Competence In Mental Health Care Research Articles

Conceptualizing healthcare professionals’ relational competence in mental healthcare: An integrative review

IntroductionThe relationship between patients and mental health professionals is the cornerstone of all mental health treatment, and good patient-professional relationships are associated with several positive therapeutic outcomes for patients with mental health challenges. Mental health professionals’ relational competence is essential for high-quality services in mental healthcare. There is currently no unified understanding of the concept of relational competence. This study seeks to address this gap by exploring how relational competence is conceptualized within the context of mental healthcare. The research question was: How is relational competence described in the research literature within the context of mental healthcare? MethodsAn integrative review was conducted with systematic searches in the databases PsycInfo, Ovid Medline, Embase, CINAHL, ERIC, Academic Search Elite, IDUN, and Svemed+, spanning from January 2012 to October 2023, as well as hand searches in the reference lists of the included studies. A thematic synthesis was carried out based on the results in the included studies. ResultsOut of 2476 scientific studies screened, 30 were included, employing a variety of research methodologies to explore relational competence within mental healthcare. Four themes were found to describe relational competence in mental healthcare: having the ability to self-reflect and self-regulate, having a genuine interest in understanding the patient, engaging in reciprocal interaction with the patient, and meeting the patient so that they feel acknowledged. Each theme describes a central and important part of relational competence, but fully developed relational competence must be understood as a whole in which all the themes are present. ConclusionRelational competence in mental healthcare incorporates all the identified components. Each theme complements the others and contributes to the construction of a strong therapeutic relationship between patients and mental health professionals. To provide the best possible care for mentally ill patients, healthcare professionals must embrace and integrate these elements into their practice.

Evaluating the Organizational Cultural Competence of a Clinical Psychology Training Clinic: Findings and Implications for Training Sites

Canadians from diverse ethnocultural backgrounds have specific mental health needs. Cultural competence in mental health care enhances client satisfaction and improves outcomes for individuals from minority groups. Few studies examine cultural competence at the organizational level. This program evaluation examined organizational cultural competence of a university-based psychology clinic. Surveys were completed by internal stakeholders and clients. Results suggest a high level of commitment to cultural competence among internal stakeholders. Clients reportedly felt welcomed and that their cultural needs were met. Challenges related to cultural competency training, educational opportunities, policies, and procedures will be discussed. Recommendations have implications for psychology clinics.

A Tide of Technical Trends: Technology Competence Among Licensed Counselors

The inclusion of technology in mental health care can revolutionize the accessibility, affordability, and effectiveness of counseling services, while furnishing practical solutions to reduce mental health disparities and meet widening care demands. Steered by the Coalition for Technology in Behavioral Science (CTiBS) telebehavioral health (TBH) competencies, this study employed a descriptive survey design to investigate licensed counselors’ (LCs’) perceived technology competence in mental health care. The following research question steered the study’s exploration: What is the nature of perceived technology competence among LCs? The overarching hypothesis speculated that LCs’ exposure, familiarity, and current utilization of various mental health technologies would impact their perceived competence to integrate technology into their clinical work with clients. A total of 153 respondents completed all survey items. Through descriptive and chi-square analyses, the results illuminated LCs’ perceived technological proficiency. Implications and future study recommendations are detailed.

Perceptions of School Nurses in Addressing Student Mental Health Concerns: An Integrative Review.

Mental health disorders in school-aged children are on the rise. The need for mental health care is well recognized, and the provision of this care in schools is recommended. An integrative review explored how school nurses view their role in addressing students' mental health. Fourteen articles were identified, eleven using a qualitative design and three using a quantitative design. Findings suggest that school nurses see their role as trusted members of the school community. They perceive upholding standards of practice as an integral part of their position and recognize competence in mental health care to be highly important. Practice recommendations include providing school nurses with evidence-based training on managing the mental health needs of students, as well as ensuring access to school nurses who can provide mental health supervision in the community.

Issues of cultural competence in mental health care

As the United States’ population continues to grow in its diversity, health care providers, including pharmacists, need to be able to provide culturally competent care to their patients. Cultural competence allows patients to feel comfortable with their provider and leads to their continuing to seek out care. Mental health is one of the most underused services in health care, particularly in underrepresented minority communities. This review looks at different published literature that assessed the reasons why individuals from minority communities may avoid seeking mental health care, cultural competence in psychiatric care for underrepresented minority communities, strategies for implementation for training providers in cultural competency, and barriers to implementation in mental health services. Current ideas include providing cultural competency training to students in their respective professional school or residency, incorporating the cultural formulation interview into psychiatric sessions, or increasing minority representation in the psychiatric services. On the basis of the literature examined, research is still needed to identify the best approach to improve culturally competent care in psychiatric services in the United States.

Perceived training needs of nurses working with mentally ill patients

Introduction: In Malaysia, nurses form a significant part of the clinical mental health team, but the current level of training in mental health results in suboptimal nursing care delivery. Methods: For this study 220 registered nurses and medical assistants working with the mentally ill completed a structured questionnaire. The purpose of this study was to explore perceived competence in mental healthcare and the training needs of nurses working with mentally ill patients in inpatient mental healthcare facilities. Results: The skills perceived as important for practicing in mental health varied among the nurse participants. Post basic training in mental health was significantly related to perceived competence in patient mental state assessment (p=0.036), risk assessment for suicide (p=0.024), violence (p=0.044) and self-harm (p=0.013). Conclusion: There is little emphasis on psychosocial skills in current post basic mental health training in Malaysia.

