Model For Mental Health Services Research Articles

Spiritual and Community-Based Mental Health Services for Children with Special Needs in Islamic Boarding School

This study focuses on enhancing the care and educational support for children with special needs, particularly in rural areas where their families often lack adequate support. Recognizing the vital roles of communities and governments, the research seeks to create an inclusive education and mental health service model that incorporates spirituality and community engagement. A qualitative research method was used to achieve this, involving 19 managers and caregivers of children with special needs. Through interviews, participant observations, and three focus group discussions, data were collected using the free association technique and analyzed via thematic analysis. This analysis highlighted four key themes: the development of spiritual and community-based mental health services, the application of these approaches in service delivery, the care strategies for children with special needs, and the evaluation methods and psychological interventions rooted in indigenous psychology. The goal is to establish a mental health service model for rural settings that can be adapted for broader application in other regions.

Perceived control moderates the internalized stigma model of seeking mental health services in distressed older adults.

Older adults are especially unlikely to seek mental health services, and internalized stigma is a key reason why. However, little research has investigated which older adults are particularly likely to have stigma influence help-seeking. To address this, we tested whether perceived control (PC) moderates an internalized stigma model in which public stigma is internalized as self-stigma, which negatively predicts help-seeking attitudes and help-seeking intentions. We employed moderated mediation analysis of cross-sectional, secondary data from 348 psychologically distressed Canadian adults aged 65 years and older. Participants completed an online survey that included measures of public stigma of help-seeking, self-stigma of help-seeking, help-seeking attitudes, conditional help-seeking intentions, psychological distress, and PC. PC emerged as a moderator of the internalized stigma model. Those lower in PC were more likely to have public stigma negatively predict help-seeking intentions through the serial mediation of (a) self-stigma and (b) help-seeking attitudes. Further, those lower in PC were more likely to have public stigma internalized as self-stigma and more likely to have negative help-seeking attitudes predict lower help-seeking intentions. Finally, those lower in PC also had lower help-seeking intentions in the face of low levels of self-stigma. These results contribute to a nuanced understanding of which older adults are unlikely to seek help. Identifying PC as a moderator of the internalized stigma model suggests that interventions that enhance PC should protect against public stigma's internalization and improve help-seeking behaviors for older adults who need such help. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

A Nominal Group Technique to finalise Safewards Secure model and interventions for forensic mental health services

Accessible SummaryWhat is known on the subject? Safewards was developed for acute mental health units, and while could be effective in forensic mental health services, there are some gaps in the model for such services, where factors including offending behaviour and longer term care can have an influence. What this paper adds to existing knowledge? The importance of acknowledging and addressing responses related to offending behaviour in forensic mental health settings, while also understanding the vulnerability of the consumer group and responsibilities to the maintenance of professional boundaries. Enhancing collaboration with consumers/families/carers/supporters is important in a forensic mental health setting, and an important element of Safewards Secure. What are the implications for practice? This study completes the development of Safewards Secure, designed to foster collaboration, address issues pertinent to forensic mental health settings to enhance implementation and acceptance of the model and reduce conflict and containment. AbstractIntroductionSafewards is a model developed for acute mental health settings designed to reduce conflict and containment; however, it requires adaptation to forensic mental health settings.AimTo develop the Safewards Secure model, a model to assist forensic mental health services to reduce conflict and containment.MethodA literature review was conducted to elicit possible modifiers and adjustments to the interventions. A Nominal Group Technique was then used to engage forensic mental health experts who had experience implementing Safewards (n = 12) to seek feedback about the suggestions and reach consensus on the Safewards Secure model and interventions. Data were thematically analysed.ResultsExperts reached consensus on all suggestions, however, did recommend minor additions and modifications. Two themes were also interpreted: Safewards Secure is just as much for staff as it is for consumers, and the proposed additions encourage more meaningful staff to consumer collaboration.DiscussionThis study identified key challenges experienced by nurses working in forensic mental health settings, however, these challenges were not seen as insurmountable. The Safewards Secure model offers prompts and suggestions to encourage reflection, collaboration and a humanistic approach to care in forensic mental health settings.Implications for PracticeAddressing reactions to offending behaviour and encouraging more collaboration might assist in ensuring a more person‐centred approach to forensic mental health nursing care.

