Model Of Mental Health Care Research Articles

Holding the Whole Person: Perinatal Women’s Perspectives on the Integrated Infant Mental Health Care Model in Obstetrical Care during COVID-19 Pandemic

Holding the Whole Person: Perinatal Women’s Perspectives on the Integrated Infant Mental Health Care Model in Obstetrical Care during COVID-19 Pandemic

International experience in mental health provision in secondary schools

The protection of children's mental health is an important task, since missed opportunities for psychiatric care during this period are very difficult to make up for in the future. On the basis of research by domestic and foreign authors in recent years, we analyzed the foreign experience that has developed to date in providing psychological and psychiatric care to children in school settings from the position of their applicability in domestic practice. The current state of knowledge on models of mental health care for children in the school setting is reviewed, and possibilities for their use in mental health promotion are identified. Mental health services embedded in the educational system, both abroad and in Russia, synergistically promote mental health and education. The school as an organized collective provides a broad organizational opportunity to provide diagnostic and treatment interventions, as well as to equalize the availability of mental health care. However, it is currently recognized that the educational system and the mental health care delivery system are structurally, administratively and legislatively disconnected.

Scaling up community-delivered mental health support and care: A landscape analysis.

The mental health crisis has caused widespread suffering and has been further exacerbated by the COVID-19 pandemic. Marginalized groups are especially affected, with many concerns rooted in social determinants of mental health. To stem this tide of suffering, consideration of approaches outside the traditional biomedical model will be necessary. Drawing from task-sharing models of mental health care that have been pioneered in low-resource settings, community-initiated care (CIC) represents a potentially promising collection of approaches. This landscape analysis seeks to identify examples of CIC that have been implemented outside of the research context, with the aim of identifying barriers and facilitators of scale up. A narrative review approach was used for this landscape analysis in which the PubMed database was searched and further supplemented with Google Scholar. Promising programs were then discussed over multiple rounds of meetings with the research team, consisting of collaborators with varied experiences in mental health. Using the selection criteria and feedback derived from group meetings, a final list of programs was identified and summarized according to common characteristics and features. The initial PubMed search yielded 16 results, supplemented by review of the first 100 entries in Google Scholar. Through 5 follow-up meetings among team members, consensus was reached on a final list of 9 programs, which were grouped into three categories based on similar themes and topics: (1) approaches for the delivery of psychosocial interventions; (2) public health and integrative approaches to mental health; and (3) approaches for addressing youth mental health. Key facilitators to scale up included the importance of sustainable financing and human resources, addressing social determinants and stigma, engaging diverse stakeholders, leveraging existing health infrastructure, using sustainable training models, ensuring cultural relevance and appropriateness, and leveraging digital technologies. This landscape analysis, though not an exhaustive summary of the literature, describes promising examples of efforts to scale up CIC outside of the research context. Going forward, it will be necessary to mobilize stakeholders at the community, health system, and government levels to effectively promote CIC.

Social Needs and Acculturation as Predictors of Emotional Problems and Perceived Stress Among Latinx Mothers with Low Income

Associations between household social needs, acculturation, and emotional health remain understudied, particularly among Latinx mothers. We analyzed baseline survey data from 455 Latinx mothers in a previous study. Using multinomial regression, we examined whether emotional problems and perceived stress were associated with household social needs and acculturation. Almost half the sample reported four or more household social needs. Social needs cumulatively and independently predicted increased odds of frequent emotional problems or perceived stress. Lower acculturation predicted lower odds of frequent emotional problems. There is increased risk for emotional problems and stress in low-income Latinx mothers who experience high social need. Integrated social service and mental health care models may be one way to improve health outcomes. More research is needed to understand how clinical settings can leverage unique cultural protective factors to address the social and emotional health needs of Latinx mothers.

Shared decision-making interventions for people with mental health conditions.

Shared decision-making interventions for people with mental health conditions.

