‘I don’t think there’s many British African Caribbean men that talk positively about mental health services’: Risk, trust, racism and the Mental Health Act
Detention under mental health law is based on professional assessments of risk but impacts on patients’ trust. Little attention has been paid by sociologists to the operation of risk, trust and racism during mental health detention processes. Our study addresses this gap through thirteen qualitative interviews with professionals, conducted in England in 2023 focusing on the mental health detention of British African Caribbean men: a group disproportionately detained. Data were analysed using thematic analysis and the SILENCES framework. Participant accounts highlighted mistrust between British African Caribbean men and mental health services. This group’s mental health was seen to be affected at a macro level by poverty, drug misuse and racism, as well as cultural mistrust and bias. Negative assumptions of British African Caribbean men were seen to operate at a meso level through institutional practices within risk management processes that discriminated against them, leading to coercive treatments and poorer outcomes. Micro level factors were largely absent from interviews. Participants stressed the need to rebuild trust with British African Caribbean communities, but the strategies they described overlooked the macro and meso factors identified elsewhere within interviews. The article is significant in highlighting cultural drivers of (mis)trust between mental health services and British African Caribbean men at macro and meso levels.
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3
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- Aug 1, 2008
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In April 2003 the Alberta government integrated specialized mental health services, formerly organized independently, with the health regions, which are responsible for general health services. The objective of this article is to determine whether the transfer was associated with an increase or decrease in the share of resources in the region allocated to mental health care relative to total spending for health care. The measure of the share for mental health care is the total costs for mental health care resources as a percentage of total health care spending. Resources and spending examined were those that were actually or potentially under the regions' control. Annual costs for mental health services in the province were obtained for a seven-year period (fiscal year [FY] 2000 through FY 2006) from provincial utilization records for all residents in the province. Unit costs were assigned to each visit. The trend in the share measure was plotted for each year. The share for mental health care increased overall from FY 2000 (7.6%) to FY 2003 (8.2%), but returned to pre-FY 2003 levels in the three years after the transfer (7.6%). Despite concerns expressed before the transfer by federal and provincial reports over the level of expenditures devoted to mental health care, the integration of mental health services with other health services did not result in an increase of the share for mental health care.
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274
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This paper summarizes the history of the development of Chinese mental health system; the current situation in the mental health field that China has to face in its effort to reform the system, including mental health burden, workforce and resources, as well as structural issues; the process of national mental health service reform, including how it was included into the national public health program, how it began as a training program and then became a treatment and intervention program, its unique training and capacity building model, and its outcomes and impacts; the barriers and challenges of the reform process; future suggestions for policy; and Chinese experiences as response to the international advocacy for the development of mental health.
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6
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16
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25
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To provide a model to estimate human resource needs for community-based mental health services in South Africa. A situation analysis was conducted of current community-based mental health service provision in South Africa, which comprise outpatient and emergency services, residential care and day care. Service utilisation rates and staffing needs were estimated for two levels of service coverage, using data from the situation analysis, local epidemiological studies and consultation with key stakeholders. For a population of 100,000 people, 7.3-23.8 full-time equivalent staff would be required to provide services in outpatient services, 14.9-41.6 in day care and 11.5-23.0 in residential care at minimum and full coverage levels respectively. The model can facilitate rational planning by requiring transparency and accountability in the assumptions used. This method can be adapted to a range of countries, by entering relevant country data. The model fills a gap, particularly in low- and middle-income countries, where community-based mental health services are sparse, and decisions regarding allocations to them are hampered by a lack of good quality data. The results of the model are limited by the quality of data and the assumptions upon which the modelling are based.
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8
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- Dec 1, 2007
- Psychiatric Services
Initiation and Use of Public Mental Health Services by Persons With Severe Mental Illness and Limited English Proficiency
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2
- 10.3969/j.issn.1002-0829.2012.01.007
- Feb 1, 2012
- Shanghai Archives of Psychiatry
A new mental health law to protect patients' autonomy could lead to drastic changes in the delivery of mental health services: is the risk too high to take?
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74
- 10.1176/ps.2007.58.6.816
- Jun 1, 2007
- Psychiatric Services
Information about mental health systems is essential for mental health planning to reduce the burden of neuropsychiatric disorders. Unfortunately, many low- and middle-income countries lack systematic information on their mental health systems. The objectives, scope, structure, and contents of mental health assessment and monitoring instruments commonly used in high-income countries may not be appropriate for use in middle- and low-income countries. The World Health Organization (WHO) has recently developed the WHO Assessment Instrument for Mental Health Systems (WHO-AIMS), a comprehensive assessment tool for mental health systems designed for middle- and low-income countries. WHO-AIMS was developed through an iterative process that included input from in-country and international experts on the clarity, content, validity, and feasibility of the instrument, as well as a pilot trial. The resulting instrument, WHO-AIMS 2.2, consists of six domains: policy and legislative framework, mental health services, mental health in primary care, human resources, public information and links with other sectors, and monitoring and research. These domains address the ten recommendations of the World Health Report 2001 through 28 facets and 155 items. All six domains need to be assessed to form a basic, yet broad, picture of a mental health system, with a focus on health sector activities. WHO-AIMS provides essential information for mental health policy and service delivery. Countries will be able to develop information-based mental health policy and plans with clear baseline information and targets. Moreover, they will be able to monitor progress in implementing reform policies, providing community services, and involving consumers, families, and other stakeholders in mental health promotion, prevention, care and rehabilitation. This article provides an overview of the rationale, development process, and potential uses and benefits of WHO-AIMS.
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