Community-based Mental Health Programs Research Articles

Perceptions of the acceptability and effectiveness of a localised lifestyle medicine initiative to improve mental health – the lift project

ABSTRACT Objective Evaluate survey respondents’ perceptions concerning the acceptability and effectiveness of a localised, community-based mental health program. Method Avondale University and Lake Macquarie City Council partnered to implement an online, lifestyle-based program for all Council residents during a COVID-19 lockdown period. The University and Council promoted the program through established networks, resulting in 2390 registrations representing 4041 participants. Researchers invited registered users to respond to a post-program survey assessing their perceptions concerning program satisfaction, mental health benefits, and self-efficacy for managing mental health. Qualitative questions probed respondents’ likes and dislikes and were analysed thematically. Results Response rates were low, 6% (138/2390) of registered participants completed the post-program survey. Of the 138 responses, 99% indicated they would recommend the program to others, and 94% believed they gained skills to manage their mental well-being into the future. Themes generated from the qualitative data indicated that respondents liked the video content and delivery style, community camaraderie, personal empowerment, and easy accessibility. Some respondents found online accessibility problematic, disliked the delivery style, and experienced technical difficulties. Discussion The findings from a limited number of respondents indicate that a localised, community-based lifestyle program may offer a replicable model that is acceptable and effective in improving perceived mental health and self-efficacy in managing mental well-being. Survey respondents valued the practical content, community togetherness and emphasis on self-empowerment.

Racial and ethnic disparities in access to community-based perinatal mental health programs: results from a cross-sectional survey

BackgroundPerinatal mental health is a major public health problem that disproportionately affects people from racial and ethnic minority groups. Community-based perinatal mental health programs, such as peer support groups, are essential tools for the prevention and treatment of perinatal depression. Yet, little is known about racial and ethnic disparities in accessibility and utilization of community-based perinatal mental health programs.MethodsWe conducted a cross-sectional study using an online survey with program administrators representing perinatal mental health community-based services and support programs throughout New Jersey. Descriptive analysis and mapping software was used to analyze the data.ResultsThirty-three program administrators completed the survey. Results showed substantial racial and ethnic disparities in availability and utilization of community-based programs. In the majority of programs, Black, Hispanic, and Asian individuals made up less than 10% of total annual participants and less than 10% of facilitators. There were also geographic disparities in program accessibility and language availability across counties. Program administrators identified mental health stigma, lack of support from family, fear of disclosure of mental health challenges, social determinants, lack of language-concordant options in programs, and limited awareness of programs in the community as significant barriers to participation of racial and ethnic minorities. Strategies to address barriers included adding language options, improving program outreach, and increasing diversity of facilitators.ConclusionsThis study provides new evidence on racial and ethnic disparities in access to community-based perinatal mental health programs. Efforts to build the resources and capacities of community-based programs to identify equity gaps, increase diversity of staff, and address barriers to participation is critical to reducing racial and ethnic inequities in perinatal mental health.

"I Think Peer Support Helps to Demystify People Who Have Mental Health Issues and Helps to Remove That Stigma": Exploring the Defining Characteristics and Related Challenges of Youth Peer Support Through Participatory Research.

Despite the emerging body of literature on the benefits of youth peer support, there is also evidence that peer support can have unintended negative impacts on peers themselves. It is important to explore what aspects of the peer role contribute to these difficulties in order to mitigate risks. This paper uses a participatory approach to examine the unique attributes of youth peer practice and the related challenges. We conducted semi-structured interviews and focus groups with both peer and non-peer staff from a community-based youth mental health program that provides peer support services (N = 29). Thematic analyses were completed using QSR NVivo. Analyses capture the defining features and related challenges of the peer support role (self-disclosure, boundaries, role confusion and dynamic recovery), and risk factors that affect peers (stigma, exposure to harm and burnout). This paper contributes to the literature on peer support as well as youth participatory evaluation. The findings will be useful to support the development of improved organizational contexts for peer practice and more effective peer support programming.

