conflict were chosen for modelling: Misrata (population of 444,812), Benghazi (pop. 674,094), Zintan (pop. 40,000), displaced people within Tripoli/Zlitan (pop. 49,000), displaced people within Misrata (pop. 25,000) and Ras Jdir camps (pop. 3,700). Proposed targets for service coverage, resource utilisation and full-time equivalent staffing for management of severe cases of major depression and post-traumatic stress disorder (PTSD) are based on a published model for LMIC's. Severe PTSD prevalence in populations exposed to a high level of political terror and traumatic events was estimated at 12.4% (95%CI 8.5-16.7) and was 19.8% (95%CI 14.0-26.3) for severe depression. Across all six populations (total population 1,236,600), the conflict could be associated with 123,200 (71,600-182,400) cases of severe PTSD and 228,100 (134,000-344,200) cases of severe depression; 50% of PTSD cases were estimated to co-occur with severe depression. Based upon service coverage targets, approximately 154 full-time equivalent staff would be required to respond to these cases sufficiently which is substantially below the current level of resource estimates for these regions. This is the first attempt to predict the mental health burden and consequent service response needs of such a conflict, and is crucially timed for Libya.

Predicting the Impact of the 2011 Conflict in Libya on Population Mental Health: PTSD and Depression Prevalence and Mental Health Service Requirements

PubMed Central

Charlson, Fiona J.; Steel, Zachary; Degenhardt, Louisa; Chey, Tien; Silove, Derrick; Marnane, Claire; Whiteford, Harvey A.

2012-01-01

Background Mental disorders are likely to be elevated in the Libyan population during the post-conflict period. We estimated cases of severe PTSD and depression and related health service requirements using modelling from existing epidemiological data and current recommended mental health service targets in low and middle income countries (LMIC’s). Methods Post-conflict prevalence estimates were derived from models based on a previously conducted systematic review and meta-regression analysis of mental health among populations living in conflict. Political terror ratings and intensity of exposure to traumatic events were used in predictive models. Prevalence of severe cases was applied to chosen populations along with uncertainty ranges. Six populations deemed to be affected by the conflict were chosen for modelling: Misrata (population of 444,812), Benghazi (pop. 674,094), Zintan (pop. 40,000), displaced people within Tripoli/Zlitan (pop. 49,000), displaced people within Misrata (pop. 25,000) and Ras Jdir camps (pop. 3,700). Proposed targets for service coverage, resource utilisation and full-time equivalent staffing for management of severe cases of major depression and post-traumatic stress disorder (PTSD) are based on a published model for LMIC’s. Findings Severe PTSD prevalence in populations exposed to a high level of political terror and traumatic events was estimated at 12.4% (95%CI 8.5–16.7) and was 19.8% (95%CI 14.0–26.3) for severe depression. Across all six populations (total population 1,236,600), the conflict could be associated with 123,200 (71,600–182,400) cases of severe PTSD and 228,100 (134,000–344,200) cases of severe depression; 50% of PTSD cases were estimated to co-occur with severe depression. Based upon service coverage targets, approximately 154 full-time equivalent staff would be required to respond to these cases sufficiently which is substantially below the current level of resource estimates for these regions. Discussion This is the first attempt to predict the mental health burden and consequent service response needs of such a conflict, and is crucially timed for Libya. PMID:22808201

Implementing practice guidelines: lessons from public mental health settings.

PubMed

Parks, Joseph J

2007-01-01

There is evidence that state-of-the-art psychiatric treatments are not being translated into community settings, resulting in the de facto denial of up-to-date psychiatric care for many Americans with mental illness. Although multiple models of evidence-based care exist, little is known about how to disseminate information regarding these models to clinicians in real-world practice. Suggested solutions have included the use of published practice guidelines, such as the American Psychiatric Association Practice Guidelines and the Expert Consensus Guidelines, or algorithm-based programs, such as the Texas Medication Algorithm Project. Unfortunately, the real-world utility of practice guidelines tends to be limited, because their implementation depends entirely on practitioner self-motivation. Similarly, the use of algorithm-based programs may be limited by their pervasive high specificity, practitioner resistance, and various patient misperceptions. Another solution is the implementation of evidence-based practices (EBPs), such as the Substance Abuse and Mental Health Services Administration (SAMHSA) EBPs. However, states' use of the SAMHSA EBPs has been hampered by misalignment of the funding structure, lack of information regarding EBPs, high costs to train and supervise staff, staff turnover, and a lack of resources. As a result, federal and clinical/professional agencies have called for a change in the nation's mental health care delivery system, supplying persuasive arguments for the economic and clinical superiority of integrated care models. One such model, the Missouri Medical Risk Management (MRM) Program for Medicaid Recipients with Schizophrenia, currently assists patients identified as being at high risk for adverse medical and behavioral outcomes. Preliminary results from the Missouri MRM Program are described.

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.

Workplace satisfaction in a mental health service for older adults: an analysis of the effects of setting and professional status.

PubMed

McCrae, Niall; Prior, Sue; Silverman, Marisa; Banerjee, Sube

2007-02-01

Research in mental health services for working-age adults has repeatedly shown that work is found more satisfying, if more stressful, by community practitioners than by hospital-based staff. This study examined whether similar differences exist in services for older adults and how this might be influenced by the high proportion of nonprofessionally qualified workers in inpatient settings for mentally infirm older people. The Work Environment Scale was given to all practitioners in a mental health service for older adults in a single London borough. Adjusting for the effect of professional status, community practitioners rated involvement, task orientation, and supervision more positively than institutional staff, but gave less favorable ratings for work pressure and physical comfort. Nurses rated peer cohesion, supervision, autonomy, and innovation more positively than nursing assistants, after controlling for type of setting. Multivariate modeling confirmed that type of setting and professional group were both associated with workplace satisfaction, accounting for 24% and 13% of the variance, respectively. The study highlights aspects of the work environment of mental health staff working with older adults that might benefit from attention.

Acculturation differences in communicating information about child mental health between Latino parents and primary care providers.

PubMed

Lê Cook, Benjamin; Brown, Jonathan D; Loder, Stephen; Wissow, Larry

2014-12-01

Significant Latino-white disparities in youth mental health care access and quality exist yet little is known about Latino parents' communication with providers about youth mental health and the role of acculturation in influencing this communication. We estimated regression models to assess the association between time in the US and the number of psychosocial issues discussed with the medical assistant (MA) and doctor, adjusting for child and parent mental health and sociodemographics. Other proxies of acculturation were also investigated including measures of Spanish and English language proficiency and nativity. Parent's length of time in the US was positively associated with their communication of: their child's psychosocial problems with their child's MA, stress in their own life with their child's MA, and their child's school problems with their child's doctor. These differences were especially apparent for parents living in the US for >10 years. Parent-child language discordance, parent and child nativity were also significantly associated with communication of psychosocial problems. Greater provider and MA awareness of variation in resistance to communicating psychosocial issues could improve communication, and improve the prevention, diagnosis and treatment of youth mental illness.

The role of internet technology and social branding in improving the mental health and wellbeing of young people.

PubMed

Nicholas, Jonathan

2010-03-01

With large numbers of young people experiencing mental health difficulties but not seeking help, there is a need to develop not only innovative but also well-promoted strategies that are appealing to this population and reduce barriers to help seeking. Reach Out! (http://www.reachout.com.au) is presented as a case study, demonstrating an internet-based initiative that sucessfully incorporates technology and social branding to provide a service that promotes the mental health and wellbeing of young people in Australia aged 16 to 25. With over seven million visits since its launch in 1998 and one in three young Australians aware of the website, Reach Out! is a trusted service that young people in Australia use when going through a tough time. Online user profiling suggests that after visiting Reach Out!, 38% of young people contact a mental health professional. The implications of these results will be discussed. Reach Out! can serve as a model for the social sector to utilize technology and social branding to enhance existing community-based services and promote the mental health and wellbeing of young people.

Understanding the mental lexicon through neglect dyslexia: a study on compound noun reading.

PubMed

Marelli, Marco; Aggujaro, Silvia; Molteni, Franco; Luzzatti, Claudio

2013-04-01

The present study employs neglect dyslexia (ND) as an experimental model to study compound-word processing; in particular, it investigates whether compound constituents are hierarchically organized at mental level and addresses the possibility of whole-word representation. Seven Italian-speaking patients suffering from ND participated in a word naming task. Both left-headed (pescespada, swordfish) and right-headed (astronave, spaceship) Italian compound nouns were used as stimuli. Non-existent compounds, which were generated by substituting the leftmost constituent of a compound with an orthographically similar word (e.g., *pestespada, *plaguesword), were also employed. A significant headedness effect emerged in the group analysis: patients read left-headed compounds better than right-headed compounds. A significant lexicality effect was also found: the participants read real compounds better than their non-existent compound pairs. Moreover, logit mixed-effects analyses indicated a left-hand constituent frequency effect. Results are discussed in terms of hierarchical representation of compounds and direct access to compound lemma nodes.

Racial/Ethnic Disparities in the Mental Health Care Utilization of Fifth Grade Children

PubMed Central

Coker, Tumaini R.; Elliott, Marc N.; Kataoka, Sheryl; Schwebel, David C.; Mrug, Sylvie; Grunbaum, Jo Anne; Cuccaro, Paula; Peskin, Melissa F.; Schuster, Mark A.

2015-01-01

Objective The aim of this study was to examine racial/ethnic differences in fifth grade children’s mental health care utilization. Methods We analyzed cross-sectional data from a study of 5147 fifth graders and their parents in 3 US metropolitan areas from 2004–06. Multivariate logistic regression was used to examine racial/ethnic differences in mental health care utilization. Results Nine percent of parents reported that their child had ever used mental health care services; fewer black (6%) and Hispanic (8%) children had used services than white children (14%). Fewer black and Hispanic children with recent symptoms of attention-deficit/hyperactivity disorder, oppositional defiant disorder, and conduct disorder, and fewer black children with symptoms of depression had ever utilized services compared with white children. In multivariate analyses controlling for demographic factors, parental mental health, social support, and symptoms of the 4 mental health conditions, we found that black children were less likely than white children to have ever used services (Odds ratio [OR] 0.3, 95% confidence interval [95% CI], 0.2–0.4, P <.001). The odds ratio for black children remained virtually unchanged when the analysis was restricted to children with symptoms of ≥1 mental health condition, and when the analysis was stratified by mental health condition. The difference in utilization for Hispanic compared with white children was fully explained by sociodemographics in all multivariate models. Conclusions Disparities exist in mental health care utilization for black and Hispanic children; the disparity for black children is independent of sociodemographics and child mental health need. Efforts to reduce this disparity may benefit from addressing not only access and diagnosis issues, but also parents’ help-seeking preferences for mental health care for their children. PMID:19329099

Using near infrared spectroscopy and heart rate variability to detect mental overload.

PubMed

Durantin, G; Gagnon, J-F; Tremblay, S; Dehais, F

2014-02-01

Mental workload is a key factor influencing the occurrence of human error, especially during piloting and remotely operated vehicle (ROV) operations, where safety depends on the ability of pilots to act appropriately. In particular, excessively high or low mental workload can lead operators to neglect critical information. The objective of the present study is to investigate the potential of functional near infrared spectroscopy (fNIRS) - a non-invasive method of measuring prefrontal cortex activity - in combination with measurements of heart rate variability (HRV), to predict mental workload during a simulated piloting task, with particular regard to task engagement and disengagement. Twelve volunteers performed a computer-based piloting task in which they were asked to follow a dynamic target with their aircraft, a task designed to replicate key cognitive demands associated with real life ROV operating tasks. In order to cover a wide range of mental workload levels, task difficulty was manipulated in terms of processing load and difficulty of control - two critical sources of workload associated with piloting and remotely operating a vehicle. Results show that both fNIRS and HRV are sensitive to different levels of mental workload; notably, lower prefrontal activation as well as a lower LF/HF ratio at the highest level of difficulty, suggest that these measures are suitable for mental overload detection. Moreover, these latter measurements point toward the existence of a quadratic model of mental workload. Copyright © 2013 Elsevier B.V. All rights reserved.

A Longitudinal Investigation of Syndemic Conditions Among Young Gay, Bisexual, and Other MSM: The P18 Cohort Study.

PubMed

Halkitis, Perry N; Kapadia, Farzana; Bub, Kristen L; Barton, Staci; Moreira, Alvaro D; Stults, Christopher B

2015-06-01

The persistence of disparities in STI/HIV risk among a new generation of emerging adult gay, bisexual, and other men who have sex with men (YMSM) warrant holistic frameworks and new methodologies for investigating the behaviors related to STI/HIV in this group. In order to better understand the continued existence of these disparities in STI/HIV risk among YMSM, the present study evaluated the presence and persistence of syndemic conditions among YMSM by examining the co-occurrence of alcohol and drug use, unprotected sexual behavior, and mental health burden over time. Four waves of data, collected over the first 18 months of a 7 wave, 36-month prospective cohort study of YMSM (n=600) were used to examine the extent to which measurement models of drug use, unprotected sexual behavior, and mental health burden remained consistent across time using latent class modeling. Health challenges persisted across time as these YMSM emerged into young adulthood and the measurement models for the latent constructs of drug use and unprotected sexual behavior were essentially consistent across time whereas models for mental health burden varied over time. In addition to confirming the the robustness of our measurement models which capture a more holistic understandings of the health conditions of drug use, unprotected sex, and mental health burden, these findings underscore the ongoing health challenges YMSM face as they mature into young adulthood. These ongoing health challenges, which have been understood as forming a syndemic, persist over time, and add further evidence to support ongoing and vigilant comprehensive health programming for sexual minority men that move beyond a sole focus on HIV.

A longitudinal investigation of syndemic conditions among young gay, bisexual, and other MSM: The P18 Cohort Study

PubMed Central

Halkitis, Perry N.; Kapadia, Farzana; Bub, Kristen L.; Barton, Staci; Moreira, Alvaro D.; Stults, Christopher B.

2014-01-01

The persistence of disparities in STI/HIV risk among a new generation of emerging adult gay, bisexual, and other men who have sex with men (YMSM) warrant holistic frameworks and new methodologies for investigating the behaviors related to STI/HIV in this group. In order to better understand the continued existence of these disparities in STI/HIV risk among YMSM, the present study evaluated the presence and persistence of syndemic conditions among YMSM by examining the co-occurrence of alcohol and drug use, unprotected sexual behavior, and mental health burden over time. Four waves of data, collected over the first 18 months of a 7 wave, 36-month prospective cohort study of YMSM (n=598) were used to examine the extent to which measurement models of drug use, unprotected sexual behavior, and mental health burden remained consistent across time using latent class modeling. Health challenges persisted across time as these YMSM emerged into young adulthood and the measurement models for the latent constructs of drug use and unprotected sexual behavior were essentially consistent across time whereas models for mental health burden varied over time. In addition to confirming the the robustness of our measurement models which capture a more holistic understandings of the health conditions of drug use, unprotected sex, and mental health burden, these findings underscore the ongoing health challenges YMSM face as they mature into young adulthood. These ongoing health challenges, which have been understood as forming a syndemic, persist over time, and add further evidence to support ongoing and vigilant comprehensive health programming for sexual minority men that move beyond a sole focus on HIV. PMID:25192900

Golden roots to golden fruits of mental health in Gujarat.

PubMed

Mehta, Ritambhara; Shah, Anil; Vankar, G K; Chauhan, Ajay; Bakre, Ravindra

2018-02-01

Through the behavioral descriptions in age-old texts it is obvious that Mental Health problems exist since the existence of Homo Sapiens and humanity, with ever changing norms, contexts, definitions and hence their management. Gujarat state of India is one of the oldest land plateaus existing. It has been inhabited, ruled and governed by many different people, races, kings; and invaded through its longest sea-coast by Dutch, Portuguese, British. Even after freedom of India in 1947, Gujarat emerged as a separate state in 1960 only. The history of Mental Health, before being a separate state, could be summed up in 2 Mental Hospitals started by British governance and 2 very unique institutions. Post NMHP, there has been a tremendous growth in the sector, supported by many leaders in the governance. This is an attempt to review some documented and some gathered information from dependable sources, from pre-independence colonial era, post-independence and post-statehood contemporary period.

[The model program of psycho-social treatment and staff training].

PubMed

Ikebuchi, Emi

2012-01-01

The model program of psycho-social treatment and staff training were reported in this issue. The mission of model program is supporting recovery of persons with mental illness and their family as well as empowering their hope and sense of values. The personal support specialists belonging to multi-disciplinary team have responsibility to support life-long process of recovery across hospitalization, out-patients clinic, day treatment, and outreach service. The shared value of multi-disciplinary team (the community life supporting team) is recovery so that the team renders self directive life, various alternatives of their lives, and peer group with models of recovery to persons with mental illness. There should be several technologies which are used in the team such as engagement, psycho-education, cognitive-behavior therapy, care-management, cooperating with other resources. The responsibility, assessment and evaluation techniques, guarantee of opportunities for training, and auditing system of the team and process of treatment are important factors to educate team staff. Raising effective multi-disciplinary team requires existence of a mentor or good model near the team.

Sterilization of the Mentally Ill and the Mentally Retarded.

ERIC Educational Resources Information Center

National Association of State Mental Health Program Directors, Washington, DC.

Reported were the results of a survey on the sterilization of the mentally ill and the mentally retarded. Thirty-three states responded to the survey. It was found that 17 states have a sterilization statute, but the existence of the statute was explained not to mean that the procedure was used. Sixteen states responded that they did not have a…

Psychiatry, mental health nurses, and invisible power: Exploring a perturbed relationship within contemporary mental health care.

PubMed

Cutcliffe, John; Happell, Brenda

2009-04-01

Interpersonal relationships, although considered to be the cornerstone of therapeutic engagement, are replete with issues of power; yet, the concept of 'invisible power' within such formal mental health care relationships is seldom explored and/or critiqued in the literature. This paper involves an examination of power in the interpersonal relationship between the mental health nurse and the consumer. Issues of power are emphasized by drawing on examples from clinical experiences, each of which is then deconstructed as an analytical means to uncover the different layers of power. This examination highlights the existence of both obscure and seldomly acknowledged invisible manifestations of power that are inherent in psychiatry and interpersonal mental health nursing. It also identifies that there is an orthodoxy of formal mental health care that perhaps is best described as 'biopsychiatry' (or 'traditional psychiatry'). Within this are numerous serious speech acts and these provide the power for mental health practitioners to act in particular ways, to exercise control. The authors challenge this convention as the only viable discourse: a potentially viable alternative to the current of formal mental health care does exist and, most importantly, this alternative is less tied to the use of invisible power.

Moral judgment as information processing: an integrative review.

PubMed

Guglielmo, Steve

2015-01-01

How do humans make moral judgments about others' behavior? This article reviews dominant models of moral judgment, organizing them within an overarching framework of information processing. This framework poses two distinct questions: (1) What input information guides moral judgments? and (2) What psychological processes generate these judgments? Information Models address the first question, identifying critical information elements (including causality, intentionality, and mental states) that shape moral judgments. A subclass of Biased Information Models holds that perceptions of these information elements are themselves driven by prior moral judgments. Processing Models address the second question, and existing models have focused on the relative contribution of intuitive versus deliberative processes. This review organizes existing moral judgment models within this framework and critically evaluates them on empirical and theoretical grounds; it then outlines a general integrative model grounded in information processing, and concludes with conceptual and methodological suggestions for future research. The information-processing framework provides a useful theoretical lens through which to organize extant and future work in the rapidly growing field of moral judgment.

Moral judgment as information processing: an integrative review

PubMed Central

Guglielmo, Steve

2015-01-01

How do humans make moral judgments about others’ behavior? This article reviews dominant models of moral judgment, organizing them within an overarching framework of information processing. This framework poses two distinct questions: (1) What input information guides moral judgments? and (2) What psychological processes generate these judgments? Information Models address the first question, identifying critical information elements (including causality, intentionality, and mental states) that shape moral judgments. A subclass of Biased Information Models holds that perceptions of these information elements are themselves driven by prior moral judgments. Processing Models address the second question, and existing models have focused on the relative contribution of intuitive versus deliberative processes. This review organizes existing moral judgment models within this framework and critically evaluates them on empirical and theoretical grounds; it then outlines a general integrative model grounded in information processing, and concludes with conceptual and methodological suggestions for future research. The information-processing framework provides a useful theoretical lens through which to organize extant and future work in the rapidly growing field of moral judgment. PMID:26579022

Utility-free heuristic models of two-option choice can mimic predictions of utility-stage models under many conditions

PubMed Central

Piantadosi, Steven T.; Hayden, Benjamin Y.

2015-01-01

Economists often model choices as if decision-makers assign each option a scalar value variable, known as utility, and then select the option with the highest utility. It remains unclear whether as-if utility models describe real mental and neural steps in choice. Although choices alone cannot prove the existence of a utility stage, utility transformations are often taken to provide the most parsimonious or psychologically plausible explanation for choice data. Here, we show that it is possible to mathematically transform a large set of common utility-stage two-option choice models (specifically ones in which dimensions are can be decomposed into additive functions) into a heuristic model (specifically, a dimensional prioritization heuristic) that has no utility computation stage. We then show that under a range of plausible assumptions, both classes of model predict similar neural responses. These results highlight the difficulties in using neuroeconomic data to infer the existence of a value stage in choice. PMID:25914613

Using concept maps to describe undergraduate students’ mental model in microbiology course

NASA Astrophysics Data System (ADS)

Hamdiyati, Y.; Sudargo, F.; Redjeki, S.; Fitriani, A.

2018-05-01

The purpose of this research was to describe students’ mental model in a mental model based-microbiology course using concept map as assessment tool. Respondents were 5th semester of undergraduate students of Biology Education of Universitas Pendidikan Indonesia. The mental modelling instrument used was concept maps. Data were taken on Bacteria sub subject. A concept map rubric was subsequently developed with a maximum score of 4. Quantitative data was converted into a qualitative one to determine mental model level, namely: emergent = score 1, transitional = score 2, close to extended = score 3, and extended = score 4. The results showed that mental model level on bacteria sub subject before the implementation of mental model based-microbiology course was at the transitional level. After implementation of mental model based-microbiology course, mental model was at transitional level, close to extended, and extended. This indicated an increase in the level of students’ mental model after the implementation of mental model based-microbiology course using concept map as assessment tool.

Dominant vs. nondominant arm advantage in mentally simulated actions in right handers.

PubMed

Gandrey, Philippe; Paizis, Christos; Karathanasis, Vassilis; Gueugneau, Nicolas; Papaxanthis, Charalambos

2013-12-01

Although plentiful data are available regarding mental states involving the dominant-right arm, the evidence for the nondominant-left arm is sparse. Here, we investigated whether right-handers can generate accurate predictions with either the right or the left arm. Fifteen adults carried out actual and mental arm movements in two directions with varying inertial resistance (inertial anisotropy phenomenon). We recorded actual and mental movement times and used the degree of their similarity as an indicator for the accuracy of motor imagery/prediction process. We found timing correspondences (isochrony) between actual and mental right arm movements in both rightward (low inertia resistance) and leftward (high inertia resistance) directions. Timing similarities between actual and mental left arm movements existed for the leftward direction (low inertia resistance) but not for the rightward direction (high inertia resistance). We found similar results when participants reaching towards the midline of the workspace, a result that excludes a hemispace effect. Electromyographic analysis during mental movements showed that arm muscles remained inactivate, thus eliminating a muscle activation strategy that could explain intermanual differences. Furthermore, motor-evoked potentials enhancement in both right and left biceps brachii during mental actions indicated that subjects were actively engaged in mental movement simulation and that the disadvantage of the left arm cannot be attributed to the nonactivation of the right motor cortex. Our findings suggest that predictive mechanisms are more robust for the right than the left arm in right-handers. We discussed these findings from the perspective of the internal models theory and the dynamic-dominance hypothesis of laterality.

Does it exist a personality core of mental illness? A systematic review on core psychobiological personality traits in mental disorders.

PubMed

Fassino, S; Amianto, F; Sobrero, C; Abbate Daga, G

2013-12-01

Research investigating the relationship between mental disorders and personality traits leads to interesting results. Individuals affected by several mental disorders have been worldwide assessed according to the psychobiological model of personality. This review aims to explore which temperament and character traits are recurrent in mental disorders and to highlight what traits may be shared determinants or consequences of the expression of a mental disorder. Systematic search of Medline database between 1998 and 2011 has been conducted to select the studies exploring the Temperament and Character Inventory (TCI) dimensions in the most relevant axis I psychiatric disorders. Of the 110 studies that were retrieved, 88 met the inclusion/exclusion criteria and were analyzed. High HA (HA) and low self-directedness are recurrent and can be considered as a "personality core" regardless of the diagnosis. They may be risk factors and relapse-related, they can indicate incomplete remission or chronic course of mental disorders, and consistently influence patients' functioning. Furthermore, they can be modified by medications or psychotherapy and represent outcome predictors of treatments. This "core" may represent a personality diathesis to psychopathology. Relational environment can influence the development of both temperament and character, thus prevention of mental disorders should promote a positive development of these traits. Although further research is needed, psychotherapeutic interventions should be performed also considering that mental disorders could benefit from HA desensitization and SD reinforcement. Finally, these traits may be used to provide diagnostic, prognostic, quality of life and efficacy inferences on psychiatric treatments.

Submentalizing or Mentalizing in a Level 1 Perspective-Taking Task: A Cloak and Goggles Test

PubMed Central

2016-01-01

It has been proposed that humans possess an automatic system to represent mental states (‘implicit mentalizing’). The existence of an implicit mentalizing system has generated considerable debate however, centered on the ability of various experimental paradigms to demonstrate unambiguously such mentalizing. Evidence for implicit mentalizing has previously been provided by the ‘dot perspective task,’ where participants are slower to verify the number of dots they can see when an avatar can see a different number of dots. However, recent evidence challenged a mentalizing interpretation of this effect by showing it was unaltered when the avatar was replaced with an inanimate arrow stimulus. Here we present an extension of the dot perspective task using an invisibility cloaking device to render the dots invisible on certain trials. This paradigm is capable of providing unambiguous evidence of automatic mentalizing, but no such evidence was found. Two further well-powered experiments used opaque and transparent goggles to manipulate visibility but found no evidence of automatic mentalizing, nor of individual differences in empathy or perspective-taking predicting performance, contradicting previous studies using the same design. The results cast doubt on the existence of an implicit mentalizing system, suggesting that previous effects were due to domain-general processes. PMID:27893269

Mental health services assessment in Brazil: systematic literature review.

PubMed

da Costa, Pedro Henrique Antunes; Colugnati, Fernando Antonio Basile; Ronzani, Telmo Mota

2015-10-01

Assessment in the mental health area is a mechanism able to generate information that positively helps decision-making. Therefore, it is necessary to appropriate on the existing discussions, reasoning the challenges and possibilities linked to knowledge production within this scientific filed. A systematic review of publications about the Brazilian scientific production on mental health service assessment was performed, identifying and discussing methods, assessment perspectives and results. The search for articles was done in IBECS, Lilacs and Scielo databases, considering the publication of Federal Law 10.216. Thirty-five articles were selected based on the used terms and on the inclusion and exclusion criteria. Scientific production in this field is concentrated in the South and Southwest regions and holds different scopes and participants. Such wide range of possibilities is adopted as a way to help improving services and decision-making processes in mental health care. Advances in humanized, participative and community care are highlighted, but requiring more investments, professional qualification and organizational improvements. It is postulated greater integration among research, with evaluations going beyond structural aspects and the comparison with hospitalocentric models.

Functionalism and consciousness.

PubMed

Shoemaker, S

1993-01-01

It is widely held that a mental state and the subject's introspective belief about it are always 'distinct existences' and only contingently connected. This suggests that for each sort of mental state there could be a creature that is introspectively 'blind' with respect to states of that sort, meaning that while it is capable of having such states, and of conceiving of itself as having them, it is totally without introspective access to its states of that sort. It is argued here that introspective blindness with respect to many sorts of mental states, in particular beliefs and sensory states, is not a possibility, because it is incompatible with requirements of rationality that are internal to the functional roles that are constitutive of these states. Introspective accessibility is essential to the functional roles of such mental states when the conceptual and cognitive resources of the subject of those states are sufficiently rich to make beliefs and thoughts about them a possibility. This is a version of the view that such states are necessarily self-intimating and is incompatible with the perceptual model of introspection favoured by some functionalists as well as by many non-functionalists.

Mental Imagery, Impact, and Affect: A Mediation Model for Charitable Giving

PubMed Central

Dickert, Stephan; Kleber, Janet; Västfjäll, Daniel; Slovic, Paul

2016-01-01

One of the puzzling phenomena in philanthropy is that people can show strong compassion for identified individual victims but remain unmoved by catastrophes that affect large numbers of victims. Two prominent findings in research on charitable giving reflect this idiosyncrasy: The (1) identified victim and (2) victim number effects. The first of these suggests that identifying victims increases donations and the second refers to the finding that people’s willingness to donate often decreases as the number of victims increases. While these effects have been documented in the literature, their underlying psychological processes need further study. We propose a model in which identified victim and victim number effects operate through different cognitive and affective mechanisms. In two experiments we present empirical evidence for such a model and show that different affective motivations (donor-focused vs. victim-focused feelings) are related to the cognitive processes of impact judgments and mental imagery. Moreover, we argue that different mediation pathways exist for identifiability and victim number effects. PMID:26859848

Mental Imagery, Impact, and Affect: A Mediation Model for Charitable Giving.

PubMed

Dickert, Stephan; Kleber, Janet; Västfjäll, Daniel; Slovic, Paul

2016-01-01

One of the puzzling phenomena in philanthropy is that people can show strong compassion for identified individual victims but remain unmoved by catastrophes that affect large numbers of victims. Two prominent findings in research on charitable giving reflect this idiosyncrasy: The (1) identified victim and (2) victim number effects. The first of these suggests that identifying victims increases donations and the second refers to the finding that people's willingness to donate often decreases as the number of victims increases. While these effects have been documented in the literature, their underlying psychological processes need further study. We propose a model in which identified victim and victim number effects operate through different cognitive and affective mechanisms. In two experiments we present empirical evidence for such a model and show that different affective motivations (donor-focused vs. victim-focused feelings) are related to the cognitive processes of impact judgments and mental imagery. Moreover, we argue that different mediation pathways exist for identifiability and victim number effects.

A model for dual disorder treatment in acute psychiatry in a VA population.

PubMed

Ahrens, M P

1998-01-01

One model for addressing the dual disorders of substance abuse and a concomitant mental disorder in an acute-psychiatry inpatient ward of a VA Medical Center utilized psychoeducation and ward policies to empower patients to make decisions affecting their recoveries. Existing staff shared responsibilities for implementing activities and creating ward milieu that supported psychiatric patients toward a life free of alcohol and drugs as they gained in acceptance of responsibility for the management of their mental disorders. Integrated programming assisted patients in constructing a meaningful path of recovery out of multiple treatment approaches and philosophies. Treatment principles, ward policies, and goals for an integrated acute-psychiatry model evolved over 4 years. Designed from a consumer-oriented "strengths perspective," patients responded to the new programming with satisfaction and gratitude. Recent adaptation of these policies, principles, and goals to a newly instituted continuous-care treatment program indicates the appropriateness of their application for outpatient dual disorder treatment and programming as well.

Invariant measures in brain dynamics

NASA Astrophysics Data System (ADS)

Boyarsky, Abraham; Góra, Paweł

2006-10-01

This note concerns brain activity at the level of neural ensembles and uses ideas from ergodic dynamical systems to model and characterize chaotic patterns among these ensembles during conscious mental activity. Central to our model is the definition of a space of neural ensembles and the assumption of discrete time ensemble dynamics. We argue that continuous invariant measures draw the attention of deeper brain processes, engendering emergent properties such as consciousness. Invariant measures supported on a finite set of ensembles reflect periodic behavior, whereas the existence of continuous invariant measures reflect the dynamics of nonrepeating ensemble patterns that elicit the interest of deeper mental processes. We shall consider two different ways to achieve continuous invariant measures on the space of neural ensembles: (1) via quantum jitters, and (2) via sensory input accompanied by inner thought processes which engender a “folding” property on the space of ensembles.

Philippines mental health country profile.

PubMed

Conde, Bernardo

2004-01-01

The Philippines is one of the world's most heavily populated countries. Even though democracy was restored in 1986 after years of occupation and dictatorship, a high level of poverty still exists and malnutrition and communicable diseases continue to be the main cause of morbidity. For almost 50 years people with mental disorders have been treated in a mental hospital setting. The National Mental Health Program aims to establish psychiatric wards in university and private hospitals and encourage community-based mental health care.

Understanding mental retardation in Down's syndrome using trisomy 16 mouse models.

PubMed

Galdzicki, Z; Siarey, R J

2003-06-01

Mental retardation in Down's syndrome, human trisomy 21, is characterized by developmental delays, language and memory deficits and other cognitive abnormalities. Neurophysiological and functional information is needed to understand the mechanisms of mental retardation in Down's syndrome. The trisomy mouse models provide windows into the molecular and developmental effects associated with abnormal chromosome numbers. The distal segment of mouse chromosome 16 is homologous to nearly the entire long arm of human chromosome 21. Therefore, mice with full or segmental trisomy 16 (Ts65Dn) are considered reliable animal models of Down's syndrome. Ts65Dn mice demonstrate impaired learning in spatial tests and abnormalities in hippocampal synaptic plasticity. We hypothesize that the physiological impairments in the Ts65Dn mouse hippocampus can model the suboptimal brain function occuring at various levels of Down's syndrome brain hierarchy, starting at a single neuron, and then affecting simple and complex neuronal networks. Once these elements create the gross brain structure, their dysfunctional activity cannot be overcome by extensive plasticity and redundancy, and therefore, at the end of the maturation period the mind inside this brain remains deficient and delayed in its capabilities. The complicated interactions that govern this aberrant developmental process cannot be rescued through existing compensatory mechanisms. In summary, overexpression of genes from chromosome 21 shifts biological homeostasis in the Down's syndrome brain to a new less functional state.

Reducing and preventing internalizing and externalizing behavior problems in children with type 1 diabetes: a randomized controlled trial of the Triple P-Positive Parenting Program.

PubMed

Westrupp, E M; Northam, E; Lee, K J; Scratch, S E; Cameron, F

2015-11-01

Children with type 1 diabetes are at increased risk of mental health problems, which in turn are associated with poor glycemic control, diabetes-related complications, and long-term psychiatric morbidity. We tested the efficacy of the Triple P-Positive Parenting Program in reducing or preventing mental health problems and improving glycemic control in children with type 1 diabetes in a randomized controlled trial. Participants were recruited from the Diabetes Clinic, Royal Children's Hospital, Melbourne, Australia, and randomized to Triple P or standard diabetes care. The primary outcome was child internalizing and externalizing behavior problems 3 and 12 months postrandomization. Secondary outcomes were glycemic control, parent mental health, parenting skills, and family functioning at 3 and 12 months, and glycemic control at 24 months. A total of 76 participants were randomized (38 to intervention and 38 to control), 60 completed 3-month, and 57 completed 12-month assessments. Benefits of Triple P were evident at 3 months for parent mental health, parenting skills, and family functioning (p < 0.05), but not for child mental health or glycemic control, with little effect at 12 months. Prespecified subgroup analyses for children with pre-existing internalizing or externalizing behavior problems indicated greater improvements in child mental health, parent mental health, parenting skills, and diabetes family conflict (p < 0.05), but lower parenting self-efficacy at 3 months. Improvements in parent mental health and parenting competency associated with Triple P were sustained to 12 months for children with pre-existing mental health problems. This study provides some support for the efficacy of Triple P in improving parent and family outcomes, and reducing child internalizing and externalizing behavior problems primarily in children who have pre-existing mental health problems. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

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…

Testing the Community-Based Learning Collaborative (CBLC) implementation model: a study protocol.

PubMed

Hanson, Rochelle F; Schoenwald, Sonja; Saunders, Benjamin E; Chapman, Jason; Palinkas, Lawrence A; Moreland, Angela D; Dopp, Alex

2016-01-01

High rates of youth exposure to violence, either through direct victimization or witnessing, result in significant health/mental health consequences and high associated lifetime costs. Evidence-based treatments (EBTs), such as Trauma-Focused Cognitive Behavioral Therapy (TF-CBT), can prevent and/or reduce these negative effects, yet these treatments are not standard practice for therapists working with children identified by child welfare or mental health systems as needing services. While research indicates that collaboration among child welfare and mental health services sectors improves availability and sustainment of EBTs for children, few implementation strategies designed specifically to promote and sustain inter-professional collaboration (IC) and inter-organizational relationships (IOR) have undergone empirical investigation. A potential candidate for evaluation is the Community-Based Learning Collaborative (CBLC) implementation model, an adaptation of the Learning Collaborative which includes strategies designed to develop and strengthen inter-professional relationships between brokers and providers of mental health services to promote IC and IOR and achieve sustained implementation of EBTs for children within a community. This non-experimental, mixed methods study involves two phases: (1) analysis of existing prospective quantitative and qualitative quality improvement and project evaluation data collected pre and post, weekly, and monthly from 998 participants in one of seven CBLCs conducted as part of a statewide initiative; and (2) Phase 2 collection of new quantitative and qualitative (key informant interviews) data during the funded study period to evaluate changes in relations among IC, IOR, social networks and the penetration and sustainment of TF-CBT in targeted communities. Recruitment for Phase 2 is from the pool of 998 CBLC participants to achieve a targeted enrollment of n = 150. Study aims include: (1) Use existing quality improvement (weekly/monthly online surveys; pre-post surveys; interviews) and newly collected quantitative (monthly surveys) and qualitative (key informant interviews) data and social network analysis to test whether CBLC strategies are associated with penetration and sustainment of TF-CBT; and (2) Use existing quantitative quality improvement (weekly/monthly on-line surveys; pre/post surveys) and newly collected qualitative (key informant interviews) data and social network analysis to test whether CBLC strategies are associated with increased IOR and IC intensity. The proposed research leverages an on-going, statewide implementation initiative to generate evidence about implementation strategies needed to make trauma-focused EBTs more accessible to children. This study also provides feasibility data to inform an effectiveness trial that will utilize a time-series design to rigorously evaluate the CBLC model as a mechanism to improve access and sustained use of EBTs for children.

Return-to-Work Strategies for Employees With Mental Health Conditions.

PubMed

Pomaki, Georgia

2017-01-01

There's no question that employers can no longer ignore mental health issues. Compassion and support for employees aside, it is simply good business to protect the mental health and productivity of employees. This article describes existing challenges surrounding employees with mental disorders: the link between mental disorders, disability and an employee's ability to return to work; best practices for employers, employees and health care providers; and the role of the insurance company. Together, using proven strategies, everyone contributes to the optimal solution of helping employees with mental disorders return to work.

Managing preconceived expectations: mental health service users experiences of going home from hospital: a grounded theory study.

