History Of Mental Health Care Research Articles

Predictive modeling of initiation and delayed mental health contact for depression

BackgroundDepression is prevalent among Operation Enduring Freedom and Operation Iraqi Freedom (OEF/OIF) Veterans, yet rates of Veteran mental health care utilization remain modest. The current study examined: factors in electronic health records (EHR) associated with lack of treatment initiation and treatment delay; the accuracy of regression and machine learning models to predict initiation of treatment.MethodsWe obtained data from the VA Corporate Data Warehouse (CDW). EHR data were extracted for 127,423 Veterans who deployed to Iraq/Afghanistan after 9/11 with a positive depression screen and a first depression diagnosis between 2001 and 2021. We also obtained 12-month pre-diagnosis and post-diagnosis patient data. Retrospective cohort analysis was employed to test if predictors can reliably differentiate patients who initiated, delayed, or received no mental health treatment associated with their depression diagnosis.Results108,457 Veterans with depression, initiated depression-related care (55,492 Veterans delayed treatment beyond one month). Those who were male, without VA disability benefits, with a mild depression diagnosis, and had a history of psychotherapy were less likely to initiate treatment. Among those who initiated care, those with single and mild depression episodes at baseline, with either PTSD or who lacked comorbidities were more likely to delay treatment for depression. A history of mental health treatment, of an anxiety disorder, and a positive depression screen were each related to faster treatment initiation. Classification of patients was modest (ROC AUC = 0.59 95%CI = 0.586–0.602; machine learning F-measure = 0.46).ConclusionsHaving VA disability benefits was the strongest predictor of treatment initiation after a depression diagnosis and a history of mental health treatment was the strongest predictor of delayed initiation of treatment. The complexity of the relationship between VA benefits and history of mental health care with treatment initiation after a depression diagnosis is further discussed. Modest classification accuracy with currently known predictors suggests the need to identify additional predictors of successful depression management.

Identification of factors associated with hospitalization in an outpatient population with mental health conditions: a case-control study.

Addressing relevant determinants for preserved person-centered rehabilitation in mental health is still a major challenge. Little research focuses on factors associated with psychiatric hospitalization in exclusive outpatient settings. Some variables have been identified, but evidence across studies is inconsistent. This study aimed to identify and confirm factors associated with hospitalization in a specific outpatient population. A retrospective monocentric case-control study with 617 adult outpatients (216 cases and 401 controls) from a French community-based care facility was conducted. Participants had an index outpatient consultation between June 2021 and February 2023. All cases, who were patients with a psychiatric hospitalization from the day after the index outpatient consultation and up to 1 year later, have been included. Controls have been randomly selected from the same facility and did not experience a psychiatric hospitalization in the 12 months following the index outpatient consultation. Data collection was performed from electronic medical records. Sociodemographic, psychiatric diagnosis, historical issues, lifestyle, and follow-up-related variables were collected retrospectively. Uni- and bivariate analyses were performed, followed by a multivariable logistic regression. Visit to a psychiatric emergency within a year (adjusted odds ratio (aOR): 13.02, 95% confidence interval (CI): 7.32-23.97), drug treatment discontinuation within a year (aOR: 6.43, 95% CI: 3.52-12.03), history of mental healthcare without consent (aOR: 5.48, 95% CI: 3.10-10.06), medical follow-up discontinuation within a year (aOR: 3.17, 95% CI: 1.70-5.95), history of attempted suicide (aOR: 2.50, 95% CI: 1.48-4.30) and unskilled job (aOR: 0.26, 95% CI: 0.10-0.65) are the independent variables found associated with hospitalization for followed up outpatients. Public health policies and tools at the local and national levels should be adapted to target the identified individual determinants in order to prevent outpatients from being hospitalized.

