Practice Of Mental Health Professionals Research Articles

Supporting interdisciplinary mental health professionals through online professional development: eleven years of the MHPN webinar program in Australia

ABSTRACT Objective The Mental Health Professionals’ Network (MHPN) has been delivering webinars for professionals working in primary mental health care in Australia since 2010. This study aimed to investigate changes in engagement in and outcomes of MHPN webinars over 11 years from 2010 to 2020. Method Over 11-years, 75 webinars were delivered by a multi-disciplinary panel of mental health professionals, using a case-study format to stimulate discussion of collaborative care. Attendees were invited to complete a post-webinar online questionnaire to assess webinar effectiveness and impacts on work practice. Change over time was assessed using chi-square tests and analysis of variance. Results From 53,468 webinar attendances, 30,617 (57.3%) questionnaires were collated and analysed. There was a steady and significant increase in webinar attendance over time. The degree to which learning needs were met increased significantly over time, as did the relevance of the webinars and their anticipated impacts on improving work practice. Discussion The findings indicate that practitioner engagement in MHPN webinars and the associated positive impacts on work practice have both increased over the past decade. By improving the knowledge, attitudes and practice of mental health professionals, MHPN plays an important role in improving mental health promotion, prevention, early detection and treatment in Australia.

Attachment dimensions and problem behaviors in middle-childhood children: a comparative study in terms of maternal mental health

This study aimed to examine the differences between middle-childhood children of mothers receiving and not receiving mental health services in terms of attachment dimensions and problem behaviors, and the relationship of problem behaviors in middle-childhood children with some socio-demographic variables.
 Using quantitative research method, this study had two sample groups: the study and comparison groups. Additionally, it involved a total of 127 mothers and 127 children in the 9-14 age group, including 62 mothers and their children in the study group (receiving mental health services) and 65 mothers and their children in the comparison group (not receiving mental health services). For data collection, the following scales were applied to both groups. The data collecting process consisted of the Personal Information Form, the Experiences in Close Relationships Scale II – Middle-Childhood, and the Strengths and Difficulties Questionnaire (AB 4-16).
 The results showed that the study group children tended to have insecure attachment and problematic behaviors more than the comparison group children. In addition to mother’s need for mental health services, mother’s educational level, child’s birth after an unplanned pregnancy, and separation from one or both parents for a period were also considered as important factors affecting problem behaviors in children.
 This study revealed the preventable factors in the development of problem behaviors in children. These results contribute to the practices of mental health professionals and the role of child welfare systems in developing protective-preventive services.

Integrated Case Presentation Seminar: Bridging Parallel Fields to Improve Psychiatry and Psychology Learner Experience.

Daily clinical practice of mental health professionals often requires interaction between providers from diverse training and professional backgrounds. Efforts to engage mental health trainees across disciplines are necessary and have had varied outcomes. The current study reviews the development and implementation of a monthly one-hour integrated case presentation seminar (ICPS) as part of independent psychology and psychiatry two-year fellowships at a Midwestern teaching hospital. The training integrated a semi-structured seminar to facilitate case presentation within a group setting. The focus of the seminar was to allow for exposure to conceptualization, diagnostic, and treatment strategies and skills, as well as science-based practice techniques for trainees. Learner survey results and the sustained offering of the seminar suggest the format and goals of the seminar are feasible and acceptable. Based on the current preliminary findings, similar training programs may find benefit in strategies to enhance integrated training opportunities for psychiatry and psychology trainees.

Knowledge, attitudes and practices of mental health professionals regarding the management of major cognitive disorders in the Republic of Moldova

