Views Of Mental Health Professionals Research Articles

Stakeholders’ perspectives on adverse effects of ECT: A qualitative thematic analysis

Background: In the Indian context, published systematic research on the opinions of mental health professionals and other stakeholders (patients and caregivers) regarding the different adverse effects of electroconvulsive therapy (ECT) is not available. This type of study allows for an in-depth exploration of complex phenomena, such as the perspectives of mental health professionals, which can provide a rich understanding of their experiences regarding ECT and also helps to understand the views of mental health professionals regarding the adverse effects of ECT during the post-ECT recovery period and its management. Conversely, the perception of patients and caregivers regarding the adverse effects of ECT can provide a more comprehensive understanding of the treatment and its impact on the patients who receive it. Purpose: To explore the understanding of participants about the various adverse effects following ECT and their perception of managing different adverse effects of ECT during the post-ECT recovery period. Methods: A qualitative approach using focus group discussion (FGD) was used. A convenience sampling technique was followed for selecting the participants. FGDs were conducted with stakeholders including mental health professionals, patients, and caregivers. Five FGDs were conducted with psychiatry residents, nursing officers from the ECT suite, and different psychiatry wards at NIMHANS. Four FGDs were held separately for patients receiving ECT and their caregivers, admitted to various psychiatry wards at NIMHANS. A total of 28 mental health professionals, 20 patients, and 20 caregivers participated. The number of participants for FGDs was decided based on data saturation. The FGDs, lasting 30–40 minutes each, occurred between October 2022 and December 2022. The FGDs were audio-recorded with prior permission from the participants. All the participants were informed about the study. Written informed consent was obtained. All FGDs were transcribed. Thematic analysis was done using Atlas. ti software. Results: The broad categories identified were adverse events associated with ECT during the ECT procedure, adverse events associated with ECT after the ECT procedure, prevalence of different adverse effects according to mental health professionals, effects of adverse effects on the continuity of ECT, and difficulties encountered by mental health professionals throughout the management. Other broad categories were found after conducting FGDs with caregivers and patients, which were patients’ experience as per the caregivers over the course of ECT, caregivers’ and patients’ willingness to continue ECT, unfavorable impacts of ECT experienced by the patients immediately after ECT sessions, and, later till the end of that day, suggestions of the caregivers and patients to improvise the management of ECT-related adverse effects and management of adverse effects by the treating team. Conclusion: The findings will develop a standard operating procedure that may help nursing officers monitor and identify the adverse effects immediately after ECT and minimize the complications during the post-ECT recovery period.

Views of German mental health professionals on the use of digital mental health interventions for eating disorders: a qualitative interview study

IntroductionDigital mental health interventions (DMHIs) are getting increasingly important for mental health care. In the case of eating disorders (EDs), DMHIs are still in early stages. Few studies so far investigated the views of mental health professionals for EDs on the integration of DMHIs in routine care.ObjectiveTo gain insights into the experiences, perspectives, and expectations of mental health professionals for EDs regarding DMHIs and to identify requirements for the future integration of DMHIs into routine care.MethodsSemi-structured qualitative telephone interviews with 24 German mental health professionals treating patients with EDs were conducted. A content analysis following a deductive-inductive approach asked for experiences, advantages and chances, disadvantages and boundaries, desired functions and properties, target groups, and general conditions and requirements for DMHIs for patients with EDs.ResultsOnly few professionals reported experiences with DMHIs besides video-based psychotherapy during the pandemic. From the therapists’ point of view, DMHIs have the potential to deliver low-threshold access for patients with EDs. Useful functionalities were seen in digital meal records, skills training, and psychoeducation. However, a stable therapeutic alliance was reported as an important prerequisite for the successful integration into care. Therapists expressed concerns in case of severe anorexia nervosa or suicidality. The participants felt to be informed inadequately on recent developments and on the evidence base of DMHIs.ConclusionsMental health professionals for EDs show positive attitudes towards DMHIs, however many barriers to the integration in routine care were observed. The highest potential was seen for the use of DMHIs in addition to outpatient care and in aftercare. Specific requirements for DMHIs are related to different areas of the healthcare spectrum and for the different symptom profiles in anorexia nervosa, bulimia nervosa and binge eating disorder. Targeted DMHIs are needed and appropriate especially for concepts of blended care.