The Role of Management Information Systems in the History of Mental Health Care for Prisoners in the USA

From the prehistorical to contemporary periods, prisoners’ mental health has been a burgeoning issue in the United States (USA). After a decade of incarceration and a misleading penal system, prisoners' mental health has become a discussed topic for scholars not only in the correctional system but also in other disciplines. Despite having diverse initiatives for the improvement of the penal system, few initiatives have been held to take into consideration of prisoner's mental health. To fill this gap, the main purpose of this paper is to provide a brief overview of the mental health of prisoners by analyzing previous research on the mental health of prisoners along with suggesting some probable ways from management information perspectives that can be helpful to reduce a great number of prisoners and bring some positive changes in the correctional system.

University Students’ Mental Health Services Need and Utilization, Telemental Health Awareness, and Barriers to Seeking Care During the COVID-19 Pandemic

ABSTRACT Telemental health services have become more pressing for higher education students since the onset of the COVID-19 pandemic. The extent of that need, and barriers to accessing care, remain uncertain – including demographic inequities. Between June 2020 and December 2021, public university students (N = 1441) were surveyed about demographic factors, history of mental healthcare, telemental health awareness, and perceived pandemic-time mental healthcare needs and barriers. Approximately one-third of the sample reported feeling an increased unmet need for mental health services, with connection to services being predicted by semester cohort, neighborhood income level, mental healthcare history, and level of telemental health awareness. A variety of barriers to seeking care were endorsed by a minority of participants. Results can inform outreach and capacity efforts in the post-vaccines era to improve access to care – including telemental healthcare – for historically marginalized groups, poorer students, and those unfamiliar with mental health services.

The Use of Oral History in Researching Psychiatry's Past

Oral history has become firmly established as a method to delve into and bring to light the experiences and viewpoints of individuals who have been suppressed or marginalised in the history of psychiatry and mental healthcare. This article aims to provide an overview of the ways in which oral history has been deployed, both as a method and as a source, to address the absence of voices and the silences that continue to persist within the history of mental healthcare in the British context. The article argues for the relevance of oral history methodology to the history of psychiatry in restoring and amplifying the voices of the less powerful. The article will evidence how the collection of and re-use of oral histories of those at the receiving end of mental healthcare, and of those who provide it, has the potential to promote democratic relations in mental healthcare research by challenging traditional power relations in what historically has constituted the history of psychiatry. It has the power to bring to the fore the perspectives of key actors, particularly those with serious, long-term mental health conditions who remain under-served all along throughout the long history of mental healthcare, albeit in different ways. The article will show how oral history methodology can broaden the history of psychiatry and mental healthcare by addressing and redressing the silences and erasures therein in a range of disciplinary contexts and perspectives.

Psychopathology and history of mental healthcare among male detainees transferred to a facility for managing otherwise uncontrollable in-prison violence: An exploratory study.

In-prison violence by detainees is a problem worldwide, but despite evidence of a much higher prevalence of a range of psychiatric disorders than in the general population, little is known about psychopathology among violent detainees. Our aim was to explore the psychopathology and mental healthcare history of Dutch detainees who were transferred to the highly restrictive facility for uncontrollably violent detainees following severe in-prison violence. Anonymised data for all 253 male detainees incarcerated at any time between January 2016 and January 2020 in the specialist national facility for those seriously violent while in prison-'the Violence Facility'-were obtained from the Dutch Ministry of Justice together with similarly recorded data for a matched comparison group of 253 detainees admitted to an in-prison psychiatric facility-'the Psychiatric Facility'. There was no record of any psychiatric assessment for 29% of the Violence Facility men. Almost all of the detainees who had been assessed were classified with at least one disorder. Compared to detainees in the Psychiatric Facility, Violence Facility men were more likely to be diagnosed with attention deficit hyperactivity disorder (ADHD), anxiety, behavioural and personality disorders; Psychiatric Facility men were more likely to be diagnosed with psychosis or substance use disorder. Most men in both groups had previously used mental health services. This first study of detainees in the Dutch in-prison facility for violent detainees raises questions about whether the extent of violence among these men may have masked mental healthcare needs and leads to questions about potential benefits from establishing more systematic mental health assessments for them, and a need for more specialist services.

