Quality Of Mental Health Care Research Articles

Norwegian adaptation of the Quality in Psychiatric Care – In-Patient instrument: psychometric properties and factor structure

BackgroundValidated instruments measuring the quality of mental healthcare from patients’ perspectives are scarce, and available instruments have been requested. One of the few instruments measuring the quality of care from a patient’s perspective is the Swedish Quality in Psychiatric Care–In–Patient (QPC-IP). This cross-sectional study aimed to translate and adapt the QPC-IP instrument for a Norwegian context and assess its psychometric properties.MethodsThe QPC-IP was translated and adapted to a Norwegian context using a translation back-translation process model. A total of 169 inpatients from specialised mental health services responded to the questionnaire. The QPC-IP comprises six dimensions: Encounter (eight items), Participation (eight items), Discharge (four items), Support (four items), Secluded Environment (three items), and Secure Environment (three items), totalling 30 items. Confirmatory factor analysis was conducted to assess the instrument’s factor structure. Additionally, Cronbach’s alpha was used to establish the instrument's internal consistency.ResultsThe results indicated that the Norwegian adaptation of the QPC-IP possesses good psychometric properties, including internal consistency, content, and construct validity, as confirmed by the confirmatory factor analysis results. The confirmatory factor analysis demonstrated an adequate fit for the six-factor structure, consistent with the original Swedish instrument.ConclusionsThe QPC-IP is a user-friendly and easily implementable tool that assesses various dimensions of the quality of inpatient mental healthcare from a patient’s perspective. Moreover, the Norwegian QPC-IP holds potential for use in comparative, cross-cultural studies within mental healthcare services to monitor the quality of the provided services.

Service and Treatment Factors as Predictors of Satisfaction with Mental Health Services Among Service Users with Psychosis.

Satisfaction with services among service users is an important aspect of quality in mental health care. This prospective study investigated associations between service and treatment factors at baseline and satisfaction with services at 18-month follow-up among service users with psychosis in specialist mental health services. Data were collected from 119 service users with psychosis and their clinicians from 26 clinical sites across Norway at baseline and after 18 months. Satisfaction with services was measured using the Client Satisfaction Questionnaire-8 (CSQ-8). Linear mixed models with random intercepts for units were estimated to test the association between service- and treatment-related predictors and the CSQ-8. Participating in the Individual Placement and Support program or other interventions to promote work or study, receiving well-coordinated services, and receiving helpful assistance from a general practitioner at baseline were positively associated with satisfaction with services at 18-month follow-up. The present results suggest that receiving integrated and well-coordinated services and targeting the goal of facilitating employment and study opportunities is important for satisfaction with services among service users with psychosis.

24. CURRENT STATUS OF MENTAL HEALTH CARE AT COMMUNE HEALTH STATIONS IN BEN TRE PROVINCE, 2024

Background: The increasing prevalence of mental disorders has highlighted the urgent need to enhance the quality of community-based mental health care. Objective: To evaluate the quality of community-based mental health services provided at commune health stations in Ben Tre province. Methods: A cross-sectional study design was employed to collect data from 157 commune health stations. Results: The community-based mental health program at commune health stations in Ben Tre has achieved relatively high outcomes, particularly in terms of treatment efficacy and functional recovery of patients. However, the quality of mental health care services still has limitations, especially in screening, case management, and rehabilitation. Factors influencing the quality of care include the qualifications of healthcare providers, supervision, and resource availability. Conclusion: To improve the quality of mental health care services, there is a need to enhance the capacity of healthcare workers, strengthen supervision, ensure adequate resources, and establish effective inter-sectoral coordination mechanisms.