PubMed

Keogh, B; Callaghan, P; Higgins, A

2015-11-01

What is known on the subject? The time of discharge from a mental health hospital can be challenging for mental health service users, with high rates of readmission in the immediate months following discharge. Although some research exists that explores service users' perspectives of being discharged, little evidence exists that explores the processes influencing or used by service users' to adapt to the transition from in-patient acute mental health service. What this papers adds to existing knowledge? The findings of this grounded theory study demonstrates the strategies service users used to managed their own, as well as their social audiences, preconceived expectations arising from their new identity as 'psychiatric patients' following their discharge from hospital. While there is a move to develop recovery-orientated mental health services, key indicators of recovery-oriented practices were often absent from service users' experiences of service provision. What are the implications for practice? Nurses and other mental health professionals need to recognize their contribution to the architecture of stigma that transcends the physical structures of hospital or ward and are entrenched within attitudes, interactions and practices. The findings of this study can provide guidance to those working with service users and help them to understand the complexities of their experiences when using mental health services, which go far beyond the management of their symptoms. Following a period of hospitalization, the transition to home can result in increased vulnerability and a source of stress for mental health service users. Readmission rates have been suggested as one indicator of the success of the transition from hospital to community care. Despite knowledge of some of the factors that impact on service users following discharge, no coherent model or theoretical framework could be located in the literature, which explains or aides an in-depth understanding of the transition from hospital to community for service users. The aim of this study was to develop a grounded theory that explored service users' experiences of going home from hospital. This qualitative study used grounded theory, and a total of 35 interviews were conducted with 31 service users. The core category was 'Managing Preconceived Expectations', which had seven subcategories, describes how the participants were negatively perceived by themselves and others following their admission and discharge from hospital. This theory presents the strategies that the participants used to manage this new identity. This theory demonstrates that although there has been a move to adopt recovery-orientated services, key indicators of recovery were often absent for service users being admitted and subsequently discharged. © 2015 John Wiley & Sons Ltd.

Physical Invariants of Intelligence

NASA Technical Reports Server (NTRS)

Zak, Michail

2010-01-01

A program of research is dedicated to development of a mathematical formalism that could provide, among other things, means by which living systems could be distinguished from non-living ones. A major issue that arises in this research is the following question: What invariants of mathematical models of the physics of systems are (1) characteristic of the behaviors of intelligent living systems and (2) do not depend on specific features of material compositions heretofore considered to be characteristic of life? This research at earlier stages has been reported, albeit from different perspectives, in numerous previous NASA Tech Briefs articles. To recapitulate: One of the main underlying ideas is to extend the application of physical first principles to the behaviors of living systems. Mathematical models of motor dynamics are used to simulate the observable physical behaviors of systems or objects of interest, and models of mental dynamics are used to represent the evolution of the corresponding knowledge bases. For a given system, the knowledge base is modeled in the form of probability distributions and the mental dynamics is represented by models of the evolution of the probability densities or, equivalently, models of flows of information. At the time of reporting the information for this article, the focus of this research was upon the following aspects of the formalism: Intelligence is considered to be a means by which a living system preserves itself and improves its ability to survive and is further considered to manifest itself in feedback from the mental dynamics to the motor dynamics. Because of the feedback from the mental dynamics, the motor dynamics attains quantum-like properties: The trajectory of the physical aspect of the system in the space of dynamical variables splits into a family of different trajectories, and each of those trajectories can be chosen with a probability prescribed by the mental dynamics. From a slightly different perspective, the mechanism of decision-making is feedback from the mental dynamics to the motor dynamics, and this mechanism provides a quantum-like collapse of a random motion into an appropriate deterministic state, such that entropy undergoes a pronounced decrease. The existence of this mechanism is considered to be an invariant of intelligent behavior of living systems, regardless of the origins and material compositions of the systems.

Integrated Care to Address the Physical Health Needs of People with Severe Mental Illness: A Mapping Review of the Recent Evidence on Barriers, Facilitators and Evaluations.

PubMed

Rodgers, Mark; Dalton, Jane; Harden, Melissa; Street, Andrew; Parker, Gillian; Eastwood, Alison

2018-01-25

People with mental health conditions have a lower life expectancy and poorer physical health outcomes than the general population. Evidence suggests this is due to a combination of clinical risk factors, socioeconomic factors, and health system factors, notably a lack of integration when care is required across service settings. Several recent reports have looked at ways to better integrate physical and mental health care for people with severe mental illness (SMI). We built on these by conducting a mapping review that looked for the most recent evidence and service models in this area. This involved searching the published literature and speaking to people involved in providing or using current services. Few of the identified service models were described adequately and fewer still were evaluated, raising questions about the replicability and generalisability of much of the existing evidence. However, some common themes did emerge. Efforts to improve the physical health care of people with SMI should empower staff and service users and help remove everyday barriers to delivering and accessing integrated care. In particular, there is a need for improved communication among professionals and better information technology to support them, greater clarity about who is responsible and accountable for physical health care, and greater awareness of the effects of stigmatisation on the wider culture and environment in which services are delivered.

The integration of behavioral health interventions in children's health care: services, science, and suggestions.

PubMed

Kolko, David J; Perrin, Ellen

2014-01-01

Because the integration of mental or behavioral health services in pediatric primary care is a national priority, a description and evaluation of the interventions applied in the healthcare setting is warranted. This article examines several intervention research studies based on alternative models for delivering behavioral health care in conjunction with comprehensive pediatric care. This review describes the diverse methods applied to different clinical problems, such as brief mental health skills, clinical guidelines, and evidence-based practices, and the empirical outcomes of this research literature. Next, several key treatment considerations are discussed to maximize the efficiency and effectiveness of these interventions. Some practical suggestions for overcoming key service barriers are provided to enhance the capacity of the practice to deliver behavioral health care. There is moderate empirical support for the feasibility, acceptability, and clinical utility of these interventions for treating internalizing and externalizing behavior problems. Practical strategies to extend this work and address methodological limitations are provided that draw upon recent frameworks designed to simplify the treatment enterprise (e.g., common elements). Pediatric primary care has become an important venue for providing mental health services to children and adolescents due, in part, to its many desirable features (e.g., no stigma, local setting, familiar providers). Further adaptation of existing delivery models may promote the delivery of effective integrated interventions with primary care providers as partners designed to address mental health problems in pediatric healthcare.

A unifying perspective on personality pathology across the life span: Developmental considerations for the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders

PubMed Central

TACKETT, JENNIFER L.; BALSIS, STEVE; OLTMANNS, THOMAS F.; KRUEGER, ROBERT F.

2010-01-01

Proposed changes in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-V) include replacing current personality disorder (PD) categories on Axis II with a taxonomy of dimensional maladaptive personality traits. Most of the work on dimensional models of personality pathology, and on personality disorders per se, has been conducted on young and middle-aged adult populations. Numerous questions remain regarding the applicability and limitations of applying various PD models to early and later life. In the present paper, we provide an overview of such dimensional models and review current proposals for conceptualizing PDs in DSM-V. Next, we extensively review existing evidence on the development, measurement, and manifestation of personality pathology in early and later life focusing on those issues deemed most relevant for informing DSM-V. Finally, we present overall conclusions regarding the need to incorporate developmental issues in conceptualizing PDs in DSM-V and highlight the advantages of a dimensional model in unifying PD perspectives across the life span. PMID:19583880

Discrimination and common mental disorders of undergraduate students of the Universidade Federal de Santa Catarina.

PubMed

de Souza, Maria Vitória Cordeiro; Lemkuhl, Isabel; Bastos, João Luiz

2015-01-01

The pathogenic and consistent effect of discrimination on mental health has been largely documented in the literature. However, there are few studies measuring multiple types of discrimination, evaluating the existence of a dose-response relationship or investigating possible effect modifiers of such an association. To investigate the association between experiences of discrimination attributed to multiple reasons and common mental disorders, including the adjustment for potential confounders, assessment of dose-response relations, and examination of effect modifiers in undergraduate students from southern Brazil. In the first semester of 2012, 1,023 students from the Universidade Federal de Santa Catarina answered a self-administered questionnaire on socio-demographic characteristics, undergraduate course, experiences of discrimination and common mental disorders. Associations were analyzed through logistic regression models, estimation of Odds Ratios and 95% confidence intervals (95%CI). The study results showed that students reporting discrimination at high frequency and intensity were 4.4 (95%CI 1.6 - 12.4) times more likely to present common mental disorders. However, the relationship between discrimination and common mental disorders was protective among Electrical Engineering students, when compared to Accounting Sciences students who did not report discrimination. The findings suggest that the dose-response relationship between experiences of discrimination and common mental disorders reinforces the hypothetical causal nature of this association. Nevertheless, the modification of effect caused by the undergraduate course should be considered in future studies for a better understanding and measurement of both phenomena.

[The first Mental Health Act in China 2013 : An historical step towards human rights].

PubMed

Zhao, X

2017-05-01

In the past, the mentally ill used to be relentlessly stigmatized and their basic needs grossly neglected in China. Only the coastal cities with their Western oriented universities provided Western type mental healthcare. In general, traditional Chinese medicine (TCM) embracing medicinal herbs and acupuncture was practiced. Mental hospitals were non-existent before 1889 and care of the chronically mentally ill rested with their families and the community; however, the prevalence and spectrum of mental disorders were similar to those in Western countries. After the establishment of the People's Republic of China old-fashioned mental hospitals were founded. The "Great Leap Forward" starting in 1958 envisaged the creation of a mental healthcare system based on Soviet Union standards. Psychiatry had a strong biological orientation, and psychotherapy did not exist. Psychology was rejected as not being science and was not taught at universities before 1978. With the Reform and Opening Policy in 1978 the education of psychology was stepped up. Psychology was introduced as an academic discipline in 1978 and psychotherapy and psychosomatic medicine were established in mental healthcare. The current mental healthcare in China resembles the standard in Germany before the "Psychiatrie-Enquete" (expert commission official report). With the Mental Health Act adopted in 2013 after 27 years of planning, China has laid the legal foundation for planning and establishing a humane system of mental healthcare. The Act safeguards patients' human and individual rights and increases trust in psychiatric institutions. It guarantees the right to optimal treatment and provides legal protection in cases of malpractice.

Mental toughness latent profiles in endurance athletes

PubMed Central

Zeiger, Robert S.

2018-01-01

Mental toughness in endurance athletes, while an important factor for success, has been scarcely studied. An online survey was used to examine eight mental toughness factors in endurance athletes. The study aim was to determine mental toughness profiles via latent profile analysis in endurance athletes and whether associations exist between the latent profiles and demographics and sports characteristics. Endurance athletes >18 years of age were recruited via social media outlets (n = 1245, 53% female). Mental toughness was measured using the Sports Mental Toughness Questionnaire (SMTQ), Psychological Performance Inventory-Alternative (PPI-A), and self-esteem was measured using the Rosenberg Self-Esteem Scale (RSE). A three-class solution emerged, designated as high mental toughness (High MT), moderate mental toughness (Moderate MT) and low mental toughness (Low MT). ANOVA tests showed significant differences between all three classes on all 8 factors derived from the SMTQ, PPI-A and the RSE. There was an increased odds of being in the High MT class compared to the Low MT class for males (OR = 1.99; 95% CI, 1.39, 2.83; P<0.001), athletes who were over 55 compared to those who were 18–34 (OR = 2.52; 95% CI, 1.37, 4.62; P<0.01), high sports satisfaction (OR = 8.17; 95% CI, 5.63, 11.87; P<0.001), and high division placement (OR = 2.18; 95% CI, 1.46,3.26; P<0.001). The data showed that mental toughness latent profiles exist in endurance athletes. High MT is associated with demographics and sports characteristics. Mental toughness screening in athletes may help direct practitioners with mental skills training. PMID:29474398

Recession, debt and mental health: challenges and solutions

PubMed Central

2009-01-01

Background During the economic downturn, the link between recession and health has featured in many countries' media, political, and medical debate. This paper focuses on the previously neglected relationship between personal debt and mental health. Aims Using the UK as a case study, this paper considers the public health challenges presented by debt to mental health. We then propose solutions identified in workshops held during the UK Government's Foresight Review of Mental Capital and Wellbeing. Results Within their respective sectors, health professionals should receive basic ‘debt first aid’ training, whilst all UK financial sector codes of practice should – as a minimum – recognise the existence of customers with mental health problems. Further longitudinal research is also needed to ‘unpack’ the relationship between debt and mental health. Across sectors, a lack of co-ordinated activity across health, money advice, and creditor organisations remains a weakness. A renewed emphasis on co-ordinated ‘debt care pathways’ and better communication between local health and advice services is needed. Discussion The relationship between debt and mental health presents a contemporary public health challenge. Solutions exist, but will require action and investment at a time of competition for funds. PMID:22477896

Treatment of Mentally Ill Offenders in Nine Developing Latin American Countries.

PubMed

Almanzar, Santiago; Katz, Craig L; Harry, Bruce

2015-09-01

The prevalence of psychiatric conditions among prisoners in Latin America is greatly underestimated, and because of the lack of awareness about mental illness among service providers in Latin American prisons, oftentimes these conditions go unrecognized or are not treated properly. In the worst-case scenarios, human rights violations occur. Despite the high levels of need, many prisoners have not received adequate or timely treatment. The sparse existing literature documents prison conditions throughout Latin American countries, ranging from poor to extremely harsh, overcrowded, and life threatening. Most prison systems do not meet international prison standards. The information on forensic mental health services and the treatment of offenders with mental illness have been less extensively studied and compared with forensic practices in developed American nations. This study analyzes the existing literature on forensic psychiatry, focusing on nine socioeconomically developing nations in Latin America, to improve understanding of treatment approaches for offenders with mental illness and identify emerging themes. A review was conducted and data were included in regression analyses to investigate information relative to the treatment of offenders with mental illness and its interaction with the mental health system. © 2015 American Academy of Psychiatry and the Law.

Childhood socioeconomic position and adult mental wellbeing: Evidence from four British birth cohort studies.

PubMed

Wood, Natasha; Bann, David; Hardy, Rebecca; Gale, Catharine; Goodman, Alissa; Crawford, Claire; Stafford, Mai

2017-01-01

There is much evidence showing that childhood socioeconomic position is associated with physical health in adulthood; however existing evidence on how early life disadvantage is associated with adult mental wellbeing is inconsistent. This paper investigated whether childhood socioeconomic position (SEP) is associated with adult mental wellbeing and to what extent any association is explained by adult SEP using harmonised data from four British birth cohort studies. The sample comprised 20,717 participants with mental wellbeing data in the Hertfordshire Cohort Study (HCS), the MRC National Survey of Health and Development (NSHD), the National Child Development Study (NCDS), and the British Cohort Study (BCS70). Warwick Edinburgh Mental Wellbeing Scale (WEMWBS) scores at age 73 (HCS), 60-64 (NSHD), 50 (NCDS), or 42 (BCS70) were used. Harmonised socioeconomic position (Registrar General's Social Classification) was ascertained in childhood (age 10/11) and adulthood (age 42/43). Associations between childhood SEP, adult SEP, and wellbeing were tested using linear regression and multi-group structural equation models. More advantaged father's social class was associated with better adult mental wellbeing in the BCS70 and the NCDS. This association was independent of adult SEP in the BCS70 but fully mediated by adult SEP in the NCDS. There was no evidence of an association between father's social class and adult mental wellbeing in the HCS or the NSHD. Socioeconomic conditions in childhood are directly and indirectly, through adult socioeconomic pathways, associated with adult mental wellbeing, but findings from these harmonised data suggest this association may depend on cohort or age.

Mental health law in India: origins and proposed reforms

PubMed Central

Ahmad, Zulkarnain Z.

2016-01-01

Although mental health legislation has existed in India since the mid-19th century, it has gone through various changes over the years and the Mental Health Care Bill 2013 has generated a lot of debate and criticism. Despite its shortcomings, the general expectation is that this bill will usher in a new era of proper care and allow people with mental disorders to lead a dignified life. PMID:29093906

A false dichotomy? Mental illness and lone-actor terrorism.

PubMed

Corner, Emily; Gill, Paul

2015-02-01

We test whether significant differences in mental illness exist in a matched sample of lone- and group-based terrorists. We then test whether there are distinct behavioral differences between lone-actor terrorists with and without mental illness. We then stratify our sample across a range of diagnoses and again test whether significant differences exist. We conduct a series of bivariate, multivariate, and multinomial statistical tests using a unique dataset of 119 lone-actor terrorists and a matched sample of group-based terrorists. The odds of a lone-actor terrorist having a mental illness is 13.49 times higher than the odds of a group actor having a mental illness. Lone actors who were mentally ill were 18.07 times more likely to have a spouse or partner who was involved in a wider movement than those without a history of mental illness. Those with a mental illness were more likely to have a proximate upcoming life change, more likely to have been a recent victim of prejudice, and experienced proximate and chronic stress. The results identify behaviors and traits that security agencies can utilize to monitor and prevent lone-actor terrorism events. The correlated behaviors provide an image of how risk can crystalize within the individual offender and that our understanding of lone-actor terrorism should be multivariate in nature.

Who needs collaborative care treatment? A qualitative study exploring attitudes towards and experiences with mental healthcare among general practitioners and care managers.

PubMed

Møller, Marlene Christina Rosengaard; Mygind, Anna; Bro, Flemming

2018-05-30

Collaborative care treatment is widely recognized as an effective approach to improve the quality of mental healthcare through enhanced and structured collaboration between general practice and specialized psychiatry. However, studies indicate that the complexity of collaborative care treatment interventions challenge the implementation in real-life general practice settings. Four Danish Collaborative Care Models were launched in 2014 for patients with mild/moderate anxiety and depression. These involved collaboration between general practitioners, care managers and consultant psychiatrists. Taking a multi-practice bottom-up approach, this paper aims to explore the perceived barriers and enablers related to collaborative care for patients with mental health problems and to investigate the actual experiences with a Danish collaborative care model in a single-case study in order to identify enablers and barriers for successful implementation. Combining interviews and observations of usual treatment practices, we conducted a multi-practice study among general practitioners who were not involved in the Danish collaborative care models to explore their perspectives on existing mental health treatment and to investigate (from a bottom-up approach) their perceptions of and need for collaborative care in mental health treatment. Additionally, by combining observations and qualitative interviews, we followed the implementation of a Danish collaborative care model in a single-case study to convey identified barriers and enablers of the collaborative care model. Experienced and perceived enablers of the Danish collaborative care model mainly consisted of a need for new treatment options to deal with mild/moderate anxiety and depression. The model was considered to meet the need for a free fast track to high-quality treatment. Experienced barriers included: poor adaptation of the model to the working conditions and needs in daily general practice, time consumption, unsustainable logistical set-up and unclear care manager role. General practitioners in the multi-practice study considered access to treatment and not collaboration with specialised psychiatry to be essential for this group of patients. The study calls for increased attention to implementation processes and better adaptation of collaborative care models to the clinical reality of general practice. Future interventions should address the treatment needs of specific patient populations and should involve relevant stakeholders in the design and implementation processes.

Ethnic Differences in Adolescents' Mental Distress, Social Stress, and Resources

ERIC Educational Resources Information Center

Choi, Heeseung; Meininger, Janet C.; Roberts, Robert E.

2006-01-01

Limited data on ethnic group differences among young adolescents exist regarding the prevalence of mental distress, social stress, and resources. The aim of this cross-sectional study was to examine ethnic differences among African American (AA), European American (EA), Hispanic American (HA), and Asian American adolescents in mental distress,…

Preschoolers' Mental Rotation: Sex Differences in Hemispheric Asymmetry

ERIC Educational Resources Information Center

Hahn, Nicola; Jansen, Petra; Heil, Martin

2010-01-01

Mental rotation performance has been found to produce one of the largest sex differences in cognition accompanied by sex differences in functional cerebral asymmetry. Although sex differences in mental rotation performance can be reliably demonstrated as early as age 5 years old, that is, long before puberty, no data exist as to whether…

Values and Subjective Mental Health in America: A Social Adaptation Approach.

ERIC Educational Resources Information Center

Kahle, Lynn R.; And Others

Although surveys of mental health involve some controversy, a significant relationship between values and mental health appears to exist. To study the adaption of individuals with alternative values to their psychological worlds, over 2,000 adults identified their most important values. Alcohol abuse, drug abuse, dizziness, anxiety, and general…

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…

42 CFR 51d.4 - What information is required in the application?

Code of Federal Regulations, 2011 CFR

2011-10-01

... GRANTS MENTAL HEALTH AND SUBSTANCE ABUSE EMERGENCY RESPONSE PROCEDURES § 51d.4 What information is...'s designee, that a mental health or substance abuse emergency exists, as well as a written statement..., the principal elected official, or such officer's or official's designee, that a mental health or...

42 CFR 51d.4 - What information is required in the application?

Code of Federal Regulations, 2010 CFR

2010-10-01

... GRANTS MENTAL HEALTH AND SUBSTANCE ABUSE EMERGENCY RESPONSE PROCEDURES § 51d.4 What information is...'s designee, that a mental health or substance abuse emergency exists, as well as a written statement..., the principal elected official, or such officer's or official's designee, that a mental health or...

42 CFR 51d.4 - What information is required in the application?

Code of Federal Regulations, 2014 CFR

2014-10-01

... GRANTS MENTAL HEALTH AND SUBSTANCE ABUSE EMERGENCY RESPONSE PROCEDURES § 51d.4 What information is...'s designee, that a mental health or substance abuse emergency exists, as well as a written statement..., the principal elected official, or such officer's or official's designee, that a mental health or...

42 CFR 51d.4 - What information is required in the application?

Code of Federal Regulations, 2012 CFR

2012-10-01

... GRANTS MENTAL HEALTH AND SUBSTANCE ABUSE EMERGENCY RESPONSE PROCEDURES § 51d.4 What information is...'s designee, that a mental health or substance abuse emergency exists, as well as a written statement..., the principal elected official, or such officer's or official's designee, that a mental health or...

42 CFR 51d.4 - What information is required in the application?

Code of Federal Regulations, 2013 CFR

2013-10-01

... GRANTS MENTAL HEALTH AND SUBSTANCE ABUSE EMERGENCY RESPONSE PROCEDURES § 51d.4 What information is...'s designee, that a mental health or substance abuse emergency exists, as well as a written statement..., the principal elected official, or such officer's or official's designee, that a mental health or...

Mental health concerns of gay and bisexual men seeking mental health services.

PubMed

Berg, Michael B; Mimiaga, Matthew J; Safren, Steven A

2008-01-01

Little data exist about the mental health needs of gay and bisexual men. This is due to limitations of existing studies such as small and nonrepresentative samples, failure to assess sexual orientation, and concerns about stigmatization, possibly causing sexual minority individuals to be reluctant to disclose their sexual orientation to researchers. Fenway Community Health is a large urban health center that serves the LGBT community. The large number of gay and bisexual men who present for mental health treatment allows for a unique opportunity to gain insight into mental health, prevention, and intervention needs for this group. The current study is a review of the mental health information from all of the gay and bisexual men who reported that they were HIV-negative during their mental health intake over a six-month period at Fenway Community Health (January to June 2000; N = 92). The most frequent presenting problems were depression, anxiety, and relationship issues. Additionally, presenting problems included current or past abuse, substance abuse, finance and employment, recent loss, and family issues. The most frequent diagnoses were depression, anxiety disorders, and adjustment disorders. These findings support the notion that presenting problems and mental health concerns among gay and bisexual men are similar to those frequently reported by individuals in other mental health facilities, however, specific psychosocial stressors are unique to this population.

Global mental health and neuroscience: potential synergies.

PubMed

Stein, Dan J; He, Yanling; Phillips, Anthony; Sahakian, Barbara J; Williams, John; Patel, Vikram

2015-02-01

Global mental health has emerged as an important specialty. It has drawn attention to the burden of mental illness and to the relative gap in mental health research and services around the world. Global mental health has raised the question of whether this gap is a developmental issue, a health issue, a human rights issue, or a combination of these issues-and it has raised awareness of the need to develop new approaches for building capacity, mobilising resources, and closing the research and treatment gap. Translational neuroscience has also advanced. It comprises an important conceptual approach to understanding the neurocircuitry and molecular basis of mental disorders, to rethinking how best to undertake research on the aetiology, assessment, and treatment of these disorders, with the ultimate aim to develop entirely new approaches to prevention and intervention. Some apparent contrasts exist between these fields; global mental health emphasises knowledge translation, moving away from the bedside to a focus on health systems, whereas translational neuroscience emphasises molecular neuroscience, focusing on transitions between the bench and bedside. Meanwhile, important opportunities exist for synergy between the two paradigms, to ensure that present opportunities in mental health research and services are maximised. Here, we review the approaches of global mental health and clinical neuroscience to diagnosis, pathogenesis, and intervention, and make recommendations for facilitating an integration of these two perspectives. Copyright © 2015 Elsevier Ltd. All rights reserved.

Effects of mental health interventions for students in higher education are sustainable over time: a systematic review and meta-analysis of randomized controlled trials.

PubMed

Winzer, Regina; Lindberg, Lene; Guldbrandsson, Karin; Sidorchuk, Anna

2018-01-01

Symptoms of depression, anxiety, and distress are more common in undergraduates compared to age-matched peers. Mental ill health among students is associated with impaired academic achievement, worse occupational preparedness, and lower future occupational performance. Research on mental health promoting and mental ill health preventing interventions has shown promising short-term effects, though the sustainability of intervention benefits deserve closer attention. We aimed to identify, appraise and summarize existing data from randomized control trials (RCTs) reporting on whether the effects of mental health promoting and mental ill health preventing interventions were sustained at least three months post-intervention, and to analyze how the effects vary for different outcomes in relation to follow-up length. Further, we aimed to assess whether the effect sustainability varied by intervention type, study-level determinants and of participant characteristics. A systematic search in MEDLINE, PsycInfo, ERIC, and Scopus was performed for RCTs published in 1995-2015 reporting an assessment of mental ill health and positive mental health outcomes for, at least, three months of post-intervention follow-up. Random-effect modeling was utilized for quantitative synthesis of the existing evidence with standardized mean difference (Hedges' g ) used to estimate an aggregated effect size. Sustainability of the effects of interventions was analyzed separately for 3-6 months, 7-12 months, and 13-18 months of post-intervention follow-up. About 26 studies were eligible after reviewing 6,571 citations. The pooled effects were mainly small, but significant for several categories of outcomes. Thus, for the combined mental ill health outcomes, symptom-reduction sustained up to 7-12 months post-intervention (standardized mean difference (Hedges' g ) effect size (ES) = -0.28 (95% CI [-0.49, -0.08])). Further, sustainability of symptom-reductions were evident for depression with intervention effect lasting up to 13-18 months (ES = -0.30 (95% CI [-0.51, -0.08])), for anxiety up to 7-12 months (ES = -0.27 (95% CI [-0.54, -0.01])), and for stress up to 3-6 months (ES = -0.30 (95% CI [-0.58, -0.03])). The effects of interventions to enhance positive mental health were sustained up to 3-6 months for the combined positive mental health outcomes (ES = 0.32 (95% CI [0.05, 0.59])). For enhanced active coping, sustainability up to 3-6 months was observed with a medium and significant effect (ES = 0.75 (95% CI [0.19, 1.30])). The evidence suggests long-term effect sustainability for mental ill health preventive interventions, especially for interventions to reduce the symptoms of depression and symptoms of anxiety. Interventions to promote positive mental health offer promising, but shorter-lasting effects. Future research should focus on mental health organizational interventions to examine their potential for students in tertiary education.

An Evaluation of Understandability of Patient Journey Models in Mental Health

PubMed Central

2016-01-01

Background There is a significant trend toward implementing health information technology to reduce administrative costs and improve patient care. Unfortunately, little awareness exists of the challenges of integrating information systems with existing clinical practice. The systematic integration of clinical processes with information system and health information technology can benefit the patients, staff, and the delivery of care. Objectives This paper presents a comparison of the degree of understandability of patient journey models. In particular, the authors demonstrate the value of a relatively new patient journey modeling technique called the Patient Journey Modeling Architecture (PaJMa) when compared with traditional manufacturing based process modeling tools. The paper also presents results from a small pilot case study that compared the usability of 5 modeling approaches in a mental health care environment. Method Five business process modeling techniques were used to represent a selected patient journey. A mix of both qualitative and quantitative methods was used to evaluate these models. Techniques included a focus group and survey to measure usability of the various models. Results The preliminary evaluation of the usability of the 5 modeling techniques has shown increased staff understanding of the representation of their processes and activities when presented with the models. Improved individual role identification throughout the models was also observed. The extended version of the PaJMa methodology provided the most clarity of information flows for clinicians. Conclusions The extended version of PaJMa provided a significant improvement in the ease of interpretation for clinicians and increased the engagement with the modeling process. The use of color and its effectiveness in distinguishing the representation of roles was a key feature of the framework not present in other modeling approaches. Future research should focus on extending the pilot case study to a more diversified group of clinicians and health care support workers. PMID:27471006

Suicide risk and mental health co-morbidities in a probationer population.

PubMed

Cardarelli, Roberto; Balyakina, Elizabeth; Malone, Kendra; Fulda, Kimberly G; Ellison, Michael; Sivernell, Ron; Shabu, Tanjina

2015-02-01

Mental health problems are disproportionately represented in the community corrections system with limited information on the epidemiology of mental health and correlated factors such as suicide among probationers. This study recruited 2,077 probationers who completed screeners for mental health and substance disorders and suicide risk. Results found 13% of probationers were at high risk of suicide. Those who screened positive for a mental health condition were between 2 and 8 times more likely to screen positive for suicide risk. Allocation of additional resources to mental health in the criminal justice system and to effectively coordinate existing mental health services is needed.

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

The role of job strain in understanding midlife common mental disorder: a national birth cohort study.

PubMed

Harvey, Samuel B; Sellahewa, Dilan A; Wang, Min-Jung; Milligan-Saville, Josie; Bryan, Bridget T; Henderson, Max; Hatch, Stephani L; Mykletun, Arnstein

2018-06-01

Long-standing concerns exist about reverse causation and residual confounding in the prospective association between job strain and risk of future common mental disorders. We aimed to address these concerns through analysis of data collected in the UK National Child Development Study, a large British cohort study. Data from the National Child Development Study (n=6870) were analysed by use of multivariate logistic regression to investigate the prospective association between job strain variables at age 45 years and risk of future common mental disorders at age 50 years, controlling for lifetime psychiatric history and a range of other possible confounding variables across the lifecourse. Population attributable fractions were calculated to estimate the public health effect of job strain on midlife mental health. In the final model, adjusted for all measured confounders, high job demands (odds ratio 1·70, 95% CI 1·25-2·32; p=0·0008), low job control (1·89, 1·29-2·77; p=0·0010), and high job strain (2·22, 1·59-3·09; p<0·0001) remained significant independent predictors of future onset of common mental disorder. If causality is assumed, our findings suggest that 14% of new cases of common mental disorder could have been prevented through elimination of high job strain (population attributable fraction 0·14, 0·06-0·20). High job strain appears to independently affect the risk of future common mental disorders in midlife. These findings suggest that modifiable work-related risk factors might be an important target in efforts to reduce the prevalence of common mental disorders. iCare Foundation and Mental Health Branch, NSW Health. Copyright © 2018 Elsevier Ltd. All rights reserved.

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.

Mental health literacy in korean older adults: A cross-sectional survey.

PubMed

Kim, Y S; Lee, H Y; Lee, M H; Simms, T; Park, B H

2017-09-01

WHAT IS KNOWN ON THE SUBJECT?: Mental health literacy is a fairly new concept, first introduced in 1997. It refers to what people know and believe about mental health disorders. People's knowledge and beliefs help them to recognize, manage and prevent mental disorders. Generally, older adults have lower health literacy compared to young and middle-aged adults. WHAT THIS STUDY ADDS TO EXISTING KNOWLEDGE?: This is the first study on the mental health literacy of Korean older adults. This study looks beyond peoples' ability to recognize mental health disorders and their opinions about them. It identifies factors that are associated with mental health literacy (level of education and social support, the number of people in one's social circles and how individuals rate their health). WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Older adults might get more out of mental health literacy programmes in group or social settings. Programmes that use older adult peer educators/supporters, such as the "older people's champions" of the Healthy Passport programme in England, might make the programmes more effective. Mental health campaigns, such as Australia's beyondblue, might increase mental health literacy of older adults. Introduction Korea is experiencing rapid population ageing, spurring an increased need for mental health services for the elderly. Approximately one-third of Korean older adults experience depressive symptoms, and Korea has the highest elder suicide rate among 34 developed nations. Mental health literacy is an important component of promoting mental health, yet studies on the concept have been conducted in few countries. Aim This study examines the level of mental health literacy among Korean older adults and identifies factors associated with their mental health literacy. Method A cross-sectional survey was conducted with 596 community-dwelling Korean adults aged 65 and older. Andersen's Behavioral Model of Health Services Use framed the study. Results Overall, participants displayed low levels of mental health literacy. They had difficulty recognizing their mental health issues and had limited knowledge about self-help strategies. Mental health literacy was positively associated with education, social support, social network and health status. Discussion and Implications This study highlights a need for efforts to increase mental health literacy among Korean older adults. Strategies that have the potential to empower this population to proactively attend to their mental health include community-based education and national mental health campaigns. © 2017 John Wiley & Sons Ltd.

Acculturation Differences in Communicating Information about Child Mental Health Between Latino Parents and Primary Care Providers

PubMed Central

Lê Cook, Benjamin; Brown, Jonathan D.; Loder, Stephen; Wissow, Larry

2014-01-01

Background Significant Latino-white disparities in youth mental health care access and quality exist yet little is known about Latino parents’ communication with providers about youth mental health and the role of acculturation in influencing this communication. Methods We estimated regression models to assess the association between time in the U.S. and the number of psychosocial issues discussed with the medical assistant (MA) and doctor, adjusting for child and parent mental health and sociodemographics. Other proxies of acculturation were also investigated including measures of Spanish and English language proficiency and nativity. Results Parent’s length of time in the U.S. was positively associated with their communication of: their child’s psychosocial problems with their child’s MA, stress in their own life with their child’s MA, and their child’s school problems with their child’s doctor. These differences were especially apparent for parents living in the U.S. for greater than ten years. Parent-child language discordance, parent and child nativity were also significantly associated with communication of psychosocial problems. Discussion Greater provider and MA awareness of variation in resistance to communicating psychosocial issues could improve communication, and improve the prevention, diagnosis and treatment of youth mental illness. PMID:24705736

A narrative review of mental health support for people during transition from incarceration to community: the grass can be greener on the other side of the fence.

PubMed

Smith-Merry, Jennifer; Mellifont, Damian; McKenzie, Kirsty; Clenaghan, Paul

2018-04-28

Despite significant need for mental health services targeting the requirements of inmates transitioning into the community there is little research about successful recovery-oriented or person-centred transition programs. This systematic narrative review brings together existing evidence to inform policymakers and practitioners about current practice in transition support, and barriers and facilitators of effective practice. We carried out a systematic narrative review of recovery-oriented or person-centred mental health support programs supporting transition from incarceration to the community. Results were obtained from a systematic search of Medline, PubMed and Scopus databases. We found 23 papers which met the paper inclusion criteria along with four other papers which were identified incidentally. Identified barriers to the implementation of effective transition support programs are: administrative problems leading to ineffective in-reach into correctional facilities or untimely support, lack of support for immediate needs meaning that inmates deprioritise their mental health needs, a lack of ongoing program resources and poor communication between correctional facilities and mental health services. Enablers for transition reflect the inverse of these barriers, alongside other successful strategies including medical home models, regionalised programs, programs which target connections with primary care, nurse-led patient-centred health programs and peer support initiatives.

Community pharmacists and mental illness: a survey of service provision, stigma, attitudes and beliefs.

PubMed

Giannetti, Vincent; Caley, Charles F; Kamal, Khalid M; Covvey, Jordan R; McKee, Jerry; Wells, Barbara G; Najarian, Dean M; Dunn, Tyler J; Vadagam, Pratyusha

2018-06-04

Background Half of Americans experience mental illness during their lifetime. Significant opportunity exists for community pharmacists to deliver services to these patients; however, personal and practice-related barriers may prevent full engagement. Objective To assess the demographics, practice characteristics, service provision, stigma, attitudes and beliefs of a national sample of community pharmacists towards individuals with mental illness. Setting National random sample of 3008 community pharmacists in the USA. Method 101-item cross-sectional mailed survey questionnaire on: (1) demographics, (2) knowledge and practice characteristics, (3) provision of clinical pharmacy services, and (4) comparative opinions. Main outcome measure Scaled measures of service provision (comfort, confidence, willingness and interest) and comparative opinions (stigma, attitudes and beliefs) of mental illness, four linear regression models to predict service provision. Results A total of 239 responses were received (response rate 7.95%). Across pharmacy services, ratings for willingness/interest were higher than those for comfort/confidence. Pharmacists who reported providing medication therapy management (MTM) services for patients reported higher comfort (18.36 vs. 17.46, p < 0.05), confidence (17.73 vs. 16.01, p < 0.05), willingness (20.0 vs. 18.62, p < 0.05) and interest (19.13 vs. 17.66, p < 0.05). Pharmacists with personal experience with mental illness also resulted in higher scores across all four domains of service provision, lower levels of stigma (18.28 vs. 20.76, p < 0.05) and more positive attitudes (52.24 vs. 50.53, p < 0.01). Regression analyses demonstrated increased frequency of MTM service delivery and more positive attitudes as significantly predictive across all four models for comfort, confidence, willingness and interest. Increased delivery of pharmacy services was significantly associated with both willingness and interest to provide mental illness-specific services. Conclusion Despite willingness/interest to provide services to patients with mental illness, decreased levels of comfort/confidence remain service-related barriers for community pharmacists.

Mental health system governance in Nigeria: challenges, opportunities and strategies for improvement.

PubMed

Abdulmalik, J; Kola, L; Gureje, O

2016-01-01

A health systems approach to understanding efforts for improving health care services is gaining traction globally. A component of this approach focuses on health system governance (HSG), which can make or mar the successful implementation of health care interventions. Very few studies have explored HSG in low- and middle-income countries, including Nigeria. Studies focusing on mental health system governance, are even more of a rarity. This study evaluates the mental HSG of Nigeria with a view to understanding the challenges, opportunities and strategies for strengthening it. This study was conducted as part of the project, Emerging Mental Health Systems in Low and Middle Income Countries (Emerald). A multi-method study design was utilized to evaluate the mental HSG status of Nigeria. A situational analysis of the health policy and legal environment in the country was performed. Subsequently, 30 key informant interviews were conducted at national, state and district levels to explore the country's mental HSG. The existing policy, legislative and institutional framework for HSG in Nigeria reveals a complete exclusion of mental health in key health sector documents. The revised mental health policy is however promising. Using the Siddiqi framework categories, we identified pragmatic strategies for mental health system strengthening that include a consideration of existing challenges and opportunities within the system. The identified strategies provide a template for the subsequent activities of the Emerald Programme (and other interventions), towards strengthening the mental health system of Nigeria.

An investigation of the mentalization-based model of borderline pathology in adolescents.

