Effect of Chime Based Group Psychoeducation on Personal Recovery in Individuals Diagnosed With Schizophrenia.

The community mental health center (CMHC) movement, largely conceived by psychiatrists to improve standards of mental health care nationally, appears to be going through an evolutionary phase in which there is decreasing utilization of psychiatrists and increasing utilization of other mental health professionals. The author discusses some factors that may have influenced this trend. In order to counter it CMHCs must become a recognized, essential, and respectable part of a pluralistic system of mental health care, and psychiatrists must be willing to assume their responsibility for involvement in all segments of mental health care, including the private and public sectors, in both leadership and clinical positions.

IntroductionPsychoeducational group programs have shown promising results for people with attention-deficit/hyperactive disorders (ADHD). This pilot study aimed to investigate the impact of a new co-produced psychoeducational group intervention on quality of life (QoL), ADHD-related symptoms, and patient satisfaction.MethodThis pragmatic pilot randomized controlled trial (RCT) had two parallel arms. Outpatients were recruited in two community mental health centers (CMHCs) in the Central Norway Regional Health Authority. Patients eligible for inclusion were diagnosed with ADHD. The psychoeducation group (PG) received a 10-session psychoeducational group program as a supplement to treatment as usual (TAU), while the control group (CG) received TAU only. The program was developed in collaboration between user representatives and health professionals. While the primary aim of this pilot study was to assess the preliminary impact of the intervention, we conducted exploratory between-group comparisons to identify potential effects on patient-centered outcomes. The primary outcome was QoL measured with the Adult ADHD Quality of Life Scale (AAQoL). Secondary outcomes were ADHD symptom severity (Adult Self-Report Scale, 6-Item) and patient satisfaction (Satisfaction with Information on ADHD and Treatment Scale). We collected data at baseline, pre-, and post-intervention (T0, T1, and T2 respectively).ResultsOf 49 patients, 27 were allocated to the PG and 22 to the CG. Between-group comparisons using linear mixed models indicated a statistically significant improvement in QoL (mean difference = 6.90; p = 0.04; 95% CI [0.20–13.60]; Cohen’s d = 0.49). Outpatients in the PG reported significantly higher satisfaction with information as compared to the CG (mean difference = 2.14; p = 0.02; 95% CI [0.33–3.95]; Cohen’s d = 0.78). However, there were no significant differences in ADHD symptoms between the groups.ConclusionThis psychoeducational group intervention significantly improved QoL and patient satisfaction but not symptom burden in adult patients with ADHD. Future studies should explore the long-term effects of psychoeducational group programs and examine ways to optimize treatment outcomes.Trial registrationClinicalTrials.gov NCT03337425, 06/11/2017.Supplementary InformationThe online version contains supplementary material available at 10.1186/s12888-025-07452-5.

BackgroundThis pilot randomised controlled trial (RCT) study presents a patient-centred educational group programme collaboratively developed with user representatives and caregivers from two organisations and health personnel from a community mental health centre (CMHC). The objectives were to investigate the feasibility of the psychoeducational programme and the satisfaction of outpatients and caregivers with programme participation. This RCT explored the potential benefits of this innovative psychoeducational programme for adults recently diagnosed with attention deficit hyperactivity disorder (ADHD).MethodsThis pilot study employed a two-arm RCT design and recruited 60 outpatients from a Norwegian CMHC. The CMHC clinicians offered the intervention group (IG) participants a two-session, patient-centred, peer-cofacilitated programme along with the standard treatment. The control group (CG) received the standard treatment and a 1-h individual informational session during the same period. The recruitment, attendance, and dropout rate indicators were assessed for feasibility. Acceptability was assessed via the Client Satisfaction Questionnaire four-item scale (CSQ-4) and a three-item scale evaluating patient satisfaction with the information provided about ADHD. In addition, four patient-reported outcome measures (PROMs) were applied: one scale to assess self-efficacy, two to assess ADHD symptoms, and one for quality of life. The statistical analysis applied intention-to-treat (ITT) and per-protocol (PP) analyses.ResultsIn total, 56 outpatients were divided into the IG (n = 30) or CG (n = 26), and the recruitment rate was 93.3%, with a dropout rate of 16%. The attendance rate was 92%, and the retention rates for the IG and CG were 56.6% and 76.9%, respectively. Concerning intervention satisfaction, the ITT analysis conducted using a linear mixed model revealed statistical improvements in satisfaction, with the scale measuring satisfaction with the information and the CSQ-4 scale. In addition, caregivers expressed high satisfaction with the programme, as measured by the CSQ-4 scale. Regarding PROMs, the ITT and PP analyses yielded mixed findings.ConclusionPreliminary evidence indicates that a two-session, patient-centred, peer-cofacilitated psychoeducational programme is feasible and well-received, with high ratings for satisfaction from outpatients and caregivers.Cliniclatrials.gov IdentifierNCT03547843, 27/01/2022.

