Mental Health Service System Research Articles

Digital Surveillance of Mental Health Care Services in Saudi Arabia: Cross-Sectional Study of National e-Referral System Data.

Mental illness affects an estimated 25% of the global population, with treatment gaps persisting worldwide. The COVID-19 pandemic has exacerbated these challenges, leading to a significant increase in mental health issues globally. In Saudi Arabia, the lifetime prevalence of mental disorders is estimated at 34.2%, yet 86.1% of those with a 12-month mental disorder report no service use. To address these challenges, digital health solutions, particularly electronic referral (e-referral) systems, have emerged as powerful tools to improve care coordination and access. Saudi Arabia has pioneered the nationwide Saudi Medical Appointments and Referrals Centre (SMARC), a centralized e-referral system using artificial intelligence and predictive analytics. This study aims to analyze Saudi Arabia's novel nationwide e-referral system for mental health services, using SMARC platform data to examine referral patterns, and service accessibility. This study also aims to demonstrate how digital health technology can inform and improve mental health care delivery and policy making. This retrospective, cross-sectional study used secondary data from SMARC on 10,033 psychiatric e-referrals in Saudi Arabia during 2020-2021. Referrals were assessed by patient sociodemographic variables, geographic data, and e-referral characteristics including date, type, bed type, and reason for e-referral. Descriptive statistical analyses identified referral patterns, while regression modeling determined predictors of external referrals to other regions. Analysis of 10,033 psychiatric e-referrals revealed that 58.99% (n=5918) were for patients aged 18-44 years, 63.93% (n=6414) were for men, and 87.10% (n=8739) were for Saudi nationals. The Western Business Unit generated 45.17% (n=4532) of all e-referral requests. Emergency cases were the most common type of referral overall, followed by routine inpatient and routine outpatient department referrals. However, in the Northern Business Unit, routine inpatient referrals were most frequent. Two-thirds of requests were for ward beds, while critical beds were rarely requested. "Unavailable subspecialty" was the primary reason for referrals across all regions. The utilization of the mental health e-referral system varied across regions, with the Northern Border and Albaha regions showing the highest rates, while Madinah, Eastern, and Riyadh regions demonstrated lower use. Temporal analysis showed almost similar monthly patterns in 2020 and 2021. There was an overall increase in referrals in 2021 compared with 2020. This pioneering study of mental health e-referrals in Saudi Arabia demonstrates how digital health transformation, particularly through an e-referral system, has significantly enhanced access to mental health services nationwide in Saudi Arabia. The success of this digital initiative demonstrates how digital health solutions can transform health care access, particularly in mental health services, offering a valuable model for other health care systems.

Psychological process and risk factors of juvenile delinquency: Evidence from a qualitative analysis.

In recent years, juvenile delinquency has continued to occur at a high rate, necessitating attention to its criminal psychological process and underlying risk factors. This study acquired psychological review data from 97 juvenile delinquents in China. Utilizing qualitative analysis, we delved into the psychological processes and risk factors that contribute to juvenile delinquency, aiming to reveal the psychological mechanisms involved. The research summarized the psychological process through stages of cognitive deviation, psychological numbness, and belief remodeling. The risk factors identified in juvenile delinquency encompass three aspects: criminal cognition, criminal motive, and criminal connection. Cognitive bias emerges as the initial and crucial stage in the genesis of juvenile delinquency, stemming from a complex interplay of internal and external factors. This research contributes significantly to the field of mental health education of minors, aiding in the prevention of future juvenile delinquency and providing an empirical reference for improving minors' mental health literacy. Furthermore, it suggests that organizations such as families, schools, and communities should optimize their practices in disseminating mental health knowledge, strengthening mental health protection, optimizing mental health services, and constructing a comprehensive mental health service system.

'I am more than my diagnosis': Amplifying the voice of consumers in the design and delivery of mental health services.

