Mental Health Care Practitioners Research Articles

Perspectives of practitioners on support for caregivers of children with intellectual disability.

Children with profound intellectual disabilities are unable to do anything for themselves and require full-time care in healthcare facilities. While caring for children, secondary caregivers become overwhelmed. Coupled with little or no support, the overwhelming work affects their psychological, social and financial well-being. Mental healthcare practitioners have perspectives on conditions under which secondary caregivers work and how can they be supported. Little is known about such perspectives. This study aims to explore and describe the perspectives of mental healthcare practitioners regarding the conditions under which secondary caregivers of children with profound intellectual disabilities work and how can they be supported. A qualitative-exploratory-descriptive and contextual research design was adopted using a non-probability purposive sampling technique. This study was conducted in Gauteng province. Semi-structured individual interviews were performed to collect data. Content data analysis and ATLAS.ti were used to analyse the data. Knowledge and skills development, stress reduction, resources and motivation were themes that emerged. This study explored and described the perspectives of mental healthcare practitioners regarding the conditions under which secondary caregivers of children with profound intellectual disabilities work and how can they be supported. If implemented, perspectives can improve the holistic well-being of secondary caregivers.Contribution:This study broadened an understanding of how secondary caregivers can be supported. Future researchers can use study results to develop programmes, intervention strategies and frameworks to support secondary caregivers.

Strategies for Achieving Better Cognitive Health in Individuals with Schizophrenia Spectrum: A Focus on the Canadian Landscape: Stratégies pour atteindre une meilleure santé cognitive chez les personnes souffrant du spectre de la schizophrénie : un regard sur le paysage canadien.

Schizophrenia spectrum disorders (SSDs) are a group of psychiatric disorders characterized by positive and negative symptoms as well as cognitive impairment that can significantly affect daily functioning. We reviewed evidence-based strategies for improving cognitive function in patients with SSDs, focusing on the Canadian landscape. Although antipsychotic medications can address the positive symptoms of SSDs, cognitive symptoms often persist, causing functional impairment and reduced quality of life. Moreover, cognitive function in patients with SSDs is infrequently assessed in clinical practice, and evidence-based recommendations for addressing cognitive impairment in people living with schizophrenia are limited. While cognitive remediation (CR) can improve several domains of cognitive function, most individuals with SSDs are currently not offered such an intervention. While the development of implementation strategies for CR is underway, available and emerging pharmacological treatments may help overcome the limited capacity for psychosocial approaches. Furthermore, combining pharmacological with non-pharmacological interventions may improve outcomes compared to pharmacotherapy or CR alone. This review highlights the challenges and discusses the potential solutions related to the assessment and management of cognitive impairment to help mental health-care practitioners better manage cognitive impairment and improve daily functioning in individuals with SSDs.

Co-designing restrictive practice elimination: A systems thinking approach with mental health service users and practitioners in rural/regional Australia.

Elimination of restrictive practices (physical/mechanical restraint and seclusion) from adult acute mental health care services has been demanded internationally for many decades. This study aimed to: (1) Identify priority issues in the elimination of and use of alternative approaches to restrictive practices (seclusion and physical/mechanical restraint) in rural/regional acute adult mental healthcare services, as told by mental healthcare service users and practitioners, (2) identify the community-based, system-level feedback loops that enhance or reduce the use of restrictive practices and viable alternatives and, (3) identify potential action areas to improve system structures to increase regional mental healthcare services' ability to eliminate restrictive practices and use alternative approaches. Group model building (GMB) workshops were held with a small group (n = 9) of mental healthcare practitioners and service users with lived experience of restrictive practice use. This participatory approach enables exploration and visual mapping of local structures causing behaviour patterns of practitioner and service user concern over time - in this case, the barriers, and enablers to alternative approaches to restrictive practices in adult acute mental healthcare services within the Geelong-Barwon region. This is the first study that specifically applies GMB in the discussion of the elimination of restrictive practices in mental health in the non-metropolitan regional/rural context. Participants identified four key priorities in relation to eliminating restrictive practices: (1) self-advocacy, (2) continuity of care, (3) early intervention, and (4) safety for all. The study findings were distilled into a novel preliminary set of mental healthcare practitioner and service user action ideas.