Symptoms of anxiety and depression and self-care behaviors during the COVID-19 pandemic in the general population

Introduction: The COVID-19 pandemic can have important psychosocial consequences in the population. Objective: To determine the levels anxiety and depression symptoms and self-care behaviors during the COVID-19 pandemic in the gener-al population. Method: Online survey distributed over three weeks using a non-probability sampling. The PHQ-9 Patient Health Questionnaire, the GAD-7 Generalized Anxiety Disorder Scale and a self-care behaviors visual analogue scale were used. Between-group (anxiety and depression) descriptive and comparison analyses were carried out. Results: Out of 1508 includ-ed participants, 20.8 % had symptoms of severe anxiety, while 27.5 % showed symptoms of severe depression. Being a woman, being single, having no children, having medical comorbidities and a history of mental health care were associated with the presence of higher levels of anxiety and depression symptoms; 66 to 80 % of the population complied with self-care recommendations. A need for receiving mental health care was identified in our study population. Conclusion: A larger num-ber of individuals with moderate to severe anxiety and depression symptoms were observed than in other pandemics. COVID-19 pandemic psychological effects are considered an emerging public mental health problem, and implementation of programs for their care is therefore recommended.

Mental health impact and mental health care among first responders following the Paris terror attacks in November 2015

Abstract Introduction During the evening of 13 November 2015, a terror attack occurred in France in the Paris area. Overall, 130 people were killed, 643 were injured and several thousands were psychologically impacted. Thousands of first responders (FRs), including health professionals, firefighters, affiliated volunteers and police officers were mobilized that night and during the subsequent weeks. The aims of our study were to measure the psychological impact on FRs, and its associated factors 12 months after the 13 November 2015 terrorist attacks, as well as their engagement in mental health care and its associated factors. Methods FRs who had intervened during the night and/or the aftermath of the terror attacks had the possibility of answering a web-based study 8-12 months after the attacks. They satisfied criterion A of the DSM 5 definition of Post Traumatic Stress Disorder (PTSD). PTSD and partial PTSD were measured using the PTSD checklist for DSM-5 (PCL-5) and depression with the hospital anxiety and depression (HAD) scale. Results Overall, 663 FRs were included in the analysis. Prevalence of PTSD in our sample went from 3.4% among firefighters to 9.5% among police officers. Low educational level, social isolation, intervention on unsecured crime scenes and lack of training were associated with PTSD. Among FRs with PTSD, partial PTSD or depression, 38% sought mental health care. Mental health care engagement was associated with a history of mental health care, post-immediate support and the presence of PTSD, partial PTSD or depression. Conclusions Our results highlight that improving access to mental health care for FRs after terror attacks is needed. Efforts should be made before and after potentially traumatic events to ensure mental health education for FRs. Special attention should be given to FRs living in social isolation, those with low educational levels and those who intervene in unsecured crime scenes.