Mental health professionals’ perspectives on the relevance of religion and spirituality to mental health care

BackgroundA large body of evidence indicates that spiritual and religious backgrounds, beliefs, and practices (SRBBPs) are related to better psychological health. Spirituality and religion (R/S) are also important aspects of multicultural diversity. There is evidence that clients would like to talk about their spirituality, and that including it in assessment and treatment planning can be beneficial. However, the extent to which practicing mental health professionals view SRBBPs as relevant to mental health and clinical practice is unclear.MethodsA survey examining several aspects of addressing SRBBPs in clinical practice was distributed to 894 professionals across mental health disciplines, including psychiatry, psychology, social work, marriage family therapy, licensed professional counselors, certified chemical dependency counselors, and psychiatric mental health nurses.Results89% of mental health professionals agreed that clinicians should receive training in R/S competencies. There were no differences between mental health disciplines in ratings of importance of such training. Younger individuals and those who identify as more spiritual were more likely to consider R/S training as important. Although 47.1% of professionals had not received much R/S training, many perceived themselves to be highly competent in R/S clinical integration practices (57.8% considered themselves able to display them very much or completely). In addition, respondents with more R/S training evaluated themselves as more proficient in R/S clinical integration. Nearly two-thirds (65.2%) of respondents reported encountering few to no barriers to engaging in R/S competent mental health care.ConclusionsThere is a growing consensus among mental health care professionals that mental health professionals should be trained in R/S competencies. Strong agreement exists that basic R/S competencies include respect, empathy, examination of bias, and routine assessment of R/S in mental health care. Four in five of those surveyed agree that more active competencies, such as identifying and addressing religious and spiritual struggles and problems and helping clients explore and access R/S strengths and resources should be included, whereas one in five report less comfort with these competencies.

Comparing the views of mental health professionals and volunteers on volunteering in mental health care in the UK

Voluntary schemes can serve to address reduced social functioning experienced by people with mental illness. However, the views of the key stakeholders in such provision remains under-researched.This article aimed to compare the views of mental health professionals and volunteers on volunteering in mental health care in the UK through a qualitative study analysing the data of six focus groups with n = 27 participants using thematic analysis.Six overarching themes were identified: (i) An act of friendship but not a true friendship, (ii) Addressing a social agenda, (iii) Structure and responsibility of volunteering schemes, (iv) Challenges of volunteering (v) Role of technology in volunteering and (vi) Impact on wider mental health care. Whilst various commonalities were identified, nuances in participants views suggest stakeholders may place differing levels of importance on the volunteering framework.Volunteering as a social intervention for people with mental illness was deemed to hold significant importance in wider mental health care. The divergent views expressed between stakeholders can be attributed to their own direct experiences with patients in practice and suggests there is a need for flexibility in the design and delivery of voluntary programmes.

Views on volunteering in mental health: a focus group study with mental health professionals and volunteers in Portugal

IntroductionVolunteering has reported health benefits. However, little is known in Portugal about the views of mental health professionals and volunteers on volunteering in mental health care.MethodsA qualitative secondary analysis of data from six focus groups with 28 participants was conducted in order to explore and compare the perspectives on volunteering in mental health of two stakeholders: mental health professionals and volunteers in Portugal.ResultsFour main themes arose: the nature of the volunteering relationship; volunteering has multiple aims; technology has potential for volunteering; and volunteering has its challenges. Although there were mostly commonalities between their views, some variability suggested that different stakeholders may consider different aspects of volunteering differently. Overall, stakeholders called for structured recruitment and support, training, defining boundaries and fighting the stigma of mental illness.ConclusionDespite the lack of volunteering tradition in mental health care in Portugal, volunteering programmes were perceived as an important resource for patients with mental illness.