Professional Values and Mental Health Tribunals: How Healthcare Professionals’ and Lawyers’ Views Are Shaped by Values, and How This Might Impede Reform

Most countries that provide for compulsory treatment for mental illness have a system by which this treatment is subject to independent legal oversight. Many countries use a special type of legal body for this purpose, called a mental health tribunal. Mental health tribunals have been subject to criticism from the points of view of both legal professionals and mental healthcare practitioners. Similar themes have manifested in these criticisms and have been consistent across several decades; legal professionals tend to focus on the tribunals being biased toward the medical opinion, and acting as a ‘rubber stamp’, whereas healthcare practitioners tend to focus on the adversarial nature of the trial, and the adverse effect that this can have on clients. However, empirical studies of the tribunals have not separated and directly compared these perspectives. This study aimed to explore this dynamic between lawyers’ views and healthcare practitioners’ views of mental health tribunals. We used thematic analysis to re-analyse data from two previous research studies, one which looked at lawyers’ views of the tribunals, and one which looked at healthcare practitioners’ views. Our results are divided into three themes: views of the problems with tribunals, professional roles in relationship to the tribunals and professional values demonstrated through these views and roles. We then consider if the ‘clash of values’ represented by these findings, and found in the literature, may pose an impediment to tribunal reform. Identifying and exploring this barrier is an important step to moving beyond critique to reform.

Confirmation bias in AI-assisted decision-making: AI triage recommendations congruent with expert judgments increase psychologist trust and recommendation acceptance

The surging global demand for mental healthcare (MH) services has amplified the interest in utilizing AI-assisted technologies in critical MH components, including assessment and triage. However, while reducing practitioner burden through decision support is a priority in MH-AI integration, the impact of AI systems on practitioner decisions remains under-researched. This study is the first to investigate the interplay between practitioner judgments and AI recommendations in MH diagnostic decision-making. Using a between-subjects vignette design, the study deployed a mock AI system to provide information about patient triage and assessments to a sample of MH professionals and psychology students with a strong understanding of assessments and triage procedures. Findings showed that participants were more inclined to trust and accept AI recommendations when they aligned with their initial diagnoses and professional intuition. Moreover, those claiming higher expertise demonstrated increased skepticism when AI's suggestions deviated from their professional judgment. The study underscores that MH practitioners neither show unwavering trust in, nor complete adherence to AI, but rather exhibit confirmation bias, predominantly favoring suggestions mirroring their pre-existing beliefs. These insights suggest that while practitioners can potentially correct faulty AI recommendations, the utility of implementing debiased AI to counteract practitioner biases warrants additional investigation.

Using Conversational AI to Facilitate Mental Health Assessments and Improve Clinical Efficiency Within Psychotherapy Services: Real-World Observational Study.

Most mental health care providers face the challenge of increased demand for psychotherapy in the absence of increased funding or staffing. To overcome this supply-demand imbalance, care providers must increase the efficiency of service delivery. In this study, we examined whether artificial intelligence (AI)-enabled digital solutions can help mental health care practitioners to use their time more efficiently, and thus reduce strain on services and improve patient outcomes. In this study, we focused on the use of an AI solution (Limbic Access) to support initial patient referral and clinical assessment within the UK's National Health Service. Data were collected from 9 Talking Therapies services across England, comprising 64,862 patients. We showed that the use of this AI solution improves clinical efficiency by reducing the time clinicians spend on mental health assessments. Furthermore, we found improved outcomes for patients using the AI solution in several key metrics, such as reduced wait times, reduced dropout rates, improved allocation to appropriate treatment pathways, and, most importantly, improved recovery rates. When investigating the mechanism by which the AI solution achieved these improvements, we found that the provision of clinically relevant information ahead of clinical assessment was critical for these observed effects. Our results emphasize the utility of using AI solutions to support the mental health workforce, further highlighting the potential of AI solutions to increase the efficiency of care delivery and improve clinical outcomes for patients.

