Training Of Mental Health Professionals Research Articles

5.58 INITIATIVE TO REDUCE THE WAITING TIMES OF “URGENT” REFERRALS IN A CHILD AND ADOLESCENT PSYCHIATRY OUTPATIENT CLINIC IN A TERTIARY CARE CENTER IN QATAR

Qatar is a small Gulf state on the northeastern coast of the Arabian Peninsula. With a population of approximately 3.1 million, a significant demand for mental health services exists in the country. There is limited availability of trained mental health professionals, which has resulted in long waiting times for child and adolescent psychiatry patients in Sidra Medicine, a tertiary care hospital affiliated with Weill Cornell Medicine–Qatar.

The current status of gender-sensitive mental health services for women-findings from a global survey of experts.

Integrating gender in all aspects of health services is important and mental health is no exception. Despite several recommendations regarding the need for gender-sensitive mental health services, the actual availability of these is not clear, both in high and low-income countries. We sought to understand what aspects of gender-sensitive mental health care were considered a priority by global experts in women's mental health and how satisfied they were with the current availability of these services in their own place of work. A survey with 43 items under 7 domains of gender-sensitive mental health care for women was sent to 150 experts in women's mental health across the world, of whom 73 responded. Rating on each item was from 0 to 5. While majority of the experts rated most of the items as being very important (median score of 4 and above), some areas that were considered most important included training of mental health professionals in gender sensitivity, having private spaces for examination, using a life course approach to service planning and delivery, and assisting women who find it difficult to navigate the system and mother-baby units. However, satisfaction rates with available services were quite low overall and much lower among experts in low-income countries compared with those from high-income countries. Even in high-income countries, only 6 of the top 20 items were scored as satisfactory by at least 50% of experts. This expert survey method to arrive at consensus on top priorities for improving delivery of gender-sensitive mental health care indicates that at least 72% of the items provided in the survey were considered extremely important. Poor satisfaction of experts in both high- and low-income countries with availability of gender-sensitive services indicates the need for local and global strategic action and multilevel stakeholder engagement.

Training of psychiatrists in Eastern Europe: problems and solutions

The analysis of the training of mental health professionals in WPA Zone 10 was performed based on a comparison of data of a specifically designed questionnaire comprising 29 questions on undergraduate education, 34 questions on postgraduate training, and six questions on training of general practitioners to work in the field of mental health. The project involved National Associations of psychiatrists of Armenia, Azerbaijan, Belarus, Georgia, Kazakhstan, Kyrgyzstan, Russian Federation, Uzbekistan, and Ukraine. This comparison provides an opportunity to identify ways to improve psychiatric training in Eastern Europe.

Examining Depression Among Perpetrators of Intimate Partner Homicide.

Male depression has been recognized as an important factor in some cases of intimate partner violence but there is a paucity of literature connecting depression and intimate partner homicide (IPH). This retrospective study provides a preliminary analysis that distinguished depressed from nondepressed perpetrators of IPH from a sample of 135 cases analyzed by a coroner's homicide death review committee in Ontario, Canada. Depressed perpetrators were more likely to commit homicide-suicide and had almost 1.5 times the number of risk factors present than nondepressed perpetrators. Consistent with the existing literature, the results indicated that depressed perpetrators were significantly older, more likely to commit homicide-suicide than homicide only, more likely to have prior threats or attempts of suicide, more likely to have been abused or witnessed domestic violence as a child than nondepressed perpetrators and more likely to exhibit sexual jealousy. The implications for these findings are outlined in terms of training of mental health professionals and public awareness about the potential lethality of domestic violence.

Evaluation of therapeutic relationship skills training for mental health professionals: the Therapeutic Relationship Enabling Programme (TREP).

