Quality Of Mental Health Care Research Articles

Partnership to tackle MH crisis for people with disabilities launched

The United Health Foundation, the philanthropic foundation of the UnitedHealth Group has awarded the nonprofit disability rights advocacy organization, The Arc of the United States, a three‐year, $2.5 million grant to improve mental health care for people with intellectual and developmental disabilities (IDD), a news release by The Arc stated. Up to 40% of people with IDD have co‐occurring mental health conditions, and this critical funding will help address their unmet mental health needs. Currently, only 1 in 10 children and adolescents with IDD and mental health disorders receive specialized services. These statistics highlight the need for training and awareness to ensure providers and caregivers are equipped to support the mental health needs of people with disabilities. This includes expanding access to quality mental health care services, improving coordination between disability and health systems, training over 2,000 providers and caregivers to recognize mental health needs in people with IDD, and launching public awareness campaigns to counteract stigma and misconceptions. A key component of the grant is partnering with the National Council for Mental Wellbeing to adapt its evidence‐based Mental Health First Aid program with information on IDD. Over three years, the United Health Foundation grant will help train caregivers, health care professionals, first responders, educators and family members to recognize the mental health needs of people with IDD and decrease the number of mental health crisis incidents experienced by this population.

Nurturing an organizational context that supports team-based primary mental health care: A grounded theory study.

The expansion of the Patient-Centred Medical Home model presents a valuable opportunity to enhance the integration of team-based mental health services in primary care settings, thereby meeting the growing demand for such services. Understanding the organizational context of a Patient-Centred Medical Home is crucial for identifying the facilitators and barriers to integrating mental health care within primary care. The main objective of this paper is to present the findings related to the following research question: "What organizational features shape Family Health Teams' capacity to provide mental health services for depression and anxiety across Ontario, Canada?" Adopting a constructivist grounded theory approach, we conducted interviews with various mental health care providers, and administrators within Ontario's Family Health Teams, in addition to engaging provincial policy informants and community stakeholders. Data analysis involved a team-based approach, including code comparison and labelling, with a dedicated data analysis subcommittee convening monthly to explore coded concepts influencing contextual factors. From the 96 interviews conducted, involving 82 participants, key insights emerged on the organizational contextual features considered vital in facilitating team-based mental health care in primary care settings. Five prominent themes were identified: i) mental health explicit in the organizational vision, ii) leadership driving mental health care, iii) developing a mature and stable team, iv) adequate physical space that facilitates team interaction, and v) electronic medical records to facilitate team communication. This study underscores the often-neglected organizational elements that influence primary care teams' capacity to deliver quality mental health care services. It highlights the significance of strong leadership complemented by effective communication and collaboration within teams to enhance their ability to provide mental health care. Strengthening relationships within primary care teams lies at the core of effective healthcare delivery and should be leveraged to improve the integration of mental health care.

Upholding rights through fostering equity and quality in mental health care

Upholding rights through fostering equity and quality in mental health care

Challenges and sustainability of Indian mental health: evaluating volunteer-based community mental health clinics with a complex adaptive system framework

PurposeThis study aims to evaluate how a community psychiatry model, referred to as the Mental Health Action Trust (MHAT) in India, provides decentralized care and comprehensive services to people with severe mental illness living in poverty. Using the complex adaptive system (CAS) framework, the authors aim to understand the factors that contribute to the diverse outcomes of the MHAT community mental health programme as observed in four different locations.Design/methodology/approachFour MHAT clinics were purposively chosen from two districts in Kerala. A comparative case study methodology was used to document each clinic’s MHAT services and activities, as found during field visits and interviews with staff members and volunteers.FindingsThe study shows that all four clinics met the basic aim of providing free, quality mental health care to the poorest populations, although not all aspects of the comprehensive model could be equally provided. Alignment with the MHAT vision, appropriate leadership, the relationship with partners and their level of community engagement determined the varied success between clinics.Originality/valueThe current study evaluation stresses that community ownership is crucial. Careful attention must be paid to the characteristics of selected partners, including their leadership styles and ability to garner resources.