Public-Academic Partnerships: Early Intervention for Psychotic Disorders in a Community Mental Health Center

This quasi-experimental study examines the effectiveness of a psychoeducational group intervention program consisting of psychoeducation sessions and group exercises based on psychodrama warm-up activities resulting from the needs of public sector call center agents in the workplace. Forty municipality call center employees from two municipalities (intervention and control groups) completed pre- and post-test measures before and after the intervention program. A follow-up session for the intervention group took place one month after the completion of the intervention sessions. The intervention group showed significant pre-to-post-test short-term effects such as reduced depersonalization, increased mental well-being, psychological resilience, personal accomplishment, group atmosphere, and group cohesion. On the other hand, no significant difference was noted in the control group from pre- to post-test, except for the decrease in the group atmosphere scores. Group atmosphere and group cohesion scores remained significantly increased after one-month follow-up measures compared to the pre-test in the intervention group.

Family Physicians' Experiences With Community Mental Health Centers: A Multilevel Analysis

Globally, COVID-19 had an immense impact on mental health systems, but research on how community mental health (CMH) systems and services contributed to the pandemic mental health response is limited. We conducted a systematic review and meta-ethnography to understand the roles of CMH services, determinants of the quality of CMH care, and dynamics within CMH systems during COVID-19. We searched and screened across five databases and appraised study quality using the CASP tool, which yielded 27 qualitative studies. Our meta-ethnographic process used Noblit and Hare’s approach for synthesizing findings and applying interpretive analysis to original research. This identified several key themes. Firstly, CMH systems played the valuable pandemic role of safety nets and networks for the broader mental health ecosystem, while CMH service providers offered a continuous relationship of trust to service users amidst pandemic disruptions. Secondly, we found that the determinants of quality CMH care during COVID-19 included resourcing and capacity, connections across service providers, customized care options, ease of access, and human connection. Finally, we observed that power dynamics across the CMH landscape disproportionately excluded marginalized groups from mainstream CMH systems and services. Our findings suggest that while the pandemic role of CMH was clear, effectiveness was driven by the efforts of individual service providers to meet demand and service users’ needs. To reprise its pandemic role in the future, a concerted effort is needed to make CMH systems a valuable part of countries’ disaster mental health response and to invest in quality care, particularly for marginalized groups.

We Need to Find Right Balance Between Telehealth, In-Person Care

The young adult chronic patient: a look back.

This paper summarizes the findings for the European Region of the WPA Task Force on Steps, Obstacles and Mistakes to Avoid in the Implementation of Community Mental Health Care. The article presents a description of the region, an overview of mental health policies and legislation, a summary of relevant research in the region, a precis of community mental health services, a discussion of the key lessons learned, and some recommendations for the future.

