Mental Health Information System Research Articles

A Conceptual User-Centric Model for Mental Health Information Systems

A Conceptual User-Centric Model for Mental Health Information Systems

Generation Z’s Trust in The Chatbot of Mental Health Service

Generation Z is the age group that has experienced the most mental health-related issues due to the COVID-19 pandemic in Indonesia. Mental health information system services have become increasingly popular, so patient services are overwhelmed. Chatbot has emerged as one of the solutions to address this problem. However, conversations with them have led to social issues alongside the growing use of chatbots. This study aims to identify the factors influencing Generation Z's trust in patient service chatbots within mental health applications in Indonesia. Using the Interpretative Phenomenological Analysis method, this research analyses qualitative data from observations and interviews with five undergraduate students. Based on the analysis, the study identified seven factors that influence Generation Z's trust in chatbot customer service within mental health applications, with three being novel findings.

Trajectories of homelessness and association with mental health and substance use disorders among young people transitioning from out-of-home care in Australia

BackgroundResearchers have examined sub-groups that may exist among young people transitioning from out-of-home care (OHC) using various theoretical models. However, this population group has not been examined for trajectories of homelessness risk. ObjectivesTo examine whether different subtypes of homelessness risk exist among young people transitioning from care and whether these trajectories of homelessness are associated with mental health and substance use disorders. Participants and settingA retrospective population-based cohort study was conducted from a population of 1018 young people (aged 15–18 years) who transitioned from out-of-home in 2013 to 2014 in the state of Victoria, Australia, with follow-up to 2018. MethodsLatent Class Growth Analysis was conducted using linked data from homelessness data collections, child protection, mental health information systems, alcohol and drug use, and youth justice information systems. ResultsThree sub-groups of young people were identified. The ‘moving on’ group (88 %) had the lowest levels of homelessness, with the slope of this trajectory remaining almost stable. The ‘survivors’ (7 %) group started off with a high risk of homelessness, followed by a sharp decrease in homelessness risk over time. The ‘complex’ (5 %) group started off with a low risk of homelessness but faced sharp increases in the risk of homelessness over time. ConclusionsOur study demonstrates that subgroups of young people transitioning from care exist with distinct longitudinal trajectories of homelessness, and these classes are associated with different risk factors. Early intervention and different approaches to tackling homelessness should be considered for these three distinct groups before transitioning from care and during the first few years after leaving care.

Manajemen Proyek Sistem Informasi Kesehatan Mental Mahasiswa berbasis Akun Tiktok @healing.campus

Project Management for Mental Health Information System among Students Based on TikTok Accounts (Healing.Campus) is an initiative aimed at providing an alternative solution to assist students in dealing with mental health issues. Mental health is a crucial aspect of general well-being, yet issues related to mental health among students remain constrained and limited. This research employs a qualitative research method and data analysis techniques as a theoretical study. Qualitative research methods are used due to literature indicating constraints and limitations in using TikTok as a platform for developing students' mental health. Data analysis techniques, as part of the theoretical study, are utilized to determine whether the hypotheses formulated in the literature review are accurate. The research findings demonstrate that the TikTok-based information system, Healing.Campus, for mental health has achieved satisfactory outcomes, reflecting a significant positive impact on its audience. The Healing.Campus TikTok account has been able to contribute positively to students' mental health. Motivational video content has successfully created a supportive and empathetic atmosphere, provided practical solutions, and reduced stigma associated with mental health issues. It has successfully attained positive and significant outcomes in aiding students in addressing mental health concerns. This TikTok account proves its effectiveness in creating a supportive and empathetic atmosphere, offering practical solutions, and reducing the stigma associated with mental health problems. The existence of this mental health information system is expected to provide motivation and encouragement to students facing difficulties.

