Distribution Of Mental Health Services Research Articles

Effectiveness of Group Activity Therapy: "Family Gathering", to Ensure Family in Caring for Housing Disorders and Preventing Health

Mental health problems in the community originate from three main things. The first is the public's understanding of the lack of knowledge about mental disorders, the second is the stigma about mental disorders that develops in the community and the last is the uneven distribution of mental health services. The purpose of this study was to apply Group Activity Therapy: "Family Gathering", to empower families in dealing with mental disorders at home and preventing relapses. The research method is a quasi-experimental design pre post intervention sample taken from families who have members with mental disorders in the city of Semarang with a total of 30 respondents. The results of the research analysis using the pair T test with statistical test results as follows: the details of the variables before and after the intervention are as follows: knowledge of P value of 0.787 no difference, P value of attitude 0.489 no difference, self-efficacy P value of 0.018 no difference, family role P value 0.000 there is a difference, independence. P value 0.813 no difference. So it can be concluded that the application of Group Activity Therapy: "Family Gathering", to maintain family care in treating mental disorders at home and preventing recurrence, namely from knowledge of attitude and independence there was an increase but not significant with P value > 0.005, while self-efficacy and mentoring family there is a significant difference with the P value <0.05.

Effectiveness of Group Activity Therapy: "Family Gathering", to Ensure Family in Caring for Housing Disorders and Preventing Health

Mental health problems in the community originate from three main things. The first is the public's understanding of the lack of knowledge about mental disorders, the second is the stigma about mental disorders that develops in the community and the last is the uneven distribution of mental health services. The purpose of this study was to apply Group Activity Therapy: "Family Gathering", to empower families in dealing with mental disorders at home and preventing relapses. The research method is a quasi-experimental design pre post intervention sample taken from families who have members with mental disorders in the city of Semarang with a total of 30 respondents. The results of the research analysis using the pair T test with statistical test results as follows: the details of the variables before and after the intervention are as follows: knowledge of P value of 0.787 no difference, P value of attitude 0.489 no difference, self-efficacy P value of 0.018 no difference, family role P value 0.000 there is a difference, independence. P value 0.813 no difference. So it can be concluded that the application of Group Activity Therapy: "Family Gathering", to maintain family care in treating mental disorders at home and preventing recurrence, namely from knowledge of attitude and independence there was an increase but not significant with P value > 0.005, while self-efficacy and mentoring family there is a significant difference with the P value <0.05.

Geospatial attributes in psychogeriatric service delivery in the district of Colombo, Sri Lanka.

Mental health is a neglected area within the healthcare systems in developing nations, including Sri Lanka. However, the rapid population aging and the resulting rise in psychological issues among the elderly are becoming major concerns within the country. Therefore, a proper assessment of distribution of mental healthcare facilities within the country is much needed in reducing the unmet need among people with psychological symptoms. In this study, the distribution of mental health services within the district of Colombo, which is the capital of the country, was assessed. With this view, mapping of mental healthcare services within the district of Colombo was carried out using the Geographic Information System to assess service and human resource availability and physical accessibility to the elderly within the district. Certain deficiencies in availability and accessibility of the services were identified which were more significant toward eastern parts of the district. Establishment of new mental healthcare facilities as well as upgrading of already available centres while ensuring availability of professional human resources to these centres is a timely need.

Clinical psychology service distribution and integration into primary health care in KwaZulu-Natal, South Africa

Inadequate investment in mental health care by the governments of both high- and low-income countries contributes to recurrent challenges of uneven distribution of and access to mental health services between urban and non-urban communities. While recent research has acknowledged the role of mental health in well-being and the cost of failure to invest in the sector, prioritising mental health to the same degree as physical health remains a challenge. This article highlights the unequal distribution of mental health services, and psychological services in particular, in KwaZulu-Natal. This is achieved by considering the background of psychology in South Africa and KwaZulu-Natal and then examining the ratio of clinical psychologists to the KwaZulu-Natal population. Furthermore, the article explores the geographical distribution of psychological services in KwaZulu-Natal and concludes with a discussion of the impact of uneven mental health service distribution on service provision and utilisation in non-urban areas of KwaZulu-Natal.

Geographic distribution of California mental health professionals in relation to sociodemographic characteristics.

