Types Of Mental Health Services Research Articles

Mental Health Service Use Among Adults With Suicide Ideation, Plans, or Attempts: Results From a National Survey.

Despite the existence of efficacious interventions that reduce suicide risk, connecting high-risk individuals with care remains a problem. Little is known about factors that may be associated with service use and nonuse among suicidal adults. This study aimed to identify correlates of mental health service use among adults reporting past-year ideation, plans, or attempts. Data from the 2013 National Survey on Drug Use and Health (NSDUH) were analyzed to identify correlates of mental health service use among a nationally representative sample of adults reporting past-year suicide ideation (N=2,126), plans (N=690), or attempts (N=345). Findings were compared with results for individuals reporting no past-year suicidality (N=35,106). Approximately 50% of adults with past-year ideation, plans, or attempts reported contact with any type of mental health services in the past year. Individuals who were more likely to have connected with services in the past year included females, non-Hispanic whites, those in worse general medical health, and those with a more severe clinical picture (that is, presence of serious psychological distress or a past-year diagnosis of a major depressive episode). Among the groups with suicide ideation, plans, or attempts, no significant differences in service use emerged between veterans and nonveterans or between married and nonmarried individuals. Findings underscore the low rates of service use among adults at elevated risk of suicide and reveal possible avenues by which to increase treatment engagement in this population. Additional research is warranted to examine correlates of service use within a prospective design.

Racial–Ethnic Variation in Mental Health Service Utilization Among People with a Major Affective Disorder and a Criminal History

Using a nationally representative sample, this study examined the extent to which the utilization of various mental health services was associated with racial-ethnic identity among people with major affective disorders who have a criminal history. Approximately 33.7% of the sample received any type of mental health services in a given year. Multivariate models indicated that married Blacks and Latinos were less likely to use specialty mental health care than their white counterparts. To provide equitable mental health treatment for vulnerable subgroups of this population, mental health professionals should account for the heterogeneity of mental health care in diverse cultural contexts.

Mental health and social service needs for mental health service users in Japan: a cross-sectional survey of client- and staff-perceived needs

BackgroundThe appropriate utilization of community services by people with mental health difficulties is becoming increasingly important in Japan. The aim of the present study was to describe service needs, as perceived by people with mental health difficulties living in the community and their service providers. We analyzed the difference between two necessity ratings using paired data in order to determine implications related to needs assessment for mental health services.MethodsThis cross-sectional study used two self-reported questionnaires, with one questionnaire administered to mental health service users living in the community and another questionnaire to staff members providing services to those users at community service facilities. The study was conducted in psychiatric social rehabilitation facilities for people with mental health difficulties in Japan. The paired client and staff responses rated needs for each kind of mental health and social service independently. The 19 services listed in the questionnaire included counseling and healthcare, housing, renting, daily living, and employment. Overall, 246 individuals with mental health difficulties were asked to participate in this study, and after excluding invalid responses, 188 client-staff response dyads (76.4% of recruited people, 83.6% of people who gave consent) were analyzed in this study. A Wilcoxon matched-pairs signed rank test was used to compare the perceived needs, and weighted and unweighted Kappa statistics were calculated to assess rating agreement within client-staff dyads.ResultsOver 75% of participants in our study, who were people with mental health difficulties living in the community, regarded each type of mental health service as “somewhat necessary,” or “absolutely necessary” to live in their community. Most clients and staff rated healthcare facilities with 24/7 crisis consultation services as necessary. Agreement between client and staff ratings of perceived needs for services was low (Kappa = .02 to .26). Services regarding housing, renting a place to live, and advocacy had the same tendency in that clients perceived a higher need when compared to staff perceptions (p < .01).ConclusionsIt is essential for the service providers to identify the services that each user needs, engage in dialogue, and involve clients in service planning and development.Electronic supplementary materialThe online version of this article (doi:10.1186/s13033-015-0009-7) contains supplementary material, which is available to authorized users.