Examining the tapestry of mental health crises in low- & middle-income countries: an intercontinental analysis of the contributing factors and instructive approaches"

In recent decades, the intricate landscape of mental health challenges has become a focal point of global concern, with particular urgency in Low- and Middle-Income Countries (LMICs). This manuscript delves into the multidimensional tapestry of mental health issues prevalent in these regions, offering an intercontinental analysis that seeks to unravel the contributing factors and proposes strategies for improvement. Through a meticulous examination of diverse sociocultural, economic, and healthcare-related variables, this study aims to provide a comprehensive understanding of the complex dynamics shaping mental health crises in LMICs. Through an intercontinental lens, our analysis aims to transcend geographical boundaries, examining the commonalities and distinctions inherent in the mental health landscapes of LMICs. This inquiry is driven by a dual commitment: to comprehensively understand the determinants of mental health challenges and to identify instructive approaches that can serve as foundations for targeted interventions. In navigating this intellectual terrain, our study not only strives to contribute to the academic discourse on global mental health but also aspires to inform policy and practice, fostering a nuanced understanding of mental health dynamics and cultivating evidence-based strategies to ameliorate the burden faced by individuals in LMICs. By synthesizing current research, empirical data, and theoretical frameworks, our exploration not only illuminates the challenges but also endeavors to identify instructive approaches for mitigating the impact of mental health issues in resource-constrained settings. The confluence of factors influencing mental health in LMICs demands an interdisciplinary lens, and this manuscript endeavors to navigate this intricate terrain with rigor and precision. This article exposes the significant gap in mental health services, attributing this disparity to limited public funding, insufficient allocation for children and adolescents, and an inadequate distribution of funds in mental health infrastructure. The scarcity of mental health workers, particularly in primary healthcare settings, further exacerbates the problem. The contributing factors to mental health crises in LMICs include ineffective legislation, leadership, and national health policies, as well as cultural beliefs and stereotypes. The lack of a mental health information system further hampers meaningful progress in these regions. There is a need for a comprehensive mental health system that considers cultural, social, and economic factors unique to LMICs. To address the challenges faced by LMICs, the article suggests strategies, including legislative reforms, policy development, public education to reduce stigma, and promotion of evidence-based interventions. By drawing on existing principles and considerations, the authors provide a specific system of mental health services grounded in community-based care and "mental health-in-all-policies" approach which advocates for rational investment allocations, considering social determinants, prevalence data, and the humane treatment of individuals with mental health issues in these regions.

Real-time monitoring for sport and mental health prevention of college student based on wireless sensor network

This article uses wireless sensor network technology to freely combine multiple sensor nodes to achieve, but the scale and capacity of WSN internal nodes are limited, so it is easier to encounter a series of network attacks and security threats. When setting the access protocol, the protocol needs to identify the precautions for malicious attacks against the network, and at the same time try to achieve a balance between network weights to improve the life cycle of the network. This paper presents a multi-station basis for a wireless sensor connection system. The design uses elliptic curve encryption technology to ensure the security of identification between the base station and the cluster head, and uses blockchain technology to ensure the security and efficiency of the ID card between the base station and the terminal. And design a real-time monitoring system through wireless sensor network to monitor the sport and mental health of students. We have analyzed the system demand information of college students' sport and mental health, and analyzed the problems that the system needs to solve in detail. Through in-depth analysis of the sport and mental health information system, using wireless sensor network technology, we conducts a thorough investigation of the needs of the student sport and mental health system. Then we conduct an in-depth analysis of the system structure, architecture design, business model, available system, database system, to make the system more acceptable to people.

A National Program to scale up investment and reducing the gap in mental health in Somaliland: first year achievements