Adult Depression and Anxiety Outcomes at a Student-Staffed Mental Health Clinic

Purpose: Student-staffed behavioral health clinics may increase low-cost access to mental health services, but there is a need to assess these models. This retrospective study evaluates the effect of a community-based, nonprofit, and student-staffed mental health program on adult clients’ depression, anxiety, and global distress to determine if this program model improves outcomes. Method: Historical, de-identified client demographic and Brief Symptom Inventory (BSI) data ( n = 627) was evaluated using paired sample t-tests to determine the effectiveness of treatment from graduate students working at a community mental health clinic. Results: As clients progressed in therapy, their depression, anxiety, and overall global severity index significantly improved. Over the course of treatment, there was an 18% decrease in the number of clients presenting with clinically relevant scores. Discussion: It is recommended that community-based student-staffed behavioral health clinics be considered as they have the potential to provide effective, low-cost services for many in need.

Elevating community-driven socioecological participation and action: A case study with Black youth.

Context is important when considering how racism acts to harm Black youth. Hence, social scientists developed socioecological theories that consider both the individual and the context(s) which shapes them. We used these theories to make sense of the challenges facing Black youth and identify points for intervention. However, these theories were rarely shared with community participants. Theory, at its core, is a way to make sense of the world. Theory shared in an age-appropriate manner can help youth make sense of their experiences in a way that promotes psychological wellness. This paper describes the intentional sharing of socioecological theory with community members engaged in two community-based mental health programs. Our team has collaborated closely with community stakeholders to implement and iteratively improve these programs. This first-person account presents the doctoral students' experiences in engaging community members in using socioecological theory to improve the programs with which they have identified as useful to their community. The article underscores the importance of elevating community voices when engaging in community-based research and how that engagement is more fundamental as programs become well-established.

Addressing Social Determinants of Mental Health in Pediatrics During the Coronavirus Disease 2019 Pandemic.

Addressing Social Determinants of Mental Health in Pediatrics During the Coronavirus Disease 2019 Pandemic.

Evaluating an Agricultural Community Suicide Prevention Program: Instrumentation and Impact

Highlights This paper details an evaluation of a piloted community-based farmer suicide prevention training program using a revised Willingness to Intervene Against Suicide Questionnaire. Indicating program utility and impact, willingness to intervene with a person in crisis increased by 0.21 logits (p<0.01) in program participants who completed pre- and post-training surveys. A comparison of growth in the willingness to intervene variable across participant demographics and characteristics revealed a change of 0.43 logits among males, compared to 0.096 for females (p=0.059). Researchers recommend that the program be tailored to consider gender differences. Abstract. In this study, researchers detail an evaluation of a pilot community-based farmer suicide prevention program that used QPR-based training customized for the agricultural community. Community-based mental health programs have been cited as key to addressing the worldwide suicide rate, but evidence of their execution and utility is not well documented, particularly within the agricultural community context. Researchers used Kirkpatrick's (1998) training evaluation model and a pre-post one-group design (Eseryel, 2002) of consenting training participants to conduct a preliminary assessment of programmatic impact. Using a revised Willingness to Intervene Against Suicide Questionnaire (Aldrich et al., 2014), which treated the questionnaire as an interval level scale suitable for parametric analysis, researchers found statistically significant differences in pre-training willingness to intervene between male and female respondents as well as those who work in agriculture and those who do not. An analysis of those respondents who completed both pre- and post-training surveys indicated statistically significant growth of 0.21 logits in the willingness to intervene variable, as well as remarkable growth for male participants in comparison to female participants. Keywords: . Evaluation of suicide prevention program, Farmer suicide prevention, Rasch analysis, Willingness to intervene.

A Group Videogame-Based Physical Activity Program Improves Walking Speed in Older Adults Living With a Serious Mental Illness.