Trajectories towards affirmation: Gender identity in mental health services after the ICD-11

Depathologisation of gender diversity in the ICD-11 marks a shift in psychological services for transgender and gender nonconforming people. Even though the stipulated changes are only practically applicable ever since early 2022, a general move towards affirmative psychotherapeutic and counselling practice has been noticed ever since 2018. The present paper covers three main models of mental health care for gender minorities, namely the conversion therapy model, the transsexual gatekeeping model, and the affirmative model, in order to view them under a novel lens. Drawing on Science, Technology and Society Studies, the universalist presumptions and rigid gender roles of the traditional models are brought under scrutiny. Moreover, the itinerary reveals the need for situated narratives that encourage self-determination and renovate the therapeutic relationship as a means of self-exploration instead of an institutional control mechanism. Concluding, it is remarked that intersectional knowledge is crucial in compensating for micro-aggressive practices and dynamics historically promoted by psychologists and other mental health providers.

The Longitudinal Youth in Transition Study (LYiTS) Cohort Profile: Exploration by Hospital- Versus Community-Based Mental Health Services.

Youth face numerous challenges in receiving coordinated and continuous mental health services, particularly as they reach the age of transition from child and adolescent mental health services (CAMHS) to adult mental health services (AMHS). The Longitudinal Youth in Transition Study (LYiTS) follows youth prospectively as they cross this transition boundary to better understand their transition pathways and resulting symptoms and health service use outcomes. The current paper presents the baseline profile description for the LYiTS cohort and additionally examines differences in symptoms and functioning and health service utilization between youth receiving services at hospital- versus community-based CAMHS. A cross-sectional design was used. A sample of 237 16-18-year-old youth recruited from outpatient CAMHS at two hospitals and two community sites completed self-report measures at their first of four annual assessments. A latent profile analysis was conducted to identify symptomology profiles, and youth were compared on symptoms and health service use between hospital- and community-based sites. Four distinct symptomology profiles were identified (subclinical, moderate internalizing, moderate externalizing, and high symptomology). Symptom profiles and functioning levels reported by youth were no different across both types of organization, although there were differences detected in health service utilization, such as type of provider seen and use of medications. These findings suggest that there is little difference in symptomology between youth accessing hospital versus community-based CAMHS. With growing interest in understanding the effectiveness and cost-effectiveness of different models of mental health care, these findings provide a new understanding of the clinical and service use profiles of transition-aged youth that will be explored further as this cohort is followed across the CAMHS to AMHS transition boundary.

A transdisciplinary public health model for child and adolescent mental healthcare in low- and middle-income countries.

The Ministry of Women and Child Development, Government of India, provides financial support to the SAMVAD initiative.

Mixed-methods investigation of barriers and needs in mental healthcare of adults with autism and recommendations for future care (BarrierfreeASD): study protocol

IntroductionAutism refers to an early-onset neurodevelopmental condition with characteristic impairments and difficulties in practical living skills, which persist across the lifespan such that adults with autism often require substantial support...

Assessing Student Burnout, Treatment Acquisition, and Barriers to Care to Prompt Changes in a Student Mental Healthcare Program.

ObjectiveMedical students demonstrate disproportionately higher levels of burnout and depression than their non-medical age-matched peers. Few studies have been conducted about rates of treatment acquisition and the barriers to care among students with mental health concerns. This study further characterizes rates of burnout, obstacles to treatment, and program preference for medical students at The University of Michigan.MethodsIn June 2020, a 31-question survey eliciting information regarding student burnout, well-being, barriers to care, and improvements to overcome such barriers was sent to 588 current and recently graduated medical students at The University of Michigan. Participation was anonymous and voluntary, with optional response to each question.ResultsUltimately, 312 (53%) students responded. Pre-clinical and core clinical students were significantly more burned out than clinical elective students, with pre-clinical students’ odds ratio (OR) of 2.45 and core clinical students’ OR of 2.48. Most participants (81%) reported concerns regarding their emotional well-being. Two-thirds (66%) indicated a new or previously diagnosed mental health concern, with 37% of these students never having sought treatment. Commonly reported barriers to care and suggested improvement to mental health services are outlined. Commonly reported barriers to care were financial concerns, time constraints, and stigma-related fear of career-ending consequences.ConclusionsThis study showed stratification of the high levels of burnout among medical students. Student-driven feedback and survey results can help prompt medical schools to develop more robust mental healthcare models and drive much-needed structural changes.

