National Mental Health Policy Research Articles

일상 속으로: 로버트 펠릭스(Robert H. Felix)와 정신보건법의 기원

This study traces the origins of the transition from an institution-based mental health structure to a community-based policy by examining the early career and contributions of Dr. Robert H. Felix, a major figure who helped pass the National Mental Health Act of 1946 and was the first director of the National Institute of Mental Health. Felix began his career in the U.S. Public Health (USPHS) in the 1930s and was stationed at various PHS-affiliated institutes in the early 1940s. Post-World War II (WWII), he leveraged his professional experiences with federal-level institutions, by laying the groundwork for overarching national mental health policy plans. Based on lessons learned from total war, his prospective plan mainly focused on the prevention of mental illness, whether chronic or acute. In this regard, this paper demonstrates how American mental health policies use centralized federal funds to help community-based prevention of early-stage illness.

Perinatal Mental Disorders: The ‘Non Liquet’ Facet of Mental Health Legislative Instruments in India

Due to the impetus provided by the Millennium Development Goals and the Sustainable Development Goals, maternal health has become the subject matter of various legislative instruments worldwide. However, perinatal mental disorders have remained an underestimated public health issue in many countries. High prevalence rates of such perinatal disorders in India have been reported by various evidence-based studies. This makes it imperative to analyse the provisions of the mental healthcare legislative instruments that have been brought into force in India. This article aims to evaluate and analyse coverage of perinatal mental disorders under the provisions of the legislative instruments, especially statutes, providing for mental health in India. Websites of the Government of India, various Indian Ministries and other government agencies were visited to obtain relevant documents regarding the mental health policy and legislation. None of the mental health legislative instruments in India underscore perinatal mental disorders as a public health concern, whereby failing to identify the unique characteristics of perinatal mental disorders. They consequently do not provide for nationwide detection and treatment measures. There is an immediate and pertinent need to highlight perinatal mental disorders through legislative instruments. The National Mental Health Policy, 2014 provides for comprehensive healthcare services; however, it excludes measures for perinatal mental health services. The Mental Healthcare Act, 2017 should be amended to explicitly include women during the perinatal period, along with originally provided mental health services for children and elderly individuals.

Patrick J. Kennedy to lead national MH, addiction policy practice

Former U.S. Rep. Patrick J. Kennedy has been named as a partner with Healthsperien, LLC, the leading national health care policy consulting firm announced Jan. 24 in a news release. Healthsperien plans to establish and lead a new national mental health and addiction policy practice. Rep. Kennedy will bring his decades of national leadership, advocacy, and expertise in mental health to advise a diverse array of clients, focusing on mental health and addiction, community‐based services and supports, and the need for health system transformation, officials announced. Rep. Kennedy will provide guidance on policy development, strategic advice and lobbying to clients — including patient groups, providers, employers, innovator companies, payors and more — to advance innovative approaches and improve access to high‐quality, affordable mental health and addiction care for individuals and their caregivers in the United States. Issues to be addressed include.

Addressing Mental Health Needs in Low- and Middle-Income Countries: The case of São Caetano do Sul, Brazil.

São Caetano do Sul, a city in southeastern Brazil, boasts exemplary social indicators and healthcare services, with a population of 162,763 and a density of 9,736.03 inhabitants/km². Allocating 25% of its budget to healthcare, the city's mental healthcare services adhere to the National Mental Health Policy. Structured services include a CAPS-II, CAPS-AD, outpatient teams, and teams in various locations. Initiatives since 2000 include inaugurating a CAPS-AD in 2006, a psychiatric emergency service in 2010, and a CAPS-II in 2016, relocating CAPS-AD in 2019, and establishing the Cuca Legal Project in 2022. São Caetano do Sul has a Mental Health Risk Classification Protocol to aid clinical decision-making. Developing care lines for various groups, it offers programs like smoking prevention, school psychology, and obesity support. Collaborating with community centers, these facilities serve as teaching environments. The mental health care network focuses on five axes: Communication, Care, Prevention, Management, and Education, with specific proposed actions and competencies. Despite progress, challenges remain. Expanding access, reducing stigma, and implementing robust monitoring are crucial. São Caetano do Sul's experience offers valuable insights for similar urban settings in LMICs developing mental health programs.