One of the most overlooked populations in our society and in health care are middle-aged and older adults living with a serious mental illness (SMI) despite the growing numbers of this population. Health care communities, including both inpatient and outpatient mental health programs, have a responsibility to provide care that nurtures clients' mental as well as physical health needs. Providing accessible and engaging physical activity programs is an excellent way to provide this type of holistic care. The purpose of this article is to describe the impact of a pilot videogame-based physical activity program on walking speed in older adults with SMI. A one-group pretest post-test pilot study was conducted with a sample of 52 older adults with SMI recruited from community-based mental health programs. Participants played an active videogame (using the Kinect for Xbox 360 game system; Microsoft, Redmond, WA) for 50-minute group sessions 3 times a week for 10 weeks. Walking speed was assessed with the timed 3-m walk from the Short Physical Performance Battery at enrollment, 5 weeks, and 10 weeks. Participants achieved statistically significant improvement in walking speed (0.10 m/s, bias-corrected confidence interval Lower Limit (LL) 0.04, Upper Limit (UL) 0.15) over a 10-week period. This change represents a clinically and statistically (p ≤ .05) significant improvement in walking speed. Best estimates for clinically meaningful changes in walking speed are 0.05 m/s for a small change and 0.10 m/s for a substantial change. Results suggest that engagement in a group videogame-based physical activity program has the potential to improve walking speed in older adults with SMI. In turn, walking speed is an important indicator of premature mortality and cardiorespiratory fitness.

Mental Health Condition and Psychological Well-being of Filipino Older People: basis for an enhanced community-based Mental Health Program

Mental Health Condition and Psychological Well-being of Filipino Older People: basis for an enhanced community-based Mental Health Program

Addressing sexuality and intimate relations in community mental health services for people with serious mental illness: A qualitative study of mental health practitioners' experiences.

The literature on the experience of mental health providers (MHPs) working with people with serious mental illness (SMI) in community-based mental health programs related to sex, sexuality, and intimacy is scarce. The purpose of the present study was to explore the situations, thoughts, feelings, dilemmas, and challenges experienced by MHPs around these issues. Semistructured interviews were conducted with 13 MHPs working with people with SMI in six different community mental health programs in Israel. Four main themes emerged: (a) lack of professional training and skill sets to discuss clients' sexuality and intimacy issues, (b) ambivalence regarding the status and appropriateness of sexual relationships and intimacy as recovery-related goals, (c) discomfort discussing sexuality as a barrier to shared decision making and person-centered care, and (d) distinct programmatic and structural barriers to discussing and addressing needs and preferences related to sexuality and intimacy. The study highlights challenges experienced by MHPs working with people with SMI when confronted with sexual activities, relationships, and intimacy issues raised by service users. The development and implementation of trainings and resources designed to bolster MHPs' skill sets addressing sexuality and intimacy should be a priority for the field of psychiatric rehabilitation. MHPs who work with people with SMI in community-based settings often experience complex thoughts, feelings, dilemmas, and challenges related to clients' desire for or involvement in intimate and sexual relationships. Our study indicates a need to develop and implement stronger training and supervision to support MHPs to respond effectively to these complex situations and associated challenges. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Delivery of Cognitive Behavioral Therapy With Diverse, Underresourced Youth Using Telehealth: Advancing Equity Through Consumer Perspectives

ABSTRACT The purpose of this qualitative study was to capture the perspectives of individuals representing an urban, predominantly Latinx community who are underresourced by mental health services about the use of telehealth to deliver mental health treatment. The COVID-19 pandemic required hospital- and community-based mental health programs to pivot to telehealth with alarming speed and very little opportunity to assess the feasibility, acceptability, and disparate impact on unique populations of patients. This study aimed to assess perceived strengths and limitations of telehealth mental health service delivery via qualitative focus group methods. Three focus groups were conducted with 13 youth (aged 8–17) who were being treated at an urban, academic children’s hospital serving a predominantly Latinx community mental health population; two focus groups were conducted with 19 parents of said children; and one focus group was conducted with four mental health providers providing services to this population. A coding schema was designed to capture themes relevant to the following: (1) privacy and confidentiality; (2) perceived limitations of telehealth; (3) comfort with telehealth; (4) therapeutic relationship; (5) perceived strengths of telehealth; (6) perceived safety of telehealth; and (7) advice for providers engaging in telehealth. Findings were illustrative of both perceived strengths and limitations across these domains that can inform optimized telehealth mental health services moving forward.