This article was migrated. The article was marked as recommended. Background: A 3-day workshop in Taiwan, developed in accordance with Carl Rogers' person-centred theory, used an experiential-learning pedagogy and a helping learning technology mPath. This study aimed to evaluate the effectiveness of a short-term course for mental health professional students assessing to the acquisition of therapeutic relationship competencies. Objective:To evaluate the training effects and investigate any changes in the level of therapeutic relationship competence of the participants before, at the end and two weeks after the intervention. Methods:A sample of 59 mental health professional students from 7 medical schools studying in nursing, occupational therapy, medicine, clinical psychology and other specialities with the completion of psychiatry-relevant courses. 26 of 59 mental health professional students volunteered to form the experimental group, and the controls were recruited using the snowball sampling technique. All of them completed the Barrett-Lennard Relationship Inventory OS-40 three times. Mean values and statistical significance tests were computed to compare the results. Results:Within 3 days, the mental health professional students in the experimental group (N=26) completed the Therapeutic Relationship Enabling Programme (TREP) and showed a statistically significant level of change (Mean Difference= +9.5, p= 0.002), which was in contrast to the outcome of the control group (N=33, Mean Difference= +0.18, p= 0.683), in the therapeutic relationship competences. The effecting growth curve of therapeutic relationship competence in the experimental group continually inclined two weeks after the intervention (Mean Difference= +19.423, p= 0.000) while the control group reflected a decline in therapeutic relationship competence (Mean Difference= -0.515, p= 0.812). Conclusions: A person-centred-theory-based training workshop with the use of a specially designed technology enhanced Taiwanese mental health professional students' learning on therapeutic relationship competences. A further investigation into learning person-centred therapeutic relationship qualities in the workshop as an innovative pedagogy and learning approach for medical education would be recommended.

Seattle lawmakers approve plan to fix mental health system

Washington legislators took substantial steps to reshape the mental health system, including funding for new facilities, legislation to increase the number of qualified workers and the creation of new types of treatment centers, The Seattle Times reported. Lawmakers approved the plan — which sprawls across two different state budgets, as well as several other bills — in the legislative session that ended April 28. The work comes after years of court orders and federal inspections that meticulously documented the poor treatment of psychiatric patients in the state's care, as well as a steep shortage of treatment beds and staffers to operate them. “The 2019–21 capital‐construction budget spends roughly $33 million for predesign and design of a new behavioral health teaching hospital at the University of Washington. The facility would train mental health professionals while also providing as many as 150 treatment beds.

The Illinois EMSC Pediatric Preparedness Checklist - An Innovative Approach to Improving Pediatric Disaster Planning and Preparedness in Chicago

Introduction:The Illinois EMSC Pediatric Facility Recognition Program was implemented in 1998. The objective was to identify the capability of a hospital to provide optimal pediatric emergency and critical care. Beginning in 2004, steps were taken to integrate pediatric disaster preparedness into the facility recognition process.Aim:The goal of this study was to identify strengths and areas for improvement in pediatric disaster preparedness in participating Chicago hospitals.Methods:The impact of the EMSC Pediatric Preparedness Checklist was assessed during the 2016 Pediatric Facility Recognition hospital site surveys. The following components were surveyed as they relate to pediatrics: Overall Emergency Operations Plan (EOP), Surge Capacity, Decontamination, Reunification/Patient Tracking, Security, Evacuation, Mass Casualty Triage/JumpSTART, Children with Special Health Care Needs/Children with Functional Access Needs, Pharmaceutical Preparedness, Recovery, Exercise/Drills/Trainings. All survey items were extracted, collated, and reviewed.Results:Fourteen Chicago hospitals participated in the survey. Almost all hospitals (93%) surveyed indicated that they consult staff with pediatric expertise when updating their EOP, incorporate pediatric trained mental health professionals into their disaster call lists (93%), and integrate staff with pediatric focus into their incident command system/emergency operation center during a disaster (79%). Almost all of the hospitals (93%) had an infant/child abduction plan and all hospitals (100%) were testing the process at least once per year. Finally, almost all of the hospitals (93%) had incorporated a patient connection program into their tracking and reunification plan. However, not all hospitals included drills for pediatric surge, decontamination, and evacuation. Less than one-third of the hospitals had pediatric components in their alternate treatment site plans. Half of the hospitals did not have pediatric components incorporated into their decontamination plans.Discussion:Integrating the EMSC Pediatric Preparedness Checklist surveys into the recognition process is an innovative approach to improve pediatric disaster planning and preparedness in hospitals.

Transdiagnostic Mobile Health: Smartphone Intervention Reduces Depressive Symptoms in People With Mood and Psychotic Disorders.

