Field Of Mental Health Care Research Articles

Consensus development of priority outcome domains for community mental health cares by multiple stakeholders: Protocol for an online Delphi study in Japan.

BackgroundTreatment goals for mental illness have expanded from hospital discharge and improved functioning to employment, living alone, and personal realization. These changes in treatment goals have also influenced mental health research. Recent studies have addressed the development of core outcome sets focusing on clinical aspects of mental illness such as depression and anxiety. However, a well‐developed framework of essential outcomes for people with mental illness (service users) who live in the community is lacking. In addition, recent worldwide trends suggest more patient and public involvement and the importance of considering multiple stakeholders’ views in the area of mental health research. Purpose of this study is to explore consensus on high‐priority outcome domains among multiple stakeholders in community mental healthcare fields in Japan.MethodsA three‐step approach to developing an outcome list will be used. First, we developed a long list of outcomes for community mental health through a literature review, focus group interviews with key stakeholders, and online questionnaire surveys of service users and caregivers. Second, the long list was checked and revised in a pilot study. Third, the long list will be shortened to the outcome list through the Delphi methodology with participation from multiple stakeholders.DiscussionIdentifying important common outcome domains through collaboration with multiple stakeholders appears to contribute to the development of evidence for community mental health research in Japan. In addition, the study process itself may help promote patient and public involvement in education, practice, and research in the field of community mental health.

Nutrition, Exercise, and Stress Management for Treatment and Prevention of Psychiatric Disorders. A Narrative Review Psychoneuroendocrineimmunology-Based

Psychoneuroendocrineimmunology (PNEI) brings together knowledge acquired since the 1930s from endocrinology, immunology, neuroscience, and psychology. With PNEI, a model of research and interpretation of health and disease is emerging, which sees the human body as a structured and interconnected unit, where the psychological and biological systems are mutually coordinated. In the PNEI view, many factors could influence mental health, with the endocrine system involved in mediating the effects of environmental stress on mental health and inflammation in the onset and course of psychiatric disorders as a result of individual and collective conditions and behaviors. Among these, nutrition is one way by which the environment impacts physiology: indeed, many pieces of research showed that several elements (e.g., probiotics, fish oil, zinc) have a positive effect on mental disorders thus being potentially augmentation agents in treatment. Still, physical activity can moderate depressive symptoms, while prolonged stress increases the risk of psychopathology. Taken together, the PNEI-based approach may inform prevention and treatment strategies, also in the field of mental health care.

Professionals' understanding of their responsibilities in the collaboration with family caregivers of older persons with mental health problems in Norway.

Research has highlighted the importance of health and social care professionals' collaboration with family caregivers. In the field of mental healthcare, involvement of family members is perceived as beneficial to the recovery process of the care recipient. Furthermore, family care-giving is an essential part of elderly care. It is well documented that family members need support to prevent negative consequences of care-giving. Nevertheless, involvement of and support for family caregivers have not developed into a common practice, and research has identified professional barriers to collaboration with family caregivers in several areas. The aim of this study was to explore professionals' experiences of collaboration with family caregivers of older persons with mental health problems, and how they understood their responsibility towards families. We conducted three focus group interviews with 18 health and social care professionals working in community-based services, in three rural municipalities in Western Norway. The thematic analysis by Braun and Clarke guided the analysis. The findings in relation to the professionals' role and responsibility towards family caregivers are presented in three themes: family caregivers - a resource that needs support; a responsibility with unclear boundaries; and balancing different needs. Professionals recognised family caregivers' need for support and acknowledged the importance of family relationships. However, they experienced dilemmas in performing their dual responsibility of caring for the older care recipient as well as the family member, which they described as having unclear guidelines. They also experienced that they had insufficient knowledge to take on this responsibility. We argue that the exercising of discretion is essential for the professionals' responsibility, and that clarification of their responsibility is needed. We recommend a stronger focus in education on developing competence in the family perspective. Furthermore, the apportionment of professionals' responsibility needs to be formalised, especially when several services are involved in providing care.

Supported Employment, Participation at Work, and Peer Support: A Qualitative, Participatory Case Study Report of the Geesthacht Model.