Covid-19 Impact on Agricultural Farmer’s Social, Physical, and Mental Health: A Literature Review

Background: COVID-19 pandemic disrupted in many business sectors and affected negatively the agricultural sector. The objectives of this review are to determine the impact of COVID-19 in the social life, physical and mental of agricultural farmer.Method: This study was a literature review. The population in the study was farmers. The process of review was; identification of literature; screening questions; eligibility using inclusion criteria; and assessment of the quality of the studies. This review was conducted by identify relevant literature, in Science Direct, PubMed, Scopus and Google Scholar using the following keywords: “Covid-19” OR “Pandemic” combined with “farmer” “farmworker” “agricultural worker”. Articles found then be charted and analysis.Result: This review found 10 articles. The finding of this review showed that COVID 19 has impacted directly on the farmer’s life both on social life, physical and mental health.Conclusion: This finding showed that farmers problems should be addressed to prevent long-term negative consequences that impair the food system and enlarge current inequalities. Also, it should be developed and implemented the appropriate community-based mental health programs targeting farmers who impacted by pandemic and who are at risk to develop adverse mental health outcomes.

Mental health legislation in the Philippines: Its beginnings, highlights, and updates

Background: The Philippines is an autonomous Southeast Asian country which has long been encumbered with the burden of mental health-related concerns. Aside from the commonly occurring psychiatric illnesses, it also has to contend with the dearth of epidemiological data on such disorders as well as the scarcity of mental health practitioners. On top of these, one enduring challenge is the absence of mental health legislation. Thus, the passage of Republic Act (R.A.) 11036 or the Philippine Mental Health Act has been considered one of the greater achievements in Philippine psychiatry in the recent years. Methods: In this review, the author examines the origins, highlights, and updates on the legislature of R.A. 11036. Results: This legislature (or the Philippine Mental Health Act) elaborates on its highlights which equitably covers the rights of patients and their families as well as that of the mental health professionals; the standards of psychiatric, psychosocial, and neurologic services that need to be upheld in both government and private hospitals; the promotion of mental health in educational institutions and in the workplace; the need for mental health providers to undergo capacity building and proper training in research and development; the duties and responsibilities of the government agencies involved; the creation of a council to serve as a policymaking, planning, coordinating, and advisory body to oversee the implementation of the law; and the penalty clauses involved with violations of the law. It also provides updates on the enactment of the law's implementing rules and regulations, namely, the upgrading of existing mental health facilities, the standardization of a community-based mental health program, the development of a national suicide prevention strategy, the integration of mental health into the educational system and the workplace, the first-ever Philippine national survey on mental health and well-being, as well as the augmentation of the practice of telepsychiatry to extend the reach of services to the geographically isolated Filipinos. Conclusion: The Philippines made a history through the passage of the first-ever Mental Health Act on June 21, 2018, now known as R.A. 11036. The Philippine Psychiatric Association and other related organizations spearheaded a multisectoral lobby in the drafting of the bill. It took 16 years, and 31 drafts before R.A. 11036 became a reality. We still need to monitor the implementation of the law closely. Future revisions are expected to better improve the mental health law for citizens to receive better rights of mental health treatment and human rights protection.

Effects of Community-Based Programs on Integration into the Mental Health and Non-Mental Health Communities.

Aims: The purpose of this study was to verify how integration into the mental health community, a subculture of persons with mental illness, affects the integration into the non-mental health community. Thus, we analyzed the effect of community-based mental health service programs on non-mental health community integration, mediated by mental health community integration. Methods: In total, 190 persons with mental illness (M age = 42.78; SD = 11.3; male, 54.7%; female, 45.3%), living in local communities and using community-based mental health programs, participated in the study. We measured their sociodemographic and clinical variables, the environmental variables of mental health service programs, and the level of integration of the mental health and non-mental health communities. The data collected were analyzed to test the proposed hypotheses using Structural Equation Modeling (SEM). Results: The common significant predictors affecting the two types of community integration were symptoms and resource accessibility: the more accessible the various community resources and the less severe the psychiatric symptoms were, the higher the level of the two types of community integration was. In path analysis, the program’s atmosphere and the participation of people with mental illness (program involvement) significantly predicted the level of integration into the mental health community. This, in turn, had a positive effect on their physical integration, social contact frequency, and psychological integration into the non-mental health community, mediated by the integration of the mental health community. Conclusion: Based on the results, we emphasize the importance of mental health communities and suggest strategies to support the integration of mental health communities.