In Somaliland, mental health has been a neglected sector since the inception of the country almost 30 years ago. Only two years ago, there was no office, no staff, and no funding for mental health. Public mental health services were confined to five public in-patient facilities within the regional general hospitals, with a total bed capacity of 216 beds for a population of 4 million people. All the facilities experienced severe shortages of human and material resources, and proper supervision or control by the ministry did not exist. Lack of adequate and good quality-public mental health services has encouraged the opening of a plethora of unregulated private mental health facilities with poor records of human rights and services. One of the major impediments to improving mental health in the country was a lack of financial resources. In recognition of the deteriorating situation of mental health in the country and public pressure to do something about the problem. In late 2020, the government decided to scale up mental health services through khat taxation. Tax collection started in January 2021, and the first funds were released for use in July 2021. A five-year national program on mental health was then launched on August 1, 2021 underpinned by four main objectives: 1) establishment of leadership and governance in mental health; 2) strengthening existing mental health services and their integration into primary health care; 3) development of human resources in mental health; and finally 4) setting up a mental health information and research system. In this paper, we present early program achievements and their relevance to public health for other countries with similar settings looking to improve their mental health through effective mobilization of local resources.

The effect of dance on rehabilitation training after COVID-19.

This study aims at investigating the effect of dance on rehabilitation training after COVID-19. In this study, a total of 112 patients with COVID-19 were recruited for rehabilitation training. Before enrollment, a neurologist conducted medical history inquiry, basic information collection, MMSE (MiniMental State Examination), MoCA (Montreal Cognitive Assessment) and MHIS (Mental Health Information Systems) assessment. In the end, 68 patients with COVID-19 who met the entry criteria and signed the informed consent were included in the training. 8 patients with greater exercise risk after the ECG exercise test were not included in the group. Therefore, 60 patients were finally included in the group. The improved BMCE (Basic Medicine Comprehensive Examination) protocol was used to evaluate the cardiac function and exercise adaptability of the patients. The 12 lead ECG and gas metabolism instrument were used to monitor the changes of ECG and gas metabolism, and the blood pressure was measured at the same time. The exercise intensity was evaluated by subjective fatigue degree. The patient stopped the exercise test and rested for 15 minutes under the following conditions: (1) complained of any discomfort or intolerable fatigue; (2) horizontal or oblique ST segment pressure in ECG not shorter than 3 mm; (3) moderate to severe angina pectoris or reduction of systolic blood pressure greater than 10 mmhg. The heart rate when stopping the test was the maximum heart rate of the patient. The average participation times of MCI patients in the aerobic dance group were 33.9 (IQR = 34, 36), 89.7% of MCI patients participated in 90% of aerobic dance training, and only 3.4% of MCI patients participated in less than 80% of aerobic dance courses. Compared with the control group, the 3-month change value of Wechsler's logical memory of MCI patients in the aerobic dance group was significantly improved (p < 0.01). The 3-month change value of digital connection test B score was significantly improved (mean value of difference between groups = -32. The treatment speed was significantly shortened at 6 months (P300 latency 6 months change value = -20 ms). The intensity and frequency of aerobic dance play a key role in the effect of cognitive improvement, requiring long-term persistence and ensuring the intensity and frequency of training. Second, the patient's processing speed (P300 latency) tends to gradually extend with the passage of time, and aerobic dance intervention helps shortening the P300 latency, suggesting that patients can delay the decline of their cognitive function through early aerobic dance intervention.

Increased mortality and non-cancer morbidity risk may be associated with early menopause and varies with aetiology: An exploratory population-based study using data-linkage

