Provision Of Mental Health Services Research Articles

Mental Illnesses and Stigma among Medical Undergraduates in India.

The current Medical Education system of India, with its enormous workload and academic demands tend to cause the medical students stress. There is evidence showing medical students at a higher risk of depression, anxiety and burnout compared to other Indian students. Despite, the huge reported numbers, the proportion of students and doctors who seek help for their problems is alarmingly low. One of the reasons provided for the same is stigma towards mental health and an apprehension regarding labels and treatment history on the careers of the students. Increased awareness and with a National Health Programme catered towards mental health, there has been a boost in the utilization and provision of mental health services but it rarely translates into better mental health facilities for the healthcare providers. The special set of challenges faced by a medical students are gradually being recognized and efforts are being made to address them. Curriculum guidelines, teaching methods, student welfare centres and helplines have been the areas of intervention. There should also be changes in approaches towards the students who face problems and providing a safe environment for them to discuss their problems, including encouraging peer support. Thus, a fine balance needs to be present between ensuring the protection of the mental health of a medical student and ensuring a quality medical education for them. Further exploration to address stigma and building empathy among the students and evaluation of the intervention methods devised to address the same becomes very necessary to ensure fruitful interventions. It is the need of the hour to help Indian Medical students overcome their struggles with mental health.

Provider reaches Latino community by being ‘culturally humble’

Staff members at North Carolina's largest provider of mental health services for the Latino community, El Futuro, realize the care they deliver can't be cookie‐cutter. What the rest of the field might label as “evidence‐based” will likely fall short for a population that has had little role in designing or testing what have become the conventional treatment strategies.

Role of Professional Counselling in Mental Health Services Provision: A Case of Zimbabwe

This study sought to examine the role of professional counselling in mental health services provision: A case of Zimbabwe. The representative sample consisted of a staff compliment of five (5) registered mental health nurses (RMN), two (2) social workers, four (4) general hands and one (1) psychiatrist were involved in this study. A qualitative research descriptive survey design was employed to guide the methodology. Data was generated through in-loco observations; face to face interviews, focused group discussions and document analysis. Findings from the study showed that most patients did exceptionally well whilst in the institution but relapse once discharged. It was also noted that patients or their relative(s) who received support information on the rationale for medication were the ones who were good on adherence to the medication.

Capturing autonomy, competence, and relatedness at work: further examining and validating an English language version of the work-related basic need satisfaction scale.

Self-Determination Theory (SDT) maintains that the satisfaction of the basic psychological needs for autonomy, competence, and relatedness is associated with optimal individual functioning, including in the workplace. A self-report instrument, the Work-related Basic Need Satisfaction scale (W-BNS), has previously been developed and validated in Dutch and Italian. We aimed to validate an English version of the W-BNS. We also evaluated a bifactor model to assess the extent to which the item responses could be explained by a single, underlying general latent trait. A Rasch calibration was also carried out to assess the extent to which the scores conformed to the assumptions of 'fundamental measurement' and could be converted to a common metric. We used data from 141 staff employed by a large UK-based mental health service provider. The postulated three-factor structure provided a good fit to the data. However, a bifactor model, introducing an underlying general factor, provided a superior fit. The items generally conformed to the Rasch measurement model. Evidence of convergent/divergent validity was observed via the correlations between the W-BNS scores and those for the Basic Psychological Needs Satisfaction and Frustration Scale (BPNFS). Regarding construct validity, both the separate needs and total W-BNS scores statistically significantly predicted an individual's reported intention to leave the current employer. Our findings foster research with the WBNS and have implications for how the W-BNS is optimally implemented in practice as a useful brief tool for assessing staff work-related need satisfaction.

Exploring past research to move forward: a scoping review of aims, outcomes, and recommendations in parental mental illness qualitative research.