Spirituality and Mental Health Among South Asians in the United States

Spirituality and psychiatry have had a complex relationship, with much debate on the inclusion of spiritual and religious concepts in guiding psychiatric care. South Asians in the United States (US) are the largest growing immigrant population with a heterogeneous mix of many religions including Hinduism, Buddhism, Islam, Jainism, Sikhism, and Christianity. South Asians are more vulnerable to mental health disorders compared to the US general population in general, yet have much lower health care utilization rates. This article aims to address the unmet needs in mental health care for South Asians and address the knowledge gap among mental health care practitioners, to enable spiritually integrated care. [ Psychiatr Ann . 2023;53(12):550–555.]

Psychological distress during the COVID-19 pandemic: An integrative perspective.

Informed by socio-ecological psychology and the conservation of resources model, the present study proposes an integrative perspective on the association between psychological distress and a constellation of factors, during the COVID-19 outbreak in Israel. Our sample, comprised of 991 adult participants, was measured for psychological distress, locus of control (internal/ external), resilience, loneliness, social support, dimensions of citizens' trust in government organizations (perceived competence, benevolence, and integrity), and demographic characteristics. The findings showed that women, non-religious people, and the unemployed reported higher levels of psychological distress. Internal locus of control, resilience, social support, and the extent to which citizens perceive government organizations as benevolent were negatively associated with psychological distress. Self-reported loneliness and external locus of control positively predicted the level of respondent psychological distress. No association was detected between age, competence and integrity and psychological distress. An overview of the research findings indicates that individuals with greater resources were less likely to suffer from psychological distress during the COVID-19 outbreak. These findings call upon mental health care practitioners to help as well as to enable clients to attain resources in order to lower their levels of psychological distress. Policies developed by policymakers during periods of acute crisis should consider the specific needs and vulnerabilities of certain population groups, including women and the unemployed who may be more susceptible to psychological distress. It is also important for policymakers to be aware that the perception of democratic governments as benevolent can serve as a buffer against psychological distress during times of crisis.

A Qualitative Study of the Psychosocial, Physical and Spiritual Benefits and Challenges Experienced by Psychiatric Patients Engaging Community Mental Health Services

Background Mental illness generates feelings of shame, low self-esteem, isolation, and hopelessness which affect wellbeing and quality of life. Mental health care practitioners, therefore, need to support their clients to improve their quality of life. Despite an increasing awareness of the importance of spirituality in mental health contexts, a religiosity gap exists in the difference in the value placed on spirituality and religion. This may be due to a lack of understanding about the complex ways people connect with spirituality within contemporary society and mental health contexts and can result in people's spiritual needs being neglected or dismissed within clinical practice (K. Milner et al., 2020). Additionally, mental illness may cause a variety of psychosocial problems such as decreased quality of life of the patient and their family members as well as increased social distance for the patient and the family caring for the patient. Psychosocial challenges are enhanced by the stigma attached to mental illness, which is a problem affecting not only the patient but also the family. Coping mechanisms for dealing with mentally ill patients differ from one family to another for a variety of reasons (Kakuma R et al., 2010). Objective: The aim of this study was to explore the contribution of community mental healthcare services to the wellbeing of persons with a history of mental illness using the Betty Ferrell’s Quality of Life (QoL) model. Methods A qualitative research approach was adopted, using exploratory descriptive design to describe the experiences of psychiatric patients engaging community mental health services. An in-depth interview was conducted using Betty Ferrell’s Model as a guiding framework. Each interview lasted about an hour. All interviews were audiotaped, transcribed, and the content analyzed thematically. A purposive sampling method was used to select 11 participants who participated in a face-to-face in-depth interview. Responses from the interviews were transcribed verbatim and analysed using the thematic content analysis approach. Results The findings from the study revealed the important and valuable contribution of community mental health nursing services to the quality of life and wellbeing of persons with mental illness in all spheres of their functioning. The main themes and sub-themes on how community mental healthcare services impact the wellbeing of persons with history of mental illness were Spiritual wellbeing (‘hope’, ‘transcendence’, ‘positive changes’), Social wellbeing (‘good social interaction’, ‘good relationship with family’, ‘good relationship with community members’, ‘good relationship with church members’), Psychological wellbeing (‘perception of overall quality of life’, ‘anxiety/depression’, cognition/attention’, assertiveness’), and Physical wellbeing (‘adherence to medication regimen’, overall physical health’, functional ability’, appetite’). Community mental health nurses have also been instrumental in promoting the social wellbeing of people with history of mental illness. Improvement in the spiritual lives and religious activities of the clients through the intervention of the nurses helped them to find some purpose and meaning in life. Counselling, reassurance, encouragement, and education of clients by the nurses provided some relief from their anxieties and depression and promoted client compliance with prescribed treatment regimen. Conclusion Both theoretical and empirical literature reviewed show that social and emotional support for persons living with mental illness, or with a history of mental illness, are important to their quality of life. The support given within the community is invaluable. Thus, community mental health care services span the well-being in the domains of physical, social, spiritual, and psychological functioning.