Major cognitive impairment is a significant public health problem despite advances in patient management. The purpose of the research was to analyze the knowledge, attitudes, and practices of mental health specialists regarding the management of major cognitive disorders in the Republic of Moldova. Material and method: The research were descriptive online survey type. A structured questionnaire with self-completion questions was used. The questionnaires were pre-tested and validated prior to conducting the research. Results: Barriers identified: 50.0% lack of social support services, 34.4% lack of a national guide/program, 46.9% lack of interdisciplinary collaboration, 43.8% problems in communicating with the patient, 25, 0% difficulties in establishing the diagnosis and developing the treatment plan, 31.3% in communication with relatives/caregiver, and 40.6% in the diagnosis and treatment of concomitant diseases. During consultations, 75.0% of those interviewed quantify the degree of impairment of cognitive function, 71.9% know national and international guidelines/protocols, 90.6% consider training in social and cultural activities useful, 75.0% – performing exercises physical therapy, 65.6% physical therapy, 56.3% cognitive-behavioral therapy, 53.1% speech therapy sessions, 46.9% psychotherapy, and 28.1% state that all options are useful. Positive attitudes 96.9% believe that the patient with cognitive disorders must benefit from access to medical services according to individual needs and that the patient has the right to live with dignity, without suffering, 81.3% are of the opinion that patients must be included in social and cultural activities, 62.5% support that people with cognitive disorders should benefit from institutionalization for palliative care. Negative attitudes 50.0% believe that patients consume time, emotions, and resources, and 25.0% mention that they are a burden on the healthcare system. Conclusion: The most frequent difficulties in the approach and management of patients with cognitive disorders are cited as the lack of social support services for patients or families, interdisciplinary collaboration/difficulty referring to other specialists and a national guide/program for cognitive disorders.

Nutritional Psychiatry: Knowledge, Attitudes and Clinical Practice of Mental Health Professionals

IntroductionIn 2016 the United Nations launched their “Decade of action on nutrition” promoting a healthy and sustainable food pattern. The International Society for Nutritional Psychiatry Research held its first International Conference in 2017. Current evidence in this area consists mainly of association studies, while interventional studies with food supplements or altered diet patterns are starting to emerge.ObjectivesTo our knowledge practice based research on promoting healthy food and investigating the role of medical professionals is scarse in general and especially so in psychiatry. Hence, our research questions were: 1. What is the attitude of mental health professionals with regard to promoting healthy food in their patients. 2. What is the subjective knowledge and attention in training schemes on this topic.MethodsWe conducted a self-made online questionnaire using a 5 point Likert Scale. Surveys were sent out to 50 mental health professionals of our institution, including psychiatrists, psychiatric residents, General Practitioners and Mental Health Nurse Practitioners. Results were analysed with descriptive statistics.Results40 (80%) of the respondents returned the questionnaire. 65% of respondents considered promoting healthy food as a key task for themselves in their daily practice. 45% of respondents believed their patients would be reluctant to follow advice on healthy diet. 62% had sufficient knowledge on the subject to give professional advice, while 65% answered this topic received insufficient attention during their training.ConclusionsIn this survey we found the role of promoting healthy diet deserves more attention in mental health practice and training. Smartphone applications may ameliorate treatment adherence.DisclosureNo significant relationships.

Understanding Mental Health Professionals' Perspectives and Practices Regarding the Implementation of Digital Mental Health: Qualitative Study.

BackgroundDespite the potential of digital mental health to provide cost-effective mental health care, its adoption in clinical settings is limited, and little is known about the perspectives and practices of mental health professionals regarding its implementation or the factors influencing these perspectives and practices.ObjectiveThis study aims to characterize in depth the perspectives and practices of mental health professionals regarding the implementation of digital mental health and explore the factors affecting such perspectives and practices.MethodsA qualitative study using in-depth semistructured interviews with Portuguese mental health professionals (N=13)—psychologists and psychiatrists—was conducted. The transcribed interviews were thematically analyzed.ResultsMental health professionals deemed important or engaged in the following practices during the implementation of digital mental health: indication evaluation, therapeutic contract negotiation, digital psychological assessment, technology setup and management, and intervention delivery and follow-up. Low-threshold accessibility and professionals’ perceived duty to provide support to their clients facilitated the implementation of digital mental health. Conversely, the lack of structured intervention frameworks; the unavailability of usable, validated, and affordable technology; and the absence of structured training programs inhibited digital mental health implementation by mental health professionals.ConclusionsThe publication of practice frameworks, development of evidence-based technology, and delivery of structured training seem key to expediting implementation and encouraging the sustained adoption of digital mental health by mental health professionals.