In line with the Australian Government's Vision 2030, this research foregrounds consumer experiences of recovery to inform the (co)design and delivery of mental health services for people living with complex needs and/or a severe and persistent mental health condition. The research takes a specialist focus on the regional setting, with data collected from client experiences within Western NSW, Australia, in the context of the National Disability Insurance Scheme (NDIS) implementation and inclusion of psycho-social disability within the NDIS service environment. Thirty-seven people aged 19-70 years living with complex needs and/or a diagnosis of a severe and persistent mental health condition were recruited from services where they had a care plan or where they were members of a consumer reference group for recovery-oriented services. A tripartite framework integrating recovery oriented, trauma-informed and collective impact approaches for a qualitative, arts-based (photovoice) study. In areas of the mental health service system that had not yet applied a personalised understanding of recovery or embraced trauma-informed practice there were a range of issues and gaps in service delivery relating to authentic relationships, belonging and connection, service cultures, trauma-informed care, and workforce investment. Clinical and non-clinical services need to ensure consistent person-centred and trauma-informed practice is implemented throughout the mental health service system to meet the needs of the consumer. An eight-point checklist serves as the basis for services to reflect on how they are working with consumers and to support the review of systems and clinical governance frameworks.

Vermont association leader wants to drive behavioral integration

The newly appointed executive director of the Vermont Association for Mental Health & Addiction Recovery (VAMHAR) intends to embark on a mission reflecting the organization's name. Daniel Franklin believes that one of Vermont's oldest advocacy organizations can serve as a catalyst for integrating mental health and addiction service systems that remain largely siloed.

Primary and secondary prevention of postpartum depression

Pregnancy is one of the important life events in a woman's life, which in the face of pregnancy, childbirth and breastfeeding process, maternal psychology and physiology will have obvious changes, among which postpartum depression is more common. Postpartum depression (PPD) is a mental syndrome with obvious depressive symptoms or typical depressive episodes during the puerperal period. Its etiology is complex, with sleepiness, gloomy expression, crying and other symptoms in clinic, and even some patients will have suicidal tendencies, which seriously endangers maternal physical and mental health. In recent years, the adverse events caused by postpartum depression have attracted more and more social attention, and postpartum women's mental health has become a hot spot in clinical research. Clinical workers should improve the awareness of postpartum depression, and strengthen the maternal mental health screening, so as to detect psychological abnormalities as early as possible and give timely intervention measures. In view of the high incidence of postpartum depression, it is very important to establish a sound mental health service system for pregnant women. This paper will analyze the high risk factors of PPD summarized the targeted primary prevention and secondary prevention, and proposed prevention strategies before and after the onset of postpartum depression, respectively, to provide theoretical basis for effectively preventing the occurrence of postpartum depression or delaying the progression of postpartum depression.

Development of Mental Health and Social Rehabilitation Service Models for Psychosocial Disabilities

This study aims to determine the extent to which policies related to persons with disabilities and mental health can accommodate the rights of people with psychosocial disabilities, then the extent to which the model of mental health services and social rehabilitation for psychosocial disabilities contributes to mental health treatment in DIY. YAKKUM Rehabilitation Center through capital development of mental health services and post-recovery social rehabilitation that is accessible and community-resourced. This model is oriented towards improving the quality of life of people with psychosocial disabilities and the existence of communities that contribute proactively to community-based mental health efforts in DIY. The data mining method in this study uses a mixed method, namely discriptive studies, descriptive qualitative, participant as observer and participant non observer. Subjects in this study included people with psychosocial disabilities, caregivers, mental health cadres, village governments, puskesmas and related local organizations. The results of this study show that the service model developed by the YAKKUM rehabilitation center is able to encourage social recovery in people with psychosocial disabilities, strengthen their role in the community in community-based mental health, local mental health policies that accommodate the rights of people with psychosocial disabilities, the existence of a mental health service system that focuses on fulfilling the rights of psychosocial disabilities and social rehabilitation.

The Use of Multifamily Discharge Preparation Groups in the Discharge Process of Patients with Schizophrenia.