Patterns of Use in Mental Health Specialised Care: Treated Prevalence in the Portuguese Mental Health Services

1. Introduction As stated by WHO in 2003 the perspective in which services are organised helps to define the effectiveness not only of care but also of access to care. Mental Health Services organisation should be based on principles of accessibility, coordination, continuity, effectiveness and equity of care, in a clear respect for human rights. To do this, service planners and providers have to determine the exact mix of different types of mental health services and the treatment gap levels. 2. Objectives 1. Estimate the treated prevalence of mental disorders in the mental health specialised services. 2. Estimate the existing treatment gap. 3. Methods An analysis of the patterns of use in mental health secondary care services was made using data from the national information health system, compiled by the Directorate General of Health - Information Analysis Unit. 4. Results 22.146 patients were treated in the specialised services for mental health disorders, in 2013. This group represents 1,43% of the total patients treated for all health problems and 0,21% of total population. Average length of stay was 16,46 days. Depression was the main diagnosis in 33% of all patients treated, representing 22% of total inpatient days. 5. Conclusion Taking in account that the global annual prevalence of mental disorders in Portugal is 22,9% and that 6,3% are severe mental disorders, there is still a big treatment gap in Portugal. In addition, depression still accounts for a substantial proportion of patients treated in the specialised services inpatient units.

The Management and Control of Chronic Physical and Mental Disorders Among Older Adults in the United States.

Objectives: Explores significant differences in types of mental health facilities accessed by and services received by elderly in the United States as compared with the total population, how frequently chronic disease management needs are met, and variance by state. Methods: Secondary analysis of the National Mental Health Services Survey (N-MHSS), 2010, of 15,562 facilities in the United States comparing the type of mental health services used by the elderly to the general population. Results: The highest proportion of patients 65 and older in residential treatment was in General Hospitals (17% were elderly) and by the Veteran’s Affairs (VA; 15% were elderly). Discussion: General Hospitals and the VA system need to prepare for the increase in the number of patients with mental illnesses and diminished capacity who are simultaneously being treated for chronic conditions. Coordinated care of patients with these comorbidities is needed.

Mental Health Service Use Among Youth with Mental Health Need: Do School-Based Services Make a Difference for Sexual Minority Youth?

Evidence suggests that despite higher rates of mental health service use, sexual minority youth (SMY) have greater unmet mental health need than peers. Using a representative subsample of students with a mental health need from the National Longitudinal Study of Adolescent Health (n = 8,034), a multilevel analysis was conducted to explore whether: (1) Availability of school mental health services affects the odds that youth with a mental health need will use mental health services; and whether (2) sexual minority status (SMS) interacts with availability of school mental health services to moderate the relationship between SMS and mental health service use. SMY accounted for 10.3 % (n = 766) of the subsample. Mental health need was defined using measures for physical and sexual victimization, anxiety, depression, and suicidality. A hierarchical logistical regression tested for cross-level interaction (SMS × school mental health services). SMY had 82 % higher odds of using mental health services in any sector than their heterosexual peers (OR = 1.82, p < .001). Overall, youth with a mental health need had 40 % higher odds of using any type of mental health services if they attended schools offering mental health services (OR = 1.40, p < .001). The cross-level interaction test between SMS and service use was nonsignificant. Model-predicted probabilities are presented to better understand the findings. School-based mental health services are a crucial gateway to mental health service use in any sector for youth with a mental health need regardless of SMS.

Interventions for family members of adolescents with disruptive behavior disorders.

The family members of adolescents diagnosed with disruptive behavior disorders (DBDs) experience profound stress and burden. Despite the need for empirically supported interventions that address the challenges faced by these family members, few such interventions are available. In this qualitative descriptive study, we conducted in-depth interviews with 15 families of adolescents diagnosed with DBD. We asked the family members to identify what types of mental health services they needed and to describe the "ideal" program that would best address their concerns. Family members identified several intervention modalities that would fit their needs, including multifamily groups, family therapy, individual therapy, and community-based hotlines. They indicated that programs should address the following topics: family communication, conflict resolution, education about DBD, and strategies to improve interactions with child service agencies. Clinicians should recognize that all family members may need support to manage the stressors associated with caring for or living with adolescents with DBD. When working with families, clinicians should provide information about the etiology and management of DBD, help navigate interactions with child service agencies, and employ strategies to improve family communication and functioning.

Suicidal Behaviors and the Use of Mental Health Services Among Active Duty Army Soldiers

U.S. Army personnel experience a significant mental health burden, particularly during times of war and multiple deployments. This study identified rates of suicidality (seriously considering or attempting suicide) and types of mental health services used in the past 12 months by active duty Army soldiers. This study used the 2008 Department of Defense Survey of Health Related Behaviors Among Active Duty Military Personnel, which sampled 10,400 Army soldiers from a total population of 508,088 soldiers. Mental health service utilization included receiving counseling or therapy from a general medical doctor, receiving counseling or therapy from a mental health professional, and being prescribed medications for depression, anxiety, or sleep. Suicidality was assessed via self-report questions. Thirteen percent had seriously considered or attempted suicide at some point in their lives, 7% since joining the military. One percent who reported suicidality since joining the Army reported having considered or attempted suicide in the past year. After the analyses adjusted for sociodemographic factors, soldiers who seriously considered or attempted suicide since joining the military versus those who did not were 1.71 times more likely to have used a mental health service, 2.33 times more likely to have used two or more types of services, 1.82 times more likely to have seen a mental health specialist, and 1.67 times more likely to have received medication in the past year. Understanding the relationship between suicidal thoughts and behaviors and the specific levels and types of mental health services received in this military population is important for health care provision and planning.