Understanding the Needs and Experiences of Spiritual and Religious Clients Seeking Mental Health Counseling

Currently, mental health clinicians lack training in spiritual and religious competence, while counseling psychology research does not give adequate attention to the spiritual and religious concerns of clients seeking mental health counseling. In order to improve the quality of mental healthcare, I argue for more research and training to better understand clients’ spiritual and religious needs. I review existing approaches to mental healthcare that integrate spirituality and religion, then outline my own survey- and interview-based research. My study assesses clients’ levels of religiosity and spirituality, discovers the role of spirituality and religion in their mental health, and finds out their experiences working with mental health clinicians. My data indicates that spiritual and religious interest often intersects with defining life events, such as traumatic experiences and existential crises, and that mental health clinicians should be better prepared to understand the role of spirituality and religion to support clients’ psychological and spiritual health.

The Role of Saudi Nurses in the Care of Patients with Obsessive-Compulsive Disorder: A Systematic Review

This systematic review investigates the pivotal, yet underexplored, role of Saudi nurses in caring for patients with Obsessive-Compulsive Disorder (OCD), a prevalent mental health condition that profoundly impacts individuals' daily lives and well-being. Given the rising mental health challenges in Saudi Arabia and the cultural stigma often surrounding mental health care, it is essential to better understand and strengthen the support provided by nurses—frequently the frontline caregivers in OCD treatment. The study synthesizes existing research on the contributions of Saudi nurses to OCD care across multiple domains, including patient assessment, therapeutic interventions, and family support, which is particularly significant within the Saudi cultural context. By examining current practices and the challenges nurses face, such as limited mental health training, lack of institutional resources, and cultural barriers to open discussions of mental health, this review reveals structural limitations that impact the effectiveness of nursing care. At the same time, the analysis highlights the resilience and adaptability of Saudi nurses, who frequently operate with limited specialized resources and navigate considerable obstacles in their work. The findings underscore an urgent need for a culturally informed approach to OCD care that combines enhanced mental health training specific to OCD with strengthened institutional support to address the unique challenges faced by Saudi nurses. This review calls on healthcare policymakers to prioritize mental health within the Saudi healthcare system and advocates for developing comprehensive mental health nursing frameworks that integrate cultural sensitivity with clinical expertise. By providing a nuanced understanding of Saudi nurses' roles in OCD care, this study illuminates the specific barriers they face and suggests pathways to improve mental health care quality across Saudi Arabia. Ultimately, it establishes a foundation for future research aimed at transforming mental health nursing practices to better meet the complex needs of OCD patients in ways that are both culturally respectful and clinically effective.

“It’s a Circus”: Family Caregivers’ Perceptions on Accessing Mental Health Care for Individuals with Intellectual and Developmental Disabilities

ABSTRACT Background Previous research has demonstrated that individuals with intellectual and developmental disabilities (IDD) experience a variety of barriers in accessing mental health care and that family caregivers often play an integral role in helping individuals with IDD navigate these systems. However, little research has focused on family caregivers’ perceptions of accessing mental health services. Methods To better understand their perspectives, we analyzed responses to an open-ended question about challenges to accessing mental health resources for adults with IDD from 208 family caregivers. Responses were analyzed using a team-based approach to qualitative data analysis. Results We identified five themes that capture both systematic issues and personal or interpersonal challenges that reduce access to high quality mental health care among adults with IDD. In addition to the barriers, we also identified some accounts of families succeeding in accessing adequate mental health care. Conclusions We offer practical implications for research, policy, and practice that can help reduce barriers to mental health care for adults with IDD.

Racism and Redlining in the History of Psychiatric Policy and Practice in Atlanta: Implications for Nursing.

Recently, the Georgia state House of Representatives passed House Bill 1013, also called The Mental Health Parity Act. The bill sought to address access to and insurance coverage for mental health services, first identified in a report in 2020. The budget for mental health services was reduced by $8 m in 2020, despite an all-time high demand due to the beginning of the Covid-19 pandemic. There is an increasing inability to secure mental health care in the state. Georgia is ranked 37th in the country for access to quality mental health care (Reinert, Fritze, and Nguyen, 2022) and half the counties in the state have no psychiatrist; the projected mental health workforce will be able to meet only 12% of consumer demand by 2025. Problems with mental health care in Georgia have a long history which intersects with the history of racism, geographical segregation, and policing. HB1013 does not consider any of this history in its recommendations, which barely include nursing. At the same time, policy and practice in Georgia continues to entangle nurses and other professionals with a carceral and punitive system which not only threatens the safety of patients, but also nurses themselves. Nurses need to understand this history if they hope to develop policy that will intervene in the mental health care crisis.