London and Its Asylums, 1888-1914: Politics and Madness, by Robert Ellis

Reviewed by: London and Its Asylums, 1888-1914: Politics and Madness by Robert Ellis Leslie Topp (bio) London and Its Asylums, 1888-1914: Politics and Madness, by Robert Ellis; pp. viii + 296. Cham, Switzerland: Palgrave Macmillan, 2020, $119.99, $89.00 ebook. Scholars of Victorian asylums are often faced with archival and primary sources that are if anything too rich and interesting: case notes, daily logs, photographs, and inspectors' reports that bring these immense institutions to life in all their problematic human complexity. Robert Ellis, by contrast, has been brave enough to tackle a very different set of sources, much drier and more impenetrable. London and Its Asylums, 1888-1914: Politics and Madness is not, despite its title, directly concerned with the British capital's psychiatric institutions, but rather with the bureaucratic structures that oversaw them (and poor people's mental healthcare more generally) at the end of the nineteenth century and the beginning of the twentieth. The sources that Ellis digests and deploys [End Page 512] are the products of administrative bureaucracy, above all the carefully compiled minutes of twenty-six-years' worth of committee meetings. The result of this herculean task is an account that, while requiring some effort and persistence to read, offers an original and compelling angle on the history of mental healthcare, particularly as it was affected by electoral politics. The Local Government Act of 1888 created the London County Council (LCC), setting up for the first time a municipal government for all of London. In one stroke, this new body became responsible for the institutional care and treatment of residents who were deemed to need confinement due to mental disturbance and who could not pay for their maintenance, a group of people who were still referred to throughout this period as "pauper lunatics" (10). The LCC took on responsibility for the management and funding of four existing asylums, completed one which had been in the planning stages, and built six further asylums. Altogether, by 1914, this group of institutions housed thousands of patients. The Local Government Act meant that for the first time in England, institutional mental healthcare was the responsibility of a democratically elected body. Ellis's decision to focus on London and the LCC results in an in-depth study of how this combination of democratic local politics and the provision for (and control of) this large, growing, and very vulnerable group worked in practice. London's exceptional status as a world city and capital of empire, and its vast scale, give his findings wide relevance. Central to Ellis's argument is his insistence that the sources show that mental healthcare in the period was not the "non-contentious" science-led area of public policy it was often presented to be later in the twentieth century (49). (Indeed, Ellis points out that the neglect of mental healthcare under the Conservative austerity politics of the 2010s in the UK shows that this area still cannot be separated from political positions.) The years covered by the book witnessed two distinct party-political regimes within the LCC: the Progressives, who were aligned with the Liberals at the national level, had a majority until they lost the 1907 election to the Municipal Reformers, who were aligned with the Conservatives. The contrasting approaches of the two parties allow Ellis to open up new key insights into why asylums and asylum-based practices developed in the ways they did. And, often, this had nothing to do with internal psychiatric debates. For instance, the Municipal Reformers had as a central plank of their platform control over spending and keeping taxes down. The very large asylums they built represented not an impressive commitment to a marginalized group, but, in the context of laws that compelled local councils to build asylums, an attempt at savings through economies of scale and a deprioritization of patients' and their families' needs to have institutions closer to their homes and accessible for visiting. Ellis also shows that the Council made itself aware (through impressive transnational networks) of international tendencies in asylum design toward the so-called villa asylum, but instead chose to persist with outmoded corridor-system designs in order to control budgets. Under the...

Care & Custody: Past Responses to Mental Health, National Library of Medicine

<i>Care &amp; Custody: Past Responses to Mental Health</i>, National Library of Medicine

Special Issue of Issues in Mental Health Nursing on the Topic of the History of Mental Health Care - Why It Matters

Special Issue of Issues in Mental Health Nursing on the Topic of the History of Mental Health Care - Why It Matters

Mental health care utilization by first responders after Paris attacks.

BackgroundFirst responders (FRs) are frequently exposed to potentially traumatic events, including terror attacks, and may consequently be at risk of developing mental health disorders. Prior research suggests that FRs with mental health disorders often do not receive appropriate treatment. More knowledge is needed about their use of mental health care (MHC).AimsThis study aimed to identify factors associated with receiving immediate support, post-immediate support and engagement in MHC among FRs of the November 2015 terror attacks in Paris.MethodsA web-based study was conducted 8–12 months after the attacks on 663 FRs who were mobilized during the night and/or the aftermath of the attacks. Logistic regression was performed to analyse factors associated with MHC.ResultsOverall, 44 FRs sought MHC. Among FRs with post-traumatic stress disorder (PTSD), partial PTSD or depression (n = 60), 38% sought MHC (n = 23). Post-immediate support was associated with immediate support, and both were associated with knowing someone who could help regarding the potential psychological risks following a traumatic event. MHC engagement was associated with a history of MHC, post-immediate support and the presence of PTSD, partial PTSD or depression.ConclusionsAmong FRs with PTSD, partial PTSD or depression, few sought MHC. Improved access to MHC for FRs after terror attacks is essential. Knowing someone who could help regarding potential psychological risks may facilitate immediate and/or post-immediate support. Furthermore, post-immediate support could encourage engagement in MHC. Efforts should be made before and after potentially traumatic events to ensure mental health education for FR.