Examining Youth Flexible ACT Model Implementation in the Netherlands.

Model adherence is a key indicator of mental health care quality. This study investigates the degree of model adherence, as well as content and staging of care, among the first Youth Flexible Assertive Community Treatment (ACT) teams in the Netherlands. Model fidelity was assessed in sixteen teams with the Youth Flexile ACT model fidelity scale (2014 version). Mental health workers completed a 'content of care questionnaire' to map the interventions applied in the teams. Model fidelity scores revealed that twelve teams adhered to the Youth Flexible ACT standard with 'optimal implementation' (≥ 4.1 on a 5 point scale) and four teams with 'adequate implementation'. Most disciplines were well integrated within the teams; however, several items regarding the involvement of specific disciplines and the availability of treatment interventions (peer support worker, employment and education specialist and programs, family interventions, integrated dual disorder treatment) scored below the optimum. Frequency of contact during ACT and the use of Routine Outcome Monitoring instruments scored below the optimum as well. The 'content of care' data showed that most clients received an individual psychological intervention, and nearly half of the client sample received scaled-up / intensified ACT care. The findings indicate a predominantly successful translation of care from the theoretical Flexible ACT framework into practice, covering both ACT and non-ACT functions. Further room for improvement lies in the incorporation of specialized disciplines in the personal and social recovery domains, including the peer support worker and employment and education specialist, as well as in specific protocolled interventions.

WHO Guidelines about Mental Health Gap Action Programme (mhGAP) for mental, neurological and substance use disorders: Review and Comments

Introduction: The World Health Organization (WHO) has been instrumental in developing evidence-based guidelines to address mental, neurological, and substance use disorders through its Mental Health Gap Action Programme (mhGAP). These guidelines provide essential recommendations for healthcare professionals to deliver effective care in non-specialized health settings. Aim: This article aims to review and analyze the updated WHO guidelines on the mhGAP intervention for mental, neurological, and substance use disorders, focusing on their significance, content, and implications for clinical practice. Methods: A comprehensive review of the WHO documents published in 2023, including the "mhGAP intervention guide for mental, neurological, and substance use disorders in non-specialized health settings" and the "Update of the Mental Health Gap Action Programme (mhGAP) guidelines for mental, neurological, and substance use disorders, 2015," was conducted. The review examines the scope of the guidelines, their recommendations, and the evidence supporting them. Results: The updated WHO guidelines cover a wide range of mental health conditions, including alcohol use disorders, anxiety disorders, depression, and more. Each guideline provides evidence-based recommendations for prevention, diagnosis, and treatment, with the aim of improving access to quality mental health care in diverse healthcare settings. The guidelines are freely accessible online through the WHO's mhGAP Evidence Resource Centre website, offering detailed evidence profiles and recommendations for healthcare professionals. Conclusions: The WHO guidelines on the mhGAP represent a critical resource for healthcare professionals worldwide, offering evidence-based guidance for the delivery of mental health care. By providing standardized recommendations informed by the best available evidence, these guidelines support the implementation of evidence-based practice and contribute to improved patient outcomes. The WHO's commitment to updating and disseminating these guidelines underscores its dedication to promoting mental health equity and advancing evidence-based care globally.

The State of Mental Health Services for Incarcerated Adults in Ontario: A Scoping Review.

Individuals with mental illness are significantly overrepresented in the Canadian justice system. Given the high rate of mental illness among individuals who are incarcerated, correctional facilities must implement accessible and effective mental health resources. This not only improves their health and well-being but also contributes to their rehabilitation efforts. However, evidence suggests that the care provided in prisons is inadequate. This scoping review asks, "What is known about the access and quality of mental health care services for adults who are incarcerated in Ontario?" Mental health care services included non-acute interventions and care that is provided in the institution. This scoping review followed the PRISMA Extension for Scoping Reviews methodology. Databases searched include MedLINE, EMBASE, CINAHL, PsycINFO, Criminal Justice Abstracts, JSTOR, Google Scholar, and the grey literature. The search yielded 354 titles and abstracts of which 16 met the inclusion criteria. Conducted from 2010-2022, the 16 studies included qualitative, quantitative, and mixed methods. Common themes that were identified related to segregation, mental health assessments, medication prescribing and access, opioid agonist therapy, psychiatric service access, systemic and institutional barriers, mental health perception, and the need for collaboration. Despite the significant demand for mental health care in Ontario correctional facilities, limitations to quality care are evident. Such limitations intersect and are then exacerbated, resulting in poor mental health care provision among the incarcerated population. More research is warranted regarding the access, quality, and efficiency of mental health care in Ontario prisons, and how factors including ethnicity, gender, and prison classification (provincial vs. federal) may influence mental health care and its outcomes.

