Role Of Mental Health Services Research Articles

“Own Goodness and Service for Others” A Motivation to Serve People with Mental Disorders: Systematic Review

Volunteers have an important role in mental health services. Volunteers are present among the stigma and discrimination against people with mental disorders. To understand the motivation of volunteers in caring for people with mental disorders. A systematic review was conducted by collecting the results of scientific publications. The data bases used were ProQuest, PubMed, Sincedirect, and Springer link. Searching was carried out using the keywords of motivation, volunteers and mental disorders. Determination of the number of articles and articles contained in the review was determined by using PRISMA methods. Eight articles were found using the inclusion criteria for the article. Volunteer’s motivation was for their own goodness and service for others. Motivation of own goodness was divided into personal growth, altruism and self-existence. Motivation to serve others was to help others and contribute to society. There was strong evidence that volunteers had good motivation in improving the health status of people with mental disorders.

The nurse consultant in mental health services: A national, mixed methods study of an advanced practice role

WHAT IS KNOWN ON THE SUBJECT?: Internationally, systematic reviews have identified evidence of equal or improved clinical outcomes comparing advanced practitioner treatment with medical treatment as usual, across a range of specialities. Studies of nurse consultants in the United Kingdom have largely been non-empirical. Most studies specifically related to nurse consultant roles in mental health services are case studies or reports of views on this role. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: The study demonstrates that nurse consultant numbers vary over time and by clinical specialty. This is influenced by the value invested in the role by local nursing leadership and by national policy change. A lack of role clarity affects the uptake and sustainability of advanced practice roles internationally and is also an issue for the nurse consultant role in England's mental health services. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Successfully introducing advanced practice nursing roles in mental health services requires role clarity and support from local nurse directors. The continued absence of robust evidence as to the clinical/cost-effectiveness of nurse consultant roles in mental health settings places an onus on individual posts to generate data to justify the role at a time of financial constraint. Detailed post holder characteristics reported in this paper provide a basis for future comparison with other advanced practice roles in mental health services and other specialties nationally and internationally. Abstract Introduction The nurse consultant is an advanced practice role providing expert clinical practice, consultancy and professional leadership. To date, few studies have examined this role within mental health services and none have described the professional characteristics of post holders. Aims The main aims of the study were to identify changes in nurse consultant numbers in mental health services, identify post holder characteristics and factors influencing number of posts. Method We used a triangulated mixed methods approach comprised of a longitudinal examination of national workforce data, a national cross-sectional survey of post holder characteristics and semi-structured interviews with directors of nursing. Results Of 58 mental health organizations, 51 (88%) responded, identifying 123 nurse consultant posts, and a range of 0-12 posts per organization. One in 229 mental health nurses and 1 in 186 learning disability nurses were nurse consultant. An average of 40% of nurse consultants' work time was reported as being in clinical practice. Themes identified as important in relation to role sustainability were cost and value, contribution of individual post holders, role clarity and domains of work. Discussion Nurse consultants are represented to a greater extent in the mental health service workforce than in nursing generally, but their roles often lack clarity. Attitudes of local professional leaders and national policies are likely to affect post numbers. Implications for practice Developing and sustaining nurse consultant roles requires role clarity and active support from nurse leaders. Roles need to demonstrate their value to the clinical systems in which they work.

Co-production and involuntary psychiatric settings

Purpose The purpose of this paper is to examine whether the popular policy assumption of co-production is feasible in secure psychiatric settings. Design/methodology/approach The assumptions of co-production are listed and then used as a basis for an immanent critique to test the feasibility described in the purpose of the paper. An explanatory critique exploring consumerism in the welfare state then follows. These forms of critique are derived from the philosophy of critical realism. Findings A distinction is made between the co-production of knowledge about mental health services and the actual co-production of those services. It is concluded that the former has emerged but the latter is not feasible, given the limitations on citizenship imposed by psychiatric detention. Research limitations/implications Evidence for the co-production of mental health services (rather than the co-production of knowledge about those services) remains sparse. Practical implications The contradictions about citizenship created by the existence of mental health legislation and the social control role of mental health services requires ongoing honest reflects by mental health professionals and those responsible for the development of mental health services. Social implications As described above, mental health legislation pre-empts confidence in the co-production of mental health services. Originality/value Whilst there is a small literature on co-production and mental health services, alluded to at the outset, this paper uses immanent and explanatory critiques to deepen our understanding of the topic.