To determine whether geographic access to licensed mental health providers in California is a barrier for underserved populations. Data from the master file of the California Board of Psychology and Board of Behavioral Sciences were merged with U.S. Census data to determine the correlations between the concentration of providers and the corresponding sociodemographic characteristics of places in California. This article shows that the concentration of licensed mental health providers in the communities of California varies systematically with the racial, ethnic, age, education, and economic characteristics of those places. Specifically, licensed mental health providers are more concentrated in places that are wealthier, Whiter, older, and more educated. Policy and advocacy efforts in health service psychology can help assure more equitable distribution of mental health services. (PsycINFO Database Record

Lessons from the past: Historical perspectives of mental health in the Eastern Cape

Mental healthcare provision in the Eastern Cape Province is inextricably entwined with the province’s colonial past and, in later years, by the introduction of the policy of apartheid and the Bantustans. These laid the foundation for an inequitable distribution of mental health services in the province. The objective of this article is to provide a background for the historical factors that have had an impact on the provision of public sector mental health services. The archives of the British Medical Journal and the South African Medical Journal and universities in South Africa were accessed to obtain the information presented here. History and geography played a pivotal role in shaping the Eastern Cape first into Bantustans and later the Eastern Cape Province in

Treatment of depressive illness among children and adolescents in the United States

Background Psychotherapy has proven to be an effective treatment modality in children and adolescents with depressive illness. The American Academy of Child and Adolescent Psychiatry advocates the use of selective serotonin reuptake inhibitors (SSRIs) as first-line pharmacotherapy in the treatment of depression without comorbid mental illness. Tricyclic antidepressants (TCAs) are not recommended as first-line treatment because of insufficient evidence of their efficacy in children and adolescents, as well as potential adverse effects. Objective The present study was designed to determine the extent of the use of antidepressant pharmacotherapy and/or psychotherapy among children and adolescents in the United States aged 5 through 18 years with a diagnosis of depressive illness. Methods Using data from the National Ambulatory Medical Care Survey (NAMCS) for 1990 through 1995, office-based physician-patient encounters (ie, office visits) documenting the use of antidepressant pharmacotherapy and/or a recorded diagnosis of depression were obtained. The rate per 1000 office visits for children and adolescents aged 5 through 18 years and the rate per 1000 US population aged 5 through 18 years were calculated for: (1) prescribing of antidepressant pharmacotherapy for any reason; (2) recorded diagnosis of depression with or without comorbid mental illness; (3) diagnosis of depression with or without comorbid mental illness resulting in the prescribing of antidepressant pharmacotherapy; (4) diagnosis of depression without comorbid mental illness; and (5) diagnosis of depression without comorbid mental illness resulting in the prescribing of antidepressant pharmacotherapy. Treatment modalities used in the management of depressive illness (pharmacotherapy, psychotherapy, both, or neither) are reported as percentages of the total number of office visits for the 1990–1992 period and for 1995 (the years for which data on the use of psychotherapy were recorded in the NAMCS). Results Between 1990 and 1995, an estimated 4,638,608 office visits documented the prescribing of antidepressant pharmacotherapy for any reason in children and adolescents aged 5 through 18 years (9.0 per 1000 encounters; 15.3 per 1000 population). The majority of encounters (58.2%) documented the prescribing of a TCA. The rate of a documented diagnosis of depression with or without comorbid mental illness was 8.0 per 1000 encounters and 13.6 per 1000 population. The rate for a documented diagnosis of depression with or without comorbid mental illness, in concert with the prescribing of antidepressant pharmacotherapy, was 3.9 per 1000 encounters and 6.6 per 1000 population. The rate for a documented diagnosis of depression without comorbid mental illness was 5.1 per 1000 encounters and 8.7 per 1000 population. The rate for a documented diagnosis of depression without comorbid mental illness, in concert with the prescribing of antidepressant pharmacotherapy, was 2.6 per 1000 encounters and 4.4 per 1000 population. Of the 1,327,466 patients with a recorded diagnosis of depression without comorbid mental illness who were prescribed antidepressant pharmacotherapy, 54.9% received an SSRI, and 39.8% a TCA. During the 1990–1992 period and in 1995, the modality of treatment for patients with a documented diagnosis of depression without comorbid mental illness was antidepressant pharmacotherapy alone in 12.7% of patients, psychotherapy alone in 31.8%, psychotherapy and antidepressant pharmacotherapy in 36.0%, and neither psychotherapy nor antidepressant pharmacotherapy in 19.5%. Conclusions The use of psychotherapy and antidepressant pharmacotherapy for the treatment of depressive illness in US children and adolescents is extensive. The use of the TCAs in patients with a documented diagnosis of depression without comorbid mental illness is widespread even though this drug class is not recommended as first-line therapy in this population. Approximately 19% of children and adolescents with a recorded diagnosis of depressive illness received neither psychotherapy nor pharmacotherapy. This finding may reflect problems associated with access to health insurance, the coverage of mental health services under insurance policies, geographic distribution of mental health services, and/or decisions by patients or guardians.