BackgroundDepression is the most prevalent mental health problem. The need for effective treatments for depression far outstrips the availability of trained mental health professionals. Smartphones and other widely available technologies are increasingly being leveraged to deliver treatments for depression. Whether there are patient characteristics that affect the potency of smartphone interventions for depression is not well understood.ObjectiveThis study aimed to evaluate whether patient characteristics including clinical diagnosis, depression severity, psychosis status, and current use of antidepressant medications impact the effects of an evidence-based smartphone intervention on depressive symptoms.MethodsData were collected as part of a 2-arm randomized controlled trial comparing a multimodal smartphone intervention called FOCUS with a clinic-based intervention. Here, we report on 82 participants assigned to 12 weeks of FOCUS treatment. We conducted assessments of depressive symptoms using the Beck Depression Inventory-second edition (BDI-II) at baseline, postintervention (3 months), and follow-up (6 months). We tested for differences in the amount of improvement in BDI-II scores from baseline to posttreatment and 6-month follow-up between each of the following patient subgroups using 2 (group) × 2 (time) mixed effects models: diagnosis (ie, schizophrenia spectrum disorder vs bipolar disorder vs major depressive disorder), depression severity (ie, minimal-mild vs moderate-severe depression), psychosis status (ie, presence vs absence of psychotic symptoms), and antidepressant use (ie, taking antidepressants vs not taking antidepressants).ResultsThe majority of participants were male (60%, 49/82), African American (65%, 53/82), and middle-aged (mean age 49 years), with a high school education or lower (62%, 51/82). There were no differences in patient demographics across the variables that were used to stratify the analyses. There was a significant group × time interaction for baseline depression severity (F1,76.8=5.26, P=.02 [posttreatment] and F1,77.4=6.56, P=.01 [6-month follow-up]). Participants with moderate or severe depression had significant improvements (t42=3.20, P=.003 [posttreatment] and t42=4.20, P<.001 [6-month follow-up]), but participants with minimal or mild depression did not (t31=0.20, P=.84 [posttreatment] and t30=0.43, P=.67 [6-month follow-up]). There were no significant group × time interactions for diagnosis, psychosis status, or antidepressant medication use. Participants with minimal or mild depression had negligible nonsignificant improvements (<1 point on the BDI-II). Reduction in depression in all other groups was larger (range 1.7-6.5 points on the BDI-II).ConclusionsOur results suggest that FOCUS can be deployed to treat moderate to severe depressive symptoms among people with schizophrenia spectrum disorders, bipolar disorder, and major depressive disorder, in concert with antidepressant medications or without them, in both people with and without active psychotic symptoms. The study results are consistent with research on transdiagnostic models in psychotherapy and extend our knowledge about the potential of transdiagnostic mobile health.Trial RegistrationClinicalTrials.gov NCT02421965; http://clinicaltrials.gov/ct2/show/NCT02421965 (Archived by WebCite at http://www.webcitation.org/76pyDlvAS)

Service user involvement in cognitive behavioural therapy training: an interpretive phenomenological analysis

PurposeThe last two decades have seen an increase in service user involvement (SUI) in the training of Mental Health Professionals (MHP). There is developing empirical support for SUI in MHP training, however, there is no published research into SUI in the training of Cognitive Behavioural Therapists. The purpose of this paper is to explore cognitive behavioural therapy (CBT) trainees’ experience of SUI in their training. The study focuses on how an individual service user (SU) led training session is experienced and how this differs to routine CBT training.Design/methodology/approachSemi-structured interviews were conducted with six participants. Transcripts of the interviews were analysed using interpretative phenomenological analysis.FindingsData revealed three superordinate themes: first, predisposing influences on learning; second, factors associated with emotional processing of experience; and third, impact upon learning outcomes. The results suggest that participants’ appraisal of their learning from SUI maybe influenced by how they accommodate the emotional impact of the experience.Originality/valueThe paper makes recommendations for educators on courses involving service users (SUs), acknowledges the study’s methodological limitations and suggests areas for future research.

Now they’re listening: involvement in clinical psychology training

PurposeThe 2014/2015 UK requirement for involvement of service users and carers in training mental health professionals has prompted the authors to review the work of involvement in clinical psychology training in the university programme. Have the voices of service users and carers been heard? The paper aims to discuss this issue.Design/methodology/approachThe authors update the paper of 2011 in which the authors described the challenges of inclusion and the specific approaches the authors take to involvement. The authors do this in the context of the recent change to UK standards for service user and carer involvement, and recent developments in relation to partnership working and co-production in mental healthcare. The authors describe the work carried out by the authors – members of a service user involvement group at a UK university – to ensure the voices of people affected by mental health difficulties are included in all aspects of training.FindingsCareful work and the need for dedicated time is required to enable inclusive, effective and comprehensive participation in a mental health training programme. It is apparent that there is a group of service users whose voice is less heard: those who are training to be mental health workers.Social implicationsFor some people, involvement has increased. Trainee mental health professionals’ own experience of distress may need more recognition and valuing.Originality/valueThe authors are in a unique position to review a service-user-led project, which has run for 12 years, whose aim has been to embed involvement in training. The authors can identify both achievements and challenges.