Engaging the Community to Effectively Plan and Implement Community-Based Mental Health Programs.

Community engagement is recognized as an effective means to maximizing public health program impacts despite challenges such as power imbalances that can undermine efforts. The value of engaging communities as equitable partners in the design and delivery of community-based programs has gained increasing traction over the last few decades. Most research in this area has been focused on partnerships between academia and communities, leaving a knowledge gap regarding engagement between community organizations and between community organizations and members. This paper presents a process evaluation that aimed to identify and describe factors found to impact and promote community engagement efforts within a multisite, multiyear, community-based prevention initiative. Findings highlight that strategies such as investing in trust-building efforts, engaging community influencers, and providing meaningful opportunities for community member involvement can help facilitate effective implementation. Recognizing the value and necessity of community engagement in community-based programming is an integral and continuous process.

Depression, Anxiety and Stress among Students amidst COVID-19 Pandemic: A Cross-Sectional Study in Philippines

Background: COVID-19 considered as a global health crisis poses mental health problems among individual and specifics to students.Purpose: This study aimed to determine the depression, anxiety, and stress levels among students amidst COVID-19 pandemic in Philippines.Methods: A cross-sectional study was undertaken in Region 8, Eastern Visayas Philippines. A total of 311 tertiary respondents randomly selected both private and government owned higher education institutions. The data compilation was done using online questionnaires through Google Forms with validated version of the Stress, Anxiety and Depression Scales 21 (DASS21) is used to calculate students' level of stress, anxiety and, depression with their socio-demographic featuresResults: We revealed that depression, anxiety and stress are instituted in 18.6 %, 35.1 % and 2.85% of students, respectively, amidst the COVID – 19 pandemics. The symptoms of disorders were moderate to extremely severe in 6.1%, 23.5%, and 0.6% of the study sample, respectively. Age, gender, marital status and family history of illness are significantly different with age group 20 and below, females, singles, and families with no history of illness displaying high level of anxiety. Results also established an association between anxiety and family’s monthly income and history of illness. The higher the monthly income and no presence of illness of families, the more anxious the person.Conclusion: Finally, the variables used, explained only 1.5% depression, 3.4% anxiety and 1.4% stress in this time of COVID-19 outbreak. It is therefore recommended to essentially develop community-based mental health program for preventive purposes.

Evaluating the Performance of Community Mental Health Centers in Iran: Strengths and Challenges

Objectives: This study aims to evaluate the performance of Community-based Mental Health Centers (CMHCs) in Iran and identifying the strengths and challenges in the provision of mental health services. Methods: This is a qualitative study, conducted using 36 individual interviews and 13 focus group discussions. Content analysis was performed and data were categorized. The findings were presented in terms of the needs for program implementation, achieving the expected goals and outcomes, and the findings of program evaluation. First, the points related to the provision of infrastructure and setting up the centers were mentioned, and then, the features, strengths and challenges facing the program were discussed. Results: Significant successes were achieved in providing infrastructure and implementing the community-based mental health program. Challenges in the implementation of this program included the barriers to attracting more general physicians and the impact of culture and attitudes in each city on the effectiveness of the program. Conclusion: To improve the performance of CMHCs, more attention should be paid to psychiatry and mental health educational programs in the general medicine curriculum, public education about the mental health and providing solutions for better implementation of the program.

The impact of COVID-19 on mental health outcomes among hospital fever clinic attendants across Nepal: A cross-sectional study.