Mental Hospitals in India: Reforms for the future.

Mental hospitals are an integral part of mental health services in India. It is an interesting story how mental hospitals have responded to the challenges of contemporary period they were built in. It is beyond doubt that it is a progressive journey along with advances in mental health both in India and internationally. As in other countries, mental hospitals in India have responded to the social challenges, disparities, and poor resources of workforce and fiscal investment. Historically, there have been changes and three major reforms are needed, namely attempt to facilitate discharge and placing patients back into the family, introducing teaching and research in mental hospitals, and accountability to civil rights as per the requirements of the National Human Rights Commission. In this review, we explore the brief history of mental hospitals in India and examine the reforms in the clinical, administrative, and psychosocial areas of these hospitals and progress in teaching and research. We finally summarize and conclude the necessity and the relevance of mental hospitals in India akin to modern psychiatric practice. We believe that mental hospitals have an important and perhaps a central role in mental health services in India. Its modernization to address issues of long-term stay, burden on caregivers, stigma, research and teaching including undergraduate and postgraduate training, new curriculum, and training for nonpsychiatric professionals and primary care physicians are necessary components of the role of mental hospitals and responsibilities of both government and nongovernmental sectors. Last but not the least, it is obligatory for mental hospitals to ensure that evidence-based treatments are implemented and that the standard of care and respect of civil and human rights of the patients and families are provided while involving the people's participation in its functioning.

Child and adolescent mental health services: longitudinal data sheds light on current policy for psychological interventions in the community

PurposeThe purpose of this paper is to expand upon policy implications of a recent study assessing adolescent mental health service contact and subsequent depression.Design/methodology/approachReview of related evidence from academic and grey literature.FindingsStudies assessing the role of mental health services in reducing mental disorder during adolescence are sparse, and even prevalence figures for adolescent mental disorders are out-of-date. Adolescent mental health service contact rates are shown to fall concurrent with budgetary decreases. School-based counselling is highlighted as an important source of help that may be at risk of being cut. Increased training of General Practitioners and school counsellors is needed to improve efficiency in specialist Child and Adolescent Mental Health Services (CAMHS).Practical implicationsLongitudinal studies of young people’s mental health should include mental health service usage and its relationship with subsequent mental health outcomes.Social implicationsFunding cuts to CAMHS must be avoided, school-based counselling must be protected, and service referrers should be better trained.Originality/valueThis paper highlights the need for increased CAMHS data, sustained funding, and improved training for this vital service.

Teaching-learning process from service teaching of mental health nursing: experience report

Objective: Describe the conceptions of resident nurses about the nurse's role in mental health services.
 Method: Descriptive/reflexive study of the experience-report type, carried out from experiences of nurses from the Multiprofessional Residency Program in Mental Health, guided by the theoretical presuppositions of the Brazilian Psychiatric Reform and structured from the Arch of Charles Maguerez.
 Results: In-service teaching provided reflections on the residents' conceptions of nurses' performance in mental health services. The key posts were the insertion in the specific nursing care, the construction of the multiprofessional work process, the recognition of their professional identity. Therapeutic relationship and communication, receptiveness, co-responsibility of care and the construction of links with clients, family and work colleagues for the solution of the problems. 
 Conclusions: The Arch of Charles Maguerez facilitated the teaching process in service. In addition, it provided the perception of the action-reflection-action movement as essential to understand fundamentals of care practices in nursing and to collaborate to the insertion of the nurse and the process of changes, from the daily services of mental health.

New Ways of Working in UK mental health services: developing distributed responsibility in community mental health teams?