PubMed

Quek, Jeremy; Bennett, Clair; Melvin, Glenn A; Saeedi, Naysun; Gordon, Michael S; Newman, Louise K

2018-07-01

According to mentalization-based theory, transgenerational transmission of mentalization from caregiver to offspring is implicated in the pathogenesis of borderline personality disorder (BPD). Recent research has demonstrated an association between hypermentalizing (excessive, inaccurate mental state reasoning) and BPD, indicating the particular relevance of this form of mentalizing dysfunction to the transgenerational mentalization-based model. As yet, no study has empirically assessed a transgenerational mentalization-based model of BPD. The current study sought firstly to test the mentalization-based model, and additionally, to determine the form of mentalizing dysfunction in caregivers (e.g., hypo- or hypermentalizing) most relevant to a hypermentalizing model of BPD. Participants were a mixed sample of adolescents with BPD and a sample of non-clinical adolescents, and their respective primary caregivers (n = 102; 51 dyads). Using an ecologically valid measure of mentalization, mediational analyses were conducted to examine the relationships between caregiver mentalizing, adolescent mentalizing, and adolescent borderline features. Findings demonstrated that adolescent mentalization mediated the effect of caregiver mentalization on adolescent borderline personality pathology. Furthermore, results indicated that hypomentalizing in caregivers was related to adolescent borderline personality pathology via an effect on adolescent hypermentalizing. Results provide empirical support for the mentalization-based model of BPD, and suggest the indirect influence of caregiver mentalization on adolescent borderline psychopathology. Results further indicate the relevance of caregiver hypomentalizing to a hypermentalizing model of BPD. Copyright © 2018 Elsevier Inc. All rights reserved.

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.

Anxiety after completion of treatment for early-stage breast cancer: a systematic review to identify candidate predictors and evaluate multivariable model development.

PubMed

Harris, Jenny; Cornelius, Victoria; Ream, Emma; Cheevers, Katy; Armes, Jo

2017-07-01

The purpose of this review was to identify potential candidate predictors of anxiety in women with early-stage breast cancer (BC) after adjuvant treatments and evaluate methodological development of existing multivariable models to inform the future development of a predictive risk stratification model (PRSM). Databases (MEDLINE, Web of Science, CINAHL, CENTRAL and PsycINFO) were searched from inception to November 2015. Eligible studies were prospective, recruited women with stage 0-3 BC, used a validated anxiety outcome ≥3 months post-treatment completion and used multivariable prediction models. Internationally accepted quality standards were used to assess predictive risk of bias and strength of evidence. Seven studies were identified: five were observational cohorts and two secondary analyses of RCTs. Variability of measurement and selective reporting precluded meta-analysis. Twenty-one candidate predictors were identified in total. Younger age and previous mental health problems were identified as risk factors in ≥3 studies. Clinical variables (e.g. treatment, tumour grade) were not identified as predictors in any studies. No studies adhered to all quality standards. Pre-existing vulnerability to mental health problems and younger age increased the risk of anxiety after completion of treatment for BC survivors, but there was no evidence that chemotherapy was a predictor. Multiple predictors were identified but many lacked reproducibility or were not measured across studies, and inadequate reporting did not allow full evaluation of the multivariable models. The use of quality standards in the development of PRSM within supportive cancer care would improve model quality and performance, thereby allowing professionals to better target support for patients.

Summary: Report to President's Commission on Mental Health from the Special Populations Subtask Panel; Mental Health of Hispanic Americans; Recommendations to the Commission.

ERIC Educational Resources Information Center

Carrillo, Carmen

The issue of the delivery of mental health services to Hispanic Americans is discussed in this report to the President's Commission on Mental Health. Hispanics, who will be the largest minority group in the United States within the next 25 years, do not make use of sufficient existing health services. They have a need for alternative services…

Measurement-based management of mental health quality and access in VHA: SAIL mental health domain.

PubMed

Lemke, Sonne; Boden, Matthew Tyler; Kearney, Lisa K; Krahn, Dean D; Neuman, Matthew J; Schmidt, Eric M; Trafton, Jodie A

2017-02-01

We outline the development of a Mental Health Domain to track accessibility and quality of mental health care in the United States Veterans Health Administration (VHA) as part of a broad-based performance measurement system. This domain adds an important element to national performance improvement efforts by targeting regional and facility leadership and providing them a concise yet comprehensive measure to identify facilities facing challenges in their mental health programs. We present the conceptual framework and rationale behind measure selection and development. The Mental Health Domain covers three important aspects of mental health treatment: Population Coverage, Continuity of Care, and Experience of Care. Each component is a composite of existing and newly adapted measures with moderate to high internal consistency; components are statistically independent or moderately related. Development and dissemination of the Mental Health Domain involved a variety of approaches and benefited from close collaboration between local, regional, and national leadership and from coordination with existing quality-improvement initiatives. During the first year of use, facilities varied in the direction and extent of change. These patterns of change were generally consistent with qualitative information, providing support for the validity of the domain and its component measures. Measure maintenance remains an iterative process as the VHA mental health system and potential data resources continue to evolve. Lessons learned may be helpful to the broader mental health-provider community as mental health care consolidates and becomes increasingly integrated within healthcare systems. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Diagnosing Students' Mental Models via the Web-Based Mental Models Diagnosis System

ERIC Educational Resources Information Center

Wang, Tzu-Hua; Chiu, Mei-Hung; Lin, Jing-Wen; Chou, Chin-Cheng

2013-01-01

Mental models play an important role in science education research. To extend the effectiveness of conceptual change research and to improve mental model identi?cation and diagnosis, the authors developed and tested the Web-Based Mental Models Diagnosis (WMMD) system. In this article, they describe their WMMD system, which goes beyond the…

The Language of Social Support in Social Media and its Effect on Suicidal Ideation Risk

PubMed Central

De Choudhury, Munmun; Kıcıman, Emre

2017-01-01

Online social support is known to play a significant role in mental well-being. However, current research is limited in its ability to quantify this link. Challenges exist due to the paucity of longitudinal, pre- and post mental illness risk data, and reliable methods that can examine causality between past availability of support and future risk. In this paper, we propose a method to measure how the language of comments in Reddit mental health communities influences risk to suicidal ideation in the future. Incorporating human assessments in a stratified propensity score analysis based framework, we identify comparable subpopulations of individuals and measure the effect of online social support language. We interpret these linguistic cues with an established theoretical model of social support, and find that esteem and network support play a more prominent role in reducing forthcoming risk. We discuss the implications of our work for designing tools that can improve support provisions in online communities. PMID:28840079

Medicaid managed care for mental health services: the survival of safety net institutions in rural settings.

PubMed

Willging, Cathleen E; Waitzkin, Howard; Nicdao, Ethel

2008-09-01

Few accounts document the rural context of mental health safety net institutions (SNIs), especially as they respond to changing public policies. Embedded in wider processes of welfare state restructuring, privatization has transformed state Medicaid systems nationwide. We carried out an ethnographic study in two rural, culturally distinct regions of New Mexico to assess the effects of Medicaid managed care (MMC) and the implications for future reform. After 160 interviews and participant observation at SNIs, we analyzed data through iterative coding procedures. SNIs responded to MMC by nonparticipation, partnering, downsizing, and tapping into alternative funding sources. Numerous barriers impaired access under MMC: service fragmentation, transportation, lack of cultural and linguistic competency, Medicaid enrollment, stigma, and immigration status. By privatizing Medicaid and contracting with for-profit managed care organizations, the state placed additional responsibilities on "disciplined" providers and clients. Managed care models might compromise the rural mental health safety net unless the serious gaps and limitations are addressed in existing services and funding.

The Language of Social Support in Social Media and its Effect on Suicidal Ideation Risk.

PubMed

De Choudhury, Munmun; Kıcıman, Emre

2017-05-01

Online social support is known to play a significant role in mental well-being. However, current research is limited in its ability to quantify this link. Challenges exist due to the paucity of longitudinal, pre- and post mental illness risk data, and reliable methods that can examine causality between past availability of support and future risk. In this paper, we propose a method to measure how the language of comments in Reddit mental health communities influences risk to suicidal ideation in the future. Incorporating human assessments in a stratified propensity score analysis based framework, we identify comparable subpopulations of individuals and measure the effect of online social support language. We interpret these linguistic cues with an established theoretical model of social support, and find that esteem and network support play a more prominent role in reducing forthcoming risk. We discuss the implications of our work for designing tools that can improve support provisions in online communities.

The Effects of Organizational Culture on Mental Health Service Engagement of Transition Age Youth.

PubMed

Kim, HyunSoo; Tracy, Elizabeth M; Biegel, David E; Min, Meeyoung O; Munson, Michelle R

2015-10-01

Nationwide, there is a growing concern in understanding mental health service engagement among transition age youth. The ecological perspective suggests that there are multiple barriers to service engagement which exist on varying levels of the ecosystem. Based on the socio-technical theory and organizational culture theory, this study examined the impact of organization-level characteristics on perceived service engagement and the moderating role of organizational culture on practitioner-level characteristics affecting youth service engagement. A cross-sectional survey research design was used to address the research questions. The data were collected from 279 practitioners from 27 mental health service organizations representing three major metropolitan areas in Ohio. Hierarchical linear modeling was used to address a nested structure. Findings revealed that location of organization, service setting, and organizational culture had significant effects on the continuation of services. In addition, the relationship between service coordination and resource knowledge and service engagement was moderated by organizational culture.

Evidence-based treatment and supervision practices for co-occurring mental and substance use disorders in the criminal justice system.

PubMed

Peters, Roger H; Young, M Scott; Rojas, Elizabeth C; Gorey, Claire M

2017-07-01

Over seven million persons in the United States are supervised by the criminal justice system, including many who have co-occurring mental and substance use disorders (CODs). This population is at high risk for recidivism and presents numerous challenges to those working in the justice system. To provide a contemporary review of the existing research and examine key issues and evidence-based treatment and supervision practices related to CODs in the justice system. We reviewed COD research involving offenders that has been conducted over the past 20 years and provide an analysis of key findings. Several empirically supported frameworks are available to guide services for offenders who have CODs, including Integrated Dual Disorders Treatment (IDDT), the Risk-Need-Responsivity (RNR) model, and Cognitive-Behavioral Therapy (CBT). Evidence-based services include integrated assessment that addresses both sets of disorders and the risk for criminal recidivism. Although several evidence-based COD interventions have been implemented at different points in the justice system, there remains a significant gap in services for offenders who have CODs. Existing program models include Crisis Intervention Teams (CIT), day reporting centers, specialized community supervision teams, pre- and post-booking diversion programs, and treatment-based courts (e.g., drug courts, mental health courts, COD dockets). Jail-based COD treatment programs provide stabilization of acute symptoms, medication consultation, and triage to community services, while longer-term prison COD programs feature Modified Therapeutic Communities (MTCs). Despite the availability of multiple evidence-based interventions that have been implemented across diverse justice system settings, these services are not sufficiently used to address the scope of treatment and supervision needs among offenders with CODs.

Development of lifetime comorbidity in the WHO World Mental Health (WMH) Surveys

PubMed Central

Kessler, Ronald C.; Ormel, Johan; Petukhova, Maria; McLaughlin, Katie A.; Green, Jennifer Greif; Russo, Leo J.; Stein, Dan J.; Zaslavsky, Alan M; Aguilar-Gaxiola, Sergio; Alonso, Jordi; Andrade, Laura; Benjet, Corina; de Girolamo, Giovanni; de Graaf, Ron; Demyttenaere, Koen; Fayyad, John; Haro, Josep Maria; Hu, Chi yi; Karam, Aimee; Lee, Sing; Lepine, Jean-Pierre; Matchsinger, Herbert; Mihaescu-Pintia, Constanta; Posada-Villa, Jose; Sagar, Rajesh; Üstün, T. Bedirhan

2010-01-01

CONTEXT Although numerous studies have examined the role of latent variables in the structure of comorbidity among mental disorders, none has examined their role in the development of comorbidity. OBJECTIVE To study the role of latent variables in the development of comorbidity among 18 lifetime DSM-IV disorders in the WHO World Mental Health (WMH) surveys. SETTING/PARTICIPANTS Nationally or regionally representative community surveys in 14 countries with a total of 21,229 respondents. MAIN OUTCOME MEASURES First onset of 18 lifetime DSM-IV anxiety, mood, behavior, and substance disorders assessed retrospectively in the WHO Composite International Diagnostic Interview (CIDI). RESULTS Separate internalizing (anxiety and mood disorders) and externalizing (behavior and substance disorders) factors were found in exploratory factor analysis of lifetime disorders. Consistently significant positive time-lagged associations were found in survival analyses for virtually all temporally primary lifetime disorders predicting subsequent onset of other disorders. Within-domain (i.e., internalizing or externalizing) associations were generally stronger than between-domain associations. The vast majority of time-lagged associations were explained by a model that assumed the existence of mediating latent internalizing and externalizing variables. Specific phobia and obsessive-compulsive disorder (internalizing) and hyperactivity disorder and oppositional-defiant disorder (externalizing) were the most important predictors. A small number of residual associations remained significant after controlling the latent variables. CONCLUSIONS The good fit of the latent variable model suggests that common causal pathways account for most of the comorbidity among the disorders considered here. These common pathways should be the focus of future research on the development of comorbidity, although several important pair-wise associations that cannot be accounted for by latent variables also exist that warrant further focused study. PMID:21199968

Supporting the Implementation of Evidence-Based Practices for Adults with Co-Occurring Mental and Substance Use Disorders

ERIC Educational Resources Information Center

Biegel, David E.; Kola, Lenore A.; Ronis, Robert R.

2007-01-01

Significant barriers exist to the implementation of evidence-based practices into routine mental health and substance abuse settings. This paper discusses the role and function of technical assistance centers to help support the implementation process using, as a guide, the experience of the Ohio Substance Abuse and Mental Illness Coordinating…

Community Music as a Vehicle for Tackling Mental Health-Related Stigma

ERIC Educational Resources Information Center

Rodgers, Debra

2017-01-01

This paper seeks to highlight some of the key issues of the social stigma associated with mental health-related issues, to present examples of some existing anti-stigma concepts found within mental health literature and, in turn, to begin to suggest ways in which the personal and social experience of participation within community music activities…

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…

The Study on the Psychological Problems and Countermeasures of the Full-Time Professional Masters

ERIC Educational Resources Information Center

Hui, Tang; Liang, Ma

2012-01-01

Mental health education is one of the most important tasks in postgraduate education. Professional master, as a graduate of an emerging group, its mental health education cannot be ignored. This paper focuses on the existence of some mental health problems of Chinese full-time professional master, explores and analyzes their causes and finally…

Students Seeking Help for Mental Health Problems: Do Australian University Websites Provide Clear Pathways?

ERIC Educational Resources Information Center

Laws, Thomas A.; Fiedler, Brenton A.

2013-01-01

Mental health problems in young Australians continue to be a major public health issue. Studying at university can generate social pressures particularly for youth, which have been associated with the onset of a mental illness or a worsening of an existing condition. Many universities provide health services to support students with health…

Comparison of health-related quality of life among men with different co-existing severe mental disorders in treatment for substance use.

PubMed

Adan, Ana; Marquez-Arrico, Julia E; Gilchrist, Gail

2017-10-23

Patient-perceived health-related quality of life has become an important outcome in health care as an indicator of treatment effectiveness and recovery for patients with substance use disorder. As no study has assessed health-related quality of life among male patients with substance use disorder and co-existing severe mental illness, we compared health-related quality of life among patients with substance use disorder and the following severe mental illness diagnosis in Barcelona, Spain: schizophrenia, bipolar disorder, major depressive disorder, and examined the associations with clinically related variables. Additionally, we compared results for health-related quality of life in patients with substance use disorder and severe mental illness, with Spanish population norms. We assessed 107 substance use disorder male patients using the 36-Item Short Form Health Survey comparing results across three groups with: comorbid schizophrenia (n = 37), comorbid bipolar disorder (n = 34), and comorbid major depressive disorder (n = 36). Multiple analyses of variance were performed to explore health-related quality of life by the type of co-existing SMI and linear regression analyses examined clinical correlates for the 36-Item Short Form Health Survey dimensions for each group. There were differences in Physical Functioning, Vitality and the Physical Composite Scale among groups. Poorer Physical Functioning was observed for patients with comorbid schizophrenia (80.13±3.27) and major depressive disorder (81.97±3.11) compared with comorbid bipolar disorder patients (94.26±1.93). Patients with substance use disorder and schizophrenia presented lower scores in Vitality (41.6±2.80) than those with co-existing bipolar disorder (55.68±3.66) and major depressive disorder (53.63±2.92). Finally, results in the Physical Composite Scale showed lower scores for patients with comorbid schizophrenia (51.06±1.41) and major depressive disorder (51.99±1.87) than for those with bipolar disorder (60.40±2.17). Moreover, all groups had poorer health-related quality of life, especially Social Functioning, Role-Emotional and Mental Health, compared with population norms. Different clinical variables (e.g. medical disease comorbidity, severity of addiction, psychiatric symptomatology, suicide attempts, drug relapses) were related to different health-related quality of life dimensions depending on the co-existing severe mental illness. Among male patients with substance use disorder, co-existing severe mental illness may influence some health-related quality of life dimensions and clinically related variables. Such differences may require tailored therapeutic interventions.

Learning about static electricity and magnetism in a fourth-grade classroom

NASA Astrophysics Data System (ADS)

Henry, David Roy

Students begin to develop mental models to explain electrostatic and magnetic phenomena throughout childhood, middle childhood and high school, although these mental models are often incoherent and unscientific (Borges, Tenico, & Gilbert, 1998; Maloney, 1985). This is a case study of a classroom of grade four students and the mental models of magnetism and static electricity they used during a six-week science unit. The 22 students studied magnetism and static electricity using inquiry activities structured to create an environment where students would be likely to construct powerful scientific ideas (Goldberg & Bendall, 1995). Multiple data sources, including students' writing, student assessments, teacher interviews, student interviews, teacher journals, and classroom video and audio recordings were used to uncover how fourth grade students made sense of static electricity and magnetism before, during, and after instruction. The data were analyzed using a social constructivist framework to determine if students were able to develop target scientific ideas about static electricity and magnetism. In general, students were found to have three core mental models prior to instruction: (1) Static electricity and magnetism are the same "substance"; (2) This substance exists on the surface of a magnet or a charged object and can be rubbed off, and (3) Opposite substances attract. During the activities, students had many opportunities to observe evidence that contradicted these core mental models. Using evidence from direct observations, the students practiced differentiating between evidence and ideas. Through group and class discussions, they developed evidenced-based (scientific) ideas. Final assessments revealed that students were able to construct target ideas such as: (1) static electricity and magnetism are fundamentally different; (2) there are two kinds of static "charge;" (3) magnet-rubbed wires act like a magnet; and (4) opposite substances move toward each other, like substances push away from each other. Some target ideas, such as "Magnetic materials are made up of magnetic domains that align to give an overall magnetic effect" were found to be difficult for students this age to develop. This case study will augment research about effective science teaching, teacher development and the support necessary for curriculum change.

mHealth and global mental health: still waiting for the mH2 wedding?

PubMed Central

2014-01-01

Background Two phenomena have become increasingly visible over the past decade: the significant global burden of disease arising from mental illness and the rapid acceleration of mobile phone usage in poorer countries. Mental ill-health accounts for a significant proportion of global disability-adjusted life years (DALYs) and years lived with disability (YLDs), especially in poorer countries where a number of factors combine to exacerbate issues of undertreatment. Yet poorer countries have also witnessed significant investments in, and dramatic expansions of, mobile coverage and usage over the past decade. Debate The conjunction of high levels of mental illness and high levels of mobile phone usage in poorer countries highlights the potential for “mH2” interventions – i.e. mHealth (mobile technology-based) mental health interventions - to tackle global mental health challenges. However, global mental health movements and initiatives have yet to engage fully with this potential, partly because of scepticism towards technological solutions in general and partly because existing mH2 projects in mental health have often taken place in a fragmented, narrowly-focused, and small-scale manner. We argue for a deeper and more sustained engagement with mobile phone technology in the global mental health context, and outline the possible shape of an integrated mH2 platform for the diagnosis, treatment, and monitoring of mental health. Summary Existing and developing mH2 technologies represent an underutilised resource in global mental health. If development, evaluation, and implementation challenges are overcome, an integrated mH2 platform would make significant contributions to mental healthcare in multiple settings and contexts. PMID:24670011

E-Mental Health Innovations for Aboriginal and Torres Strait Islander Australians: A Qualitative Study of Implementation Needs in Health Services.

PubMed

Puszka, Stefanie; Dingwall, Kylie M; Sweet, Michelle; Nagel, Tricia

2016-09-19

Electronic mental health (e-mental health) interventions offer effective, easily accessible, and cost effective treatment and support for mental illness and well-being concerns. However, e-mental health approaches have not been well utilized by health services to date and little is known about their implementation in practice, particularly in diverse contexts and communities. This study aims to understand stakeholder perspectives on the requirements for implementing e-mental health approaches in regional and remote health services for Indigenous Australians. Qualitative interviews were conducted with 32 managers, directors, chief executive officers (CEOs), and senior practitioners of mental health, well-being, alcohol and other drug and chronic disease services. The implementation of e-mental health approaches in this context is likely to be influenced by characteristics related to the adopter (practitioner skill and knowledge, client characteristics, communication barriers), the innovation (engaging and supportive approach, culturally appropriate design, evidence base, data capture, professional development opportunities), and organizational systems (innovation-systems fit, implementation planning, investment). There is potential for e-mental health approaches to address mental illness and poor social and emotional well-being amongst Indigenous people and to advance their quality of care. Health service stakeholders reported that e-mental health interventions are likely to be most effective when used to support or extend existing health services, including elements of client-driven and practitioner-supported use. Potential solutions to obstacles for integration of e-mental health approaches into practice were proposed including practitioner training, appropriate tool design using a consultative approach, internal organizational directives and support structures, adaptations to existing systems and policies, implementation planning and organizational and government investment.

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…

Realistic neurons can compute the operations needed by quantum probability theory and other vector symbolic architectures.

PubMed

Stewart, Terrence C; Eliasmith, Chris

2013-06-01

Quantum probability (QP) theory can be seen as a type of vector symbolic architecture (VSA): mental states are vectors storing structured information and manipulated using algebraic operations. Furthermore, the operations needed by QP match those in other VSAs. This allows existing biologically realistic neural models to be adapted to provide a mechanistic explanation of the cognitive phenomena described in the target article by Pothos & Busemeyer (P&B).

The Structure of Psychopathology: Toward an Expanded Quantitative Empirical Model

PubMed Central

Wright, Aidan G.C.; Krueger, Robert F.; Hobbs, Megan J.; Markon, Kristian E.; Eaton, Nicholas R.; Slade, Tim

2013-01-01

There has been substantial recent interest in the development of a quantitative, empirically based model of psychopathology. However, the majority of pertinent research has focused on analyses of diagnoses, as described in current official nosologies. This is a significant limitation because existing diagnostic categories are often heterogeneous. In the current research, we aimed to redress this limitation of the existing literature, and to directly compare the fit of categorical, continuous, and hybrid (i.e., combined categorical and continuous) models of syndromes derived from indicators more fine-grained than diagnoses. We analyzed data from a large representative epidemiologic sample (the 2007 Australian National Survey of Mental Health and Wellbeing; N = 8,841). Continuous models provided the best fit for each syndrome we observed (Distress, Obsessive Compulsivity, Fear, Alcohol Problems, Drug Problems, and Psychotic Experiences). In addition, the best fitting higher-order model of these syndromes grouped them into three broad spectra: Internalizing, Externalizing, and Psychotic Experiences. We discuss these results in terms of future efforts to refine emerging empirically based, dimensional-spectrum model of psychopathology, and to use the model to frame psychopathology research more broadly. PMID:23067258

People with dyslexia and heart, chest, skin, digestive, musculoskeletal, vision, learning, speech and mental disorders were more dissatisfied with neighbourhoods: Scottish Household Survey, 2007-2008.

PubMed

Shiue, Ivy

2016-12-01

Rarely do we know the perception toward neighbourhoods in people specifically with health conditions. Therefore, the aim of the present study was to understand the perception toward neighbourhoods among adults with a series of the existing health conditions in a country-wide and population-based setting. Data were retrieved from and analysed in Scottish Household Survey, 2007-2008. Information on demographics, self-reported health conditions and perception toward neighbourhoods and the surrounding facilities was obtained by household interview. Analysis including chi-square test, t test and logistic regression modelling were performed. Of 19,150 Scottish adults (aged 16-80) included in the study cohort, 1079 (7.7 %) people were dissatisfied with their living areas; particularly for those who experienced harassment (15.4 %), did not recycle or with dyslexia, chest, digestive, mental and musculoskeletal problems. Twenty to forty per cent reported common neighbourhood problems including noise, rubbish, disputes, graffiti, harassment and drug misuse. People with heart or digestive problems were more dissatisfied with the existing parks and open space. People with arthritis, chest or hearing problems were more dissatisfied with the waste management condition. People with dyslexia were more dissatisfied with the existing public transportation. People with heart problems were more dissatisfied with the current street cleaning condition. People with hearing, vision, speech, learning problems or dyslexia were also more dissatisfied with sports and recreational facilities. People with heart, chest, skin, digestive, musculoskeletal, vision, learning, speech and mental disorders and dyslexia were more dissatisfied with their current neighbourhood environments. Upgrading neighbourhood planning to tackle social environment injustice and put pleasant life experience as priorty would be suggested. Graphical abstract interrelations of individual health and neighbourhood health.

Enhancing social networks: a qualitative study of health and social care practice in UK mental health services.

PubMed

Webber, Martin; Reidy, Hannah; Ansari, David; Stevens, Martin; Morris, David

2015-03-01

People with severe mental health problems such as psychosis have access to less social capital, defined as resources within social networks, than members of the general population. However, a lack of theoretically and empirically informed models hampers the development of social interventions which seek to enhance an individual's social networks. This paper reports the findings of a qualitative study, which used ethnographic field methods in six sites in England to investigate how workers helped people recovering from psychosis to enhance their social networks. This study drew upon practice wisdom and lived experience to provide data for intervention modelling. Data were collected from 73 practitioners and 51 people who used their services in two phases. Data were selected and coded using a grounded theory approach to depict the key themes that appeared to underpin the generation of social capital within networks. Findings are presented in four over-arching themes - worker skills, attitudes and roles; connecting people processes; role of the agency; and barriers to network development. The sub-themes which were identified included worker attitudes; person-centred approach; equality of worker-individual relationship; goal setting; creating new networks and relationships; engagement through activities; practical support; existing relationships; the individual taking responsibility; identifying and overcoming barriers; and moving on. Themes were consistent with recovery models used within mental health services and will provide the basis for the development of an intervention model to enhance individuals' access to social capital within networks. © 2014 John Wiley & Sons Ltd.

Assessing what to address in science communication.

PubMed

Bruine de Bruin, Wändi; Bostrom, Ann

2013-08-20

As members of a democratic society, individuals face complex decisions about whether to support climate change mitigation, vaccinations, genetically modified food, nanotechnology, geoengineering, and so on. To inform people's decisions and public debate, scientific experts at government agencies, nongovernmental organizations, and other organizations aim to provide understandable and scientifically accurate communication materials. Such communications aim to improve people's understanding of the decision-relevant issues, and if needed, promote behavior change. Unfortunately, existing communications sometimes fail when scientific experts lack information about what people need to know to make more informed decisions or what wording people use to describe relevant concepts. We provide an introduction for scientific experts about how to use mental models research with intended audience members to inform their communication efforts. Specifically, we describe how to conduct interviews to characterize people's decision-relevant beliefs or mental models of the topic under consideration, identify gaps and misconceptions in their knowledge, and reveal their preferred wording. We also describe methods for designing follow-up surveys with larger samples to examine the prevalence of beliefs as well as the relationships of beliefs with behaviors. Finally, we discuss how findings from these interviews and surveys can be used to design communications that effectively address gaps and misconceptions in people's mental models in wording that they understand. We present applications to different scientific domains, showing that this approach leads to communications that improve recipients' understanding and ability to make informed decisions.

Patients' mental models and adherence to outpatient physical therapy home exercise programs.

PubMed

Rizzo, Jon

2015-05-01

Within physical therapy, patient adherence usually relates to attending appointments, following advice, and/or undertaking prescribed exercise. Similar to findings for general medical adherence, patient adherence to physical therapy home exercise programs (HEP) is estimated between 35 and 72%. Adherence to HEPs is a multifactorial and poorly understood phenomenon, with no consensus regarding a common theoretical framework that best guides empirical or clinical efforts. Mental models, a construct used to explain behavior and decision-making in the social sciences, may serve as this framework. Mental models comprise an individual's tacit thoughts about how the world works. They include assumptions about new experiences and expectations for the future based on implicit comparisons between current and past experiences. Mental models play an important role in decision-making and guiding actions. This professional theoretical article discusses empirical research demonstrating relationships among mental models, prior experience, and adherence decisions in medical and physical therapy contexts. Specific issues related to mental models and physical therapy patient adherence are discussed, including the importance of articulation of patients' mental models, assessment of patients' mental models that relate to exercise program adherence, discrepancy between patient and provider mental models, and revision of patients' mental models in ways that enhance adherence. The article concludes with practical implications for physical therapists and recommendations for further research to better understand the role of mental models in physical therapy patient adherence behavior.

Sustaining a culture of practice development in an acute adolescent inpatient mental health unit.

PubMed

Vella, Natalie; Page, Laura; Edwards, Clair; Wand, Timothy

2014-08-01

It is recognized that facilitating change in workplace culture is a significant challenge in healthcare service delivery. Practice development strategies and principles provide a framework for initiating and sustaining programs focused on enhancing patient-centered care by concentrating on the therapeutic attributes of nursing. However, little literature exists on explicating "what worked" in practice development programs. This paper details the processes, people, resources, and relationships that enabled the successful implementation, and led to the sustainability, of a practice development program employed in an acute adolescent mental health unit in Sydney, Australia. Following an external review of the unit, a meeting of key stakeholders was convened and subsequently an advisory panel formed to address specific issues facing nursing staff. This process resulted in the development of an educational package and adoption of the tidal model as the framework for mental health nursing practice in the unit. Clinical reasoning sessions and journal article presentations were incorporated to consolidate and maintain the change in nursing care. A planned, structured, and inclusive practice development program has transformed the nursing culture and vastly improved the care provided to adolescents presenting in acute states of distress to this mental health unit. © 2014 Wiley Periodicals, Inc.

Correlation of understanding of physics and psychological symptoms among high-school students in Greece

NASA Astrophysics Data System (ADS)

Aggeliki, Anagnostopoulou; Miltiades, Kyprianou; Antigoni-Elisavet, Rota; Evangelia, Pavlatou; Loizos, Zaphiris

2017-09-01

Depression may essentially influence cognitive function contributing to poor school performance. The present study undertakes to determine the existence and strength of correlation between depressive symptomatology and other mental conditions with the acquired level of understanding of Newtonian physics taught in schools. The current study recruited 490 students (262 girls, 228 boys) attending the first semester of the Greek Second Grade of General Lyceum School. Force Concept Inventory (FCI) tested the depth of the students’ understanding of Newtonian Physics. Symptom Checklist-90-R assessed general mental status. The tests took place in the classroom during a 1 h session. Low FCI scores significantly correlated with mental conditions, with depression ranking first. Girls had higher scores in all nine symptoms scales of SCL-90 and lower FCI scores. Stepwise regression models proved that the gender effect on FCI could be effectively explained through the significant effect of depression. An understanding of Newtonian physics among high school students may be restricted by common problematic mental conditions, with depression being the greatest among all. Further research, using a more systematic approach to measure depression among adolescents with poor understanding of physics, would help to elucidate the nature of the effect.

Closing the mental health treatment gap in South Africa: a review of costs and cost-effectiveness.

PubMed

Jack, Helen; Wagner, Ryan G; Petersen, Inge; Thom, Rita; Newton, Charles R; Stein, Alan; Kahn, Kathleen; Tollman, Stephen; Hofman, Karen J

2014-01-01

Nearly one in three South Africans will suffer from a mental disorder in his or her lifetime, a higher prevalence than many low- and middle-income countries. Understanding the economic costs and consequences of prevention and packages of care is essential, particularly as South Africa considers scaling-up mental health services and works towards universal health coverage. Economic evaluations can inform how priorities are set in system or spending changes. To identify and review research from South Africa and sub-Saharan Africa on the direct and indirect costs of mental, neurological, and substance use (MNS) disorders and the cost-effectiveness of treatment interventions. Narrative overview methodology. Reviewed studies indicate that integrating mental health care into existing health systems may be the most effective and cost-efficient approach to increase access to mental health services in South Africa. Integration would also direct treatment, prevention, and screening to people with HIV and other chronic health conditions who are at high risk for mental disorders. We identify four major knowledge gaps: 1) accurate and thorough assessment of the health burdens of MNS disorders, 2) design and assessment of interventions that integrate mental health screening and treatment into existing health systems, 3) information on the use and costs of traditional medicines, and 4) cost-effectiveness evaluation of a range of specific interventions or packages of interventions that are tailored to the national context.

Legal protection of the right to work and employment for persons with mental health problems: a review of legislation across the world.

PubMed

Nardodkar, Renuka; Pathare, Soumitra; Ventriglio, Antonio; Castaldelli-Maia, João; Javate, Kenneth R; Torales, Julio; Bhugra, Dinesh

2016-08-01

The right to work and employment is indispensable for social integration of persons with mental health problems. This study examined whether existing laws pose structural barriers in the realization of right to work and employment of persons with mental health problems across the world. It reviewed disability-specific, human rights legislation, and labour laws of all UN Member States in the context of Article 27 of the UN Convention on the Rights of Persons with Disabilities (CRPD). It wes found that laws in 62% of countries explicitly mention mental disability/impairment/illness in the definition of disability. In 64% of countries, laws prohibit discrimination against persons with mental health during recruitment; in one-third of countries laws prohibit discontinuation of employment. More than half (56%) the countries have laws in place which offer access to reasonable accommodation in the workplace. In 59% of countries laws promote employment of persons with mental health problems through different affirmative actions. Nearly 50 years after the adoption of the International Covenant on Economic, Social, and Cultural Rights and 10 years after the adoption of CRPD by the UN General Assembly, legal discrimination against persons with mental health problems continues to exist globally. Countries and policy-makers need to implement legislative measures to ensure non-discrimination of persons with mental health problems during employment.

Perinatal mental health: Fathers - the (mostly) forgotten parent.

PubMed

Wong, Olivia; Nguyen, Tram; Thomas, Naomi; Thomson-Salo, Frances; Handrinos, Dennis; Judd, Fiona

2016-12-01

The importance of parental mental health as a determinant of infant and child outcomes is increasingly acknowledged. Yet, there is limited information regarding paternal mental health during the perinatal period. The aim of this review is to summarize existing clinical research regarding paternal mental health in the perinatal period in various contexts, and its possible impact on infant development. An electronic literature search was conducted using MEDLINE and PubMed databases. Key texts were used to cross-check for any further articles of interest. Men are at increased risk of mental health problems during the transition to fatherhood, as well as during the perinatal period. Paternal mental health during the perinatal period has been shown to impact on their child's emotional and behavioral development. However, research addressing the needs of fathers with mental illness and the impact of their illness on their infant and family has been limited. A paradigm shift is required, from a focus on women following childbirth and women with pre-existing psychiatric disorders, to a broader family perspective with the focus firmly on parent-infant relationships. This paradigm shift needs to involve greater research into the fathering role and paternal mental illness during the perinatal period, including further studies into risk factors, impact on the family system, and the most appropriate form of intervention and service provision. © 2015 Wiley Publishing Asia Pty Ltd.

Religious Involvement and the Use of Mental Health Care

PubMed Central

Harris, Katherine M; Edlund, Mark J; Larson, Sharon L

2006-01-01

Objectives To examine the association between religious involvement and mental health care use by adults age 18 or older with mental health problems. Methods We used data from the 2001–2003 National Surveys on Drug Use and Health. We defined two subgroups with moderate (n=49,902) and serious mental or emotional distress (n=14,548). For each subgroup, we estimated a series of bivariate probit models of past year use of outpatient care and prescription medications using indicators of the frequency of religious service attendance and two measures of the strength and influence of religious beliefs as independent variables. Covariates included common Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, disorders symptoms, substance use and related disorders, self-rated health status, and sociodemographic characteristics. Results Among those with moderate distress, we found some evidence of a positive relationship between religious service attendance and outpatient mental health care use and of a negative relationship between the importance of religious beliefs and outpatient use. Among those with serious distress, use of outpatient care and medication was more strongly associated with service attendance and with the importance of religious beliefs. By contrast, we found a negative association between outpatient use and the influence of religious beliefs on decisions. Conclusion The positive relationship between religious service participation and service use for those with serious distress suggests that policy initiatives aimed at increasing the timely and appropriate use of mental health care may be able to build upon structures and referral processes that currently exist in many religious organizations. PMID:16584455

Prevention of common mental disorders: what can we learn from those who have gone before and where do we go next?

PubMed

Jacka, Felice N; Reavley, Nicola J; Jorm, Anthony F; Toumbourou, John W; Lewis, Andrew J; Berk, Michael

2013-10-01

Prevention strategies have made a major contribution to the considerable successes in reductions in cardiovascular disease and cancer mortality seen in recent decades. However, in the field of psychiatry, similar population-level initiatives in the prevention of common mental disorders, depression and anxiety, are noticeably lacking. This paper aims to provide a brief overview of the existing literature on the topic of the prevention of common mental disorders and a commentary regarding the way forward for prevention research and implementation. This commentary considers what we currently know, what we might learn from the successes and failures of those working in prevention of other high prevalence health conditions, and where we might go from here. Taking cognisance of previous preventive models, this commentary additionally explores new opportunities for preventive approaches to the common mental disorders. The consensus from a large body of evidence supports the contention that interventions to prevent mental disorders across the lifespan can be both effective and cost-effective. However, funding for research in the area of prevention of common mental disorders is considerably lower than that for research in the areas of treatment, epidemiology and neurobiology. Thus, there is a clear imperative to direct funding towards prevention research to redress this imbalance. Future prevention interventions need to be methodologically rigorous, scalable to the population level and include economic evaluation. Evidence-based knowledge translation strategies should be developed to ensure that all stakeholders recognise preventing mental disorders as an imperative, with appropriate resources directed to this objective. There has been a recent expansion of research into potentially modifiable risk factors for depression, and it is now timely to make a concerted effort to advance the field of prevention of common mental disorders.

Unmet mental health care needs in U.S. children with medical complexity, 2005-2010.

PubMed

An, Ruopeng

2016-03-01

Children with special healthcare needs (CSHCN) are those who have or are at elevated risk for a chronic physical, developmental, behavioral or emotional condition and need healthcare services of a type or quantity beyond that required by children generally. Within CSHCN, a small group of children with medical complexity have medical vulnerability and intensive care needs that are not easily met by existing healthcare models. This study estimated the national prevalence of unmet mental healthcare needs among CSHCN with and without medical complexity. Secondary data analysis (N=80,965) based on the National Survey of CSHCN 2005-2006 and 2009-2010 waves. During 2005-2010, 7.66% of CSHCN in the U.S. were with medical complexity. The prevalence of unmet needs for mental healthcare services among CSHCN increased from 3.71% in 2005-2006 to 5.62% in 2009-2010. In 2005-2006 the prevalence of unmet mental healthcare needs among children with medical complexity was 9.92%, tripling the prevalence among CSHCN without medical complexity of 3.10%. The prevalence of unmet mental healthcare needs among children with medical complexity further increased to 13.71% in 2009-2010, whereas that among CSHCN without medical complexity increased to 5.07%. Among CSHCN with medical complexity, older children and children living in poorer households were more likely to have an unmet need for mental healthcare services. Substantial disparities in access to mental healthcare services between CSHCN with and without medical complexity were present, and the prevalence of unmet mental healthcare needs among both groups had noticeably increased during 2005-2010. Copyright © 2016 Elsevier Inc. All rights reserved.