Leave no one behind: Rethinking policy and practice at the national level to prevent mental disorders

The global burden of mental disorders is increasing, in line with the shift from communicable to chronic non-communicable diseases. Mental disorders affect the functioning of individuals, resulting not only in enormous emotional suffering and diminished quality of life, but also in stigma and discrimination. This burden extends to the community and society, with far-reaching economic and social consequences. Even under optimal conditions, treatment alone will never be sufficient to reduce the global burden of mental disorders, so a shift in focus from treatment to prevention of mental disorders should be promoted at the central level in the form of legislation, policy formulation and resource allocation. Universal and selective prevention programs should be prioritized nationally, as they aim to change the risk profile of the entire population and specifically target populations at risk for mental disorders, respectively. In this article, we review the key risk factors for mental disorders and the measures that can be taken at the national level to prevent them, taking into due consideration that prevention efforts can vary based on the audience they are addressing, level of intensity they are providing, and the life phase they target. By adopting a human rights perspective and placing the social determinants of health at the center of our narrative, we maintain that improving mental health cannot be achieved by strengthening health services alone. Coordination across government departments is needed to implement multi-level public health interventions across a wide range of settings, programs, and policies. Focusing on children's mental health and addressing poverty, gender inequality and social discrimination should be absolute priorities for national mental health policies and plans.

Lingerie, high heels, lipstick, alcohol and tobacco: paraphilias and fetishes and the Mental Health of Sex Workers

Law No. 10,216 (National Mental Health Policy) reports on the rights and protection of people suffering from mental disorders. Objective: to report the perceptions of female sex workers about their mental health in light of the Mandala of Knowledge. Results: 1st moment: Who are we – participants make their self-introduction. 2nd moment: Getting to know the Mandala - explanation of what Popular Health Education is. 3rd moment: Our daily mental health - presentation of images with the main CMDs. 4th moment: How can I help myself? – the sex workers brought their stories about each image present in the mandala. Through constructions and deconstructions of EPS, strong and real stories from sex workers about CMD were highlighted. Conclusion: we noticed the precariousness between quality of life and the job carried out by sex workers, their long working hours, risk of harassment and police violence, precarious financial situation, thus reflecting on their mental health, whether at home or in the work environment.

Understanding the burden of mental and physical health disorders on families: findings from the Saudi National Mental Health Survey

ObjectiveTo assess prevalence and correlation of factors of family burden associated with mental and physical disorders in the general population of Saudi Arabia.Setting and participantsA secondary analysis of data from...

A Review of Policy Analysis: Gender Equality in Saudi Arabia’s Mental Health Policy

This study employs the Walt and Gilson Policy Triangle Method to analyse the mental health policy in Saudi Arabia and explore the position of gender equality within the content context, process and development of mental health. Four relevant articles were reviewed, focusing on policy development, legislation, human rights, financing, organisational integration, and women's mental health challenges. The national mental health policy in Saudi Arabia highlights access to care, quality of services, awareness, prevention, and family support, with 4% of the healthcare budget allocated to mental health services. However, gender-specific needs and experiences of women may need to be adequately addressed. Contextual factors such as cultural norms, religious beliefs, and gender segregation shape mental health policy in Saudi Arabia. The process of policy development involves collaboration between the Ministry of Health and various stakeholders, incorporating international guidelines. The study also underlines the Transformational Plan of Saudi Vision 2030 and its influence on mental health policy. However, gender equality actions are not explicitly addressed in the current policies. The research shows the need for comprehensive policy improvements to ensure gender equality in mental health care and provide appropriate support for women's mental health needs in Saudi Arabia.

Typology of Mental Health Peer Support Work Components: Systematised Review and Expert Consultation

AbstractThe employment of mental health peer support (PS) is recommended in national and international mental health policy, and widely implemented across many countries. The key components of PS remain to be identified. This study aimed to develop a typology of components involved in one-to-one PS for adults in mental health services. A systematised review was performed to establish a preliminary long list of candidate components, followed by expert consultation (n = 21) to refine the list. Forty-two publications were full-text reviewed, comprising 26 trial reports, nine training manuals, and seven change model papers. Two hundred forty-two candidate components were identified, which were thematically synthesised to 16 components and eight sub-components, categorised into four themes: recruitment, preparation, practice, and PS worker wellbeing. Our typology can inform reflection and planning of PS practice, and allow more rigorous and synthesised studies, such as component network meta-analyses, to characterise the impact of each component and their interactions.

Mental Health Nurses' attitudes towards mental illness and recovery-oriented practice in acute inpatient psychiatric units: Anon-participant observation study.