Practitioner Narrative Competence in Mental Health Care

This paper aims to develop a model of practitioner narrative competence specifically for mental health care. I begin by considering the status of narratives as a form of evidence. Following Rita Charon and Cheryl Misak, I claim that there is no distinction to be made between evidence-based medicine and narrative medicine. I then explore Charon’s model of practitioner narrative competence, and suggest that it can be fruitfully adapted for mental health care contexts, a project for which I employ Jennifer Radden and John Z. Sadler’s psychiatric ethics. This project brings together two independently promising accounts to develop what I refer to as the adapted model of practitioner narrative competence in mental health care. I argue that this adaptation is necessary because mental health care is a distinct health care setting posing specific challenges. The importance of addressing these challenges can be made clear by considering first-person accounts of those participating in mental health care; here, I give examples in the form of the patient account offered by Michiko Tsukada and the practitioner experience presented by Richard Martinez. I close by considering a possible objection to the adapted model, and suggesting possible ways forward.

A case study of organisational cultural competence in mental healthcare

BackgroundEnsuring Cultural Competence (CC) in health care is a mechanism to deliver culturally appropriate care and optimise recovery. In policies that promote cultural competence, the training of mental health practitioners is a key component of a culturally competent organisation. This study examines staff perceptions of CC and the integration of CC principles in a mental healthcare organisation. The purpose is to show interactions between organisational and individual processes that help or hinder recovery orientated services.MethodsWe carried out a case study of a large mental health provider using a cultural competence needs analysis. We used structured and semi-structured questionnaires to explore the perceptions of healthcare professionals located in one of the most ethnically and culturally diverse areas of England, its capital city London.ResultsThere was some evidence that clinical staff were engaged in culturally competent activities. We found a growing awareness of cultural competence amongst staff in general, and many had attended training. However, strategic plans and procedures that promote cultural competence tended to not be well communicated to all frontline staff; whilst there was little understanding at corporate level of culturally competent clinical practices. The provider organisation had commenced a targeted recruitment campaign to recruit staff from under-represented ethnic groups and it developed collaborative working patterns with service users.ConclusionThere is evidence to show tentative steps towards building cultural competence in the organisation. However, further work is needed to embed cultural competence principles and practices at all levels of the organisation, for example, by introducing monitoring systems that enable organisations to benchmark their performance as a culturally capable organisation.

Cultural competence: definition, delivery and evaluation

It is again suggested that people from black and minority ethnic (BME) communities comprise a disproportionately high percentage of mental health inpatients. Furthermore, the Commission for Racial Equality (CRE) concluded the Department of Health (DH) did not have ‘due regard’ to the Race Equality Duty, retaining major concerns regarding the ability of the DH to ensure future compliance (CRE, 2007). In light of these ongoing problems the DH published a five‐year action plan, Delivering Race Equality (DRE) in Mental Health Care to develop race equality and cultural competence training for mental health practitioners (DH, 2005).A focused review of literature was undertaken, structured around three questions.1. How is cultural competence in mental health care defined?2. How is cultural competence in mental health care delivered?3. How is the delivery of cultural competence in mental health care evaluated?Consensus is lacking on definition of cultural competence and on the sequence of when the components should be acquired, some terms being used interchangeably. It is unclear how cultural competence in mental health care can be delivered. No attempts have been adequately evaluated, particularly by service users (Bhui et al, 2007). More innovative research is needed to develop a consensual definition of cultural competence and to facilitate the delivery and evaluation of such, in ways acceptable to service users and service providers.

Cultural competence in mental health care: a review of model evaluations.

BackgroundCultural competency is now a core requirement for mental health professionals working with culturally diverse patient groups. Cultural competency training may improve the quality of mental health care for ethnic groups.MethodsA systematic review that included evaluated models of professional education or service delivery.ResultsOf 109 potential papers, only 9 included an evaluation of the model to improve the cultural competency practice and service delivery. All 9 studies were located in North America. Cultural competency included modification of clinical practice and organizational performance. Few studies published their teaching and learning methods. Only three studies used quantitative outcomes. One of these showed a change in attitudes and skills of staff following training. The cultural consultation model showed evidence of significant satisfaction by clinicians using the service. No studies investigated service user experiences and outcomes.ConclusionThere is limited evidence on the effectiveness of cultural competency training and service delivery. Further work is required to evaluate improvement in service users' experiences and outcomes.

Competence in Mental Health Care: A Hermeneutic Perspective

In this paper we develop a hermeneutic approach to the concept of competence. Patient competence, according to a hermeneutic approach, is not primarily a matter of being able to reason, but of being able to interpret the world and respond to it. Capacity should then not be seen as theoretical, but as practical. From the perspective of practical rationality, competence and capacity are two sides of the same coin. If a person has the capacity to understand the world and give meaning to the situation, he or she is able to make decisions, and is thus competent. People can fail in the area of practical rationality. They can feel ill at ease, uncomfortable or not at home in the situation. Under such conditions, they appear as incompetent, and urge caregivers to respond in such a way that their competence can be raised. The issue is not how to measure their incompetence, but how to help them to become more competent, that is to get a practical grip on their situation and to be able to live out their lives in such a way that they develop their identity in relations with others. From a hermeneutic point of view, assessing a patient's capacity implies focusing on the patient's way of meaning making and regarding her behavior from the perspective of practical rationality. The focus should not be on the assessment as a matter of fact, but on improving capacity. This requires allowing the patient to experience the world meaningfully and affording her, in the context of a supportive and trustful institutional environment, the possibility of developing a personal narrative where her choices are expressed verbally or non-verbally.