101
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Ostrow L, Cook JA, Salzer MS, Pelot M, Burke-Miller JK. Employment Outcomes After Certification as a Behavioral Health Peer Specialist in Four U.S. States. Psychiatr Serv 2022; 73:1239-1247. [PMID: 35734863 DOI: 10.1176/appi.ps.202100651] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE A 3-year study explores employment outcomes of certified peer specialists (CPSs). Analyses reported here identified relationships between demographic, clinical, work history, and geographic characteristics and employment status and current employment in peer services jobs versus other jobs. METHODS The study recruited adults who recently became a CPS, regardless of current employment status, in four states. Online survey data were collected from March to October 2020 and included demographic information, health status and diagnoses, mental health service use, motivations for becoming certified, employment history, and job characteristics, including job satisfaction. Descriptive statistics and logistic regression models were used to compare groups. RESULTS Of 681 respondents, 591 provided data on current employment and were included. Participants who received Social Security Disability Insurance or Supplemental Security Income, veterans, those who used outpatient counseling or therapy, and those who did not disclose their mental health status in the workplace were less likely to report current employment. Lack of disclosure and higher local unemployment rates contributed to a lower likelihood of working in peer services jobs, whereas individuals reporting depressive disorders were more likely to hold such jobs. Compared with those in other jobs, those in peer services jobs reported longer job tenure, and a larger proportion received employee benefits. Job satisfaction was significantly higher among those with peer services jobs. CONCLUSIONS Workers with a CPS credential had higher employment rates, compared with adults with psychiatric disabilities, and the quality of peer specialist jobs was equal to or higher than the quality of other jobs held by study participants.
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Affiliation(s)
- Laysha Ostrow
- Live & Learn, Inc., Morro Bay, California (Ostrow, Pelot); School of Global and Community Health, Claremont Graduate University, Claremont, California (Ostrow); Center on Mental Health Services Research and Policy, University of Illinois at Chicago, Chicago (Cook, Burke-Miller); Department of Social and Behavioral Sciences, Temple University, Philadelphia (Salzer)
| | - Judith A Cook
- Live & Learn, Inc., Morro Bay, California (Ostrow, Pelot); School of Global and Community Health, Claremont Graduate University, Claremont, California (Ostrow); Center on Mental Health Services Research and Policy, University of Illinois at Chicago, Chicago (Cook, Burke-Miller); Department of Social and Behavioral Sciences, Temple University, Philadelphia (Salzer)
| | - Mark S Salzer
- Live & Learn, Inc., Morro Bay, California (Ostrow, Pelot); School of Global and Community Health, Claremont Graduate University, Claremont, California (Ostrow); Center on Mental Health Services Research and Policy, University of Illinois at Chicago, Chicago (Cook, Burke-Miller); Department of Social and Behavioral Sciences, Temple University, Philadelphia (Salzer)
| | - Morgan Pelot
- Live & Learn, Inc., Morro Bay, California (Ostrow, Pelot); School of Global and Community Health, Claremont Graduate University, Claremont, California (Ostrow); Center on Mental Health Services Research and Policy, University of Illinois at Chicago, Chicago (Cook, Burke-Miller); Department of Social and Behavioral Sciences, Temple University, Philadelphia (Salzer)
| | - Jane K Burke-Miller
- Live & Learn, Inc., Morro Bay, California (Ostrow, Pelot); School of Global and Community Health, Claremont Graduate University, Claremont, California (Ostrow); Center on Mental Health Services Research and Policy, University of Illinois at Chicago, Chicago (Cook, Burke-Miller); Department of Social and Behavioral Sciences, Temple University, Philadelphia (Salzer)
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102
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Alsultany G, El Masri A, MacMillan F, Williams K, McBride K. Support needs of people living with obesity during transition from tertiary obesity treatment to community care. Obes Res Clin Pract 2022; 16:514-523. [PMID: 36207249 DOI: 10.1016/j.orcp.2022.09.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2022] [Accepted: 09/27/2022] [Indexed: 12/04/2022]
Abstract