National mental health policies accentuate the importance of having positive attitudes, skills, and knowledge among mental health professionals to facilitate recovery-oriented practices in all areas of mental health care. However, evidence suggests that mental health professionals' negative attitudes towards mental illness are still evident and that recovery-oriented practice in acute inpatient units may be poorly implemented. At the same time, there is also a paucity of research to understand Mental Health Nurses' attitudes towards mental illness and recovery-oriented practice specifically. Therefore, this non-participant observation study aimed to explore Mental Health Nurses' attitudes towards mental illness and recovery-oriented practice in acute inpatient units by observing the interactions between the consumers and nurses. The Mental Illness Clinicians Attitudes Scale-v4 and The Recovery Attitudes Questionnaire inspired the development of a non-participant observation chart for this study and the observations were recorded on the chart. Six observations were conducted in three acute inpatient units. Observations focused on Mental Health Nurses' knowledge about mental illness, communication, dignity, respect, anxiety, fear, punishment, facilitation of real choices for consumers, physical care, cooperation with consumers' families and others and recovery orientation. Interpretive descriptive analysis was used to analyse the data. The results show that Mental Health Nurses generally have positive attitudes towards mental illness and recovery-oriented practice. Some deficits in the physical care of people with mental illness in the acute inpatient units were observed. Therefore, future research could address the adequate preparation of Mental Health Nurses to provide physical care to people with mental illnesses.

Child and adolescent mental well-being intervention programme: A systematic review of randomised controlled trials.

There has been an increasing awareness and recognition of mental well-being as one of the main outcome measures in national mental health policy and service provision in recent years. Many systemic reviews on intervention programmes for mental health or general well-being in young people have been conducted; however, these reviews were not mental well-being specific. This study aims to examine the effectiveness of child and adolescent mental well-being intervention programmes and to identify the approach of effective intervention by reviewing the available Randomised Controlled Trials. This systematic review study followed the PRISMA guidelines for systematic reviews ensuring a methodical and structured approach for the literature search and the subsequent review processes. The systematic literature search utilised major medical and health databases. Covidence, an online application for conducting systematic reviews, was used to assemble the titles, abstracts and full articles retrieved from the initial literature search. To examine the quality of the included trials for determining the strength of the evidence provided, the JBI Critical Appraisal Tool for Randomised Controlled Trial was used. There were 34 studies identified after an extensive search of the literature following the PRISMA guidelines. Seven (7) fulfilled all selection criteria and provided information on the effect of an intervention programme on mental well-being in adolescence. Data were extracted and analysed systematically with key information summarised. The results suggested that two (2) programmes demonstrated significant intervention effects, but with a small effect size. The quality of these trials was also assessed using the JBI Critical Appraisal Tool for Randomised Controlled Trials and identified some methodological issues. In conclusion, activity-based and psychoeducation are shown to be potentially effective approaches for future programme development. More research on a well-designed programme is urgently needed, particularly in developing countries, to provide good evidence in supporting the mental health policy through the enhancement of mental well-being in young people.

An exploratory study on the 10-year dynamic changes of mental health policy development and media stigma reporting in China (2011-2020).

China has introduced a large number of national mental health policies over the past decade. However, few studies have touched on what changes the policies brought to the media. This study aimed to investigate the relationship between stigma reports, classifications of mental disorders (SMI: severe mental illness vs. CMD: common mental disorders) and sources of information (mental health professionals vs. non-mental health professionals) from 2011 to 2020 in China Daily, an established official media of China. This study consists of policy review and media review. The policy review reviewed the media management content in Chinese national plans, policies, and laws on mental health from 2011 to 2020. China Daily news articles reporting mental illness-related topics were included in this study as the media material. After a two-step review, the eligible news articles were coded with a structured codebook. The proportion and frequency of stigma depiction of mental disorders, classifications of mental disorders and source of information were counted by year. Chi-test was undertaken to determine the relationship between stigma reports and different classifications of mental disorders and sources of information. An exploratory analysis was conducted to explore the changes in depiction around time points of policy publications. The number of anti-stigmatizing articles increased significantly from 2011 to 2020. There is a statistical difference in the proportion of stigmatizing codes between articles featuring SMI and CMD (χ2 = 44.56, p < .001) and different sources of information (χ2 = 78.49, p < .001). And the statistical difference remained over the decade. The results of the research indicate that the media may have alleviated the problem of stigma. But the subtle stigmatization still exists, which needs joint efforts of the government and media.