Telehealth Outreach Program for Child Traumatic Stress: Strategies for Long-Term Sustainability.

There are high documented rates of exposure to traumatic events and mental health disorders among youths yet existing disparities in access to care for racial and ethnic minority youths and youths in rural communities. Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) is an evidence-based behavioral health therapy for children. The delivery of TF-CBT via telehealth can decrease access to care barriers. An interdisciplinary clinical team developed a training program to guide clinicians to effectively provide TF-CBT via telehealth. The goal of this study was to describe variation in implementation processes of the telehealth TF-CBT program and identify barriers and facilitators to program implementation post-training, which were utilized to develop implementation strategies for intervention sustainability. Using a mixed-methods approach, data were collected on telehealth implementation processes and facilitators and barriers to the delivery of telehealth TF-CBT. This study was guided by an adapted implementation science framework, namely the Exploration, Preparation, Implementation, Sustainment model. Interviews and surveys were completed with clinical site leaders who had participated in the telehealth TF-CBT training. Throughout clinical sites, there was varied adoption and penetration of the telehealth TF-CBT program. Facilitators to implementation included leadership and site staff buy in, community needs, and training resources, while barriers included funding, available logistical resources, and child and family involvement. The feedback gained from this project assisted in the development of implementation strategies for increased adoption and sustainment of TF-CBT delivered via telehealth. Strategies include ongoing interactive assistance and resource support, enhanced training for stakeholders, and program adaptations, with the goal to increase access to quality mental health care for underserved populations.

The Transition to Adulthood: A Qualitative Study of Autism Spectrum Disorder From Military and Veteran Parents and Military-Dependent Young Adults.

Given the unique experiences of military service members and their families, military-dependent young adults (18-25 years old) with autism spectrum disorder (ASD) and their military or veteran families experience unique barriers to accessing quality mental health care during the transition to adulthood. In fact, developing services to address ASD challenges for military families is a burgeoning area of interest for the department of defense. However, there is a limited knowledge on the specific needs of military families as the young adult's transition outside of high school and lose supports. The present study conducted 3 focus groups with 16 military and veteran parents, and 3 focus groups with 10 military-dependent young adults to evaluate the needs of military-dependent young adults (17-25 years old) with ASD and military/veteran parents with a young adult with ASD. Parents reported several key topics, including barriers to services (e.g., permanent change of station, recently moving to a state and lacking awareness of the available resources), defining adulthood in terms working in a cohesive family structure, and therapy recommendations for parents and young adults with ASD transitioning to adulthood. Young adults provided key information, including describing experiences with having a parent in the military, difficulty accessing services during the transition to adulthood, and recommendations on therapy for military-dependent young adults with ASD. Military and veteran families with autistic dependents lack access to important mental-health resources. When developing programs for military families and military-dependent autistic young adults, mental health providers should consider the frequent relocations, lack of access to important transition resources, and common military values. The presence of advocates at military bases should be encouraged to help military families navigate autism services in their local community.

Ten Years of Bipolar Telehealth: Program Evaluation of a Team-Based Telemental Health Clinic.

Objectives: Telemental health via videoconferencing (TMH-V) can overcome many of the barriers to accessing quality mental health care. Toward this end, in 2011, the U.S. Department of Veterans Affairs (VA) established the National Bipolar Disorders TeleHealth (BDTH) Program to provide expert mental health consultation and treatment to Veterans with bipolar spectrum disorders. Methods: Initial analyses of BDTH services suggested that participants had positive changes in quality-of-care indices and clinical outcomes; however, that evaluation was based on a limited sample of both participants and VA medical centers. We were able to confirm and expand upon those early results by using nearly eight times the number of participants and more than twice as many medical centers. Results: For the 2,456 Veterans who completed the intake to our program, there were significant improvements in some of the quality metrics (e.g., lithium use) and a 54% reduction in positive suicide screens (p < 0.05). The Veterans who completed the initial and postprogram assessments (n = 815) reported a 16.6% reduction in manic symptoms (p < 0.001), a 29.3% reduction in depressive symptoms (p < 0.001), and a 21.2% reduction in mood episodes (p < 0.001). Additionally, these Veterans demonstrated significant improvements (p < 0.001) in mental health-related quality of life between the two assessments. Conclusions: These analyses provide further support for the general effectiveness and safety of telemental health via videoconferencing. Future research should examine the generalizability of these findings across various subgroups (e.g., minority patients, patients in rural areas), populations, and health care systems.