Intensive home treatment in different settings

Randomised controlled trials of models of acute mental health care that provide generalisable results are hard to conduct. On the one hand, service users, their informal supporters, and health professionals have preferences regarding hospital admission versus an alternative, making randomisation difficult where such an option is already available. On the other hand, where the intervention of interest is newly provided through the research, subsequent fidelity can be difficult to achieve. The trial by Cornelis and colleagues1 is an important contribution to the literature on intensive home treatment; based on their review of previous literature, it is only the third trial on the topic, and the intensive home treatment teams concerned were already in operation.

Concurrent 19. Presentation for: Mental health and the resources sector: findings from a research program to promote effective mental health solutions

Presented on Wednesday 18 May: Session 19 This paper outlines a multifaceted national workplace mental health research program that incorporated assessment of individual level, work characteristics and organisational factors on mental health among workers in the resources sector within Australia and internationally. This multistep program included: identification of level of mental health and substance use problems in an Australian national study; examination of risk and protective factors (work roles, social networks and location); attitudes to seeking mental health assistance; organisational policies regarding mental health within a workplace health and safety framework; piloting a resources-specific workplace mental health program for team leaders and supervisors and a workplace suicide prevention program; and application of digital mental health interventions to this sector. Additional linked studies in New South Wales and Queensland in the resources sector assessed personal factors influencing perception of workplace physical risks and hazards, risk behaviours and opportunities for risk mitigation; and links between mental and physical health factors. A summary of the key findings are presented within the context of a program of research addressing mental health within remote settings in the resources sector. Mental health-related problems are highly prevalent among workers in remote resource settings, which has significant implications for workplace health and safety. Strategies to address prevention and effective intervention need to be tailored to the industry and employee characteristics, and address models of mental health care that are feasible and accessible in often remote and challenging environments. To access the presentation click the link on the right. To read the full paper click here

Mental Health Screening and Digital Intervention for Thai Seniors Citizen in Primary Care

IntroductionAvoidable disability associated with depression, anxiety, and impaired cognition among older adults is pervasive. Incentives for the detection of mental disorders in late life include increased reimbursement, reduced cost, and less burden for patients and families.ObjectivesMental health problems in the elderly are major public health issues around the world. Thai older adults who experience mental illness rarely seek care from mental health specialists; rather, they tend to seek help from a general physician. Primary health care is, therefore, an important setting for the detection of mental health symptoms and subsequent treatment. We describe the design and implementation of a mental health care model in the Thai primary care system. Initial results of screening for behavioral and emotional problems are reported.MethodsThis work is intended to explore mental health conditions in Thai elderly people to provide of identifying and non-pharmacological treating psychiatric conditions in the Primary care unit. The instruments used in the survey, which consists of twelve symptoms found in the elderly, developed into an online program to suit pandemic conditions.ResultsIn an effort to document mental health problems in the primary care system, 4,854 veterans (mean age 68) from 46 provinces across Thailand were screened for multiple mental health symptoms. The sample divided into 1,701 males (35%) and 3,153 females (65%).ConclusionsWhile screening for depressed mood is now common in primary care, we found it useful to screen for specific symptoms of depression in older persons (including insomnia, change in eating habits, facial expression, and anxiety) in a primary setting.DisclosureNo significant relationships.