Gaining distance learning effectiveness through mental health improvement during the COVID-19 pandemic: The role of patience

Nowadays, the COVID-19 pandemic has impacted communities' mental health worldwide. Therefore, studies on minimizing the pandemic's mental health impact are urgently needed. This study aimed to examine the role of patience on distance learners' mental health during the COVID-19 pandemic. A correlational study was conducted involving a total of 330 university students of distance learners, and they were selected using stratified random sampling. The Patience Scale (PS-11) was used to measure interpersonal patience, life hardships patience, and daily hassles patience. The Depression, Anxiety, and Stress Scale (DASS-21) were used to measure mental health from the aspects of depression, anxiety, and stress. The data were analyzed using descriptive analysis and multiple regression. The study showed that life hardships and patience were predictors of reducing depression and anxiety. Besides that, life hardships patience and interpersonal patience were predictors of reducing stress, and the main contributing factor was life hardships patience. This study contributes to humanistic therapy theories and their practical implications. It also contributes to developing the national mental health policy strategy, Ministry of Health Malaysia, and Sustainable Development Goals 2030.

U.S. Maternal Mental Health Awareness Week finds a new home

2020 Mom, a national maternal mental health policy organization, announced today that it is transitioning its Maternal Mental Health Awareness Week Social Media Campaign and TheBlueDotProject.org — the corresponding website and social media platforms — to Postpartum Support International this month, a news release stated. 2020 Mom has been the host of TheBlueDotProject.org and the U.S. Maternal Mental Health Awareness Week Social Media Campaign since 2014, first in conjunction with nonprofit partners such as Postpartum Support International (PSI), through the National Coalition for Maternal Mental Health. The campaign aims to raise awareness about maternal mental health disorders like postpartum depression and promote the blue dot symbol as the universal symbol of maternal mental health awareness. “We are thrilled to host The Blue Dot Project as part of Postpartum Support International. From conception, we were involved in establishing the blue dot as the symbol for promoting awareness and solidarity for perinatal mental health. This natural collaboration allows us to continue to increase awareness for perinatal mental health disorders, while also promoting hope through the use of the symbol,” said Wendy Davis, Ph.D., executive director of PSI.

He Who Has Hope, Has Everything.

He Who Has Hope, Has Everything.

Adolescent schizophrenia: state of the art and proposals to improve transition management in Italy.

In mental health care, transition refers to the pathway of a young person from a child and adolescent mental health service (CAMHS) to an adult mental health service (AMHS). In Italy, the age of transition from adolescents to adults' mental health services is at the age of 18. Difficulties in transitioning have shown to favor patients' and families' disengagement and discontinuity of care with pharmacological treatment dropouts. On the other hand, a smooth and effective transition may improve the management of the disease and increase the chances of improvement of young schizophrenic patients. This project of roundtables, including child neuropsychiatrists (CNPs) and adult psychiatrists (Psy) throughout Italy, was aimed at exploring the problems of transition in clinical practice and collecting the proposals to improve transition management. The need to fill some cultural and organizational aspects strongly emerged to improve the transition process of adolescents with schizophrenia to adults' mental health services. On the one hand, specific training programs for both Psy and CNPs on the transition process are hoped for. On the other hand, both Psy and CNPs have expressed a need for shared official protocols, direct handover between the services including a period of shared management, and building of territorial multidisciplinary teams. All these aspects imply having a national mental health policy dedicated to taking charge of young people with mental health disorders, and accompanying them across the border between children and adults' mental health services. Improving transitional care can facilitate not only recovery but also prevention of mental illness for young people. Allocation of resources should aim at matching the epidemiological burden and reducing the heterogeneity between Italian regions.

Mental Healthcare of Elderly Population of Bangladesh: Current Situation and Challenges