Background: For people who have experienced mental health crises or psychosocial disabilities, it is considerably more difficult to receive support to participate in work on an equal basis with others. In the town of Geesthacht, in Northern Germany, an integrative care network was implemented that allows for acute psychiatric treatment as well as participation in work and activities. This paper aims to explore the principles, advantages, and challenges of this innovative project.Methodology: Within the context of a participatory and collaborative process evaluation of a prospective controlled cohort study (PsychCare), researchers with and without experiential expertise conducted expert interviews and focus groups to evaluate the experiences of 37 employees, with and without lived experience, from various institutions associated with this care network. The data was analyzed using qualitative content analysis.Results: It was the change from financial compensation paid on a daily basis to a global treatment budget that allowed for a significant reduction of hospital beds in Geesthacht and freed up resources to implement a complex care network. Since then, various possibilities for participation, work, and activities for former service users, some of which are compensated financially, have been made available. These developments now allow for a less bureaucratic and often smooth transition from being a service user to involvement in participatory activities in the role of a peer, which is frequently perceived to be empowering and beneficial by participants with lived experience. At the same time, this care model has led to multiple role conflicts and different challenges for all parties involved.Conclusion: This innovative project in Geesthacht demonstrates the multifaceted potential of a global treatment budget system in the field of mental health care. To address certain downsides of the Geesthacht model, further development is necessary.

Organizing as negotiation: the construction of a pathway in Norwegian mental health services

BackgroundIn 2015, a decision was made to implement clinical pathways in Norwegian mental health services. The idea was to construct pathways similar to those used in cancer treatment. These pathways are based on diagnosis and evidence-based medicine and have strict timeframes for the different procedures. The purpose of this article is to provide a thorough examination of the formulation of the pathway “mental illness, adults” in Norwegian mental health services. In recent decades, much research has examined the implementations and outcomes of different mental health sector reforms and services in Western societies. However, there has been a lack of research on the process and creation of these reforms and/or services, particularly how they emerge as constructs in the contexts of policy, profession and practice.MethodsA qualitative single case study design was employed. A text and document analysis was performed in which 52 articles and opinion pieces, 30 public hearing responses and 8 political documents and texts were analysed to identify the main actors in the discourse of mental health services and to enable a replication of their affiliated institutional logics and their views concerning the clinical pathway. Additionally, ten qualitative interviews were performed with members of the work group responsible for designating the pathway “mental illness, adults”.ResultsThis article shows how the two main actor groups, “Mental health professionals” and “Politicians”, are guided by values associated with a specific logic when understanding the concept of a clinical pathway (CP). The findings show that actors within the political field believe in control and efficiency, in contrast to actors in mental health services, who are guided by values of discretion and autonomy. This leads to a debate on the concept of CPs and mental health services. The discussion becomes polarized between concern for patients and concern for efficiency. The making of the pathway is led by the Directorate of Health, with health professionals operating in the political domain and who have knowledge of the values of both logics, which were taken into consideration when formulating the pathways, and explains how the pathway became a complex negotiation process between the two logics and where actors on both sides were able to retain their core values. Ultimately, the number of pathways was reduced from 22 to 9. The final “Pathway for mental illness, adults” was a general pathway involving several groups of patients. The pathway explains the process from diagnosis through treatment and finalizing treatment. The different steps involve time frames that need to be coded, requiring more rigid administrative work for compliance, but without stating specific diagnostic tools or preferred treatment strategies.ConclusionsThis article shows that there is also a downside of having sense making guided by strong values associated with a specific institutional logic when constructing new, and hopefully better, mental health care services. This article demonstrates how retaining values sometimes becomes more crucial than engaging in constructive debates about how to solve issues of importance within the field of mental health care.