The Influence of Social and Economic Motivational Factors in the Performance of Health Professionals Involved in Mental Health Care in Douala, Littoral Region of Cameroon

Aim: Social and economic motivational factors can influence the performance of health workers. This and has special importance in mental health. In low and middle-income countries, health professionals are essential for the delivery of mental health interventions. However, inadequate mental health professional’s performance is a very widespread problem. Motivation is a prerequisite for better organizational performance. Motivation involves the biological, economic, social and cognitive forces that activate behavior. In everyday usage, the term “motivation” is frequently used to describe why a person does something. It is the driving force behind human actions. Thus this study seeks to investigate the extent to which motivational factors influence the performance of health professionals involved in mental health care in Douala, Littoral Region of Cameroon.
 Study Design: A descriptive cross-sectional and analytical study design was adopted to investigate the extent to which motivational factors influence the performance of 210 mental health workers.
 Place and Duration of Study: It involved five mental health institutions in Douala, from May 2022 to August 2022.
 Methodology: A snowball sampling technique purely based on referrals and a purposive sampling technique to select the participants was used. Pilot test was done on 6 mental health workers in Minds Clinic Buea using a Crobach’s Alpha formula to calculate and the value 0.985 was gotten to prove the validity and reliability of the research tools. Data was collected quantitatively and qualitatively with the use of self-administered, well-structured questionnaire and face to face interview was applied to collect data, and analyzed with SPSS version 23.0.
 Results: Results revealed that social (rs=0.406), economic (rs=0.248), cognitive (rs=0.471) and biological (rs=0.263) motivational factors influenced the performance of health professionals involved in mental health care and consequently improve the quality of mental health care. Spearman’s rank correlation revealed that motivational factors improved work performance. Also, motivational factors have a significant relationship with performance at a two tail test. Moreover, there was general consensus among the management staff that the general motivation packages and strategies are yielding desired results and this has positively affected the moral and performance of staff.
 Conclusion: Overall the findings of the study suggest that to improve the performance of health professionals involved in mental health care in Douala Littoral Region of Cameroon there is the need to carefully define motivational factors that are reliable and strategically relevant ensuring that they are free from criterion contamination and deficiency.

Exploring primary mental healthcare nurses’ perceptions of the post-treatment needs of women admitted for psychiatric treatment

Primary mental healthcare nurses are an essential workforce that provide necessary inpatient psychiatric treatment. Continuity of care has become a significant aspect of the provision of mental health services. However, caring for South African healthcare users comes with challenges, including difficulties accompanying the provision of care for acutely ill patients with complex mental health problems. Therefore, this study explored the perceptions and experiences of primary mental healthcare nurses concerning the continuity of care required in post-inpatient psychiatric treatment for mental health users from low-income communities in the Western Cape. Through undertaking a study using a qualitative exploratory design and purposive sampling technique, and in which nine primary mental healthcare nurses from two psychiatric hospitals in the Western Cape were interviewed, the researchers were able to obtain a deeper understanding of the participants’ experiences. Four themes were identified during the reflexive thematic analysis namely: the roles and responsibilities of primary mental healthcare nurses, the lack of support within the current continuity-of-care system, barriers to continuity of care for women patients, and suggested improvements for quality of mental healthcare. It was evident that both women patients and primary mental healthcare nurses experienced various forms of marginalisation, discrimination, and gendered oppression. This intersectionality accentuates systemic issues within the current public healthcare system and highlights the stigmatisation of mental illness, especially among women. Overall, primary mental healthcare nurses have a plethora of roles and responsibilities within the primary healthcare sector, which hinder their ability to provide mental health services to women patients. Their reports highlight the needs of a specific patient population that first need to translate into changes that will assist in improving their roles as primary mental healthcare nurses. Their shared experiences of a lack of support from South Africa’s healthcare system were the focal points of this study.