Assessment of Drug-Induced QTc Prolongation in Mental Health Practice: Validation of an Evidence-Based Algorithm.

Drug-induced QTc interval prolongation (QTcIP) can lead to serious consequences and is often a concern for mental health practitioners, as access to experts such as cardiologists, for consultation is time-limiting and can delay treatment decisions. This research aimed at validating the content of an algorithm for the assessment, management and monitoring of drug-induced QTcIP in mental health practice. Following an initial face validity by content experts, a cross-sectional survey of mental health care practitioners with a 4-point Likert-type scale was used to assess the validity of the decision steps on the QTcIP algorithm (QTcIPA) by estimating the content validity index (CVI) and the modified kappa statistic (κ*). Participants' open-ended comments were also thematically analyzed. Mental health practitioners found the QTcIPA to be appropriate, safe, and evidence-based, as indicated by the high individual item CVI scores ranging from 0.89 to 1 for all of the steps/decision statements in the three domains assessed: appropriateness, safety and reliability of the references used. Five themes emerged from the qualitative analysis of the open-ended comments, of which three were identified as strengths, including practical usability, reliable references and beneficial for pharmacists. Two themes were recognized as limitations, namely, the need for additional clinical content and application barriers. These results suggest that the QTcIPA may be a useful tool for mental health clinicians at the time of prescribing medications with potential risk of QTcIP. Future research will explore the implementation of the QTcIPA into clinical practice using computerized decision support tools through web-based and mobile applications.

Domestic/Intimate Partner Violence, Abuse, and Trauma During COVID-19 Lockdown: Gaslighting, Non-consensual Condom Removal, Grooming, Coercive Control, Power Dynamic, and Sexual Entitlement in Emotional and Psychological Abuse

The COVID-19 outbreak has amplified psychosocial and emotional stressors for the more vulnerable segments of population. This article explored the drastic increase in emotional/psychological forms of abuse in intimate partner violence during COVID-19 lockdown period. Additionally, predisposing, precipitating, and perpetuating factors of gaslighting abuse, including non-consensual condom removal, grooming, love bombing, coercion, and power dynamics in controlling relationship, are discussed. Published articles on PubMed, Embase, Google Scholar, and Elsevier about psychological aspects of abuse in intimate partner violence during COVID-19 have been considered and reviewed. This article facilitates a solution-focused response for mental healthcare practitioners to support sustainable well-being through collective solidarity, empowerment, and resilience for survivors. This article introduced personal-collective growth process through humanistic-centered approaches for individuals to share their experiences, realign meaningfulness, create hope, and develop coping strategies.