Care work and social justice in creative arts therapy: Putting queer performance theory and disability justice in conversation with drama therapy

The COVID-19 pandemic has increased existing health disparities for the LGBTQIA2S+ community, reducing (or eliminating) access to healthcare through traditional pathways and increasing the value and necessity of community care. Putting queer performance theory in conversation with disability justice frameworks allows for exploration of how the creative arts therapies – and drama therapy specifically – can adapt to meet the emerging needs of marginalized populations. Situating drama therapy within a queer disability justice lens can support drama therapists in reclaiming the most revolutionary aspects of drama therapy theory and principles. Contrasting clinical and community-based approaches to drama therapy via autoethnography, limitations of the medical model of mental healthcare are interrogated while offering examples of alternative approaches to providing care rooted in activism and community organizing.

Screening Depressive Symptoms and Incident Major Depressive Disorder Among Chinese Community Residents Using a Mobile App-Based Integrated Mental Health Care Model: Cohort Study.

BackgroundDepression is associated with significant morbidity and human capital costs globally. Early screening for depressive symptoms and timely depressive disorder case identification and intervention may improve health outcomes and cost-effectiveness among affected individuals. China’s public and academic communities have reached a consensus on the need to improve access to early screening, diagnosis, and treatment of depression.ObjectiveThis study aims to estimate the screening prevalence and associated factors of subthreshold depressive symptoms among Chinese residents enrolled in the cohort study using a mobile app–based integrated mental health care model and investigate the 12-month incidence rate and related factors of major depressive disorder (MDD) among those with subthreshold depressive symptoms.MethodsData were drawn from the Depression Cohort in China (DCC) study. A total of 4243 community residents aged 18 to 64 years living in Nanshan district, Shenzhen city, in Guangdong province, China, were encouraged to participate in the DCC study when visiting the participating primary health care centers, and 4066 (95.83%) residents who met the DCC study criteria were screened for subthreshold depressive symptoms using the Patient Health Questionnaire-9 at baseline. Of the 4066 screened residents, 3168 (77.91%) with subthreshold depressive symptoms were referred to hospitals to receive a psychiatric diagnosis of MDD within 12 months. Sleep duration, anxiety symptoms, well-being, insomnia symptoms, and resilience were also investigated. The diagnosis of MDD was provided by trained psychiatrists using the Mini-International Neuropsychiatric Interview. Univariate and multivariate logistic regression models were performed to explore the potential factors related to subthreshold depressive symptoms at baseline, and Cox proportional hazards models were performed to explore the potential factors related to incident MDD.ResultsAnxiety symptoms (adjusted odds ratio [AOR] 1.63, 95% CI 1.42-1.87) and insomnia symptoms (AOR 1.13, 95% CI 1.05-1.22) were associated with an increased risk of subthreshold depressive symptoms, whereas well-being (AOR 0.93, 95% CI 0.87-0.99) was negatively associated with depressive symptoms. During the follow-up period, the 12-month incidence rate of MDD among participants with subthreshold depressive symptoms was 5.97% (189/3168). After incorporating all significant variables from the univariate analyses, the multivariate Cox proportional hazards model reported that a history of comorbidities (adjusted hazard ratio [AHR] 1.49, 95% CI 1.04-2.14) and anxiety symptoms (AHR 1.13, 95% CI 1.09-1.17) were independently associated with an increased risk of incident MDD. The 5-item World Health Organization Well-Being Index was associated with a decreased risk of incident MDD (AHR 0.90, 95% CI 0.86-0.94).ConclusionsElevated anxiety symptoms and unfavorable general well-being were significantly associated with subthreshold depressive symptoms and incident MDD among Chinese residents in Shenzhen. Early screening for subthreshold depressive symptoms and related factors may be helpful for identifying populations at high risk of incident MDD.

The Need For Antistigma Services And Quality Of Life Of Schizophrenia At The Care For Soul Health City In Semarang City, Indonesia

The Semarang City Government's efforts for the mental health village program have not been programmed intensively. The purpose of this study was to explore an urban care model for mental health in an effort to reduce stigma and improve the quality of life of people living with HIV. This research is a qualitative research with an exploratory descriptive approach. Data collection includes in-depth interviews with program stakeholders and direct observations of the program, as well as qualitative feedback from program participants. Based on the results of research using content analysis. The stages are: the text in the transcript, doing the unit of meaning, coding, categories so that the theme is obtained. Ethics clearance was obtained from the Faculty of Public Health, Diponegoro University, number: 579/EA/KEPK-FKM/2 Seven in-depth interviews were conducted representing different mental health programs. The service model in mental health care villages that is expected by the community is a form of intervention that aims to reduce stigma and improve the quality of life of Schizophrenia and prevent recurrence.