How do patient and care experience data inform policy and practice? Insights from the Irish National Care Experience Programme

Abstract Issue Patient experiences are central to the delivery of quality, person-centred care and an important predictor of outcomes. Prior to 2017, there was no unified, national approach to the collection of care experience data in Ireland. Description of the problem The National Care Experience Programme is a partnership between a regulator, policy makers and the Irish public health service, with a suite of surveys of inpatient, maternity, nursing home and end of life care. The surveys aim to learn from people's feedback on health and social care services to identify areas of good experience and areas requiring improvement. Results Findings have informed national policies, including a healthcare communication programme to support staff to develop communication skills with patients and families. Survey data provide a key input to the Irish health quality indicator framework and the Health Systems Performance Assessment Framework, which assess the overall performance of the Irish health system. National Maternity Experience Survey results informed the allocation of funding for post-natal supports and new lactation consultant posts, and supported the implementation of a specialist perinatal mental health services model of care, leading to increased diagnosis and vigilance of mental health issues ante- and postnatally. National Nursing Home Experience Survey findings supported legislative amendments, including provision for the delivery of in-person advocacy awareness campaigns and the strengthening of complaints processes within nursing homes. Lessons In order to maximise the use of survey findings and ensure the voices of people using health and social care services are acted on, routine surveying of care experiences is required to track the impact of policy and practice initiatives. The programme is currently expanding to include people's experiences of cancer care and mental health services, in addition to exploring options for continuous, local care experience surveys.

Using the National Mental Health Service Planning Framework to inform integrated regional planning: a case study in Tasmania, Australia

BackgroundThe aim of this study was to demonstrate the application of a needs-based mental health service planning model in Tasmania, Australia to identify indicative directions for future service development that ensure the equitable provision of mental health services across the State.MethodsThe activity and capacity of Tasmania’s 2018–19 mental health services were compared to estimates of required care by: (1) generating estimates of required care using the National Mental Health Service Planning Framework (NMHSPF); (2) collating administrative mental health services data; (3) aligning administrative data to the NMHSPF; and (4) comparing aligned administrative data and NMHSPF estimates to identify priority areas for service development. Findings were contextualised using information about service location, population demographics, and upcoming service development.ResultsBed-based services capacity reached 85% of the NMHSPF estimate. However, access to certain bed types was inequitable across regional areas. Access to jurisdictional clinical ambulatory team-based services was lowest in the South, while overall full-time equivalent staff capacity reached 58% of the NMHSPF estimate. Access to Primary Health Tasmania (PHT) primary care services was highest in the North West; access to Medicare services was highest in the South. Collectively, activity across primary care (PHT, headspace and Medicare) reached 43% of the NMHSPF estimate. Over half of Community Managed Mental Health Support Services were state-wide services.ConclusionsThis study demonstrates the application of a needs-based planning model for mental health services. Findings revealed service priority areas across Tasmania and highlight considerations for needs-based planning.

정신장애인 대상 지역사회통합돌봄의 실행 및 성과에 대한 실무자의 인식 연구

Through focus group interviews, this study explores perceptions of practitioners participating in the community care for people with mental illnesses and analyzes the operation process and performance of the community care. The main contents are ① evaluation of the overall circumstances that have changed while promoting the community care project, ② public participation and its role in the service delivery process, ③ collaboration with various service delivery entities, ④ expansion of regional social network for providing multi-field services, and ⑤ changes in awareness of people with mental disabilities and mental health through the community care. In terms of changes in users, the major keywords include expansion of community services and user-centered service provision method. In regards to changes in the service delivery system, the major keywords are ① securing access to regional services, ② changes in service provision methods based on linkage and cooperation, and ③ general changes in community service provision and community perceptions of care. The results of the analysis serve as evidence in evaluating the changes in the service users and the service delivery system, and identifying the performance and limitations of the community care project for people with mental illnesses. This study provides basic knowledge necessary to develop a community-centered mental health service system and service delivery method in the future. This study will contribute to the establishment and expansion of a community-centered mental health service model that supports the mentally disabled to return to the community and normalized life.