Childhood socioeconomic position and adult mental wellbeing: Evidence from four British birth cohort studies

PubMed Central

Bann, David; Hardy, Rebecca; Gale, Catharine; Goodman, Alissa; Crawford, Claire; Stafford, Mai

2017-01-01

Background There is much evidence showing that childhood socioeconomic position is associated with physical health in adulthood; however existing evidence on how early life disadvantage is associated with adult mental wellbeing is inconsistent. This paper investigated whether childhood socioeconomic position (SEP) is associated with adult mental wellbeing and to what extent any association is explained by adult SEP using harmonised data from four British birth cohort studies. Methods The sample comprised 20,717 participants with mental wellbeing data in the Hertfordshire Cohort Study (HCS), the MRC National Survey of Health and Development (NSHD), the National Child Development Study (NCDS), and the British Cohort Study (BCS70). Warwick Edinburgh Mental Wellbeing Scale (WEMWBS) scores at age 73 (HCS), 60–64 (NSHD), 50 (NCDS), or 42 (BCS70) were used. Harmonised socioeconomic position (Registrar General’s Social Classification) was ascertained in childhood (age 10/11) and adulthood (age 42/43). Associations between childhood SEP, adult SEP, and wellbeing were tested using linear regression and multi-group structural equation models. Results More advantaged father’s social class was associated with better adult mental wellbeing in the BCS70 and the NCDS. This association was independent of adult SEP in the BCS70 but fully mediated by adult SEP in the NCDS. There was no evidence of an association between father’s social class and adult mental wellbeing in the HCS or the NSHD. Conclusions Socioeconomic conditions in childhood are directly and indirectly, through adult socioeconomic pathways, associated with adult mental wellbeing, but findings from these harmonised data suggest this association may depend on cohort or age. PMID:29069091

Rights, laws and tensions: A comparative analysis of the Convention on the Rights of Persons with Disabilities and the WHO Resource Book on Mental Health, Human Rights and Legislation.

PubMed

Duffy, Richard M; Kelly, Brendan D

Good mental health legislation is essential for ensuring high quality mental health care and protecting human rights. Many countries are attempting to bring mental health legislation in line with the UN - Convention on the Rights of Persons with Disability (UN-CRPD). The UN-CRPD requires policy-makers to rethink the 'medical model' of mental illness and existing laws. It also challenges WHO guidelines on drafting mental health law, described in the WHO Resource Book on Mental Health, Human Rights and Legislation (WHO-RB). This study examines the relationship between the UN-CRPD and the WHO-RB. It compares the documents, highlighting similarities and identifying areas of disagreement. The WHO-RB contains a checklist of human rights standards it recommends are met at national level. This study analyses each component on this checklist and identifies the relevant sections in the UN-CRPD that pertain to each. Both the UN-CRPD and WHO-RB address more than just acute exacerbations of illness, providing guidelines on, inter alia, treatment, education, occupation and housing. They are patient-centred and strongly influenced by social rights. The UN-CRPD, however, gives just superficial consideration to the management of acute illness, forensic and risk issues, and does little to identify the role of family and carers. The UN-CRPD has evolved from disability research and strong advocacy organisations. Careful consideration is needed to enable it to address the specific needs encountered in mental illness. Both the UN-CRPD and WHO-RB highlight common tensions that must be resolved by clinicians, and provide some guidance for stakeholders who commonly need to observe one principle at the expense of another. Copyright © 2017 Elsevier Ltd. All rights reserved.

A qualitative study of programs for parents with serious mental illness and their children: building practice-based evidence.

PubMed

Nicholson, Joanne; Hinden, Beth R; Biebel, Kathleen; Henry, Alexis D; Katz-Leavy, Judith

2007-10-01

The rationale for the development of effective programs for parents with serious mental illness and their children is compelling. Using qualitative methods and a grounded theory approach with data obtained in site visits, seven existing programs for parents with mental illness and their children in the United States are described and compared across core components: target population, theory and assumptions, funding, community and agency contexts, essential services and intervention strategies, moderators, and outcomes. The diversity across programs is strongly complemented by shared characteristics, the identification of which provides the foundation for future testing and the development of an evidence base. Challenges in program implementation and sustainability are identified. Qualitative methods are useful, particularly when studying existing programs, in taking steps toward building the evidence base for effective programs for parents with serious mental illness and their children.

Neural evidence that three dimensions organize mental state representation: Rationality, social impact, and valence

PubMed Central

Tamir, Diana I.; Thornton, Mark A.; Contreras, Juan Manuel; Mitchell, Jason P.

2016-01-01

How do people understand the minds of others? Existing psychological theories have suggested a number of dimensions that perceivers could use to make sense of others’ internal mental states. However, it remains unclear which of these dimensions, if any, the brain spontaneously uses when we think about others. The present study used multivoxel pattern analysis (MVPA) of neuroimaging data to identify the primary organizing principles of social cognition. We derived four unique dimensions of mental state representation from existing psychological theories and used functional magnetic resonance imaging to test whether these dimensions organize the neural encoding of others’ mental states. MVPA revealed that three such dimensions could predict neural patterns within the medial prefrontal and parietal cortices, temporoparietal junction, and anterior temporal lobes during social thought: rationality, social impact, and valence. These results suggest that these dimensions serve as organizing principles for our understanding of other people. PMID:26621704

Stigma Predicts Treatment Preferences and Care Engagement among Veterans Affairs Primary Care Patients with Depression

PubMed Central

Campbell, Duncan G.; Bonner, Laura M.; Bolkan, Cory R.; Lanto, Andrew B.; Zivin, Kara; Waltz, Thomas J.; Klap, Ruth; Rubenstein, Lisa V.; Chaney, Edmund F.

2016-01-01

Background Whereas stigma regarding mental health concerns exists, the evidence for stigma as a depression treatment barrier among patients in Veterans Affairs (VA) primary care (PC) is mixed. Purpose To test whether stigma, defined as depression label avoidance, predicted patients' preferences for depression treatment providers, patients' prospective engagement in depression care, and care quality. Methods We conducted cross-sectional and prospective analyses of existing data from 761 VA PC patients with probable major depression. Results Relative to low stigma patients, those with high stigma were less likely to prefer treatment from mental health specialists. In prospective controlled analyses, high stigma predicted lower likelihood of the following: taking medications for mood, treatment by mental health specialists, treatment for emotional concerns in PC, and appropriate depression care. Conclusions High stigma is associated with lower preferences for care from mental health specialists and confers risk for minimal depression treatment engagement. PMID:26935310

The prevalence of psychopathology in siblings of children with mental health problems: a 20-year systematic review.

PubMed

Ma, Nylanda; Roberts, Rachel; Winefield, Helen; Furber, Gareth

2015-02-01

While the importance of looking at the entire family system in the context of child and adolescent mental health is well recognised, siblings of children with mental health problems (MHPs) are often overlooked. The existing literature on the mental health of these siblings needs to be reviewed. A systematic search located publications from 1990 to 2011 in four electronic databases. Thirty-nine relevant studies reported data on the prevalence of psychopathology in siblings of target children with MHPs. Siblings of target children had higher rates of at least one type of psychopathology than comparison children. Risk of psychopathology varied across the type of MHP in the target child. Other covariates included sibling age and gender and parental psychopathology. Significant variations and limitations in methodology were found in the existing literature. Methodological guidelines for future studies are outlined. Implications for clinicians, parents, and for future research are discussed.

Current situations and future directions for mental health system governance in Nepal: findings from a qualitative study.

PubMed

Upadhaya, Nawaraj; Jordans, Mark J D; Pokhrel, Ruja; Gurung, Dristy; Adhikari, Ramesh P; Petersen, Inge; Komproe, Ivan H

2017-01-01

Assessing and understanding health systems governance is crucial to ensure accountability and transparency, and to improve the performance of mental health systems. There is a lack of systematic procedures to assess governance in mental health systems at a country level. The aim of this study was to appraise mental health systems governance in Nepal, with the view to making recommendations for improvements. In-depth individual interviews were conducted with national-level policymakers (n = 17) and district-level planners (n = 11). The interview checklist was developed using an existing health systems governance framework developed by Siddiqi and colleagues as a guide. Data analysis was done with NVivo 10, using the procedure of framework analysis. The mental health systems governance assessment reveals a few enabling factors and many barriers. Factors enabling good governance include availability of mental health policy, inclusion of mental health in other general health policies and plans, increasing presence of Non-Governmental Organizations (NGOs) and service user organizations in policy forums, and implementation of a few mental health projects through government-NGO collaborations. Legal and policy barriers include the failure to officially revise or fully implement the mental health policy of 1996, the existence of legislation and several laws that have discriminatory provisions for people with mental illness, and lack of a mental health act and associated regulations to protect against this. Other barriers include lack of a mental health unit within the Ministry of Health, absence of district-level mental health planning, inadequate mental health record-keeping systems, inequitable allocation of funding for mental health, very few health workers trained in mental health, and the lack of availability of psychotropic drugs at the primary health care level. In the last few years, some positive developments have emerged in terms of policy recognition for mental health, as well as the increased presence of NGOs, increased presence of service users or caregivers in mental health governance, albeit restricted to only some of its domains. However, the improvements at the policy level have not been translated into implementation due to lack of strong leadership and governance mechanisms.

From Scientists' and Inventors' Minds to Some Scientific and Technological Products: Relationships between Theories, Models, Mental Models and Conceptions.

ERIC Educational Resources Information Center

Franco, Creso; de Barros, Henrique Lins; Colinvaux, Dominique; Krapas, Sonia; Queiroz, Gloria; Alves, Fatima

1999-01-01

Argues for the need for theoretical work on mental models in the field of science education. Considers relationships between both models and theories, and mental models and conceptions in order to improve the notions of "model" and "mental model" used in the literature. Contains 20 references. (Author/WRM)

Silence or Sanism: A Review of the Dearth of Discussions on Mental Illness in Adult Education

ERIC Educational Resources Information Center

Procknow, Greg

2017-01-01

This literature review engages mental illness in adult education (AE) to locate what research exists and to suggest a research agenda moving forward. This structured review located research related to mental health issues published in the conference proceedings of the Canadian Association for the Study of Adult Education (CASAE) and the Adult…

20 CFR 416.995 - If we make a determination that your physical or mental impairment(s) has ceased, did not exist...

Code of Federal Regulations, 2010 CFR

2010-04-01

... INCOME FOR THE AGED, BLIND, AND DISABLED Determining Disability and Blindness Continuing Or Stopping Disability Or Blindness § 416.995 If we make a determination that your physical or mental impairment(s) has... determination that the physical or mental impairment(s) on the basis of which disability or blindness benefits...

Community Supports for People Labeled by Both the Mental Retardation and the Mental Health Systems.

ERIC Educational Resources Information Center

Knoll, James; Racino, Julie Ann

The paper addresses issues in providing community services for people with both mental retardation and emotional or behavioral disorders. First, it explores the meaning often found at the root of the often elusive definition of dual diagnosis concluding that this has become a catch-all category for people who present existing service systems with…

Children's Left Parietal Brain Activation during Mental Rotation Is Reliable as Well as Specific

ERIC Educational Resources Information Center

Heil, Martin; Jansen-Osmann, Petra

2007-01-01

Some recent evidence suggests that mental rotation of characters in children aged 7 or 8 years might be lateralized to the left parietal hemisphere. An alternative statement exists, however, the finding might be completely unspecific for mental rotation but either be simply a function of task difficulty or a consequence of the use of characters as…

Integrated Care to Address the Physical Health Needs of People with Severe Mental Illness: A Mapping Review of the Recent Evidence on Barriers, Facilitators and Evaluations

PubMed Central

Dalton, Jane; Harden, Melissa; Street, Andrew; Parker, Gillian; Eastwood, Alison

2018-01-01

People with mental health conditions have a lower life expectancy and poorer physical health outcomes than the general population. Evidence suggests this is due to a combination of clinical risk factors, socioeconomic factors, and health system factors, notably a lack of integration when care is required across service settings. Several recent reports have looked at ways to better integrate physical and mental health care for people with severe mental illness (SMI). We built on these by conducting a mapping review that looked for the most recent evidence and service models in this area. This involved searching the published literature and speaking to people involved in providing or using current services. Few of the identified service models were described adequately and fewer still were evaluated, raising questions about the replicability and generalisability of much of the existing evidence. However, some common themes did emerge. Efforts to improve the physical health care of people with SMI should empower staff and service users and help remove everyday barriers to delivering and accessing integrated care. In particular, there is a need for improved communication among professionals and better information technology to support them, greater clarity about who is responsible and accountable for physical health care, and greater awareness of the effects of stigmatisation on the wider culture and environment in which services are delivered. PMID:29588643

Negative emotionality across diagnostic models: RDoC, DSM-5 Section III, and FFM.

PubMed

Gore, Whitney L; Widiger, Thomas A

2018-03-01

The research domain criteria (RDoC) were established in an effort to explore underlying dimensions that cut across many existing disorders and to provide an alternative to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). One purpose of the present study was to suggest a potential alignment of RDoC negative valence with 2 other dimensional models of negative emotionality: five-factor model (FFM) neuroticism and the DSM-5 Section III negative affectivity. A second purpose of the study, though, was to compare their coverage of negative emotionality, more specifically with respect to affective instability. Participants were adult community residents (N = 90) currently in mental health treatment. Participants received self-report measures of RDoC negative valence, FFM neuroticism, and DSM-5 Section III negative affectivity, along with measures of affective instability, borderline personality disorder, and impairment. Findings suggested that RDoC negative valence is commensurate with FFM neuroticism and DSM-5 Section III negative affectivity, and it would be beneficial if it was expanded to include affective instability. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Changing perspectives on resource extraction.

NASA Astrophysics Data System (ADS)

Gibson, Hazel; Stewart, Iain; Pahl, Sabine; Stokes, Alison

2015-04-01

Over the last century, resource extraction in the UK has changed immeasurably; from relatively small-scale, manually-operated facilities to the larger technological advanced sites that exist today. The communities that live near these sites have also changed, from housing workers that were as much of a resource as the geological material, to local residents who are environmentally literate and strongly value their landscape. Nowadays great pressure is put on the extractive industry to work in both environmentally sustainable and socially ethical ways, but how does this impact upon the local population? How do communities perceive the resource extraction that neighbours them? And is this perception rooted in a general understanding of geology and the subsurface? To explore resident's perceptions of the geological environment, three villages in the southwest of England have been investigated, using a mixed-methods mental models approach. The villages were selected as each has a different geological setting, both commercially and culturally. The first village has a strong historical geological identity, but little current geological activity. The second village has a large tungsten mine in the process of beginning production. The third village has no obvious cultural or commercial relationships with geology and acts as the control site. A broad sample from each of the three villages was qualitatively interviewed, the results of which were analyzed using an emergent thematic coding scheme. These qualitative results were then modelled using Morgan et al's mental models method (2002) and tested using a quantitative questionnaire. The results of this mixed method approach reveals the principal perceptions (or mental models) of residents in these three villages. The villages each present a different general perception of resource exploitation, which appears to be culturally driven, with the first village having the most positive correlations. These mental models are important as they indicate the changing perceptions of local residents in relation to both their local geology and human exploitation of geological resources. The implications of this research for developing strategies of engagement with local communities will be discussed.

Mental disorder and violence: is there a relationship beyond substance use?

PubMed

Van Dorn, Richard; Volavka, Jan; Johnson, Norman

2012-03-01

A general consensus exists that severe mental illness (SMI) increases violence risk. However, a recent report claimed that SMI "alone was not statistically related to future violence in bivariate or multivariate analyses." We reanalyze the data used to make this claim with a focus on causal relationships between SMI and violence, rather than the statistical prediction of violence. Data are from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC), a two-wave study (N = 34,653: Wave 1: 2001-2003; Wave 2: 2004-2005). Indicators of mental disorder in the year prior to Wave 1 were used to examine violence between Waves 1 and 2. Those with SMI, irrespective of substance abuse status, were significantly more likely to be violent than those with no mental or substance use disorders. This finding held in both bivariate and multivariable models. Those with comorbid mental and substance use disorders had the highest risk of violence. Historical and current conditions were also associated with violence, including childhood abuse and neglect, household antisocial behavior, binge drinking and stressful life events. These results, in contrast to a recently published report, show that the NESARC data are consistent with the consensus view on mental disorder and violence: there is a statistically significant, yet modest relationship between SMI (within 12 months) and violence, and a stronger relationship between SMI with substance use disorder and violence. These results also highlight the importance of premorbid conditions, and other contemporaneous clinical factors, in violent behavior.

Unmet Health Care Needs among Children Exposed to Parental Incarceration.

PubMed

Turney, Kristin

2017-05-01

Objectives The incarceration rate in the United States has increased rapidly since the mid-1970s and, accordingly, a large number of children are exposed to parental incarceration. Research finds that parental incarceration is associated with deleterious physical and mental health outcomes among children, but little is known about these children's health care access. Methods I used data from the 2011-2012 National Survey of Children's Health (N = 95,531), a population-based and nationally representative survey of non-institutionalized children ages 0-17 in the United States, to estimate the association between exposure to parental incarceration and children's unmet health care needs. Results In logistic regression models that adjust for an array of demographic and socioeconomic characteristics, children exposed to parental incarceration, compared to their counterparts, have 1.26 (95% CI 1.02-1.54) times the odds of having any unmet health care need. Analyses that disaggregate by type of unmet health care need (mental, dental, vision, mental health, or other) suggest this association is driven by a greater likelihood of unmet mental health care needs (OR 1.60; 95% CI 1.04-2.46). Conclusions Children exposed to parental incarceration, a vulnerable group especially at risk of physical and mental health problems, face challenges to health care access, especially mental health care access. Given that parental incarceration is concentrated among those children most in need of health care, parental incarceration may exacerbate existing inequalities in unmet health care needs.

Shared decision making in mental health: the importance for current clinical practice.

PubMed

Alguera-Lara, Victoria; Dowsey, Michelle M; Ride, Jemimah; Kinder, Skye; Castle, David

2017-12-01

We reviewed the literature on shared decision making (regarding treatments in psychiatry), with a view to informing our understanding of the decision making process and the barriers that exist in clinical practice. Narrative review of published English-language articles. After culling, 18 relevant articles were included. Themes identified included models of psychiatric care, benefits for patients, and barriers. There is a paucity of published studies specifically related to antipsychotic medications. Shared decision making is a central part of the recovery paradigm and is of increasing importance in mental health service delivery. The field needs to better understand the basis on which decisions are reached regarding psychiatric treatments. Discrete choice experiments might be useful to inform the development of tools to assist shared decision making in psychiatry.

Perceptions and receptivity of non-spousal family support: A mixed methods study of psychological distress among older, church-going African American men

PubMed Central

Watkins, Daphne C.; Wharton, Tracy; Mitchell, Jamie A.; Matusko, Niki; Kales, Helen

2016-01-01

The purpose of this study was to explore the role of non-spousal family support on mental health among older, church-going African American men. The mixed methods objective was to employ a design that used existing qualitative and quantitative data to explore the interpretive context within which social and cultural experiences occur. Qualitative data (n=21) were used to build a conceptual model that was tested using quantitative data (n= 401). Confirmatory factor analysis indicated an inverse association between non-spousal family support and distress. The comparative fit index, Tucker-Lewis fit index, and root mean square error of approximation indicated good model fit. This study offers unique methodological approaches to using existing, complementary data sources to understand the health of African American men. PMID:28943829

Managing the demands of the preregistration mental health nursing programme: The views of students with mental health conditions.

PubMed

Ramluggun, Pras; Lacy, Mary; Cadle, Martha; Anjoyeb, Mahmood

2018-05-30

An increasing number of students with a pre-existing mental health condition are enrolling on preregistration mental health nursing programmes. The challenges faced by these students in managing the demands of the programme have not been fully explored. Mental health and well-being is an integral part of providing a healthy university in which students can flourish. The purpose of the study was to explore how students with an underlying mental health issue manage the demands of the mental health nursing programme. The outcomes of the study are aimed at informing inclusive teaching and learning and current student support provision. Ethics approval was given. Students from two universities in South East England who met the criterion of having a pre-existing mental health condition when enrolling on the mental health preregistration nursing programme were invited to take part. Nine students took part in the study. Using an interpretative descriptive design, 1:1 face-to-face, audio-taped, semistructured interviews were undertaken. The data were analysed using a framework approach, and this revealed four main themes: timing of disclosure; managing lived experience in learning environments; students' coping mechanisms, and experience of support. Recommendations for practice was that approved education institutes (AEIs) should ensure they have a robust, inclusive practice by implementing strategies to develop these students' resilience, and enhance their learning and the current support provisions. This will ensure the barriers to disclosing their mental health conditions are recognized and minimized to enable these students to fully contribute to their own learning and teaching experience. © 2018 Australian College of Mental Health Nurses Inc.

Clients and carers perception of mental illness and factors that influence help-seeking: Where they go first and why.

PubMed

Chilale, Harris K; Silungwe, Ndumanene Devlin; Gondwe, Saulos; Masulani-Mwale, Charles

2017-08-01

In Northern Malawi, the duration of untreated psychosis (DUP) is longer than that in high-income countries. The reasons for the delay in help-seeking are not known, although studies show multiple reasons. This research was conducted to establish health care help-seeking behaviours and identify barriers that exist between service users and health care providers. The study also intended to establish the beliefs that clients and family members have regarding the causes of mental illness which profoundly shape help-seeking, care giving process and outcomes. The study employed the exploratory phenomenological method, utilizing focus group discussions (FGDs) in the sampled population. The Health Belief Model and Disease Explanatory Models were conveniently chosen a priori by researchers to develop guide questions to explore clients' and carers' perceptions of the illness and their health care help-seeking behaviours. Results show a bio-psycho-social inclination of disease causation and help-seeking behaviour. Causes of mental illness are understood in three categories, namely: physical/biological, psychological and socio-cultural. The majority of participants attributed mental illness to socio-cultural factors, with witchcraft, spirit possession and curses as main determinants. Causal perceptions also influenced help-seeking pathways. Many participants reported consulting traditional healers first, for diagnosis and to know who was responsible. In this study, it has been found that help-seeking is influenced by the understanding of the source of the illness - which has a bio-psychosocial inclination. The socio-cultural explanation of witchcraft and spirit possession is dominant and a determinant of help-seeking behaviour. While participants noted benefits to hospital treatment, barriers and bio-psychosocial in nature were also noted. Guardians and not clients hold the key to choice of treatment modality and therefore a potential ally in all treatment interventions promotive, preventive and curative. There is need for strengthening of a bio-psychosocial intervention model in the treatment of mental illness.

An Implicit Measure of Associations with Mental Illness versus Physical Illness: Response Latency Decomposition and Stimuli Differential Functioning in Relation to IAT Order of Associative Conditions and Accuracy

PubMed Central

Mannarini, Stefania; Boffo, Marilisa

2014-01-01

The present study aimed at the definition of a latent measurement dimension underlying an implicit measure of automatic associations between the concept of mental illness and the psychosocial and biogenetic causal explanatory attributes. To this end, an Implicit Association Test (IAT) assessing the association between the Mental Illness and Physical Illness target categories to the Psychological and Biologic attribute categories, representative of the causal explanation domains, was developed. The IAT presented 22 stimuli (words and pictures) to be categorized into the four categories. After 360 university students completed the IAT, a Many-Facet Rasch Measurement (MFRM) modelling approach was applied. The model specified a person latency parameter and a stimulus latency parameter. Two additional parameters were introduced to denote the order of presentation of the task associative conditions and the general response accuracy. Beyond the overall definition of the latent measurement dimension, the MFRM was also applied to disentangle the effect of the task block order and the general response accuracy on the stimuli response latency. Further, the MFRM allowed detecting any differential functioning of each stimulus in relation to both block ordering and accuracy. The results evidenced: a) the existence of a latency measurement dimension underlying the Mental Illness versus Physical Illness - Implicit Association Test; b) significant effects of block order and accuracy on the overall latency; c) a differential functioning of specific stimuli. The results of the present study can contribute to a better understanding of the functioning of an implicit measure of semantic associations with mental illness and give a first blueprint for the examination of relevant issues in the development of an IAT. PMID:25000406

An implicit measure of associations with mental illness versus physical illness: response latency decomposition and stimuli differential functioning in relation to IAT order of associative conditions and accuracy.

PubMed

Mannarini, Stefania; Boffo, Marilisa

2014-01-01

The present study aimed at the definition of a latent measurement dimension underlying an implicit measure of automatic associations between the concept of mental illness and the psychosocial and biogenetic causal explanatory attributes. To this end, an Implicit Association Test (IAT) assessing the association between the Mental Illness and Physical Illness target categories to the Psychological and Biologic attribute categories, representative of the causal explanation domains, was developed. The IAT presented 22 stimuli (words and pictures) to be categorized into the four categories. After 360 university students completed the IAT, a Many-Facet Rasch Measurement (MFRM) modelling approach was applied. The model specified a person latency parameter and a stimulus latency parameter. Two additional parameters were introduced to denote the order of presentation of the task associative conditions and the general response accuracy. Beyond the overall definition of the latent measurement dimension, the MFRM was also applied to disentangle the effect of the task block order and the general response accuracy on the stimuli response latency. Further, the MFRM allowed detecting any differential functioning of each stimulus in relation to both block ordering and accuracy. The results evidenced: a) the existence of a latency measurement dimension underlying the Mental Illness versus Physical Illness - Implicit Association Test; b) significant effects of block order and accuracy on the overall latency; c) a differential functioning of specific stimuli. The results of the present study can contribute to a better understanding of the functioning of an implicit measure of semantic associations with mental illness and give a first blueprint for the examination of relevant issues in the development of an IAT.

Divorce, divorce rates, and professional care seeking for mental health problems in Europe: a cross-sectional population-based study.

PubMed

Bracke, Piet F; Colman, Elien; Symoens, Sara A A; Van Praag, Lore

2010-04-29

Little is known about differences in professional care seeking based on marital status. The few existing studies show more professional care seeking among the divorced or separated compared to the married or cohabiting. The aim of this study is to determine whether, in a sample of the European general population, the divorced or separated seek more professional mental health care than the married or cohabiting, regardless of self-reported mental health problems. Furthermore, we examine whether two country-level features--the supply of mental health professionals and the country-level divorce rates--contribute to marital status differences in professional care-seeking behavior. We use data from the Eurobarometer 248 on mental well-being that was collected via telephone interviews. The unweighted sample includes 27,146 respondents (11,728 men and 15,418 women). Poisson hierarchical regression models were estimated to examine whether the divorced or separated have higher professional health care use for emotional or psychological problems, after controlling for mental and somatic health, sociodemographic characteristics, support from family and friends, and degree of urbanization. We also considered country-level divorce rates and indicators of the supply of mental health professionals, and applied design and population weights. We find that professional care seeking is strongly need based. Moreover, the divorced or separated consult health professionals for mental health problems more often than people who are married or who cohabit do. In addition, we find that the gap between the divorced or separated and the married or cohabiting is highest in countries with low divorce rates. The higher rates of professional care seeking for mental health problems among the divorced or separated only partially correlates with their more severe mental health problems. In countries where marital dissolution is more common, the marital status gap in professional care seeking is narrower, partially because professional care seeking is more common among the married or cohabiting.

Ontological addiction theory: Attachment to me, mine, and I.

PubMed

Van Gordon, William; Shonin, Edo; Diouri, Sofiane; Garcia-Campayo, Javier; Kotera, Yasuhiro; Griffiths, Mark D

2018-06-07

Background Ontological addiction theory (OAT) is a novel metaphysical model of psychopathology and posits that human beings are prone to forming implausible beliefs concerning the way they think they exist, and that these beliefs can become addictive leading to functional impairments and mental illness. The theoretical underpinnings of OAT derive from the Buddhist philosophical perspective that all phenomena, including the self, do not manifest inherently or independently. Aims and methods This paper outlines the theoretical foundations of OAT along with indicative supportive empirical evidence from studies evaluating meditation awareness training as well as studies investigating non-attachment, emptiness, compassion, and loving-kindness. Results OAT provides a novel perspective on addiction, the factors that underlie mental illness, and how beliefs concerning selfhood are shaped and reified. Conclusion In addition to continuing to test the underlying assumptions of OAT, future empirical research needs to determine how ontological addiction fits with extant theories of self, reality, and suffering, as well with more established models of addiction.

Mental health service user and staff perspectives on tobacco addiction and smoking cessation: A meta-synthesis of published qualitative studies.

PubMed

Malone, V; Harrison, R; Daker-White, G

2018-05-01

WHAT IS KNOWN ON THE SUBJECT?: There are high rates of tobacco smoking in people living with mental illness, and rates are much higher than the general population. People living with mental illness experience high rates of cardiovascular disease and other physical health problems as a result of tobacco smoking. There is a lack of evidence on successful interventions for reducing the rates of smoking in people living with mental illness. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: A meta-synthesis of data from a number of studies to support mental health nurses to access data quickly and support the translation of findings into practice. Studies found staff working in mental health services expressed they did not have the confidence to adequately address smoking cessation for people living with mental illness. People living with mental illness would like support and encouragement support to help them achieve successful smoking cessation. People living with mental illness want support from mental health service staff to increase their confidence in smoking cessation rather than mainstream smoking cessation services. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Existing evidence-based interventions for smoking cessation has had limited impact on the smoking rates of people living with mental illness. Research is needed into innovative smoking cessation interventions and the service delivery of these interventions for people living with mental illness. Interventions to support people living with mental illness in smoking cessation could be part of mainstream mental health service delivery. Opportunities for smoking cessation training for mental health service staff could be provided. Introduction People with mental illness are up to three times more likely to smoke and experience greater challenges and less success when trying to quit and therefore have higher risk of smoking-related morbidity and mortality. There is a lack of evidence on successful interventions to reduce the smoking rates in people living with serve mental illness. A meta-synthesis was undertaken to summarize the data from multiple studies to inform the development of future smoking cessation intervention studies. Methods MEDLINE, PsycINFO, Embase and CINAHL were searched in March 2017. A total of 965 titles and abstracts were screened for inclusion with 29 papers reviewed in full and 15 studies that met inclusion criteria. Included studies were assessed for quality using the Critical Appraisal Skills Programme tool. Key data across studies were examined and compared, and a thematic analysis was conducted. Results Analysis and synthesis developed five analytical themes: environmental and social context, living with a mental health illness, health awareness, financial awareness and provision of smoking cessation support. Themes generated the interpretive construct: "Whose role is it anyway?" which highlights tensions between staff perspectives on their role and responsibilities to providing smoking cessation support and support service users would like to receive. Relevance to mental health nursing Routine smoking cessation training for mental health professionals and research on innovative smoking cessation interventions to support people living with mental illness are needed. The Cochrane tobacco group has not found sufficient direct evidence of existing evidence-based interventions that have beneficial effect on smoking in people living with mental illness. With this in mind, mental health professionals should be encouraged to engage in future research into the development of new interventions and consider innovative harm reduction strategies for smoking into their practice, to reduce the morbidity and mortality many people living with mental illness experience from tobacco smoking. © 2018 John Wiley & Sons Ltd.

Effects of mental health interventions for students in higher education are sustainable over time: a systematic review and meta-analysis of randomized controlled trials

PubMed Central

Guldbrandsson, Karin; Sidorchuk, Anna

2018-01-01

Background Symptoms of depression, anxiety, and distress are more common in undergraduates compared to age-matched peers. Mental ill health among students is associated with impaired academic achievement, worse occupational preparedness, and lower future occupational performance. Research on mental health promoting and mental ill health preventing interventions has shown promising short-term effects, though the sustainability of intervention benefits deserve closer attention. We aimed to identify, appraise and summarize existing data from randomized control trials (RCTs) reporting on whether the effects of mental health promoting and mental ill health preventing interventions were sustained at least three months post-intervention, and to analyze how the effects vary for different outcomes in relation to follow-up length. Further, we aimed to assess whether the effect sustainability varied by intervention type, study-level determinants and of participant characteristics. Material and Methods A systematic search in MEDLINE, PsycInfo, ERIC, and Scopus was performed for RCTs published in 1995–2015 reporting an assessment of mental ill health and positive mental health outcomes for, at least, three months of post-intervention follow-up. Random-effect modeling was utilized for quantitative synthesis of the existing evidence with standardized mean difference (Hedges’ g) used to estimate an aggregated effect size. Sustainability of the effects of interventions was analyzed separately for 3–6 months, 7–12 months, and 13–18 months of post-intervention follow-up. Results About 26 studies were eligible after reviewing 6,571 citations. The pooled effects were mainly small, but significant for several categories of outcomes. Thus, for the combined mental ill health outcomes, symptom-reduction sustained up to 7–12 months post-intervention (standardized mean difference (Hedges’ g) effect size (ES) = −0.28 (95% CI [−0.49, −0.08])). Further, sustainability of symptom-reductions were evident for depression with intervention effect lasting up to 13–18 months (ES = −0.30 (95% CI [−0.51, −0.08])), for anxiety up to 7–12 months (ES = −0.27 (95% CI [−0.54, −0.01])), and for stress up to 3–6 months (ES = −0.30 (95% CI [−0.58, −0.03])). The effects of interventions to enhance positive mental health were sustained up to 3–6 months for the combined positive mental health outcomes (ES = 0.32 (95% CI [0.05, 0.59])). For enhanced active coping, sustainability up to 3–6 months was observed with a medium and significant effect (ES = 0.75 (95% CI [0.19, 1.30])). Discussion The evidence suggests long-term effect sustainability for mental ill health preventive interventions, especially for interventions to reduce the symptoms of depression and symptoms of anxiety. Interventions to promote positive mental health offer promising, but shorter-lasting effects. Future research should focus on mental health organizational interventions to examine their potential for students in tertiary education. PMID:29629247

User involvement in adolescents' mental healthcare: protocol for a systematic review.

PubMed

Viksveen, Petter; Bjønness, Stig Erlend; Berg, Siv Hilde; Cardenas, Nicole Elizabeth; Game, Julia Rose; Aase, Karina; Storm, Marianne

2017-12-21

User involvement has become a growing importance in healthcare. The United Nations state that adolescents have a right to be heard, and user involvement in healthcare is a legal right in many countries. Some research provides an insight into the field of user involvement in somatic and mental healthcare for adults, but little is known about user involvement in adolescents' mental healthcare, and no overview of the existing research evidence exists. The aim of this systematic review is to provide an overview of existing research reporting on experiences with and the effectiveness and safety issues associated with user involvement for adolescents' mental healthcare at the individual and organisational level. A systematic literature search and assessment of published research in the field of user involvement in adolescents' mental healthcare will be carried out. Established guidelines will be used for data extraction (Cochrane Collaboration guidelines, Strengthening the Reporting of Observational studies in Epidemiology and Critical Appraisal Skills Programme (CASP)), critical appraisal (Cochrane Collaboration guidelines and Pragmatic-Explanatory Continuum Indicator Summary) and reporting of results (Preferred Reporting Items for Systematic reviews and Meta-Analyses, Consolidated Standards of Reporting Trials and CASP). Confidence in the research evidence will be assessed using the Grading of Recommendations Assessment, Development and Evaluation approach. Adolescents are included as coresearchers for the planning and carrying out of this systematic review. This systematic review will provide an overview of the existing research literature and thereby fill a knowledge gap. It may provide various stakeholders, including decision-makers, professionals, individuals and their families, with an overview of existing knowledge in an underexplored field of research. Ethics approval is not required for this systematic review as we are not collecting primary data. The results will be published in a peer-reviewed journal and at conference presentations and will be shared with stakeholder groups. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Support for medical students with mental health problems: a conceptual model.

PubMed

Grant, Andrew; Rix, Andrew; Winter, Peter; Mattick, Karen; Jones, Debbie

2015-02-01

Medical students experience higher prevalence of mental illness than age-matched controls and are less likely to access appropriate help when this happens. The aim of this study was to determine the range of strategies deployed by medical schools to support medical students with mental health concerns and to use this to identify distinct categories. Websites and documents relating to all 32 UK medical schools were looked at, as were reports for quality assurance visits carried out by the General Medical Council (UK). A structured telephone interview was carried out with medical schools. Support services were examined by tracing the path that might be taken by a hypothetical student with mental health concerns of varying severity, seeing what was required and what was available at each stage. A range of support strategies is available to most medical students both from their medical school and from generic services in the university. Medical students will usually first contact a personal tutor or a senior member of faculty or be contacted by them as a result of concerns raised either via performance issues or by another student. While individual support interventions are mostly based on evidence of effectiveness, there is no unifying theory in terms of what constitutes effective support. To enable analysis of support interventions and comparison across providers, a six-stage conceptual model of prevention was developed. The six stages are the following: prevention, identification, referral, escalation, treatment, and reintegration. The staged model, derived from analysis of existing interventions, provides a framework for evaluation of current provision and comparison of different methods of delivery. Moreover, it provides a framework for future research.

Mental ill health in structural pathways to women's experiences of intimate partner violence.

PubMed

Machisa, Mercilene T; Christofides, Nicola; Jewkes, Rachel

2017-01-01

Depression, post-traumatic stress disorder (PTSD), and binge drinking are among mental health effects of child abuse and intimate partner violence (IPV) experiences among women. Emerging data show the potential mediating role of mental ill health in the relationship of child abuse and IPV. There is evidence that PTSD, depression and alcohol abuse are comorbid common mental disorders and that a bidirectional relationship exists between depression and IPV in some settings. Furthermore, the temporal direction in the relationship of alcohol abuse and women's IPV experiences from different studies is unclear. We undertook a study with women from the general population to investigate the associations of child abuse, mental ill health and IPV; and describe the underlying pathways between them. Data is from a household survey employing a multi-stage random sampling approach with 511 women from Gauteng, South Africa. IPV was measured using the WHO Multi-country Study on Women's Health and Domestic Violence Questionnaire. Child abuse was measured using a short form of the Childhood Trauma Questionnaire. Depression was measured using the Centre for Epidemiologic Studies Depression Scale (CESD). PTSD symptoms were measured using the Harvard Trauma Questionnaire. Binge drinking was measured using the Alcohol Use Disorders Identification Test (AUDIT) scale. All data analyses were conducted in Stata 13. Regression modelling was used to test the association between variables. Structural equation modelling with full information maximum likelihood estimation accounting for missing data was done to analyse the underlying pathways between variables. Fifty percent of women experienced IPV in their lifetime and 18% experienced IPV in the 12 months before the survey. Twenty three percent of women were depressed, 14% binge drank and 11.6% had PTSD symptoms. Eighty six percent of women had experienced some form of child abuse. Sociodemographic factors associated with recent IPV in multivariate models were younger age and foreign nationality. Depression, PTSD and binge drinking mediated the relationship of child abuse and recent IPV. Depression, PTSD and binge drinking were also effects of recent IPV. Other factors associated with recent IPV experience included relationship control, having a partner who regularly consumed alcohol and experiencing other life traumatic experiences. Mental ill health plays a mediating role in the relationship of child abuse and recent IPV experiences among women. Conversely, IPV also negatively affects women's mental health. Interventions to reducing the incidence of IPV could help alleviate the burden of mental ill health among women and vice versa. Effective integration of mental health services in primary health care, detection of symptoms, brief interventions and strengthened referral mechanisms for sustained community-based care are necessary in responding to victims of intimate partner violence. Response for abused children needs to take similar approaches and reduce the long-term mental health effects associated with violent exposures.