Serenity Integrated Mentoring and the High Intensity Network: a scheme that raises serious questions for practice and governance in UK psychiatry.

Serenity Integrated Mentoring (SIM) involved the police and mental health crisis services working in a single team, developing case management plans that allowed a seamless move from offers of therapeutic engagement (by the mental health team) to use of coercive measures (by the police) with those who persisted with frequent crisis presentations. Withdrawn after widespread criticism, the scheme raises important questions - about the practice of mental health professionals who are involved in decisions about using criminal sanctions for people presenting in crisis, about the ethical and legal status of the sharing of confidential clinical information with the police, and about the processes that professional bodies use in promoting, monitoring and responding to controversial service developments.

Improving Practices of Mental Health Professionals in Recommending More Physical Activity and Less Sedentary Behaviour to Their Clients: An Intervention Trial

We investigated the effects of increasing physical activity (PA) and reducing sedentary behaviour (SB) of mental health professionals on their attitudes towards and practices in recommending more PA and less SB to their clients. A 4-week pre-post intervention trial was conducted involving 17 mental health professionals. The participants who increased their own physical activity during the intervention increased the frequency of recommending more PA (p = 0.009) and less SB (p = 0.005) to their clients. A relatively simple, low-cost intervention, consisting of group behaviour change counselling, goal setting and positive feedback, may improve the practices of mental health professionals.

Physical activity and sedentary behaviour counselling: Attitudes and practices of mental health professionals.

Despite recent interest in the mental health benefits of increasing physical activity (PA) and reducing sedentary behaviour (SB), little is known about PA and SB counselling provided by mental health professionals. Therefore, the aim of this study was to explore the attitudes and practices of mental health professionals in recommending more PA and less SB to their clients. Quantitative data were collected using a modified version of the Exercise in Mental Illness Questionnaire in a sample of 17 Australian mental health professionals. The collected data were reported using percentages (for categorical data) and means and standard deviations (for numerical data). Additionally, in focus group discussions, 10 mental health professionals provided in-depth information about their clinical practice, facilitators, and perceived barriers in recommending more PA and less SB. They also provided suggestions on how to potentially improve their PA and SB counselling practices. The focus groups were audio-recorded, transcribed and analysed using thematic analysis. Only 35.3% of participants have undergone formal training in recommending PA in the treatment of mental illness. Most participants (64.7%) ranked PA counselling among the top three types of mental health treatment. All participants reported recommending PA to their clients at least "occasionally", while 88% of them also provided SB counselling. However, the recommendations provided were usually not specific. The most commonly reported barriers for providing PA and SB counselling were a lack of knowledge and confidence. Participants also believed that, if they were more active themselves, they would be in a better position to recommend PA to their clients, by sharing their own experience of evidence-informed strategies designed to increase PA and reduce SB. The findings of this study indicate that mental health professionals commonly provide generic PA and SB counselling to their clients. PA and SB counselling in the mental health setting could be improved by: including training on PA and SB counselling in formal education and continued professional training for mental health professionals; implementing interventions to increase PA and reduce SB among mental health professionals themselves; and ensuring support from an exercise or PA promotion specialist as a part of a multi-disciplinary approach to mental health care.

The experience of Trauma Center-Trauma Sensitive Yoga training on professional practice of mental health professionals and yoga instructors

Background and purposeTraumatic psychological events are thought to alter brain physiology, notably regions such as the thalamus and the limbic system, affecting personal choice, autonomy, and behavior. Innovative therapies are needed to address the diverse, mental and physical consequences of these changes. Trauma Center–Trauma Sensitive Yoga (TC-TSY) has shown promising results in clinical trials among individuals experiencing posttraumatic symptomatology. Materials and methodsUsing a qualitative, descriptive design, we examined the impact of TC-TSY training on the professional practice of seven practitioners who were certified yoga instructors and/or registered psychologists. ResultsThe findings suggest TC-TSY training enriched their practices, chiefly through its choice-based, widely applicable approach; invitation- and mindfulness-based language; and building of therapeutic trust and attunement. Some participants questioned the accessibility and suitability of the training, as well as the rigidity of TC-TSY terminology. ConclusionMore research is needed to examine potential outcomes of TC-TSY practice related to self-efficacy, coping, quality of life, and stress reduction among traumatized individuals.