Provision of Mental Health Services as a Quality Indicator for Adolescent Substance Abuse Treatment Facilities

The study tested whether adolescents receiving substance abuse treatment at facilities offering full (can treat all psychiatric conditions) or partial (cannot treat severe or persistent mental illness) mental health services have better 12-month substance use and mental health outcomes than youths at facilities with no mental health services. Data were collected from 3,235 adolescents who were assessed at baseline and at 12 months at one of 50 adolescent treatment facilities. Propensity scores were applied to compare client outcomes from three types of facilities (full, partial, or no mental health services); weighted linear models were estimated to examine outcomes. Youths attending facilities offering full or partial mental health services had better substance abuse treatment outcomes than youths attending facilities offering no such services. There was no evidence of a difference in substance use outcomes between facilities offering full versus partial services, nor was there evidence of differences in mental health outcomes. These preliminary findings suggest that the availability of mental health services may be a useful quality indicator for adolescent substance abuse treatment facilities. More research is needed to examine specific types of mental health services offered at different facilities.

Clarifying the role of the mental health peer specialist in Massachusetts, USA: insights from peer specialists, supervisors and clients

Mental health peer specialists develop peer-to-peer relationships of trust with clients to improve their health and well-being, functioning in ways similar to community health workers. Although the number of peer specialists in use has been increasing, their role in care teams is less defined than that of the community health worker. This qualitative study explored how the peer specialist role is defined across different stakeholder groups, the expectations for this role and how the peer specialist is utilised and integrated across different types of mental health services. Data were collected through interviews and focus groups conducted in Massachusetts with peer specialists (N = 44), their supervisors (N = 14) and clients (N = 10) between September 2009 and January 2011. A consensus coding approach was used and all data outputs were reviewed by the entire team to identify themes. Peer specialists reported that their most important role is to develop relationships with clients and that having lived mental health experience is a key element in creating that bond. They also indicated that educating staff about the recovery model and peer role is another important function. However, they often felt a lack of clarity about their role within their organisation and care team. Supervisors valued the unique experience that peer specialists bring to an organisation. However, without a defined set of expectations for this role, they struggled with training, guiding and evaluating their peer specialist staff. Clients reported that the shared lived experience is important for the relationship and that working with a peer specialist has improved their mental health. With increasing support for person-centred integrated healthcare delivery models, the demand for mental health peer specialist services will probably increase. Therefore, clearer role definition, as well as workforce development focused on team orientation, is necessary for peer specialists to be fully integrated and supported in care teams.

Change, Challenge, and Opportunity: Psychiatry in the Age of Health Care Reform

Change, Challenge, and Opportunity: Psychiatry in the Age of Health Care Reform

Behavioral Predictors of Outpatient Mental Health Service Utilization Within 6 Months After Traumatic Brain Injury in Adolescents

To characterize utilization of mental health services and determine the ability of a behavior problem and clinical functioning assessment to predict utilization of such services within the first 6 months after moderate and severe traumatic brain injury in a large cohort of adolescents. Multicenter cross-sectional study. Outpatient setting of 4 tertiary pediatric hospitals, 2 tertiary general medical centers, and 1 specialized children's hospital. Adolescents age 12-17 years (n = 132), 1-6 months after moderate-to-severe traumatic brain injury. Logistic regression was used to determine the association of mental health service utilization with clinical functioning as assessed by the Child and Adolescent Functional Assessment Scale and behavior problems assessed by the Child Behavioral Checklist. Mental health service utilization measured by the Service Assessment for Children and Adolescents. Behavioral or functional impairment occurred in 37%-56%. Of the total study population, 24.2% reported receiving outpatient mental health services, 8.3% reported receiving school services, and 28.8% reported receiving any type of mental health service. Use of any (school or outpatient) mental health service was associated with borderline to impaired total Child and Adolescent Functional Assessment Scale (odds ratio 3.50 [95% confidence interval, 1.46-8.40]; P < .01) and the Child Behavioral Checklist Total Competence (odds ratio 5.08 [95% confidence interval, 2.02-12.76]; P < .01). A large proportion of participants had unmet mental health needs. Both the Child and Adolescent Functional Assessment Scale and the Child Behavioral Checklist identified individuals who would likely benefit from mental health services in outpatient or school settings. Future research should focus on methods to ensure early identification by health care providers of adolescents with traumatic brain injury in need of mental health services.