The development of mental health care in Guangzhou, China

As an upper-middle-income country, China has a vast territory, a large population and substantial variations in the nature of mental health service provision. Guangzhou, one of the five biggest cities in China, is considered as indicative of the current development of mental health services in a more economically developed part of China. In this paper, we first introduce mental health services in Guangzhou and their historical development: from the rising development of mental health care (1949 to the mid-1960s), the stagnant development period of the psychiatric hospitals (1966–1976), the rapid development period of the psychiatric hospitals (1978 to the 1990s), to the integrated development period of community mental health care (2000–2020). This historical trajectory partly reflects the development of mental health services across China. Second, from the public health perspective, we introduce the current mental health care delivery system and resources in Guangzhou, including the psychiatric specialist hospitals, psychiatric units of general hospitals, and community mental health care. Third, based on the current mental health service system, we highlight community mental health care in Guangzhou. We will describe these elements of the mental health system under the following headings: organizational setup, management, and services. We also explore the design of community mental health service models and the challenges in the post-covid-19 era. Finally, we provide considerations and recommendations for mental health service delivery in Guangzhou in the future.

University Students' Life Stressors and Mental Health in Georgia and German-Speaking Switzerland

Abstract: Background: The university years are associated with a variety of stressors, and recently, COVID-19 has presented an additional burden on students’ mental well-being. As mental health manifestations of stressors may differ between countries, this study compared students from Switzerland and the Republic of Georgia regarding the burden of stressors and the role of potentially culture-dependent risk and protective factors of mental health (i.e., help-seeking, cross-cultural coping, fatalism, sense of coherence). Method: We assessed two samples of university students in Georgia ( N = 425) and German-speaking Switzerland ( N = 298), using a cross-sectional design. Quantitative data were collected with online questionnaires during the third wave of the pandemic. Mental health screenings included measures of depression, anxiety, and adjustment disorder. Results: General life- and COVID-19-related stress levels were higher in Georgia than in Switzerland. Georgian students experienced more adjustment disorder symptoms but lower levels of depression and anxiety. While Swiss students reported more protective factors (formal and informal help-seeking, sense of coherence), Georgian students experienced more risk factors (fatalism and avoidance coping). Despite significant correlations between potentially culture-dependent risk and protective factors and mental health, few associations remained significant above and beyond the impact of general life stress. Conclusions: The high prevalence of stressors and adjustment disorder symptoms and risk factors for mental health among Georgian students illustrates a potential need for psychosocial support with stress management. The cross-cultural applicability of Western models of student mental health services should be evaluated.

Innovative Models of Geriatric Mental Health Services

The demographics of residents residing in long term care facilities is changing in many ways. There is a substantial increase of those admitted with serious mental illness, and at a younger age. Greater than 50% of residents have a neurodegenerative illness, such as dementia, and subsequently they all will experience behavioral and psychological symptoms of dementia during their admission. The new ICD-10 codes are integral to quality care and outcomes for this population. Most current approaches to the behavioral health needs of this population fall short of meeting resident and facility needs. This presentation seeks to consider a bold, interprofessional, and integrated approach to the bedside care of geriatric mental health services in long term care. Consideration includes proper ICD-10 code diagnosis and a culture of care that emphasizes the patient as an individual to improve quality of life and quality of care. This falls directly in line with the President's Commission on Aging Quality and Best Practices in Geriatric Psychiatric services and includes: a multidisciplinary team approach, specific geriatric expertise, individualized assessment, collaborative treatment planning between the consultant and facility staff, as well as a strong educational component. Current barriers to success will be explored to improve overall performance of the mental healthcare team.

Right time for the community based mental health care

The World Health Organization has produced a series of publications to create the general framework of mental health services. One of the main data sources is the WHO guide on community mental health services and the document promoting person-centered and human rights-based approaches. It includes the regulation of service providers' relations with the housing, education and employment sectors at the point of implementation of regional and national policies and the promotion of actions that are respectful of human rights and focused on recovery. It is a guide that offers various technical packages for the establishment and successful implementation of community-oriented mental health services. Various international framework agreements, including the United Nations Convention on the Rights of Persons with Disabilities, also suggest the establishment of community-oriented mental health services. The common goal of up-to-date medical evidence-based information and international policymakers is to make the community-based mental health service model permanent on a global scale, especially in low-income and developing countries.