Mental Health Training for Health Care Workers at Eradah and Mental Health Complex in Jeddah City

Aims: This study aims to implement the impact of a mental health training program designed for health workers at Eradah Complex in Jeddah City, Saudi Arabia.
 Study Design:  A quasi-study in addition to qualitative designs.
 Place and Duration of Study: A mixed method was made at Eradah Complex for the program took 4 months.
 Methodology: A mixed-methods research design was employed with A quasi-experimental design employing a single group pre-test/post-test approach utilized to assess the impact of training on knowledge and attitude and using semi-structured interviews. Additionally, qualitative feedback from both the health workers and patients was gathered to gauge the program's impact on the quality of mental health care provided at the Eradah Complex.
 Results: A total of 100 participants with different healthcare specialities were selected on quasi-experimental design with nearly equality of males and females’ gender and majority of ages more than 25 years old or less and house officers (physicians). Assessing the knowledge revealed that the group showed a significant difference before assessing the program and after it (p=0.00) with a mean difference of more than 5±1.07 for each type of mental health, also, assessing the attitude revealed that the group showed a significant difference between before assessing the program and after it (p=0.00) except for epilepsy (p= 0.17) with mean difference more than 6±1.06 for each type of mental health.
 Conclusion: The findings of this case study highlight the positive outcomes of the mental health training program. Health workers demonstrated significant improvements in their understanding of mental health disorders, communication skills, and ability to support patients experiencing mental health crises. Moreover, the program contributed to a noticeable reduction in the stigma surrounding mental illness among both staff members and patients, fostering a more supportive and compassionate healthcare environment. This case study provides valuable insights into the importance of mental health training for healthcare professionals and offers practical recommendations for other healthcare facilities aiming to enhance the mental health competencies of their staff. The study concludes with a discussion of the implications of the findings and suggestions for future research and improvements in mental health training programs for healthcare workers in similar contexts.

PSYCHOTHERAPEUTIC TOOLS IN DEALING WITH NEGATIVE PSYCHOEMOTIONAL STATES BY EXAMPLE OF ONLINE GAMES "TETRIS" AND "FARM"

Introduction: The war has exacerbated the negative psycho-emotional states of people living in Ukraine and abroad. Right now, there is an urgent need for quality mental health care. The search for new effective and at the same time simple methods of providing relevant psychological and psychotherapeutic assistance determines the relevance of this research.
 The aim: To investigate and prove the effectiveness of the dosed daily use of an online game as a psychotherapeutic tool in dealing with the negative psychoemotional states of people living abroad during the war in Ukraine.
 Materials and Methods: 500 people took part in the experimental research - Ukrainian immigrants in China, the USA, Portugal and Germany – 267 women and 233 men aged 18-35, who were randomly divided into control and experimental groups of 250 each. The research continued for 13 months. Methods: psychological counselling, psychoeducation, dosed daily using online games «Tetris» and «Farm» in the control and experimental groups, respectively. Diagnostic methods: Questionnaire for the detection of psychosomatic disorders, Depression Self-Assessment Scale and Anxiety Self-Assessment Scale.
 Results: In the primary diagnosis, the following results were obtained: high rates of psychosomatic disorders in 70,8% of the control and 66,7% of the experimental groups; depression in 63,3% of the control and 66,7% of the experimental groups; high rates of anxiety in 66,7% of the control and 70% of the experimental groups. After using the online games «Tetris» and «Farm» in the control and experimental groups, respectively, the following results were obtained: high rates of psychosomatic disorders decreased to 37,5% of people in the control group and 33,3% in the experimental group; 33,3% of people in the control group and 30% in the experimental group have depression; high rates of anxiety were found in 33,3% of people in the control group and 26,7% in the experimental group, which is half as much as the previous indicators.
 Conclusions: the results of the experimental research suggest that the dosed daily use of the online game «Farm» is an effective psychotherapeutic tool in dealing with negative psycho-emotional states, proven by the authors.