A Comparison of Suicide Attempt Histories of Pediatric and Adult Medical Inpatients and Implications for Screening

Objective A suicide attempt is the most potent predictor of future suicidal behavior, yet little is known about how to manage and respond to reports of attempt histories in hospitalized medical patients. This study aims to describe the prevalence and characteristics of pediatric and adult medical inpatients who report a past suicide attempt. Method Participants were medical inpatients, aged 10–93 years, enrolled in two suicide risk screening instrument validation studies. Participants completed the Ask Suicide-Screening Questions (ASQ) and the Patient Health Questionnaire (PHQ). Results A total of 1324 medical inpatients (624 pediatric, 700 adult) completed the ASQ, with 114 participants (8.6%) reporting a past suicide attempt (51 pediatric; 63 adults). Comparing youth to adults, there was no significant difference between attempt rates (χ 2=0.29, p = 0.59). Youth with a past attempt were significantly more likely to report past week suicidal ideation (OR = 28.22; 95% CI = 5.90, 135.06) and have a history of mental health care (OR = 9.11; 95% CI = 2.59–32.10), compared to those without a past attempt. Adults with a past attempt were significantly more likely to screen positive for depression, compared to those without attempt histories (OR = 5.00; 95% CI = 2.31–10.83). Conclusions Nearly 9% of hospitalized medical patients endorsed a past suicide attempt when screened. Since adolescence is a critical time for detecting suicide risk, screening that includes past suicidal behavior may be an important means to identify youth with recent suicidal thoughts. By assessing recency of suicide attempts in adults, medical settings may optimize the effectiveness of how positive suicide risk screens are managed. HIGHLIGHTS Roughly 9% of medical patients reported a past suicide attempt when screened. Adolescence is a critical time for detecting suicide risk and intervening. Assessing past suicide attempts in adults can help with managing positive screens.

Perinatal Complications as a Mediator of the Association Between Chronic Disease and Postpartum Mental Illness

Background: Chronic disease is associated with increased risk of postpartum mental illness, but the mechanisms underlying this association are unclear. Our aim was to explore the mediating role of perinatal complications in the association between chronic disease and postpartum mental illness. Materials and Methods: This was a population-based retrospective cohort study of all women in Ontario, Canada, from 2005 to 2015 with a singleton live birth and no recent history of mental illness during or 2 years before pregnancy. The outcome was mental illness diagnosis between delivery and 365 days postpartum, with perinatal complications, including pregnancy, delivery, and neonatal complications. Modified Poisson regression models were used to examine the association between chronic disease and perinatal mental illness, with generalized estimating equations for the calculation of total, direct, and indirect effects. All models were adjusted for sociodemographic characteristics and remote history of mental health care. Results: Of the 792,972 women, 21.1% had a chronic disease. Chronic disease was associated with an increased risk of postpartum mental illness (adjusted relative risk [aRR] 1.15 [95% confidence interval, CI 1.14-1.16]). There was no evidence of an indirect effect of chronic disease on postpartum mental illness via perinatal complications (aRR 1.003, 95% CI 1.002-1.003). Perinatal complications explained only 1.5% of the association between chronic disease and postpartum mental illness. Results were consistent by type of perinatal complication and chronic disease diagnosis. Conclusion: We observed no clinically meaningful mediating effect of perinatal complications in the association between chronic disease and postpartum mental illness. Future research should investigate alternative mechanisms explaining this association.

Obstetric near misses among women with serious mental illness: data linkage cohort study.

Investigating obstetric near misses (life-threatening obstetric complications) provides crucial information to prevent maternal mortality and morbidity. To investigate the rate and type of obstetric near misses among women with serious mental illness (SMI). We conducted a historical cohort study, using de-identified electronic mental health records linked with maternity data from Hospital Episode Statistics. The English Maternal Morbidity Outcome Indicator was used to identify obstetric near misses at the time of delivery in two cohorts: (1) exposed cohort - all women with a live or still birth in 2007-2016, and a history of secondary mental healthcare before delivery in south-east London (n = 13 570); (2) unexposed cohort - all women with a live or still birth in 2007-2016, resident within south-east London, with no history of mental healthcare before delivery (n = 223 274). The rate of obstetric near misses was 884.3/100 000 (95% CI 733.2-1057.4) maternities in the exposed group compared with 575.1/100 000 (95% CI 544.0-607.4) maternities in the unexposed group (adjusted odds ratio 1.6, 95% CI 1.3-2.0, P < 0.001). Highest risks were for acute renal failure (adjusted odds ratio 2.1, 95% CI 1.1-3.8, P = 0.022); cardiac arrest, failure or infarction (adjusted odds ratio 2.3, 95% CI 1.1-4.8, P = 0.028); and obstetric embolism (adjusted odds ratio 3.1, 95% CI 1.6-5.8, P < 0.001). Findings emphasise the importance of integrated physical and mental healthcare before and during pregnancy for women with SMI.