ŽVILGSNIS Į PSICHIKOS SVEIKATĄ MOKYKLOSE

Background. For many children in the United States, it is most cost e! ective and e cacious if mental health services are provided within the school setting (NASP, 2008). The mental well-being of a child has a large impact on their academic, behavioral and interpersonal development which provides yet another reason for providing mental health services in the schools. Purpose. The purpose of this study was to identify the need for mental health services within Nebraska schools, the extent to which they were being provided, and the level of satisfaction regarding the provision of mental health services reported by school professionals. Methods and Results. Two hundred and forty principals, school psychologists, and school counselors were sent a survey to assess the need, provision and satisfaction of mental health services within Nebraska's schools. Results indicate that the perceived needs, provision and satisfaction for various types of mental health services within Nebraska schools di! er signi# cantly. Respondents indicated a higher percentage of school counselors providing the various types of mental health services. Finally, results indicate no signi# cant di! erence among administrators, school counselors, and school psychologists in the mean ratings of need, provision, and satisfaction of mental health services. Conclusions. School administrators, school psychologists, and school counselors in Nebraska are in agreement with their perceptions of the need, provision and satisfaction of various mental health services within their schools. Signi# cant di! erences exist among the needs, provision and satisfaction between the various types of mental health services being provided within the schools.

Factors Associated with Mental Health Services Use among Disconnected African-American Young Adult Population

Research related to mental health service use among vulnerable young adults is limited. This study used an expanded version of Andersen's Behavioral Model of Health Services Use to evaluate factors associated with the use of different types of mental health services among a sample of predominantly African-American 16-24 year olds (n = 500) in an employment training program in Baltimore City. Results indicated that participants were more likely to have received mental health services in correctional facilities than in community- or school-based contexts. Use of mental health services in correctional facilities was significantly greater among males, those less than 18 years, and those who experienced more stressful events. Findings illustrate the need to develop seamless mental health services for vulnerable young adults in multiple contexts, including the criminal justice system.

Mental Health Service Use Among Suicidal Adolescents: Findings From a U.S. National Community Survey

This study assessed patterns of mental health service use among adolescents who had attempted suicide and examined factors associated with their service use at individual, family, and community levels. Bivariate and multiple logistic regression analyses were conducted with data from 877 adolescents aged 12-17 who had attempted suicide in the past 12 months and who participated in the 2000 National Household Survey on Drug Abuse. Of the 877 adolescents, less than half (45%) reported that they had used mental health services in the past 12 months. Adolescents from racial-ethnic minority groups were less likely than whites to receive inpatient or outpatient mental health treatment, even when the analyses controlled for other demographic, individual, and family and community characteristics. Poor self-perceived health and living in a single-parent family were associated with use of inpatient services. Female gender, higher family income, participation in extracurricular activities, and the presence of symptoms of anxiety or disruptive disorders were associated with use of outpatient services. Use of school-based mental health services was associated only with participation in extracurricular activities. The mental health service needs of suicidal adolescents, especially those from ethnic minority groups and lower-income families, too frequently remain unmet. Larger racial-ethnic disparities were found in use of inpatient and outpatient mental health services than in use of school-based services. Mental health services offered within school settings can reach suicidal adolescents who need services but may experience barriers to standard types of care.

Service Use by At-Risk Youths After School-Based Suicide Screening

Objective We sought to examine follow-up service use by students identified at risk for suicidal behavior in a school-based screening program and assess barriers to seeking services as perceived by youths and parents. Method We conducted a longitudinal study of 317 at-risk youths identified by a school-based suicide screening in six high schools in New York State. The at-risk teenagers and their parents were interviewed approximately 2 years after the initial screen to assess service use during the intervening period and identify barriers that may have interfered with seeking treatment. Results At the time of the screening, 72% of the at-risk students were not receiving any type of mental health service. Of these students, 51% were deemed in need of services and subsequently referred by us to a mental health professional. Nearly 70% followed through with the screening's referral recommendations. The youths and their parents reported perceptions about mental health problems, specifically relating to the need for treatment, as the primary reasons for not seeking service. Conclusions Screening seems to be effective in enhancing the likelihood that students at risk for suicidal behavior will get into treatment. Well-developed and systematic planning is needed to ensure that screening and referral services are coordinated so as to facilitate access for youths into timely treatment.