Revolutionizing Mental Health Care: Analysis of an Online Mental Health Platform (EmpowerMindSpace)

In an era characterized by increased awareness of mental health issues, the development of innovative solutions to address these challenges has become paramount. This research paper presents an in-depth analysis of mental health platform designed to offer accessible mental health support to individuals facing a spectrum of psychological concerns. The primary objective of this study was to investigate the functionality and impact of the platform, encompassing its user experience, therapeutic offerings, and outcomes. Utilizing a mixed-methods approach, we examined user interactions, therapist-patient dynamics, and the utilization of various support features. The platform seamlessly integrates chatbot support for lower-severity cases and offers an extensive network of qualified therapists for higher-severity situations. Additionally, users benefit from support groups, journaling tools, and positive reinforcement prompts aimed at fostering a positive mindset. This research paper discusses the implications of our findings, highlighting the potential for digital mental health platforms to democratize access to quality mental health care. Furthermore, the paper underscores the importance of ethical considerations, data privacy, and therapist qualifications in ensuring the platform's credibility

Role of Institutional Support for Evidence-Based Psychotherapy in Satisfaction and Burnout Among Veterans Affairs Therapists.

Burnout is widespread among psychotherapists and leads to negative mental and other health outcomes, absenteeism, and turnover. Job resources, including institutional support for evidence-based practices, can buffer against burnout and may improve satisfaction among therapists. The Veterans Health Administration (VHA) is the nation's largest integrated health system and employs 23,000 therapists, including psychologists, social workers, and counselors. The authors assessed associations between perceived institutional support for evidence-based treatment and satisfaction and burnout among VHA therapists. This analysis used data from the VHA's national 2018 Mental Health Provider Survey. Responding therapists (N=5,341) answered questions about the quality of mental health care and job satisfaction. Multilevel logistic regression models were used to predict burnout and satisfaction. The authors tested availability of evidence-based treatment and measurement-based care (MBC) as predictors; analyses were adjusted for therapist workload, demographic characteristics, and potential clustering by facility. VHA therapists had less burnout and more job satisfaction when they perceived receiving institutional support for evidence-based psychotherapy (EBP) and MBC, irrespective of whether the analyses were adjusted for workload. Less difficulty in scheduling EBP was significantly associated with decreased likelihood of burnout (OR=0.83, p<0.001) and increased satisfaction (OR=1.09, p=0.008). Less difficulty ending psychotherapy was significantly associated with decreased likelihood of burnout (OR=0.89, p=0.002) and increased satisfaction (OR=1.12, p=0.004). Support for evidence-based practices, including EBP and MBC, was closely linked to VHA therapists' satisfaction and burnout. Expanding support for therapists to provide evidence-based treatment may benefit therapists, patients, and the health care system.

Assessing the quality of the care offer for people with personality disorders in Italy: the QUADIM project. A multicentre research based on the database of use of Mental Health services

BackgroundItaly can be viewed as a laboratory to assess the quality of mental healthcare delivered in a community-oriented system, especially for severe mental disorders, such as personality disorders. Although initiatives based on clinical indicators for assessing the quality of mental healthcare have been developed by transnational-organisations, there is still no widespread practice of measuring the quality of care pathways delivered to patients with severe mental disorders in a community-oriented system, especially using administrative healthcare databases. The aim of the study is to evaluate the quality of care delivered to patients with personality disorders taken-in-care by mental health services of four Italian regions (Lombardy, Emilia-Romagna, Lazio, Sicily).MethodsA set of thirty-three clinical indicators, concerning accessibility, appropriateness, continuity, and safety of care, was implemented using regional healthcare utilization databases, containing data on mental health treatments and diagnosis, hospital admissions, outpatient interventions and exams and drug prescriptions.RESULTS31,688 prevalent patients with personality disorders treated in 2015 were identified, of whom 2,331 newly taken-in-care. One-in-10 patients received a standardized assessment, the treatment discontinuity affected half of the cases. 12.7% of prevalent patients received at least one hospitalization, 10.6% in the newly taken-in-care cohort. 6-out-of-10 patients had contact with community-services within 14 days from hospital discharge. Access to psychotherapy and psychoeducational treatments was low and delivered with a low intensity. The median of psychosocial interventions per person-year was 19.1 and 9.4, respectively, in prevalent and newly taken-in-care cases. Nearly 50% of patients received pharmacological treatments.ConclusionsHealthcare utilization databases were used to systematically evaluate and assess service delivery across regional mental health systems; suggesting that in Italy the public mental health services provide to individuals with personality disorders suboptimal treatment paths.