Assessing Social Anxiety in Japanese and Japanese-Americans in the United States

A Social Anxiety Scale designed to assess culture-specific symptoms in Japanese clients was assessed for face validity data. Taijin-Kyofusho is a culture-bound syndrome specific to Japanese culture in the DSM-5. A Social Anxiety Scale (SAS) was designed by the first author from existing Western social anxiety scales and a Taijin-Kyofusho scale. A demographic form yielded information about culturally- knowledgeable clinician respondents, and a questionnaire was used to get feedback on the SAS. Responses were obtained from 27 mental health professionals who worked clinically with Japanese legal residents in the United States and Japanese Americans, regarding culturally appropriate social anxiety assessment. Participants perceived the SAS as comprehensive and applicable to Japanese residents and Japanese Americans. Regarding Taijin-Kyofusho, most agreed that it should be assessed in Japanese residents but were undecided about its clarity and applicability to Japanese Americans. Several concerns were expressed about the validity of Western social anxiety scales for these populations. Most stressed the need for contextualization of social anxiety scales, differences in stigma against mental disorders across ethnicities, and the need for sensitivity of mental health professions to LGBTQ members in these populations. This is the first study on the views of clinicians working with these populations about Taijin-Kyofusho and how to assess anxiety. Nuances between Japanese residents and Japanese Americans were noted. We urge incorporation of cultural differences in manifestations of distress and specifically on Taijin-Kyofusho in training for mental health professionals. The purpose of this paper is to report on the first step in development of a culturally appropriate social anxiety scale for Japanese and Japanese-Americans living in the United States (U.S.). We first review the literature on differences in anxiety presentation across U.S. and Japanese cultures. We then report on feedback from culturally knowledgeable clinicians of the new scale, and specifically on the question of whether Taijin-Kyofusho symptoms should be included.

Are Older Adults Unique? Examining Presenting Issues and Changes in Therapy Across the Life Span

With the urgent need to increase and improve mental health care of the growing population of older adults in the United States, clinical research is warranted to further the knowledge and improve the relevant training for mental health professionals working with older adults. This study drew from two diverse clinical samples of adults ages 18 years to 80 years to examine whether and how initial clinical presentations and changes over time in individual, family-of-origin, and relational measures differed across the life span. Results indicated a variety of linear and curvilinear associations between individual, family-of-origin, and relational measures at intake and age, with some moderation by gender. There were no significant results between the amount of change on those measures and age, indicating that older adults may change in similar fashion to middle-aged and younger adults in psychotherapy. Relevant clinical implications are provided.

3.29 Increasing Child Trauma Competence Among Mental Health Providers Through a Problem-Based Learning Approach

Curricula for training mental health professionals, including child and adolescent psychiatrists, on the complex impact of child trauma are limited. To address this issue, the National Child Traumatic Stress Network (NCTSN) developed the Core Curriculum on Childhood Trauma (CCCT), which incorporates 12 core concepts into child trauma case studies delivered to mental health professionals through a problem-based learning (PBL) approach. Primary CCCT learning objectives include using the core concepts to frame information, guiding critical reasoning, supporting case conceptualization, judging relative impact of factors, communicating effectively with stakeholders, and improving professional practice. The UCLA National Center for Child Traumatic Stress and the National Child Trauma Workforce Institute (NCTWI) at Hunter College are collaborating to develop a corps of CCCT facilitators and disseminate the CCCT across mental health disciplines nationwide, including child psychiatry. This analysis examines impact of this professional training.