COVID-19 IMPACT: NEW TENDENCIES AND TRENDS IN MENTAL HEALTH RESEARCH

The aim: To provide an analysis of contemporary investigations in the area of Mental Health Care for the individual \ population; to define the main trends, tendencies, key concepts of these investigations during \ after Covid -19 pandemic and established restrictions. Materials and methods: A literary review (163 research publications totally) of relevant articles was performed (a scoping review method) based on the followings criteria: publication year (2020-2021), publication source (only PubMed and Open Access), mental health issues in regards of individual \ population. We used “mental health,” “covid19 mental health”, “impact of covid 19 on mental health,” and “covid 19 mental health impact” keywords for searching related research papers in the Pubmed database. Additionally, the clinical case of social restrictions’ impact on a patient’ mental health is described. Conclusions: The main trends of modern research are determined by: the search for more modern scientific terms and categories (E – Mental Health, digital Mental Health, Tele-Mental Health, etc.); study of risks and benefits of widespread use of virtual and information technologies in the field of Mental Health Care; diagnosis and treatment of new mental health disorders; reassessment of traditional values, active search for new meanings in the field of interpersonal and intergroup relationships; development of health-responsive economy and health-responsive society

Utilization of Art Therapy with Children with ADHD Co-Morbid Intellectual Disability for Decreasing Inattention

The research aimed to examine the positive role art therapy could play in improving the attention span of children with Attention-Deficit/Hyperactivity Disorder co-morbid Intellectual Disability in the context of Karachi (Pakistan). The key presumption was that art therapy can help in decreasing inattention among the children with ADHD co-morbid Intellectual Disability. Purposive sampling was used for the selection of cases from schools in Karachi (Pakistan) which are offering educational services to the children with special needs. The sample comprised 14 children, ages 6 to 12 years (mean age= 7.391; SD = 1.315) with ADHD co-morbid Mild ID. Experimental design was adopted for carrying out the investigation, entailing the division of the sample into the treatment group (which received 25 art therapy sessions as a form of intervention) and control group (which was provided with regular classroom activities). The allocation of children to both groups was carried out through the ABBA technique as well as the use of observation. The tools of the Attention Deficit Hyperactivity Disorder test were used to gauge the differences in the level of inattention in both groups. Analysis of data was conducted through SPSS version 17.0, using descriptive statistics to examine the pattern of data as well as identify the level of effectiveness of art therapy through administering the Wilcoxon test. The findings of the study support the assumption that art therapy is useful for curtailing impulsiveness in children with ADHD. Therefore, it can be concluded that art therapy is likely to bring positive changes in the level of attention in children with ADHD co-morbid ID. The study carries implications for individuals practicing in the field of mental health care and special education.

Telepsychiatry and the Role of Artificial Intelligence in Mental Health in Post-COVID-19 India: A Scoping Review on Opportunities.

Background:COVID-19 has a profound impact on people with existing mental disorders, augmenting the prevailing inequalities in mental health.Methods:In order to understand the status of telepsychiatry in India and the role of artificial intelligence (AI) in mental health and its potential applications, a scoping review was done between March 2020 and May 2020. The literature review revealed 253 papers, which were used to derive the primary framework for analysis. The information was then reviewed for ideas and concepts, which were integrated with evidence from gray literature and categorized under broader themes based on the insights derived. Finally, a thematic framework was developed for discussion to tailor scientific information for decision-makers’ needs.Results:Review findings are summarized under the following headings: changing patterns of health-seeking behavior, origin and evolution of telepsychiatry, possible applications of telepsychiatry and AI, technological features, and AI models in mental health.Conclusions:Though there are several potential opportunities, the time is not yet ripe for telepsychiatry and AI to be adopted fully in the field of mental health care. But it is time that we develop indigenous proprietary technology and test and validate it. With many solutions offered by telepsychiatry and AI, psychiatrists must choose an appropriate tool based on their requirements, availability of resources, and feasibility of deployment. Harmony between conventional care and technology-based care must be reached gradually.

Подготовка волонтеров в сфере охраны психического здоровья (опыт социологической оценки эффективности мероприятий в рамках социального проекта «Здоровье души»)

The topic of mental health in the conditions of modern society is becoming more and more urgent due to constant social changes, active migration processes, strict requirements to educational and professional activities of a personality, spread of unhealthy lifestyle among the population. Most mental disorders of personality are based on spiritual diseases, so it is the Church that pays increased attention to the spiritual, mental and body components of personality. Volunteers help to cope with mental illness and maintain peace of mind. After all, the development of volunteer work as a voluntary form of social service, aimed at providing free assistance to people, associated with the adoption of Christianity in Russia. The ‘Soul health social project: training Orthodox volunteers in the field of mental health care’ won the international grant competition ‘Orthodox Initiative 2018–2019’. A working group of the sociological laboratory of Smolensk State University organized and conducted a comprehensive study of the effectiveness of the project activities in the training of Orthodox volunteers. The study used quantitative and qualitative methods of sociology: questionnaires, expert evaluation method, in-depth interview method. Four types of tools were developed to measure the effectiveness of activities in achieving the project goal. The sociological assessment made it possible to determine the effectiveness and prospects of the project activities for the development of confessional-oriented volunteer activities in the field of mental health care.

