Mainstream Mental Health Research Articles

A systematic review of training for mainstream mental health professionals working with people with intellectual disabilities and mental health needs

Purpose Policy in the UK and many other countries states that mainstream mental health services should be accessible to people with intellectual disabilities (ID). The purpose of this paper is to systematically review training and development needs assessments and delivered training and development for professionals working in mainstream mental health services who may work with people with IQ. Design/methodology/approach A systematic search of four databases (Web of Science; PsychInfo; PubMed; CINAHL) over the period of 2011–2023 was used. Papers were included if they described training or development delivered to, or specific training or development needs analyses of, mainstream qualified staff to support working with adults who have an ID. Findings Two papers were found that described training and development initiatives and six that described training and development needs analysis, five of these papers originated from Australia and were part of the development of a comprehensive workforce competency framework. Research limitations/implications Training and development approaches for mainstream mental health services to facilitate the support of people with IQ should be systematically developed and trialled. Originality/value To the best of the authors’ knowledge, this is the first study to review training and training needs analysis in this area since 2012. The review finds only a small number of papers in what is an important area for service development.

Traditional healing as mental health intervention: Contemporary insights from an American Indian healer.

Contemporary American Indian communities experience a disproportionately high rate of specific mental health concerns, including psychiatric disorders as defined by professional psychology. Although integrating mainstream mental health services and Indigenous traditional healing (ITH) has been presented as a promising approach to addressing these inequities, such integration necessitates in-depth exploration and consideration of ITH. To that effect, this article provides a thematic analysis of an interview with an urban American Indian traditional healer who reflected on more than 4 decades of therapeutic experience. Based on this analysis, we identified two major themes. The first theme, Expansive View of ITH, reflects this healer's conceptualization and understanding of the therapeutic process while the second theme, Guiding Principles of ITH, explicates the foundational commitments that shape and guide this healer's application and practice of ITH. These insights reinforce previous observations made by scholars of Indigenous health and well-being that challenge dominant Euro-American perspectives and call for transformative change in psychology research and practice, advocating for professional consideration of a broader range of therapeutic rationales, traditions, and practices than what is common within the field. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Exploring The Role of Shirodhara In Alleviating Post-Covid Psychological Symptoms.

The COVID-19 pandemic has profoundly impacted global mental health, leading to an increased prevalence of psychological symptoms such as - anxiety, depression, and insomnia. This review explores the potential role of Shirodhara, an ancient Ayurvedic therapy, in alleviating post-COVID psychological symptoms. A comprehensive literature search was conducted across PubMed, Scopus, and Google Scholar, up to May 2024, using terms such as “Shirodhara,” “post-COVID,” “insomnia,” “anxiety,” “stress,” “oil dripping therapy,” and “depression.” The findings indicate that Shirodhara may significantly promote mental well-being through its calming effects. Despite the promising results, further research, including Randomized controlled trials (RCTs), is needed to validate these findings and integrate ‘Shirodhara therapy’ into mainstream mental health treatment protocols. Tackling the psychological consequences of COVID-19 necessitates a multifaceted strategy, with Shirodhara potentially being key to improving the well-being of those impacted.

Mental health of the Pacific Island Nation communities: What the rest in the world can contribute to and learn from?

Creating Futures initiative has established a network of mental health professionals, researchers, and community members from the Pacific Island Nations (PIN), Australia, and New Zealand to address the growing challenges of mental health conditions compounded by the climate change crisis. The enormous amount of work done in Global Mental Health can be particularly helpful to improve population-level mental health. However, translation of this evidence base into practice poses several challenges. This perspective paper discusses the role of local culture and health systems context in determining the feasibility and acceptability of implementing and scaling up evidence-based interventions designed in an American-European context. The paper also advocates development (and evaluation) of mental health interventions in the PIN communities particularly and Global South generally and exporting these interventions to the rest of the world. COVID-19 crisis underlined the role of global cooperation as well as national level 'self-reliance'. In this post COVID-19 world, it will be desirable for the mental health community to cooperate and collaborate to scale up evidence-based interventions through rigorous contextualization and at the same time main-stream mental health interventions developed in the Global South by incorporating them in the Global Mental Health discourse.