As parental mental illness is a global public health concern, rigorous qualitative research is central to understanding families' experiences, needs and outcomes to inform optimal service provision in adult mental health and children's social services. The current review identified, appraised and synthesized international qualitative research exploring Families and Parent Mental Illness (FaPMI) research to determine the focus, findings and outcomes and to summarize the recommendations made about the direction of future research. Findings are classified according to outcomes for children, parents, and families. While some children experienced positive outcomes from a parent's illness, most faced impacts on their social-emotional wellbeing, school performance, increased caregiving responsibilities, strained parent relationships, and lack of understanding about parental mental illness. Some family members endured abuse and struggled to adapt to an ill parent's unpredictable needs, with reluctance to discuss the situation. Parents found parenting challenging yet viewed having children as a protective factor. Future research should gather diverse perspectives, explore within-family factors and social environments, develop and test interventions, and address methodological issues like sampling. This review highlights the centrality of qualitative data in comprehensively understanding and evaluating outcomes of parental mental illness on families and provides clear recommendations regarding future research.

Inuit mental health service utilisation in Manitoba: results from the qanuinngitsiarutiksait study

ABSTRACT Despite decades of Inuit accessing services in Manitoba, Inuit-centric services remain scant and have only begun to emerge. This article reports on Inuit utilisation of mental health services in Manitoba. In this study, we focused on two interrelated cohorts: Inuit living in Manitoba and Inuit from the Kivalliq region who come to Winnipeg to access specialised services. We used administrative data routinely collected by Manitoban agencies. The study was conducted in partnership with the Manitoba Inuit Association, and Inuit Elders from Nunavut and Manitoba. Our results show that mental health-related consults represent between 1 in 5 and 1 in 3 of all consults made by Inuit in Manitoba. Rates of hospitalisation for mental health conditions are considerably lower than those of residents from the Manitoba northern health authority. Given that Nunavut has the highest rate of suicide in the world, our results suggest underserved needs rather than lower needs. Kivalliq and Manitoba Inuit utilise mental health services in Manitoba extensively, yet these services for the most part remain western-centric. Epistemological accommodations in the provision of mental health services have yet to be implemented. This is now the focus of our work.

Learning About Mental Health Lived Experience in Social Work Education

ABSTRACT Lived experience education occupies an increasingly important space in mental health education for social workers. Despite being plagued by practices that continue to be discriminating and exclusionary, the mental health policy and practice context demand robust attention to the meaningful inclusion of service users and their families to achieve genuine partnership, reciprocity, and equality in mental health service provision. For social work educators, lived experience education is now an indispensable component of a critically informed mental health curriculum and pedagogy. Framed within an appeal for epistemic justice, this article reports on qualitative survey data from social work students who experienced teaching from people with lived experience. Findings show that students greatly valued lived experience education, as it created opportunities for authentic and more diverse understandings of mental health that fostered critical reflection. A curriculum that supports epistemic equality and a social justice agenda would help scaffold lived experience expertise for student learning. IMPLICATIONS Mental health lived experience education positively impacts social work students’ values and attitudes towards mental health service users. Lived experience education supports social work students to expand their understandings of mental health and recovery beyond dominant biomedical perspectives. Genuine valuing of lived experience knowledge and expertise in social work education helps address epistemic injustice.

Examining dimensions of help-seeking intentions and associations with personal mental illness stigma among racial and ethnic minority immigrants.

This study examined the factor structure of the General Help-seeking Questionnaire and how personal mental illness stigma was associated with different types of help-seeking intentions among racial and ethnic minority immigrants in the United States. A sample of 202 immigrants aged 18-39 were recruited from a Qualtrics panel and completed the online survey. Confirmatory factor analysis and multiple linear regression were conducted. Results confirmed four dimensions of help-seeking intentions: informal, formal, semi-formal, and traditional sources. Immigrants with higher levels of mental illness stigma are more likely to seek help from traditional sources (e.g., religious leader or other community-based nonfaith resources) and semi-formal sources (e.g., web-based resources). Lack of awareness of service options is a key barrier to formal help-seeking. Results signal the importance of collaboration between mental health service providers. Adopting culturally sensitive care and web-based delivery formats may help address immigrants' concerns about mental health stigma.