Views of Mental Health Professionals on Positive Changes in Service Practices and Staff-User Relationships After One Year of Covid-19 Pandemic in Italy

This study explored views of mental health services (MHS) professionals regarding positive changes in service practices and organizations, and staff-user relationships after one year of COVID-19 in Italy. Professionals from a community-oriented MHS completed online the Questionnaire on MHS Transformations during the COVID-19 pandemic, a 30-item tool developed by a participatory approach and validated. Of the 184 participants, 91.8% felt it was “true/definitely true” that during the pandemic they had informed users on procedures to reduce contagion risks, and 82.1% stated that they had increased telephone contact with users. Sixty-nine percent of professionals reported that staff revised treatment plans according to new needs of care and 78.6% stated that they had been able to mediate between user needs and safe working procedures. Moreover, 79.4% of respondents stated that they had rediscovered the importance of gestures and habits, and 65% that they had gained strength among colleagues to face fear. Fifty-four percent of participants admitted that they had discovered unexpected personal resources in users. Overall, 59.6% of participants stated that they found some positives in the COVID-19 experience. Perceived positive changes was greater among professionals from community facilities vs. those from hospital and residential facilities. In community-oriented MHS, the pandemic offered an opportunity to change practices and rethink the meaning of relationships between people. This data may be useful in generating a more balanced understanding of COVID-19's impact on MHS and for MHS planning in the pandemic era.

Caring for Patients with Psychosis: Mental Health Professionals' Views on Informal Caregivers' Needs.

The aim of this study was to explore the views of mental health professionals regarding the needs of the informal caregivers of patients with chronic psychotic syndrome. A qualitative research design was used. The sample consisted of 12 mental health professionals selected by a purposive sampling strategy. Data were collected through semistructured, face to face interviews. Framework analysis was used to analyze qualitative data and establish main themes and subthemes. Three main themes emerged namely, (i) impact of caring on caregivers’ lives, (ii) caregivers’ needs, and (iii) recommendations for better care. Informal caregivers’ needs were conceptualized into subthemes within the main themes. Caregivers’ increased responsibilities of caring for their relatives, the impact on their mental and physical health status and the restrictions in their social and professional life were revealed. Targeted health interventions and social policy planning are recommended for supporting informal caregivers and improving patient care.

The German version of the Exercise in Mental Illness Questionnaire (EMIQ-G): Translation and testing of psychometric properties

BackgroundPhysical activity (PA) shows many benefits for mental health. Mental health professionals play an important role in recommending PA to their patients. There is little research on PA recommendation behaviour in German mental health professionals. Aim of this study was to translate the Exercise in Mental Illness Questionnaire (EMIQ-HP) to German and test the psychometric properties of the translated version. MethodsWe translated the questionnaire following the guidelines on the cross-cultural adaption of self-rating questionnaires and tested its 7-day test-retest reliability in a sample of 40 German mental health professionals using Intra-Class-Correlations (ICC) and Cohen's kappa (κ). ResultsThe German version of the questionnaire (EMIQ-G) can be found in supplement 1. The items and scales showed ICCs between 0.58 and 1.00 and κ between 0.35 and 1.00 while the vast majority showed excellent to almost perfect 7-day-retest reliability (>0.81). ConclusionThe EMIQ-G represents the first standardized German questionnaire for the assessment of mental health professionals view on PA in mental disorders. Its use in future research might help to generate further knowledge that might help to support patients with mental disorders to increase or maintain a health beneficial level of PA.

Mental health professionals view about the impact of male gender for the treatment of men with depression - a qualitative study

BackgroundThe underestimation of depression among men may result from atypical depression symptoms and male help-seeking behaviour. However, higher suicide rates among men than among women indicate a need for gender-specific services for men with depression. In order to develop gender-specific services, it is essential to examine professionals’ attitudes towards men’s depressive symptoms and treatment needs as well as barriers to and facilitators of treatment. This study examined gender-specific treatment needs in male patients and treatment approaches to male patients from a professional perspective.MethodsSemi-structured face-to-face interviews were conducted with 33 mental health professionals (MHPs) from five German psychiatric institutions. The study assessed the characteristics and attributes of male patients with depression risk factors for the development of depression among men, their condition at the beginning of treatment, male patients’ depressive symptoms, the needs and expectations of male patients, the importance of social networks in a mental health context, and MHPs’ treatment aims and treatment methods. Transcripts were analysed using qualitative content analysis.ResultsThe professionals’ reference group of male patients were men who were characterised in accordance with traditional masculinity. Attributes reported as in line with this type of men were late initiations of inpatient treatment after crisis, suicidal ideation or attempted suicide, and high expectations towards treatment duration, success rate in recovery and therapeutic sessions. In contrast, male patients who deviate from these patterns were partially described with reference to female stereotypes. Professionals referred to psychosocial models in their explanations of the causes of depression and provided sociological explanations for the development of masculine ideals among men. The consequences of these for treatment were discussed against the background of normative expectations regarding the male gender. From the professionals’ point of view, psychoeducation and the acceptance of depression (as a widespread mental illness) were the most important goals in mental health treatment.ConclusionsIn order to improve mental health among men, gender-specific services should be offered. Awareness of the role of gender and its implications on mental health treatment should be an integral part of MHPs’ education and their daily implementation of mental health treatment practices.