BackgroundThe COVID-19 pandemic has been creating a panic and distressing situations among the entire population globally including Nepal. No study has been conducted assessing the psychological impact of this pandemic on the general public in Nepal. The objective of this study is to assess the mental health status during COVID-19 outbreak and explore the potential influencing factors among the population attending the hospital fever clinics with COVID–19 symptoms.MethodsA cross-sectional survey was conducted between May—June, 2020 with a sample of 645 participants aged 18 and above in 26 hospitals across Nepal. Telephone interviews were conducted using a semi-structured questionnaire along with a validated psychometric tool, the Depression, Anxiety and Stress (DASS-21) scale. The metrics and scores of symptoms and their severity were created and analyzed. Multivariate logistic regression was used to determine the association of potential covariates with outcome variables.ResultsThe prevalence of anxiety, depression and stress were 14%, 7% and 5% respectively. In reference to Karnali, participants from Bagmati province reported higher level of anxiety (OR 3.44, 95% CI 1.31–9.06), while stress (OR 4.27, 95% CI 1.09–18.32) and depressive symptoms (OR 3.11, 95% CI 1.05–9.23) observed higher among the participants in Province 1. Women were more at risk of anxiety (OR 3.41, 95% CI 1.83–6.36) than men. Similarly, people currently living in rented houses reported more stress (OR 2.97, 95% CI 1.05–8.43) and those living far from family reported higher rates of depressive symptoms (OR 3.44, 95% CI 1.03–11.46).ConclusionThe study identified increased prevalence of stress, anxiety and depressive symptoms during the initial stage of COVID-19 pandemic in Nepal. Considering the findings, there is urgent need to develop and implement appropriate community-based mental health programs targeting individuals who have had COVID-19 symptoms and who are prone to develop adverse mental health outcomes.

Perceived Coercion of Persons with Mental Illness Living in a Community.

Aims: The purpose of this study is to analyze the effect of the perceived coercion of people with mental illness living in a community on their therapeutic satisfaction and life satisfaction, mediated by therapeutic relationships. Methods: We evaluated several clinical variables (symptoms, psychosocial functioning, and insight), levels of perceived coercion, therapeutic relationships, therapeutic satisfaction, and life satisfaction in 185 people with mental illness (Mean age = 47.99, standard deviation (SD) = 12.72, male 53.0%, female 45.9%) who live in the community and use community-based mental health programs. The data collected were analyzed to test the proposed hypotheses using structural equation modeling (SEM). Results: The correlation analysis of all variables showed that clinical variables had statistically significant correlations with therapeutic relationship, therapeutic satisfaction, and life satisfaction, but no significant correlation with perceived coercion. Furthermore, perceived coercion was found to have significant predictive power for treatment satisfaction and life satisfaction mediated by therapeutic relationship. Specifically, the lower the perceived coercion, the better the therapeutic relationship. This, in turn, has a positive effect on the therapeutic satisfaction and life satisfaction of participants. Conclusions: Based on these findings, we suggest strategies to minimize coercion in a community.

Designing community sports-based programmes for men with mental illness: A qualitative study of the Offload rugby league programme

Despite the increasing appeal of community sport programmes which focus on men's mental health, the key design characteristics of these programmes, and the roles played by delivery staff in their conception and development, have not yet been systematically or widely studied. In this qualitative paper we address this gap in knowledge by reporting on interviews with stakeholders (n = 18) from north-west of England involved in designing a men's rugby league community-based mental health programme, Offload. Findings suggest that tacit forms of knowledge, developed through years of professional practice and co-production activity, was critical to how men's mental health was conceptualised and the use of existing non-clinical community assets (e.g. professional club stadia) as delivery sites for the programme. The use of non-stigmatising language, supported by opportunities for men to engage in non-threatening and solutions-focused activities, were central to programme design. The use of former professional sportspeople who recall their own lived experience of mental illness, and personal adversity, in programme sessions was deemed important for engendering trust among men and enabling them to engage in modelling alternative forms of masculine behaviour which can enhance mental health and encourage greater help-seeking. The paper concludes by arguing for a relational understanding of community sport and mental health programmes, since our data indicate that by focusing on the networks of relationships involved in Offload and the social contexts in which it was to be delivered, the programme designers effectively leveraged the benefits of their collective expertise to maximise men's engagement.