Community Mental Health Professionals Research Articles

Use of AI in Mental Health Care: Community and Mental Health Professionals Survey.

Artificial intelligence (AI) has been increasingly recognized as a potential solution to address mental health service challenges by automating tasks and providing new forms of support. This study is the first in a series which aims to estimate the current rates of AI technology use as well as perceived benefits, harms, and risks experienced by community members (CMs) and mental health professionals (MHPs). This study involved 2 web-based surveys conducted in Australia. The surveys collected data on demographics, technology comfort, attitudes toward AI, specific AI use cases, and experiences of benefits and harms from AI use. Descriptive statistics were calculated, and thematic analysis of open-ended responses were conducted. The final sample consisted of 107 CMs and 86 MHPs. General attitudes toward AI varied, with CMs reporting neutral and MHPs reporting more positive attitudes. Regarding AI usage, 28% (30/108) of CMs used AI, primarily for quick support (18/30, 60%) and as a personal therapist (14/30, 47%). Among MHPs, 43% (37/86) used AI; mostly for research (24/37, 65%) and report writing (20/37, 54%). While the majority found AI to be generally beneficial (23/30, 77% of CMs and 34/37, 92% of MHPs), specific harms and concerns were experienced by 47% (14/30) of CMs and 51% (19/37) of MHPs. There was an equal mix of positive and negative sentiment toward the future of AI in mental health care in open feedback. Commercial AI tools are increasingly being used by CMs and MHPs. Respondents believe AI will offer future advantages for mental health care in terms of accessibility, cost reduction, personalization, and work efficiency. However, they were equally concerned about reducing human connection, ethics, privacy and regulation, medical errors, potential for misuse, and data security. Despite the immense potential, integration into mental health systems must be approached with caution, addressing legal and ethical concerns while developing safeguards to mitigate potential harms. Future surveys are planned to track use and acceptability of AI and associated issues over time.

Emotional well-being among community mental health professionals during COVID-19: an exploratory study

ABSTRACT This paper presents a study related to burnout and well-being deriving from professional practice in community mental health services. The sample consisted in 133 workers from the public mental health system of Barcelona (Spain). An ad-hoc questionnaire was used, and data was analyzed from a descriptive approach. The results reveal a high level of emotional distress and exhaustion related to professional practice that prevents from job satisfaction and affects work quality. Furthermore, the pandemic led to an increase in distress related to work in that field. Finally, the limitations of the study and directions for future research are raised.

Associative stigma among community mental health professionals in work and nonwork settings.

Associative stigma among community mental health professionals in work and nonwork settings.

A Self-Care Deficiency Syndrome: Self-Neglect

Self-neglect is the individual's failure to show the necessary attention and care in his own care. Self-neglect manifests itself as non-adherence to treatment, failure to maintain personal and environmental hygiene, and maladaptive health behaviours. At the global level, although self-neglect is frequently seen especially in the elderly population, it is seen in all age groups and especially in disease groups where disability is in question and their caregivers. Self-neglect, which is divided into two categories as intentional and unintentional, is an important cause of morbidity and mortality. Failure to maintain accepted self-care standards caused by self-neglect threatens not only personal but also public health and well-being and increases the burden of health services and health care costs. Self-neglect is difficult to detect because individuals are isolated and do not have the risk of directly harming themselves. Due to reasons such as non-compliance with current treatment, ineffective health management, these individuals' access to the health system is disrupted and the diagnosis and intervention of self-neglect is delayed because they only apply to health services in emergencies. Health professionals working in the field of public health and mental health, especially community mental health professionals, have important responsibilities for the diagnosis and intervention of self-neglect.

Organizational response to the COVID-19 pandemic and its association with moral distress in community mental health teamsin the UK: A qualitative study.

In March 2020, Coronavirus-19 (COVID-19) rapidly spread across the globe impacting the mental health of the population and putting an overwhelming pressure on health services. Much has been written about the impact of the pandemic on health-care workers working in hospital settings but less attention has been paid to its effect on community mental health teams (CMHTs). This study is based on 21 remote interviews with community mental health professionals during the first wave of the COVID-19 pandemic. Interviews were transcribed and analysed using a thematic analysis whereby codes of similar meaning were grouped into main themes. Analysis identified three major contributors to moral distress; changes in the nature of contact with service users, changes to the place of work, and difficulties of balancing risks to the families of CMHT staff and service users. This study demonstrates that necessary organizational changes instituted to minimize the spread of COVID-19, required different ways of working which were not perceived to be in the best interests of service users or the families of CMHT staff. In order to comply with Government directives, CMHT staff were forced to behave in a way which did not match their moral values causing them to experience moral distress.

