Use Of Community Mental Health Services Research Articles

Exploring community mental health service use following hospital-treated intentional self-harm among older Australians: a survival analysis.

This study aimed to examine the impact of community mental health (CMH) care following index hospital-treated intentional self-harm (ISH) on all-cause mortality. A secondary aim was to describe patterns of CMH care surrounding index hospital-treated ISH. A longitudinal whole-of-population record linkage study was conducted (2014-2019), with index ISH hospitalization (Emergency Department and/or hospital admissions) linked to all available hospital, deaths/cause of death, and CMH data. Australia's most populous state, New South Wales (NSW) comprised approximately 7.7 million people during the study period. CMH services are provided statewide, to assess and treat non-admitted patients, including post-discharge review. Individuals with an index hospital presentation in NSW of ISH during the study period, aged 45 years or older. CMH care within 14 days from index, versus not. Cox-proportionate hazards regression analysis evaluated all-cause mortality risk, adjusted for relevant covariates. Totally, 24,544 persons aged 45 years or older experienced a nonfatal hospital-treated ISH diagnosis between 2014 and 2019. CMH care was received by 56% within 14 days from index. Survival analysis demonstrated this was associated with 34% lower risk of death, adjusted for age, sex, marital status, index diagnosis, and 14-day hospital readmission (HR 0.66, 95% CI 0.58, 0.74, p < 0.001). Older males and chronic injury conveyed significantly greater risk of death overall. CMH care within 14 days of index presentation for self-harm may reduce the risk of all-cause mortality. Greater effort is needed to engage older males presenting for self-harm in ongoing community mental health care.

Perceptions of community mental health services among culturally diverse adult Singaporeans with major depressive disorder: A descriptive qualitative study.

Persons with major depressive disorder (PMDDs) often experience pernicious ramifications on the biopsychosocial aspects of their health. While community mental health services (CMHSs) in Singapore are increasingly leveraged to meet the escalating demand for mental healthcare, shortcomings such as a substantial treatment gap and the lack of holistic, culturally sensitive care have been highlighted. Of note, the perspectives of the service users, which have hardly been studied in the literature, are crucial to our understanding of their needs to continuously improve CMHSs. Accordingly, this qualitative descriptive study explored the perceptions and experiences of community-dwelling adults with major depressive disorder in their use of CMHSs in Singapore. Seventeen adults with major depressive disorder purposefully sampled from a CMHS providerwereinterviewed through a semi-structured guide between October and November 2021. Data analysis via Braun and Clarke's six-step thematic framework yielded five themes corresponding to three different phases: pre-CMHS encounter ((i) procrastination to seek help and (ii) factors influencing CMHS utilization); intra-CMHS encounter ((iii) incongruous perceptions of the impacts on biopsychosocial health and (iv) differing perceptions and experiences of culturally sensitive care); and post-CMHS encounter ((v) enhancing CMHSs for PMDDs based on end-users' experiences). Our findings underscore the need to improve the delivery of personalized mental healthcare services, use of settings- and culturally-specific anti-stigma strategies, and nationwide mental health literacy in symptom recognition and awareness of help-seeking resources.

Racial Disparities in Community Mental Health Service Use Among Juvenile Offenders.

Investigate differences in community mental health service utilization by race among a sample of juvenile offenders in the time surrounding adjudication for a serious offense. It was predicted that racial minority youth would demonstrate lower utilization of these services. The Pathways to Desistance data were used in analyses. This consisted of the responses of 1354 juvenile offenders. Wave 1 of the data was used in analyses. Logistic regression models were used to examine the relevance of racial identification and control covariates for predicting odds of receiving community mental health services during the prior 6months. Results indicate that Black youth had lower odds of receiving all types of community mental health services, relative to White participants. Hispanic juvenile offenders had lower odds of receiving several types of services also, relative to White juvenile offenders. Findings indicate that minority justice-involved youth utilize community mental health services in the time surrounding adjudication at lower rates than White juvenile offenders do, a net of all effects. This may be indicative of additional barriers to service use and possible institutionalized racism which restrict mandating of services which may reduce mental health symptom severity and risk for recidivism among minority juvenile offenders.