Coherence in intersectoral collaboration between psychiatric centres and community mental healthcare: A critical discourse analysis

There is scarce research studying healthcare professionals’ and users’ perceptions in relation to creating coherence in intersectoral collaboration between psychiatric centres and community mental healthcare. Drawing on the discourse analysis framework of Fairclough, this study aimed to explore how healthcare professionals and users could perceive coherence in intersectoral collaboration between psychiatric centres and community mental healthcare. But also to explore their perception of how coherence could be maintained through an intersectoral journey, and what discourses manifested themselves within the field of mental healthcare. Data were collected through 11 focus group interviews, five of which with healthcare professionals ( n = 20) and six with users ( n = 18). Fairclough’s three-dimensional model for the studying of discourse was used to analyse the transcribed texts. This study is reported in accordance with the COREQ checklist. Coherence in intersectoral collaboration was interpreted to exist in tension between being predominantly steered by the healthcare professionals while the users had a desire to be more involved in decisions regarding their own intersectoral journey. The users were subjected to a paternalistic steering, expressed by the power of the healthcare professionals to select the right efforts as well as the purpose of the users’ journeys. The findings showed that coherence in intersectoral collaboration in general was articulated from an overall discourse of neoliberal governance, with its embedded discourses of rationality and structure, and discourses of linearity, objectivity, paternalism, biomedicine and evidence have a controlling influence on how users should guide themselves based on the discourse of self-care.

Utilizing games in the co-production of mental health services

This study analyses the application of a co-production approach in utilizing digital games and game-related methods in mental health services. The goal is to offer a real-world experiment on co-production, focusing on mental health service users, active gamers and mental health practitioners who worked together in equal ways and valued each other’s unique contributions during the experiment. The implications of a co-production approach for applying digital games in the field of mental healthcare are somewhat limited and under-explored. In this case study, seven workshop sessions were held involving service users, gamers and professionals. Participants were interviewed concerning their experiences with the activities and content of the co-production workshops. Thematic analysis of the participants’ experiences and perceptions resulted in three main themes: 1) empowering participation; 2) cooperation on a level playing field; and 3) improving self-efficacy. The experiment showed that applying a co-production approach in utilizing digital games is worth implementing in mental health services, particularly when putting novel nursing approaches and procedures into practice. Overall, co-production turned out to be a beneficial approach to introduce and implement game activities into mental healthcare; therefore, it can be taken one step further, meaning that service users’ experiences are truly valued, and they can play a crucial role in developing mental health services.

Fidelity Scale: From Black Box to Holy Grail

Fidelity scales are indispensable in the pursuit of evidence-based mental healthcare. Without fidelity checks, treatment remains a mysterious black box. The aim of this article is to comment on the studies in this special section, and to discuss some general issues with regard to fidelity assessment. Despite all of their supposed benefits, resistance to fidelity scales persists among mental health practitioners. One way to overcome this resistance is to conduct fidelity assessments in the context of a well-guided learning community. The predictive validity of fidelity scales is considered the single most valuable attribute of these instruments. Research on predictive validity requires large sample sizes, which is difficult to achieve. It should nevertheless not prevent us from rigorously searching for this Holy Grail of fidelity assessment. In addition, fidelity assessment should be placed in a broader perspective. The quality of care for people with severe mental illness cannot be assessed conclusively according to the extent to which separate interventions have been applied with good fidelity. These individuals need access to high-quality treatment and support systems within the community, which can enable them to live their lives as valued citizens. In conclusion, fidelity assessment, both at the level of interventions and systems, contributes to a highly desirable transparency in practice variations within the field of mental healthcare.