Background: This paper examines the introduction and operation of a number of support roles in mental health services. This is done in the context of concerns about the effectiveness of CMHTs.Aims: Three questions are addressed: the degree to which concern for the work of consultant psychiatrists informed the introduction of the new roles; what the reforms implied for the work of the psychiatrist and those in new roles; and the impact of any changes on the operation of CMHTs.Method: Data were collected as part of a national-level evaluation. The main means of collection was the semi-structured interview.Results: The study shows: that reform was underpinned by concerns about the workload of psychiatrists; and that while in principle the responsibilities of the psychiatrist were to be distributed across other team members, those in new roles felt themselves to be isolated.Conclusions: Despite the intentions of policy, the creation of the new roles did little to extend the idea of distributed responsibility in CMHTs.

The Role of Mental Health Services in Addressing HIV Infection Among Women With Serious Mental Illness.

This article reviews how mental health services can best prevent and treat HIV infection among women with serious mental illness. This is a selective narrative review of the recent literature on mental health services and HIV. The author used the terms "HIV," "serious mental illness," and "women" to search Google Scholar. Out of 500 relevant papers retrieved, 82 were included, based on their state-of-the-art findings. Women with serious mental illness at risk of HIV were found to be an especially vulnerable group. The evidence suggests that discussion of the modes of viral transmission reduces the risk of infection in this population, as do psychoeducation; long-term antipsychotic medication; adherence therapy; community treatment orders; prevention of domestic violence and homelessness; disbursement of financial entitlements; provision of psychotherapy and social support; cognitive rehabilitation; promotion of abstinence, monogamy, or reduction in the number of sexual partners; access to and training in the use of condoms; prophylaxis with vaginal microbicides and oral antiretroviral drugs; prompt diagnosis and treatment of sexually transmitted diseases; across-the-board offers of HIV testing; and preservation and monitoring of reproductive health. For HIV-positive individuals, comprehensive treatment measures have included prompt HIV treatment; long-term retention in care; supervision of medication adherence and drug interactions; rapid management of substance use disorders and all other comorbidities as well as drug side effects; and preclusion of professional stigmatization. There is now sufficient evidence to recommend effective combinations of strategies to prevent and treat HIV within mental health services.

Impact of the role of senior dual disability coordinator on the perceived self-efficacy and job satisfaction of mental health clinicians

Purpose: This study aimed to evaluate a new service role in mental health services, namely, the senior dual disability coordinator role (SDDC) for its impact on the perceived self-efficacy of mental health clinicians in managing clients with dual disability (mental illness and acquired brain injury and/or intellectual disability) and their job satisfaction. Method: Mental health clinicians from a health service district in Queensland, Australia who contacted the SDDC for clinical consultation and liaison between July 2011 and July 2013 were asked to complete a questionnaire assessing perceived self-efficacy in working with clients with dual disability as well as their job satisfaction, prior to (T1) and following (T2) their contact with the SDDC. Results: Twenty-five clinicians completed and returned pre- and post-measure questionnaires. Self-reported knowledge of dual disability, clinical skills in dual disability, service knowledge in dual disability as well as perceived self-efficacy, and job satisfaction increased significantly from T1 to T2. There were no significant differences across professional discipline or years of service. Conclusions: The delivery of a clinical consultation liaison service as part of the role of SDDC may assist mental health clinicians with self-efficacy and job satisfaction, regardless of the number of years they have worked in the service or their professional discipline. Mental health clinicians with improved self-efficacy for working with clients with dual disability may be more likely to consider the client suitable for services through mental health and follow-up with treatment and linking the client with other identified suitable services.Implications for RehabilitationDual disability (mental illness and acquired brain injury and/or intellectual disability) presents specific challenges for mental health services Specific strategies are needed to build capacity among mental health practitioners in order to meet the needs of people with dual disability and provide appropriate services.Introducing dual disability coordinators as a specific position within a health service district may assist to improve self-efficacy and job satisfaction of mental health practitioners assisting people with dual disability.