Developing fit-for-purpose funding models for rural settings: Lessons from the evaluation of a step-up/step-down service in regional Australia.

Sub-acute mental health community services provide a bridging service between hospital and community care. There is limited understanding of the local factors that influence success, and of the funding implications of delivering services in rural areas. This paper draws from quantitative and qualitative evaluation data from a regional Western Australian service to explore these issues. Consumers satisfaction with the service was high and, overall, admission to the service resulted in positive outcomes. High re-admission rates may be linked to limited community support services following discharge. Our results suggest that outcomes may be enhanced by implementing flexible approaches that address the resource limitations of the rural context, and that the current funding model for sub-acute mental health services in rural Australian may not be fit for purpose. More needs to be understood about how these services can be better integrated with existing support services, and how they can be better funded.

Paradigm Shift to Promote a Revolution of Treatment of Schizophrenia to Achieve Recovery

Active schizophrenia is characterized by psychotic symptoms that can include delusions, hallucinations, disorganized speech, trouble with thinking, and a lack of motivation. The introduction of antipsychotics in the 50ties was called a revolution for the treatment of schizophrenia and psychosis and is now a cornerstone of treatment. The effects are considered well documented. Guidelines suggest that all patients be offered antipsychotics. Nearly all patients are medicated. Concerns have been raised about non-responders, and there is no evidence for long-term effects. The validity of the diagnosis of schizophrenia according to the Diagnostic and Statistical Manual Mental Disorders (DSM) is controversial and discussed. Patients experience side effects and low benefits and try to stop. This is considered non-conformance, which can lead to relapse. Therefore, caregivers consider medication necessary and use forced drugging. Antipsychotics reduce psychotic symptoms. New patient laws in many countries aim to promote recovery. The United Nations Special Rapporteur on the Right to Health has called 2019 for «World needs a "revolution" in mental health care». "There is now unequivocal evidence of the failures of a system that relies too heavily on the biomedical model of mental health services, including the front-line and excessive use of psychotropic medicines, and yet these models persist". However, this proposal is highly controversial for clinicians. World Health Organization (WHO) followed up 2021: “New WHO guidance seeks to put an end to human rights violations in mental health care”. "This comprehensive new guidance provides a strong argument for a much faster transition from mental health services that use coercion and focus almost exclusively on the use of medication to manage symptoms of mental health conditions to a more holistic approach that takes into account the specific circumstances and wishes of the individual and offers a variety of approaches for treatment and support". This is highly controversial; however, the United Nations High Commissioner for Human Rights (OHCHR) supported the WHO proposal with a guideline to reform legislation in order to end human rights abuses and increase access to quality mental health care. A realistic path to implement WHO treatment improvements seems to need the courage of legislators to follow OHCHR suggestions and a shift of paradigm.

Current Situation Of Supply And Demand Of Mental Health Services For Community Residents In D City And Suggestions On Countermeasures

The important task of community construction in China in the new era is to establish a scientific and effective community mental health service model, which plays an important role in improving the psychological quality of community residents and having a happy and beautiful life. On the basis of analyzing the current supply and demand situation of mental health services for community residents in D city and investigating the mental health status of community residents, countermeasures and suggestions for improving the construction of community mental health service system are proposed.

Efficacy of Online-Based Intervention for Anxiety during COVID-19: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