Experiences and support needs of psychiatrists under investigation.

This study aimed to explore the experiences and support requirements of psychiatrists undergoing investigations within their mental health organisation. An anonymous online survey was distributed to all non-training psychiatrists registered as members of the Royal College of Psychiatrists. Of the 815 psychiatrists who responded to the survey, 287 (35%) had been investigated. The majority (76%) were unaware of the concerns before being notified, 36% lacked understanding and 62% experienced timeline deviations. Furthermore, 34% had concerns over conflicts of interest, with 52% perceiving the investigation as unfair, 62% were not informed of their rights. Many respondents reported feeling isolated and lacking support and experienced significant psychological distress, such as symptoms of post-traumatic stress disorder. Suggestions for improvement included better communication, transparency, impartiality, adherence to timelines, proactive support and oversight, and opportunities for learning and reparation post-investigation. Mental health service providers should recognise the multifaceted nature of complaints and provide comprehensive support and guidance to psychiatrists undergoing investigations.

A STUDY OF THE IMPACT OF SERVICE QUALITY ON CUSTOMER REVISIT INTENTION OF PSYCHOLOGICAL SERVICE COMPANIES: USING CUSTOMER EXPERIENCE AND DISEASE AWARENESS AS MEDIATING VARIABLES

In today's society, mental health issues are receiving increasing attention, and numerous psychological service companies have emerged as providers of professional mental health services. However, the market competition is also becoming more intense, making service quality a crucial factor for psychological enterprises to achieve long-term development and customer loyalty. This study aims to explore the specific mechanisms by which various elements of service quality, such as accessibility, convenience, reliability, and efficiency, affect clients' willingness to revisit psychological consulting firms. Through empirical analysis, the study seeks to clarify the degree of association between different service quality dimensions and the intention to revisit and analyze their internal relationships. Therefore, the study will survey clients who have received psychological counseling and therapy services, using client experience and disease perception as mediating variables to examine the impact of service quality on the revisit intention of customers in psychological service enterprises. Additionally, through an in-depth study of the YM Psychological Counselor Training Company, the research will analyze issues related to the company's low revisit intention and propose recommendations for adjustment, offering a reference for similar enterprises.

Debate: How much should nonspecialists be involved in mental health care for children and young people when resources are limited?

From the barber-surgeons of the Middle Ages to the digitally enabled clinical interventions of today, the role of nonspecialists in delivering accessible health care remains relevant and important. Their contribution in developing and supporting appropriate interventions and care pathways in the community can make a big difference for the overwhelming majority of children and young people with diagnosable mental health conditions who are not eligible for specialist treatment or do not seek help. Even if resources for specialist services were unlimited, there are independent benefits in involving nonspecialists in mental health care, albeit not without limitations and concerns. The natural shift over time in the boundaries of specialisms, the omnipresence and omnipotence of digital media in our lives and the vision of 'no wrong door' for service users, mean that it is not a question of whether, but of how, nonspecialists should be involved. We need to get past the point of considering them just as alternative providers of mental health interventions and services. Instead, they are best placed to protect children and young people's mental health through ubiquitous everyday actions, which counter the negative and maximise the positive elements in current practices, environments and interactions that influence families and communities.

Adolescent Perceptions of Teen Suicide: Implications from Focus Groups

Adolescent suicide is a growing public health concern. This research explores adolescent perceptions of suicide to identify potential focus areas for future prevention programming. This qualitative study utilized focus groups with 14 high school students. Thematic analysis was used to capture key concepts. Salient themes included: “Deciding whether suicide risk is real,” which spoke to the challenge in interpretating suicide-referencing language, and “Desire to engage in more conversations about mental health and suicide,” which suggested more potential benefit than detriment associated with explicit discussions with adolescents. Adolescents also identified the need for an alternative, “in between” adult contact who is not a school-affiliated counselor or a parent. These findings suggest adolescents may benefit from suicide prevention programming that emphasizes exchange and dialogue rather than just didactic instruction. Adolescent concerns about confidentiality may be addressed through use of K-12 partnerships with universities for mental health services provision.