Transitional psychiatry in the Netherlands: Experiences and views of mental health professionals.

BackgroundThe majority of psychopathology emerges in late adolescence and continues into adulthood. Continuity of care must be guaranteed in this life phase. The current service configuration, with a distinction between child/adolescent and adult mental health services (CAMHS and AMHS), impedes continuity of care.AImTo map professionals' experiences with and attitudes towards young people's transition from CAMHS to AMHS and the problems they encounter.MethodsAn online questionnaire distributed among professionals providing mental health care to young people (15‐25 years old) with psychiatric disorders.ResultsFive hundred and eighteen professionals completed the questionnaire. Decision‐making regarding transition is generally based on the professional's own deliberations. The preparation was limited to discussing changes with the adolescent and parents. Most transition‐related problems are experienced in CAMHS, primarily with regard to collaboration with AMHS. Respondents report that the developmental age should be leading in the transition‐decision making process and that developmentally appropriate services are important in bridging the gap.ConclusionProfessionals in CAMHS and AMHS experience problems in the preparation of, and the collaboration during transition. The problems are related to coordination, communication and rules and regulations. Professionals attach importance to improvement through an increase in flexibility and more specialist services for youth.

A quantitative assessment of the views of mental health professionals on exercise for people with mental illness: perspectives from a low-resource setting.

Exercise is nowadays considered as an evidence-based treatment modality in people with mental illness. Nurses and occupational therapists working in low-resourced mental health settings are well-placed to provide exercise advice for people with mental illness. We examined the current exercise prescription practices employed by Ugandan health care professionals when working with people with mental illness, and identified perceived barriers to exercise prescription and exercise participation for people with mental illness. In this study, 31 Ugandan health care professionals 20 men; 31.2 ± 7.1 years completed the Exercise in Mental Illness Questionnaire- Health Professionals Version EMIQ-HP. The vast majority of the respondents 29/31, 94% reported they prescribed exercise at least "occasionally" to people with mental illness. Exercise-prescription parameters used were consistent with those recommended for people with mental illness. Regarding barriers to exercise participation, coping with side effects of psychotropic medication at the individual level and reducing stigma at community level should be prioritized. A health care reform to enable collaboration with exercise professionals, such as exercise physiologists or physiotherapists, might increase exercise uptake for people with mental illness, thereby improving health outcomes for this vulnerable population.

Mental Health Professionals View on the Need for Early Intervention for Offspring of Individual With Schizophrenia in India

Schizophrenia is a debilitating mental illness not only for the individual but also for the family, especially the children. There is a definitive likelihood of the vulnerability being transmitted to the child. As a result of the parents illness there may also be disruptions in the family dynamics and in home environment. However, many children have been found to show resiliency. The aim of this particular study was to explore the need for intervention in children who’s either parent were being treated for schizophrenia. Using qualitative Interpretative Phenomenological Approach (IPA) mental health professionals from all over India were interviewed with the help of validated interview guide. To understand their lived in experience of these professionals the audio recorded interviews were transcribed and analysed for exploring the themes using thematic analysis. Significant themes found indicated that early interventions were crucial for the wellbeing of the child, specifically in the Indian scenario.