Mental health and the resources sector: findings from a research program to promote effective mental health solutions

This paper outlines a multifaceted national workplace mental health research program that incorporated assessment of individual level, work characteristics and organisational factors on mental health among workers in the resources sector within Australia and internationally. This multistep program included: identification of level of mental health and substance use problems in an Australian national study; examination of risk and protective factors (work roles, social networks and location); attitudes to seeking mental health assistance; organisational policies regarding mental health within a workplace health and safety framework; piloting a resources-specific workplace mental health program for team leaders and supervisors and a workplace suicide prevention program; and application of digital mental health interventions to this sector. Additional linked studies in New South Wales and Queensland in the resources sector assessed personal factors influencing perception of workplace physical risks and hazards, risk behaviours and opportunities for risk mitigation; and links between mental and physical health factors. A summary of the key findings are presented within the context of a program of research addressing mental health within remote settings in the resources sector. Mental health-related problems are highly prevalent among workers in remote resource settings, which has significant implications for workplace health and safety. Strategies to address prevention and effective intervention need to be tailored to the industry and employee characteristics, and address models of mental health care that are feasible and accessible in often remote and challenging environments.

Case Study in Youth Flexible Assertive Community Treatment: An Illustration of the Need for Integrated Care.

Youth Flexible Assertive Community Treatment (Youth Flexible ACT) is a client- and family-centered service delivery model for young people up to 24 years of age who have interrelated psychiatric- and social problems across multiple life domains and do not readily engage with office-based mental health services. Youth Flexible ACT teams were set up to meet the multifaceted needs of this subgroup in an integrated manner. In this paper, we present a case study to (1) describe the core principles of Youth Flexible ACT and (2) illustrate the application of the mental healthcare model. Subsequently, we describe the contribution of model elements to a positive care process and discuss the challenges of the team in working with the model. The case study displays the importance of integrated flexible and personalized care services to enable adolescents to remain engaged in care.

Mental Disorders in Assisted Living Facilities. A Narrative Review of the Prevalence, Existing Models of Care Delivery, and Outcomes