"He Just Wants Someone to Hear Him and Listen to Him": Barriers and Facilitators to Autistic Youth with Anxiety Receiving Quality Mental Healthcare.

About half of autistic youth present with clinically interfering anxiety. Psychotherapies with exposure-focused elements are effective in academic clinical settings and controlled trials. However, there is relatively less research examining the implementation of modified interventions for autistic youth with anxiety in community mental health settings. The current study explores community members' perceptions of barriers and facilitators that impact autistic youth with anxiety's receipt of quality mental health services in their community. Semi-structured interviews were conducted with 15 autistic youth, 15 caregivers of autistic youth, 11 community mental health clinicians, and 8 community mental health clinic leaders. Interviews were analyzed thematically. Participants shared their experiences with facilitators and barriers to autistic youth with anxiety receiving quality mental healthcare. Themes that emerged include (1) characteristics of the autistic youth, (2) engagement of autistic youth and caregivers, (3) building rapport between providers, autistic youth, and caregivers, (4) access to mental health services, (5) intervention fit, and (6) provider characteristics. Based on participants' perspectives and suggestions, future directions for anxiety treatment programs tailored for autistic youth include building more time into the intervention sessions to build rapport, incorporating autistic youth's preferences into provider matches, and providing families with more psychoeducation.

Prisoners' perceptions and satisfaction with telepsychiatry services in Greece.

Telepsychiatry is an effective tool to support and provide mental health services to prison inmates. In Greece, telepsychiatry was formally applied in two correctional facilities in 2018. The objective of this study was to compare inmates' perceptions and satisfaction with telepsychiatry versus face-to-face consultation. The sample consisted of 100 male inmates with a multicultural background and prior experience with both methods of services provision. The data were obtained through a Demographic Data Questionnaire, a Participant Satisfaction Questionnaire to assess satisfaction with face-to-face psychiatric services, and another Participant Satisfaction Questionnaire to assess satisfaction with telepsychiatric services. The results have shown a higher level of satisfaction with telepsychiatry compared to face-to-face care. Statistically significant improvements (all p-values <0.001) were noted in: waiting times, support for relapse prevention, follow up, quality of mental health care, quality of care in the management of psychiatric problems and related medication, behaviour of psychiatrists, duration of the assessment, sense of comfort, and confidentiality. Telepsychiatry has proved to be an acceptable way of approaching and supporting inmates in Greece, with most of the participants expressing high acceptance, satisfaction, and preference rates. Implications for additional research and further development of telepsychiatry are discussed.

ChatGPT as a psychotherapist for anxiety disorders: An empirical study with anxiety patients.

Purpose: this study aims to investigate the role of ChatGPT as a psychotherapist for anxiety disorders, examining its effectiveness, acceptability, and potential benefits among individuals with anxiety disorders. Methods: a quasi-experimental design was adopted, involving a 4-week intervention where participants used ChatGPT as a therapeutic tool. The study included outpatients aged above 18 years from public hospitals in Saudi Arabia. A total of 399 participants completed a survey questionnaire that focused on their experiences with AI-based psychotherapy (six items), perceptions of ChatGPT (four items), and its role in different therapy modalities for anxiety management (seven items). Measures were taken to ensure the validity and reliability of responses by using Cronbach's alpha reliability testing (> 0.7), including the use of a translated and verified questionnaire. Results: majority received prior therapy (89.6%), reporting severe anxiety symptoms (36.1%). ChatGPT was widely used and perceived as accurate by 91.2% of users. Concerns included privacy (67.2%) and ethics (64.9%). Statistically significant differences (p < .05) in perceptions of ChatGPT for anxiety disorders were observed. While urban residents generally rated ChatGPT more positively, females consistently reported higher levels of trustworthiness, effectiveness, and coherence in guidance compared to males. Conclusion: ChatGPT has the potential to complement traditional psychotherapeutic approaches and enhance access to quality mental health care.