Symptoms of anxiety, depression and self-care behaviors during the COVID-19 pandemic in the general population.

The COVID-19 pandemic can have important psychosocial consequences in the population. To determine the levels of anxiety, depression and self-care symptoms during the COVID-19 pandemic in the general population. Online survey distributed over three weeks using a non-probability sampling. The PHQ-9 Patient Health Questionnaire, the GAD-7 Generalized Anxiety Disorder Scale and Visual analog scale for self-care behaviors were used. Between-group (anxiety and depression) descriptive and comparison analyses were carried out. Out of 1508 included participants, 20.8% had symptoms of severe anxiety, while 27.5% showed symptoms of severe depression. Being a woman, being single, having no children, having medical comorbidities and a history of mental health care were risk factors for developing symptoms of anxiety and depression; 66 to 80 % of the population complied with self-care recommendations. A need for receiving mental health care was identified in our study population. A larger number of individuals with moderate to severe anxiety and depression symptoms were observed than in other pandemics. COVID-19 pandemic psychological effects are considered an emerging public health problem, and implementation of programs for their care is therefore recommended.

Social Psychiatry and the demand for Mental Health Services: Some caution is valid?

Mental health in the interface with social psychiatryis a constantly evolving field. Psychiatry faces major challenges. The therapeutic relationship remains paramount. Methods: A Short Communication that focus the informational spaces of professional interests, many new ideas and concepts what are issued under the banner of "social psychiatry.". Include: discovery or development of new information’s, novelty in modeling scientific and channels of information. Results: The evidences emphasize that Mental illness and interventions in psychiatry should be considered in the of social context where patients live and factors they face on a daily basis. There’s a need for greater numbers of psychiatrists. Limitations: As Short Communications are expected to have higher than average impact on the field rather than report on incremental research, they will receive prioritized and rapid publication. Conclusion: Social values and concepts have played a central role in the history of mental health care, allowing more focus on possible environmental causes or factors. Keywords: Social Psychiatryis; Mental Health; Therapeutic Relationship.

Chronic physical conditions and risk for perinatal mental illness: A population-based retrospective cohort study.