BACKGROUND As the number of people living with obesity increases, the maintenance of treatment outcomes is especially pertinent. Treatment at tertiary obesity services have proven to be successful, but patients need to be transitioned out of these services to community-based care to accommodate the influx of new patients. Little is known about the support needs of patients after transition from acute tertiary obesity services. It is important to establish the supports needed by these patients, especially in the context of maintaining treatment outcomes and ensuring continuity of care. METHODS A qualitative study was conducted to identify the support needs of people with obesity as they transition to community care. Patients and clinicians recruited from a tertiary obesity clinic participated in semi-structured interviews and focus groups to explore factors influencing transition and supports needed in the community. Data was collected through audio recordings, transcribed verbatim and analysed thematically. RESULTS A total of 16 patients and 7 clinicians involved in the care of these patients participated between July 2020 and July 2021. Themes identified included the influence of clinic and individual factors on transition, the benefits of phased transition, patient-centred communication, and the role of social support. It was found that dependency and lack of self-efficacy, as well as low social support, hindered transition efforts. It was also identified that patients required substantial integrated professional and social support structures in the community to adequately address their care needs both during and following transition. CONCLUSION Interventions are needed to provide social community services following transition to ensure adequate community care that can support the maintenance of treatment outcomes. Such services should be integrated and address the social needs of people living with obesity.
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Affiliation(s)
- Ghada Alsultany
- School of Medicine, Western Sydney University, Penrith, NSW 2751, Australia
| | - Aymen El Masri
- School of Health Sciences, Western Sydney University, Penrith, NSW 2751, Australia
| | - Freya MacMillan
- School of Health Sciences, Western Sydney University, Penrith, NSW 2751, Australia; Translational Health Research Institute (THRI), Western Sydney University, Penrith, NSW 2751, Australia
| | - Kathryn Williams
- Charles Perkins Centre-Nepean, Faculty of Medicine and Health, The University of Sydney, Kingswood, New South Wales, Australia; Department of Endocrinology, Nepean Hospital, Nepean Blue Mountains Local Health District, Kingswood, New South Wales, Australia
| | - Kate McBride
- School of Medicine, Western Sydney University, Penrith, NSW 2751, Australia; Translational Health Research Institute (THRI), Western Sydney University, Penrith, NSW 2751, Australia.
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103
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Woodward A, de Graaff AM, Dieleman MA, Roberts B, Fuhr DC, Broerse JE, Sijbrandij M, Cuijpers P, Ventevogel P, Gerretsen B, Sondorp E. Scalability of a task-sharing psychological intervention for refugees: A qualitative study in the Netherlands. SSM - MENTAL HEALTH 2022. [DOI: 10.1016/j.ssmmh.2022.100171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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104
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Poremski D, Kuek JHL, Yuan Q, Li Z, Yow KL, Eu PW, Chua HC. The impact of peer support work on the mental health of peer support specialists. Int J Ment Health Syst 2022; 16:51. [PMID: 36258206 PMCID: PMC9578199 DOI: 10.1186/s13033-022-00561-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Accepted: 10/07/2022] [Indexed: 11/12/2022] Open
Abstract
Background Peers support specialists have positive impacts on the mental health of their service users. However, less is known about how their mental health changes as a result of their activities. Methods We followed 10 peer support specialists over their first year of employment and interviewed them thrice. We used grounded theory to analyse the way in which the health of participants changed. Results Self-reported mental health of our participants did not change over the course of the study. However, the role did help participants grow and learn about their condition and their strengths. While sharing their past experiences could be taxing, they learned how to harness their recovery journey without risking relapse. Conclusion Entering the role of a peer support specialist does not appear to negatively impact mental health, but might enhance insight and resilience. However, this appears to occur in individuals who already possess an inclination toward introspection. Supplementary Information The online version contains supplementary material available at 10.1186/s13033-022-00561-8.