ObjectiveIatrogenic early menopause (EM), that is, menopause before the age of 45 years due to surgery or chemotherapy or radiotherapy, is associated with negative health impacts. However, it is unclear how these vary according to the cause of EM. We investigated mortality and non-cancer morbidity in women with iatrogenic EM of different aetiologies. Study designPopulation-based retrospective cohort study with 36-year follow-up using data-linkage with the Western Australia hospital morbidity database, cancer, birth and death registries, the midwives notification system and the mental health information system. The sample comprised women aged 20–44 years at index date with iatrogenic EM associated with breast or gynaecological cancer (n = 607), or benign bilateral oophorectomy (n = 414), and age-matched female controls (n = 16,998). Index date (breast, ovarian or uterine cancer diagnosis or oophorectomy procedure) ranged from 1982 to 1997, with follow-up until 2018. Main outcome measuresMortality and hospitalisation for circulatory disorders, endocrine, psychological, respiratory, musculoskeletal and gastrointestinal morbidities. ResultsSignificant differences in mortality were observed (% dead by follow-up: cancer, 53.0; oophorectomy, 10.9; and controls, 3.5; p < 0.001). Incidence rate ratios (IRRs) were increased for circulatory (1.23, 95 % CI 1.07–1.42) and endocrine disorders (1.31, 95%CI 1.08–1.56) and hip fracture (3.90, 95 % CI 1.83–7.40) in cancer survivors, compared with controls. IRRs for circulatory (0.62, 95 % CI 0.53–0.72) and endocrine disorders (0.62, 95 % CI 0.38–0.97) were reduced in the oophorectomy group, but were increased for psychological (8.53, 95 % CI 7.29–9.94) and gastrointestinal morbidities (1.43, 95%CI 1.21–1.67) compared with controls. ConclusionCancer-related or benign iatrogenic EM may be associated with increased mortality and morbidity, which vary with the cause of EM.

The interRAI Child and Youth Suite of Mental Health Assessment Instruments: An Integrated Approach to Mental Health Service Delivery.

Various biological, social, psychological, and environmental factors impact children and youth living with mental health problems across their lifespan. To meet the wide-ranging challenges of mental illness, service system integration is needed to improve efficiencies and reduce fragmentation. Unfortunately, the mental health system has been plagued by the lack of coordination across services. There is a general consensus that mental health service delivery must ensure a child or youth’s needs are addressed in a collaborative, coordinated, and seamless manner. A key element to successful integration is the development of a comprehensive standardized screening and assessment system. Numerous assessments have been developed to assess child mental health and functioning, but they typically have a very narrow focus with limited use and utility. Not only does this reduce the ability to take a life course perspective to mental health, but this uncoordinated approach also results in redundancies in information collected, additional resources, and increased assessor burden for children, youth, and their families. The interRAI child and youth mental health assessment suite was developed in response to the need for an integrated mental health system for young persons. This suite includes screening and assessment instruments for in-patient and community settings, emergency departments, educational settings, and youth justice custodial facilities. The instruments form a mental health information system intentionally designed to work in an integrated fashion beginning in infancy, and incorporate key applications such as care planning, outcome measurement, resource allocation, and quality improvement. The design of these assessment tools and their psychometric properties are reviewed. Data is then presented using examples related to interpersonal trauma, illustrating the use and utility of the integrated suite, along with the various applications of these assessment systems.

A comparison of trajectories of offending among people with psychotic disorders, other mental disorders and no mental disorders: Evidence from a whole-of-population birth cohort study.

Trajectory analysis has been used to study long-term offending patterns and identify offender subgroups, but few such studies have included people with psychotic disorders (PDs) and these have been restricted to adult offenders. To compare offending trajectories among 10-26-year-olds with PDs with those with other mental disorders (OMDs) or none (NMD) and identify associated risk factors. This is a record-linkage study of 184,147 people born in Western Australia (WA) 1983-1991, drawing on data from WA mental health information system, WA corrective services and other state-wide registers. Group-based trajectory modelling was used to identify offending trajectories. Four offender groups were identified in each mental health status group: G1-no/negligible offending; G2-early onset, adolescent, desisting by age 18; G3-early onset, low rate, offending into early adulthood; and G4-very early onset, high rate, peaking at age 17, continuing into early adulthood. The PDs group had the lowest proportion of individuals with no or negligible offending histories-84% compared with 88.5% in the OMDs group and 96.6% in the no mental disorder group. Within mental health status offender groups, the PDs group was characterised by early or very early onset offending persisting into adulthood, accounting for 5.4% and 3.7% of the group respectively (OMD: 3.8%, 1.5%; NMD: 1.0%, 0.5%). Gender, indigenous status, substance use problems, childhood abuse and parental offending were generally associated with trajectory group membership, although among those with PDs childhood abuse and parental offending were only significant in the early onset-life-course-persistent group. While most people with PDs never offend, some are disproportionately vulnerable from a particularly early age. If the offending subgroup is to be helped away from criminal justice involvement, interventions must be considered in childhood.