Filicídio e psicose: relato de dois casos

Individuals have a four-fold higher chance of being a victim of murder in the first year of life. This article presents definitionsof filicide and reports on two cases of women with psychotic disorders who tried to murder their children. The role of mental health services in preventing the loss of contact and non-adherence to treatment is emphasized, as these aspects frequently precede homicide committed by people with severe mental illnesses.

“Graceful Failure”: The Privatization of Resilience

The author describes the 2012-2013 school year at East Hampton High School in New York, which began with tragedy. In late September, a sixteen-year-old student, an immigrant from Ecuador, committed suicide. This was the second suicide in three years, followed two weeks later by the third, committed by a student about to transfer to the school. Asked in an interview to reflect on the past year, the principal of East Hampton (ranked as one of the best schools in the nation, with many graduates going on to Ivy League universities) "'sighed and moved his hand up and down, suggesting a roller coaster. 'Resiliency,' he said. 'That's my theme word for graduation'" (quoted in Rutenberg 2013). In this article the author considers the popularity of resilience in relation to its more specific emergence in the constellation of issues raised in the East Hampton story: class, race and education. Without seeking completely to discount the value of resilience as a focus and strategy for individuals, institutions, and communities, she concurs with those critics who counsel wariness, regarding the all-too-neat alignment between the concept of resilience, or the capacity to thrive through change, and the ideology of neoliberalism (Botterell 2009; Evans and Reid 2013; Joseph 2013; Neocleous 2012; O'Malley 2010; Walker and Cooper 2011; Zebrowski 2009). In particular, she notes the enthusiastic embrace of resilience by independent schools at a time of growing social disparity and reduced funding for public schools, and suggest that this trend is not just symptomatic of this disparity, but complicit in its deepening. Language: en

New ways of working in mental health services: a qualitative, comparative case study assessing and informing the emergence of new peer worker roles in mental health services in England

BackgroundA variety of peer worker roles are being introduced into the mental health workforce in England, in a range of organisational contexts and service delivery settings. The evidence base demonstrating the effectiveness of peer worker-based interventions is inconclusive and largely from outside England. An emerging qualitative literature points to a range of benefits, as well as challenges to introducing the peer worker role.AimsIn this study we aimed to test the international evidence base, and what is known generally about role adoption in public services, in a range of mental health services in England. We also aimed to develop organisational learning supporting the introduction of peer worker roles, identifying learning that was generic across mental health services and that which was specific to organisational contexts or service delivery settings.TeamThe research was undertaken by a team that comprised researchers from a range of academic and clinical disciplines, service user researchers, a peer worker, and managers and service providers in the NHS and voluntary sector. Service user researchers undertook the majority of the data collection and analysis. We adopted a coproduction approach to research, integrating the range of perspectives in the team to shape the research process and interpret our findings.Study designThe study employed a qualitative, comparative case study design. We developed a framework, based on existing evidence and the experiential insight of the team, which conceptualised the challenges and facilitators of introducing peer worker roles into mental health services. The framework was used to inform data collection and to enable comparisons between different organisational contexts, service delivery settings and the perspectives of different stakeholders.SettingsThe study took place in 10 contrasting cases comprising mental health NHS trusts, voluntary sector service providers and partnerships between the NHS and voluntary sector or social care providers. Peer workers were employed in a variety of roles, paid and unpaid, in psychiatric inpatient settings, community mental health services and black and minority ethnic (BME)-specific services.ParticipantsParticipants were 89 people involved in services employing peer workers, recruited purposively in approximately equal proportion from the following stakeholder groups: service users; peer workers; (non-peer) coworkers; line managers; strategic managers; and commissioners.Data collectionAll participants completed an interview that comprised structured and open-ended questions. Structured questions addressed a number of domains identified in the existing evidence as barriers to, or facilitators of, peer worker role adoption. Open-ended questions elicited detailed data about participants’ views and experiences of peer worker roles.Data analysisStructured data were analysed using basic statistics to explore patterns in implementation across cases. Detailed data were analysed using a framework approach to produce a set of analytical categories. Patterns emerging in the structured analysis informed an in-depth interrogation of the detailed data set, using NVivo 9 qualitative software (QSR International Pty Ltd, Victoria, Australia) to compare data between organisational contexts, service delivery settings and stakeholder groups. Preliminary findings were refined through discussion with a range of stakeholders at feedback workshops.FindingsMany of the facilitators of peer worker role adoption identified in the existing evidence base were also evident in mental health services in England, although there were issues around pay, leadership, shared understanding of the role, training and management where good practice was uneven. A number of examples of good practice were evident in the voluntary sector, where peer worker roles had been established for longer and organisations were more flexible. In the NHS there were a range of challenges around introducing peer worker roles into existing structures and cultures of practice. Peer workers were able to engage people with services by building relationships based on shared lived experience – the language they used was particularly important in BME-specific services – but barriers to engagement could be created where roles were overformalised.ConclusionsKey barriers to, and facilitators of, peer worker role adoption were identified, including valuing the differential knowledge and practice that peer workers brought to the role (especially around maintaining personally, rather than professionally defined boundaries); maintaining peer identity in a role of work; changing organisational structures to support peer workers to remain well in their work; and challenging organisational cultures to empower peer workers to use their lived experience. Recommendations for future research include developing a theoretical framework articulating the change mechanisms underpinning ‘what peer workers do’, piloting and formally evaluating the effectiveness and cost-effectiveness of peer worker interventions, and mixed-method research to better understand the impact of working as a peer worker.FundingThe National Institute for Health Research Health Services and Delivery Research programme.