Pre‐sentence mental health service use by adult offenders in Western Australia: Baseline results from a longitudinal whole‐population cohort study

Little is known about community mental health service use prior to offending. This study aimed to investigate the 1-year community mental health service use by adult offenders (18-44 years) prior to their first ever criminal sentence in Western Australia. Administrative mental health service data were compared between all offenders (n = 23,755) commencing their first ever criminal sentence in Western Australia during 1985-1994 and a matched community group of 21,977 non-offenders. Just over 8% of offenders had used mental health services prior to sentence compared with 1% of non-offenders. After adjusting for age, offenders were more likely to have used these services than non-offenders in all gender-race groups, but the effect was strongest for non-Indigenous women, who were over 12 times more likely to have used such services, and weakest among Indigenous men, who were about twice as likely to have used them as their non-offending peers. Service use for substance use disorder, the most common diagnosis, was about one and a half times more prevalent among Indigenous than non-Indigenous offenders, regardless of gender. For non-Indigenous offenders, prevalence of any mental health service contact was higher for violent than non-violent offenders, irrespective of gender. Service use was no different between offenders receiving custodial or non-custodial sentences in all gender-race groups. The higher likelihood of mental health service use by offenders in the year prior to their first ever sentence than by non-offenders suggests that, insofar as the disorder was relevant to offending, there were some opportunities for preventive measures during that time. Differential service use according to gender and Indigenous/non-Indigenous status is of concern. It would be important to understand more about this apparently unequal service access, not least because Indigenous populations tend to be over-represented in prison.

Community mental health service use by older adults with dementia.

Community mental health service use by older adults with dementia.

Community mental health service use by older adults in California

The objective of this research was to examine older Californians who used county mental health services between 1999 and 2002. We estimated treated prevalence rates, identified repeat service users, depicted service mix patterns and tested for differences among these service process outcomes. We observed 36,230 older Californians who used at least one service between 1999 and 2002. Logistic regressions estimated the effects of time, geographic region, age, diagnosis and insurance status on service process outcomes across 49 county mental health departments. The number of older adults who used services increased significantly during the observation period. Odds of accessing care were higher in the state's northern region, for those diagnosed with mood disorders and Medi-Cal beneficiaries. Repeat service use increased over time, and odds were higher for mood disorders and Medi-Cal beneficiaries. Odds of one-time service use were higher for persons with dementia and other psychiatric diagnoses; mood disorders and Medi-Cal beneficiaries had higher odds of consistent and continuous service use. The counties entered a period of diversification between 1999 and 2002, and varied significantly across treated prevalence rates, service continuity and service mix patterns. We considered how these differences may relate to administrative polices, service management practices, local market conditions and individual characteristics, and called for future research to determine how the public mental health system can assume a more critical role in providing care to older adults.

Who Gets Care? Mental Health Service Use Following a School-Based Suicide Prevention Program

To examine symptomatology and mental health service use following students' contact with a large urban school district's suicide prevention program. In 2001 school district staff conducted telephone interviews with 95 randomly selected parents approximately 5 months following their child's contact with the district's suicide prevention program, a School Gatekeeper Training model. Parents provided information regarding service use, their child's depressive symptoms (using the Diagnostic Interview Schedule for Children Predictive Scale, Depression module), and their perceptions of their child's need for services. Information about the crisis intervention was abstracted from a standardized assessment form. More than two thirds of students received school or community mental health services following contact with the suicide prevention program. Depressive symptoms, but not past year suicide attempt, predicted community mental health service use. Latino students had lower rates of community mental health service use than non-Latinos. School-based service use did not differ by student characteristics including race/ethnicity. Most students identified by a school-based suicide prevention program received follow-up care, although Latinos were less likely to access services outside the school. School-based mental health services may be an important way in which underserved populations at risk of suicide can receive care.

Impact of mental health reform on service use

This article will explore the impact of early implementation of mental health reform on community mental health service use by clients. The results from a review of agency charts for mental health clients are reported. Service use for all clients in the sample, for elderly clients, for ethnic minority clients, and for clients who are chronically mentally ill was compared for a 3-month period prior to implementation of the mental health reform and a 3-month period subsequent to reform. The following questions were addressed: (a) Did use of case management services increase in comparison to day treatment and individual therapy services? (b) Did use of medication management services increase? (c) Did use of vocational services increase? (d) Did use of crisis services increase? (e) Did use of substance abuse services increase? (f) Following implementation of the mental health reform, were clients more likely to receive a wider range of services than prior to reform?