After acute treatment, patients with schizophrenia return to their original living environment for further rehabilitation, which not only determines the quality of life of the patients and their families but also has an important impact on society. However, patients often find it difficult to adapt to changes in the environment when they are discharged from the hospital. This may be related to the incompleteness of China's mental health service system, as many services for schizophrenia patients are only in the treatment stage. In China, schizophrenia is traditionally associated with poor moral quality, and patients find it difficult to obtain support. Many patients have trouble reintegrating into the community after treatment. Schizophrenic multifamily teams gather families affected by the same illness and pain together to promote healing together in an environment that allows mutual sharing, understanding and transparency, maximizes the use of family resources for support, improves discharge readiness, and better deals with post-discharge recovery. The multifamily group intervention method was used to improve the motivation of the patients' family motivation as well as the discharge readiness and self-efficacy of the patient. After the intervention, the motivation of the family and discharge readiness of the patient were improved compared with that of the baseline period; however, the improvement was not significant. The self-efficacy of the patients was significantly improved (P=0.042). In the discharge preparation of schizophrenia patients, multifamily teams can be used to help patients and their families share resources, enhance support and prepare for discharge. Patients will have better support following discharge for recovery in the community. Additional consideration should be given to the impact of the environment on patient services, and the evaluation of the service process is key to continuously improving the service effect.

Employee Assistance Programs for Indigenous People in the Workplace

According to a survey regarding indigenous employment, in Taiwan, a high proportion of indigenous people are engaged in construction work compared with the overall population. However, among indigenous construction workers, 56.15% have received no occupational safety or health training, and 9.39% have encountered occupational accidents in their workplaces. Therefore, this study aimed to develop employee assistance programs (EAPs) for indigenous workers in Taiwan by focusing on three dimensions—namely work, life, and health—and by establishing corresponding implementation paths for these EAPs. A modified Delphi method was adopted to screen EAP measures for the workplaces of indigenous workers, and a formal evaluation followed. Subsequently, the analytic hierarchy process was employed to calculate the overall weights among the factors in order to discern the relative importance of each factor in achieving the target goal or to resolve target problems and establish an order of priority. The results indicated that health was the most important of the three dimensions of indigenous EAPs, followed by the life dimension and then the work dimension. Compared with previous studies regarding Han Taiwanese workers, mental health services in the health dimension were particularly important in the present study. Finally, regarding the health dimension, this study suggests developing mental health services that respect indigenous culture and therefore are appropriate for indigenous people, such as the establishment of drug and alcohol addiction support groups and mental health service systems. In addition, corresponding welfare measures can be offered to enhance people’s motivation to change.

Recovery at 30: Perspectives from Psychiatry Clinicians and Senior Faculty.

According to William Anthony's "Recovery from mental illness: the guiding vision of the mental health service system in the 1990s," mental health recovery means "changing one's attitudes, values, feelings, goals, and skills in order to live a satisfying life within the limitations caused by illness." This seminal work served as an overarching goal, a call to action, and a roadmap for the enhancement of psychiatric recovery. Unfortunately, from many viewpoints, the goals encouraged by Anthony have not been achieved. Through semi-structured interviews with psychiatry clinicians and senior faculty members, this article aims to elucidate the current status of psychiatric recovery, how the movement progressed to this point, and where we could go from here. The development of the recovery movement will be discussed, along with its assumptions and explicit goals. The interviews focus on the extent to which these goals have been achieved, barriers to progress, whether goals should be revised, and how to achieve these goals.

“We Wanted to Get Her Help”: Child-Welfare-Involved Caregivers’ Perceptions of Decision-Making When Accessing Residential Treatment

Despite increased research and policy interest in reducing the use of residential treatment settings (RTS), there have been few studies of caregivers’ experiences accessing these settings. This study aimed to explore how caregivers perceive their role in decision-making when accessing RTS for youth using interpretive phenomenological analysis. Themes included gaining a voice, losing power as services intensified, challenging journey, and inflection point. Findings suggest providers act as gateways to RTS for youth for those parents who currently do not have access to these settings. Implications for practice include increasing caregiver knowledge about how to navigate mental health service systems may improve their sense of empowerment to make decisions and that more resources are needed for caregivers.