COVID-19 has caused widespread psychological suffering. Anxiety is one of the several psychological disorders that are escalating globally, yet social distance constraints restrict in-person mental health therapy. Anxiety and other psychological disorders whose treatments are limited due to social distancing continue to grow, so there is an increasing need to use mental healthcare that can be offered remotely, especially in the pandemic era. This study aimed to conduct a systematic review and meta-analysis of the efficacy of online-based interventions for anxiety during COVID-19. This study followed the Preferred Reporting Item for Systematic Review and Meta-analysis (PRISMA). We collected data from three databases, namely PubMed, CINAHL, and Oxford Library Press, published in 2020–2022. Additionally, we collected data using the snowball technique. This meta-analysis analyzed the pooled mean difference (MD) and its p-value using random-effects models. Critical appraisal and risk of bias were assessed using Cochrane Risk of Bias (Rob) 2. We retrieved 34 RCTs for systematic review and 14 RCTs for meta-analysis, yielding 9159 participants for general anxiety disorder (GAD-7) measurement and 1303 participants for depression anxiety stress scale (DASS-21) measurement. This study shows that online-based interventions significantly reduce GAD-7 score (a pooled MD of 1.30; 95% CI: 2.83–4.65; p = 0.00001) and insignificantly reduce DASS-21 (0.05; 95% CI: −2.63–2.72; p = 0.97) according to pre- and post-test in intervention group. Additionally, there is a significant difference between the intervention and control groups, where the intervention group performed statistically progressively better than the controls (−7.26; 95% CI: −11.58–−2.95; p = 0.001) (−2.08; 95% CI: −6.71–2.55; p = 0.001). Online-based interventions have proved effective for reducing general anxiety during the COVID-19 pandemic. Consequently, this meta-analysis can be adapted as a model for mental health services in the new normal.

Sport Psychology in Collegiate Athletics: A Review of Mental Health Service Models

ABSTRACT In 2016, an NCAA multidisciplinary task force published a consensus document outlining best practices for addressing student-athletes mental wellness. However, despite their recommendations and the growing development of mental health services for college student-athletes, no published literature exists reviewing the existing models of collegiate sport psychology programs. This article serves to address that gap by providing a general overview of common models, followed by an in-depth description of a successful sport psychology model at a Power Five, Division I athletic program. Considerations and recommendations for other institutions, including barriers to student-athlete wellness, availability of university resources, and advantages and disadvantages of the models, will be discussed.

Roles and Functions of School Mental Health Professionals Within Comprehensive School Mental Health Systems.

Mental health concerns are on the rise among youth, contributing to a growing need for school-based mental health services. However, challenges to service provision arise due, in part, to workforce shortages, service fragmentation, and inefficient allocation of staff time. The current study describes the professional competencies and time allocation of four school-based mental health professions (i.e., school counselors, school psychologists, school social workers, and school nurses) in order to demonstrate how schools can leverage the skills of their existing staff to coordinate a comprehensive approach to support student mental health. First, we identified the core clinical competencies needed to implement the key features of comprehensive school mental health systems. Then, we crosswalked these clinical competencies with the training standards of the four professions. Finally, we conducted a systematic review of the literature to understand how these professionals’ time is allocated, as well as their responsibilities related to the provision of mental health services. Results demonstrated that, although all four professions receive training in most of the core competencies needed to implement comprehensive school mental health services, their skillsets are often underutilized in day-to-day practice. Thus, we concluded that there are at least two untapped opportunities for school leaders to support student mental health—first, maximize the use of school mental health professionals through task-shifting (i.e., reassigning tasks less central to mental health service delivery to other staff), and second, implement an integrated model of school mental health services to efficiently leverage the mental health training of professionals.Supplementary InformationThe online version contains supplementary material available at 10.1007/s12310-022-09535-0.

Knowledge Management-Based Mental Health Service Model: Sustainable Application during College Students’ Education

In order to meet the dynamic mental health needs of college students, it is important to promote quality mental health services and to improve the development view of college students’ mental health. This paper uses a knowledge management method to construct college students’ developmental mental health service model. The model is informed by knowledge management, which comprehensively considers service-related components, namely, resources, content, approach, process, personnel, and objects. Furthermore, knowledge management constructs the system structure of the model and expands the research ideas and contents of the service resource pool. Moreover, knowledge management supports the platform, core technology system, and service process in the model. Finally, using Suzhou University as an example, this study examines the implementation and application of the service model to test the effectiveness of the knowledge management method. Thus, this study provides theoretical and methodological support for the construction, implementation, and application of a sustainable mental health service model for college students.

Safewards Secure: A Delphi study to develop an addition to the Safewards model for forensic mental health services.