Geografisk variasjon i vaksnes bruk av avtalespesialistar og DPS i psykisk helsevern

Background: Equitable mental healthcare regardless of area of residence is a political aim in Norway. The purpose of this study is to evaluate geographical variation in private practitioner coverage, and explore differences between private practitioners with public reimbursement and local community mental health centers (CMHCs) in terms of diagnoses and scope of outpatient treatment, with a focus on mood and neurotic disorders. Method: Cross-sectional registry-based study of adults in outpatient mental healthcare at private practitioners or CMHCs in Norway in 2014–2018. We calculated distribution of diagnoses, geographical variation in rates of private practitioners, and analyzed scope of treatment for patients with mood and neurotic disorders (ICD-10 disorders F3, F4). We estimate cost per treated patient and report geographic variation for hospital catchment areas. Results: Patients with F3, F4 disorders accounted for 64.7 % at private practitioners, and 31.5 % at CMHCs, and received more treatment at private practitioners, five more consultations in a 42 day longer period. There is considerable geographical variation in private practitioner coverage, highest in South-East Norway and lowest in North Norway. Implications: As long as management and priority setting are differently organized for CMHCs and private practitioners in mental health care, we must expect geographical variation in access and use. It appears as an equity paradox that a group of patients, rejected by or not referred to CMHC, receive more treatment by private practitioners. Keywords: mental healthcare, outpatient consultations, private practitioners, CMHC, geographical variation, equal access, equity, priority setting

Preparing for the unexpected: a comparative study of policies addressing post-terror health reactions in Norway and France

BackgroundIn the wake of terrorist attacks, protecting the health and psychosocial wellbeing of those affected and the general population, are important tasks for the healthcare system. The responses to such emergencies are often complex, including different phases and many actors, and may unveil insufficiencies that incite reforms to existing systems. Recently, initiatives have been promoted to strengthen cooperation and coordination regarding the governance of health threats in Europe. Comparative research is requested on how states prepare for health emergencies such as terrorist attacks. This study investigated how governments in two European countries with universal health coverage prepared to address the civilian population’s health needs after terrorist attacks, and the factors that contributed to shaping their chosen approach.MethodsUtilizing document analysis and Walt and Gilson’s model for the analysis of health policy, national plans for post-terror health responses in Norway and France were studied with a focus on context, process, content, and actors.ResultsWhereas target groups for psychosocial care and certain measures were similar in both cases, the contents of prescribed policies and the actors responsible for enacting them differed. One of the most distinct differences was to what extent specialized mental healthcare was relied upon to provide psychosocial follow-up in the emergency phase. In the French approach, specialized mental healthcare practitioners, such as psychiatrists, psychologists and psychiatric nurses, provided early psychosocial support. In contrast, the Norwegian approach relied on interdisciplinary primary care crisis teams in the local municipalities to provide early psychosocial support, with further involvement of specialized mental healthcare if this was considered necessary. Historical, political, and systemic differences contributed to the variation in the countries’ responses.ConclusionsThis comparative study highlights the complexity and diversity of health policy responses to terrorist attacks across countries. Moreover, challenges and opportunities for research and health management in response to such disasters, including possibilities and potential pitfalls for the coordination of this work across Europe. An important first step could be to map out existing services and practices across countries to better understand if and how common core elements for psychosocial follow-up might be implemented internationally.

Optimizing an Adolescent Hybrid Telemedical Mental Health Service Through Staff Scheduling Using Mathematical Programming: Model Development Study.

According to the World Health Organization, globally, one in seven 10- to 19-year-olds experiences a mental disorder, accounting for 13% of the global burden of disease in this age group. Half of all mental illnesses begin by the age of 14 years and some teenagers with severe presentations must be admitted to the hospital and assessed by highly skilled mental health care practitioners. Digital telehealth solutions can be useful for the assessment of young individuals remotely. Ultimately, this technology can save travel costs for the health service rather than assessing adolescents in person at the corresponding hospital. Especially in rural regions, where travel times can be high, this innovative approach can make a difference to patients by providing quicker assessments. The aim of this study is to share insights on how we developed a decision support tool to assign staff to days and locations where adolescent mental health patients are assessed face to face. Where possible, patients are seen through video consultation. The model not only seeks to reduce travel times and consequently carbon emissions but also can be used to find a minimum number of staff to run the service. To model the problem, we used integer linear programming, a technique that is used in mathematical modeling. The model features 2 objectives: first, we aim to find a minimum coverage of staff to provide the service and second, to reduce travel time. The constraints that are formulated algebraically are used to ensure the feasibility of the schedule. The model is implemented using an open-source solver backend. In our case study, we focus on real-world demand coming from different hospital sites in the UK National Health Service (NHS). We incorporate our model into a decision support tool and solve a realistic test instance. Our results reveal that the tool is not only capable of solving this problem efficiently but also shows the benefits of using mathematical modeling in health services. Our approach can be used by NHS managers to better match capacity and location-dependent demands within an increasing need for hybrid telemedical services, and the aims to reduce traveling and the carbon footprint within health care organizations.