Readiness to deliver person\u2010focused care in a fragile situation: the case of Mental Health Services in Lebanon

BackgroundEvidence suggests wide variability in the provision of mental healthcare across countries. Countries experiencing fragility related risks suffer from a high burden of mental-ill health and additionally have limited capacity to scale up mental health services given financial and human resource shortages. Integration of mental health services into routine primary care is one potential strategy for enhancing service availability, however little is known about the experiences of currently active health care providers involved in mental health and psychosocial support service (MHPSS) provision at primary care level. This study aims to determine how healthcare providers offering MHPSS services at primary care levels in Lebanon perceive mental health and the health system’s ability to address the rising mental ill-health burden with a view to identify opportunities for strengthening MHPSS service implementation geared towards integrated person focused care model.MethodsA qualitative study design was adopted including 15 semi-structured interviews and 2 participatory group model-building workshops with health care providers (HCPs) involved in mental healthcare delivery at primary care level. Participants were recruited from two contrasting fragility contexts (Beirut and Beqaa). During workshops, causal loop diagrams depicting shared understandings of factors leading to stress and mental ill health, associated health seeking behaviors, and challenges and barriers within the health system were elicited. This research is part of a larger study focused on understanding the dynamics shaping mental health perceptions and health seeking behaviours among community members residing in Lebanon.ResultsFindings are organized around a causal loop diagram depicting three central dynamics as described by workshop participants. First, participants linked financial constraints at household levels and the inability to secure one’s livelihood with contextual socio-political stressors, principally referring to integration challenges between host communities and Syrian refugees. In a second dynamic, participants linked exposure to war, conflict and displacement to the occurrence of traumatic events and high levels of distress as well as tense family and community relations. Finally, participants described a third dynamic linking cultural norms and patriarchal systems to exposure to violence and intergenerational trauma among Lebanon’s populations. When describing help-seeking pathways, participants noted the strong influence of social stigma within both the community and among health professionals; the latter was noted to negatively affect patient-provider relationships. Participants additionally spoke of difficulties in the delivery of mental health services and linked this to the design of the health system itself, noting the current system being geared towards patient centered care, which focuses on the patient’s experiences with a disease only, rather than person focused care where providers and patients acknowledge broader structural and social influences on health and work together to reach appropriate decisions for tackling health and other social needs. Barriers to delivery of person focused care include the lack of coherent mental health information systems, limited human capacity to deliver MHPSS services among primary health care staff and inadequate service integration and coordination among the many providers of mental health services in our study contexts. Critically however, provider accounts demonstrate readiness and willingness of health professionals to engage with integrated person focused care models of care.ConclusionsMental ill health is a major public health problem with implications for individual health and wellbeing; in a fragile context such as Lebanon, the burden of mental ill health is expected to rise and this presents substantive challenges for the existing health system. Concrete multi-sectoral efforts and investments are required to (1) reduce stigma and improve public perceptions surrounding mental ill health and associated needs for care seeking and (2) promote the implementation of integrated person focused care for addressing mental health.

Global estimates of service coverage for severe mental disorders: findings from the WHO Mental Health Atlas 2017.