Lost in transition? Professional perspectives on transitional mental health services for young people in Germany: a qualitative study

BackgroundThe transition of young patients from child and adolescent to adult mental health services often results in the interruption or termination of care. At this intersection, mental health professionals function as gatekeepers between systems, and their personal views on current clinical practice can contribute to a broader understanding of procedures and help identify reasons for service gaps. This qualitative study investigated the views of mental health professionals on services for young people during the transition from child and adolescent to adult mental health care, as well as on factors which facilitate or hinder continuity of care.MethodsFour group discussions with 24 mental health professionals with various backgrounds were conducted. Groups were audio-taped, transcribed verbatim and analyzed following the reconstructive approach of R. Bohnsack’s documentary method.ResultsA main theme and six subthemes emerged. Participants’ overall concern was an increasing lack of patient centeredness in care provision. They criticized the limited flexibility and time constraints of their work, which was held to be incompatible with the time-consuming process of engaging young patients in care and coping with their individual needs. A lack of adequate interprofessional exchange and networking was seen as resulting in a diffuse sense of responsibility and a lack of clarity for all involved parties. Participants focused on the adverse impact of neglecting developmental characteristics in care procedures for young patients and revealed personal issues they experienced in their work with young patients (e. g. personal difficulties with diagnosing).ConclusionsMental health professionals at this transitional point face a number of complex tasks as well as limitations in terms of time and personal support. An emphasis should be placed on forming and maintaining partnerships within and between systems which could contribute significantly to relieving professionals’ workload. Furthermore, an open style of communication to engage young patients in care is essential. Strengthening communicative skills, improving knowledge about this life stage (especially when working in adult services), and promoting interprofessional encounters can help to develop new procedures in clinical practice. On higher system levels, heightened awareness of the need to reduce fragmentation of care and administrative barriers is needed.

Social exclusion prevents us understanding the role of sleep in psychosis and “schizophrenia”

PurposeThe purpose of this paper is to discuss recent papers on trauma, sleep and psychotic experiences to highlight the lack of attention given to sleep.Design/methodology/approachA search was carried out to find recent papers on psychosis or schizophrenia, trauma and sleep.FindingsPapers tended to focus on trauma and psychosis, or on sleep and psychosis, but not on trauma, sleep and psychosis. The two papers discussed in most detail here focussed on sleep difficulties from either a service user or professional perspective. Both concluded that sleep difficulties need more attention. The author also discussed evidence suggesting that stress and trauma cause sleep difficulties and that these, in turn, are an important cause of psychotic experiences. Severe or prolonged stress may also directly cause some psychotic experiences.Originality/valueThe two main papers highlight for the first time in detail service users’ own experiences of sleep difficulties, and how mental health professionals view them, suggesting more help is needed. Other papers suggest that sleep is overlooked in research into the causes of psychosis. There is growing evidence that people have sleep problems before psychotic experiences, and that many have experienced severe or prolonged stress due to life events and circumstances, often in childhood. Given that stress can interfere with sleep, it is time to investigate further the role of stress and sleep in the development and maintenance of psychosis.

Mental health promotion competencies in the health sector in Finland: a qualitative study of the views of professionals.

In this study, we aimed to investigate what competencies are needed for mental health promotion in health sector practice in Finland. A qualitative study was carried out to seek the views of mental health professionals regarding mental health promotion-related competencies. The data were collected via two focus groups and a questionnaire survey of professionals working in the health sector in Finland. The focus groups consisted of a total of 13 professionals. Further, 20 questionnaires were received from the questionnaire survey. The data were analysed using the qualitative data analysis software ATLAS.ti Scientific Software Development GmbH, Berlin. A content analysis was carried out. In total, 23 competencies were identified and clustered under the categories of theoretical knowledge, practical skills, and personal attitudes and values. In order to promote mental health, it is necessary to have a knowledge of the principles and concepts of mental health promotion, including methods and tools for effective practices. Furthermore, a variety of skills-based competencies such as communication and collaboration skills were described. Personal attitudes and values included a holistic approach and respect for human rights, among others. The study provides new information on what competencies are needed to plan, implement and evaluate mental health promotion in health sector practice, with the aim of contributing to a more effective workforce. The competencies provide aid in planning training programmes and qualifications, as well as job descriptions and roles in health sector workplaces related to mental health promotion.