“It’s Us That Have to Deal with it Seven Days a Week”: Carers and Borderline Personality Disorder

Carers provide unpaid support to family or friends with physical or mental health problems. This support may be within the domain of activities of daily living, such as personal care, or providing additional emotional support. While research has explored the carer experience within the National Health Service in the United Kingdom, it has not focused specifically on carers of individuals with a diagnosis of borderline personality disorder (BPD). Eight carers for those with a diagnosis of BPD were invited to take part in two focus groups. The first carers' focus group, entitled 'The role of Mental Health services,' produced four super-ordinate themes. The second carers' focus, entitled 'Experiences in the Community,' produced six super-ordinate themes. It seems carers of those with a diagnosis of BPD are continuing to be overlooked by mental health services, and subsequently require more support to ensure their own well-being.

BISFT – A Tribute

This article describes the dilemmas posed in my life by a conflict between the role models offered to educated women in the 1950s and 1960s and those offered by the surrounding culture. The absence of feminism in the education system and the separation from other women by constructs of the family and motherhood resulted in mental illness. The role of mental health services in reinforcing the surrounding culture is explored and tributes paid to the Britain and Ireland School of Feminist Theology (BISFT) and other feminist theology groups for helping me to find a way out of the imprisoning power of patriarchy through my creativity, especially in the area of hymn writing and performance.

Her Majesty's Government's pleasure: providing appropriate community intervention can improve care and save money

SummaryIn answer to Louis Appleby's editorial, I am proposing that the role of mental health services in offender healthcare is to improve people's mental health and it is the role of the courts and the government to reduce the prison population. I also argue that with a reinvestment of existing resources into prison mental health we can reduce admission to expensive medium secure and low secure placements, save money and further reinvest in better care.

“I don't know how to find my way in the world”: Contributions of User-Led Research to Transforming Mental Health Practice

Background: A number of forces have converged to promote participatory research in mental health.Aim: To present the findings of a user-led project in which eight people in recovery conducted narrative interviews with 80 peers.Method: Interviews focused on what participants' lives were like, what they would like their lives to be like, the role of mental health services, and how they would choose to spend their mental health dollars. Researchers used qualitative analysis to identify key themes from the first 30 interviews.Results: Participants described multiple, profound losses and feeling that they were existing day-to-day, with their symptoms under control but not knowing how to make their way in the world. They suggested it would be useful to have a “map” to guide them back to a normal life, and reported that mental health care was most useful when it attended both to controlling illness and enabling them to rebuild an ordinary life. If they had the choice, they would spend their mental health dollars at this point primarily on having other people act as guides in pursuit of normal activities that interest them.Conclusion: Mental health care can be more effective in helping people join in to normal activities.