Digital Beacons of Hope? The Challenges and Potentials of Digital Health Applications for Children and Adolescents with Mental Disorders in Germany

Digital Beacons of Hope? The Challenges and Potentials of Digital Health Applications for Children and Adolescents with Mental Disorders in Germany Abstract: With the Digital Healthcare Act, Germany has taken a decisive step toward promoting high-quality, evidence-based digital health applications (DiHAs). Presently, there is a significant gap in the provision of mental health services throughout Germany, particularly regarding children and adolescents and especially in the aftermath of the COVID-19 pandemic. DiHAs as low-threshold, location- and time-independent additional mental health services - may offer a way to address this situation. Particularly in the emerging generation of digital natives, there is a high demand for digital mental health services. However, despite the rapidly growing supply of DiHAs for adults, there is a lack of approved DiHAs for children and adolescents with mental disorders. Rather, the demand for care is left to the unregulated market of diverse internet- and mobile-based interventions; early studies have questioned the evidence base, safety, and quality. This discrepancy arises from various specific challenges and risks that reduce incentives to develop DiHAs for this particularly vulnerable target group, including (1) limited evidence, (2) high complexity in study execution, (3) high complexity in the development of applications, (4) poorly researched specific risks, and (5) high regulatory requirements. This article discusses these challenges and risks and outlines the perspectives for a high-quality, safe, and evidence-based digital mental healthcare for children and adolescents.

Co-designing the Family Wellbeing Program to Address Mental Health Disparities in a Latino Community: Lessons Learned

Abstract: Background: Latino caregivers caring for children under 5 years old who are under resourced, and underserved may be most vulnerable for experiencing mental health problems. Furthermore, Latino families with young children—during the COVID-19 pandemic—were at particular risk for multiple and concurrent stressors and acute adversities. Objectives: The Family Wellbeing Program (FWP) was designed to strengthen Latino caregivers’ mental health and mental well-being, and facilitate their access to mental health supports and service providers. Methods: Using the principles of community-based participatory research, a university research team and staff from a federally qualified health care center co-developed and implemented the FWP. Pre- and post-implementation focus groups with six staff were conducted and data analysis was guided by the RE-AIM framework. Results: Staff identified implementation challenges related to the pandemic and socioenvironmental factors affecting the reach and participation of Latino families. Staff perceived the program improved caregivers’ help-seeking behaviors, yet suggestions for improving the FWP for Latino caregivers were noted. Staff also discussed implementation strategies to sustain future programming. Conclusions: Implementation strategies along the RE-AIM dimensions were identified to improve the participation of Latino caregivers in future adaptations of the FWP. The implications of this work could show promise for sustaining programs designed to address disparities in mental health among Latino caregivers.

Remote mental health services during the COVID-19 pandemic in Finland and the Netherlands: a qualitative study