Distance Decay Effects in a Swiss Mental Health Services System

To investigate psychiatric service use depending on distances (travel times) to inpatient and outpatient service sites. Retrospective cohort analysis of all patients aged 18-64 years who had been treated in a Swiss psychiatric services system in 2022. Outpatient service utilization rates decreased statistically significantly with increasing distance (travel time by public transportation) between the place of residence and the responsible outpatient clinic. For inpatient utilization, the distance decay effects were much less strong and did not always reach a statistically significant level. In an easily accessible and economically reasonable psychiatric services system, inpatient and specialized services should be organized centrally, while general outpatient psychiatric services should be planned decentralized and close to the communities where people live.

Data resource profile of an online database system for forensic mental health services

This paper introduces a forensic psychiatry database established in Japan and discusses its significance and future issues. The purpose of this Database, created under the Medical Treatment and Supervision Act (MTSA) Database Project, is to improve the quality of forensic psychiatry treatment. It can collect monthly data on “basic information,” “Orders and hospitalizations under the MTSA,” “Treatment process,” “Criminal and medical treatment history,” and “problematic behavior in the unit.” The online system has accumulated data on more than 8,000 items in 24 broad categories. Medical data are exported from the medical care assisting system of 32 designated inpatient facilities in XML format and then saved on USB memory sticks. The files are imported into the Database system client, which sends the data to the Database server via a virtual private network. This system minimizes errors and efficiently imports patient data. However, there is a limitation that it is difficult to set items that need to be analyzed to solve everyday clinical problems into the database system because they tend to change over time. By evaluating the effectiveness of the Database, and collecting appropriate data, it is expected to disseminate a wide range of knowledge that will contribute to the future development of mental health and welfare care.

Getting More Out of Clinical Documentation: Can Clinical Dashboards Yield Clinically Useful Information?

This study investigated coded data retrieved from clinical dashboards, which are decision-support tools that include a graphical display of clinical progress and clinical activities. Data were extracted from clinical dashboards representing 256 youth (M age = 11.9) from 128 practitioners who were trained in the Managing and Adapting Practice (MAP) system (Chorpita & Daleiden in BF Chorpita EL Daleiden 2014 Structuring the collaboration of science and service in pursuit of a shared vision. 43(2):323 338. 2014, Chorpita & Daleiden in BF Chorpita EL Daleiden 2018 Coordinated strategic action: Aspiring to wisdom in mental health service systems. 25(4):e12264. 2018) in 55 agencies across 5 regional mental health systems. Practitioners labeled up to 35 fields (i.e., descriptions of clinical activities), with the options of drawing from a controlled vocabulary or writing in a client-specific activity. Practitioners then noted when certain activities occurred during the episode of care. Fields from the extracted data were coded and reliability was assessed for Field Type, Practice Element Type, Target Area, and Audience (e.g., Caregiver Psychoeducation: Anxiety would be coded as Field Type = Practice Element; Practice Element Type = Psychoeducation; Target Area = Anxiety; Audience = Caregiver). Coders demonstrated moderate to almost perfect interrater reliability. On average, practitioners recorded two activities per session, and clients had 10 unique activities across all their sessions. Results from multilevel models showed that clinical activity characteristics and sessions accounted for the most variance in the occurrence, recurrence, and co-occurrence of clinical activities, with relatively less variance accounted for by practitioners, clients, and regional systems. Findings are consistent with patterns of practice reported in other studies and suggest that clinical dashboards may be a useful source of clinical information. More generally, the use of a controlled vocabulary for clinical activities appears to increase the retrievability and actionability of healthcare information and thus sets the stage for advancing the utility of clinical documentation.

GERONTOLOGICAL AND GERIATRIC SERVICES FOR THE OLDER GENERATION

The article deals with measures aimed at the development of gerontological and geriatric services, the study of social and psychological determinants of the elderly in order to improve the processes of the organization of providing medical, social and psychological services to people with mental health problems. Attention is paid to topical issues of gerontpsychology, issues of adaptation of people with mental health disorders in society, development of abilities that allow them to live independently. The current state of the system of mental health and social protection services is presented from the point of view of the need to create alternative forms of services. The article pays attention to the importance and necessity of introducing and developing new forms and types of psychological and medical-social care, increasing the targeting of services based on individual psychological features and capabilities of elderly people with mental health problems. The data of the studies conducted by the author as well as those conducted with his participation are given. Conclusions are made and recommendations are provided on the measures necessary to improve the social and psychological condition of people with mental health disorders.