The study estimated service coverage for severe mental disorders (psychosis, bipolar disorder and moderate-severe depression), globally and regionally, using data collected from the Mental Health Atlas 2017. Service coverage was defined as the proportion of people with a disorder contacting a mental health service among those estimated to have the disorder during a 12-month period. We drew upon 12-month service utilisation data from the Mental Health Atlas 2017. Expected prevalent cases of individual disorders were estimated using the disorder-specific prevalence rate estimates of the Global Burden of Disease Study 2016 and total population sizes. Methods for assessing the validity of country-reported service utilisation data were developed and applied. From 177 countries, 50 countries provided reliable service coverage estimates for psychosis, along with 56 countries for bipolar disorder, and 65 countries for depression. The mean service coverage for psychosis was lowest in low- [10.9% (95% confidence interval (CI) 3.3-30.4)] and lower middle-income countries [21.5% (95% CI 11.9-35.7)] and highest in high-income countries [59.5% (95% CI 42.9-74.1)]. Service coverage for bipolar disorder ranged between 3.1% (95% CI 0.8-11.5) and 10.4% (95% CI 6.7-15.8). Mean service coverage for moderate-severe depression ranged between 2.9% (95% CI 1.3-6.3) for low-income countries and 31.1% (95% CI 18.3-47.6) for high-income countries. The reporting method utilised by the Mental Health Atlas appears to be reliable for psychosis but not for depression. This method of estimating service coverage provides progress in tracking an important indicator for mental health; however, it highlights that considerable work is needed to further develop global mental health information systems.

A Comparison of Functional and Radiographic Outcomes following Microfracture with Extracellular Matrix Augmentation versus Osteochondral Autograft Transplantation for the Treatment of Medium-Sized Osteochondral Lesions of the Talus

Objectives:The aim of this study is to directly compare clinical outcomes following the treatment of medium-sized osteochondral lesions of the talus (OLTs) using a microfracture technique augmented with Extracellular Matrix and Bone Marrow Aspirate Concentrate (MFX) versus OAT to determine which treatment is superior for medium-sized lesions.Methods:Patients treated for an OLT between 2015 and 2018 by a single surgeon, fellowship-trained in sports medicine and foot and ankle, were screened for this study. Retrospective chart review determined treatment, lesion size, lesion location, concurrent injuries, and demographic information. Patients at a minimum of 12 months follow-up, treated with MFX or OAT, and lesions sized 80-165mm2 were eligible for inclusion. All surgical repairs were augmented with an adjuvant mixture of micronized cartilage extracellular matrix and bone marrow aspirate concentrate (ECM-BMAC). Patient-reported functional outcomes were collected through our institution’s prospective Registry database. Patients treated prior to March 2016 were administered preoperative Foot and Ankle Outcome Score questionnaires. Those treated after this date were administered preoperative Physical Function, Pain Interference, Global Physical Health, Global Mental Health, Depression, and Pain Intensity Patient-Reported Outcome Information System (PROMIS) domains. Both FAOS and PROMIS were administered postoperatively. Postoperative MRIs were assessed using a modified magnetic resonance observation of cartilage repair tissue (MOCART) score. Student’s paired and two-group t-tests were used to evaluate for statistically significant pre-to-postoperative change and differences between procedure groups (p less than 0.05).Results:Twenty-seven patients treated with MFX (age range, 14-58) and twenty-three patients treated using OAT (age range, 22-64) were identified. All OAT patients received a single-plug transplantation. The final average lesion size ± standard deviation (SD) for patients treated with MFX was 115.44mm2± 22.51 (range, 156-80mm2) and 121.78mm2± 23.98 (range, 165-80mm2) for those treated using OAT (p=0.34). On average, functional outcome scores improved pre-to-postoperatively across all scales within both groups. Statistically significant improvements were detected in PROMIS Physical Function (Δ=8.32, p=0.01), Pain Interference (Δ=-7.15, p=0.02), Global Physical Health (Δ=5.87, p=0.03), and Pain Intensity (Δ=-7.06, p=0.05) domains for the MFX cohort. For the OAT patient group, significant pre-to-postoperative change was seen in the FAOS subcategories of Pain (Δ=28.70, p=0.03), Sports Activities (Δ=43.12, p<0.01), and Quality of Life (Δ=43.75, p=0.01); overall FAOS score (Δ=29.93, p=0.01); and PROMIS Physical Function (Δ=13.66, p=0.01), Pain Interference (Δ=-14.58, p<0.01), Global Physical Health (Δ=12.2, p=0.01), Depression (Δ=-4.13, p=0.02), and Pain Intensity (Δ=-16.56, p=0.02) domains. On average, with the exception of the postoperative Sports Activities subscale, postoperative FAOS and pre-to-postoperative change in FAOS were higher and greater in the OAT patient group. Similarly, on average, the OAT group had better PROMIS t-scores indicating higher function or less pain and greater pre-to-postoperative change in each PROMIS domain. The OAT cohort’s average postoperative Pain Interference t-score (± SD) of 43.09 (± 5.81) and Depression t-score of 40.06 (± 6.84) were significantly lower than their respective counterparts in the MFX cohort: 50.08 (± 9.47) for Pain Interference and 48.09 (± 7.86) in Depression. (Table 1) Finally, the mean overall MOCART score was 55.67 (± 24.11) within the MFX cohort, average follow-up 15.29 months, and 71 (± 15.60) within the OAT cohort average follow-up 15.8 months. This difference was also statistically significant (p=0.04).Conclusion:The OAT group had a higher MOCART score indicating the use of a single osteochondral autograft plug may result in better structural repair than microfracture abrasion chondroplasty augmented with a mixture of adjuvant ECM-BMAC. In addition, higher average FAOS scores, better average PROMIS t-scores, and greater pre-to-postoperative change in the OAT patient group indicate functional results may be better in this group as well. Specifically, significantly lower Pain Interference and Depression domains and significantly higher Global Mental Health scores indicate patients treated using OAT experience less pain and better psychological benefits postoperatively compared to patients treated using MFX. These results suggest filling the lesion with transplanted autograft bone and native, hyaline cartilage may perform better than and the biomechanically inferior fibrocartilage produced following microfracture even when augmented with adjuvant therapy. OAT may result in better overall clinical outcomes, specifically in a population of patients with medium sized lesions (range, 80 mm2 -165 mm2).