BackgroundThe COVID-19 pandemic has increased worldwide mental health conditions, substantially affecting the demand and provision of mental health services. To continue services and safeguard the health and well-being of mental health service users, service providers have responded to the pandemic with the adoption of remote services. The objective of our study was to identify and compare the promoters and challenges of the adoption of remote mental health services experienced by service users in Finland and the Netherlands during the COVID-19 pandemic with help of the FITTE framework.MethodsThe study adopted a qualitative descriptive approach, consisting of in-depth semi-structured interviews with mental health service users in Finland (n = 12) and the Netherlands (n = 13) during the COVID-19 pandemic. Qualitative content analysis with both inductive and deductive approach was utilized, and the extended FITTE framework was applied to identify the factors related to the fit between individual, task, technology, and environment that influenced the adoption of remote services.ResultsOverall, the adoption of remote mental health services during the COVID-19 pandemic involved several promoters related to easy access to mental health services, support for mental health and well-being, and benefits of the home environment such as not having to leave outside for services and having less risk of getting the corona virus. Most of the challenges were related to lack of non-verbal communication, difficulties with expressing oneself and interpreting others, technological issues, the organization of remote services, usability and suitability of services, affinity of the health professional with the provision of remote services, and the safety and security of remote services.ConclusionsWhile remote services are accessible, support our well-being and mental health and protect us against the coronavirus, our findings also show that face-to-face contact was often indispensable when adopting mental health services. Therefore, the design of future mental health services should include both remote and face-to-face delivery. Further research should be done on blended approaches and on ways in which the challenges and development needs which emerged from this study can be tackled to improve remote mental health services.

Development and implementation determinants of competency frameworks for mental health clinicians and service providers working with youth: a scoping review protocol

IntroductionDespite high prevalence, access to mental healthcare for Canadian youth is limited, with less than 20% receiving adequate treatment. Marginalised and at-risk youth face particular challenges, including cultural misunderstandings, long...

Exploring the Health Impact of Intersectional Minority Identity Stressors on Arab Sexual Minority Women Migrants to the United States.

Using an intersectionality lens and the minority stress theory as our theoretical grounding, this qualitative study is the first to examine the mental health of Arab sexual minority women (SMW) migrants to the United States. The study aimed to (1) explore the perceptions and experiences of intersectional minority identity-related life stressors and (2) discern their impact on the mental health of first-generation Arab SMW migrants. From December 2022 to March 2023, we conducted 20 semi-structured interviews with Arab SMW migrants. Guided by principles of community engagement in research, four community advisors, including three Arab SMW migrants and a mental health service provider, assisted in mock interviews, recruitment, and data analysis. This enriched our thematic analysis providing a nuanced understanding of Arab SMW migrant experiences. Participants reflected diverse nationalities, socioeconomic statuses, and religions and identified as lesbian, bisexual, or queer. Our sample included asylum seekers, documented migrants, and non-binary individuals (assigned female at birth). Findings revealed three major themes: (1) Community- and Interpersonal-Level Stressors, (2) Strategies for Coping with Stressors, and (3) Impact of Intersectional Life Stressors on Mental Health. Community- and interpersonal-level stressors included challenges navigating migration-related stressors, rejection and discrimination from the Arab, queer, and dominant-group (i.e., non-Arab, non-White) communities, and experiences of invalidation of their intersectional identities. Coping mechanisms included avoidance, identity concealment, and seeking social support. Participants reported various mental health impacts, from anxiety, depression to suicidal thoughts, emphasizing the urgency for tailored interventions. Participants called for the development of support groups specifically for Arab SMW migrants.

Spatial and Socioeconomic Patterns of Mental Health and Healthcare Utilization in Cologne, Germany.

Children and adolescents are significantly tied to their family's socioeconomic position and living environment. Neighbourhood and the living environment have been identified as potential risk factors for mental disorders in this age group. The aim of the study was to investigate the distribution of mental and behavioural disorders (prevalence) and the provision of mental health services for children and adolescents aged 0-19 years in the city of Cologne. In particular, the study aimed to examine the association of these factors with area deprivation and the availability of mental health services covered by statutory health insurance. Finally, possible spatial variations in these aspects were analysed. Claims data of children and adolescents aged 0 to 19 years included in four statutory health insurance of the year 2021 were analysed. A deprivation index using data on the level of the ZIP code area was calculated. Analyses were carried out descriptively, using ordinary least squares (OLS) and geographically weighted regression (GWR). The prevalence of mental and behavioural disorders in children and adolescents varied across ZIP code areas, with higher rates in the northern, southern, and eastern parts of the city. The results indicated that the use of services by male children and adolescents with a prevalent diagnosis of mental and behavioural disorders was higher in areas with a higher density of healthcare providers. However, prevalence was on the whole lower in areas with a higher density of healthcare providers. In addition, the density of health care providers was higher in the city centre with comparatively lower deprivation. These results indicate inadequate access to care for children and young people outside the city centre. However, due to the heterogeneity of the population in these areas, this study provides only preliminary insights. Data with a finer geographic resolution are needed for further research in order to analyse the association further.