Research on the Construction and Strategies of the “Familyschool-social-medical” Collaboration System for Adolescent Mental Health Services

Research on the Construction and Strategies of the “Familyschool-social-medical” Collaboration System for Adolescent Mental Health Services

Analysis of the current status of children’s mental health

This paper systematically analyzes the current status of the mental health of young children, summarizing both the positive and negative aspects. It explores the underlying causes of these phenomena and proposes corresponding suggestions for improvement. Through a detailed analysis of the literature, the paper highlights how increasing attention and the popularization of mental health education have allowed more children to access mental health knowledge and counselling early on. Despite this progress, challenges persist due to modern lifestyle changes, rapid technological advancements, and urbanization, which negatively impact children’s mental health. Many children suffer from a lack of emotional support, high psychological pressure, and exposure to harmful information within their family and social environments. To address these issues, the paper emphasizes the need for improvements in family environments, societal support, and policies, as well as enhancements to the mental health service system. The recommendations include fostering better parent-child communication, using electronic devices judiciously, and creating supportive home environments. On a broader scale, it calls for stronger policy support, improved mental health services, and widespread mental health education.

Diagnostic profiles and trauma history among treatment-seeking young adults with positive post-traumatic stress disorder screens: Findings and implications for public mental health care.

This study examined diagnostic profiles and trauma history among treatment-seeking young adults with positive PTSD screens in public mental health care. Screening for trauma history and PTSD symptoms was implemented in a community mental health service system. 266 treatment-seeking young adults (aged 18-35) endorsed trauma exposure with a score of at least 45 on the DSM-IV PTSD Checklist, indicating probable PTSD. Young adults with positive PTSD screens were predominantly female, minority, and diagnosed with mood disorders. Of those with positive screens, only 15% had a chart diagnosis of PTSD; 17.3% (ages 18-24) versus 14.1% (ages 25-35). Variables significantly associated with a decreased likelihood of PTSD detection included a diagnosis of schizophrenia or bipolar disorder, exposure to fewer types of traumatic events, male gender, and white race. Routine PTSD screening for young adults receiving public mental health care should be prioritized to address long-term impacts of trauma.

Influencing factors of Six Sigma management in the construction of students mental health service system in the post-COVID-19 era

PurposeThis study aims to construct a mental health service system for middle school students in the post-COVID-19 era with the framework of Six Sigma DMAIC (define, measure, analyze, improve and control) and analyze the influencing factors of the mental health service system to study the implementation strategies of quality-oriented mental health services in middle schools.Design/methodology/approachThis study was conducted in Tianjin, China, from September to November 2022, and 350 middle school students from Tianjin Public Middle School were selected as subjects. A questionnaire survey was used to collect data. In this study, the Six Sigma DMAIC method, sensitivity analysis method, exploratory factor analysis and principal component analysis were used to analyze the mental health services provided to middle school students.FindingsBased on the Six Sigma DMAIC framework, this study indicates that the contribution rate of the mental health service process factor is the largest in the post-COVID-19 era. The mental health cultivation factor ranks second in terms of its contribution. Mental health quality and policy factors are also important in the construction of middle school students’ mental health service system. In addition, the study highlights the importance of parental involvement and social support in student mental health services during the post-COVID-19 era.Originality/valueTo the best of the authors’ knowledge, a study on middle school students’ mental health in the post-Covid-19 era has not yet been conducted. This study developed a quality-oriented mental health system and analyzed the influencing factors of mental health for middle school students based on data analysis and the Six Sigma DMAIC method.

Approaching Jail Diversion and Prevention of Criminal Legal System Involvement Simultaneously.

Despite prolific jail diversion initiatives, people with serious mental illness continue to be overrepresented in the criminal legal system. This continued overrepresentation has led to recent calls to address social determinants of health and criminal risk factors rather than to allocate new resources to diverting people from the criminal legal system. This shift toward prevention by addressing social factors that influence health and criminal legal outcomes should occur alongside a continued focus on diversion to understand what works and for whom. An effective, well-funded, and comprehensive community-based mental health services system could serve as the ultimate intercept for preventing criminal legal system involvement.

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.