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Affiliation(s)
- Daniel Poremski
- Health Intelligence Unit, Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, Singapore, 539747, Singapore.
| | - Jonathan Han Loong Kuek
- Health Intelligence Unit, Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, Singapore, 539747, Singapore
| | - Qi Yuan
- Research Department, Institute of Mental Health, Singapore, Singapore
| | - Ziqiang Li
- Department of Nursing, Institute of Mental Health, Singapore, Singapore
| | - Kah Lai Yow
- Department of Allied Health Services, Institute of Mental Health, Singapore, Singapore
| | - Pui Wai Eu
- Department of General Psychiatry, Institute of Mental Health, Singapore, Singapore
| | - Hong Choon Chua
- Office of the CEO, Institute of Mental Health, Singapore, Singapore
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105
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Lui LMW, McIntyre RS. Canadian Healthcare System and Individuals with Severe Mental Disorders During Coronavirus Disease 2019: Challenges and Unmet Needs. SCHIZOPHRENIA BULLETIN OPEN 2022; 3:sgac036. [PMID: 36348645 PMCID: PMC9620765 DOI: 10.1093/schizbullopen/sgac036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The Coronavirus Disease 2019 (COVID-19) pandemic is a syndemic of viral infection and mental health adversity. The pandemic has exacerbated inequalities of access to care in vulnerable populations within the Canadian mental healthcare system. Primary care services are first-line health services in Canada, and are necessary to access specialized services. However, as a result of the limited availability of primary health services, and subsequently, specialized providers (eg, psychiatrists), the demand for these services outweigh the supply. Hitherto, timely access to appropriate services has been cited as a common challenge in Canada as a result of limitations as it relates to resources and in-person activities and support services. While there has been an increase in virtual care opportunities, concerns have been raised with respect to the digital divide. Moreover, while individuals with serious mental illness (SMI) and psychosis are at an increased risk for hospitalization and death from COVID-19, testing and vaccination services have not been prioritized for this population. Taken together, increased funding for mental health service delivery should be emphasized especially for individuals with SMI. There should also be a focus on increased collaboration among individuals with lived experience and health care providers to ensure future policies are developed specifically for this population. Addressing the social determinants of health and prioritizing a continuum of care across various stakeholders may lead to strong integration of care both during and after the pandemic.
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Affiliation(s)
- Leanna M W Lui
- Institute of Medical Science, University of Toronto, Toronto, ON, Canada,Mood Disorders Psychopharmacology Unit, Poul Hansen Family Centre for Depression, University Health Network, Toronto, ON, Canada
| | - Roger S McIntyre
- To whom correspondence should be addressed; Mood Disorders Psychopharmacology Unit, University Health Network, University of Toronto, 399 Bathurst Street, MP 9-325, Toronto, ON M5T 2S8, Canada; tel: 416-603-5279, fax: 416-603-5368, e-mail:
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106
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Bujanover M, Mashiach-Eizenberg M, Moran GS. Meaning in life and flow experiences among people with psychiatric disabilities who are engaged in peer-helping vs. non-helping work-roles. JOURNAL OF VOCATIONAL REHABILITATION 2022. [DOI: 10.3233/jvr-221217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND: Finding meaning in life and wellbeing through vocational work-roles are central to recovery of persons with psychiatric disabilities. However, there is a disconnect between positive concepts and vocational rehabilitation, rendering meaning and wellbeing rarely explored in vocational rehabilitation. OBJECTIVE: We assume higher meaning and wellbeing exists among individuals engaged in peer helping work-roles (meaningful role) as compared to non-helping work-roles. We examine this and additional questions to learn about relationships between positive concepts and vocational work-roles illuminating mental health recovery. METHODS: 114 individuals with psychiatric disabilities (ages 20-70) from various vocational-services participated. Sixty-nine worked in peer-helping roles (i.e. consumer-providers/peer-supporters) and 45 engaged in non-helping work-roles (vendors/clerical work, etc.). Participants filled in the Meaning in Life and Work-related Flow (assessing wellbeing at work) scales. Additionally, participants in peer-helping work-roles filled a peer-developed scale estimating their salience of peer-role characteristics. RESULTS: Individuals in peer-helping work-roles had significantly higher meaning in life levels than those in non-helping roles. Having meaning in life also predicted higher work-related flow across the sample. Finally, meaning in life positively mediated relations between salience of peer-role characteristics and work-related flow experiences. CONCLUSION: Researching meaning and wellbeing can broaden theoretical understanding and bear practical implications for enhancing vocational work-role fit and recovery.