A Retrospective Study of Cat Hoarding Cases and Their Management Through Voluntary Spay/Neuter and Relinquishment In New York City

Introduction: Animal hoarding cases are complex sources of shelter intake. Cases require significant planning, collaboration, and resources, often from multiple responding organizations. Study objectives included description of cat hoarding cases in New York City not criminally pursued, case outcomes when managed by a spay/neuter and relinquishment program utilizing a collaborative approach with caregivers, and characteristics or interventions leading to better outcomes. Methods: Data were extracted from the American Society for the Prevention of Cruelty to Animal’s Community Engagement (CE) case files. Eligible cases were retrieved using a keyword search and screened for inclusion criteria. Client demographics, case factors, and outcomes were described with descriptive statistics. Data were further analyzed using adjusted logistic regression models to investigate variables predictive of outcomes. Results: The study population included 79 cases with a median population size of 22 cats. The majority of clients were female, lived alone, and had high levels of social vulnerability. Object hoarding was reported in 29.1% of cases and unsanitary conditions in 68.4% of cases. Almost one-third (30.4%) identified as rescuers or community cat caregivers. At the time of the first interaction with CE, 88.6% of clients were interested in spay/neuter and 76.0% in surrender services. Social service agencies were involved in the initial CE intervention in 26.4% of cases. Successful outcomes were defined as cases in which clients were left with a manageable population of cats, or all cats were removed. Successful outcomes were achieved in 67.1% of cases after the first CE intervention. Recidivism occurred in 41.5% of these cases. Clients who showed an initial interest in surrender were 10 times more likely (OR 10.0, P = 0.014) to experience a successful outcome than clients not interested in surrender. Significant predictors of re-collection included clients identifying as rescuers (OR 4.8, P = 0.039) and the involvement of human service agencies during or after the CE intervention (OR 6.1, P = 0.041). Conclusion: Results demonstrate animal hoarding cases involving cooperative caregivers and rescuers can be successfully managed by programs using a collaborative approach with clients. The high rates of initial interest in spay/neuter and surrender in caregivers suggest a need to expand access to veterinary care and strategically manage case intake into shelters. Further interdisciplinary research is needed on how mental health, social service, and animal service providers can attain successful outcomes long-term and reduce recidivism in animal hoarding cases.

Emotional Distress and Access to Mental Healthcare Among First-Generation College Students During the Onset of the COVID-19 Pandemic

ABSTRACT The shift to remote learning during the COVID-19 pandemic presented significant mental health challenges for college students, particularly for students with minoritized identities. The current study used quantitative and qualitative methods to examine how psychological distress and barriers to mental healthcare shifted for first-generation college students (FGCS) as the pandemic affected campuses in Spring 2020. FGCS across three college settings (N = 314) responded to surveys in December 2019 and again following the onset of the pandemic in May/June 2020. A sub-sample of 28 participants also provided in-depth interviews . Results showed an increase in depressive symptoms and perceived stress following the onset of the pandemic, with Latinx and female FGCS reporting greater increases in stress compared to other groups. FGCS were significantly less confident in their knowledge about where to seek mental health support following the onset of the pandemic, and mental healthcare utilization dropped significantly as well. Interviews highlighted specific stressors contributing to mental health, as well as key barriers to mental healthcare that intensified during the pandemic. These findings inform our understanding of the mental health needs of college students with minoritized identities, and have implications for policies and procedures around provision of mental health services on university campuses.