Introducing embedded indigenous psychological support teams: a suggested addition to psychological first aid in an international context.

PubMed

Edwards-Stewart, Amanda; Ahmad, Zeba S; Thoburn, John W; Furman, Rich; Lambert, Ashly J; Shelly, Lauren; Gunn, Ginger

2012-01-01

The current article introduces Embedded Indigenous Psychological Support Teams (IPST) as a possible addition to current disaster relief efforts. This article highlights psychological first aid in an international context by drawing on mainstream disaster relief models such as The American Red Cross, Critical Incident Stress Management, and Flexible Psychological First Aid. IPST are explained as teams utilizing techniques from both CISM and FPFA with a focus on resiliency. It is currently theorized that in utilizing IPST existing disaster relief models may be more effective in mitigating negative physical or mental health consequences post-disaster.

Psyche, soma, and science studies: new directions in the sociology of mental health and illness.

PubMed

Pickersgill, Martyn D

2010-08-01

With the expanding scope of scientific and technological discourse within psychiatry, social scientists need new theoretical tools to grapple with the complex links between psychiatry, science and society. Benefit may be afforded through engagement with the discipline of science and technology studies (STS), which is concerned explicitly with the relationships between science and society. To highlight existing engagements between STS and the sociology of (mental) health, and to encourage researchers to consider ways in which insights from these traditions may be developed further through interdisciplinary debate and analysis. Some of the key works in STS and the sociology of mental illness that use the empirical or theoretical writings of the other were reviewed and appraised. Whilst it is clear that some research synthesizing insights from STS and the sociology of mental health exists, this is currently limited. Sociologists and others concerned with longstanding and emergent issues in mental health might usefully familiarize themselves with some work in STS. A new sociology of psychiatric knowledge production and application represents an important way forward.

Mental health training for health workers in Africa: a systematic review.

PubMed

Liu, Germaine; Jack, Helen; Piette, Angharad; Mangezi, Walter; Machando, Debra; Rwafa, Chido; Goldenberg, Matthew; Abas, Melanie

2016-01-01

Commitment to building mental health treatment capacity in Africa is increasing but little agreement exists on strategies to train health workers on mental health or evaluation of training efforts. We systematically reviewed published literature on interventions to train health-care workers in Africa on mental health. 37 studies met our inclusion criteria. Training outcomes focused on changes in knowledge and attitude, with few studies evaluating skill and practice and only two studies measuring clinical outcomes. Quality of study methodology was generally not high, with scarce follow-up data and use of control cohorts. Existing studies provide examples of many training and evaluation strategies, but evidence to draw conclusions about the efficacy of different training techniques is inadequate. Key knowledge gaps include development and testing of innovative educational strategies; development of standardised, competency-based learning objectives and outcome measures; and training that facilitates implementation of integrated mental health systems. African institutions need to be empowered to do research in these areas to encourage the development of best practices for the continent. Copyright © 2016 Elsevier Ltd. All rights reserved.

Disaster mental health preparedness plan in Indonesia.

PubMed

Setiawan, G Pandu; Viora, Eka

2006-12-01

The tsunami brought into focus many issues related to mental health and psychosocial distress. A prompt response to the disaster relies on existing disaster management plans so that appropriate interventions can be put in place in order to meet the needs of the affected populations. The response must involve both physical and psychological aspects of care. The Indonesian experience was unique in a number of ways and it allowed us to explore the lessons in order to develop strategies to maximize the resources in order to ensure that the whole affected population was cared for. Massive destruction of the physical structures and the work force made the task particularly difficult. Existing policies did not include psychosocial efforts in the plan. However, mental health and psychosocial relief efforts are now being integrated into the disaster preparedness plan of Indonesia. To further implement the plan, a strong community mental health system is being developed. This system will be able to deliver mental health and psychosocial interventions on a routine basis and could be scaled up in times of disasters.

An ARC-Informed Family Centered Care Intervention for Children’s Community Based Mental Health Programs

PubMed Central

Madenwald, Kappy; Hoagwood, Kimberly E.

2017-01-01

The experience of parents in helping their children access and use mental health services is linked to service outcomes. Parent peer support service, based on the principles of family-centered care, is one model to improve parent experience and engagement in services. Yet, little is known about how best to integrate this service into the existing array of mental health services. Integration is challenged by philosophical differences between family-centered services and traditional children’s treatment services, and is influenced by the organizational social contexts in which these services are embedded. We describe an organizational and frontline team intervention that draws on research in behavior change, technology transfer, and organizational social context for youth with serious emotional disturbance. The two-pronged intervention, called FAMILY (FCC and ARC Model to Improve the Lives of Youth) is guided by the evidence-based Availability, Responsiveness, and Continuity (ARC) organizational intervention, targeted primarily at program and upper management leadership and includes a family-centered care (FCC) intervention, targeted at frontline providers. The approach employs multilevel implementation strategies to promote the uptake, implementation and sustainability of new practices. We include examples of exercises and tools, and highlight implementation challenges and lessons learned in facilitating program and staff level changes in family-centered service delivery. PMID:28781510

Mental health service user participation in Chinese culture: a model of independence or interdependence?

PubMed

Tang, Jessica Pui-Shan; Tse, Samson Shu-Ki; Davidson, Larry; Cheng, Patrick

2017-12-22

Current models of user participation in mental health services were developed within Western culture and thus may not be applicable to Chinese communities. To present a new model of user participation, which emerged from research within a Chinese community, for understanding the processes of and factors influencing user participation in a non-Western culture. Multiple qualitative methods, including focus groups, individual in-depth interviews, and photovoice, were applied within the framework of constructivist grounded theory and collaborative research. Diverging from conceptualizations of user participation with emphasis on civil rights and the individual as a central agent, participants in the study highlighted the interpersonal dynamics between service users and different players affecting the participation intensity and outcomes. They valued a reciprocal relationship with their caregivers in making treatment decisions, cooperated with staff to observe power hierarchies and social harmony, identified the importance of peer support in enabling service engagement and delivery, and emphasized professional facilitation in advancing involvement at the policy level. User participation in Chinese culture embeds dynamic interdependence. The proposed model adds this new dimension to the existing frameworks and calls for attention to the complex local ecology and cultural consistency in realizing user participation.

Objects Mental Rotation under 7 Days Simulated Weightlessness Condition: An ERP Study.

PubMed

Wang, Hui; Duan, Jiaobo; Liao, Yang; Wang, Chuang; Li, Hongzheng; Liu, Xufeng

2017-01-01

During the spaceflight under weightlessness condition, human's brain function may be affected by the changes of physiological effects along with the distribution of blood and body fluids to the head. This variation of brain function will influence the performance of astronauts and therefore create possible harm to flight safety. This study employs 20 male subjects in a 7-day-6° head-down tilted (HDT) bed rest model to simulate physiological effects under weightlessness condition, and use behavioral, electrophysiological techniques to compare the changes of mental rotation ability (MR ability) before and after short-term simulated weightlessness state. Behavioral results suggested that significant linear relationship existed between the rotation angle of stimuli and the reaction time, which means mental rotation process do happen during the MR task in simulated weightlessness state. In the first 3 days, the P300 component induced by object mental rotation followed the "down-up-down" pattern. In the following 4 days it changed randomly. On HDT D2, the mean of the amplitude of the P300 was the lowest, while increased gently on HDT D3. There was no obvious changing pattern of the amplitude of P300 observed after 3 days of HDT. Simulated weightlessness doesn't change the basic process of mental rotation. The effect of simulated weightlessness is neural mechanism of self-adaptation. MR ability didn't bounce back to the original level after HDT test.

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.

An Integrated Approach to Universal Prevention: Independent and Combined Effects of PBIS and SEL on Youths' Mental Health

ERIC Educational Resources Information Center

Cook, Clayton R.; Frye, Megan; Slemrod, Tal; Lyon, Aaron R.; Renshaw, Tyler L.; Zhang, Yanchen

2015-01-01

Mental health among children and adolescents is a growing national concern and schools have taken center stage in efforts to prevent problems and promote wellness. Although research and policymakers support the integration of mental health services into the schools, there is limited agreement on the ways to package or combine existing supports to…

Approaches to Children, Young People and Mental Health: Confusion in the Ranks, Confusion among the Commanders

ERIC Educational Resources Information Center

Murray, Judith A.

2005-01-01

The need to provide support for the mental health needs of children and young people is not in dispute. However, there does exist confusion as to the most appropriate means and methods of providing such support. This confusion is particularly evident among those who work closely in providing daily for the mental health needs of children and young…

Attitudes, Skills and Knowledge Change in Child and Adolescent Mental Health Workers Following AOD Screening and Brief Intervention Training

ERIC Educational Resources Information Center

Christie, Grant; Black, Stella; Dunbar, Lucy; Pulford, Justin; Wheeler, Amanda

2013-01-01

Adolescent mental health workers are generally poor at identifying and treating co-existing alcohol and other drug (AOD) disorder. This study aimed to evaluate the utility and acceptability of an AOD screening and brief intervention (BI) training package delivered to child and adolescent mental health workers and its impact on relevant attitudes,…

Dissociation between Key Processes of Social Cognition in Autism: Impaired Mentalizing but Intact Sense of Agency

ERIC Educational Resources Information Center

David, Nicole; Gawronski, Astrid; Santos, Natacha S.; Huff, Wolfgang; Lehnhardt, Fritz-Georg; Newen, Albert; Vogeley, Kai

2008-01-01

Deficits in social cognition and interaction, such as in mentalizing and imitation behavior, are hallmark features of autism spectrum disorders. Both imitation and mentalizing are at the core of the sense of agency, the awareness that we are the initiators of our own behavior. Little evidence exists regarding the sense of agency in autism. Thus,…

What do they know about Heat and Heat Conduction? A case study to excavate Pre-service Physics Teachers’ Mental Model in Heat and Heat Conduction

NASA Astrophysics Data System (ADS)

Sari, I. M.

2017-02-01

Teacher plays a crucial role in Education. Helping students construct scientifically mental model is one of obligation of Physics Education Department of Teacher Education Institute that produce physics teacher. Excavating students’ mental model is necessary to be done in physics education. This research was first to identify 23 physics students’ mental model of heat and heat conduction. A series of semi-structured interviews was conducted to excavate the students’ understanding of heat and mental models on heat conduction. The students who involved in this study come from different level from sophomore to master degree in Physics Education Department. This study adopted a constant comparison method to obtain the patterns of the participants’ responses through the students’ writing, drawing and verbal utterances. The framework for assessing mental model and the instruments were adopted and adapted from Chiou and Anderson (2010). We also compared the students’ understanding of heat and mental models on heat conduction. The result shows that Heat is treated as Intrinsic property, material substances, and caloric flow. None of students expressed heat as transfer of thermal energy. Moreover, there are two kinds of students’ fundamental component of mental model in heat conduction were found: medium and molecules. Students understanding of heat and fundamental components of mental model in heat conduction are not resulted from running mental model.

From positive screen to engagement in treatment: a preliminary study of the impact of a new model of care for prisoners with serious mental illness.

PubMed

Pillai, Krishna; Rouse, Paul; McKenna, Brian; Skipworth, Jeremy; Cavney, James; Tapsell, Rees; Simpson, Alexander; Madell, Dominic

2016-01-15

The high prevalence of serious mental illness (SMI) in prisons remains a challenge for mental health services. Many prisoners with SMI do not receive care. Screening tools have been developed but better detection has not translated to higher rates of treatment. In New Zealand a Prison Model of Care (PMOC) was developed by forensic mental health and correctional services to address this challenge. The PMOC broadened triggers for referrals to mental health teams. Referrals were triaged by mental health nurses leading to multidisciplinary team assessment within specified timeframes. This pathway for screening, referral and assessment was introduced within existing resources. The PMOC was implemented across four prisons. An AB research design was used to explore the extent to which mentally ill prisoners were referred to and accepted by prison in-reach mental health teams and to determine the proportion of prison population receiving specialist mental health care. The number of prisoners in the study in the year before the PMOC (n =  9,349) was similar to the year after (n = 19,421). 24.6 % of prisoners were screened as per the PMOC in the post period. Referrals increased from 491 to 734 in the post period (Z = -7.23, p < 0.0001). A greater number of triage assessments occurred after the introduction of the PMOC (pre = 458; post = 613, Z = 4.74, p < 0.0001) leading to a significant increase in the numbers accepted onto in-reach caseloads (pre = 338; post = 426, Z = 3.16, p < 0.01). Numbers of triage assessments completed within specified time frames showed no statistically significant difference before or after implementation. The proportion of prison population on in-reach caseloads increased from 5.6 % in the pre period to 7.0 % in the year post implementation while diagnostic patterns did not change, indicating more prisoners with SMI were identified and engaged in treatment. The PMOC led to increased prisoner numbers across screening, referral, treatment and engagement. Gains were achieved without extra resources by consistent processes and improved clarity of professional roles and tasks. The PMOC described a more effective pathway to specialist care for people with SMI entering prison.

Interventions and approaches to integrating HIV and mental health services: a systematic review

PubMed Central

Chuah, Fiona Leh Hoon; Haldane, Victoria Elizabeth; Cervero-Liceras, Francisco; Ong, Suan Ee; Sigfrid, Louise A; Murphy, Georgina; Watt, Nicola; Balabanova, Dina; Hogarth, Sue; Maimaris, Will; Otero, Laura; Buse, Kent; McKee, Martin; Piot, Peter; Perel, Pablo; Legido-Quigley, Helena

2017-01-01

Abstract Background The frequency in which HIV and AIDS and mental health problems co-exist, and the complex bi-directional relationship between them, highlights the need for effective care models combining services for HIV and mental health. Here, we present a systematic review that synthesizes the literature on interventions and approaches integrating these services. Methods This review was part of a larger systematic review on integration of services for HIV and non-communicable diseases. Eligible studies included those that described or evaluated an intervention or approach aimed at integrating HIV and mental health care. We searched multiple databases from inception until October 2015, independently screened articles identified for inclusion, conducted data extraction, and assessed evaluative papers for risk of bias. Results Forty-five articles were eligible for this review. We identified three models of integration at the meso and micro levels: single-facility integration, multi-facility integration, and integrated care coordinated by a non-physician case manager. Single-site integration enhances multidisciplinary coordination and reduces access barriers for patients. However, the practicality and cost-effectiveness of providing a full continuum of specialized care on-site for patients with complex needs is arguable. Integration based on a collaborative network of specialized agencies may serve those with multiple co-morbidities but fragmented and poorly coordinated care can pose barriers. Integrated care coordinated by a single case manager can enable continuity of care for patients but requires appropriate training and support for case managers. Involving patients as key actors in facilitating integration within their own treatment plan is a promising approach. Conclusion This review identified much diversity in integration models combining HIV and mental health services, which are shown to have potential in yielding positive patient and service delivery outcomes when implemented within appropriate contexts. Our review revealed a lack of research in low- and middle- income countries, and was limited to most studies being descriptive. Overall, studies that seek to evaluate and compare integration models in terms of long-term outcomes and cost-effectiveness are needed, particularly at the health system level and in regions with high HIV and AIDS burden. PMID:29106512

Closing the mental health treatment gap in South Africa: a review of costs and cost-effectiveness

PubMed Central

Jack, Helen; Wagner, Ryan G.; Petersen, Inge; Thom, Rita; Newton, Charles R.; Stein, Alan; Kahn, Kathleen; Tollman, Stephen; Hofman, Karen J.

2014-01-01

Background Nearly one in three South Africans will suffer from a mental disorder in his or her lifetime, a higher prevalence than many low- and middle-income countries. Understanding the economic costs and consequences of prevention and packages of care is essential, particularly as South Africa considers scaling-up mental health services and works towards universal health coverage. Economic evaluations can inform how priorities are set in system or spending changes. Objective To identify and review research from South Africa and sub-Saharan Africa on the direct and indirect costs of mental, neurological, and substance use (MNS) disorders and the cost-effectiveness of treatment interventions. Design Narrative overview methodology. Results and conclusions Reviewed studies indicate that integrating mental health care into existing health systems may be the most effective and cost-efficient approach to increase access to mental health services in South Africa. Integration would also direct treatment, prevention, and screening to people with HIV and other chronic health conditions who are at high risk for mental disorders. We identify four major knowledge gaps: 1) accurate and thorough assessment of the health burdens of MNS disorders, 2) design and assessment of interventions that integrate mental health screening and treatment into existing health systems, 3) information on the use and costs of traditional medicines, and 4) cost-effectiveness evaluation of a range of specific interventions or packages of interventions that are tailored to the national context. PMID:24848654

Diagnosis and treatment delays among elderly breast cancer patients with pre-existing mental illness.

PubMed

Iglay, Kristy; Santorelli, Melissa L; Hirshfield, Kim M; Williams, Jill M; Rhoads, George G; Lin, Yong; Demissie, Kitaw

2017-11-01

This study aimed to compare diagnosis and treatment delays in elderly breast cancer patients with and without pre-existing mental illness. A retrospective cohort study was conducted using the Surveillance, Epidemiology and End Results-Medicare data including 16,636 women 68+ years, who were diagnosed with stage I-IIIa breast cancer in the United States from 2005 to 2007. Mental illness was identified using International Classification of Diseases, Ninth Revision, Clinical Modification codes recorded on inpatient and outpatient claims during the 3 years prior to breast cancer diagnosis. Patients were classified as having no mental illness, anxiety, depression, anxiety and depression, or severe mental illness (bipolar disorder, schizophrenia, and other psychotic disorder). Multivariable binomial regression was used to assess the association between mental illness and delays of ≥60 and ≥90 days after adjustment for confounders. Patients with comorbid anxiety and depression had an increased risk for diagnosis delay of ≥90 days from symptom recognition (RR 1.11; 95% CI 1.00, 1.23), and those with severe mental illness had an increased risk for initial treatment delay of ≥60 days from diagnosis (RR 1.36; 95% CI 1.06, 1.74). Patients with any mental illness experienced an increased risk for adjuvant chemotherapy delay of ≥90 days from last operation (RR 1.13; 95% CI 1.01, 1.26) and each category of mental illness, except depression, showed a non-significant trend for this association. Breast cancer patients with mental illness should be closely managed by a cross-functional care team, including a psychiatrist, a primary care physician, and an oncologist, to ensure adequate care is received within an appropriate timeframe.

Mental Insanity Assessment of Pedophilia: The Importance of the Trans-Disciplinary Approach. Reflections on Two Cases.

PubMed

Scarpazza, Cristina; Pennati, Ambrogio; Sartori, Giuseppe

2018-01-01

A 60 plus-year-old male was charged with pedophilia for forcing a child to touch him inappropriately near a primary school fence. In another case, a 70 plus-year-old male was charged with pedophilia for intimately touching a boy in a cinema. What led them to manifest this socially-inappropriate and legally-relevant behavior? Is there an explanation for the sexually-related behavioral changes emerging late in life of these two men? Indeed, a common point exists between the two men: both were found to suffer from highly-disabling neurological conditions, known to have a potential effect on social behavior. Specifically, a large right frontoparietal meningioma was found to have important influence on the first man's cognition and control inhibition, whereas frontotemporal dementia prevented the second man from understanding the moral disvalue of his sexually-inappropriate behavior and controlling his sexual impulses. In the current presentation, particular emphasis is placed on the logical reasoning supporting the conclusions that both the pedophiles should be considered not guilty by reason of insanity. Furthermore, experimental methods have been used to explore both cases, which rely on the existence of cognitive models for the phenomena under study, the integration of insights offered by different disciplines and the application of a variety of tools and approaches that follow the "convergence of evidence" principle, which could be safely used in court to support a mental insanity claim. Here, we describe how the use of the experimental method could become useful to reduce the uncertainty in mental insanity assessments. The use of a transdisciplinary, scientifically-grounded approach can help to change the way legal phenomena are interpreted. For instance, when assessing mental insanity, consultants should not only investigate the eventual existence of a diagnosis, but should assess the cognitive/affective abilities that are necessary to understand our own behavior and emotions as well as those of others. The criteria for responsibility should be symptoms-based and not diagnosis-based. Since pedophilia is among the most hideous behaviors condemned by society, a more comprehensive and transdisciplinary approach is recommended in court.

Psychiatric care or social defense? The origins of a controversy over the responsibility of the mentally ill in French forensic psychiatry.

PubMed

Protais, Caroline

2014-01-01

While some countries like Belgium chose a penal system clearly inspired by social-defense theories for mentally disturbed criminals, the French law hasn't been consistent and varies from the enlightened classical law and social-defense law. Indeed paragraph 1 of article 122-1 states that people whose discernment or control is abolished by a psychiatric disorder are non-responsible respecting the classical logic of law. On the other hand, Paragraph 2 of Article 122-1 allows the mentally ill to be judged responsible whereas no institution exists to take care about them. Then the system of psychiatric care in prisons present as a solution for professionals wishing to promote a system where people are punished and socially rehabilitated. Thus these forensic psychiatrists don't refer to paragraph 1 of article 122-1 and even people presenting serious mental disorders are considered responsible. Moreover, if a controversy has always existed between psychiatrists who argue a large conception of mental irresponsibility and professionals who defend the right to punish and to conclude that responsibility even for mentally disturbed criminals, the controversy becomes more important in French forensic psychiatry after the Second World War. If until the 1970s the practice of imposing responsibility for mentally ill individuals shows itself as a humanism, it occurs more within a security perspective today. © 2013.

Treating substance abuse and mental health issues as 'mutually-exclusive' entities: Best practice or an outmoded approach to intervention?

PubMed

Webber, Adrian; Clark, Jane; Kelly, David

2016-02-01

Addressing the psychological distress of individuals experiencing substance use disorders has too often been relegated to the 'too hard basket', leaving those affected with little choice but to receive treatments aimed solely at addressing their drug and alcohol issues. Conversely, individuals receiving support for psychological issues are often underdiagnosed with regards to any comorbid substance misuse problems. In fact, to date, no definitive treatment model exists that gives equal focus to the treatment of both psychological well-being and substance-related addictions. This is not to suggest, however, that existing treatment programmes for substance misuse are not impacting positively on clients' mental health, rather that further research is needed in order to determine what it is that is supporting such improvements. The aim of this study, therefore, was to address this imbalance by examining the correlation between substance dependence and psychological well-being. Using a descriptive correlation design, the Severity of Dependence and Kessler 10 scales were administered to 37 inpatient and outpatient clients at a rural drug and alcohol rehabilitation service, at intake and 2 months into treatment. Data were analysed using descriptive statistics and paired-samples t-tests. Positive correlative factors of improvement between substance dependence and psychological well-being were found for both groups. In light of these findings, the authors recommend that future research be undertaken to investigate the causal factors for this correlation. © 2016 Australian College of Mental Health Nurses Inc.

Mental health and psychosocial support in humanitarian emergencies.

PubMed

van Ommeren, M; Hanna, F; Weissbecker, I; Ventevogel, P

2015-09-28

Armed conflicts and natural disasters impact negatively on the mental health and well-being of affected populations in the short- and long-term and affect the care of people with pre-existing mental health conditions. This paper outlines specific actions for mental health and psychosocial support by the health sector in the preparedness, response and recovery phases of emergencies. Broad recommendations for ministries of health are to: (1) embed mental health and psychosocial support in national health and emergency preparedness plans; (2) put in place national guidelines, standards and supporting tools for the provision of mental health and psychosocial support during emergencies; (3) strengthen the capacity of health professionals to identify and manage priority mental disorders during emergencies; and (4) utilize opportunities generated by the emergency response to contribute to development of sustainable mental health-care services.

Mental Models: Understanding the Impact of Fantasy Violence on Children's Moral Reasoning.

ERIC Educational Resources Information Center

Krcmar, Marina; Curtis, Stephen

2003-01-01

Tests the efficacy of mental models in understanding the effect of exposure to fantasy violence on children's responses to and reasoning about moral dilemmas involving aggression. Offers a possible extension to mental models that is consistent with current theory in cognitive science. Suggests that the activation of mental models regarding…

Peruvian Mental Health Reform: A Framework for Scaling-up Mental Health Services

PubMed Central

Toyama, Mauricio; Castillo, Humberto; Galea, Jerome T.; Brandt, Lena R.; Mendoza, María; Herrera, Vanessa; Mitrani, Martha; Cutipé, Yuri; Cavero, Victoria; Diez-Canseco, Francisco; Miranda, J. Jaime

2017-01-01

Background: Mental, neurological, and substance (MNS) use disorders are a leading cause of disability worldwide; specifically in Peru, MNS affect 1 in 5 persons. However, the great majority of people suffering from these disorders do not access care, thereby making necessary the improvement of existing conditions including a major rearranging of current health system structures beyond care delivery strategies. This paper reviews and examines recent developments in mental health policies in Peru, presenting an overview of the initiatives currently being introduced and the main implementation challenges they face. Methods: Key documents issued by Peruvian governmental entities regarding mental health were reviewed to identify and describe the path that led to the beginning of the reform; how the ongoing reform is taking place; and, the plan and scope for scale-up. Results: Since 2004, mental health has gained importance in policies and regulations, resulting in the promotion of a mental health reform within the national healthcare system. These efforts crystallized in 2012 with the passing of Law 29889 which introduced several changes to the delivery of mental healthcare, including a restructuring of mental health service delivery to occur at the primary and secondary care levels and the introduction of supporting services to aid in patient recovery and reintegration into society. In addition, a performance-based budget was approved to guarantee the implementation of these changes. Some of the main challenges faced by this reform are related to the diversity of the implementation settings, eg, isolated rural areas, and the limitations of the existing specialized mental health institutes to substantially grow in parallel to the scaling-up efforts in order to be able to provide training and clinical support to every region of Peru. Conclusion: Although the true success of the mental healthcare reform will be determined in the coming years, thus far, Peru has achieved a number of legal, policy and fiscal milestones, thereby presenting a unique and fertile environment for the expansion of mental health services PMID:28949462

Developing European guidelines for training care professionals in mental health promotion.

PubMed

Greacen, Tim; Jouet, Emmanuelle; Ryan, Peter; Cserhati, Zoltan; Grebenc, Vera; Griffiths, Chris; Hansen, Bettina; Leahy, Eithne; da Silva, Ksenija Maravic; Sabić, Amra; De Marco, Angela; Flores, Paz

2012-12-27

Although mental health promotion is a priority mental health action area for all European countries, high level training resources and high quality skills acquisition in mental health promotion are still relatively rare. The aim of the current paper is to present the results of the DG SANCO-funded PROMISE project concerning the development of European guidelines for training social and health care professionals in mental health promotion. The PROMISE project brought together a multidisciplinary scientific committee from eight European sites representing a variety of institutions including universities, mental health service providers and public health organisations. The committee used thematic content analysis to filter and analyse European and international policy documents, scientific literature reviews on mental health promotion and existing mental health promotion programmes with regard to identifying quality criteria for training care professionals on this subject. The resulting PROMISE Guidelines quality criteria were then subjected to an iterative feedback procedure with local steering groups and training professionals at all sites with the aim of developing resource kits and evaluation tools for using the PROMISE Guidelines. Scientific committees also collected information from European, national and local stakeholder groups and professional organisations on existing training programmes, policies and projects. The process identified ten quality criteria for training care professionals in mental health promotion: embracing the principle of positive mental health; empowering community stakeholders; adopting an interdisciplinary and intersectoral approach; including people with mental health problems; advocating; consulting the knowledge base; adapting interventions to local contexts; identifying and evaluating risks; using the media; evaluating training, implementation processes and outcomes. The iterative feedback process produced resource kits and evaluation checklists linked with each of these quality criteria in all PROMISE languages. The development of generic guidelines based on key quality criteria for training health and social care professionals in mental health promotion should contribute in a significant way to implementing policy in this important area.

Mental models of audit and feedback in primary care settings.

PubMed

Hysong, Sylvia J; Smitham, Kristen; SoRelle, Richard; Amspoker, Amber; Hughes, Ashley M; Haidet, Paul

2018-05-30

Audit and feedback has been shown to be instrumental in improving quality of care, particularly in outpatient settings. The mental model individuals and organizations hold regarding audit and feedback can moderate its effectiveness, yet this has received limited study in the quality improvement literature. In this study we sought to uncover patterns in mental models of current feedback practices within high- and low-performing healthcare facilities. We purposively sampled 16 geographically dispersed VA hospitals based on high and low performance on a set of chronic and preventive care measures. We interviewed up to 4 personnel from each location (n = 48) to determine the facility's receptivity to audit and feedback practices. Interview transcripts were analyzed via content and framework analysis to identify emergent themes. We found high variability in the mental models of audit and feedback, which we organized into positive and negative themes. We were unable to associate mental models of audit and feedback with clinical performance due to high variance in facility performance over time. Positive mental models exhibit perceived utility of audit and feedback practices in improving performance; whereas, negative mental models did not. Results speak to the variability of mental models of feedback, highlighting how facilities perceive current audit and feedback practices. Findings are consistent with prior research  in that variability in feedback mental models is associated with lower performance.; Future research should seek to empirically link mental models revealed in this paper to high and low levels of clinical performance.

Economic downturns and population mental health: research findings, gaps, challenges and priorities

PubMed Central

Zivin, K.; Paczkowski, M.; Galea, S.

2013-01-01

Prior research suggests that the current global economic crisis may be negatively affecting population mental health. In that context, this paper has several goals: (1) to discuss theoretical and conceptual explanations for how and why economic downturns might negatively affect population mental health; (2) present an overview of the literature on the relationship between economic recessions and population mental health; (3) discuss the limitations of existing empirical work; and (4) highlight opportunities for improvements in both research and practice designed to mitigate any negative impact of economic declines on the mental health of populations. Research has consistently demonstrated that economic crises are negatively associated with population mental health. How economic downturns influence mental health should be considered in policies such as social protection programs that aim to promote recovery. PMID:20836907

Biology Students’ Initial Mental Model about Microorganism

NASA Astrophysics Data System (ADS)

Hamdiyati, Y.; Sudargo, F.; Redjeki, S.; Fitriani, A.

2017-02-01

The purpose of this study was to identify biology students’ initial mental model about microorganism. This research used descriptive method with 32 sixth semester biology students at Biology Education Departement-Universitas Pendidikan Indonesia as its respondents. Data was taken at the beginning of the 6th semester before respondents endure microbiology course. Instrument used to assess mental model was drawing-writing test in which it contains concepts such as structure of bacteria, archaea, virus, and fungi. Students were asked to describe their imagination about the structure of microorganisms and subsequently asked to explain the structure of microorganisms in writing through open-ended questions. Students’ response was then compared to scientists or experts’ mental models as the targeted mental model. Student mental models were categorized into five levels (levels 1-5), namely “there is no drawing/writing,” “wrong or irrelevant drawing/writing of question,” “partially correct drawing/writing,” “the drawing/writing that has some deficiencies,” and “completely correct and complete drawing/writing.” Results showed that the level of mental models through drawing or writing about the four concepts were varied. The highest level of mental models through drawing (D5) was found in the concept of bacteria, while the highest level of mental models through writing (W3) was found in the concept of bacteria, virus, and fungi. Mental model levels most commonly found in each concept through drawing-writing tests (D/W) were bacteria (D2/W2), Archaea (D1/W1 and D2/W2), virus (D3/W3), and fungi (D2/W1). From these results it is advisable to improve lectures and assessment strategy to enhance or complement students’ mental models about microorganisms.

The SNARC effect in two dimensions: Evidence for a frontoparallel mental number plane.

PubMed

Hesse, Philipp Nikolaus; Bremmer, Frank

2017-01-01

The existence of an association between numbers and space is known for a long time. The most prominent demonstration of this relationship is the spatial numerical association of response codes (SNARC) effect, describing the fact that participants' reaction times are shorter with the left hand for small numbers and with the right hand for large numbers, when being asked to judge the parity of a number (Dehaene et al., J. Exp. Psychol., 122, 371-396, 1993). The SNARC effect is commonly seen as support for the concept of a mental number line, i.e. a mentally conceived line where small numbers are represented more on the left and large numbers are represented more on the right. The SNARC effect has been demonstrated for all three cardinal axes and recently a transverse SNARC plane has been reported (Chen et al., Exp. Brain Res., 233(5), 1519-1528, 2015). Here, by employing saccadic responses induced by auditory or visual stimuli, we measured the SNARC effect within the same subjects along the horizontal (HM) and vertical meridian (VM) and along the two interspersed diagonals. We found a SNARC effect along HM and VM, which allowed predicting the occurrence of a SNARC effect along the two diagonals by means of linear regression. Importantly, significant differences in SNARC strength were found between modalities. Our results suggest the existence of a frontoparallel mental number plane, where small numbers are represented left and down, while large numbers are represented right and up. Together with the recently described transverse mental number plane our findings provide further evidence for the existence of a three-dimensional mental number space. Copyright © 2016 Elsevier Ltd. All rights reserved.

Facilitators and barriers to doing workplace mental health research: Case study of acute psychological trauma in a public transit system.

PubMed

Links, Paul S; Bender, Ash; Eynan, Rahel; O'Grady, John; Shah, Ravi

2016-03-10

The Acute Psychological Trauma (APT) Study was a collaboration between an acute care hospital, a specialized multidisciplinary program designed to meet the mental health needs of injured workers, and a large urban public transit system. The overall purpose was to evaluate a Best Practices Intervention (BPI) for employees affected by acute psychological trauma compared to a Treatment as Usual (TAU) group. The specific purpose is to discuss facilitators and barriers that were recognized in implementing and carrying out mental health research in a workplace setting. Over the course of the APT study, a joint implementation committee was responsible for day-to-day study operations and made regular observations on the facilitators and barriers that arose throughout the study. The facilitators to this study included the longstanding relationships among the partners, increased recognition for the need of mental health research in the workplace, and the existence of a community advisory committee. The significant barriers to doing this study of mental health research in the workplace included differences in organizational culture, inconsistent union support, co-interventions, and stigma. Researchers and funding agencies need to be flexible and provide additional resources in order to overcome the barriers that can exist doing workplace mental health research.

Mental health, sexual identity, and interpersonal violence: Findings from the Australian longitudinal Women's health study.

PubMed

Szalacha, Laura A; Hughes, Tonda L; McNair, Ruth; Loxton, Deborah

2017-09-30

We examined the relationships among experiences of interpersonal violence, mental health, and sexual identity in a national sample of young adult women in Australia. We used existing data from the third (2003) wave of young adult women (aged 25-30) in the Australian Longitudinal Study on Women's Health (ALSWH). We conducted bivariate analyses and fit multiple and logistic regression models to test experiences of six types of interpersonal violence (physical abuse, severe physical abuse, emotional abuse, sexual abuse, harassment, and being in a violent relationship), and the number of types of violence experienced, as predictors of mental health. We compared types and number of types of violence across sexual identity subgroups. Experiences of interpersonal violence varied significantly by sexual identity. Controlling for demographic characteristics, compared to exclusively heterosexual women, mainly heterosexual and bisexual women were significantly more likely to report physical, sexual, and emotional abuse. Mainly heterosexual and lesbian women were more likely to report severe physical abuse. Mainly heterosexual women were more than three times as likely to have been in a violent relationship in the past three years, and all three sexual minority subgroups were two to three times as likely to have experienced harassment. Bisexual women reported significantly higher levels of depression than any of the other sexual identity groups and scored lower on mental health than did exclusively heterosexual women. In linear regression models, interpersonal violence strongly predicted poorer mental health for lesbian and bisexual women. Notably, mental health indicators were similar for exclusively heterosexual and sexual minority women who did not report interpersonal violence. Experiencing multiple types of interpersonal violence was the strongest predictor of stress, anxiety and depression. Interpersonal violence is a key contributor to mental health disparities, especially among women who identify as mainly heterosexual or bisexual. More research is needed that examines within-group differences to determine which subgroups are at greatest risk for various types of interpersonal violence. Such information is critical to the development of effective prevention and intervention strategies.

Effects of mental rotation on acalculia: differences in the direction of mental rotation account for the differing characteristics of acalculia induced by right and left hemispheric brain injury.

PubMed

Asada, Tomohiko; Takayama, Yoshihiro; Oita, Jiro; Fukuyama, Hidenao

2014-04-01

We observed a 59-year-old right-handed man with an infarction in his right-middle cerebral artery that included the parietal lobe, who abnormally manipulated mental images in the horizontal direction, resulting in calculation disturbances. Three years later, the patient suffered an infarction in the left parietal lobe and displayed abnormalities during the creation of mental images; i.e., he rotated them in the vertical direction, which again resulted in calculation disturbances. These mental imagery disturbances might indicate that a common acalculia mechanism exists between the right and left hemispheres.

Students’ mental model on heat convection concept and its relation with students conception on heat and temperature

NASA Astrophysics Data System (ADS)

Amalia, R.; Sari, I. M.; Sinaga, P.

2017-02-01

This research depended by previous studies that only to find out the misconceptions of students without figuring out the mechanism of the misconceptions. The mechanism of misconceptions can be studied more deeply with mental models. The purpose of this study was to find students ‘mental models of heat convection and its relation with students conception on heat and temperature. The method used in this study is exploratory mixed method design that implemented in one of the high schools in Bandung. The results showed that 7 mental models of heat convection in Chiou’s study (2013), only first model (diffusion-based convention), third model (evenly distributed convection) and fifth model (warmness topped convection II) were found and model hybrid convection as a new mental model. In addition, no specific relationship between mental models and categories of students’ conceptions on heat and temperature.

Depressive disorders co-existing with Addison-Biermer anemia - case report.

PubMed

Just, Mark Jean; Kozakiewicz, Mariusz

2015-01-01

Anemia is a disease that can co-exist with depression, other mental disorders, or somatic diseases. Anemia can imitate symptoms of depression, while depression symptoms can mask concurring symptoms of anemia. I am presenting a case of a 48-year-old woman with Addison-Biermer anemia, with co-existing mood disorders. The clinical analysis of the presented patient's history indicates diagnostic problems and a need for a detailed analysis of drug-related complications that occurred during previous treatment, eg, in the form of neuroleptic malignant syndrome. The presented case report contains valuable guidelines that can be of assistance in diagnostics and treatment of patients treated for mental disorders, who are also diagnosed with somatic diseases.

Towards social autonomous vehicles: Efficient collision avoidance scheme using Richardson's arms race model.