“Mirroring” the World Versus “World-Making”: The Crisis of Ethics in Indian Mental Health Systems

In the context of neoliberalism and increasing globalization, technocratization, and scientification of mental health care, people suffering from socio-politico-economic problems ranging from poverty to structural violence are often transmogrified into “patients” with mental health problems to be “treated” with psychopharmaceuticals and individualized psychological therapies. Drawing from three socio-political issues India witnessed in the past 3 years, concerning three marginalized sections, namely, farmers, LGBTQIA+ people, and migrant workers, I illustrate the silence of mainstream mental health disciplines in India on sheer instances of structural violence and social suffering. Deflection of attention from human rights violations by mainstream mental health systems raises critical questions about the ethics and politics of mental health disciplines. The social, political, and material contexts that are central to lived experiences are almost always unaccounted in mental health academia, research, and practice. Engaging people with lived experiences advances equity by breaking down power dynamics, establishing collaborative decision-making, and improving equitable outcomes. Thus, knowledge production in mental health becomes irrelevant to political action and transformative policies that are crucial for positive mental health outcomes. By ignoring and thus implicitly sanctioning discriminatory, exploitive neoliberal architecture, mental health systems maintain the very upstream factors that cultivate and sustain mental distress. In this way, mainstream mental health practice in India fails to undertakeworld-making, raising deeper questions in public mental health ethics.

APPLICATION OF MEDICINAL PLANTS IN MENTAL HEALTH CARE: A COMPREHENSIVE REVIEW

Ayurveda, an ancient Indian system of medicine, offers a rich repository of medicinal plants with therapeutic potential for various health conditions, including mental health disorders. This review aims to explore the application of Ayurvedic medicinal plants in mental health care. A comprehensive search was conducted in electronic databases, including PubMed, Scopus, and Google Scholar, and Various Ayurvedic texts. Several Ayurvedic medicinal plants, such as Brahmi (Bacopa monnieri), Ashwagandha (Withania somnifera), Jatamansi (Nardostachys jatamansi), and Shankhpushpi (Convolvulus pluricaulis), have demonstrated significant neuroprotective, anxiolytic, antidepressant, and cognitive-enhancing properties in preclinical and clinical studies. The mechanisms of action of these plants involve modulation of neurotransmitter levels, antioxidant effects, and anti-inflammatory properties. Moreover, Ayurvedic formulations, such as Sarasvata Churna, Smriti Sagar Ras, and Brahma Rasayana, have been traditionally used to improve memory, cognition, and overall mental well-being. Despite the promising evidence, further research is warranted to elucidate the precise mechanisms of action and establish the safety and efficacy of these plants in mental health disorders. In conclusion, Ayurvedic medicinal plants offer a valuable adjunctive or alternative approach to the management of mental health disorders. Integrating Ayurveda into mainstream mental health care could provide holistic and personalized treatment options for patients.

Walking together in friendship: Learning about cultural safety in mainstream mental health services through Aboriginal Participatory Action Research.

Culturally safe service provision is essential to improving social and emotional wellbeing among Aboriginal and Torres Strait Islander communities, and to eliminating health inequities. Cultural safety is about ensuring that all people have a safe and healing journey through services, regardless of their cultural background. In this project, we aim to (1) understand how Aboriginal and Torres Strait Islander peoples conceptualise cultural safety, and (2) co-design a qualitative interview for the next phase of this project, where we plan to learn about experiences of cultural safety within mental health services. We conducted six focus groups (in one metro and two regional areas, Western Australia). Following an Aboriginal Participatory Action Research methodology, we yarned with Aboriginal and Torres Strait Islander mental health service users, carers, community members, mental health professionals and Cultural Healers about cultural safety. Participants described a culturally safe service as one where Aboriginal cultural knowledges, life experiences, issues and protocols are understood and acknowledged, and reported that mainstream mental health services are not currently culturally safe. Participants emphasised the importance of building trust, rapport, reciprocity and following appropriate relational processes when designing a qualitative interview for the next phase. A lack of cultural safety in mental health services is likely to contribute to the disparity in outcomes between Aboriginal and Torres Strait Islander peoples and non-Indigenous Australians. Embedding cultural safety into research design allows for authentic community engagement and facilitates knowledge sharing around ways to improve cultural safety in mental health services.