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Affiliation(s)
- May Bujanover
- Department of Social Work, Ben-Gurion University, Beer Sheba, Israel
| | | | - Galia S. Moran
- Department of Social Work, Ben-Gurion University, Beer Sheba, Israel
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107
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Hanna JR, Semple CJ. 'I didn't know what was in front of me'-Bereaved parents' experience of adapting to life when a co-parent of dependent children has died with cancer. Psychooncology 2022; 31:1651-1659. [PMID: 35949162 PMCID: PMC9825999 DOI: 10.1002/pon.6010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2022] [Revised: 07/26/2022] [Accepted: 07/28/2022] [Indexed: 01/11/2023]
Abstract
OBJECTIVE It is not clear how the bereaved parent navigates life with the children after a co-parent has died. The objective of this study is to explore bereaved parents' experience of managing life when a co-parent of dependent children has died with cancer. METHODS Twenty-one in-depth interviews were conducted with bereaved parents when a co-parent died with cancer. Data were analysed thematically. RESULTS Bereaved parents highlighted how their children was their key focus after the death of a co-parent with cancer, as they effortfully strived to be a 'perfect parent'. While some bereaved parents struggled to adapt to the role as a sole parent, others described the importance of maximising social networks to help with the practical aspects of parenting. However, most bereaved parents described intense feelings of loneliness as they navigated parenting alone. To help navigate this post-bereavement period, parents considered it important for their children to openly talk about the deceased parent. Also, meeting others who have experienced similar situations was helpful for the bereaved parent and children, providing hope for the future. Results are discussed under two themes: (1) adapting to life without the parent, and (2) a desire to keep the memory alive of the parent that died with cancer. CONCLUSIONS Bereaved parents should be encouraged to practice self-care when a co-parent has died from cancer so they can appropriately meet the needs of their children. Bereaved parents should be reassured that showing emotion in front of the children is helpful and could facilitate better grief experiences for the whole family.
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Affiliation(s)
| | - Cherith J. Semple
- School of NursingUlster UniversityNewtownabbeyUK,South Eastern Health and Social Care TrustCancer Services Ulster HospitalBelfastUK
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108
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Layman DM, Fisher CB. Profiles of Psychological Strengths on Symptom Distress, Recovery, and Quality of Life Among Young Adults with a History of Adolescent Psychiatric Hospitalization. Community Ment Health J 2022; 58:1279-1296. [PMID: 35066736 DOI: 10.1007/s10597-022-00936-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Accepted: 01/07/2022] [Indexed: 11/28/2022]
Abstract
The current study surveyed 166 young adults (ages 20-35) with a history of adolescent psychiatric hospitalization to identify profiles of psychological strengths (self-determination, identity commitment, and low mental health self-stigma) and to examine their association with symptom distress, recovery, and quality of life in young adulthood. Over half of all participants (51%) reported a high quality of life, and over one-third (40%) were not experiencing clinically-significant psychiatric symptoms. k-means cluster analysis identified three distinct profiles: low psychological strengths, mixed, and high strengths. Multiple regression analyses indicated the high strengths profile was significantly associated with lower symptom distress, higher recovery, and higher quality of life after controlling for demographics, psychiatric history, treatment experience, and psychiatric interference in school and relationships during adolescence. Findings have implications for targeted support and services based on psychological profile, including family support, interventions to support medication management such as shared decision-making, and peer support.