VIRTUAL EXPOSURE AS AN INSTRUMENT TO OVERCOME STUDENTS’ FEAR OF PUBLIC SPEAKING AND SOCIAL INTERACTIONS

The article provides an overview of research on social anxiety and fear of public speaking among students. It focuses on the possibility of psychological assistance with the methods using virtual reality. The anxiety of public speaking, communication, or other public activities can be described as early signs of some anxiety and affective disorders, in particular, a social anxiety disorder. Anxiety of social interactions, which manifests as significant discomfort and can be qualified as a mental health disorder, is characteristic for 7-13% of population. People who are afraid of public actions face challenges in achieving career goals and can be described as less ambitious and purposeful. Based on the worked-out materials, the article author indicates that discomfort felt by students because of their social anxiety causes their financial losses, low economic stability, and the avoidance of possible career prospects. According to the current scientific resources, the main problems associated with fear of public speaking are based on negative perceptions of themselves and ineffective strategies, which people use to resolve social situations. The searches for the best plan to feel “in safety” and fixed attention on minor discomforts during joint activities leads to student’s increased criticism concerning their own results and dissatisfaction with their achievements. It provokes problems with learning, their frequent absence at lessons, and social deprivation, which usually manifested by signs of burnout or depression. Therefore, creating and implementation of appropriate, effective, and empirical evidence-based psychological support is an essential area of research and practice for mental health professionals. The author notes that the recommended psychological therapy for specific and social phobias based on the cognitive-behavioural therapy can be supplemented by the virtual environment, which allows systematic and step-by-step overcoming and desensibilization of negative (traumatic) experiences of situations that anxious students try to avoid. The materials discussed in the article points to the achievement of psycho-emotional stability and the reduction of social anxiety during virtual exposure. The results of virtual exposure techniques used with students indicate decrease of their anxiety, reduction of negative automatic thoughts and improvement of their self-esteem, which contributes to restoring of their psychosocial functioning. &nbsp

Hearing voices, sexual abuse and service system responses

ABSTRACTResearch indicates that routine effective screening for sexual abuse by mental health professionals is infrequent, and when experiences of sexual abuse are disclosed to mental health professionals it is unclear whether these disclosures are meaningfully incorporated into professional formulations and treatment plans. Screening rates and inclusion of trauma details on formulations and treatment plans appear to be less common amongst consumers with psychotic diagnoses. The aim of this study was to further investigate the work practices of mental health professionals who engage with consumers who hear voices and have experienced sexual abuse. The results indicate over half of respondents were not routinely screening voice hearers for sexual abuse or assault. The findings also point to a number of mediating factors that influence whether or not mental health professionals screen for abuse. When respondents were aware of sexual abuse histories most included this information in their professional formulations and treatment plans but struggled to implement effective trauma related treatment plans due to a lack of trauma-specific services. These findings indicate a need for organisational and systemic leadership to address barriers to effective responses to sexual abuse survivors.

The Impact of the "Semente" Program on the Family-Focused Practice of Mental Health Professionals in Portugal.