The place and promotion of well‐being in mental health services: a qualitative investigation

The study investigated the place and promotion of well-being from the perspectives of services users and mental health professionals. * Data from focus groups and interviews were analysed and found that well-being promotion was available, for example weight management groups in mental health services. However, they also found that there were some contradictions between the groups of people interviewed about what was available and what to promote in the future. * The study concludes suggesting partnerships with local communities to further develop well-being services, such as opportunities for physical activity, for people with mental health problems. Abstract This study explored service users' and mental health professionals' understandings, experiences and opinions of well-being and its promotion within mental health services. A qualitative case study methodology included nine participants (five adult service users, three mental health professionals, one senior manager) who were purposively sampled from a Mental Health Trust in England. Service users participated in a focus group, while individual semi-structured interviews were held with the mental health professionals and senior manager. Interpretative phenomenological analysis of the data revealed five main themes including well-being as a holistic concept; well-being promotion; the place, promotion and position of well-being; role of mental health services in well-being promotion; and areas for further improvement. Findings revealed evidence of well-being promotion; however, there were contradictions regarding what was known between the groups of participants and what could be provided in the future. Implications for practice include the need to establish more effective partnership working between mental health services and local communities, especially in light of financial constraints within health services at large. This could assist the increased provision of therapeutic services for well-being promotion.

Family Matters: Developments Concerning the Role of the Nearest Relative and Social Worker under Mental Health Law in England and Wales

The ‘nearest relative’ and social work roles in mental health services share common ground. Although the social worker is a trained professional and the nearest relative is identified from a fixed hierarchy of kin, both roles were awarded the authority to make a compulsory order for hospital admission of a person with serious mental disorder warranting detention in hospital. Both roles will alter if amendments to the 1983 Mental Health Act in England and Wales come into force. This article considers the changing roles of relatives, carers and practitioners in the context of policy shifts in mental health legislation and services in England and Wales. Drawing on the interlinked tenets of anti-discriminatory and anti-oppressive practice, it presents an analysis of the interlocking powers of the nearest relative and the Approved Social Worker, and an overview of defunct and existing legal proposals. The article concludes that the lay and professional roles remain in flux but they are still interdependent in many instances. Note: The term ‘patient’ is used to describe a person who is detained or liable to be detained under the 1983 Mental Health Act. The term ‘service user’ is used to describe someone who uses mental health services. However, the authors acknowledge that both descriptors are problematic given the stigma associated with the term ‘patient’ and possible offence caused by defining people by the services they use. The terms are used to reflect the legal status implied and no prejudicial meanings or interpretations are intended.

Gebruik van de GGZ na rampen

Mental health services utilization after disasters Victims of disaster are confronted with posttraumatic stress reactions in the short, intermediate or long term. Part of the victims does not recover from these problems, suffer from for instance PTSD, and may seek treatment. The present paper focuses on the role of mental health services (MHS) at different stages after disasters, the use of MHS among victims and especially among victims with severe psychological problems, and factors associated with MHS utilization. The main conclusion are that a) the use of MHS during the first days/ weeks is minimal; b) at later stages, the majority of victims with current psychological disturbances do not use MHS at that moment; c) post-disaster psychological disturbances are the most robust predictors of use while other factors are less consistently associated with use. In addition, measures to improve the use of MHS are discussed.

Occupation for Mental Health and Social Inclusion

Social inclusion and occupational science sit well together and there is a strong case for occupational therapists to take more of a lead with socially inclusive practice. The implications and challenges for occupational therapy roles in mental health services are explored and inclusive practice is discussed in the light of policy that is designed to broaden professional roles. It is argued that if occupational therapists in mental health are going to meet the social inclusion agenda with an occupational focus, they need a political and social awareness in their work with service users and mental health teams.