Systematic Barriers to Quality Mental Health Care and Services in Selected Mental Hospitals in West Bengal

Systematic Barriers to Quality Mental Health Care and Services in Selected Mental Hospitals in West Bengal

Youth Mental Health in the Wake of the COVID-19 Pandemic.

In this article we examine the current state of youth mental health across the United States and in Delaware, and discuss the impact of the COVID-19 pandemic on the mental health and well-being of children and adolescents. We review available literature detailing the short- and long-term effects of the COVID-19 pandemic on youth mental health and discuss the resultant programmatic and legislative efforts in Delaware and nationally. The COVID-19 pandemic had a severe impact on the mental health of young people. The prevalence of depression and anxiety among children and adolescents, which was already increasing pre-pandemic, spiked after the pandemic's onset. Even as public health precautions have lifted, young people continue to struggle with mental health in conjunction with lower levels of educational achievement, hindered social development, increased screen time, diminished access to effective mental healthcare, and economic instability. The negative impact of the pandemic will continue to have ramifications on the health and wellbeing of young people for years to come. Compiling evidence examining mental health trends is an important first step to understanding the impact of the pandemic on child and adolescent mental health and developing effective solutions. Although the official state of emergency is over, the effects of the COVID-19 pandemic are far-reaching and long-lasting. It is imperative that legislators and program administrators in Delaware and nationally work to ensure that young people and their families have access to affordable, high quality mental healthcare.

Barriers to care for mental health conditions in Canada

There are growing concerns in Canada about access barriers to quality mental health care, which has worsened significantly by the COVID-19 pandemic and for some Canadians more than others. With a nationally representative sample of 1501 adults, surveyed by the Angus Reid Institute, this study examined the mental health conditions Canadians experience the most difficulties in accessing care. Among half of the respondents who sought mental health care, the majority encountered challenges in accessing help for posttraumatic stress disorder (PTSD) (34%) and depression (33%). When examining the data based only on those seeking care for specific conditions, attention deficit hyperactivity disorder (ADHD), obsessive-compulsive disorder (OCD), substance use disorders, and generalized anxiety disorder (GAD) emerged as those for which it was most difficult to find treatment. Indigenous and Black Canadians had significantly more difficulty finding care across several conditions. We discuss the implications of these findings, including the critical need to increase the supply and diversity of mental health providers across Canada. This study is one of the first to provide quantitative data on the perceived barriers in accessing mental health care, while exploring the role of race and ethnicity and other social identities.

Child mental health: Early detection and interventions in anxiety disorders and depression

Introduction: Child mental health is a critical public health issue, with disorders such as anxiety and depression affecting up to 20% of children worldwide. Early detection and effective interventions are essential to mitigate the effects of these disorders and improve the quality of life of affected children. This study conducted a systematic review to identify the most effective strategies for early detection and interventions in childhood anxiety disorders and depression. Methods: The systematic review was conducted in the PubMed, Scopus, PsycINFO, and Web of Science databases, using descriptors such as “Child Mental Health,” “Early Detection,” “Anxiety Disorders in Children,” and “Childhood Depression.” Empirical studies published between 2010 and 2024 were included. Study selection was performed by two independent reviewers, and methodological quality was assessed using the AMSTAR tool and the Newcastle-Ottawa Scale. Results: Thirteen studies were included that indicate the effectiveness of instruments such as the "Spence Children's Anxiety Scale" (SCAS) and the "Child Depression Inventory" (CDI) in the early detection of anxiety and depression in children. Interventions based on Cognitive-Behavioral Therapy (CBT) and multidisciplinary approaches were effective in reducing symptoms and improving the quality of life of children. However, the implementation of these strategies faces significant challenges, such as lack of resources and the need for cultural adaptations. Conclusion: Early detection and timely interventions are essential for the effective management of anxiety disorders and depression in children. The importance of public policies for training professionals and intersectoral collaboration to ensure quality mental health care is reinforced. Future research should focus on culturally adapted interventions and evaluate their long-term effectiveness.