Exploring the workplace well-being of staff at a new integrated community mental health service for children and young people

Background There is a lack of research into the workplace well-being of community mental health professionals. Given children and young people’s increasing needs for mental health support in the wake of the coronavirus disease 2019 pandemic, it is timely to explore the workplace well-being of community mental health teams.Aim To explore the workplace well-being of staff working in a new integrated community mental health service for children and young people.Method Eleven mental health professionals from a range of disciplines took part in the study. The 11 participants completed an online questionnaire and the Professional Quality of Life (ProQOL) scale, which measures levels of compassion satisfaction, burnout and secondary traumatic stress. Three of them also took part in an individual semi-structured interview.Findings Participants felt hopeful and optimistic about the future of the service, felt supported by managers and peers, and wanted to enhance their skills to meet children and young people’s increasingly complex needs within the constraints of a service offering brief interventions. Participants displayed high levels of compassion satisfaction, low levels of burnout and particularly low levels of secondary traumatic stress.Conclusion Emotionally supportive leadership, a culture of continuous learning and peer support may reduce the uncertainty felt by community mental health staff about a new service and create optimism about the future, which may in turn contribute to workplace well-being.

Student Threats of Violence Often Signal Underlying Psychiatric Disorders

Student Threats of Violence Often Signal Underlying Psychiatric Disorders

Community MH Must Include Care for Incarcerated Individuals, Released Prisoners

Community MH Must Include Care for Incarcerated Individuals, Released Prisoners

Community Participation Among Individuals with Severe Mental Disorders During COVID-19 Pandemic.

Utilizing a sample of 286 community-dwelling adults with severe mental disorders (SMDs) in Beijing, this study examined their social and community participation during COVID-19 pandemic. The descriptive results showed that adults with SMDs living in the pandemic Beijing mostly engaged in social activities, followed by productive and leisure/recreational activities. More than two-thirds of the participants indicated that their participation was not sufficient. The multivariate analyses revealed that higher social support and self-esteem predicted more participation days, higher social support and independent usage of Health Kit were linked to more participation items, while higher social support and stronger self-stigma were associated with lower perceived participation sufficiency. Thus, community mental health professionals need to provide more tailored interventions to people with SMDs to enhance their participation performance and perceived participation sufficiency during the pandemic era.

16.1 The Tool for Evaluating Media Portrayals of Suicide (TEMPOS): A Novel Tool for Reducing the Risk of Media-Influenced Suicide Contagion

16.1 The Tool for Evaluating Media Portrayals of Suicide (TEMPOS): A Novel Tool for Reducing the Risk of Media-Influenced Suicide Contagion

Recovery-Oriented Cross-Sectoral Network Meetings between Mental Health Hospital Professionals and Community Mental Health Professionals: A Critical Discourse Analysis.

Aims and objectives: In the medical field, we lack knowledge on how interprofessional collaboration across sectors is carried out. This paper explores how healthcare professionals and users perceive recovery-oriented cross-sectoral discharge network meetings between mental health hospital professionals and community mental health professionals and which discourses manifest themselves within the field of mental healthcare. Method: Ten professionals from a mental health hospital and eight community mental health professionals participated. In addition, five users with experience in mental health services in both sectors participated. Fairclough’s discourse analysis framework was used to explore their experiences. The study was designed following the ethical principles of the Helsinki Declaration and Danish law. Each study participant in the two intersectoral sectors gave their informed consent after verbal and written information was provided. The Consolidated Criteria for Reporting Qualitative Research checklist was used as a guideline to secure accurate and complete reporting of the study). Results: The healthcare professionals in both sectors are governed by steering tools, legislation and a strong biomedical tradition to solve illness-related problems, such that users must be offered treatment and support to achieve self-care as soon as possible. This can be seen as a reflection of, and a driving force in, a change in the wider social practice that Fairclough terms the ‘marketisation of discourse’—a social development in late modernity, whereby market discourse colonises the discursive practices of public institutions. The user of psychiatric and social services experiences a structured system that does not offer the necessary time for deep conversations. Users do not consider recovery as something that is only seen in relation to the efforts of the professionals, as recovery largely takes place independently of professionals. Recovery depends on users’ internal resources and a strong network that can support them on the journey. Conclusion: Healthcare professionals perceive recovery-oriented cross-sectoral discharge network meetings to reflect paternalistic and biomedical discourses. Users want to be seen more as whole persons and did not experience sufficient involvement in the intersectoral care. Relevance to clinical practice: Healthcare professionals need to be supported to seek clarity in the understanding and operationalisation of a recovery-oriented approach, if the agenda is to be truly adopted and strengthened.