PubMed

Riaz, Faisal; Niazi, Muaz A

2017-01-01

This paper presents the concept of a social autonomous agent to conceptualize such Autonomous Vehicles (AVs), which interacts with other AVs using social manners similar to human behavior. The presented AVs also have the capability of predicting intentions, i.e. mentalizing and copying the actions of each other, i.e. mirroring. Exploratory Agent Based Modeling (EABM) level of the Cognitive Agent Based Computing (CABC) framework has been utilized to design the proposed social agent. Furthermore, to emulate the functionality of mentalizing and mirroring modules of proposed social agent, a tailored mathematical model of the Richardson's arms race model has also been presented. The performance of the proposed social agent has been validated at two levels-firstly it has been simulated using NetLogo, a standard agent-based modeling tool and also, at a practical level using a prototype AV. The simulation results have confirmed that the proposed social agent-based collision avoidance strategy is 78.52% more efficient than Random walk based collision avoidance strategy in congested flock-like topologies. Whereas practical results have confirmed that the proposed scheme can avoid rear end and lateral collisions with the efficiency of 99.876% as compared with the IEEE 802.11n-based existing state of the art mirroring neuron-based collision avoidance scheme.

Towards social autonomous vehicles: Efficient collision avoidance scheme using Richardson’s arms race model

PubMed Central

Niazi, Muaz A.

2017-01-01

This paper presents the concept of a social autonomous agent to conceptualize such Autonomous Vehicles (AVs), which interacts with other AVs using social manners similar to human behavior. The presented AVs also have the capability of predicting intentions, i.e. mentalizing and copying the actions of each other, i.e. mirroring. Exploratory Agent Based Modeling (EABM) level of the Cognitive Agent Based Computing (CABC) framework has been utilized to design the proposed social agent. Furthermore, to emulate the functionality of mentalizing and mirroring modules of proposed social agent, a tailored mathematical model of the Richardson’s arms race model has also been presented. The performance of the proposed social agent has been validated at two levels–firstly it has been simulated using NetLogo, a standard agent-based modeling tool and also, at a practical level using a prototype AV. The simulation results have confirmed that the proposed social agent-based collision avoidance strategy is 78.52% more efficient than Random walk based collision avoidance strategy in congested flock-like topologies. Whereas practical results have confirmed that the proposed scheme can avoid rear end and lateral collisions with the efficiency of 99.876% as compared with the IEEE 802.11n-based existing state of the art mirroring neuron-based collision avoidance scheme. PMID:29040294

St. Louis Initiative for Integrated Care Excellence (SLI(2)CE): integrated-collaborative care on a large scale model.

PubMed

Brawer, Peter A; Martielli, Richard; Pye, Patrice L; Manwaring, Jamie; Tierney, Anna

2010-06-01

The primary care health setting is in crisis. Increasing demand for services, with dwindling numbers of providers, has resulted in decreased access and decreased satisfaction for both patients and providers. Moreover, the overwhelming majority of primary care visits are for behavioral and mental health concerns rather than issues of a purely medical etiology. Integrated-collaborative models of health care delivery offer possible solutions to this crisis. The purpose of this article is to review the existing data available after 2 years of the St. Louis Initiative for Integrated Care Excellence; an example of integrated-collaborative care on a large scale model within a regional Veterans Affairs Health Care System. There is clear evidence that the SLI(2)CE initiative rather dramatically increased access to health care, and modified primary care practitioners' willingness to address mental health issues within the primary care setting. In addition, data suggests strong fidelity to a model of integrated-collaborative care which has been successful in the past. Integrated-collaborative care offers unique advantages to the traditional view and practice of medical care. Through careful implementation and practice, success is possible on a large scale model. PsycINFO Database Record (c) 2010 APA, all rights reserved.

[Towards an Understanding of Stigma: What is the Stereotype Associated with Schizophrenia].

PubMed

Yvon, Florence; Prouteau, Antoinette

Objectives Stigmatization of people suffering from schizophrenia spectrum disorder relies on the existence of a stereotype which is associated with a social category, here schizophrenia. The short report's aim is to briefly synthesize the recent literature about the content of the stereotype associated with schizophrenia, and to suggest some perspectives for future studies, on the basis of recent advances in the domain.Methods First, we present the theoretical concepts of stigma and stereotype. Second, we propose a brief synthesis of the recently published articles focusing on the content of schizophrenia stereotype in the general population, in English and in French.Results The stereotype associated with mental illness is clearly negative. The most common model in the literature assumes 4 factors in the content of stereotype: attribution of responsibility in the condition, dangerousness, poor prognosis, unpredictability and incompetence in social roles. If the stereotype could vary among countries, it is clearly associated with desire for social distance and discrimination. The stereotype also varies among mental illnesses. Compared with bipolar disorders and autism, schizophrenia focuses the most negative aspects of mental illness stereotype, especially in terms of dangerousness and social distance.Conclusion The study of stereotype, though rapidly growing, still raises questions about the validity of commonly used models in the psychiatric literature, and may benefit from further specific studies. Social psychology models and methods appear to be a promising perspective. The production of data, useful for users, families as well as for professionals may require multidisciplinarity for future projects.

Trajectories of Perceived Workplace Age Discrimination and Long-Term Associations With Mental, Self-Rated, and Occupational Health.

PubMed

Marchiondo, Lisa A; Gonzales, Ernest; Williams, Larry J

2017-07-12

This study addresses older employees' trajectories of perceived workplace age discrimination, and the long-term associations among perceived age discrimination and older workers' mental and self-rated health, job satisfaction, and likelihood of working past retirement age. We evaluate the strength and vulnerability integration (SAVI) model. Three waves of data from employed participants were drawn from the Health and Retirement Study (N = 3,957). Latent growth modeling was used to assess relationships between the slopes and the intercepts of the variables, thereby assessing longitudinal and cross-sectional associations. Perceived workplace age discrimination tends to increase with age, although notable variance exists. The initial status of perceived age discrimination relates to the baseline statuses of depression, self-rated health, job satisfaction, and likelihood of working past retirement age in the expected directions. Over time, perceived age discrimination predicts lower job satisfaction and self-rated health, as well as elevated depressive symptoms, but not likelihood of working past retirement age. This study provides empirical support for the SAVI model and uncovers the "wear and tear" effects of perceived workplace age discrimination on older workers' mental and overall health. We deliberate on social policies that may reduce age discrimination, thereby promoting older employees' health and ability to work longer. © The Author 2017. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Parents' work patterns and adolescent mental health.

PubMed

Dockery, Alfred; Li, Jianghong; Kendall, Garth

2009-02-01

Previous research demonstrates that non-standard work schedules undermine the stability of marriage and reduce family cohesiveness. Limited research has investigated the effects of parents working non-standard schedules on children's health and wellbeing and no published Australian studies have addressed this important issue. This paper contributes to bridging this knowledge gap by focusing on adolescents aged 15-20 years and by including sole parent families which have been omitted in previous research, using panel data from the Household, Income and Labour Dynamics in Australia Survey. Multilevel linear regression models are estimated to analyse the association between parental work schedules and hours of work and measures of adolescents' mental health derived from the SF-36 Health Survey. Evidence of negative impacts of parents working non-standard hours upon adolescent wellbeing is found to exist primarily within sole parent families.

The use of clinical trials in comparative effectiveness research on mental health.

PubMed

Blanco, Carlos; Rafful, Claudia; Olfson, Mark

2013-08-01

A large body of comparative effectiveness research (CER) focuses on the use of observational and quasi-experimental approaches. We sought to examine the use of clinical trials as a tool for CER, particularly in mental health. Examination of three ongoing randomized clinical trials in psychiatry addressing issues that would pose difficulties for nonexperimental CER methods. Existing statistical approaches to nonexperimental data appear insufficient to compensate for biases that may arise when the pattern of missing data cannot be properly modeled such as when there are no standards for treatment, when affected populations have limited access to treatment, or when there are high rates of treatment dropout. Clinical trials should retain an important role in CER, particularly in cases of high disorder prevalence, large expected effect sizes, difficult-to-reach populations, or when examining sequential treatments or stepped-care algorithms. Progress in CER on mental health will require careful consideration of appropriate selection between clinical trials and nonexperimental designs and on allocation of research resources to optimally inform key treatment decisions for each patient. Copyright © 2013 Elsevier Inc. All rights reserved.

The mental time travel continuum: on the architecture, capacity, versatility and extension of the mental bridge into the past and future.

PubMed

Breeden, Prescott; Dere, Dorothea; Zlomuzica, Armin; Dere, Ekrem

2016-06-01

Mental time travel (MTT) is the ability to remember past events and to anticipate or imagine events in the future. MTT globally serves to optimize decision-making processes, improve problem-solving capabilities and prepare for future needs. MTT is also essential in providing our concept of self, which includes knowledge of our personality, our strengths and weaknesses, as well as our preferences and aversions. We will give an overview in which ways the capacity of animals to perform MTT is different from humans. Based on the existing literature, we conclude that MTT might represent a quantitative rather than qualitative entity with a continuum of MTT capacities in both humans and nonhuman animals. Given its high complexity, MTT requires a large processing capacity in order to integrate multimodal stimuli during the reconstruction of past and/or future events. We suggest that these operations depend on a highly specialized working memory subsystem, 'the MTT platform', which might represent a necessary additional component in the multi-component working memory model by Alan Baddeley.

Rural Parents’ Perceived Stigma of Seeking Mental Health Services for their Children: Development and Evaluation of a New Instrument

PubMed Central

Williams, Stacey L.; Polaha, Jodi

2014-01-01

The purpose of this paper was to examine the validity of score interpretations of an instrument developed to measure parents’ perceptions of stigma about seeking mental health services for their children. The validity of the score interpretations of the instrument was tested in two studies. Study 1 examined confirmatory factor analysis (CFA) employing a split half approach, and construct and criterion validity using the entire sample of parents in rural Appalachia whose children were experiencing psychosocial concerns (N=347), while Study 2 further examined CFA, construct and criterion validity, as well as predictive validity of the scores on the new scale using a general sample of parents in rural Appalachia (N=184). Results of exploratory and confirmatory factor analyses revealed support for a two factor model of parents’ perceived stigma, which represented both self and public forms of stigma associated with seeking mental health services for their children, and correlated with existing measures of stigma and other psychosocial variables. Further, the new self and public stigma scale significantly predicted parents’ willingness to seek services for children. PMID:24749752

Effects of integrated trauma treatment on outcomes in a racially/ethnically diverse sample of women in urban community-based substance abuse treatment.

PubMed

Amaro, Hortensia; Dai, Jianyu; Arévalo, Sandra; Acevedo, Andrea; Matsumoto, Atsushi; Nieves, Rita; Prado, Guillermo

2007-07-01

This study presents findings from a quasiexperimental, nonequivalent, group-design study with repeated measures that explored the effects of integrated trauma-informed services on the severity of substance abuse, mental health, posttraumatic stress disorder (PTSD) symptomatology among women with histories of trauma in urban, community-based substance abuse treatment. The study also explored if the model of integrated services was equally beneficial for women of various racial/ethnic groups. Participants in the study were 342 women receiving substance abuse treatment in intervention and comparison sites. Results indicated that at 6 and 12 month follow-ups, those in the trauma-informed intervention group, in contrast to the comparison group, had significantly better outcomes in drug abstinence rates in the past 30 days as well as in mental health and PTSD symptomatology. Results also showed that, overall, integrated services were beneficial for women across the different racial/ethnic groups in substance abuse treatment, although some differences appear to exist across racial/ethnic groups in improving addiction severity and mental health and PTSD symptomatology.

Effects of Integrated Trauma Treatment on Outcomes in a Racially/Ethnically Diverse Sample of Women in Urban Community-based Substance Abuse Treatment

PubMed Central

Dai, Jianyu; Arévalo, Sandra; Acevedo, Andrea; Matsumoto, Atsushi; Nieves, Rita; Prado, Guillermo

2007-01-01

This study presents findings from a quasiexperimental, nonequivalent, group-design study with repeated measures that explored the effects of integrated trauma-informed services on the severity of substance abuse, mental health, posttraumatic stress disorder (PTSD) symptomatology among women with histories of trauma in urban, community-based substance abuse treatment. The study also explored if the model of integrated services was equally beneficial for women of various racial/ethnic groups. Participants in the study were 342 women receiving substance abuse treatment in intervention and comparison sites. Results indicated that at 6 and 12 month follow-ups, those in the trauma-informed intervention group, in contrast to the comparison group, had significantly better outcomes in drug abstinence rates in the past 30 days as well as in mental health and PTSD symptomatology. Results also showed that, overall, integrated services were beneficial for women across the different racial/ethnic groups in substance abuse treatment, although some differences appear to exist across racial/ethnic groups in improving addiction severity and mental health and PTSD symptomatology. PMID:17356904

Indian psychiatry and research in Pakistan.

PubMed

Chaudhry, Haroon Rashid

2010-01-01

In Asian culture, there is much stigmatization attached on having mental health problems and seeking help from a mental health expert. It is therefore, not surprising, that this stigmatization results in the refutation of the subsistence of a psychiatric problem in an individual and his family but also produces obstruction to help-seeking desires. To get a clear picture of the existence of psychiatric issues in the population, various research projects addressing psychiatric issues in children, women, and elderly are conducted both in Pakistan and India. A significant input has been taken from research conducted in India combating disaster management. In addition, public awareness programs are organized to provide information about common psychiatric disorders in children, adults, women, and the elderly.-Furthermore, psychiatric patients and their families are educated for the management of mental heath problems related to marriage, pregnancy, birth and hazards of smoking & substance abuse in young adults. Keeping in view the similarity in cultural background, treatment models, family structure, and psychosocial factors, collaborative research studies should be encouraged leading to improvement in psychiatric care of the patients both in India and Pakistan.

Social networks of HIV-positive women and their association with social support and depression symptoms.

PubMed

Cederbaum, Julie A; Rice, Eric; Craddock, Jaih; Pimentel, Veronica; Beaver, Patty

2017-02-01

Social support is important to the mental health and well-being of HIV-positive women. Limited information exists about the specific structure and composition of HIV-positive women's support networks or associations of these network properties with mental health outcomes. In this pilot study, the authors examine whether support network characteristics were associated with depressive symptoms. Survey and network data were collected from HIV-positive women (N = 46) via a web-based survey and an iPad application in August 2012. Data were analyzed using multivariate linear regression models in SAS. Depressive symptoms were positively associated with a greater number of doctors in a woman's network; having more HIV-positive network members was associated with less symptom reporting. Women who reported more individuals who could care for them had more family support. Those who reported feeling loved were less likely to report disclosure stigma. This work highlighted that detailed social network data can increase our understanding of social support so as to identify interventions to support the mental health of HIV-positive women. Most significant is the ongoing need for support from peers.

The Contextualized Technology Adaptation Process (CTAP): Optimizing Health Information Technology to Improve Mental Health Systems.

PubMed

Lyon, Aaron R; Wasse, Jessica Knaster; Ludwig, Kristy; Zachry, Mark; Bruns, Eric J; Unützer, Jürgen; McCauley, Elizabeth

2016-05-01

Health information technologies have become a central fixture in the mental healthcare landscape, but few frameworks exist to guide their adaptation to novel settings. This paper introduces the contextualized technology adaptation process (CTAP) and presents data collected during Phase 1 of its application to measurement feedback system development in school mental health. The CTAP is built on models of human-centered design and implementation science and incorporates repeated mixed methods assessments to guide the design of technologies to ensure high compatibility with a destination setting. CTAP phases include: (1) Contextual evaluation, (2) Evaluation of the unadapted technology, (3) Trialing and evaluation of the adapted technology, (4) Refinement and larger-scale implementation, and (5) Sustainment through ongoing evaluation and system revision. Qualitative findings from school-based practitioner focus groups are presented, which provided information for CTAP Phase 1, contextual evaluation, surrounding education sector clinicians' workflows, types of technologies currently available, and influences on technology use. Discussion focuses on how findings will inform subsequent CTAP phases, as well as their implications for future technology adaptation across content domains and service sectors.

Person-Centered Care for Older Adults With Serious Mental Illness and Substance Misuse Within a Program of All-Inclusive Care for the Elderly.

PubMed

Cacchione, Pamela Z; Eible, Lisa; Gill, Le'Roi L; Huege, Steven F

2016-05-01

Providing person-centered care (PCC) to older adults with dual diagnosis, co-occurring serious mental illness (SMI), and substance misuse is complex and requires an interprofessional team. Older adults, who qualify for both Medicaid and Medicare (i.e., dual-eligibles) are overrepresented in the population of older adults with SMI and substance misuse. Programs of All-Inclusive Care for the Elderly (PACE) exist to support community living needs of nursing home-eligible older adults and are increasingly in a position to serve older adults with SMI and substance misuse issues. PACE programs provide integrated person-centered mental health care to address the serious medical, social, and emotional complications posed by having SMI and substance misuse disorders. The case study presented illustrates PCC provided to a dual-diagnosis PACE participant, illustrating the impact of recent and past trauma on current psychopathology and substance misuse. Finally, recommendations for addressing PCC of dual diagnosis within the PACE model are provided. [Journal of Gerontological Nursing, 42(5), 11-17.]. Copyright 2016, SLACK Incorporated.

Reasons for substance use among people with mental disorders.

PubMed

Thornton, Louise K; Baker, Amanda L; Lewin, Terry J; Kay-Lambkin, Frances J; Kavanagh, David; Richmond, Robyn; Kelly, Brian; Johnson, Martin P

2012-04-01

Comorbidity of mental disorders and substance use continues to be a major problem. To inform the development of more effective interventions for these co-existing disorders, this paper aimed to determine if there are clear variations in the reasons for tobacco, alcohol or cannabis use across people with different mental disorders. Data from five randomized controlled trials on co-existing disorders that measured reasons for tobacco, alcohol or cannabis use using the Drug Use Motives Questionnaire, Reasons for Smoking Questionnaire or via free response are reported and combined. Two studies involved participants with depression, two involved participants with a psychotic disorder and one involved participants with a range of mental disorders. A series of logistic regressions were conducted to examine differences in reasons for tobacco, alcohol or cannabis use and to compare these reasons between people with psychotic disorders or depression. Participants had a mean age of 38 (SD=12) and just over half (60%) were male. Forty-six percent of participants had a psychotic disorder and 54% experienced depression. Data from 976 participants across the five studies were included in the analyses. Tobacco and alcohol were primarily used to cope, while cannabis was primarily used for pleasure. People with psychotic disorders were more likely than people with depression to use tobacco for coping, pleasure and illness motives. People with depression, in contrast, were more likely to use alcohol for these reasons and social reasons. It may be important to tailor interventions for co-existing mental disorders and substance use by substance type and type of mental disorder. For example, interventions might be improved by including alternative coping strategies to tobacco and/or alcohol use, by addressing the social role of alcohol and by helping people with mental disorders using cannabis to gain pleasure from their lives in other ways. Copyright © 2012 Elsevier Ltd. All rights reserved.

Improving the physical health of people with severe mental illness: boundaries of care provision.

PubMed

Ehrlich, Carolyn; Kendall, Elizabeth; Frey, Nicolette; Kisely, Steve; Crowe, Elizabeth; Crompton, David

2014-06-01

There is compelling evidence that the physical health of people with severe mental illness is poor. Health-promotion guidelines have been recommended as a mechanism for improving the physical health of this population. However, there are significant barriers to the adoption of evidence-based guidelines in practice. The purpose of this research was to apply existing implementation theories to examine the capability of the health system to integrate physical health promotion into mental health service delivery. Data were collected within a regional city in Queensland, Australia. Fifty participants were interviewed. The core theme that emerged from the data was that of 'care boundaries' that influenced the likelihood of guidelines being implemented. Boundaries existed around the illness, care provision processes, sectors, the health-care system, and society. These multilevel boundaries, combined with participants' ways of responding to them, impacted on capability (i.e. the ability to integrate physical health promotion into existing practices). Participants who were able to identify strategies to mediate these boundaries were better positioned to engage with physical health-promotion practice. Thus, the implementation of evidence-based guidelines depended heavily on the capability of the workforce to develop and adopt boundary-mediating strategies. © 2013 Australian College of Mental Health Nurses Inc.

Unlocking stories: Older women's experiences of intimate partner violence told through creative expression.

PubMed

McGarry, J; Bowden, D

2017-10-01

Intimate partner violence (IPV) impacts significantly on the lives and health of those who experience abuse The impact of IPV exerts a detrimental impact on mental health as well as physical health, but this is often not recognized by professionals WHAT THE STUDY ADDS TO EXISTING KNOWLEDGE: This study highlights the impact of IPV on the lives and health of older women from the perspective of older women themselves The approach taken to the study illuminates the ways in which older women describe their experiences within the broader narratives of their experiences This study has explored the particular situation for older women as told through creative expression and their own stories of survivorship. Nurses and other healthcare professionals need to be aware of the enduring impact of IPV for older women, particularly within the context of mental health Those working with older women also need to be alert to the potential barriers to disclosure and disjuncture between professional dialogue and personal narrative ABSTRACT: Introduction Intimate partner violence (IPV) exerts a detrimental impact on the lives and health of all who experience abuse. This includes both physical and mental health and well-being. The experiences of older women however may be different, and these differences may not be recognized or accounted for within existing care provision. Aim To explore the impact of IPV on the lives and health of older women told from the particular perspective of older women themselves as these accounts are largely absence from existing IPV discourse. Method An arts-based research approach with five older women survivors of IPV through the codevelopment and organization of an arts-based workshop. The workshop essentially encompassed four main arts strands and included the creation of clay models and poetry. Findings The findings of the study highlight the significant impact of IPV on the lives, mental health and well-being of older women. This included feelings of social isolation, inability to trust others and a loss of self-identity. Discussion Intimate partner violence is a global issue and as such of relevance for those working in healthcare contexts beyond the UK. While there is a growing body of evidence surrounding IPV and older women, this has largely been presented through researcher-led accounts and as such the narratives of women themselves may not have been adequately acknowledged. Unlike much of the existing evidence, this study has explored the particular situation for older women as told through creative expression and their own stories of survivorship. In this study, the fluidity of the potential materials available in the workshops meant that both the representations through which the women spoke and the primacy of their voices, over those of more traditional researcher accounts, were in evidence throughout. Implications for Practice Mental health nurses and practitioners are often on the front line for care and support for older client populations. IPV across the life span is a global issue for healthcare practitioners. It is anticipated that the findings of this study will provide the mechanism through which mental health nurses and other practitioners may reflect on older women's accounts of IPV as told by older women in this study in their own words. Reframing from dominant professional discourse to personal narrative is central to person-centred approaches and is central to contemporary practice. Ultimately, this has the potential to improve the effectiveness of care provision and support. Relevance to Mental Health Nursing The findings presented in this study have the potential to provide a powerful tool for those working within mental health contexts and healthcare professionals working with older populations more generally to consider both the hidden nature of IPV and the ways in which IPV can significantly impact on mental health and well-being in later life. © 2017 John Wiley & Sons Ltd.

Reliability and validity of the Positive Mental Health Questionnaire in a sample of Spanish university students.

PubMed

Roldán-Merino, J; Lluch-Canut, M T; Casas, I; Sanromà-Ortíz, M; Ferré-Grau, C; Sequeira, C; Falcó-Pegueroles, A; Soares, D; Puig-Llobet, M

2017-03-01

WHAT IS KNOWN ON THE SUBJECT?: In general, the current studies of positive mental health use questionnaires or parts thereof. However, while these questionnaires evaluate aspects of positive mental health, they fail to measure the construct itself. WHAT DOES THIS PAPER ADD TO EXISTING KNOWLEDGE?: The widespread use and the lack of specific questionnaires for evaluating the positive mental health construct justify the need to measure the robustness of the Positive Mental Health Questionnaire. Also six factors are proposed to measure positive mental health. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: The availability of a good questionnaire to measure positive mental health in university students is useful not only to promote mental health but also to strengthen the curricula of future professionals. Introduction Nursing has a relevant role in managing mental health. It is important to identify and thereafter to enhance positive aspects of mental health among university nursing students. Aim The aim of the present study was to analyse the psychometric properties of the Positive Mental Health Questionnaire (PMHQ) in terms of reliability and validity using confirmatory factor analysis in a sample of university students. Method A cross-sectional study was carried out in a sample of 1091 students at 4 nursing schools in Catalonia, Spain. The reliability of the PMHQ was measured by means of Cronbach's alpha coefficient, and the test-retest stability was measured with the intraclass correlation coefficient (ICC). Confirmatory factor analysis was used to determine the validity of the factorial structure. Results Cronbach's alpha coefficient was satisfactory (>0.70) for four of the six subscales or dimensions and ranged from 0.54 to 0.79. ICC analysis was satisfactory for the six subscales or dimensions. The hypothesis was confirmed in the analysis of the correlations between subclasses and the overall scale, with the strongest correlations being found between the majority of the subscales and the overall scale. Confirmatory factor analysis showed that the model proposed for the factors fit the data satisfactorily. Discussion This scale is a valid and reliable instrument for evaluating positive mental health in university students. Implications for Practice A good questionnaire to measure positive mental health in university students is useful not only to promote mental health but also to strengthen the curricula of future professionals. © 2017 John Wiley & Sons Ltd.

Serious mental illnesses associated with receipt of surgery in retrospective analysis of patients in the Veterans Health Administration.

PubMed

Copeland, Laurel A; Zeber, John E; Sako, Edward Y; Mortensen, Eric M; Pugh, Mary Jo; Wang, Chen-Pin; Restrepo, Marcos I; Flynn, Julianne; MacCarthy, Andrea A; Lawrence, Valerie A

2015-06-18

The STOPP study (Surgical Treatment Outcomes for Patients with Psychiatric Disorders) analyzed variation in rates and types of major surgery by serious mental illness status among patients treated in the Veterans Health Administration (VA). VA patients are veterans of United States military service who qualify for federal care by reason of disability, special service experiences, or poverty. STOPP conducted a secondary data analysis of medical record extracts for seven million VA patients treated Oct 2005-Sep 2009. The retrospective study aggregated inpatient surgery events, comorbid diagnoses, demographics, and postoperative 30-day mortality. Serious mental illness -- schizophrenia, bipolar disorder, posttraumatic stress disorder, or major depressive disorder, was identified in 12 % of VA patients. Over the 4-year study period, 321,131 patients (4.5 %) underwent surgery with same-day preoperative or immediate post-operative admission including14 % with serious mental illness. Surgery patients were older (64 vs. 61 years) and more commonly African-American, unmarried, impoverished, highly disabled (24 % vs 12 % were Priority 1), obese, with psychotic disorder (4.3 % vs 2.9 %). Among surgery patients, 3.7 % died within 30 days postop. After covariate adjustment, patients with pre-existing serious mental illness were relatively less likely to receive surgery (adjusted odds ratios 0.4-0.7). VA patients undergoing major surgery appeared, in models controlling for comorbidity and demographics, to disproportionately exclude those with serious mental illness. While VA preferentially treats the most economically and medically disadvantaged veterans, the surgery subpopulation may be especially ill, potentially warranting increased postoperative surveillance.

The Impact of Discrimination on the Mental Health of Trans*Female Youth and the Protective Effect of Parental Support.

PubMed

Wilson, Erin C; Chen, Yea-Hung; Arayasirikul, Sean; Raymond, H Fisher; McFarland, Willi

2016-10-01

Significant health disparities exist for transgender female (trans*female) youth. We assessed differences in mental health outcomes based on exposure to discrimination among transgender female youth in the San Francisco Bay Area aged 16-24 years. Youth were recruited using a combination of respondent driven sampling with online and social media methods. Logistic regression models were used to estimate odds ratios for the mental health outcomes, comparing levels of discrimination and levels of resiliency promoting protective factors among sexually active youth in the sample (N = 216). High transgender-based discrimination was significantly associated with greater odds of PTSD (AOR, 2.6; 95 % CI 1.4-5.0), depression (AOR, 2.6; 95 % CI 1.2-5.9), and stress related to suicidal thoughts (AOR 7.7, 95 % CI 2.3-35.2). High racial discrimination was significantly associated with greater odds of psychological stress (AOR 3.6; 95 % CI 1.2-10.8), PTSD (AOR 2.1; 95 % CI 1.1-4.2) and stress related to suicidal thoughts (AOR 4.3, 95 % CI 1.5-13.3). Parental closeness was related to significantly lower odds of all four mental health outcomes measured, and intrinsic resiliency positively reduced risk for psychological stress, PTSD, and stress related to suicidal thoughts. Transgender and racial discrimination may have deleterious effects on the mental health of trans*female youth. Interventions that address individual and intersectional discrimination and build resources for resiliency and parental closeness may have success in preventing mental health disorders in this underserved population.

The Traumatogenic Dynamics of Internalized Stigma of Mental Illness Among Arab American, Muslim, and Refugee Clients.

PubMed

Kira, Ibrahim A; Lewandowski, Linda; Ashby, Jeffrey S; Templin, Thomas; Ramaswamy, Vidya; Mohanesh, Jamal

2014-07-01

Understanding the dynamics of mental health stigma through existing frameworks, especially in minorities with higher stigma, is problematic. There is a need to reconceptualize stigma, particularly in highly traumatized groups. The current study examines the validity of a new development-based trauma framework that conceptualizes stigma as a type III chronic trauma that contributes to negative mental health effects. This framework proposes that public stigma is a unique chronic traumatic stress that mediates the effects of similar trauma types in mental health patients. To test this proposition, this study explores the relationships between internalized stigma of mental illness (ISMI), different trauma types, and posttrauma spectrum disorders. ISMI, posttraumatic stress disorder, other posttrauma spectrum disorders, and cumulative trauma measures were administered to a sample of 399 mental health patients that included Arab (82%), Muslim (84%), and refugee (31%), as well as American patients (18%). Age in the sample ranged from 18 to 76 years (M = 39.66, SD = 11.45), with 53.5% males. Hierarchical multiple regression, t tests, and path analyses were conducted. Results indicated that ISMI predicted posttraumatic stress disorder and other posttrauma spectrum disorders after controlling for cumulative trauma. ISMI was associated with other chronic collective identity traumas. While Arab Americans, Muslims, and refugees had higher ISMI scores than other Americans, the elevated chronic trauma levels of these groups were significant predictors of these differences. The results provide evidence to support ISMI traumatology model. Implications of the results for treating victims of ISMI, especially Arab Americans, Muslims and refugees are discussed. © The Author(s) 2014.

Application of the PRECEDE model to understanding mental health promoting behaviors in Hong Kong.

PubMed

Mo, Phoenix K H; Mak, Winnie W S

2008-08-01

The burdens related to mental illness have been increasingly recognized in many countries. Nevertheless, research in positive mental health behaviors remains scarce. This study utilizes the Predisposing, Reinforcing, and Enabling Causes in Education Diagnosis and Evaluation (PRECEDE) model to identify factors associated with mental health promoting behaviors and to examine the effects of these behaviors on mental well-being and quality of life among 941 adults in Hong Kong. Structural equation modeling shows that sense of coherence (predisposing factor), social support (reinforcing factor), and daily hassles (enabling factor) are significantly related to mental health promoting behaviors, which are associated with mental well-being and quality of life. Results of bootstrap analyses confirm the mediating role of mental health promoting behaviors on well-being and quality of life. The study supports the application of the PRECEDE model in understanding mental health promoting behaviors and demonstrates its relationships with well-being and quality of life.

Dangerous noncompliance: a narrative analysis of a CNN special investigation of mental illness.

PubMed

Glick, Douglas; Applbaum, Kalman

2010-08-01

Prevention of illness has become a central theme in debates over strategies to reduce healthcare costs. Severe mental illness poses a special challenge to the paradigm of rational prevention, the principal strategy of which is adherence to pharmacological therapies. With the contraction in the US of in-patient psychiatric care from the 1960s onwards, the mentally ill have become more visible among the homeless and among those caught up in the penal system. Their characteristic visibility contributes to their image as threatening. The perceived dangerousness and the combined societal and economic costs associated with the illness have generated a heightened, and in some venues even a sensationalized rhetoric surrounding the questions of responsibility and control, which we consider in terms of compliance. Using the linguistic method of discourse analysis, we analyze one high profile instance - an episode of CNN's 'Special Investigations Unit', which aired several times in the summer of 2007 - to demonstrate a narrative linking of the high social costs and failures associated with noncompliance and, therefore, the imperative of enforcing it for the safety of society. Through the semiotic reduction of a 'poetic parallelism', the episode reflects and reinforces existing cultural models for mental illness, including its status as straightforward biological disease amenable to pharmacological therapy but which remains uncontrolled due to widespread noncompliance.

[Differential impact of social capital on mental health in the native-born and immigrant populations living in Catalonia (Spain)].

PubMed

Stoyanova, Alexandrina; Díaz-Serrano, Luis

2009-12-01

This study attempts to create a bridge between the literature on immigration and on social capital and health. The objectives were two-fold: firstly, to provide new empirical evidence on the association between social capital and health, using data from Catalonia for the first time and, secondly, to explore the possible existence of a differential impact of social capital on health between native-born residents and immigrants. We also distinguished between individual and community-level social capital. We used the 2006 Catalan Health Survey (ESCA 2006). To assess the relationship between social capital and mental health, we used multilevel models, estimated separately for native-born and immigrant residents. The results revealed a positive link between social capital and good mental health in Catalonia. However, this effect was stronger for individual than for community-level social capital. The results did not support the hypothesis of a differential impact between immigrants and native-born Catalans, but did indicate differences with respect to Spaniards born outside Catalonia. Geographic heterogeneity in the effect of individual social capital on mental health in both immigrants and native-born residents was also detected. We believe that enhancing social capital could potentially be an effective policy tool to achieve objectives related to health status improvement.

Pursuing minimally disruptive medicine: disruption from illness and health care-related demands is correlated with patient capacity.

PubMed

Boehmer, Kasey R; Shippee, Nathan D; Beebe, Timothy J; Montori, Victor M

2016-06-01

Chronic conditions burden patients with illness and treatments. We know little about the disruption of life by the work of dialysis in relation to the resources patients can mobilize, that is, their capacity, to deal with such demands. We sought to determine the disruption of life by dialysis and its relation to patient capacity to cope. We administered a survey to 137 patients on dialysis at an academic medical center. We captured disruption from illness and treatment, and physical, mental, personal, social, financial, and environmental aspects of patient capacity using validated scales. Covariates included number of prescriptions, hours spent on health care, existence of dependents, age, sex, and income level. On average, patients reported levels of capacity and disruption comparable to published levels. In multivariate regression models, limited physical, financial, and mental capacity were significantly associated with greater disruption. Patients in the top quartile of disruption had lower-than-expected physical, financial, and mental capacity. Our sample generally had capacity comparable to other populations and may be able to meet the demands imposed by treatment. Those with reduced physical, financial, and mental capacity reported higher disruption and represent a vulnerable group that may benefit from innovations in minimally disruptive medicine. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

The Stigma Resistance Scale: A multi-sample validation of a new instrument to assess mental illness stigma resistance.

PubMed

Firmin, Ruth L; Lysaker, Paul H; McGrew, John H; Minor, Kyle S; Luther, Lauren; Salyers, Michelle P

2017-12-01

Although associated with key recovery outcomes, stigma resistance remains under-studied largely due to limitations of existing measures. This study developed and validated a new measure of stigma resistance. Preliminary items, derived from qualitative interviews of people with lived experience, were pilot tested online with people self-reporting a mental illness diagnosis (n = 489). Best performing items were selected, and the refined measure was administered to an independent sample of people with mental illness at two state mental health consumer recovery conferences (n = 202). Confirmatory factor analyses (CFA) guided by theory were used to test item fit, correlations between the refined stigma resistance measure and theoretically relevant measures were examined for validity, and test-retest correlations of a subsample were examined for stability. CFA demonstrated strong fit for a 5-factor model. The final 20-item measure demonstrated good internal consistency for each of the 5 subscales, adequate test-retest reliability at 3 weeks, and strong construct validity (i.e., positive associations with quality of life, recovery, and self-efficacy, and negative associations with overall symptoms, defeatist beliefs, and self-stigma). The new measure offers a more reliable and nuanced assessment of stigma resistance. It may afford greater personalization of interventions targeting stigma resistance. Copyright © 2017 Elsevier B.V. All rights reserved.

Informing DSM-5: biological boundaries between bipolar I disorder, schizoaffective disorder, and schizophrenia

PubMed Central

2013-01-01

Background The fifth version of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) opted to retain existing diagnostic boundaries between bipolar I disorder, schizoaffective disorder, and schizophrenia. The debate preceding this decision focused on understanding the biologic basis of these major mental illnesses. Evidence from genetics, neuroscience, and pharmacotherapeutics informed the DSM-5 development process. The following discussion will emphasize some of the key factors at the forefront of the debate. Discussion Family studies suggest a clear genetic link between bipolar I disorder, schizoaffective disorder, and schizophrenia. However, large-scale genome-wide association studies have not been successful in identifying susceptibility genes that make substantial etiological contributions. Boundaries between psychotic disorders are not further clarified by looking at brain morphology. The fact that symptoms of bipolar I disorder, but not schizophrenia, are often responsive to medications such as lithium and other anticonvulsants must be interpreted within a larger framework of biological research. Summary For DSM-5, existing nosological boundaries between bipolar I disorder and schizophrenia were retained and schizoaffective disorder preserved as an independent diagnosis since the biological data are not yet compelling enough to justify a move to a more neurodevelopmentally continuous model of psychosis. PMID:23672587

Explanations of firesetting in mentally disordered offenders: a review of the literature.

PubMed

Tyler, Nichola; Gannon, Theresa A

2012-01-01

This paper reviews current explanations of firesetting in adult mentally disordered offenders. In particular, attention is given to contemporary research that has examined developmental and background characteristics, personality and associated traits, motivation for firesetting, neurobiological explanations, psychiatric diagnoses, and frequency of self-injurious behavior, including suicide. The likelihood of recidivism and associated risk factors is also considered. Evaluation of the existing research has highlighted that even though a significant proportion has been conducted with psychiatric populations, little is understood about firesetting by mentally disordered offenders. In addition, little research has been conducted that compares mentally disordered firesetters to both other mentally disordered offenders and non-mentally disordered offenders. Recommendations are made for future research to further develop knowledge of this behavior.

Critical design elements of e-health applications for users with severe mental illness: singular focus, simple architecture, prominent contents, explicit navigation, and inclusive hyperlinks.

PubMed

Rotondi, Armando J; Eack, Shaun M; Hanusa, Barbara H; Spring, Michael B; Haas, Gretchen L

2015-03-01

E-health applications are becoming integral components of general medical care delivery models and emerging for mental health care. Few exist for treatment of those with severe mental illness (SMI). In part, this is due to a lack of models to design such technologies for persons with cognitive impairments and lower technology experience. This study evaluated the effectiveness of an e-health design model for persons with SMI termed the Flat Explicit Design Model (FEDM). Persons with schizophrenia (n = 38) performed tasks to evaluate the effectiveness of 5 Web site designs: 4 were prominent public Web sites, and 1 was designed according to the FEDM. Linear mixed-effects regression models were used to examine differences in usability between the Web sites. Omnibus tests of between-site differences were conducted, followed by post hoc pairwise comparisons of means to examine specific Web site differences when omnibus tests reached statistical significance. The Web site designed using the FEDM required less time to find information, had a higher success rate, and was rated easier to use and less frustrating than the other Web sites. The home page design of one of the other Web sites provided the best indication to users about a Web site's contents. The results are consistent with and were used to expand the FEDM. The FEDM provides evidence-based guidelines to design e-health applications for person with SMI, including: minimize an application's layers or hierarchy, use explicit text, employ navigational memory aids, group hyperlinks in 1 area, and minimize the number of disparate subjects an application addresses. © The Author 2013. Published by Oxford University Press on behalf of the Maryland Psychiatric Research Center. All rights reserved. For permissions, please email: journals.permissions@oup.com.