The interRAI Suite of Mental Health Assessment Instruments: An Integrated System for the Continuum of Care.

The lives of persons living with mental illness are affected by psychological, biological, social, economic, and environmental factors over the life course. It is therefore unlikely that simple preventive strategies, clinical treatments, therapeutic interventions, or policy options will succeed as singular solutions for the challenges of mental illness. Persons living with mental illness receive services and supports in multiple settings across the health care continuum that are often fragmented, uncoordinated, and inadequately responsive. Appropriate assessment is an important tool that health systems must deploy to respond to the strengths, preferences, and needs of persons with mental illness. However, standard approaches are often focused on measurement of psychiatric symptoms without taking a broader perspective to address issues like growth, development, and aging; physical health and disability; social relationships; economic resources; housing; substance use; involvement with criminal justice; stigma; and recovery. Using conglomerations of instruments to cover more domains is impractical, inconsistent, and incomplete while posing considerable assessment burden. interRAI mental health instruments were developed by a network of over 100 researchers, clinicians, and policy experts from over 35 nations. This includes assessment systems for adults in inpatient psychiatry, community mental health, emergency departments, mobile crisis teams, and long-term care settings, as well as a screening system for police officers. A similar set of instruments is available for child/youth mental health. The instruments form an integrated mental health information system because they share a common assessment language, conceptual basis, clinical emphasis, data collection approach, data elements, and care planning protocols. The key applications of these instruments include care planning, outcome measurement, quality improvement, and resource allocation. The composition of these instruments and psychometric properties are reviewed, and examples related to homeless are used to illustrate the various applications of these assessment systems.

Health system strengthening for mental health in low- and middle-income countries: introduction to the Emerald programme.

This paper gives an overview of the Emerald (Emerging mental health systems in low- and middle-income countries) programme and introduces the subsequent seven papers in this BJPsych Open thematic series. The aims of the Emerald research programme were to improve mental health outcomes in six low- and middle-income countries (LMICs), namely Ethiopia, India, Nepal, Nigeria, South Africa and Uganda, by building capacity and by generating evidence to enhance health system strengthening in these six countries. The longer-term aim is to improve mental healthcare, and so contribute to a reduction in the large treatment gap that exists for mental disorders. This series includes papers describing the following components of the Emerald programme: (a) capacity building; (b) mental health financing; (c) integrated care (d) mental health information systems; and (e) knowledge transfer. We also include a cross-cutting paper with recommendations from the Emerald programme as a whole. The inclusion of clear mental-health-related targets and indicators within the United Nations Sustainable Development Goals now intensifies the need for strong evidence about both how to provide effective treatments, and how to deliver these treatments within robust health systems.