A referrals audit and qualitative analysis of staff experience of referrals in a specialist community learning disability service

PHOTO CREDIT: Aaron BurdenSpecialist community teams are set up to support people living with Learning Disability (LD) who are unable to access mainstream mental health (MH) teams with reasonable adjustments. National guidance is available to guide best practice in making reasonable adjustments, to support increased access to mainstream services. This audit of referrals into a specialist Community LD team, aimed to establish referral acceptance rates and reasons for referral rejection. Total referrals and referrals made specifically from mainstream MH teams were investigated. A focus group explored LD clinicians’ experiences of the referral process and criteria in the context of working alongside mainstream MH teams. A lower acceptance rate of referrals from mainstream MH teams than overall acceptance rate was found, and differences in the reasons for rejection were highlighted. No LD diagnosis in the referral was the most common rejection reason for mainstream MH team referrals. Thematic analysis highlighted four themes of clinician’s experiences which focused on: referral point struggles; service limitations; lack of diagnostic clarity; and attempts to bridge a gap between services. Recommendations include review of the referral process, joint working protocols, clarification of remit and dissemination of shared learning.

Aboriginal young people’s experiences of Cultural Safety in mental health services in two regions of New South Wales, Australia

This article assesses the Cultural Safety of mainstream mental health services in two regions of New South Wales, Australia, based on the experiences and perspectives of Aboriginal young people aged 16 – 25. Yarning semi-structured in-depth interviews were conducted with thirteen Aboriginal young people in two regions of New South Wales. Thematic analysis was undertaken by all research members to identify themes from the data and conceptual connections between them. Identified themes from individual analysis and coding were triangulated during several analysis meetings to finalize key themes and findings. Aboriginal young people identified that Aboriginal Community Controlled Health Services offered culturally safe Social and Emotional Wellbeing service supports, whereas mainstream mental health services did not. Aboriginal young people proposed that institutional reforms such as increasing engagement with cultural competency programs, employing more Aboriginal staff, and implementing culturally meaningful services, would increase Cultural Safety in mainstream mental health services. Cultural Safety within mainstream mental health services should be enhanced to ensure the subjective Social and Emotional Wellbeing support needs of Aboriginal young people are understood, addressed, and supported. Without Aboriginal young people having confidence that mainstream mental health services and systems are prioritising Cultural Safety when providing supports, mainstream mental health systems risk failing to reduce mental health and Social and Emotional Wellbeing disparities unjustly experienced by Aboriginal young people in New South Wales.

Black People, Spirituality, and Mental Health

The influence of spirituality and religiosity in the Black community has historically been significant. While spirituality and religiosity are important for the majority of Americans, compared to other races/ethnicities, Black people report the highest valuation for religion in their individual lives. Spirituality and religiosity have known protective effects on health, although, compared to the general relationship between these factors and general health care, the role of spirituality and religiosity within the mental health system is not well characterized. In significant ways for the Black community, while serving a protective and positive function, spirituality and religiosity can also create tensions for patients within mainstream mental health care systems that emphasize a biopsychosocial framework, leaving out key dimensions of spiritual well-being and formation. The complexity of the relationship between Black people's mental health and their religion and spirituality also has roots in a history of colonialism and racism. In this article, we describe some ways in which religion and spirituality have been important to the health and well-being of the Black community, as well as certain ways these factors have created tension within the community. [ Psychiatr Ann . 2023;53(12):540–544.]

Nurturing the Positive Mental Health of Autistic Children, Adolescents and Adults alongside That of Their Family Care-Givers: A Review of Reviews.