The role of ‘micro-decisions’ in involuntary admissions decision-making for inpatient psychiatric care in general hospitals in South Africa

While the ethics of involuntary admission for psychiatric inpatient care is widely contested, the practice is legally permissible across most jurisdictions. In many countries, laws governing the use of involuntary admission set out core criteria under which involuntary admission is permitted; these parameters broadly related to either risk of harm to self or others, need for treatment, or both. In South Africa, the use of involuntary admission is governed by the Mental Health Care Act no. 17 of 2002 (MHCA 2002), which sets out clear criteria to direct mental healthcare practitioners' decision-making and delineates a process by which decision-making should occur. However, recent research suggests that, in practice, the process of decision-making differs from the procedure prescribed in the MHCA 2002. To further explore how decision-making for involuntary admission occurs in practice, we interviewed 20 mental healthcare practitioners, all with extensive experience of making involuntary admission decisions, working in district, regional, and tertiary hospitals across five provinces. We also interviewed four mental health advocates to explore patient-centered insights. Our analysis suggests that the final decision to involuntarily admit individuals for a 72-h assessment period under the MHCA 2002 was preceded by a series of ‘micro-decisions’ made by a range of stakeholders: 1) the family's or police's decision to bring the individual into hospital, 2) a triage nurse's decision to prioritise the individual along a mental healthcare pathway in the emergency centre, and 3) a medical officer's decision to sedate the individual. Practitioners reported that the outcomes of each of these ‘micro-decisions’ informed aspects of their final decision to admit an individual involuntarily. Our analysis therefore suggests that the final decision to admit involuntarily cannot be understood in isolation because practitioners draw on a range of additional information, gleaned from these prior ‘micro-decisions’, to inform the final decision to admit.

The association between comorbid body dysmorphic disorder and depression: moderation effect of age and mediation effect of body mass index and body image among Pakistani students

BackgroundAmerican Psychological Association defined body dysmorphic disorder as being obsessed with observed (preoccupied) flaws in one’s appearance. The observed flaws cause ample distress and/or worsening in the quality of life, isolation, lessening in social or professional functioning, while also being linked to depression and attempt suicide. Generally, younger individuals are more displeased and anxious about defects that can be seen or unseen. The study aimed to explore the predictive role of body mass index and body image in the relationship between comorbid body dysmorphic disorder and depressive symptoms among adults. A cross-sectional study used self-report measures; for depression, body apperception, and body dysmorphic disorder scale were administered to 281 undergraduate and post-graduate adults of Hazara division, Khyber Pakhtunkhwa, Pakistan, consisting male (54.80%) and women (45.19%).ResultsResults indicated that body dysmorphic disorder was positively associated with body image and negatively with depression. As males are prone to stressors in Pakistani society, stressors overwhelm them more than females (Cohen’s d = .436). On body mass index categories, depression, age, and gender were substantially different in three categories. Structural equation modeling evidenced that body dysmorphic disorder indirectly predicts depression when age is used as a moderator and mediation effect of body mass index.ConclusionsIt is concluded that body dysmorphic disorder is prevalent at a younger age, overweight and underweight among adults. Therefore, the complexity of body dysmorphic disorder and its similarity with body image can be better understood within the specific context. The potential implication is it make easy to understand for the researchers and mental health care practitioners.

Patients' voices from music therapy at a South African psychiatric hospital.