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Affiliation(s)
- Deborah M Layman
- Psychology Department, Fordham University, 441 E. Fordham Road, Bronx, NY, 10458, USA.
| | - Celia B Fisher
- Psychology Department, Fordham University, 441 E. Fordham Road, Bronx, NY, 10458, USA
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109
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Joo JH, Bone L, Forte J, Kirley E, Lynch T, Aboumatar H. The benefits and challenges of established peer support programmes for patients, informal caregivers, and healthcare providers. Fam Pract 2022; 39:903-912. [PMID: 35104847 PMCID: PMC9508871 DOI: 10.1093/fampra/cmac004] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
PURPOSE Peer support programmes that provide services for various health conditions have been in existence for many years; however, there is little study of their benefits and challenges. Our goal was to explore how existing peer support programmes help patients with a variety of health conditions, the challenges that these programmes meet, and how they are addressed. METHODS We partnered with 7 peer support programmes operating in healthcare and community settings and conducted 43 semi-structured interviews with key informants. Audiorecordings were transcribed and qualitative analysis was conducted using grounded theory methods. RESULTS Peer support programmes offer informational and psychosocial support, reduce social isolation, and connect patients and caregivers to others with similar health issues. These programmes provide a supportive community of persons who have personal experience with the same health condition and who can provide practical information about self-care and guidance in navigating the health system. Peer support is viewed as different from and complementary to professional healthcare services. Existing programmes experience challenges such as matching of peer supporter and peer recipient and maintaining relationship boundaries. They have gained experience in addressing some of these challenges. CONCLUSIONS Peer support programmes can help persons and caregivers manage health conditions but also face challenges that need to be addressed through organizational processes. Peer support programmes have relevance for improving healthcare systems, especially given the increased focus on becoming more patient-centred. Further study of peer programmes and their relevance to improving individuals' well-being is warranted.
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Affiliation(s)
- Jin Hui Joo
- Department of Psychiatry, School of Medicine, Johns Hopkins University, Meyer 235, Baltimore, MD, United States
| | - Lee Bone
- Department of Health, Society and Behavior, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, United States
| | - Joan Forte
- Formerly Department of Patient Experience, Stanford Health Care, Sunnyvale, CA, United States
| | - Erin Kirley
- Armstrong Institute for Patient Safety and Quality, School of Medicine, Johns Hopkins University, Baltimore, MD, United States
| | - Thomas Lynch
- Department of Surgery, School of Medicine, Duke University, Durham, NC, United States
| | - Hanan Aboumatar
- Department of Health, Society and Behavior, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, United States.,Armstrong Institute for Patient Safety and Quality, School of Medicine, Johns Hopkins University, Baltimore, MD, United States.,Department of Medicine, School of Medicine, Johns Hopkins University, Baltimore, MD, United States
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110
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Kotera Y, Llewellyn-Beardsley J, Charles A, Slade M. Common Humanity as an Under-acknowledged Mechanism for Mental Health Peer Support. Int J Ment Health Addict 2022. [DOI: 10.1007/s11469-022-00916-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
AbstractMental health peer support (PS) is a relational approach to recovery. Service users are helped through a relationship focused on connection with a PS worker who shares similar experiences. Despite the strong evidence base, the mechanisms of action for mental health PS are under-researched. Several theories have been proposed to explain the mechanisms, including social comparison theory (SCT). SCT highlights the benefits arising from emphasising differences between a service user and the PS worker. An unintended consequence is that connection between them may be reduced. We propose common humanity (CH) as an under-acknowledged mechanism of action. CH is an experience recognising that there are other people living with similar suffering, and helps us regulate emotions. A CH-informed connection-based PS relationship may help a service user in different ways from a SCT-informed comparison-based PS relationship. Future PS research can investigate emotional self-regulation to establish whether CH-related outcomes arise from PS.