The rising prevalence of autism internationally has been accompanied by an increased appreciation of the poorer mental health experienced by people with this condition and also of their family care-givers. In particular, higher incidences of anxiety and depression are reported in high-income nations and these conditions are likely to be under-recognised and under-reported in lower-resourced regions or countries. Mainstream mental health services seem to be ill-equipped to respond adequately to the needs of autistic persons and their care-givers. This literature review of 29 recently published reviews covering nearly 1000 journal articles summarises the insights and strategies that have been shown to promote the mental health and emotional wellbeing of autistic persons. In particular, a focus on family-centred, community-based supports is recommended that aim to enhance social communication, extend social connections and promote an individual's self-esteem, self-determination and social motivation. These low-cost interventions are especially pertinent in low-resourced settings, but they can be used internationally to prevent mental illness and assist in the treatment of anxiety and depression in autistic persons and their family carers. The priority is to focus on primary-care responses with cross-sectoral working rather than investing in high-cost psychiatric provision.

Examining privilege, puzzlement and the problematic positioning of the ‘psychologist’ as internal consultant in psychologically-informed environments

Deliberate self-harm and the attribution of intentionality – that sufferers are choosing to harm themselves – have become dominant constructs within mainstream Western mental health care. The aim of this paper is to explore the author’s privileged positioning as internal consultant, whereby psychological knowledge was used to explain why a chronically excluded homeless adult refused an invitation to reside inside. The attribution of intention to an individual perceived as engaging in deliberate self-harm is explored over three psychological case discussions with staff. A critique is offered that psychologised attributions merely add to patients’ existing predicaments and psychosocial dismemberment. Scanlon and Adlam’s seminal work on reciprocal violence is referenced as a critique, that instead of choosing to harm oneself, subjects are communicating to carers their internalised experiences of interpersonal violation and neglect which have in turn given rise to violent states of mind. The paper could be used as a reflective aid to facilitate clinicians and scholars to consider how to digest violent and unthinkable material, and consider one’s own personal obstacles to thinking about unhoused minds and psychosocial dismemberment.

Revisiting Self-Objectification Among Black Women: The Importance of Eurocentric Beauty Norms

Models of self-objectification utilized by the existing literature have been normed with predominantly White samples and may not account for the unique pressures on Black women to engage in beauty practices that prioritize European appearance expectations. Additionally mainstream media have historically rejected Black women’s bodies and beauty, instead reifying Western European aesthetics. We expand the existing literature by testing the contribution of body surveillance using serial analyses via endorsement of Eurocentric appearance norms (i.e., feminine appearance, thinness, and Eurocentric appearance), mainstream media consumption, mental health (i.e., depression, anxiety, and hostility), and body shame. Based on a sample of 561 Black women, combined serial/parallel mediation models revealed that total media consumption was not associated with body surveillance; however, there was an indirect effect of media consumption through acceptance of European body image norms predicting mental health and body shame. Findings suggest that to fully understand the impact of sexual- and self-objectification among Black women, researchers must also examine their negotiations of Western European norms of femininity and beauty. Implications for Black women’s body image beliefs are discussed.

Mental health services for Muslim communities in England and Wales: developing a more collaborative model

ABSTRACT The landscape of mental health services for Muslim communities in England and Wales remains fragmented with many Muslims unsure how to access services that accommodate their religious beliefs and practices. This article reports findings from a pilot study of mental health services and Muslim communities in England and Wales. It explores the role of Muslim mental health organisations, charities, therapists, counsellors, faith leaders and community groups in supporting the communities they serve. The study’s aim was to establish a larger project to identify and amplify best practice across mainstream and non-mainstream mental health services in relation to improving provision for Muslim communities. Focus group data from key informants was analysed using grounded theory. Four analytical themes emerged from the analysis: “Knowledge gaps”, “Policy gaps”, “Working together” and “Moving forward”. Based on this, the authors argue for an asset-based approach to building collaborative partnerships between Muslim communities and mental health providers.

Vicarious Trauma and Health Outcomes in Forensic Mental Health Nurses.