Crisis and acute mental health care for people who have been given a diagnosis of a ‘personality disorder’: a systematic review

BackgroundPeople who have been given a diagnosis of a ‘personality disorder’ need access to good quality mental healthcare when in crisis, but the evidence underpinning crisis services for this group is limited. We synthesised quantitative studies reporting outcomes for people with a ‘personality disorder’ diagnosis using crisis and acute mental health services.MethodsWe searched OVID Medline, PsycInfo, PsycExtra, Web of Science, HMIC, CINAHL Plus, Clinical Trials and Cochrane CENTRAL for randomised controlled trials (RCTs) and observational studies that reported at least one clinical or social outcome following use of crisis and acute care for people given a ‘personality disorder’ diagnosis. We performed a narrative synthesis of evidence for each model of care found.ResultsWe screened 16,953 records resulting in 35 studies included in the review. Studies were published between 1987–2022 and conducted in 13 countries. Six studies were RCTs, the remainder were non randomised controlled studies or cohort studies reporting change over time. Studies were found reporting outcomes for crisis teams, acute hospital admission, acute day units, brief admission, crisis-focused psychotherapies in a number of settings, Mother and Baby units, an early intervention service and joint crisis planning. The evidence for all models of care except brief admission and outpatient-based psychotherapies was assessed as low or very low certainty.ConclusionThe literature found was sparse and of low quality. There were no high-quality studies that investigated outcomes following use of crisis team or hospital admission for this group. Studies investigating crisis-focused psychological interventions showed potentially promising results.

Mental health deserves better: Resisting the dilution of specialist pre-registration mental health nurse education in the United Kingdom.

This article aims to draw attention to increasing genericism in nurse education in the United Kingdom, which sees less specialist mental health education for mental health nursing students and offers opposition to such direction. In 2018, the Nursing and Midwifery Council produced the 'Future Nurse' standards which directed changes to pre-registration nurse education. This led to dissatisfaction from many mental health nurses, specifically regarding reduced mental health content for students studying mental health nursing. Concerns have been raised through public forum and evolved into a grassroots national movement 'Mental Health Deserves Better' (#MHDeservesBetter). This is a position paper which presents the perspective of many mental health nurse academics working at universities within the United Kingdom. Mental health nurse academics collaborated to develop ideas and articulate arguments and perspectives which present a strong position on the requirement for specialist pre-registration mental health nurse education. The key themes explored are; a conflict of ideologies in nursing, no parity of esteem, physical health care needs to be contextualized, the unique nature of mental health nursing, ethical tensions and values conflict, implications for practice, necessary improvements overlooked and the dangers of honesty and academic 'freedom'. The paper concludes by asserting a strong position on the need for a change of direction away from genericism and calls on mental health nurses to rise from the ashes to advocate for a quality education necessary to ensure quality care delivery. The quality of mental health care provided by mental health nurses has many influences, yet the foundation offered through pre-registration education is one of the most valuable. If the education of mental health nurses does not attend to the distinct and unique role of the mental health nurse, standards of mental health care may diminish without assertive action from mental health nurses and allies.

AI-Enabled Mental Health Assessment and Intervention: Bridging Gaps in Access and Quality of Care.