Accessible SummaryWhat is known on the subject? The Safewards model has been introduced to forensic mental health wards with mixed results.Research has identified a need to consider the addition of factors that may be relevant to forensic mental health services to enhance the introduction of Safewards. What the paper adds to existing knowledge? This study elicits factors specific to forensic mental health settings missing from the original Safewards model, which have the potential to enhance nursing care, improve safety and improve adherence to Safewards in a forensic mental health setting. What are the implications for practice? This study provides the adaptation required in a forensic mental health setting to enhance the implementation of the Safewards model of care, originally developed to assist nurses to prevent and manage conflict and containment in acute general mental health settings.The development of Safewards Secure has incorporated perspectives from expert Safewards and forensic mental health nurse leaders and healthcare clinicians and is inclusive of consumer and carer perspectives to ensure the model is applicable and broadly acceptable. IntroductionSafewards is a model designed specifically for acute mental inpatient wards. Research investigating the introduction of Safewards has identified a need to consider factors relevant in forensic mental health services, such as offence and risk issues.AimTo identify adaptations needed to address gaps in the Safewards model to assist forensic mental health nurses to prevent and manage conflict and containment.MethodA Delphi study was employed to engage a group of international Safewards and forensic mental health experts (n = 19), to elucidate adaptation of the Safewards model.ResultsExperts identified necessary elements and reached consensus on key considerations for Safewards interventions. To ensure the Safewards Secure model was robust and developed on a platform of research, all items suggested by Delphi experts were cross‐referenced and dependent on empirical evidence in the literature.DiscussionThis study identified a number of key differences between civil and forensic mental health services, which informed the development of Safewards Secure, an adjunct to the original Safewards model.Implications for PracticeThe development of person‐centred models of nursing care adapted to specific settings, such as forensic mental health, provides a potential solution to preventing and managing conflict and containment, and improving consumer outcomes.Relevance StatementManaging conflict and containment in mental health services remains an ongoing challenge for mental health nurses. Safewards is a model of care designed for acute mental health inpatient settings to prevent conflict and containment. To date, there has been mixed results when introducing Safewards in forensic mental health settings, and reported reluctance and scepticism. To address these issues, this study employed a Delphi design to elicit possible adaptions to the original Safewards model. From this study, Safewards Secure was developed with adaptations designed for forensic services, to enhance the management of conflict and containment, assist implementation and improve consumer outcomes.

The dialogic approach. An effective model for mental health services.

The quality and effectiveness of therapeutic rehabilitative interventions represent a landmark in the field of mental health. The respect of human rights is strictly linked to health in general, and these two aspects depend on how mental health services guarantee the treatment pathway.The focus of this study is on the international success of Open Dialogue (OD), once designed for those affected by schizophrenia, since it questions the traditional structure of mental health services. From the study of theoretical principles and the scientific evidences of the benefits of dialogic approach on Services, the core of this contribution consists of how much dialogue can be found inside Services themselves. The field of work was characterised by the operators of two MHCs: Modena Polo Est and Pavullo.The inquiry focused on operators’ behaviours and dispositions towards OD, regardless of the occupation of the workers, but selecting those with direct experience of Open Dialogue.Results highlight that dialogic approach is, in most cases, already adopted by operators, and that it positively affects their dispositions. Despite arduous to undertake, it can be inferred that tolerating uncertainty in its practical application and the reject of a medical-centred approach are extremely necessary. Indeed, not only are they coherent with the dialogic approach, but they also bring improvement aside from the selected approach.

The dialogic approach. An effective model for mental health services.

Background: The quality and effectiveness of therapeutic rehabilitative interventions represent a landmark in the field of mental health. The respect of human rights is strictly linked to health in general, and these two aspects depend on how mental health services guarantee the treatment pathway. Methods: The focus of this study is on the international success of Open Dialogue (OD), once designed for those affected by schizophrenia, since it questions the traditional structure of mental health services. From the study of theoretical principles and the scientific evidences of the benefits of dialogic approach on Services, the core of this contribution consists of how much dialogue can be found inside Services themselves. The field of work was characterised by the operators of two MHCs: Modena Polo Est and Pavullo. The inquiry focused on operators’ behaviours and dispositions towards OD, regardless of the occupation of the workers, but selecting those with direct experience of Open Dialogue. Results: Results highlight that dialogic approach is, in most cases, already adopted by operators, and that it positively affects their dispositions. Conclusion: Despite arduous to undertake, it can be inferred that tolerating uncertainty in its practical application and the reject of a medical-centred approach are extremely necessary. Indeed, not only are they coherent with the dialogic approach, but they also bring improvement aside from the selected approach.