Artificial intelligence and mobile apps for mental healthcare: a social informatics perspective

PurposeFor decades, artificial intelligence (AI) has been utilized within the field of mental healthcare. This paper aims to examine AI chatbots, specifically as offered through mobile applications for mental healthcare (MHapps), with attention to the social implications of these technologies. For example, AI chatbots in MHapps are programmed with therapeutic techniques to assist people with anxiety and depression, but the promise of this technology is tempered by concerns about the apps' efficacy, privacy, safety and security.Design/methodology/approachUtilizing a social informatics perspective, a literature review covering MHapps, with a focus on AI chatbots was conducted from the period of January–April 2019. A borrowed theory approach pairing information science and social work was applied to analyze the literature.FindingsRising needs for mental healthcare, combined with expanding technological developments, indicate continued growth of MHapps and chatbots. While an AI chatbot may provide a person with a place to access tools and a forum to discuss issues, as well as a way to track moods and increase mental health literacy, AI is not a replacement for a therapist or other mental health clinician. Ultimately, if AI chatbots and other MHapps are to have a positive impact, they must be regulated, and society must avoid techno-fundamentalism in relation to AI for mental health.Originality/valueThis study adds to a small but growing body of information science research into the role of AI in the support of mental health.

Under- or Overtreatment of Mental Distress? Practices, Consequences, and Resistance in the Field of Mental Health Care.

The economic, social, and health costs of mental distress are increasingly burdening individuals and societies in Europe. Yet, overmedicalization of mild symptoms is also well documented. This accumulates in more pressures and demands on health care systems. In this article, I explore how the process of help seeking in mental distress might be shaped by health system design and functioning in one of the South European societies-Spain. Employing Bourdieu's theoretical lens, in-depth interviews with health care providers and users of services are analyzed. I reveal how the logic of the mental health care field, which is reinforced by the market, the state, and the media, may result in medicalization of mild distress while severe mental illness remains undertreated. I also show how mental help-seeking practices could gradually influence the functioning of the treatment system. Nevertheless, points of resistance to medicalization can also be identified.

Mental health literacy in Pakistan: a narrative review

PurposeThe term “Mental health literacy” is defined as knowledge and beliefs about mental disorders which aid their recognition, management or prevention. The importance of health literacy for physical health is widely studied; however, the area of mental health literacy in Pakistan has been comparatively neglected. The purpose of this paper is to address the knowledge about mental health in people living in Pakistan.Design/methodology/approachRelevant literature relating to mental health literacy was identified through various database searches. The databases searched included: PubMed, Cochrane database of Systemic Reviews, PsycINFO using the terms mental health, mental health literacy, mental health education, Pakistan.FindingsLiterature suggests that there is dearth of knowledge about mental illnesses and their treatment among public. This review also highlights the importance of mental health literacy among professionals working in the field of health care. In Pakistan, due to low literacy rate, a high percentage of poverty and dearth of trained professionals warrants an emendation in approaches established for attaining the goal of public health and psychiatric care.Practical implicationsFindings have implications for practitioners in the field of mental health care as well as designing targeted interventions for enhancing mental health literacy and help-seeking behavior in the future.Originality/valueA limited understanding and lack of improvement in mental health literacy may interfere with society’s acceptance of evidence-based mental health care which may hamper the delivery of adequate mental health services to the needy.

Exploring Human Values in the Design of a Web-Based QoL-Instrument for People with Mental Health Problems: A Value Sensitive Design Approach.

Quality of life (QoL) is an important outcome measure in mental health care. Currently, QoL is mainly measured with paper and pencil questionnaires. To contribute to the evaluation of treatment, and to enhance substantiated policy decisions in the allocation of resources, a web-based, personalized, patient-friendly and easy to administer QoL instrument has been developed: the QoL-ME. While human values play a significant role in shaping future use practices of technologies, it is important to anticipate on them during the design of the QoL-instrument. The value sensitive design (VSD) approach offers a theory and method for addressing these values in a systematic and principled manner in the design of technologies. While the VSD approach has been applied in the field of somatic care, we extended the VSD approach to the field of mental healthcare with the aim to enable developers of the QoL-instrument to reflect on important human values and anticipate potential value conflicts in its design. We therefore explored how VSD can be used by investigating the human values that are relevant for the design of the QoL-ME. Our exploration reveals that the values autonomy, efficiency, empowerment, universal usability, privacy, redifinition of roles, (redistribution) of responsibilites, reliability, solidarity, surveillance and trust are at stake for the future users of the technology. However, we argue that theoretical reflections on the potential ethical impact of a technology in the design phase can only go so far. To be able to comprehensively evaluate the usability the VSD approach, a supplementary study of the use practices of the technology is needed.