Important aspects of experiences from patients and parents related to medications in Child and Adolescents Mental Health Services (CAMHS) - a qualitative study

PurposePatient-reported experiences are a key source of information on quality in mental health care. Most patient experience surveys are limited to assessments from adults, including those conducted by parents or proxies on behalf of others. The aim of this study was to produce findings to inform development of modules on patient and parent experiences with medication in outpatient CAMHS in Norway, for use in previously validated instruments applied in national surveys.Patients and methodsWe developed survey questions based on a systematic literature review, expert-group consultations, interviews with adolescents and parents, and pretesting of the modules in a pilot study. This study included adolescents aged 12–17 years and parents with experiences from outpatient CAMHS and we present findings from semi-structured interviews.ResultsAdolescents with ADHD emphasized the following aspects as important concerning medication use in CAMHS: positive effects of medication like better function and concentration in school and change of behaviour. They also stressed the importance of side effects such as eating problems, nausea, loss of appetite, insomnia, and changes in thoughts and feelings. In addition, adolescents highlighted the significance of aspects as support in daily routines for taking medications, while parents highlighted needs for a professional follow-up care. Parents emphasized aspects regarding their children’s medication included both positive effects and change in behaviour, as well as their identification of negative side effects.ConclusionOur findings from semi-structured interviews identified important aspects reported by both patients and parents on functions, side effects and follow-up care related to medication. The results indicated that both groups emphasized corresponding aspects of what was important regarding medication. However, when it came to follow-up care, the two groups highlighted distinct aspects, indicating differing priorities or concerns in this area.

Effect of older adult health and age on psychology doctoral trainees’ expectations of clinical work with older adult clients

ABSTRACT This experimental, repeated-measures study investigated the effects of client health and client age on doctoral psychology students’ clinical expectations for their work with older adult clients. Doctoral clinical and counseling psychology trainees (N = 223) completed measures assessing clinical expectations for three older adult clients of varying health status (healthy, recent Alzheimer’s Disease (AD) diagnosis, heart disease) who all presented with depressive symptoms. Trainees were randomly assigned to the 71-year-old or 81-year-old condition. Trainees perceived a depressed client with a recent AD diagnosis as a less appropriate candidate for therapy, less motivated and less responsible for therapy, and less able to develop a therapeutic relationship. Additional health-based differences in prognosis, comfort, and competence were moderated by client age. Although age did have a small effect, the health of the older adult client had a stronger influence on trainees’ clinical expectations for work with older adults. Cognitive health concerns were perceived as a greater barrier to clinical work with older adults than were physical health concerns. Health biases for clinical work with older adults could impact the quality of mental healthcare provided.

African Accounts of Religious Conversations and Interventions in Mental Healthcare

The importance of healthcare has attracted conversations from healthcare professionals, as well as other groups like the United Nations, academic institutions, governments, the private sector, and religious organisations, all contributing to healthcare conversations because healthcare is foundational to human survival. However, there are questions on the quality and gaps of conversations and interventions regarding mental health among religious groups. This is because the quality of healthcare delivery may be rooted in the quality of conversations and interventions. This study explores the quality of mental healthcare (MHC) conversations and interventions in Traditional Religions, Christianity, and Islam in Africa. It interrogates past and recent conversations and interventions within the frameworks of spiritual care (SC) as a form of compassion science, interreligious collaborations, spiritual healings, and allopathic collaborations. Lastly, it places a searchlight on the loopholes of spiritual care in MHC and recommends closure where possible in the pursuit of improved healthcare and well-being in Africa.