Developing a statewide network of coaches to support youth access to evidence-based practices.

Although youth face many barriers in accessing effective mental health care, schools are one setting where they can more easily receive treatment. Research shows that training and supports are needed for school mental health professionals to provide effective care. Coaching, which involves in vivo support for school mental health professionals, is one helpful strategy. We describe the process of recruiting and training community clinicians to become coaches. The Transforming Research into Action to Improve the Lives of Students (TRAILS) program successfully recruited and trained a network of 86 community clinicians to become coaches. Clinicians attended two day-long trainings and participated in 12 weeks of personalized consultation. Clients to whom these clinicians provided CBT showed significant symptom improvement. Clinicians also reported that they increased their knowledge and use of core CBT strategies, including psychoeducation, exposure, and behavioral activation. Community mental health professionals who are trained as coaches can address gaps in access to care for youth. We demonstrate one strategy for strengthening and leveraging clinicians' knowledge of CBT to support the school-based implementation of CBT.

Rewiring practice: community mental health professionals’ attitudes towards and knowledge of electroconvulsive therapy in the context of advance decision-making

PurposeIn England, electroconvulsive therapy (ECT) cannot be administered to service users who make an advance decision to refuse the treatment, unless in life-threatening circumstances. In a sector where person-centred practice is revered, no prior research has investigated whether community mental health practitioners (CMHPs) encourage service users to make advance decisions about ECT. This study aims to explore whether CMHPs have supported advance decision-making about ECT and whether their profession, attitudes towards and knowledge of the treatment affect this.Design/methodology/approachA quantitative online survey was completed by n = 120 CMHPs (nurses, social workers and occupational therapists). The validated Questionnaire on Attitudes and Knowledge of ECT was used.FindingsIn total, 93% of participants knew service users who had undergone ECT, yet only 12% had supported a service user to make an advance decision about ECT. Compared to those who had not supported advance decision-making, those who had shown significantly higher knowledge and a more positive attitude. Nurses and those who had worked in the mental health field for over 10 years had significantly higher knowledge of ECT.Originality/valueCMHPs are well placed to support advance decision-making about ECT. Increased knowledge about advance decisions and ECT may bolster the uptake of advance decision-making, thus greater training is recommended.

A Path Model for Burnout in Community Mental Health Professionals.

The purpose of this research is to identify a path model to explain burnout in community mental health professionals based on the compassion satisfaction–compassion fatigue (CS-CF) model. A total of 125 mental health professionals, including nurses, social professionals, and psychologists working in mental health welfare centers in various regions across South Korea were surveyed using a structured questionnaire. A path analysis was conducted using SPSS 24.0 and AMOS 24.0. The results showed that compassion satisfaction and compassion fatigue are significant predictors of burnout (β = −0.20, p = 0.011; β = 0.40, p < 0.001, respectively). The indirect pathways associated with burnout included occupational stress (β = 0.21, p = 0.021) and experience with aggressive behavior in the workplace (β = 0.33, p = 0.004) through maladaptive cognitive emotion regulation and compassion satisfaction. The total effect of the variables on burnout via compassion fatigue and compassion satisfaction explained 62.5% of burnout among mental health professionals. These findings indicate that providing nursing interventions might reduce compassion fatigue and increase compassion satisfaction to reduce burnout. Furthermore, intervention programs that help to reduce the use of maladaptive cognitive emotion regulation strategies are necessary to effectively reduce burnout in mental health professionals.

Community-Based Multi-Site Randomized Controlled Trial of Behavioral Activation for Patients with Depressive Disorders.