Legal conflicts of hospitalization in a psychiatric hospital

This discussion article describes the legislative contradictions of the legitimacy of hospitalization of the mentally ill patients in psychiatric hospitals. We give a specific recommendations to eliminate errors of practicing psychiatrists, as well as proposals to improve the legislation in the field of mental health care.

The Death of the Clinic? Emerging Biotechnologies and the Reconfiguration of Mental Health

This guest editorial opens with a brief overview of the transformations of medicine and mental health that can be observed since the second half of the twentieth century. New genetics and biotechnologies hold out the promise of overcoming presumed limitations in the field of mental health care, that is, the fact that diagnostic procedures in psychiatry and clinical psychology still largely rely on the narratives of patients and questionnaires, supposedly subjective assessments by physicians and psychologists. It is envisioned that innovative genetic and proteomic tools, (neuro)imaging technologies, and objective laboratory tests for blood biomarkers will enable better diagnosis and treatment of mental diseases. We argue that emerging biotechnologies do not revolutionize mental health, despite their promise to do so. Instead, we observe a pluralization of research and treatment approaches in the domain of mental health. The second part of this editorial discusses the contributions to this special issue on emerging biotechnologies and mental health and outlines how they address some of the gaps in social studies of psychiatry and mental health in the twenty-first century.

An Interpretive Phenomenological Analysis Of Physiotherapy In Mental Health: Exploring Barriers And Facilitators To Care

Background/Aims Current literature identifies decreased life expectancy and increased physical health complaints for service users with mental health diagnosis. However, research also highlights increased challenges for this population when accessing physical health care services. Physiotherapy is one such service shown to be of benefit for those with co-morbid physical and mental health needs. However, research is currently lacking on experiences and access to physiotherapy for this population. This study aimed to explore lived experiences of physiotherapeutic care for those with co-morbid physical and mental health complaint and identify barriers and facilitators for those attempting to access this service. Methods Semi-structured interviews were carried out with service users (n=8) with long-standing physiotherapeutic and severe and enduring psychiatric complaints. Focus groups were completed with physiotherapists working within the field of mental health care. Verbatim transcripts of the interviews and focus groups were analysed using Interpretive Phenomenological Analysis in order to obtain in depth insight into participant experiences. The study was designed to enhance quality through use of methodological and investigator triangulation, negative case analysis, reflexivity, secondary coding and a clear audit trail. Results Data was analysed systematically following the structure: individual case analysis, emergence of themes, cross case analysis, validation of themes and ideas. This analysis produced five master themes: (1) Communication with health care provider; (2) holistic care from physiotherapist; (3) perceived benefit of physiotherapy; (4) health care politics and interaction between services; (5) patient activation and motivation to comply with physiotherapy. These factors were seen to be of high importance for patient experience and, when lacking, were identified as barriers to quality physiotherapeutic care. Conclusions Results were found to be consistent with current literature around physical health care. This study identifies the need for greater integrated care between physical and mental health services and improved awareness of mental health and use of the biopsychosocial model within physiotherapy practice in order to promote holistic care. Results also highlight the need for positive experience of physiotherapy for those with severe mental illness in order to increase patient activation and motivation to attend and comply with services.

Bourdieu’s theory of fields: towards understanding help-seeking practices in mental distress

Employing Pierre Bourdieu’s sociology and his conceptual triad of field, habitus and capital, this article outlines a theoretical approach to empirically analyse help-seeking practices in mental distress. The framework helps to examine why the treatment gap in common mental disorders is wider in one setting than another and why some agents access healthcare more easily than others within the same setting, which may even drive to both over- and under-treatment resulting in inequities of access and poor use of resources. To understand help-seeking behaviour that varies across settings, time and conditions, it is suggested to relationally analyse how the field of mental healthcare as a structure of positions impacts access to healthcare; how mental structures that mirror cultural context and social conditions where they were acquired influence perceptions of access and, therefore, strategies of help seeking; and what historical genesis of both mental and objectified structures is.