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111
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Jayasinghe A, Wrobel A, Filia K, Byrne LK, Melvin G, Berk L, Berk M, Cotton S. Psychological distress in siblings of people with mental illness: A systematic review and meta-analysis. Aust N Z J Psychiatry 2022; 57:642-660. [PMID: 36113083 DOI: 10.1177/00048674221123481] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE The objective of this study was to characterise the prevalence and/or severity of psychological distress (namely, depression and anxiety symptoms) in siblings of people with mental illness (MI) and to examine correlates of distress in siblings of people with MI. METHOD Studies comparing distress in individuals with and without a sibling with MI were eligible. Studies reporting on correlates of distress in siblings were also eligible. A search of MEDLINE Complete, PsycINFO and Embase was conducted up until 17 March 2022. RESULTS Fifteen studies comprising 2304 siblings and 2263 comparison individuals were included. Meta-analyses indicated individuals with a sibling with MI experience significantly greater depressive symptoms (Hedges's g = 0.53, 95% CI = [0.32, 0.73], siblings n = 1962, comparison individuals n = 2248) and anxiety symptoms (Hedges's g = 0.40, 95% CI = [0.19, 0.61], siblings n = 653, comparison individuals n = 533) than those without. The sibling relationship, siblings' locus of control, interpersonal functioning and their appraisal of the impacts of MI were identified as important and potentially modifiable correlates. CONCLUSION Individuals with a sibling with MI experience greater depressive and anxiety symptoms than those without and would likely benefit from support. Future studies are required to elucidate the mechanisms underlying distress in siblings.
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Affiliation(s)
- Anuradhi Jayasinghe
- School of Psychology, Deakin University, Geelong, VIC, Australia.,Orygen, Parkville, VIC, Australia
| | - Anna Wrobel
- Orygen, Parkville, VIC, Australia.,Institute for Mental and Physical Health and Clinical Translation (IMPACT), School of Medicine, Deakin University, Geelong, VIC, Australia
| | - Kate Filia
- Orygen, Parkville, VIC, Australia.,Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
| | - Linda K Byrne
- School of Psychology, Deakin University, Geelong, VIC, Australia
| | - Glenn Melvin
- School of Psychology, Deakin University, Geelong, VIC, Australia.,Centre for Educational Development, Appraisal and Research, University of Warwick, Coventry, UK
| | - Lesley Berk
- Institute for Mental and Physical Health and Clinical Translation (IMPACT), School of Medicine, Deakin University, Geelong, VIC, Australia.,Melbourne School of Population and Global Health, The University of Melbourne, Parkville, VIC, Australia
| | - Michael Berk
- Orygen, Parkville, VIC, Australia.,Institute for Mental and Physical Health and Clinical Translation (IMPACT), School of Medicine, Deakin University, Geelong, VIC, Australia.,Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia.,Florey Institute for Neuroscience and Mental Health, The University of Melbourne, Parkville, VIC, Australia.,Department of Psychiatry, The Royal Melbourne Hospital, The University of Melbourne, Parkville, VIC, Australia
| | - Sue Cotton
- Orygen, Parkville, VIC, Australia.,Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
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112
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Krumm S, Haun M, Hiller S, Charles A, Kalha J, Niwemuhwezi J, Nixdorf R, Puschner B, Ryan G, Shamba D, Epstein PG, Moran G. Mental health workers' perspectives on peer support in high-, middle- and low income settings: a focus group study. BMC Psychiatry 2022; 22:604. [PMID: 36088330 PMCID: PMC9464408 DOI: 10.1186/s12888-022-04206-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Accepted: 08/05/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Peer support is increasingly acknowledged as an integral part of mental health services around the world. However, most research on peer support comes from high-income countries, with little attention to similarities and differences between different settings and how these affect implementation. Mental health workers have an important role to play in integrating formal peer support into statutory services, and their attitudes toward peer support can represent either a barrier to or facilitator of successful implementation. Thus, this study investigates mental health workers' attitudes toward peer support across a range of high- (Germany, Israel), middle- (India), and low-income country (Tanzania, Uganda) settings. METHODS Six focus groups were conducted in Ulm and Hamburg (Germany), Butabika (Uganda), Dar es Salaam (Tanzania), Be'er Sheva (Israel), and Ahmedabad, Gujarat (India) with a total of 35 participants. Transcripts were analyzed using thematic content analysis. RESULTS Participants across the study sites demonstrated overall positive attitudes towards peer support in mental health care, although some concerns were raised on potentially harmful effects of peer support such as negative role modelling and giving inadequate advice to service users. Notably, mental health workers from low- and middle-income countries described peer support workers as bridge-builders and emphasized the mutual benefits of peer support. Mental health workers' views on peer support workers' roles and role boundaries differed between sites. In some settings, mental health workers strongly agreed on the need for role clarity, whereas in others, mental health workers expressed mixed views, with some preferring blurred role boundaries. Regarding collaboration, mental health workers described peer support workers as supporters and utilizers, equal partners or emphasized a need for trust and commitment. CONCLUSIONS Mental health workers' attitudes toward peer support workers were positive overall, but they also varied depending on local context, resources and previous experiences with peer support. This affected their conceptions of peer support workers' roles, role clarity, and collaboration. This study demonstrated that reconciling the need for local adaptations and safeguarding the core values of peer support is necessary and possible, especially when the implementation of recovery-oriented interventions such as peer support is accelerating worldwide.