T the use of communication technologies to offer psychiatric services, has become a topic of great interest as a means of overcoming the effects of the shortage of psychiatrists in rural areas (1–4). The idea of using telecommunication in psychiatry is not new. In fact, examples can be found as far back as 1959, and the topic has been well reviewed (1,4–6). Although the technology has improved to the point of providing adequate audiovisual interactions, the cost-effectiveness of these interactions remains unassessed. Clearly, technological feasibility does not eliminate the need for economic practicality. Before relying on telepsychiatry as a solution to inadequate psychiatric services in rural areas, we need to consider economic variables such as the cost of the equipment, charges for maintaining connections, the volume of use, and reimbursement. We also need to consider its impact on existing systems of care into which it would be introduced. We studied the feasibility of implementing a telepsychiatry system to link psychiatrists at Michigan State University with patients at a community mental health center (CMHC) in rural Michigan. The target county we studied has a population of 58,000 and is approximately 75 miles from the university. The county is poor and demographically similar to many rural counties and is designated by the U.S. Department of Health and Human Services as an area with a shortage of mental health professionals. Many people lack transportation. Based on our feasibility study, this column examines the economics of setting up a telepsychiatry system through which care can be provided to a rural area. Moreover, we estimated the cost of delivering one type of patient care (medication management) via this system. The purpose of the paper is not to provide a technological discussion of designing a system. Rather, we offer an analysis of economic issues and systems problems encountered in setting up a very basic telepsychiatry installation at the low end of the cost range.

This article describes the development and piloting of a bilevel intervention codeveloped by persons in recovery from mental illness and addiction and university faculty with expertise in cultural competence to improve the cultural competence of a community mental health center in the northeastern United States. Two faculty and 5 persons in recovery met for 6 months to develop the bilevel training intervention. They discussed experiences of culturally responsive care and developed experiential activities and case examples for the 2-day training. Forty-five community mental health service providers attended the 2-day training. Trainees' self-reported awareness, knowledge, and skills in cultural competence were measured pre and post training and analyzed with repeated measure t tests. Next, faculty and persons in recovery provided follow-up training and helped to establish an infrastructure supported to support the agency cultural competence plan. One hundred twenty-five providers completed the Organizational Multicultural Competence Survey and between-subjects t tests measured increases in organizational cultural competence. Significant increases were found in providers' multicultural knowledge, awareness, and skills. Qualitative responses demonstrated the contribution of the experiences of persons in recovery to the training. Ratings of the organizational-level cultural competence intervention showed significant improvements in the agency's cultural competence policies (e.g., implementation of strategies to hire and retain a diverse workforce). These data suggest that bilevel interventions codeveloped by persons in recovery and researchers may be effective in increasing provider and organizational-level cultural competence. Future research should evaluate the effect of these interventions on consumers and health outcomes.

BackgroundAlthough a focus on late-life depression may help preventing suicide in older adults, many older people, especially those living in rural areas, have relatively low accessibility to treatment. This study examined the feasibility and effectiveness of a village-based intervention for depression targeting older adults living in rural areas.MethodsA community-based randomised pilot trial was performed in two small rural villages in South Korea. Two villages were randomly selected and assigned to the intervention or active control group; all older adults living in the two villages (n = 451) were included in the intervention program or received standard Community Mental Health Service (CMHS) care, and the effectiveness of the program was examined using representative samples from both groups (n = 160). The 12-week intervention included case management according to individual risk level and group-based activities. Healthy residents living in the intervention village who played major roles in monitoring at-risk older individuals were supervised by CMHS staff. The score on the Korean version of the Geriatric Depression Scale-Short Form (SGDS-K) was the primary outcome, while social network, functional status, and global cognitive function were secondary outcomes. Linear mixed models including the factors of intervention group, time, and their interaction were used to examine group differences in changes in primary and secondary outcomes from baseline to follow up.ResultsOverall, there was no significant group × time interaction with respect to the SGDS-K score, but older individuals with more depressive symptoms at baseline (SGDS-K ≥ 6) tended to have a lower likelihood of progressing to severe depression at post-intervention. The social network was strengthened in the intervention group, and there was a significant group × time interaction (F[df1, df2], 5.29 [1, 153], p = 0.023).ConclusionThis study examined a 12-week village-based intervention for late-life depression in which the CMHS helped village-dwellers deal with late-life depression in their communities. Although the intervention improved social interactions among older adults, it did not reduce depressive symptoms. Further studies including more rural villages and long-term follow up are needed to confirm the effectiveness of this prevention program.Trial registrationNCT04013165 (date: 9 July 2019, retrospectively registered).

Neuromuscular Training, Exercise Physiology Clinic, Real-time Exercise, and Cardiac Rehabilitation

Intervention for Adolescents With Early-Onset Psychosis and Their Families: A Randomized Controlled Trial