Resource distribution in mental health services: changes in geographic location and use of personnel in Norwegian mental health services 1979-1994.

BACKGROUND: During the last decades, a central aim of Norwegian health policy has been to achieve a more equal geographical distribution of services. Of special interest is the 1980 financial reform. Central government reimbursements for the treatment of in-patients were replaced by a block grant to each county, based on indicators of relative "need". AIMS OF THE STUDY: The aim of this paper is to assess whether the distribution of specialized mental health services did take the course suggested by the proponents of the reform (i.e. a more equal distribution), or the opposite (i.e. a more unequal distribution) as claimed by the opponents. METHODS: Man year per capita ratios were used as indicators for the distribution of mental health services by county. Ratios were estimated for "all personnel", and for MDs and psychologists separately. Man years were assigned to counties by location of services (i.e. in which county the services were produced), and by residence of users (i.e. in which county the services were consumed). Indicators of geographic variation were estimated using the standard deviation (STD) as a measure of absolute variation, and the coefficient of variation (CV) and the Gini index as indicators of relative variation. Indicators were estimated for 1979, 1984, 1989 and 1994, based on data for all specialized adult mental health services in the country. Changes in distributions over the period were tested, using Levene's test of homogeneity. RESULTS: Relative variations in the distribution of personnel by location of services were substantially reduced over the period, the CV being reduced by more than 50% for all groups. Variations in the personnel ratios by residence of users were smaller at the start of the period, and the reductions were also smaller. Still, relative variations were reduced by 20-35, 40 and 60% approximately for "all personnel", MDs and psychologists respectively. In spite of a major increase in the supply of MDs and psychologists, absolute variations in the personnel ratios were in all cases either reduced, or fairly stable. These results give little support to the views expressed by the opponents of the 1980 reform, although the main result seems to have been relocations in the production of services, more than re-distributions in the consumption of services. DISCUSSION: These results can be seen as a result of three aspects of the reform: 1 Distributing government grants to counties in their capacity as users of services rather than producers of services. This shift has primarily facilitated relocations in the production of services. 2 Relocation of services was also expected to produce a more equal distribution in the use of services, since reduced distances would increase accessibility. This, however, was counteracted by increased county control with use of services in other counties. 3 Distribution of grants based on "needs" rather than services produced was expected to produce a more equal distribution in the use of services. This effect seems to have been less than expected, probably because counties with high reimbursements under the old system also provided services to people from other counties. Other policy reforms have, however, contributed to the results. These reforms include increased supply of personnel, de-institutionalization of services, regionalization/sectorization of services, and the establishment of smaller psychiatric units in general hospitals. POLICY IMPLICATIONS: In recent years the 1980 reform has been under attack; partly due to alleged inequalities created by the system. As a result of the critique, government reimbursements for in-patient treatment have been reintroduced for general hospital services. In mental health services, more resources are distributed to specific projects. According to this study, this shift in policy is based on faulty premises and might lead to greater inequalities in the future.

AB 3632 mental health entitlement for special education students in California: aspects of the Los Angeles experience.

California Assembly Bill (AB) 3632, passed in 1984, ushered in an era of entitlement to mental health services for schoolchildren with serious emotional disturbances. This article examines the development of the law, the children's public mental health context in Los Angeles County, and the significant impact of the legislation on distribution of mental health services in Los Angeles County and in one Los Angeles area community mental health center. Countywide and agency data are presented that document AB 3632 and regular mental health service provision differences in gender, age, ethnic, income, and language domains and, at the agency level, an increasing proportion of AB 3632 clients. Implications of AB 3632 service provision in relation to provision of mental health services to children in general are reviewed.

The distribution of mental health services within NHS trusts

From April 1994, over 95% of health care services will be provided by NHS trusts. Mental Health services have a choice of remaining within the acute hospital trust or forming part or all of a community trust. Using data from trust directories, the distribution of mental health services within the first three trust waves is described. Forty per cent of acute hospital trusts currently do not include mental health services. Unlike other specialities, a significant proportion of mental health services are choosing to form specialist mental health trusts. The implications of the alternative trust arrangements for psychiatry are discussed.