Nurses working in forensic mental health settings are at risk of vicarious trauma because of their exposure to traumatized patients and distressing material such as the aversive details of patient crimes. The aim of this study was to determine the incidence of vicarious trauma and explore its impact on health and absence from work. A cross-sectional descriptive correlational study was undertaken. All 205 forensic mental health nurses working in a high-security inpatient facility were invited to participate. An online survey included the Vicarious Trauma Scale and the SF-36v2 to measure mental and physical health. Absence from work was also explored. Sixty-seven respondents completed the survey. Almost half of respondents had a moderate level of vicarious trauma, and only over one-quarter experienced high levels. Higher levels of vicarious trauma were associated with poorer mental health ( r = -0.59, p < 0.000) and absence from work ( r = 0.27, p < 0.010). Forensic mental health nurses are at a greater risk of vicarious trauma than nurses working in mainstream mental health services, given their exposure to aversive details of patients' violent crimes. Adverse mental health consequences of vicarious trauma, and other forms of workplace trauma experienced by forensic mental health nurses, are likely to include trauma-related symptoms, depression, and anxiety. Forensic mental health nurses experiencing vicarious trauma may use sick leave as time away from work to care for their own mental health or a coping mechanism for workplace-induced psychological distress.

Conceptualizing the peer contribution in Open Dialogue practice.

In English mental health services, people with their own experience of mental distress have trained as Open Dialogue practitioners and have been employed as peer practitioners, co-working as equals alongside workers with professional backgrounds in Network Meetings. The conceptual underpinnings of the peer practitioner role have been drawn from the principles and relational approach of Intentional Peer Support. These have significant similarities with Open Dialogue, in terms of philosophical and theoretical orientations, with a particular focus on what happens in the "between" of a relational encounter. However, there are also significant differences in how practice principles are conceptualized, particularly around areas such as mutuality and self-disclosure. This article offers an analysis of this conceptual territory drawing on the relevant literature. This is then taken forward with the teasing out of specific practice principles that capture the unique contribution that peer practitioners can bring to Open Dialogue practice. These are derived through discussions that took place in an Action Learning Set for peer practitioners who have been involved in delivering Open Dialogue services in mainstream mental health service settings. This was part of a wider research study entitled Open Dialogue: Development and Evaluation of a Social Network Intervention for Severe Mental Illness (ODDESSI). The principles address how peer practitioners may be particularly well-placed to offer attunement, validation, connection and mutuality, and self-disclosure - and hence how they may be able to contribute an additional dimension to dialogical practice.

Evaluating online teaching on working with people with learning disabilities to high intensity Improving Access to Psychological Therapies (IAPT) trainees

People with learning disabilities are known to experience barriers to accessing mainstream mental health services, and also, to have higher rates of mental health needs. Training has previously been delivered to mainstream practitioners to enhance their confidence and self-efficacy when working therapeutically with people with learning disabilities and to promote positive attitudes towards working with this group of people (Dagnan et al., 2018; Cantrell &amp; Westbrook, 2019) with positive outcomes on these areas. Our service evaluation was of a one-day online training course to high intensity Improving Access to Psychological Therapies (IAPT) trainees. It found that the teaching also demonstrated positive change in confidence, self-efficacy and attitudes. Although the percentage increase was smaller than most of those shown in previous studies this was found to be due to a higher baseline for this sample. Ideas for further research were identified including the further exploration of High intensity (IAPT) trainees’ prior experience of working therapeutically with people with learning disabilities and how this could translate into more tailored training. A key recommendation was the use of online training for IAPT trainees and practitioners to be considered as an option due to benefits in terms of the flexibility this offers including training large groups.Easy to read summary■We delivered teaching to trainee therapists who work in mental health services.■The teaching was online.■Before the teaching we asked the trainees about their confidence to give therapy to people with learning disabilities and how important they thought it was for mental health services to work with people with learning disabilities.■We asked them the same questions at the end of the teaching.■The trainees were more confident to work with people with learning disabilities after the teaching.■The trainees were more positive about working with people with learning disabilities after the teaching.