In Bangladesh, mental health of elderly people is often underestimated because of lack of awareness and perceived needs of medical care for physical health problems, whereas comorbid psychiatric conditions remain underdiagnosed among individuals in the country. Large numbers of older persons face challenges such as discrimination, negligence and abuse that severely restrict their human rights and their contribution to society. However, in recent times, NGOs, legislatives, and citizens argue that it is the high time that older persons should be identified as a distinct category deserving special care and attention under human rights law. In Bangladesh, about 14 million older adults live in the country, which is 7.7% of the total population; this ageing population has been projected to be 17.2 million by 2025. The Mental Health Act was passed by the National Parliament of Bangladesh in 2018. A multi-disciplinary working group with representatives from government Ministries, mental health professional organizations, and advocacy groups collaborated to draft a National Mental Health Policy, which was approved by the Ministry of Health in 2019 is currently awaiting endorsement by the Cabinet. The working group also drafted a National Mental Health Strategic Plan 2020- 2030, anticipating implementation over the next decade, through successive 5-year action plans. To date, neither the policy nor the strategic plan has been implemented. Adoption of the strategic plan within the MOHFW general health care plan is anticipated in 2020. Under the circumstances, this review paper aims to examine current situation and challenges in having access to mental health care for the elderly people as part of human rights and a public health concern, while the health system has already been overburdened with other public health challenges due to limited resources.

Mental health law, policy & program in India – A fragmented narrative of change, contradictions and possibilities

There has been a long-standing history of over 150 years of mental health legislation in the Indian sub-continent. India formulated its National Mental Health Program (NMHP) in 1982 and National Mental Health Policy (MHP) only in 2014. In this paper we mark significant influences on the evolution of mental health law, policy and program in India starting from colonial laws. We suggest that discursive continuities from these colonial laws have existed for a few decades in post-independence India. International influences of deinstitutionalization and growth in community psychiatry took root in India by the late 1970s and considerably shaped mental health program thinking. The decade of 2000s with two major international developments, the UN Convention on Rights of Persons with Disabilities (CRPD) as well as Movement for Global Mental Health (MGMH) have had a significant impact on the mental health sector in India. We comment on a disjuncture between the progressive frames of the current mental health law and policy framework on the one hand and the national and district mental health programs in the country on the other. We then focus on technology assisted solutions for mental health care and their promise as widely promoted by the state and the market and what these mean for a country like India. Throughout the paper, we raise critical questions regarding dominance of western bio medical psychiatry as the epistemic frame guiding policy imagination at the cost of diverse, community resources and practices.

How much are senior UK public health professionals taught about mental health?

Directors, consultants and specialists in public mental health play a major role in developing and implementing local and national mental health policy. This study focuses on what academic training they receive about mental health via Master of Public Health (MPH) programmes. If you are a clinical psychologist involved in teaching on a MPH course we would be interested in hearing about your experiences.

The Impact of Stigma on Forensic Psychiatric Patients - a Case Report

AimsThe Royal College of Psychiatrists’ Fair Deal (RCPsych 2008) highlighted the far-reaching impact of stigma and discrimination on the lives of people with mental illness. The pervading nature of stigma has been acknowledged in recent national and international mental health policies (WHO). The World Health Organisation reiterates people affected by mental illness should not suffer social exclusion and marginalisation due to stigma.MethodsA sixty-year-old gentleman presented to the Emergency Department following self-inflicted stabbing to the neck resulting in pharyngeal tear and surgical repair. Previous psychiatric history included inpatient admission on Section 2 following a major depressive episode. On this admission, inpatient psychiatric review elicited three months of psychotropic medication non-adherence due to difficulties the patient had encountered in acquiring repeat medications from his GP. He had relapsed into alcohol misuse as a coping mechanism culminating in a suicide attempt at home with a knife. Upon recommencing of sertraline and risperidone during admission, he was assessed as euthymic with low risk to self. The patient had been previously abstinent from alcohol and described religion as a protective factor. Prior to discharge, the patient's GP stated he must present to the surgery in person with a form of identification. This is despite CQC guidance stipulating practices should not refuse patients registration if proof of identity cannot be produced.ResultsThis case illustrates the socioeconomic factors increasing likelihood of suicide including forensic history, low financial status, unstable housing and lack of social support. Substance dependence is a risk factor that can be reduced by supporting patients in accessing specialist misuse input from inpatient and community teams. The patient reported fear of stigmatisation and criminalisation which led to the avoidance of seeking treatment, deterioration in mental health and severe clinical consequences. It is imperative marginalised patients with mental illness can access quality health care and this starts with GP registration.ConclusionForensic mental health patients experience multiple stigmas impacting on well-being including social, institutional and media stigmatisation and high levels of internalised stigma. The Time to Change campaign focused on changing attitudes and behaviour however evaluation illustrated difficulties in tackling this issue. Healthcare professionals should be mindful to avoid stigmatising language and actions to ensure fairness in care. There is a need for the medical profession to continue striving for a tangible shift in attitudes. Advocating for those with mental illness can enhance quality of life for vulnerable patient groups.