Background: Children of parents with mental illness (COPMI) are a high-risk group. There is a strong association between parents’ psychiatric disorders and the incidence of psychopathology in their children. These children need to be identified and supported by mental health workers early, and hence, clinical practice in adult mental health services needs to change from a focus on individual patients to a more systemic family focus. “Semente,” a mental health promotion program developed by the Psychiatry Service of Fernando Fonseca hospital (Lisbon, Portugal), had been established to identify these children and families and promote their mental health, by decreasing the impact of risk factors and promoting protective factors. The program included preventive COPMI interventions and implementation of activities offered to families with children in the mental health care. The aim of the present study was to evaluate changes in mental health care after the training in “Child Talks” intervention (two to three psycho-educational meetings with parents and children) and implementation of the “Semente” program. Methods: Participants (N = 51) were all professionals from Psychiatric Service of Fernando Fonseca Hospital who received Child Talks training. The Family-Focused Mental Health Practice Questionnaire (FFMPQ) was used to measure change in professionals’ attitudes, knowledge, confidence, and organizational structure in working with these families. All participants filled in the questionnaire before training and 10 months later. Results: The results showed that, from pre- to post-measurement, the professionals changed clinical practice significantly. The largest changes were visible in the improved provision of support at the workplace for family-focused practice and the clarity and availability of the policies and procedures. Furthermore, the skill and knowledge of the mental health workers showed significant improvement at posttest. Conclusion: The positive results of this study were not unexpected; the training, implementation of routines, and procedures as well as workplace support were aims of the “Semente” program. Interpretation of the results should be taken with caution because of the small sample and the lower reliability of some of scales of the FFMPQ. The results indicate that professionals moved from patient focus to family focus during the implementation of the “Semente” program.

Affirmative Competence and Practices of Mental Health Professionals with LGB clients: An Ibero-American Study.

There are not many studies about affirmative competence and practices among mental health professionals working with Lesbian, Gay, and/or Bisexual (LGB) clients. Thus, the objectives of this research are to assess the levels of affirmative competence and practices of professionals in Ibero-American countries. The sample consists of 630 mental health professionals from various countries whose ages range from 22 to 75years old, with a mean age of 41.46years. The study utilizes the following measures: a socio-demographic questionnaire, the Sexual Orientation Counselor Competency Scale, and the Affirmative Practice Questionnaire. Results show that mental health professionals who present higher levels of Affirmative Competence are those who have higher levels of education and training on LGBT topics, show left-wing political affiliations, self-identify as LGB, and have no religious affiliations. Regarding Affirmative Practices, it was found that single participants show lower practices, and more studies are needed to better understand this result. Regression models demonstrate that Affirmative Practices and Competences are predicted by the hypothesized variables, namely, religious and political beliefs, and training/education. Hence, this study indicates that mental health professionals could undergo some type of academic or professional training and/or possess experience in regard to working with LGB clients, in order to enhance their approach when working with this population.

Perceptions and practices of mental health professionals regarding the employment of people with serious mental illness

Perceptions and practices of mental health professionals regarding the employment of people with serious mental illness

Making Space for Every Body: Ending Sizeism in Psychotherapy and Training

The importance of addressing weight bias as a social justice issue in psychotherapy and psychology education and training is introduced. The history of the development of fat studies is briefly reviewed. Current coverage of size and sizeism in psychology is critically examined and contrasted with the increasing adoption of the medical model of “obesity.” Fat shaming in the practice of mental health professionals is examined as a barrier to clients’ physical and mental health. Alternatives to medicalized weight management and fat shaming are introduced. Models that emphasize size acceptance and resist negative embodiment are encouraged. The potential for a future that makes space for every body is assessed.

The construction of people with mental health problems as risk objects: Findings of a case study inquiry.

WHAT IS KNOWN ON THE SUBJECT?: Risk assessment and management in mental health services are contested and perceived as problematic by both professionals and service users. There is substantial emphasis on risk as a core component of professional practice. However, recovery for people with mental health problems emphasizes self-determination which seems to conflict with risk management. A critique is emerging of risk assessment and management. However, there is a lack of empirical evidence which seeks to explore how professionals manage the conflicts between recovery orientated practice and risk management. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE?: The paper reports on qualitative research which highlights people with mental health problems are objectified and frequently associated with the potential for harm. Risk dominates the work of mental health professionals and undermines individualized care. Service users are subject to increased surveillance and medication as a result. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Service users' subjective experiences need to be prioritized in mental health care by renewed focus on the relationship between professionals and service users. Mental health professionals should question the centrality of risk to their practice. ABSTRACT: Introduction The emergence of recovery, alongside significant focus on risk management, creates potential for conflicting influences in mental health care. Although evidence has critiqued risk assessment, there is a lack of research that seeks to explore how professionals make decisions within these apparently incompatible agendas. Aim To explore how practitioners, experience potential tensions arising from delivering recovery-orientated care and enforcing containment. Method This paper reports on a case study inquiry, using interviews with mental health professionals and observations in an acute ward and an assertive outreach team. Results Risk governed the practice of mental health professionals to such an extent it defined how service users were understood and treated. Service users were constructed as objects of risk, first by being objectified and secondly by creating a link between that object and harm. Discussion Hilgartner's (1992, Organizations, uncertainties and risk (pp. 39-53). Boulder, CO: Westview Press) theory of risk explains how risk dominates the identity of people with mental health problems at the cost of recovery. This results in increased monitoring, surveillance and medication to enact control. Implications for practice To undermine the dominance of risk, professionals should reconnect with the subjective experiences of people with mental health problems and challenge the acceptance of risk as central to their role.