Role of pre-existing adversity and child maltreatment on mental health outcomes for children involved in child protection: population-based data linkage study

ObjectivesTo determine mental health outcomes for children with a history of child protection system involvement, accounting for pre-existing adversity, and to examine variation in risk across diagnostic groupings and child...

Conexión de registros sanitarios: base poblacional de salud de Andalucía

ObjectiveTo describe the development of an information system that connects data from multiple health records to improve assistance to patients, health services administration, management, evaluation, and inspection, as well as public health and research. MethodDeterministic connection of pseudonymized data from a population of 8.5 million inhabitants provided by: a users database, DIRAYA electronic medical records, minimum basic data sets (inpatients, outpatient mayor surgery, hospital emergencies and medical day hospital), mental health information systems, analytical and image tests, vaccines, renal patients, and pharmacy. An automatic coder was used to code clinical diagnoses and 80 chronic pathologies were identified to follow-up. The architecture of the information system consisted of three layers: data (Oracle Database 11g), applications (MicroStrategy BI) and presentation (MicroStrategy Web, JavaScript libraries, HTML 5 and CSS style sheets). Measures for the governance of the system were implemented. ResultsData from 12.5 million health system users between 2001 and 2017 were gathered, including 435.5 million diagnoses, 88.7% of which were generated by the automatic coder. Data can be accessed through predefined reports or dynamic queries, both exportable to CSV files for processing outside the system. Expert analysts can directly access the databases and perform queries using SQL or directly treat the data with external tools. ConclusionThe work has shown that the connection of health records opens new possibilities for data analysis.

Mental health information systems in resource-challenged countries: experiences from India.

Mental health information systems are increasingly being used to measure the effectiveness of mental health interventions. Little or no data is available for mental health service availability and service uptake in low- and middle-income countries. Through a narrative review, this paper illustrates the importance of routine monitoring data and suggests methods for developing, implementing and evaluating mental health indicators in low- and middle-income countries with a primary focus on India.

Does mental health staffing level affect antipsychotic prescribing? Analysis of Italian national statistics.

IntroductionIn mental healthcare, one area of major concern identified by health information systems is variability in antipsychotic prescribing. While most studies have investigated patient- and prescriber-related factors as possible reasons for such variability, no studies have investigated facility-level characteristics. The present study ascertained whether staffing level is associated with antipsychotic prescribing in community mental healthcare.MethodsA cross-sectional analysis of data extracted from the Italian national mental health information system was carried out. For each Italian region, it collects data on the availability and use of mental health facilities. The rate of individuals exposed to antipsychotic drugs was tested for evidence of association with the rate of mental health staff availability by means of univariate and multivariate analyses.ResultsIn Italy there were on average nearly 60 mental health professionals per 100,000 inhabitants, with wide regional variations (range 21 to 100). The average rate of individuals prescribed antipsychotic drugs was 2.33%, with wide regional variations (1.04% to 4.01%). Univariate analysis showed that the rate of individuals prescribed antipsychotic drugs was inversely associated with the rate of mental health professionals available in Italian regions (Kendall's tau -0.438, p = 0.006), with lower rates of antipsychotic prescriptions in regions with higher rates of mental health professionals. After adjustment for possible confounders, the total availability of mental health professionals was still inversely associated with the rate of individuals exposed to antipsychotic drugs.DiscussionThe evidence that staffing level was inversely associated with antipsychotic prescribing indicates that any actions aimed at decreasing variability in antipsychotic prescribing need to take into account aspects related to the organization of the mental health system.