The Role of Social Network and Support in Mental Health Service Use: Findings From the Baltimore ECA Study

The Role of Social Network and Support in Mental Health Service Use: Findings From the Baltimore ECA Study

A Rural Perspective on Perinatal Depression: Prevalence, Correlates, and Implications for Help‐Seeking Among Low‐Income Women

CONTEXT/PURPOSE: To examine a low-income sample of women in the rural Midwest (N = 1,086) who were screened for perinatal depression through the outreach and education activities within a Healthy Start Initiative project. Specifically, we describe the frequency and severity of depressive symptoms, explore social and demographic correlates of depression, and examine help-seeking through patterns of self-referral to a Healthy Start perinatal depression project in a rural, medically underserved community. Depression screening data using the Primary Care Evaluation of Mental Disorders (PRIME-MD) as well as intake records from the project were analyzed in a retrospective analysis to identify important demographic and psychosocial characteristics associated with elevated levels of depressive symptoms and help-seeking patterns. Thirty-six percent of screened women met criteria for major, minor, or subthreshold depression, with 13% meeting diagnostic criteria for major depression alone. Less than 8% were currently receiving any type of mental health services or treatment at screening. The most significant correlate of self-referral to the Healthy Start project was meeting symptom criteria for major depression, although minor depression, subthreshold depression, and status as low-income/Temporary Aid to Needy Families (TANF)-eligible were all significantly associated with self-referral. The findings from this study highlight the potential significance of identifying and addressing the unmet mental health needs of low-income rural women during and around pregnancy. In addition, the study illustrates that low income, in addition to depressive symptoms, impacts mental health service delivery in this rural community with a fragmented mental health service infrastructure.

Excess mortality in persons with severe mental disorder in Sweden: a cohort study of 12 103 individuals with and without contact with psychiatric services

BackgroundInvestigating mortality in those with mental disorder is one way of measuring effects of mental health care reorganisation. This study's aim was to investigate whether the excess mortality in those with severe mental disorder remains high in Sweden after the initiation of the Community Mental Health Care Reform. We analysed excess mortality by gender, type of mental health service and psychiatric diagnosis in a large community-based cohort with long-term mental disorder.MethodsA survey was conducted in Stockholm County, Sweden in 1997 to identify adults with long-term disabling mental disorder (mental retardation and dementia excluded). The 12 103 cases were linked to the Hospital Discharge Register and the Cause of Death Register. Standardised mortality ratios (SMRs) for 1998–2000 were calculated for all causes of death, in the entire cohort and in subgroups based on treatment setting and diagnosis.ResultsMortality was increased in both genders, for natural and external causes and in all diagnostic subgroups. Excess mortality was greater among those with a history of psychiatric inpatient care, especially in those with substance use disorder. For the entire cohort, the number of excess deaths due to natural causes was threefold that due to external causes. SMRs in those in contact with psychiatric services where strikingly similar to those in contact with social services.ConclusionMortality remains high in those with long-term mental disorder in Sweden, regardless of treatment setting. Treatment programs for persons with long-term mental disorder should target physical as well as mental health.

Factors affecting self-referral to counselling services in the workplace: a qualitative study

ABSTRACT The benefits of psychological support in the workplace (also known as workplace counselling) are well documented. Most large organisations in the UK have staff counselling schemes. However, it is unclear what, if any, factors affect employee decisions to use such schemes. This study has used a qualitative methodology to explore the reasons that make employees use workplace counselling. Eleven employees of a university in the north of England who had used the staff counselling service of their employer took part in the study. The employer had two schemes available: an internal staff counselling service and an external Employee Assistance Programme (EAP). A semi-structured interview was used with each participant and grounded theory techniques were used to analyse the interviews. The analysis resulted in the construction of a model of psychological help-seeking in the workplace. The main findings indicate that most participants were motivated to use their employer's counselling service by their prior positive experiences of similar or other type of mental health services. Other encouraging factors were: recommendation of service by others, a supportive environment and trust in the confidential ethos of the service. Conversely, negative preconceptions of psychological help-seeking and a perception of the employing environment as unsafe were shown to have been discouraging factors. The study concludes with suggestions for practice and for further research.