BackgroundOne in 5 women experience mental illness in pregnancy or post partum. Universal preventive interventions have not lowered the incidence of perinatal mental illness, perhaps because those at highest risk were not targeted. Outside of pregnancy, chronic physical conditions are known to confer increased risk for mental illness. Our objective was to examine the association between chronic physical conditions and risk of perinatal mental illness.Methods and findingsWe conducted a population-based retrospective cohort study using linked health administrative data sets in Ontario, Canada, in 2005 to 2015. We compared 77,385 women with chronic physical conditions to 780,619 women without such conditions, all of whom had a singleton live birth. Excluded were women with a mental illness diagnosis within 2 years before pregnancy. Chronic physical conditions were captured using the Agency for Healthcare Research and Quality Chronic Condition Indicator, applied to acute healthcare encounters in the 2 years before pregnancy. The outcome was perinatal mental illness, defined by a mental illness or addiction diagnosis arising between conception and 365 days post partum. The outcome was further defined by timing (prenatal or post partum) and specific diagnosis (psychotic disorder, mood or anxiety disorder, substance use disorder, self-harm, or other). Modified Poisson regression generated relative risks and 95% confidence intervals (CIs), adjusted for age, parity, rural residence, income quintile, and remote history of mental health care. Women in the cohort had an average age of 29.6 years (standard deviation 5.4), 44.2% were primiparous, 11.0% lived in a rural area, 40.1% were in the lowest 2 income quintiles, and 47.9% had a remote history of mental health care. More women with (20.4%) than without (15.6%) a chronic physical condition experienced perinatal mental illness—an adjusted relative risk (aRR) of 1.20 (95% CI 1.18–1.22, p < 0.0001). The aRRs were statistically significant for mental illness in pregnancy (1.12, 95% CI 1.10–1.15, p < 0.0001) and post partum (1.25, 95% CI 1.23–1.28, p < 0.0001). Psychotic disorders (aRR 1.50, 95% CI 1.36–1.65, p < 0.0001), mood or anxiety disorders (aRR 1.19, 95% CI 1.17–1.21, p < 0.0001), substance use disorders (aRR 1.47, 95% CI 1.34–1.62, p < 0.0001), and other mental illness (aRR 1.68, 95% CI 1.50–1.87, p < 0.0001) were more likely in women with than without chronic physical conditions, but not self-harm (aRR 1.14, 95% CI 0.87–1.48, p = 0.34). The study was limited by reliance on acute health care encounters to measure chronic physical conditions and the inability to capture undiagnosed mental health problems.ConclusionsFindings from this study suggest that women with a chronic physical condition predating pregnancy may be at heightened risk of developing mental illness in the perinatal period. These women may require targeted efforts to lower the severity of their condition and improve their coping strategies and supports in pregnancy and thereafter.

A Systematic Review and Meta-analysis of Recovery Educational Interventionsfor Mental Health Professionals.

The history of mental health care has been marked by various struggles in maintaining the dignity of service users. Some reform movements have started to use educational strategies aimed at the beliefs and attitudes of professionals, as well as changing the way that practice is carried out. This paper intends to systematically review and synthesize studies assessing awareness and training activities for mental health professionals covering aspects related to recovery, empowerment, and in general, rights-based care to achieve full citizenship of mental health services users. We reviewed 26 articles and were able to include 14 of them in meta-analytic calculations. Our results at the qualitative level show an evolution of the literature towards better quality designs and focus on aspects related to the impact and maintenance of the effects of these training activities. Meta-analytic calculations found high heterogeneity but no risk of biases and low-to moderate effect sizes with a statistically significant impact on beliefs and attitudes but not on practices. The importance of this information in improving and advancing these educational activities is addressed.

A History of Mental Health Care in Japan:International Perspectives

Background: Japan has continuously received influences from foreign countries to improve care for patients suffering from mental diseases throughout its history. But an article documenting on the foreign influences on Japanese mental health (MH) care is not readily available. Methods: The author reviewed the published books, papers, and government documents on the MH care in Japan. For comparisons, the publications on MH and psychiatric care, especially those in the United States of America, the United Kingdom, as well as countries of the Organization for Economic Co-operation and Development, were also reviewed. The author also recounted his personal observations on the MH care over his own life. Results: Before the Meiji Restoration, Buddhism and temples played a major role in taking care of persons with mental illness. Kampo (Chinese medicine and medicinal herbs) was prescribed during the Edo era (1603–1867). After the Meiji Restoration in 1867, the Meiji government adopted Western medicine. German medicine was introduced as an exemplified model. Before World War II (WWII), Japanese psychiatry was under the heavy German influence. After WWII, American psychiatry was introduced. At the same time, the Japan Private Hospital Association (Nisseikyo) was formed, and it contributed to build MH care system. From 1955 to 1993, Japan continuously increased the number of private hospital beds, financed through public funds. The scandals at several private hospitals helped enact the Mental Health Law in 1987, making clear to change hospital-centered services to community-based MH services and improve the human rights of inpatients in Japan. Since then, efforts have been carried out to promote community-based MH care. But Japan nowadays is still characterized by hospital-centered MH care. Conclusion: At present, Japan has more than 1,000 psychiatric hospitals with 300,000 psychiatric beds. Japan has the largest number of psychiatric bedsthat is on the top among all countries in the world. In this review, the author expresses his own personal viewpoints on MH care for the mentally ill in Japan with focus on its international influences.