Behavioral activation (BA) is a beneficial and relatively cost-effective treatment option for depression. This study utilized a pragmatic randomized controlled research design to investigate whether BA, as compared with treatment as usual (TAU), led to superior treatment effects, when delivered in community mental health settings by retrained community mental health professionals. Patients with depressive disorders (n = 64) were randomly assigned to a 10-session BA (n = 31) or TAU (n = 33) group. The depressive symptoms and behavioral engagement were assessed at the baseline, post-treatment, and a six-month follow-up. Results showed that, as compared to the TAU group, the BA group had: (1) a reduction in depression severity, as evidenced by large effect sizes and greater response rates, and (2) an increase in behavioral engagement. However, the post-treatment gains were not maintained at the six-month follow-up. The implications and limitations of the study are also discussed (KCT0004098, June 27, 2019, retrospectively registered).

Oral health promotion practices of Australian community mental health professionals: a cross sectional web-based survey

BackgroundThis study explored the oral health promotion practices of Australian community mental health professionals working with people living with severe mental illness (SMI).MethodsAn anonymous cross-sectional web-based survey was distributed to all Community Rehabilitation and Support Workers (CRSWs) working at Neami National (n = 471), an Australian community mental health service. The validated questionnaire assessed participants’ self-rated oral health knowledge and confidence (7 questions); their perceived barriers (9 questions) and attitudes (5 questions) to oral health promotion; and their oral health promotion practices (7 questions). Differences in responses between groups were analysed using Chi-square, Fisher’s exact and Mann–Whitney U tests. Logistic Regression Analysis served to explore the probability of providing oral health support to mental health consumers.ResultsA total of 141 CRSWs were included in this study, achieving a response rate of 30 percent. Roughly two-fifths (39.0%) of participants had oral health training in the previous 12-months. The majority of CRSWs (89.3%) believed (‘Agreed’ or ‘Strongly agreed’) that mental health support workers have a role to play in promoting oral health. However, less than half (44.0%) of CRSWs practiced oral health promotion activities when working with mental health consumers. When asked about barriers to promoting oral health, ‘lack of consumer interest’ was the most prevalent issue. CRSWs who had oral health training were over three-times (OR 3.5, 95% CI 1.25–9.83, p = 0.017) more likely to provide oral health support. Results showed the provision of oral health support was most strongly associated with self-rated knowledge and confidence (OR 4.089, 95% CI 1.629–10.263, p = 0.003) and attitudes to oral health promotion (OR 3.906, 95% CI 1.77–8.65, p = 0.001).ConclusionThe results of this study suggest that mental health support workers who have more positive attitudes to oral health promotion and who have higher self-rated oral health knowledge and confidence are more likely to provide oral health support in their professional role. Training for community mental health professionals is essential to build confidence and skills to promote oral health for mental health consumers.

Assessing the Acceptability, Feasibility and Sustainability of an Intervention to Increase Detection of Domestic Violence and Abuse in Patients Suffering From Severe Mental Illness: A Qualitative Study.

Rationale: Despite interventions to improve detection rates, domestic violence, and abuse (DVA) remains largely undetected by healthcare services. We therefore aimed to examine the acceptability, feasibility, and sustainability of an intervention aiming to improve DVA detection rates, which included a clear referral pathway (i.e., the BRAVE intervention) and to explore the acceptability and feasibility of DVA management and referrals in general, in the context of low detection rates.Methods: Qualitative study design with four focus groups of 16 community mental health (CMH) clinicians from both control and intervention arms. The focus groups discussed managing DVA in clinical practice and staff experiences with the BRAVE intervention in particular. Focus groups continued until saturation of the subject was reached. Interviews were analyzed using a thematic analysis approach.Results: DVA was seen to be highly relevant to mental healthcare but is also a very sensitive subject. Barriers in CMH professionals, institutions, and society meant CMH professionals often refrained from asking about DVA in patients. Barriers included communication difficulties between CMH professionals and DVA professionals, a fear of disrupting the therapeutic alliance with the patient, and a lack of appropriate services to help victims of DVA.Conclusion: The BRAVE intervention was acceptable but not feasible or sustainable. Personal, institutional, and public barriers make it not feasible for CMH professionals to detect DVA in mental healthcare. To increase the detection of DVA, professional standards should be combined with training, feedback sessions with peers and DVA counselors, and routine enquiry about DVA.Clinical Trial Registration: ISRCTN, trial registration number: ISRCTN14115257.

The future of community psychiatry and community mental health services.