<h3>Introduction</h3> Arising in the late 1970s as an alternative to nursing homes, Assisted Living Facilities (ALFs) are residential communities for older and disabled adults needing assistance with activities of daily living but in a less restrictive, less institutional/medical setting. Offering a variety of communal home-like living arrangements as well as providing a broad range of health-related services, ALFs are highly heterogeneous. As a whole, they seek to preserve resident independence and autonomy, social wellbeing, and flexibility of service offerings to accommodate evolving resident needs. As of 2016, approximately 811,500 individuals resided in ALFs in the US, across 28,900 facilities with 996,100 licensed beds. The number of licensed beds continues to increase, a trend driven in part by consumer preference; a large national survey indicated that 78% of older adults would prefer to reside in Assisted Living versus 12% in a nursing home in the event they needed more care outside their home. While nursing homes are tightly regulated on the federal level, ALFs are regulated by states and vary widely in their approaches to standards, procedures, and staffing. Regardless of setting, community prevalence of mental illness, defined as "mental, behavioral, or emotional disorders," is 14.1% in adults over 50. In addition, about 11% of people aged 65 and older in the United States have dementia. It is becoming increasingly important to monitor the prevalence of mental illness, including dementia, in ALFs, especially as the older adult population and ALF occupancy increase. The aim of this review is to describe the prevalence of mental illness, including dementia, in Assisted Living residents, to detail existing models of mental health care for Assisted Living residents, and to discuss implications for clinical outcomes, health care utilization, and Assisted Living occupancy. For the purposes of this paper, dementia will be included under the rubric of "mental illness" due to its prevalence among Assisted Living residents, and the overlap of care delivery considerations with non-cognitive mental disorders. <h3>Methods</h3> This narrative review followed the best-practice recommendations outlined by Ferrari (2015). PubMed and Google Scholar were searched in June 2021 for the following key words: assisted living facility, psychiatric illness, limitations, hospitalization, discharge, and behavioral health integration, in addition to synonymous words related to three categories of interest including, prevalence of mental illness in ALFs, behavioral health care models in ALFs, and clinical outcomes of ALF residents. Articles were limited to the English language and to the United States or Canada. Emphasis was placed on recent systematic reviews and randomized controlled trials. All articles were initially screened according to title and abstract and were retained if they contained information on prevalence of mental illness in ALFs, behavioral health care models in ALFs, or clinical outcomes of ALF residents. Reference lists were hand-searched for additional research articles. <h3>Results</h3> Many articles reported various rates of mental illness and cognitive disorders in ALFs, however, the prevalence remains high and continues to increase as the older adult population increases. Across articles, prevalence of non-cognitive psychiatric disorders in ALFs ranged from 26% to 33% depending on methodology and study population. Prevalence of cognitive disorders in ALFs range widely depending on the type of facility: some ALFs admit exclusively persons with dementia, whereas other ALF facilities specialize in residents with fewer functional impairments. Studies have demonstrated that both depression and dementia in ALF residents are more prevalent when compared with community-dwelling controls. Behavioral health problems and high health care needs of ALF residents are common reasons for ALF discharge. Integrated models, which bring together specialty behavioral health care providers with health and supportive service providers, have been shown to reduce behavioral health symptoms and contribute to improved health of residents, improve care, and decrease associate care costs including staff turnover. <h3>Conclusions</h3> This narrative review addresses the importance of behavioral health needs in ALF residents. Articles identified limitations in ALF infrastructure and research, specifically relating to data collection and varying definitions of terms, which limits the generalizability of the results. Greater attention to the study, design, and implementation of behavioral health care for ALF residents may reduce the prevalence of distressing symptoms in those with psychiatric and cognitive disorders, and in turn decrease the need for unnecessary Emergency Department visits, hospitalizations, and premature facility discharge. Future research should consider measuring the effectiveness of mental health care in ALFs since there is limited research currently available. <h3>This research was funded by</h3> Unfunded.

How can geriatric psychiatry professional organizations maximize multidisciplinary partnerships to advance care?

The best models for mental health care for the elderly have focused on the need for multidisciplinary teams to address the breadth of physical, social and psychological needs of aging individuals. Yet, a common professional organizational structure typically focuses on a single specialty profession that may limit the ability to grow collaborative teams and foster development of across professions. One barrier that may remain is the nomenclature referring to older persons and their mental health care needs. We also identify challenges to creating these partnerships globally and across generations.Extensive survey across professions yielded responses from 332 individuals representing 20 professions and 7 major geographic regions. We identified important subgroups with understandably different views. For example, nonmembers demonstrated dissatisfaction with the term Psychogeriatrics; Non-physician members were less satisfied with the terms than physician members. While consumer sample was small, there was little opposition to the name and many reported that membership conferred expertise that was important to them both as patients and as family caregivers. Important geographic patterns emerged that indicated that in LAMC countries the terminology conferred expertise which was compelling to providers as well as consumers. Of note, LAMC had little infrastructure to support or assess non-physician providers. Reports from developed countries expressed the desire to move away from the term psychiatry/psychology and endorsed the term “mental health”. There was wide approval and acceptance of the mission to support for a multidisciplinary professional organization and acknowledgement that it serves aging patients through its strong commitment to supporting the autonomy, independence and human rights of older persons.While the field of geriatric psychiatry is recognized for its effectiveness in serving mental health needs for older persons, consideration to supporting a nomenclature that encompasses the breadth of disciplines needed to provide comprehensive care may provide a new approach for multidisciplinary professional development.