Enhancing oral health for better mental health: Exploring the views of mental health professionals.

The association between oral health, self-esteem and quality of life is well established yet there is limited research on the impact of addressing the poor oral health of people living with mental health disorders. Greater consideration is warranted on how enhancing oral health in the course of mental healthcare might reduce the burden of a person's ill health. The role of mental health professionals is important in this regard yet uncertainty persists about the role these providers can and should play in promoting oral health care for people with mental health disorders. This qualitative study explored the issue of oral health and mental health with community based mental health professionals in Perth, Western Australia. It examined their views on the oral health status and experiences of their clients, and the different and alternative ways to improve access to care, knowledge and preventative regimens. Findings indicated participants' ambivalence, reluctance and lack of training in raising oral health issues, despite its acknowledged importance, indicating a siloed approach to care. Findings offer an opportunity to reflect on whether a more integrated approach to oral health care for people with mental health disorders would improve health outcomes.

The Limits for Deinstitutionalization of Psychiatry in Russia: Perspectives of Professionals Working in Outpatient Mental Health Services

:The purpose of this study was to explore the views of mental health professionals on deinstitutionalization reforms in Russia. Qualitative interviews were conducted with 33 specialists from outpatient mental health clinics. The data were analyzed using thematic analysis. The results revealed that the professionals appeared very restrained in supporting the reforms. They argued for the preservation of the existing mental health care system rather than its transformation. Their lines of argumentation were organized around four key themes as follows: 1) critiques of state policies and a suspicion of reforms, 2) tradition instead of innovation: reclaiming the image of Soviet psychiatry, 3) hospitals as a means of social control, and 4) reform as a threat to the protection of people with mental health problems. The findings suggest that practitioner resistance to deinstitutionalization is a complex phenomenon, demonstrating how various political, economic, social, and cultural factors are intertwined in the construction of professional discourse on the reforms.

Staff views on wellbeing for themselves and for service users

Background: Wellbeing is an important outcome in the context of recovery from mental illness. The views of mental health professionals on wellbeing may influence their approach to supporting recovery.Aims: This study aims to explore views held by mental health staff about factors influencing their own wellbeing and that of service users with psychosis.Methods: Semi-structured interviews were conducted with 14 mental health staff in South London who had worked with people with psychosis. Thematic analysis was used to analyse the data and comparisons were made between staff views of wellbeing for themselves and service users.Results: Staff participants held similar conceptualisations of wellbeing for themselves and for service users. However, they suggested a differential impact on wellbeing for a number of factors, such as balance, goals and achievement, and work. Staff employed a more deficit-based perspective on wellbeing for service users and a more strengths-based view for themselves.Conclusions: Staff stated a recovery orientation in principle, but struggled to focus on service user strengths in practice. A stronger emphasis in clinical practice on amplifying strengths to foster self-management is indicated, and staff may need support to achieve this emphasis, e.g. through specific interventions and involvement of peer support workers.

Proposals for ICD-11: a report for WPA membership.

Proposals for ICD-11: a report for WPA membership.

Professionals’ perceptions of the Mental Health Recovery Star

Purpose– The Mental Health Recovery Star (MHRS) has received focus at a national policy level in consideration of outcome measurement within mental health services. The purpose of this paper is to seek the views of mental health professionals about its use within clinical practice.Design/methodology/approach– The paper employed a qualitative, exploratory design to interview 12 participants. Thematic analysis was used.Findings– Four main themes were identified: “the utility of the Recovery Star”; “not for everybody”; “service user involvement”; and “the status of the Recovery Star within the Trust”. A range of factors was found to influence participants’ use of the tool with service users.Research limitations/implications– The paper involved a small number of participants due to a low response rate. Future research could include larger studies and more detailed exploration of factors identified as limiting the use of the MHRS.Practical implications– The MHRS is a potentially useful tool but its limitations and the influence of organisational context must be considered as part of any plan to systematically implement its use within services.Originality/value– To the authors’ knowledge, this is the first study of the views of mental health professionals about the MHRS. As it is professionals who are likely to determine whether and how the tool is used, the paper is seen as a valuable initial investigation.