Longitudinal assessment of an anti-stigma campaign related to common mental disorders in rural India

Stigma related to mental health and lack of trained mental health professionals is a major cause for an increased treatment gap, particularly in rural India. The Systematic Medical Appraisal, Referral and Treatment (SMART) Mental Health project delivered a complex intervention involving task sharing, an anti-stigma campaign and use of technology-based, decision-support tools to empower primary care workers to identify and manage depression, anxiety, stress and suicide risk.AimsThe aim of this article is to report changes in stigma perceptions over three time points in the rural communities where the anti-stigma campaign was conducted. A multimedia-based anti-stigma campaign was conducted over a 3-month period in the West Godavari district of Andhra Pradesh, India. Following that, the primary care-based mental health service was delivered for 1 year. The anti-stigma campaign was evaluated in two villages and data were captured at three time points over a 24-month period (N = 1417): before and after delivery of the campaign and after completion of the health services delivery intervention. Standardised tools captured data on knowledge, attitude and behaviour towards mental health as well as perceptions related to help seeking for mental illnesses. Most knowledge, attitude and behaviour scores improved over the three time points. Overall mean scores on stigma perceptions related to help seeking improved by -0.375 (minimum/maximum of -2.7/2.4, s.d. 0.519, P &lt; 0.001) during this time. Loss to follow-up was 10%. The data highlight the positive effects of an anti-stigma campaign over a 2-year period.Declaration of interestNone.

Adult Transgender Care: An Interdisciplinary Approach for Training Mental Health Professionals

Adult Transgender Care: An Interdisciplinary Approach for Training Mental Health Professionals

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

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

Discordance between self-report and clinical diagnosis of Internet gaming disorder in adolescents

This study aimed to estimate overreporting (the false positive) and underreporting (false negative) rates in self-reported IGD assessment compared with clinical diagnosed IGD. The study population consisted of 45 with IGD and 228 without IGD based on clinical diagnosis from the Internet User Cohort for Unbiased Recognition of Gaming Disorder in Early Adolescence (iCURE) study. All participants completed self-reported IGD assessments. Clinical interviews were conducted blindly by trained mental health professionals based on DSM-5 IGD criteria. Self-assessed average daily amount of gaming time and game genre were measured. Psychological characteristics, including anxiety, suicidality, aggression, self-control, self-esteem, and family support, were obtained from the baseline survey. The false-negative rate for self-reported IGD assessment was 44%. The false-negative group reported less time playing online games than the IGD group, though their psychological characteristics were similar to those of the IGD group. The false-positive rate was 9.6%. They reported more time playing online games than non-IGD group, though their psychological characteristics were similar to those of non-IGD group except self-control. The discrepancy of IGD diagnoses between self-reports and clinical diagnosis revealed limitations of self-measurements. Various strategies are required to overcome the methodological shortfalls of self-reports for the assessment of IGD.

Providing Mental Health Services in the Primary Care Setting: the Experiences and Perceptions of General Practitioners at a New York City Clinic.

Mental illness is a significant cause of disability worldwide, including here in the United States. Given the shortage of trained mental health professionals, a significant portion of patients needing care are managed in the primary care setting. Accountable Care Organizations (ACOs), for example, are seeking to improve the quality ofcare for this vulnerable population, but many are facing significant challenges relating to integration of new services. We sought to elucidate barriers faced by primary care practitioners (PCPs)-physicians, physician trainees and nurse practitioners-at a New York primary care clinic, which impede delivery of optimal care to those suffering from mental illness. The study was conducted with 32 PCPs in 2016-2017 at Mount Sinai Internal Medicine Associates in New York City. For the quantitative component of the study, a 54-item questionnaire was devised to assess their attitude, behavior and confidence in managing psychiatric patients. For the qualitative component, data was obtained from 3 open-ended questions. Responses were coded for salient themes. Analysis revealed a range of difficulties faced by PCPs. Overall, participants felt that the need to integrate mental health care into primary care was important, however they reported significant barriers in terms of lack of time, lack of resources, low confidence in treating more complex mental health conditions and difficulties with referring patient to mental health specialists. Despite a growing body of evidence that integration of mental health services in primary care leads to improved outcomes, addressing barriers to care will be key to ensuring feasibility of integration measures.

Barriers and Facilitators to Effective Mental Health Care in Correctional Settings.

It is estimated that one third to one half of the 2.3 million individuals inside U.S. jails and prisons have a mental illness in contrast to 18.3% of the general population. The implications of this on training mental health professionals to provide efficacious treatment inside correctional facilities, as well as planning for the rehabilitation and reintegration of incarcerated individuals, are significant and numerous. This article will present a brief history and overview of mental health services in the U.S. correctional system, as well as a discussion of the barriers to and potential facilitators of providing effective care in the future.

Communication skills training for mental health professionals working with people with severe mental illness

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