BackgroundIn the Life Esidimeni tragedy, crucial voices of mental healthcare users and practitioners were silenced, captured in the Ombud’s report as a ‘failure to listen’. Working against this kind of failure, various therapeutic interventions listen deliberately and uncover the voice of the patient, that is, what matters from his or her subjective perspective in his or her particular circumstances. Amongst these interventions, music therapy provides for this sensitive listening by expanding the scope and means of expression from the verbal to the musical.AimThis article reports on a qualitative exploration of patients’ lived experiences both during and after their course of individual music therapy, expressed both verbally and in the language of active music-making.SettingA tertiary public psychiatric hospital in South Africa.MethodsAudio-video recordings of 131 music therapy sessions and 15 post-therapy interviews were analysed thematically. From three sets of themes accounting for patients’ verbal contents, musical participation and verbal post-therapy reflections, 11 salient voices were identified.ResultsThe 11 voices that emerged were (1) the voice of struggle, (2) the voice of disturbance, (3) the voice that feels, (4) the voice of isolation, (5) the powerless voice, (6) the voice that desires, (7) the voice of flow and connection, (8) the reflecting voice, (9) the symbolic voice, (10) the resilient voice and (11) the voice of liberation.ConclusionAlthough mental health practitioners may recognise these voices from their clinical experience, space and opportunity for hearing the voice of each patient should be generated deliberately.

Communication in youth mental health clinical encounters: Introducing the agential stance.

When young people seek support from mental health care practitioners, the encounters may affect the young people’s sense of self, and in particular undermine their sense of agency. For this study, an interdisciplinary team of academics and young people collaboratively analysed video-recorded encounters between young people and mental healthcare practitioners in emergency services. They identified five communication techniques that practitioners can use to avoid undermining the young person’s sense of agency in the clinical encounter. They conceptualise the use of those techniques as the adoption of an agential stance towards the young person. The agential stance consists of: (a) validating the young person’s experiences, (b) legitimising the young person’s choice to seek help, (c) refraining from objectifying the young person, (d) affirming the young person’s capacity to contribute to positive change, and (e) involving the young person in the decision-making process.

White and non-White Australian mental health care practitioners’ desirable responding, cultural competence, and racial/ethnic attitudes

BackgroundRacial, ethnic, religious, and cultural diversity in Australia is rapidly increasing. Although Indigenous Australians account for only approximately 3.5% of the country’s population, over 50% of Australians were born overseas or have at least one migrant parent. Migration accounts for over 60% of Australia’s population growth, with migration from Asia, Sub-Saharan African and the Americas increasing by 500% in the last decade. Little is known about Australian mental health care practitioners’ attitudes toward this diversity and their level of cultural competence.AimGiven the relationship between practitioner cultural competence and the mental health outcomes of non-White clients, this study aimed to identify factors that influence non-White and White practitioners’ cultural competence.MethodsAn online questionnaire was completed by 139 Australian mental health practitioners. The measures included: the Balanced Inventory of Desirable Responding (BIDR); the Multicultural Counselling Inventory (MCI); and the Color-blind Racial Attitudes Scale (CoBRAS). Descriptive statistics were used to summarise participants’ demographic characteristics. One-way ANOVA and Kruskal–Wallis tests were conducted to identify between-group differences (non-White compared to White practitioners) in cultural competence and racial and ethnic blindness. Correlation analyses were conducted to determine the association between participants’ gender or age and cultural competence. Hierarchical multiple regression analysis was conducted to predict cultural competence.ResultsThe study demonstrates that non-White mental health practitioners are more culturally aware and have better multicultural counselling relationships with non-White people than their White counterparts. Higher MCI total scores (measuring cultural competence) were associated with older age, greater attendance of cultural competence-related trainings and increased awareness of general and pervasive racial and/or ethnic discrimination. Practitioners with higher MCI total scores were also likely to think more highly of themselves (e.g., have higher self-deceptive positive enhancement scores on the BIDR) than those with lower MCI total scores.ConclusionThe findings highlight that the current one-size-fits-all and skills-development approach to cultural competence training ignores the significant role that practitioner diversity and differences play. The recommendations from this study can inform clinical educators and supervisors about the importance of continuing professional development relevant to practitioners’ age, racial/ethnic background and practitioner engagement with prior cultural competence training.

Intimate partner violence and mental health: lessons from the COVID-19 pandemic.

Intimate partner violence and mental health: lessons from the COVID-19 pandemic.