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.

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.

The Association Between Sexual Health and Physical, Mental, and Social Health in Adolescent Women.

PubMed

Hensel, Devon J; Nance, Jennifer; Fortenberry, J Dennis

2016-10-01

Developmental models link sexual well-being to physical, mental/emotional, and social well-being, yet little empirical literature evaluates these relationships in adolescents. Better understanding of how and when sexuality complements other aspects of health may yield important points to enhance existing health education and prevention efforts. Data were drawn from a 10-year longitudinal cohort study of sexual relationships and sexual behavior among adolescent women (N = 387; 14-17 years at enrollment). Sexual health data were drawn from quarterly partner-specific interviews and were linked to physical, mental/emotional, and social health information in annual questionnaires. Random intercept, mixed effects linear, ordinal logistic, or binary logistic regression were used to estimate the influence of sexual health on health and well-being outcomes (Stata, v.23, StataCorp, College Station, TX). All models controlled for participant age and race/ethnicity. Higher sexual health was significantly associated with less frequent nicotine and substance use, lower self-reported depression, lower thrill seeking, higher self-esteem, having fewer friends who use substances, higher religiosity, better social integration, lower frequency of delinquent behavior and crime, and more frequent community group membership. Sexual health was not associated with the number of friends who used cigarettes. Positive sexually related experiences in romantic relationships during adolescence may complement physical, mental/emotional, and social health. Addressing specific aspects of healthy sexual development during clinical encounters could dually help primary prevention and health education address other common adolescent health issues. Copyright © 2016 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

Organization of care and diagnosed depression among women veterans.

PubMed

Sambamoorthi, Usha; Bean-Mayberry, Bevanne; Findley, Patricia A; Yano, Elizabeth M; Banerjea, Ranjana

2010-09-01

To analyze the association between the organizational features of integration of physical and mental healthcare in womens health clinics and the diagnosis of depression among women veterans with or at risk for cardiovascular conditions (ie, diabetes mellitus, heart disease, or hypertension). Retrospective and observational secondary data analyses. We studied 27,972 women veterans from 118 facilities with diagnosed cardiovascular conditions in fiscal year 2001 (FY2001) using merged Medicare claims and Veterans Health Administration (VHA) data merged with the 1999 VHA Survey of Primary Care Practices and the 2001 VHA Survey of Women Veterans Health Programs and Practices. The dependent variable was a binary indicator for diagnosed depression during FY2001 at the individual level. We used a multilevel logistic regression model to control for clustering of women veterans within facilities. Individual-level independent variables included demographics, socioeconomic characteristics, and chronic physical conditions. Overall, 27% of women veterans using the VHA were diagnosed as having depression in FY2001. Across facilities, rates of diagnosed depression varied from 13% to 41%. After controlling for individual-level and facility-level independent variables, women veterans who were served in separate women's health clinics with integrated physical and mental healthcare were more likely to have diagnosed depression. The adjusted odds ratio was 1.12 (95% confidence interval, 1.01-1.25). Existing women-specific VHA organizational features with integration of primary care and mental health seem effective in diagnosing depression. Emerging patient-centered medical home models may facilitate diagnosis and treatment of mental health issues among women with complex chronic conditions.

Racial disparities in prescription drug use for mental illness among population in US.

PubMed

Han, Euna; Liu, Gordon G

2005-09-01

Racial minorities are a rapidly growing portion of the US population. Research suggests that racial minorities are more vulnerable to mental illness due to risk factors, such as higher rates of poverty. Given that the burden of mental illnesses is significant, equal likelihood of mental health services utilization is important to reduce such burden. Racial minorities have been known to use mental health services less than Whites. However, it is unclear whether racial disparity in prescription drug use for mental illnesses exists in a nationally representative sample. For a valid estimation of prescription drug use patterns, the characteristic in the distribution of prescription drug use should be accounted for in the estimation model. This study is intended to document whether there was a disparity in psychiatric drug use in both extensive and intensive margins between Whites and three racial minorities: Blacks, Hispanics, and Asian-Indians. The study looked at several specified mental illnesses, controlling for underlying health status and other confounding factors. Secondary data analysis was conducted using the multiyear Medical Expenditure Panel Survey (MEPS), a nationally representative panel sample from 1996 through 2000. This analysis provides estimates of the actual expenditure on prescription drug use for people with specified mental illnesses for this study, based on comparison of Whites and other racial minorities. We derived the estimates from the two-part model, a framework that adjusts the likelihood of using prescription drugs for the specified mental illnesses while estimating the total actual expenditures on prescription drugs among the users. This study found that Blacks, Hispanics, and Asian-Indians were less likely than Whites to use prescription drugs by 8.3, 6.1 and 23.6 percentage points, respectively, holding other factors constant in the sample, with at least one of the specified mental illnesses. The expenditure on prescription drugs for the specified mental illnesses differs between each of racial minorities (Blacks, Hispanics, and Asian-Indians) and Whites even after adjusting for the different likelihood of using those prescription drugs. Blacks, Hispanics, and Asian-Indians with the specified mental illnesses were estimated to spend 606.53 US dollars, 9.83 US dollars and 179.60 US dollars less per year, respectively, on their actual prescription drugs than Whites. This study concludes that three racial minorities: Blacks, Hispanics, and Asian-Indians, with the specified mental illnesses are less likely to use psychiatric drugs than Whites. Among users, racial minorities use less psychiatric drugs than Whites in terms of actual spending on those drugs. There is a need to focus on a program to reach out to racial minorities with a diagnosis of mental illnesses, and this program should consider the cultural specificity of each minority group regarding mental illnesses. In the development of mental health policy, it is crucial to understand the underlying non-socioeconomic factors which may significantly determine the access to mental health service. Also, education programs or other outreach programs for racial minorities are necessary to understand the different distribution of mental health services for racial minorities. Future research should examine the causes for racial disparity in the use of prescription drugs for mental illness both in the extensive and intensive margins. An in-depth analysis is needed to map out the attributes for the observed disparity between Whites and racial minorities in mental health service use.

The effect of patient-centeredness and gender of professional role models on trainees' mentalization responses. Implications for film-aided education.

PubMed

Bálint, Katalin; Nagy, Tamás; Csabai, Márta

2014-10-01

To examine how certain characteristics of film-presented practitioner role-models influence trainees' mentalization. In an experimental setting, psychology students watched four film clips presenting a patient-practitioner session; the clips varied in the practitioner's patient-centeredness (positive vs. negative) and gender. Participants commented on the practitioner's thoughts, emotions and intentions through the session. Analysis of 116 comments focused on the effect of patient-centeredness and gender variables on mentalization and judgment utterances. Negative role-models and female role-models induced higher levels of mentalization compared to positive and male role-models. There was no gender difference in the level of mentalization; however male participants gave more judgmental responses than female participants. The patient-centeredness had a larger effect on mentalization when trainees described the opposite gender role-model. In a systematic comparison, students' capacity for mentalization differed according to role-models' patient-centeredness and gender, as well as the gender-match of students with role-models. When working with film-presented role-models, educators should be aware of the differences in the level of mentalization elicited by positive and male role-models, as opposed to negative and female role-models. Educators should also consider the gender-match between trainees and role-models, therefore students should be exposed to both cross- and same-gender role-models. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Attributions of Mental Illness: An Ethnically Diverse Community Perspective.

PubMed

Bignall, Whitney J Raglin; Jacquez, Farrah; Vaughn, Lisa M

2015-07-01

Although the prevalence of mental illness is similar across ethnic groups, a large disparity exists in the utilization of services. Mental health attributions, causal beliefs regarding the etiology of mental illness, may contribute to this disparity. To understand mental health attributions across diverse ethnic backgrounds, we conducted focus groups with African American (n = 8; 24 %), Asian American (n = 6; 18 %), Latino/Hispanic (n = 9; 26 %), and White (n = 11; 32 %) participants. We solicited attributions about 19 mental health disorders, each representing major sub-categories of the DSM-IV. Using a grounded theory approach, participant responses were categorized into 12 themes: Biological, Normalization, Personal Characteristic, Personal Choice, Just World, Spiritual, Family, Social Other, Environment, Trauma, Stress, and Diagnosis. Results indicate that ethnic minorities are more likely than Whites to mention spirituality and normalization causes. Understanding ethnic minority mental health attributions is critical to promote treatment-seeking behaviors and inform culturally responsive community-based mental health services.

Mentalizing mediates the relationship between psychopathy and type of aggression in schizophrenia.

PubMed

Bo, Sune; Abu-Akel, Ahmad; Kongerslev, Mickey; Haahr, Ulrik Helt; Bateman, Anthony

2014-01-01

Convincing evidence demonstrates that psychopathy is associated with premeditated aggression. However, studies have failed to explain why this association exists and whether socio-cognitive functions, such as mentalizing, could explain the relation. This cross-sectional study investigates, in 108 patients with schizophrenia, the association of psychopathy and mentalizing abilities with premeditated and impulsive aggression and probes the nature of their influence on these specific aggression patterns. Patients' engagement in premeditated aggression was associated with diminishing mentalizing and increasing psychopathic tendencies. Moreover, mediation analyses reveal that the ability to attribute mental states to others mediates the relation between psychopathy and type of aggression. This mediation is facilitated by a specific mentalizing profile characterized by the presence of intact cognitive and deficient emotional mentalizing capacities. This study is the first to report a mediating effect of mentalizing on the relationship between psychopathy and type of aggression in schizophrenia. Implications of these results are discussed.

Mental health in prisons: A public health agenda.

PubMed

Fraser, A

2009-01-01

Mental illness affects the majority of prisoners. Mental health issues are beginning to take a central position in the development of prison health services, reflecting this burden of disease. This change in focus is not before time. But prison mental health services cannot exist in isolation. Public health systems should lead provision of care for patients with acute and severe illness. A whole prison approach to health and, specifically, mental health will offer the greatest likelihood that offenders will thrive, benefit from imprisonment, and lead law-abiding lives after release. Public awareness of the scale and commitment of prisons to mental health and illness, and understanding of prisons' role in society, are necessary developments that would protect and enhance public mental health, as well as creating a healthier and safer society. This article draws on recent reviews, information and statements to set out a public health agenda for mental health in prisons.

People, processes, and systems: An observational study of the role of technology in rural youth mental health services.

PubMed

Orlowski, Simone; Lawn, Sharon; Matthews, Ben; Venning, Anthony; Jones, Gabrielle; Winsall, Megan; Antezana, Gaston; Bidargaddi, Niranjan; Musiat, Peter

2017-06-01

The merits of technology-based mental health service reform have been widely debated among academics, practitioners, and policy makers. The design of new technologies must first be predicated on a detailed appreciation of how the mental health system works before it can be improved or changed through the introduction of new products and services. Further work is required to better understand the nature of face-to-face mental health work and to translate this knowledge to computer scientists and system designers responsible for creating technology-based solutions. Intensive observation of day-to-day work within two rural youth mental health services in South Australia, Australia, was undertaken to understand how technology could be designed and implemented to enhance young people's engagement with services and improve their experience of help seeking. Data were analysed through a lens of complexity theory. Results highlight the variety of professional roles and services that can comprise the mental health system. The level of interconnectedness evident in the system contrasted with high levels of service self-organization and disjointed information flow. A mental health professional's work was guided by two main constructs: risk and engagement. Most clients presented with a profile of disability, disadvantage, and isolation, so complex client presentations and decision-making were core practices. Clients (and frequently, their families) engaged with services in a crisis-dependent manner, characterized by multiple disengagements and re-engagements over time. While significant opportunities exist to integrate technology into existing youth mental health services, technologies for this space must be usable for a broad range of medical, psychological and cognitive disability, social disadvantage, and accommodate repeat cycles of engagement/disengagement over time. © 2016 Australian College of Mental Health Nurses Inc.

Adequacy of Mental Health Services for HIV-Positive Patients with Depression: Ontario HIV Treatment Network Cohort Study

PubMed Central

Choi, Stephanie K. Y.; Boyle, Eleanor; Cairney, John; Gardner, Sandra; Collins, Evan J.; Bacon, Jean; Rourke, Sean B.

2016-01-01

Background Major depression can profoundly impact clinical and quality-of-life outcomes of people living with HIV, and this disease is underdiagnosed and undertreated in many HIV-positive individuals. Here, we describe the prevalence of publicly funded primary and secondary mental health service use and antidepressant use, as well as mental health care for depression in accordance with existing Canadian guidelines for HIV-positive patients with depression in Ontario, Canada. Methods We conducted a prospective cohort study linking data from the Ontario HIV Treatment Network Cohort Study with administrative health databases in the province of Ontario, Canada. Current depression was assessed using the Center for Epidemiologic Depression Scale or the Kessler Psychological Distress Scale. Multivariable regressions were used to characterize prevalence outcomes. Results Of 990 HIV-positive patients with depression, 493 (50%) patients used mental health services; 182 (18%) used primary services (general practitioners); 176 (18%) used secondary services (psychiatrists); and 135 (14%) used both. Antidepressants were used by 407 (39%) patients. Patients who identified as gay, lesbian, or bisexual, as having low income or educational attainment, or as non-native English speakers or immigrants to Canada were less likely to obtain care. Of 493 patients using mental health services, 250 (51%) received mental health care for depression in accordance with existing Canadian guidelines. Conclusions Our results showed gaps in delivering publicly funded mental health services to depressed HIV-positive patients and identified unequal access to these services, particularly among vulnerable groups. More effective mental health policies and better access to mental health services are required to address HIV-positive patient needs and reduce depression’s impact on their lives. PMID:27280751

Online Mental Health Resources in Rural Australia: Clinician Perceptions of Acceptability

PubMed Central

Holloway, Kristi; Riley, Geoffrey; Auret, Kirsten

2013-01-01

Background Online mental health resources have been proposed as an innovative means of overcoming barriers to accessing rural mental health services. However, clinicians tend to express lower satisfaction with online mental health resources than do clients. Objective To understand rural clinicians’ attitudes towards the acceptability of online mental health resources as a treatment option in the rural context. Methods In-depth interviews were conducted with 21 rural clinicians (general practitioners, psychologists, psychiatrists, and clinical social workers). Interviews were supplemented with rural-specific vignettes, which described clinical scenarios in which referral to online mental health resources might be considered. Symbolic interactionism was used as the theoretical framework for the study, and interview transcripts were thematically analyzed using a constant comparative method. Results Clinicians were optimistic about the use of online mental health resources into the future, showing a preference for integration alongside existing services, and use as an adjunct rather than an alternative to traditional approaches. Key themes identified included perceptions of resources, clinician factors, client factors, and the rural and remote context. Clinicians favored resources that were user-friendly and could be integrated into their clinical practice. Barriers to use included a lack of time to explore resources, difficulty accessing training in the rural environment, and concerns about the lack of feedback from clients. Social pressure exerted within professional clinical networks contributed to a cautious approach to referring clients to online resources. Conclusions Successful implementation of online mental health resources in the rural context requires attention to clinician perceptions of acceptability. Promotion of online mental health resources to rural clinicians should include information about resource effectiveness, enable integration with existing services, and provide opportunities for renegotiating the socially defined role of the clinician in the eHealth era. PMID:24007949

Online mental health resources in rural Australia: clinician perceptions of acceptability.

PubMed

Sinclair, Craig; Holloway, Kristi; Riley, Geoffrey; Auret, Kirsten

2013-09-05

Online mental health resources have been proposed as an innovative means of overcoming barriers to accessing rural mental health services. However, clinicians tend to express lower satisfaction with online mental health resources than do clients. To understand rural clinicians' attitudes towards the acceptability of online mental health resources as a treatment option in the rural context. In-depth interviews were conducted with 21 rural clinicians (general practitioners, psychologists, psychiatrists, and clinical social workers). Interviews were supplemented with rural-specific vignettes, which described clinical scenarios in which referral to online mental health resources might be considered. Symbolic interactionism was used as the theoretical framework for the study, and interview transcripts were thematically analyzed using a constant comparative method. Clinicians were optimistic about the use of online mental health resources into the future, showing a preference for integration alongside existing services, and use as an adjunct rather than an alternative to traditional approaches. Key themes identified included perceptions of resources, clinician factors, client factors, and the rural and remote context. Clinicians favored resources that were user-friendly and could be integrated into their clinical practice. Barriers to use included a lack of time to explore resources, difficulty accessing training in the rural environment, and concerns about the lack of feedback from clients. Social pressure exerted within professional clinical networks contributed to a cautious approach to referring clients to online resources. Successful implementation of online mental health resources in the rural context requires attention to clinician perceptions of acceptability. Promotion of online mental health resources to rural clinicians should include information about resource effectiveness, enable integration with existing services, and provide opportunities for renegotiating the socially defined role of the clinician in the eHealth era.

The concept of shared mental models in healthcare collaboration.

PubMed

McComb, Sara; Simpson, Vicki

2014-07-01

To report an analysis of the concept of shared mental models in health care. Shared mental models have been described as facilitators of effective teamwork. The complexity and criticality of the current healthcare system requires shared mental models to enhance safe and effective patient/client care. Yet, the current concept definition in the healthcare literature is vague and, therefore, difficult to apply consistently in research and practice. Concept analysis. Literature for this concept analysis was retrieved from several databases, including CINAHL, PubMed and MEDLINE (EBSCO Interface), for the years 1997-2013. Walker and Avant's approach to concept analysis was employed and, following Paley's guidance, embedded in extant theory from the team literature. Although teamwork and collaboration are discussed frequently in healthcare literature, the concept of shared mental models in that context is not as commonly found but is increasing in appearance. Our concept analysis defines shared mental models as individually held knowledge structures that help team members function collaboratively in their environments and are comprised of the attributes of content, similarity, accuracy and dynamics. This theoretically grounded concept analysis provides a foundation for a middle-range descriptive theory of shared mental models in nursing and health care. Further research concerning the impact of shared mental models in the healthcare setting can result in development and refinement of shared mental models to support effective teamwork and collaboration. © 2013 John Wiley & Sons Ltd.

Preceptors' perspectives of an integrated clinical learning model in a mental health environment.

PubMed

Boardman, Gayelene; Lawrence, Karen; Polacsek, Meg

2018-02-14

Supervised clinical practice is an essential component of undergraduate nursing students' learning and development. In the mental health setting, nursing students traditionally undertake four-week block placements. An integrated clinical learning model, where preceptors mentor students on an individual basis, has been used successfully in the clinical learning environment. This flexible model provides the opportunity for students to work across morning, afternoon, night and weekend shifts. There is a need to improve the evidence base for a flexible model for students undertaking a mental health placement. The aim of this study was to understand preceptors' experience of, and satisfaction with, a mental health integrated clinical learning model. Focus groups were used to elicit the views of preceptors from a mental health service. Findings highlight the advantages and disadvantages of an integrated clinical learning model in the mental health setting. Participants suggested that students may benefit from flexible work arrangements, a variety of experiences and a more realistic experience of working in a mental health service. However, they found it challenging to mentor and evaluate students under this model. Most also agreed that the model impeded students' ability to engage with consumers and develop rapport with staff. The findings indicate the need to develop a placement model that meets the unique needs of the mental health setting. © 2018 Australian College of Mental Health Nurses Inc.

Reappraising the Relationships between Physics Students' Mental Models and Predictions: An Example of Heat Convection

ERIC Educational Resources Information Center

Chiou, Guo-Li

2013-01-01

Although prediction is claimed to be a prime function of mental models, to what extent students can run their mental models to make predictions of physical phenomena remains uncertain. The purpose of this study, therefore, was first to investigate 30 physics students' mental models of heat convection, and then to examine the relationship between…

Service user and caregiver involvement in mental health system strengthening in low- and middle-income countries: a cross-country qualitative study.

PubMed

Lempp, H; Abayneh, S; Gurung, D; Kola, L; Abdulmalik, J; Evans-Lacko, S; Semrau, M; Alem, A; Thornicroft, G; Hanlon, C

2018-02-01

The aims of this paper are to: (i) explore the experiences of involvement of mental health service users, their caregivers, mental health centre heads and policy makers in mental health system strengthening in three low- and middle-income countries (LMICs) (Ethiopia, Nepal and Nigeria); (ii) analyse the potential benefits and barriers of such involvement; and (iii) identify strategies required to achieve greater service user and caregiver participation. A cross-country qualitative study was conducted, interviewing 83 stakeholders of mental health services. Our analysis showed that service user and caregiver involvement in the health system strengthening process was an alien concept for most participants. They reported very limited access to direct participation. Stigma and poverty were described as the main barriers for involvement. Several strategies were identified by participants to overcome existing hurdles to facilitate service user and caregiver involvement in the mental health system strengthening process, such as support to access treatment, mental health promotion and empowerment of service users. This study suggests that capacity building for service users, and strengthening of user groups would equip them to contribute meaningfully to policy development from informed perspectives. Involvement of service users and their caregivers in mental health decision-making is still in its infancy in LMICs. Effective strategies are required to overcome existing barriers, for example making funding more widely available for Ph.D. studies in participatory research with service users and caregivers to develop, implement and evaluate approaches to involvement that are locally and culturally acceptable in LMICs.

The Structures and Possible Sources of Preservice Elementary Teachers' Mental Models About Moon Phases

NASA Astrophysics Data System (ADS)

Oh, Jun-Young; Kang, Yong-Hee; Yoo, Kye-Hwa

2005-09-01

This study was to understand the components that influence preservice elementary teachers' mental models about `astronomical phenomena' such as the Seasons of the year, and the Lunar Phases of the month. We selected university of education students among whom 23 were in the second year. The data collected from the paper-pencil test and individual interview with students. The results of this study show that the students had apparent synthetic Mental models, and that the 'distance theory, and occultation theory' had most important effects on their Mental Models. It can be said that preservice elementary teachers' initial mental models of the `astronomical phenomenon' have their origin in their belief sets (specific theory) related to `astronomical phenomenon', on the basis of which they can interpret their observations and cultural information with the constraints of a naive framework of physics. The structures and possible sources of their mental models for overcoming these synthetic mental models were also discussed.

Improving Staff Productivity in Mental Health Centers.

ERIC Educational Resources Information Center

Southern Regional Education Board, Atlanta, GA.

This guide is concerned with productivity measurement and improvement in mental health centers, and focuses on the relationship between service outputs and available clinical staff, i.e., staff productivity. Staff productivity measures are described as useful in identifying existing levels of productivity, making comparisons to determine the…

Maori Identification, Drinking Motivation and Mental Health

ERIC Educational Resources Information Center

Clarke, Dave; Ebbett, Erin

2010-01-01

Research examining the relationships among Maori cultural identification, drinking behaviour, drinking motivation and mental health is almost non-existent. A review of literature suggests that stronger Maori identification could be associated with lower alcohol consumption on a typical occasion, less frequent drinking, drinking to enhance mood or…

A Peer-Support and Mindfulness Program to Improve the Mental Health of Medical Students.

PubMed

Moir, Fiona; Henning, Marcus; Hassed, Craig; Moyes, Simon A; Elley, C Raina

2016-01-01

There is evidence that peer-support programs can improve mental health indices and help-seeking behavior among students in some secondary school and university settings and that mindfulness can improve mental health in medical students. Peer-led programs have not been formally assessed in a medical student population, where psychological issues exist and where it has been shown that students approach peers for help in preference to staff members or professional services. Medical students elected peer leaders who underwent training and then provided the intervention. The peer leaders provided support to students in the intervention group, as well as offering teaching in mindfulness meditation. An exploratory study was conducted with 2nd- and 3rd-year medical students at 1 medical school in New Zealand randomized into 2 groups. In addition to existing mental health resources, intervention participants received a program including peer support and peer-taught mindfulness practice. Study participants not offered the intervention participants could use existing mental health resources. Primary measures included depression (PHQ-9) and anxiety (GAD-7) scores. Secondary measures were quality of life, resilience (15-item resilience scale), academic self-concept, and motivation to learn, assessed at baseline and 6 months. Of the 402 students eligible, 275 (68%) participated and 232 (58%) completed the study. At baseline, 53% were female and mean age was 21 years (SD = 3)-PHQ-9 score (M = 5.2, SD = 3.7) and GAD-7 score (M = 4.5, SD = 3.4). Twelve peer leaders were elected. There was good participation in the intervention. One fourth of intervention students used the face-to-face peer support and more than 50% attended a peer social event and/or participated in the mindfulness program. Although improvements in mental health were seen in the intervention group, the difference between the intervention and nonintervention groups did not reach statistical significance. Although evidence exists for effectiveness of peer support and mindfulness in other contexts, this exploratory study was not able to show a statistically significant effect. Future studies could consider using a longer training period for the peer leaders, as well as targeting the study population to those most likely to benefit such as those with poorer mental health, or using a more intensive intervention or larger sample size. A cluster randomized study design would also reduce the risk of contamination.

Mental health care in Nepal: current situation and challenges for development of a district mental health care plan.

PubMed

Luitel, Nagendra P; Jordans, Mark Jd; Adhikari, Anup; Upadhaya, Nawaraj; Hanlon, Charlotte; Lund, Crick; Komproe, Ivan H

2015-01-01

Globally mental health problems are a serious public health concern. Currently four out of five people with severe mental illness in Low and Middle Income Countries (LMIC) receive no effective treatment. There is an urgent need to address this enormous treatment gap. Changing the focus of specialist mental health workers (psychiatrists and psychologists) from only service delivery to also designing and managing mental health services; building clinical capacity of the primary health care (PHC) workers, and providing supervision and quality assurance of mental health services may help in scaling up mental health services in LMICs. Little is known however, about the mental health policy and services context for these strategies in fragile-state settings, such as Nepal. A standard situation analysis tool was developed by the PRogramme for Improving Mental health carE (PRIME) consortium to systematically analyze and describe the current gaps in mental health care in Nepal, in order to inform the development of a district level mental health care plan (MHCP). It comprised six sections; general information (e.g. population, socio-economic conditions); mental health policies and plans; mental health treatment coverage; district health services; and community services. Data was obtained from secondary sources, including scientific publications, reports, project documents and hospital records. Mental health policy exists in Nepal, having been adopted in 1997, but implementation of the policy framework has yet to begin. In common with other LMICs, the budget allocated for mental health is minimal. Mental health services are concentrated in the big cities, with 0.22 psychiatrists and 0.06 psychologists per 100,000 population. The key challenges experienced in developing a district level MHCP included, overburdened health workers, lack of psychotropic medicines in the PHC, lack of mental health supervision in the existing system, and lack of a coordinating body in the Ministry of Health and Population (MoHP). Strategies to overcome these challenges included involvement of MoHP in the process, especially by providing psychotropic medicines and appointing a senior level officer to facilitate project activities, and collaboration with National Health Training Centers (NHTC) in training programs. This study describes many challenges facing mental health care in Nepal. Most of these challenges are not new, yet this study contributes to our understanding of these difficulties by outlining the national and district level factors that have a direct influence on the development of a district level mental health care plan.

Estimating Capacity Requirements for Mental Health Services After a Disaster Has Occurred: A Call for New Data

PubMed Central

Siegel, Carole E.; Laska, Eugene; Meisner, Morris

2004-01-01

Objectives. We sought to estimate the extended mental health service capacity requirements of persons affected by the September 11, 2001, terrorist attacks. Methods. We developed a formula to estimate the extended mental health service capacity requirements following disaster situations and assessed availability of the information required by the formula. Results. Sparse data exist on current services and supports used by people with mental health problems outside of the formal mental health specialty sector. There also are few systematically collected data on mental health sequelae of disasters. Conclusions. We recommend research-based surveys to understand service usage in non–mental health settings and suggest that federal guidelines be established to promote uniform data collection of a core set of items in studies carried out after disasters. PMID:15054009

I think of Ronald Reagan: future selves in the present.

PubMed

Roberts, P

1992-01-01

A nonlinear perspective on time (where the future exists in and affects the present) has been described by several theorists but there is little research on the extent, quality or origins of the personal future perspective. The present study examined the existence and origin of the future in the present by asking adults aged nineteen to eighty-three to: 1) project themselves into the oldest age imaginable, 2) describe their hopes and fears for that age, and 3) name role models for those hopes and fears. Data analysis revealed that length of future perspective, number of hopes and number of role models for the distant future declined with age. In addition, types of fears for the future varied with age, with older adults stressing dependency issues while younger adults reported concerns about personality and mental health. Despite age differences, most participants could name role models for both their hopes and fears for aging, but specific models were identified more often for hopes than for fears. Personalized hopes and fears for the distant future as motivators for the present are discussed.

Do great teams think alike? An examination of team mental models and their impact on team performance.

PubMed

Gardner, Aimee K; Scott, Daniel J; AbdelFattah, Kareem R

2017-05-01

Team mental models represent the shared understanding of team members within their relevant environment. Thus, team mental models should have a substantial impact on a team's ability to engage in purposeful and coordinated action. We sought to examine the impact of shared team mental models on team performance and to investigate if team mental models increase over time as teams continue to work together. New surgery interns were assigned randomly to 1 of 10 teams. Each team participated in one unique simulation every day for 5 days, each followed by video-based debriefing with a facilitator. Participants also completed independently a concept similarity tool validated previously in nonmedical team literature to assess team mental models. All performances were video recorded and evaluated with a scenario-specific team performance tool by a single, blinded junior surgeon under an institutional review board-approved protocol. Changes in performance and team mental models over time were assessed with paired samples t tests. Regression analysis was used to examine the extent to which team mental models predicted team performance. Thirty interns (age 27; 77% men) participated in the training program. Percentage of items achieved (x¯ ± SD) on the performance evaluation was 39 ± 20, 51 ± 14, 22 ± 17, 63 ± 14, and 77 ± 25 for Days 1-5, respectively. Team mental models were 30 ± 5, 28 ± 6, 27 ± 8, 26 ± 7, and 25 ± 6 for Days 1-5 respectively, such that larger values corresponded to greater differences in team mental models. Paired sample t tests indicated that both average performance and team mental models similarity improved from the first to last day (P < .01, P < .05, respectively). Additionally, regression analyses indicated that team mental models predicted team performance on Days 2-5 (all P < .05) but not on the first day of simulations. These results demonstrate that greater sharing of team mental models among the teams leads to better team performance. Additionally, the increase in team mental models over time suggests that engaging in team-based simulation may catalyze the process by which surgery teams are able to develop shared knowledge. Copyright © 2016 Elsevier Inc. All rights reserved.

Biogenetic models of psychopathology, implicit guilt, and mental illness stigma.

PubMed

Rüsch, Nicolas; Todd, Andrew R; Bodenhausen, Galen V; Corrigan, Patrick W

2010-10-30

Whereas some research suggests that acknowledgment of the role of biogenetic factors in mental illness could reduce mental illness stigma by diminishing perceived responsibility, other research has cautioned that emphasizing biogenetic aspects of mental illness could produce the impression that mental illness is a stable, intrinsic aspect of a person ("genetic essentialism"), increasing the desire for social distance. We assessed genetic and neurobiological causal attributions about mental illness among 85 people with serious mental illness and 50 members of the public. The perceived responsibility of persons with mental illness for their condition, as well as fear and social distance, was assessed by self-report. Automatic associations between Mental Illness and Guilt and between Self and Guilt were measured by the Brief Implicit Association Test. Among the general public, endorsement of biogenetic models was associated with not only less perceived responsibility, but also greater social distance. Among people with mental illness, endorsement of genetic models had only negative correlates: greater explicit fear and stronger implicit self-guilt associations. Genetic models may have unexpected negative consequences for implicit self-concept and explicit attitudes of people with serious mental illness. An exclusive focus on genetic models may therefore be problematic for clinical practice and anti-stigma initiatives. Copyright © 2009 Elsevier Ltd. All rights reserved.

Service providers' experiences of using a telehealth network 12 months after digitisation of a large Australian rural mental health service.

PubMed

Newman, Lareen; Bidargaddi, Niranjan; Schrader, Geoffrey

2016-10-01

Despite evidence of benefits of telehealth networks in increasing access to, or providing, previously unavailable mental health services, care providers still prefer traditional approaches. For psychiatric assessment, digital technology can offer improvements over analog systems for the technical and, subsequently, the social quality of provider-client interaction. This is in turn expected to support greater provider uptake and enhanced patient benefits. Within the framework of Innovation Diffusion Theory, to study service providers' experiences of an existing regional telehealth network for mental health care practice twelve months after digitisation in order to identify the benefits of digital telehealth over an analog system for mental health care purposes in rural Australia. Qualitative interviews and focus groups were conducted with over 40 service providers from June to September 2013 in South Australia, ranging from the metropolitan central operations to health providers located up to 600km away in rural and remote areas of the same state. Participants included rural mental health teams, directors of nursing at rural hospitals, metropolitan-based psychiatrists and registrars, the metropolitan-based mental health team dedicated to rural provider support, rural GPs, administrative staff, and the executive group of the state rural health department. Fieldwork was conducted 12 months after the analog system was digitised. The interview and focus group data were analysed using thematic analysis, focusing on three key areas of innovation diffusion theory: relative advantage, technical complexity and technical compatibility. Five themes with 11 sub-themes were identified: (1) "Existing Uses", with three sub-themes: current mental health use, use by GPs, and use for staff support; (2) "Relative Advantage", with four sub-themes: improved technical quality, improved clinical practice, time and cost benefits for providers, and improved patient care; (3) "Technical Complexity"; (4) "Technical Compatibility" with two sub-themes: technical-clinical and technical-administrative; and (5) "Broader Organisational Culture", with two sub-themes: organizational policy support and 'digital telehealth' culture. The digitised telehealth network was generally well received by providers and adopted into clinical practice. Compared with the previous analog system, staff found advantages in better visual and audio quality, more technical stability with less "drop-out", less time delay to conversations and less confusion for clients. Despite these advantages, providers identified a range of challenges to starting or continuing use and they recommended improvements to increase uptake among mental health service providers and other providers (including GPs), and to clinical uses other than mental health. To further increase uptake and impact of telehealth-mediated mental health care in rural and remote areas, even with a high quality digital system, future research must design innovative care models, consider time and cost incentives for providers to use telehealth, and must focus not only on technical training but also how to best integrate technology with clinical practice and must develop an organization-wide digital telehealth culture. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Objects Mental Rotation under 7 Days Simulated Weightlessness Condition: An ERP Study

PubMed Central

Wang, Hui; Duan, Jiaobo; Liao, Yang; Wang, Chuang; Li, Hongzheng; Liu, Xufeng

2017-01-01

During the spaceflight under weightlessness condition, human's brain function may be affected by the changes of physiological effects along with the distribution of blood and body fluids to the head. This variation of brain function will influence the performance of astronauts and therefore create possible harm to flight safety. This study employs 20 male subjects in a 7-day−6° head-down tilted (HDT) bed rest model to simulate physiological effects under weightlessness condition, and use behavioral, electrophysiological techniques to compare the changes of mental rotation ability (MR ability) before and after short-term simulated weightlessness state. Behavioral results suggested that significant linear relationship existed between the rotation angle of stimuli and the reaction time, which means mental rotation process do happen during the MR task in simulated weightlessness state. In the first 3 days, the P300 component induced by object mental rotation followed the “down-up-down” pattern. In the following 4 days it changed randomly. On HDT D2, the mean of the amplitude of the P300 was the lowest, while increased gently on HDT D3. There was no obvious changing pattern of the amplitude of P300 observed after 3 days of HDT. Simulated weightlessness doesn't change the basic process of mental rotation. The effect of simulated weightlessness is neural mechanism of self-adaptation. MR ability didn't bounce back to the original level after HDT test. PMID:29270115

A cross-cultural study of employers' concerns about hiring people with psychotic disorder: implications for recovery.

PubMed

Tsang, Hector W H; Angell, Beth; Corrigan, Patrick W; Lee, Yueh-Ting; Shi, Kan; Lam, Chow S; Jin, Shenghua; Fung, Kevin M T

2007-09-01

Employment discrimination is considered as a major impediment to community integration for people with serious mental illness, yet little is known about how the problem manifests differently across western and non-western societies. We developed a lay model based on Chinese beliefs and values in terms of Confucianism, Taoism, Buddhism, and folk religions which may be used to explain cross-cultural variation in mental illness stigma, particularly in the arena of employment discrimination. In this study, we tested this lay approach by comparing employers' concerns about hiring people with psychotic disorder for entry-level jobs in US and China. One hundred employers (40 from Chicago, 30 from Hong Kong, and 30 from Beijing) were randomly recruited from small size firms and interviewed by certified interviewers using a semi-structured interview guide designed for this study. Content analysis was used to derive themes, which in turn were compared across the three sites using chi-square tests. Analyses reveal that employers express a range of concerns about hiring an employee with mental illness. Although some concerns were raised with equal frequency across sites, comparisons showed that, relative to US employers, Chinese employers were significantly more likely to perceive that people with mental illness would exhibit a weaker work ethic and less loyalty to the company. Comparison of themes also suggests that employers in China were more people-oriented while employers in US were more task-oriented. Cultural differences existed among employers which supported the lay theory of mental illness.

Some Surprising Findings on the Involvement of the Parietal Lobe in Human Memory

PubMed Central

Olson, Ingrid R.; Berryhill, Marian

2009-01-01

The posterior parietal lobe is known to play some role in a far-flung list of mental processes: linking vision to action (saccadic eye movements, reaching, grasping), attending to visual space, numerical calculation, and mental rotation. Here we review findings from humans and monkeys that illuminate an untraditional function of this region: memory. Our review draws on neuroimaging findings that have repeatedly identified parietal lobe activations associated with short-term or working memory and episodic memory. We also discuss recent neuropsychological findings showing that individuals with parietal lobe damage exhibit both working memory and long-term memory deficits. These deficits are not ubiquitous; they are only evident under certain retrieval demands. Our review elaborates on these findings and evaluates various theories about the mechanistic role of the posterior parietal lobe in memory. The available data point towards the conclusion that the posterior parietal lobe plays an important role in memory retrieval irrespective of elapsed time. The two models that are best supported by existing data are the Attention to Memory Model and the Subjective Memory Model. We conclude by formalizing several open questions that are intended to encourage future research. PMID:18848635

A psychological model of mental disorder.

PubMed

Kinderman, Peter

2005-01-01

A coherent conceptualization of the role of psychological factors is of great importance in understanding mental disorder. Academic articles and professional reports alluding to psychological models of the etiology of mental disorder are becoming increasingly common, and there is evidence of a marked policy shift toward the provision of psychological therapies and interventions. This article discusses the relationship between biological, social, and psychological factors in the causation and treatment of mental disorder. It argues that simple biological reductionism is not scientifically justified, and also that the specific role of psychological processes within the biopsychosocial model requires further elaboration. The biopsychosocial model is usually interpreted as implying that biological, psychological, and social factors are co-equal partners in the etiology of mental disorder. The psychological model of mental disorder presented here suggests that disruption or dysfunction in psychological processes is a final common pathway in the development of mental disorder. These processes include, but are not limited to, cognitive processes. The model proposes that biological and social factors, together with a person's individual experiences, lead to mental disorder through their conjoint effects on those psychological processes. Implications for research, interventions, and policy are discussed.