The aim of this article is to provide a framework and analysis of a series of critical components to inform the future design, development, sustaining, and monitoring of community mental health services. Many mental health services remain too hospital-centric, often without adequate outreach services. On the basis of outcome evidence, we need to shift the balance of mental health services from hospital-centered with community outreach when convenient for staff, to community-centered and mobile, with in-reach to hospital only when necessary. Too few training programs those with emphasize the macroskills of public advocacy, working with service users, families, social movements, and the media to improve mental health and wellbeing of regional and local communities. We should adopt a health ecosystems approach to mental healthcare and training, encompassing nano to macrolevels of service in every region. Catchment mental health services should be rebuilt as community-centric mental health services, integrating all community and inpatient components, but led and integrated from community sites. Community psychiatrists and mental health professionals of the future will need to be well trained in the nano to macroskills required to take responsibility for the mental health and wellbeing of their catchment communities and to provide leadership in service-planning, management, and continuing revision on the basis of rigorous evaluation. These approaches should be the core of all training in psychiatry and all mental health professions prior to any subspecialization.

Predictors of personal accomplishment among the professionals working in community mental health settings

Background: Community mental health professionals experience personal accomplishment as a result of emotional stressors and deficiency of perceived personal accomplishment. The purpose of this study was to measure the levels of personal accomplishment, their correlation with the levels of social support and psychological disorders, and whether social support and psychological disorders can act as factors of personal accomplishment among professionals working in community mental health settings. Methods: In this cross-sectional study conducted in 2018, 80 professionals working in community mental health settings from the Association for Regional Development and Mental Health completed three scales: the Multidimensional Scale of Perceived Social Support, the General Health Questionnaire-28 (GHQ-28), and the subscale “Personal Accomplishment” of the scale Maslach Burnout Inventory to measure social support, psychological disorders, and personal accomplishment, respectively. The technique of convenience sampling was applied. The statistical analysis was performed via the IBM statistical package for the social sciences version 22.0. The statistical significance level was set up at 0.05. Results: The levels of personal accomplishment were low (Mean: 9.85, Standard Deviation: 5.9). No statistically significant effect of social support and psychological disorders on personal accomplishment was revealed among professionals working in community mental health settings. However, a statistically significant effect of “Social Dysfunction” (F = 4.564, p = 0.036)—as a dimension of psychological disorders—on personal accomplishment was found. Also, low correlations between Personal Accomplishment and the dimensions of GHQ-28 “Social Dysfunction” (r = 0.235, p = 0.018) and “Severe Depression” (r = 0.202, p = 0.036) were observed. Conclusions: Personal accomplishment does not seem to be influenced by social support or psychological disorders. However, social dysfunction seems to have a significant impact on personal accomplishment. Therefore, further research should be conducted in order to investigate potential buffering coping mechanisms of personal accomplishment, and in turn, burnout among mental health professionals.

Quality of life and its social determinants forpatients with schizophrenia and family caregivers in Cambodia.

Due to inadequate human and financial resource support, the development of mental health services in Cambodia has been undertaken by various non-governmental organizations (NGOs). Schizophrenia is the most common functional psychotic disorder, causing severe and chronic symptoms, and the programs provided by the NGOs should have enhanced the quality of life (QoL) of patients and their caregivers; however, epidemiological research, which is a driving force behind the recognition of mental health as a global public health concern, is lacking for schizophrenia in Cambodia. This study therefore aimed to create QoL evaluation questionnaires available in Khmer (the Cambodian language) for patients with schizophrenia and family caregivers, and to identify the social determinants and predictors of their QoL. This cross-sectional study recruited 59 patients and 59 caregivers attending three clinics operated by two NGOs: the Transcultural Psychosocial Organization (TPO) Cambodia and the Supporters for Mental Health (SUMH) Cambodia. We conducted linguistic validation of the Schizophrenia Quality of Life Questionnaire 18-item version (S-QoL 18) and the Schizophrenia Caregiver Questionnaire (SCQ), then analyzed correlations between the QoL dimensions and socio-demographic factors. The main findings of this study were as follows: 1) the newly created Khmer versions of S-QoL 18 and SCQ are relatively good psychometric tools that are suitable for research to identify patients’ and caregivers’ needs to improve their QoL; and 2) engaging in paid work or being of the post-Khmer Rouge generation results in higher QoL for patients, but having low household economic status or being affected by chronic disease leads to lower QoL for family caregivers. These findings are useful for enabling community mental health professionals and aid organizations to create programs to lessen the patient and caregiver burden in Cambodia. Further research is necessary to develop practical projects that will improve patients’ and caregivers’ QoL in various clinical settings in Cambodia.