A Social Network Analysis of Interagency Collaboration in the Mental Health Sector in Toronto, Canada: Service Providers’ Perspectives on Supporting Black Youth in Recovery

Objective: There is minimal research on mental health service providers’ perspectives on existing interagency relationships, collaboration, and caring for Black youth. We sought to characterize interagency relationships between Mainstream and Black-focused mental health agencies in Ontario, and their impact on service providers’ ability to provide culturally safe care for Black youth.&#x0D; Research Design and Methods: A mixed methodological approach was used to explore service providers’ perspectives on the collaborative nature and presence of relationships, communication, and influence in the mental health sector. An online survey was disseminated to service providers in Toronto, Ontario between March 2020 and April 2020. 7 focus groups were conducted in Toronto between May 2020 and December 2020. Focus groups were conducted with Black youth, families/caregivers, community, and service providers. Quantitative data were analyzed using SPSS and visualized in the form of social network analysis using Gephi, while Nvivo 12 was utilized to identify and analyze themes from the qualitative data.&#x0D; Results: Findings included a lack of interagency collaboration, infrequent Mainstream-Black agency collaborations, Mainstream agencies’ disinterest in future partnerships with Black agencies, and feelings of unpreparedness amongst service providers to provide culturally safe care to Black youth or referrals.&#x0D; Conclusions: Collaboration between mainstream agencies is common in the sector. There is a paucity of Black-focused agencies and Black service providers in the existing social networks. A limited understanding of the systemic impacts anti-Black racism at the agency and service provider level might be impairing service providers’ ability to support the mental health recovery of Black youth.&#x0D;

Culturally Adapted Cognitive Behaviour Therapy (CaCBT) to Improve Community Mental Health Services for Canadians of South Asian Origin: A Qualitative Study.

South Asian (SA) Canadians are disproportionately affected by higher rates of mood and anxiety disorders. SA Canadians with depression report significant barriers to accessing mental health care and the highest proportion of unmet mental health needs. The Mental Health Commission of Canada (MHCC) advocates for culturally and linguistically relevant services for SA Canadians. Culturally adapted cognitive behavior therapy (CaCBT) has shown to be more effective than standard cognitive behavior therapy (CBT). Adapting CBT for the growing SA population in Canada will ensure equitable access to effective, culturally-appropriate mental health interventions. The study used a qualitative design to elicit stakeholder consultation via in-depth interviews. This study is reported using the criteria included in Consolidated Criteria for Reporting Qualitative Studies (COREQ). The analysis follows an ethnographic approach and was informed by the principles of emergent design. Five themes were identified from the analysis, (i) Awareness and preparation: factors that impact the individual's understanding of therapy and mental illness. (ii) Access and provision: SA Canadians' perception of barriers, facilitators, and access to treatment. (iii) Assessment and engagement: experiences of receiving helpful treatment. (iv) Adjustments to therapy: modifications and suggestions to standard CBT. (v) Ideology and ambiguity: racism, immigration, discrimination, and other socio-political factors. Mainstream mental health services need to be culturally appropriate to better serve SA Canadians experiencing depression and anxiety. Services must understand the family dynamics, cultural values and socio-political factors that impact SA Canadians to reduce attrition rates in therapy.

"Ngany Kamam, I Speak Truly": First-Person Accounts of Aboriginal Youth Voices in Mental Health Service Reform.

Aboriginal young people are experts in their own experience and are best placed to identify the solutions to their mental health and wellbeing needs. Given that Aboriginal young people experience high rates of mental health concerns and are less likely than non-Indigenous young people to access mental health services, co-design and evaluation of appropriate mental health care is a priority. Increasing Aboriginal young people's participation in mental health service reform is key to ensuring services are culturally secure, relevant and accessible. This paper presents first-person accounts from three Aboriginal young people who worked alongside their Elders and in a positive and constructive partnership with mainstream mental health services on a three-year participatory action research project in Perth, Western Australia, in Whadjuk Nyoongar boodja (Country). The young people recount their experiences as participants and co-researchers on a systems change mental health research project and share their views on the importance of privileging Aboriginal youth voices. Their accounts highlight that Aboriginal young people's participation and leadership must be understood through a decolonising lens and that working in genuine partnership with the community is key to increasing their contact and engagement with mental health care and improving mental health and wellbeing outcomes.