Sexuality and STD/AIDS prevention in mental health care: the views and practices of mental health professionals in the city of Rio de Janeiro, Brazil

Despite major strides in the Psychiatric Reform and high HIV rates among users of mental health services, there is a lack of prevention policies for this population. The gap is further aggravated by mental health professionals' difficulty in approaching the sexuality of mental health care users. The article analyzes the perceptions and practices of mental health professionals concerning these issues in three service models in the Network of Psychosocial Care (RAPS) in the city of Rio de Janeiro, Brazil. Eight focus groups were held with mental health care teams from a public university institution in a Center for Psychosocial Care III (CAPS III) and a Street Outreach Service. A total of 61 health professionals participated (40 women and 21 men), mostly 20 to 40 years of age, both residents and professionals from various health fields. The health professionals identified greater vulnerability of users of mental health care services to situations of sexual violence, and not only to STD/AIDS. They emphasized the importance of addressing sexuality and STD/AIDS prevention; however, these issues do not appear in the team discussions and rarely surface in daily patient care due to their lack of training and knowledge, as well as to the absence of institutional guidelines. The health professionals admitted their difficulties and highlighted the importance of establishing spaces for exchange of experiences in the services. The findings point to the need to incorporate sexuality and STD/AIDS prevention in the institutional dynamics and training of mental health professionals. Despite mental health deinstitutionalization and strides in the AIDS field, in addition to the supply of comprehensive humanized care, such themes have still not been incorporated into the debates in the RAPS. The article concludes with recommendations to help improve the quality of mental health care.

Improving the Knowledge, Attitudes, and Practices of Mental Health Professionals Regarding Dual Diagnosis Treatment – a Mixed Methods Study of an Intervention

ABSTRACTThis study examined an intervention, which aimed at improving the dual diagnosis treatment at eight Danish mental health centres. The intervention included training in dual diagnosis treatment to program champions who were intended to implement at their workplace the knowledge gained from training. The study used mixed methods (questionnaires, interviews, and field observations) to examine whether there was a change in the knowledge, attitudes, and practices of the colleagues of the program champions following the intervention. Results showed that the intervention overall yielded improvement in knowledge and attitudes, while the impact on assessment and treatment practices was limited. Possible factors that might have affected the implementation of the intervention as well as the weaknesses of the intervention and the study are discussed.

Identifying and addressing sexual health in seriousmental illness: Views of mental health staff working in two National Health Service organizations in England.

People with serious mental illness (service users) have needs related to sexual health and sexuality, yet these have been poorly addressed in mental health services. In the present study, we report the current practice of mental health professionals in relation to sexual health. Focus groups conducted in two mental health trusts explored routine practice in relation to discussing, assessing, and planning care in relation to sexual health. A thematic analysis identified seven themes: (i) sexual health provision is a complex issue; (ii) mental health staff are aware of sexual health needs; (iii) current provision regarding sexual health is 'neglected'; (iv) barriers to sexual health provision; (v) enabling a discussion around sexual health; (vi) sexual health provision is a role for mental health professionals; and (vii) training needs. Mental health staff are aware of complex issues related to sexual health for service users, but this is mainly seen through the lens of risk management and safeguarding. We need to develop the mental health workforce to be able to incorporate sexual health into routine health care.