This paper explores the transformative potential of artificial intelligence (AI) in revolutionizing mental health assessment and intervention, aiming to address critical gaps in both accessibility and quality of care. Mental health disorders pose a global challenge, with a significant portion of the population facing barriers to timely and effective treatment. Traditional mental health care systems often struggle to meet the increasing demand for services, leading to prolonged waiting times and inadequate support for individuals in distress. Moreover, stigmas surrounding mental health further hinder many from seeking help. The advent of AI technologies offers a promising solution to these challenges. Through advanced machine learning algorithms, AI can enhance the accuracy and efficiency of mental health assessments, enabling early detection of disorders and personalized treatment plans. [1] AI-driven chatbots and virtual assistants can provide continuous, accessible support, offering a bridge to care for individuals who may be hesitant or unable to access traditional services. Furthermore, these technologies can help destigmatize mental health discussions by providing a private and non-judgmental space for users. The paper reviews the current landscape of AI applications in mental health, highlighting successful case studies and identifying key ethical considerations. It also delves into the potential pitfalls and challenges associated with AI implementation, emphasizing the importance of maintaining a balance between technological advancement and human-centric care. Ethical considerations, privacy concerns, and the need for ongoing human oversight are crucial elements in ensuring the responsible deployment of AI in mental health contexts. As AI continues to evolve, it is imperative to establish robust frameworks for regulation, accountability, and transparency to safeguard against unintended consequences. The paper concludes by proposing a holistic approach that integrates AI seamlessly into existing mental health care infrastructures, fostering collaboration between technology developers, mental health professionals, and policymakers to create a future where AI contributes significantly to bridging gaps in access and elevating the overall quality of mental health care.

When psychiatry encounters local knowledge of madness: Ethnographic observations in a Chinese psychiatric hospital

As the number of psychiatric hospitals are on the rise in China, this article examines how the psychiatric discourse as articulated by hospital staff interacts with local cultural understandings of madness/mental illness, as well as how such interactions impact patients and families’ reception of psychiatry. Data comes from 16 months of fieldwork in a psychiatric hospital in South China. We show that psychiatric professionals at the hospital attempted to establish their professional authority by discrediting other cultural epistemologies embraced by patients or families, such as religious and traditional Chinese medical understandings. Despite the quick effect of psychopharmaceuticals to control symptoms, the psychiatric perspective ultimately fell short in addressing the social and moral struggles faced by patients, such as patriarchy and gender-based violence. Moreover, as psychiatric professionals unreflexively used certain problematic local concepts to convey a biomedical and even genetically-determined account of mental illness to patients and families, they risked entrenching the stigma of mental illness and disempowering their clients. To improve the quality of mental healthcare, to make clients feel culturally safe and respected in clinical encounters, psychiatric professionals in China should develop a more holistic approach that takes into account the biological, psychological, and sociocultural aspects of mental illness, that recognizes the diverse sources of help clients may rely on. They should also develop a critical awareness of the language they use and of the power dynamics in which they and their clients are situated.

Milton Wainberg: co-creating scalable, equitable, and sustainable quality mental health care

Milton Wainberg: co-creating scalable, equitable, and sustainable quality mental health care

Impacts of the Affordable Care Act Medicaid Expansion on Mental Health Treatment Among Low-income Adults Across Racial/Ethnic Subgroups, 2010-2017.

This study examines whether the Affordable Care Act (ACA) Medicaid expansion (ME) was associated with changes in racial/ethnic disparities in insurance coverage, utilization, and quality of mental health care among low-income adults with probable mental illness using the National Survey on Drug Use and Health with state identifiers. This study employed difference-in-difference models to compare ME states to non-expansion states before (2010-2013) and after (2014-2017) expansion and triple difference models to examine these changes across non-Hispanic White (NHW), non-Hispanic Black (NHB), and Hispanic/Latino racial/ethnic subgroups. Insurance coverage increased significantly for all racial/ethnic groups in expansion states relative to non-expansion states (DD: 9.69; 95% CI: 5.17, 14.21). The proportion low-income adults that received treatment but still had unmet need decreased (DD: -3.06; 95% CI: -5.92, -0.21) and the proportion with unmet need and no mental health treatment increased (DD: 2.38; 95% CI: 0.03, 4.73). ME was not associated with reduced disparities.