Integrated mental health atlas of the Western Sydney Local Health District: gaps and recommendations.

PubMed

Fernandez, Ana; Gillespie, James A; Smith-Merry, Jennifer; Feng, Xiaoqi; Astell-Burt, Thomas; Maas, Cailin; Salvador-Carulla, Luis

2017-03-01

Objective Australian mental health care remains hospital centric and fragmented; it is riddled with gaps and does little to promote recovery. Reform must be built on better knowledge of the shape of existing services. Mental health atlases are an essential part of this knowledge base, enabling comparison with other regions and jurisdictions, but must be based on a rigorous classification of services. The main aim of this study is to create an integrated mental health atlas of the Western Sydney LHD in order to help decision makers to better plan informed by local evidence. Methods The standard classification system, namely the Description and Evaluation of Services and Directories in Europe for Long-term Care model, was used to describe and classify adult mental health services in the Western Sydney Local Health District (LHD). This information provided the foundation for accessibility maps and the analysis of the provision of care for people with a lived experience of mental illness in Western Sydney LHD. All this data was used to create the Integrated Mental Health Atlas of Western Sydney LHD. Results The atlas identified four major gaps in mental health care in Western Sydney LHD: (1) a lack of acute and sub-acute community residential care; (2) an absence of services providing acute day care and non-acute day care; (3) low availability of specific employment services for people with a lived experience of mental ill-health; and (4) a lack of comprehensive data on the availability of supported housing. Conclusions The integrated mental health atlas of the Western Sydney LHD provides a tool for evidence-informed planning and critical analysis of the pattern of adult mental health care. What is known about the topic? Several reports have highlighted that the Australian mental health system is hospital based and fragmented. However, this knowledge has had little effect on actually changing the system. What does this paper add? This paper provides a critical analysis of the pattern of adult mental health care provided within the boundaries of the Western Sydney LHD using a standard, internationally validated tool to describe and classify the services. This provides a good picture of the availability of adult mental health care at the local level that was hitherto lacking. What are the implications for practitioners? The data presented herein provide a better understanding of the context in which mental health practitioners work. Managers and planners of services providing care for people with a lived experience of mental illness can use the information herein for better planning informed by local evidence.

Mental health interventions in schools 1

PubMed Central

Fazel, Mina; Hoagwood, Kimberly; Stephan, Sharon; Ford, Tamsin

2015-01-01

Mental health services embedded within school systems can create a continuum of integrative care that improves both mental health and educational attainment for children. To strengthen this continuum, and for optimum child development, a reconfiguration of education and mental health systems to aid implementation of evidence-based practice might be needed. Integrative strategies that combine classroom-level and student-level interventions have much potential. A robust research agenda is needed that focuses on system-level implementation and maintenance of interventions over time. Both ethical and scientific justifications exist for integration of mental health and education: integration democratises access to services and, if coupled with use of evidence-based practices, can promote the healthy development of children. PMID:26114092

Hypothesis testing of a change point during cognitive decline among Alzheimer's disease patients.

PubMed

Ji, Ming; Xiong, Chengjie; Grundman, Michael

2003-10-01

In this paper, we present a statistical hypothesis test for detecting a change point over the course of cognitive decline among Alzheimer's disease patients. The model under the null hypothesis assumes a constant rate of cognitive decline over time and the model under the alternative hypothesis is a general bilinear model with an unknown change point. When the change point is unknown, however, the null distribution of the test statistics is not analytically tractable and has to be simulated by parametric bootstrap. When the alternative hypothesis that a change point exists is accepted, we propose an estimate of its location based on the Akaike's Information Criterion. We applied our method to a data set from the Neuropsychological Database Initiative by implementing our hypothesis testing method to analyze Mini Mental Status Exam scores based on a random-slope and random-intercept model with a bilinear fixed effect. Our result shows that despite large amount of missing data, accelerated decline did occur for MMSE among AD patients. Our finding supports the clinical belief of the existence of a change point during cognitive decline among AD patients and suggests the use of change point models for the longitudinal modeling of cognitive decline in AD research.

Employee Performance and State Mental Health Manpower Development.

ERIC Educational Resources Information Center

McCullough, Paul M.

A project explored the manpower issue termed "burnout" and the impact of this phenomenon on mental health service programs. (In the framework of this study burnout is defined as that state of non-productivity, non-motivation, and indifference which interferes with a worker's delivering services effectively.) Existing literature does not clearly…

Sex Differences in Mental and Behavioral Traits.

ERIC Educational Resources Information Center

Garai, Josef E.; Scheinfeld, Amram

1968-01-01

This review of research conducted on sex differences attempts to answer the following questions: (1) Do the sexes differ in their basic capacities for specific types of mental performance and occupational achievement? (2) If such differences exist, to what extent are they genetically determined? (3) Are sex differences in abilities, interests, and…

Stability and Change in Affect among Centenarians

ERIC Educational Resources Information Center

Martin, Peter; da Rosa, Grace; Margrett, Jennifer A.; Garasky, Steven; Franke, Warren

2012-01-01

Much information is available about physical and functional health among very old adults, but little knowledge exists about the mental health and mental health changes in very late life. This study reports findings concerning positive and negative affect changes among centenarians. Nineteen centenarians from a Midwestern state participated in four…

Sound Minds in a Soundless World.

ERIC Educational Resources Information Center

Robinson, Luther D.

The author supports the promotion of mental health for deaf individuals through improved and expanded mental health services. To illustrate the psychological, educational, vocational, and social implications of deafness, Chapter 1 presents a profile of the deaf individual with emphasis on the communication barriers which exist at each stage of…

42 CFR 440.130 - Diagnostic, screening, preventive, and rehabilitative services.

Code of Federal Regulations, 2010 CFR

2010-10-01

...) Promote physical and mental health and efficiency. (d) “Rehabilitative services,” except as otherwise... reduction of physical or mental disability and restoration of a recipient to his best possible functional... under State law, to enable him to identify the existence, nature, or extent of illness, injury, or other...

Strengthening "School" in School Mental Health Promotion

ERIC Educational Resources Information Center

Rowling, Louise

2009-01-01

Purpose: The purpose of this paper is to highlight new and existing research on school characteristics that are essential elements in building the capacity of school communities to implement whole school approaches to mental health promotion. Design/methodology/approach: Through an overview of recent research and writing the need for a…

Life Contentment and Mental Health Care Satisfaction

ERIC Educational Resources Information Center

Prince, Jonathan D.

2005-01-01

Objective: It is now well documented that satisfaction with mental health services is influenced by a variety of other factors (e.g., race, diagnosis, functioning level). Because of a generally brighter outlook, this study examined whether care satisfaction is also influenced by contentment in housing, social relations, or existence in general.…

Identification and Characterization of Tumor Antigens Associated With Breast Cancer

DTIC Science & Technology

1998-08-01

including mental retardation and alpha- thalassemia (9). The RNA transcript was shown to exist at high levels in B 16 melanoma cells and moderate levels in...D.R. Mutations in a putative global transcriptional regulator cause X-linked mental retardation with alpha- thalassemia (ATRX syndrome). Cell (80): 837

Transportation and the Mentally Retarded.

ERIC Educational Resources Information Center

President's Committee on Mental Retardation, Washington, DC.

Reported were the results of a contract that involved identification, description, and categorization of the nature of transportation problems for the mentally retarded by means of analysis of existing studies, two surveys, and an inventory of specialized programs and systems operating in the United States. One major problem was found to be…

Family Support in Children's Mental Health: A Review and Synthesis

ERIC Educational Resources Information Center

Hoagwood, Kimberly E.; Cavaleri, Mary A.; Olin, S. Serene; Burns, Barbara J.; Slaton, Elaine; Gruttadaro, Darcy; Hughes, Ruth

2010-01-01

A comprehensive review of structured family support programs in children's mental health was conducted in collaboration with leadership from key national family organizations. The goals were to identify typologies of family support services for which evaluation data existed and identify research gaps. Over 200 programs were examined; 50 met…

Personality, relationship conflict, and teamwork-related mental models.

PubMed

Vîrgă, Delia; Curşeu, Petru Lucian; CurŞeu, Petru Lucian; Maricuţoiu, Laurenţiu; Sava, Florin A; Macsinga, Irina; Măgurean, Silvia

2014-01-01

This study seeks to explore whether neuroticism, agreeableness, and conscientiousness moderate the influence of relationship conflict experienced in groups on changes in group members' evaluative cognitions related to teamwork quality (teamwork-related mental models). Data from 216 students, nested in 48 groups were analyzed using a multilevel modeling approach. Our results show that the experience of relationship conflict leads to a negative shift from the pre-task to the post-task teamwork-related mental models. Moreover, the results indicate that conscientiousness buffered the negative association between relationship conflict and the change in teamwork-related mental models. Our results did not support the hypothesized moderating effect of agreeableness and show that the detrimental effect of relationship conflict on the shift in teamwork-related mental models is accentuated for group members scoring low rather than high on neuroticism. These findings open new research venues for exploring the association between personality, coping styles and change in teamwork-related mental models.

Personality, Relationship Conflict, and Teamwork-Related Mental Models

PubMed Central

Vîrgă, Delia; CurŞeu, Petru Lucian; Maricuţoiu, Laurenţiu; Sava, Florin A.; Macsinga, Irina; Măgurean, Silvia

2014-01-01

This study seeks to explore whether neuroticism, agreeableness, and conscientiousness moderate the influence of relationship conflict experienced in groups on changes in group members' evaluative cognitions related to teamwork quality (teamwork-related mental models). Data from 216 students, nested in 48 groups were analyzed using a multilevel modeling approach. Our results show that the experience of relationship conflict leads to a negative shift from the pre-task to the post-task teamwork-related mental models. Moreover, the results indicate that conscientiousness buffered the negative association between relationship conflict and the change in teamwork-related mental models. Our results did not support the hypothesized moderating effect of agreeableness and show that the detrimental effect of relationship conflict on the shift in teamwork-related mental models is accentuated for group members scoring low rather than high on neuroticism. These findings open new research venues for exploring the association between personality, coping styles and change in teamwork-related mental models. PMID:25372143

Multilevel examination of facility characteristics, social integration, and health for older adults living in nursing homes.

PubMed

Leedahl, Skye N; Chapin, Rosemary K; Little, Todd D

2015-01-01

Testing a model based on past research and theory, this study assessed relationships between facility characteristics (i.e., culture change efforts, social workers) and residents' social networks and social support across nursing homes; and examined relationships between multiple aspects of social integration (i.e., social networks, social capital, social engagement, social support) and mental and functional health for older adults in nursing homes. Data were collected at nursing homes using a planned missing data design with random sampling techniques. Data collection occurred at the individual-level through in-person structured interviews with older adult nursing home residents (N = 140) and at the facility-level (N = 30) with nursing home staff. The best fitting multilevel structural equation model indicated that the culture change subscale for relationships significantly predicted differences in residents' social networks. Additionally, social networks had a positive indirect relationship with mental and functional health among residents primarily via social engagement. Social capital had a positive direct relationship with both health outcomes. To predict better social integration and mental and functional health outcomes for nursing homes residents, study findings support prioritizing that close relationships exist among staff, residents, and the community as well as increased resident social engagement and social trust. © The Author 2014. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

"Symptoms of something all around us": Mental health, Inuit culture, and criminal justice in Arctic communities in Nunavut, Canada.

PubMed

Ferrazzi, Priscilla; Krupa, Terry

2016-09-01

Rehabilitation-oriented criminal court mental health initiatives to reduce the number of people with mental illness caught in the criminal justice system exist in many North American cities and elsewhere but not in the mainly Inuit Canadian Arctic territory of Nunavut. This study explores whether the therapeutic aims of these resource-intensive, mainly urban initiatives can be achieved in criminal courts in Nunavut's resource constrained, culturally distinct and geographically remote communities. A qualitative multiple-case study in the communities of Iqaluit, Arviat and Qikiqtarjuaq involved 55 semi-structured interviews and three focus groups with participants representing four sectors essential to these initiatives: justice, health, community organizations and community members. These interviews explored whether the therapeutic jurisprudence (TJ) principles that guide criminal court mental health initiatives and the component objectives of these principles could be used to improve the criminal court response to people with mental illness in Nunavut. Interviews revealed 13 themes reflecting perceptions of Inuit culture's influence on the identification of people with mental illness, treatment, and collaboration between the court and others. These themes include cultural differences in defining mental illness, differences in traditional and contemporary treatment models, and the importance of mutual cultural respect. The findings suggest Inuit culture, including its recent history of cultural disruption and change, affects the vulnerability of Nunavut communities to the potential moral and legal pitfalls associated with TJ and criminal court mental health initiatives. These pitfalls include the dominance of biomedical approaches when identifying a target population, the medicalization of behaviour and culture, the risk of "paternalism" in therapeutic interventions, and shortcomings in interdisciplinary collaboration that limit considerations of Inuit culture. The pitfalls are not fatal to efforts to bring the rehabilitative benefits of these initiatives to Nunavut, but they require careful vigilance when employing TJ principles in an Indigenous circumpolar context. Copyright © 2016. Published by Elsevier Ltd.

Relationship Between Diet and Mental Health in Children and Adolescents: A Systematic Review

PubMed Central

Quirk, Shae E.; Housden, Siobhan; Brennan, Sharon L.; Williams, Lana J.; Pasco, Julie A.; Berk, Michael; Jacka, Felice N.

2014-01-01

We systematically reviewed 12 epidemiological studies to determine whether an association exists between diet quality and patterns and mental health in children and adolescents; 9 explored the relationship using diet as the exposure, and 3 used mental health as the exposure. We found evidence of a significant, cross-sectional relationship between unhealthy dietary patterns and poorer mental health in children and adolescents. We observed a consistent trend for the relationship between good-quality diet and better mental health and some evidence for the reverse. When including only the 7 studies deemed to be of high methodological quality, all but 1 of these trends remained. Findings highlight the potential importance of the relationship between dietary patterns or quality and mental health early in the life span. PMID:25208008

Feasibility of shelter-based mental health screening for homeless children.

PubMed

Lynch, Sean; Wood, Julia; Livingood, William; Smotherman, Carmen; Goldhagen, Jeffrey; Wood, David

2015-01-01

Homeless children are known to be at risk for mental health and behavioral disorders due to housing instability and family and environmental risk factors, such as domestic violence. However, homeless children seldom receive screening for mental health and behavioral disorders with validated instruments. Moreover, few examples exist of programs that integrate outreach, screening, referral to appropriate diagnostic and therapeutic services, and care coordination. We describe early results of the Medical Home for Homeless Children Project, whose nurse care coordinators work with homeless families to conduct standardized nursing assessments that include evidence-based screening for child mental health and behavioral disorders with referral and case management for mental and behavioral health services. Screening identified a group of children with mental health issues that warranted referral, and many of those referrals were successfully completed.

Privacy, consent, and the electronic mental health record: The Person vs. the System.

PubMed

Clemens, Norman A

2012-01-01

As electronic health record systems become widely adopted and proposals are advanced to integrate mental health with general health systems, there is mounting pressure to include mental health information on the same basis as general health information without any requirement for active, individual patient consent to do so. A prime example is the current effort to change the Mental Health Information Act of the District of Columbia, which has, up till now, stood as a model for protection of the privacy of patients with mental illness, the requirement of informed consent for disclosure of health information, and delimitation of minimum necessary disclosure. Mental health information is exceptionally sensitive and potentially damaging if privacy is breached, which makes patients reluctant to seek treatment if they cannot be assured of confidentiality. In addition, there have been spectacular breaches of the security of large electronic health record databases. A subtle but more likely threat is the possibility that mental health information in networks could be fully accessible to all of the patient's providers in a network, not just those for whom it would be necessary to the patient's care. In the 1996 Supreme Court decision in Jaffee v. Redmond, the high court recognized that confidentiality is essential for patients to engage in effective psychotherapy, and HIPAA maintains that special status in the protection of psychotherapy notes as well as explicitly stating that it defers to state laws that are more protective of confidentiality than is HIPAA itself. Highly sensitive information also exists in mental health records aside from psychotherapy notes. Any change in the laws that govern informed consent for disclosure of mental health information must take these factors into account. Specifically, the author opposes any change that would assume tacit consent to release mental health information through an electronic health information exchange in the absence of a patient-initiated request to "opt out"; the requirement that the patient give active, informed and non-coerced consent to disclose information--"opt in"--must be preserved.

Generalisation, decision making, and embodiment effects in mental rotation: A neurorobotic architecture tested with a humanoid robot.

PubMed

Seepanomwan, Kristsana; Caligiore, Daniele; Cangelosi, Angelo; Baldassarre, Gianluca

2015-12-01

Mental rotation, a classic experimental paradigm of cognitive psychology, tests the capacity of humans to mentally rotate a seen object to decide if it matches a target object. In recent years, mental rotation has been investigated with brain imaging techniques to identify the brain areas involved. Mental rotation has also been investigated through the development of neural-network models, used to identify the specific mechanisms that underlie its process, and with neurorobotics models to investigate its embodied nature. Current models, however, have limited capacities to relate to neuro-scientific evidence, to generalise mental rotation to new objects, to suitably represent decision making mechanisms, and to allow the study of the effects of overt gestures on mental rotation. The work presented in this study overcomes these limitations by proposing a novel neurorobotic model that has a macro-architecture constrained by knowledge held on brain, encompasses a rather general mental rotation mechanism, and incorporates a biologically plausible decision making mechanism. The model was tested using the humanoid robot iCub in tasks requiring the robot to mentally rotate 2D geometrical images appearing on a computer screen. The results show that the robot gained an enhanced capacity to generalise mental rotation to new objects and to express the possible effects of overt movements of the wrist on mental rotation. The model also represents a further step in the identification of the embodied neural mechanisms that may underlie mental rotation in humans and might also give hints to enhance robots' planning capabilities. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

Mental disorders among English-speaking Mexican immigrants to the US compared to a national sample of Mexicans.

PubMed

Breslau, Joshua; Aguilar-Gaxiola, Sergio; Borges, Guilherme; Castilla-Puentes, Ruby Cecilia; Kendler, Kenneth S; Medina-Mora, Maria-Elena; Su, Maxwell; Kessler, Ronald C

2007-05-30

Our understanding of the relationship between immigration and mental health can be advanced by comparing immigrants pre- and post-immigration with residents of the immigrants' home countries. DSM-IV anxiety and mood disorders were assessed using identical methods in representative samples of English-speaking Mexican immigrants to the US, a subsample of the US National Comorbidity Survey Replication (NCSR), and Mexicans, the Mexican National Comorbidity Survey (MNCS). Retrospective reports of age of onset of disorders and, in the immigrant sample, age of immigration were analyzed to study the associations of pre-existing mental disorders with immigration and of immigration with the subsequent onset and persistence of mental disorders. Pre-existing anxiety disorders predicted immigration (OR=3.0; 95% CI 1.2-7.4). Immigration predicted subsequent onset of anxiety (OR=1.9; 95% CI 0.9-3.9) and mood (OR=2.3; 95% CI 1.3-4.0) disorders and persistence of anxiety (OR=3.7 95% CI 1.2-11.2) disorders. The results are inconsistent with the "healthy immigrant" hypothesis (that mentally healthy people immigrate) and partly consistent with the "acculturation stress" hypothesis (i.e., that stresses of living in a foreign culture promote mental disorder). Replication and extension of these results in a larger bi-national sample using a single field staff are needed.

Childrens mental health and civil society in the Gaza strip.

PubMed

Thirkell, Lucy

2012-09-01

The Gaza Strip, with a population of 1.7 million, over half of whom are under 18 years old, has existed in a state of ongoing conflict and containment for years, most notably since its closure in 2007. There is much concern for the mental health of the vast young generation who have little memory of other circumstances of existence, and even less exposure to the outside world. Their society forms the site of direct conflict and social destruction pertaining to untreated stress among the adults. However, leaving the social realm for the institutional for mental health treatment carries strong taboo, especially for adults. Civil society expert organisations offering a range of mental health work primarily pertaining to childrens social development can bypass some of this taboo and can also intervene at their schools and in their families, and may be most strategically located as social rather than institutional actors. Empowering the youth and seeking to strengthen Gazan society through them and for them causes some friction with the local government. However, despite the cultural and political challenges of mental health treatment for children within the Gaza Strip, the wider fact remains that however treated and psychosocially rehabilitated, society is predictably the site of renewed trauma in the short term and foreseeable future, enmeshing the mental health of its future generation inseparably with the international politics it inhabits.

Extended experience benefits spatial mental model development with route but not survey descriptions.

PubMed

Brunyé, Tad T; Taylor, Holly A

2008-02-01

Spatial descriptions symbolically represent environmental information through language and are written in two primary perspectives: survey, analogous to viewing a map, and route, analogous to navigation. Readers of survey or route descriptions form abstracted perspective flexible representations of the described environment, or spatial mental models. The present two experiments investigated the maintenance of perspective in spatial mental models as a function of description perspective and experience (operationalized through repetition), and as reflected in self-paced reading times. Experiment 1 involved studying survey and route descriptions either once or three times, then completing map drawing and true/false statement verification. Results demonstrated that spatial mental models are readily formed with survey descriptions, but require relatively more experience with route descriptions; further, some limited evidence suggests perspective dependence in spatial mental models, even following extended experience. Experiment 2 measured self-paced reading during three successive description presentations. Average reading times over the three presentations reduced more for survey relative to route descriptions, and there was no evidence for perspective specificity in resulting spatial mental models. This supports Experiment 1 findings demonstrating the relatively time-consuming nature of acquiring spatial mental models from route, but not survey descriptions. Results are discussed with regard to developmental, discourse processing, and spatial mental model theory.

A prospect theory explanation of the disposition to trade losing investments for less than market price.

PubMed

Johnstone, D J

2002-06-01

Investors have a proven general reluctance to realize losses. The theory of "mental accounting" suggests that losses are easier to accept when mentally integrated with either preceding losses or with compensatory gains. Mental integration is made easier when a failed asset is exchanged against a new, apparently profitable, acquisition. The alternative is to sell the existing asset on the open market before re-investing the proceeds as desired. This is emotionally less appealing than "rolling over" a losing investment into a new venture by way of an asset trade. The psychological benefits of exchanging rather than selling a failed asset come at a cost. It is typical of trade-in arrangements, e.g., where one trades an old car against a new one, that the effective sale price of the existing asset is less than current market value. Acceptance of this low price adds to the investor's total monetary loss on the existing asset but is essential to an overall package deal apart from which that asset would often remain belatedly unsold.

"Speaking the dialect": understanding public discourse in the aftermath of an HIV vaccine trial shutdown.

PubMed

Newman, Peter A; Logie, Carmen; James, Llana; Charles, Tamicka; Maxwell, John; Salam, Khaled; Woodford, Michael

2011-09-01

We investigated how persons from key populations at higher risk of HIV exposure interpreted the process and outcomes of the Step Study HIV-1 vaccine trial, which was terminated early, and implications for willingness to participate in and community support for HIV vaccine research. We used qualitative methods and a community-based approach in 9 focus groups (n = 72) among ethnically and sexually diverse populations and 6 semistructured key informant interviews in Ontario, Canada, in 2007 to 2008. Participants construed social meaning from complex clinical and biomedical phenomena. Social representations and mental models emerged in fears of vaccine-induced infection, conceptualizations of unfair recruitment practices and increased risk behaviors among trial participants, and questioning of informed consent. Narratives of altruism and the common good demonstrated support for future trials. Public discourse on HIV vaccine trials is a productive means of interpreting complex clinical trial processes and outcomes in the context of existing beliefs and experiences regarding HIV vaccines, medical research, and historical disenfranchisement. Strategic engagement with social representations and mental models may promote meaningful community involvement in biomedical HIV prevention research.

Integration of depression and primary care: barriers to adoption.

PubMed

Grazier, Kyle L; Smith, Judith E; Song, Jean; Smiley, Mary L

2014-01-01

Despite the prevailing consensus as to its value, the adoption of integrated care models is not widespread. Thus, the objective of this article it to examine the barriers to the adoption of depression and primary care models in the United States. A literature search focused on peer-reviewed journal literature in Medline and PsycInfo. The search strategy focused on barriers to integrated mental health care services in primary care, and was based on previously existing searches. The search included: MeSH terms combined with targeted keywords; iterative citation searches in Scopus; searches for grey literature (literature not traditionally indexed by commercial publishers) in Google and organization websites, examination of reference lists, and discussions with researchers. Integration of depression care and primary care faces multiple barriers. Patients and families face numerous barriers, linked inextricably to create challenges not easily remedied by any one party, including the following: vulnerable populations with special needs, patient and family factors, medical and mental health comorbidities, provider supply and culture, financing and costs, and organizational issues. An analysis of barriers impeding integration of depression and primary care presents information for future implementation of services.

Improving access to competitive employment for service users in forensic psychiatric units

PubMed Central

Beck, Charlotte; Wernham, Connie

2014-01-01

Employment has been proven to be an effective recovery tool and therapeutic intervention for those with severe and enduring mental health conditions. Aside from monetary reward, employment is a means of structuring time and provides a sense of worth and achievement, which enhances self-esteem and confidence. A social identity is developed through employment, encouraging social support and increasing social networks. Securing employment can bring about improved quality of life and positive change in one's social circumstances; therefore it can reduce symptoms associated with mental illness and potentially prevent re-offending, as the individual develops a sense of independence, self-efficacy, and value. Barriers to employment exist for forensic mental health service users and therefore it is imperative that employment needs are addressed at the earliest possible stage in recovery. An evaluation of employment activities across two forensic mental health units revealed a lack of appropriate employment opportunities for service users, and those roles available were not implemented in line with recommended best practice. In response to this issue several enterprises were established to offer opportunities for service users to engage in meaningful employment and develop skills that a future employer would value. Each enterprise responds to a business need within the units to ensure sustainability of services. The enterprises are essentially micro-businesses with social objectives whose surpluses are reinvested for the purpose of increasing opportunities for service users. The enterprises are underpinned by the philosophy of the Individual Placement and Support (IPS) model; empirical evidence suggests that the IPS model is the most effective intervention, based on the ‘place then train’ philosophy. The model recommends a focus upon rapid job search to achieve competitive employment for those who want to work; opportunities sourced should be consistent with individual preference and benefits counselling offered. Support should be time unlimited and integrated with mental health treatment. A person-centred and strengths-based approach is also adopted to support people to build on their strengths, establish goals, and encourage motivation. PMID:26734271

Gaming well: links between videogames and flourishing mental health

PubMed Central

Jones, Christian M.; Scholes, Laura; Johnson, Daniel; Katsikitis, Mary; Carras, Michelle C.

2014-01-01

This paper is a review of the state of play of research linking videogaming and flourishing, and explores the role of videogames and technology to improve mental health and well-being. Its purpose is to develop understandings about the positive intersection of gaming and well-being, to document evidence regarding links between videogames and positive mental health, and to provide guidelines for use by other researchers as they design and use tools and games to improve mental health and well-being. Using Huppert's (Huppert and So, 2013) proposition that to flourish is more than the absence of mental disorder but rather a combination of feeling good and functioning effectively, resulting in high levels of mental well-being, and Seligman's (Seligman, 2011) PERMA theory of well-being, the paper identifies strengths in existing games that generate positive affect, positive functioning, and positive social functioning, contributing to, and supporting mental health and well-being. PMID:24744743

Gaming well: links between videogames and flourishing mental health.

PubMed

Jones, Christian M; Scholes, Laura; Johnson, Daniel; Katsikitis, Mary; Carras, Michelle C

2014-01-01

This paper is a review of the state of play of research linking videogaming and flourishing, and explores the role of videogames and technology to improve mental health and well-being. Its purpose is to develop understandings about the positive intersection of gaming and well-being, to document evidence regarding links between videogames and positive mental health, and to provide guidelines for use by other researchers as they design and use tools and games to improve mental health and well-being. Using Huppert's (Huppert and So, 2013) proposition that to flourish is more than the absence of mental disorder but rather a combination of feeling good and functioning effectively, resulting in high levels of mental well-being, and Seligman's (Seligman, 2011) PERMA theory of well-being, the paper identifies strengths in existing games that generate positive affect, positive functioning, and positive social functioning, contributing to, and supporting mental health and well-being.

Racial/Ethnic Disparities in Mental Health Care Utilization among U.S. College Students: Applying the Institution of Medicine Definition of Health Care Disparities.

PubMed

Hunt, Justin B; Eisenberg, Daniel; Lu, Liya; Gathright, Molly

2015-10-01

The authors apply the Institute of Medicine's definition of health care disparities to college students. The analysis pools data from the first two waves of the Healthy Minds Study, a multicampus survey of students' mental health (N = 13,028). A probit model was used for any past-year service utilization, and group differences in health status were adjusted by transforming the entire distribution for each minority population to approximate the white distribution. Disparities existed between whites and all minority groups. Compared to other approaches, the predicted service disparities were greater because this method included the effects of mediating SES variables. Health care disparities persist in the college setting despite improved access and nearly universal insurance coverage. Our findings emphasize the importance of investigating potential sources of disparities beyond geography and coverage.

Multifarious Functions of the Fragile X Mental Retardation Protein.

PubMed

Davis, Jenna K; Broadie, Kendal

2017-10-01

Fragile X syndrome (FXS), a heritable intellectual and autism spectrum disorder (ASD), results from the loss of Fragile X mental retardation protein (FMRP). This neurodevelopmental disease state exhibits neural circuit hyperconnectivity and hyperexcitability. Canonically, FMRP functions as an mRNA-binding translation suppressor, but recent findings have enormously expanded its proposed roles. Although connections between burgeoning FMRP functions remain unknown, recent advances have extended understanding of its involvement in RNA, channel, and protein binding that modulate calcium signaling, activity-dependent critical period development, and the excitation-inhibition (E/I) neural circuitry balance. In this review, we contextualize 3 years of FXS model research. Future directions extrapolated from recent advances focus on discovering links between FMRP roles to determine whether FMRP has a multitude of unrelated functions or whether combinatorial mechanisms can explain its multifaceted existence. Copyright © 2017 Elsevier Ltd. All rights reserved.

Does what you know matter? Investigating the relationship between mental models of climate change and pro-environmental behaviors

NASA Astrophysics Data System (ADS)

Davis, R.

2013-12-01

The purpose of this study is to test the conjecture that environmentally sustainable decisions and behaviors are related to individuals' conceptions of the natural world, in this case climate change; individuals' attitudes towards climate change; and the situations in which these decisions are made. The nature of mental models is an ongoing subject of disagreement. Some argue that mental models are coherent theories, much like scientific theories, that individuals employ systematically when reasoning about the world (Gopnik & Meltzoff, 1998). Others maintain that mental models are cobbled together from fragmented collections of ideas that are only loosely connected and context dependent (Disessa, 1988; Minstrell, 2000). It is likely that individuals sometimes reason about complex phenomena using systematic mental models and at other times reason using knowledge that is organized in fragmented pieces (Steedle & Shavelson, 2009). Thus, in measuring mental models of complex environmental systems, such as climate change, the assumption of systematicity may not be justified. Individuals may apply certain chains of reasoning in some contexts but not in others. The current study hypothesizes that an accurate mental model of climate change enables an individual to make effective evaluative judgments of environmental behavior options. The more an individual's mental model resembles that of an expert, the more consistent, accurate and automatic these judgments become. However, an accurate mental model is not sufficient to change environmental behavior. Real decisions and behaviors are products of a person-situation interaction: an interplay between psychosocial factors (such as knowledge and attitudes) and the situation in which the decision is made. This study investigates the relationship between both psychosocial and situational factors for climate change decisions. Data was collected from 436 adult participants through an online survey. The survey was comprised of demographic questions; three discreet instruments measuring (1) mental models of climate change, (2) attitudes and beliefs about climate change, and (3) self-reported behaviors; and an experimental intervention, followed by a behavioral intention question. Latent class analysis (LCA) and item-response theory (IRT) will be employed to analyze multiple-choice responses to the mental model survey to create groupings of individuals assumed to hold similar mental of climate change. A principal component analysis (PCA) using oblique rotation was employed to identify five scales (Chronbach's alpha > 0.80) within the attitude/belief instrument. Total and sub-scale scores were also calculated for self-reported behaviors. The relationships between mental models, attitudes and behaviors will be analyzed using multiple regression models. This work presents not only the development and validation of three novel instruments for accurately and efficiently measuring mental models, attitudes, and self-reported behaviors, but also provides insight into the types of mental models individuals hold. Understanding how climate change is conceptualized and how such knowledge influences attitudes and behaviors gives educators tools for guiding students towards more expert understandings while also enabling environmentalists to craft more effective messages.

Problem solving based learning model with multiple representations to improve student's mental modelling ability on physics

NASA Astrophysics Data System (ADS)

Haili, Hasnawati; Maknun, Johar; Siahaan, Parsaoran

2017-08-01

Physics is a lessons that related to students' daily experience. Therefore, before the students studying in class formally, actually they have already have a visualization and prior knowledge about natural phenomenon and could wide it themselves. The learning process in class should be aimed to detect, process, construct, and use students' mental model. So, students' mental model agree with and builds in the right concept. The previous study held in MAN 1 Muna informs that in learning process the teacher did not pay attention students' mental model. As a consequence, the learning process has not tried to build students' mental modelling ability (MMA). The purpose of this study is to describe the improvement of students' MMA as a effect of problem solving based learning model with multiple representations approach. This study is pre experimental design with one group pre post. It is conducted in XI IPA MAN 1 Muna 2016/2017. Data collection uses problem solving test concept the kinetic theory of gasses and interview to get students' MMA. The result of this study is clarification students' MMA which is categorized in 3 category; High Mental Modelling Ability (H-MMA) for 7

Comprehensive School Mental Health: An Integrated "School-Based Pathway to Care" Model for Canadian Secondary Schools

ERIC Educational Resources Information Center

Wei, Yifeng; Kutcher, Stan; Szumilas, Magdalena

2011-01-01

Adolescence is a critical period for the promotion of mental health and the treatment of mental disorders. Schools are well-positioned to address adolescent mental health. This paper describes a school mental health model, "School-Based Pathway to Care," for Canadian secondary schools that links schools with primary care providers and…

Mental health services in South Africa: taking stock.

PubMed

Lund, C; Petersen, I; Kleintjes, S; Bhana, A

2012-11-01

There is new policy commitment to mental health in South Africa, demonstrated in the national mental health summit of April 2012. This provides an opportunity to take stock of our mental health services. At primary care level key challenges include- training and supervision of staff in the detection and management of common mental disorders, and the development of community-based psychosocial rehabilitation programmes for people with severe mental illness (in collaboration with existing non-governmental organizations). At secondary level, resources need to be invested in 72-hour observation facilities at designated district and regional hospitals, in keeping with the Mental Health Care Act. At tertiary level, greater continuity of care with primary and secondary levels is required to prevent "revolving door" patterns of care. There are major challenges and also opportunities related to the high level of comorbidity between mental illness and a range of other public health priorities, notably HIV/AIDS, cardiovascular disease and diabetes. The agenda for mental health services research needs to shift to a focus on evaluating interventions. With current policy commitment, the time to act and invest in evidence-based mental health services is now.

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.

On Looking into the Black Box: Prospects and Limits in the Search for Mental Models

NASA Technical Reports Server (NTRS)

Rouse, W. B.; Morris, N. M.

1984-01-01

To place the arguments advanced in this paper in alternative points of view with regard to mental models are reviewed. Use of the construct in areas such as neural information processing, manual control, decision making, problem solving, and cognitive science are discussed. Also reviewed are several taxonomies of mental models. The available empirical evidence for answering questions concerning the nature and usage of mental models is then discussed. A variety of studies are reviewed where the type and form of humans' knowledge have been manipulated. Also considered are numerous transfer of training studies whose results provide indirect evidence of the nature of mental models. The alternative perspectives considered and the spectrum of empirical evidence are combined to suggest a framework within which research on mental models can be viewed. By considering interactions of dimensions of this framework, the most salient unanswered questions can be identified.

Profile of Students’ Mental Model Change on Law Concepts Archimedes as Impact of Multi-Representation Approach

NASA Astrophysics Data System (ADS)

Taher, M.; Hamidah, I.; Suwarma, I. R.

2017-09-01

This paper outlined the results of an experimental study on the effects of multi-representation approach in learning Archimedes Law on students’ mental model improvement. The multi-representation techniques implemented in the study were verbal, pictorial, mathematical, and graphical representations. Students’ mental model was classified into three levels, i.e. scientific, synthetic, and initial levels, based on the students’ level of understanding. The present study employed the pre-experimental methodology, using one group pretest-posttest design. The subject of the study was 32 eleventh grade students in a Public Senior High School in Riau Province. The research instrument included model mental test on hydrostatic pressure concept, in the form of essay test judged by experts. The findings showed that there was positive change in students’ mental model, indicating that multi-representation approach was effective to improve students’ mental model.

Quantum-like dynamics applied to cognition: a consideration of available options

NASA Astrophysics Data System (ADS)

Broekaert, Jan; Basieva, Irina; Blasiak, Pawel; Pothos, Emmanuel M.

2017-10-01

Quantum probability theory (QPT) has provided a novel, rich mathematical framework for cognitive modelling, especially for situations which appear paradoxical from classical perspectives. This work concerns the dynamical aspects of QPT, as relevant to cognitive modelling. We aspire to shed light on how the mind's driving potentials (encoded in Hamiltonian and Lindbladian operators) impact the evolution of a mental state. Some existing QPT cognitive models do employ dynamical aspects when considering how a mental state changes with time, but it is often the case that several simplifying assumptions are introduced. What kind of modelling flexibility does QPT dynamics offer without any simplifying assumptions and is it likely that such flexibility will be relevant in cognitive modelling? We consider a series of nested QPT dynamical models, constructed with a view to accommodate results from a simple, hypothetical experimental paradigm on decision-making. We consider Hamiltonians more complex than the ones which have traditionally been employed with a view to explore the putative explanatory value of this additional complexity. We then proceed to compare simple models with extensions regarding both the initial state (e.g. a mixed state with a specific orthogonal decomposition; a general mixed state) and the dynamics (by introducing Hamiltonians which destroy the separability of the initial structure and by considering an open-system extension). We illustrate the relations between these models mathematically and numerically. This article is part of the themed issue `Second quantum revolution: foundational questions'.

The Longitudinal Stability and Dynamics of Group Membership in the Dual-Factor Model of Mental Health: Psychosocial Predictors of Mental Health

ERIC Educational Resources Information Center

Kelly, Ryan M.; Hills, Kimberly J.; Huebner, E. Scott; McQuillin, Samuel D.

2012-01-01

This study examined the longitudinal stability and dynamics of group membership within the Greenspoon and Sakflofske's dual-factor model of mental health. This expanded model incorporates information about subjective well-being (SWB), in addition to psychopathological symptoms, to better identify the mental health status and current functioning of…