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Affiliation(s)
- Silvia Krumm
- Department of Psychiatry and Psychotherapy II, Ulm University, Ulm/Guenzburg, Germany.
| | - Maria Haun
- grid.6582.90000 0004 1936 9748Department of Psychiatry and Psychotherapy II, Ulm University, Ulm/Guenzburg, Germany
| | - Selina Hiller
- grid.6582.90000 0004 1936 9748Department of Psychiatry and Psychotherapy II, Ulm University, Ulm/Guenzburg, Germany
| | - Ashleigh Charles
- grid.4563.40000 0004 1936 8868School of Health Sciences, Institute of Mental Health, University of Nottingham, Nottingham, UK
| | - Jasmine Kalha
- grid.32056.320000 0001 2190 9326Centre for Mental Health Law and Policy, Indian Law Society, Pune, India
| | - Jackie Niwemuhwezi
- grid.461309.90000 0004 0414 2591Butabika National Referral Hospital, Kampala, Uganda
| | - Rebecca Nixdorf
- grid.13648.380000 0001 2180 3484Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Bernd Puschner
- grid.6582.90000 0004 1936 9748Department of Psychiatry and Psychotherapy II, Ulm University, Ulm/Guenzburg, Germany
| | - Grace Ryan
- grid.8991.90000 0004 0425 469XCentre for Global Mental Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Donat Shamba
- grid.414543.30000 0000 9144 642XDepartment of Health Systems, Impact Evaluation and Policy, Ifakara Health Institute, Dar es Salaam, Tanzania
| | - Paula Garber Epstein
- grid.12136.370000 0004 1937 0546Bob Shapell School of Social Work, Tel Aviv University, Tel Aviv, Israel
| | - Galia Moran
- grid.7489.20000 0004 1937 0511Department of Social Work, Ben Gurion University of the Negev, Be’er Sheva, Israel
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113
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Rice C, Ingram E, O'Mahen H. A qualitative study of the impact of peer support on women's mental health treatment experiences during the perinatal period. BMC Pregnancy Childbirth 2022; 22:689. [PMID: 36068490 PMCID: PMC9450402 DOI: 10.1186/s12884-022-04959-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Accepted: 06/22/2022] [Indexed: 11/12/2022] Open
Abstract
Background Perinatal mental health problems are prevalent, affecting up to 20% of women However, only 17–25% receive formal support during the perinatal period. In this qualitative study, we sought to examine women’s experiences with peer support for mental health problems during the perinatal period. Methods Semi-structured interviews and focus groups were conducted with twenty-five mothers from the UK who had utilised peer support for a perinatal mental health problem. Data was analysed using thematic analysis. Results Seven major themes were identified in women’s help seeking process and experience of peer support. These included; perinatal specific precipitating factors that contributed to their mental health problems, barriers in the form of unhelpful professional responses, feelings of isolation, acceptance of the problem and need to actively re-seek support, finding support either through luck or peer assistance. Conclusion Peer support showed promise as an effective means to reduce perinatal mental health difficulties; either as a form of formal support or as an adjunct to formal support. The results highlight ways to improve perinatal women’s access to mental health support through peer-based mechanisms. Supplementary Information The online version contains supplementary material available at 10.1186/s12884-022-04959-7.
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Affiliation(s)
- Chloe Rice
- Mood Disorders Centre, University of Exeter, Washington Singer Building, EX4 4QG, Exeter, UK
| | - Emma Ingram
- Mood Disorders Centre, University of Exeter, Washington Singer Building, EX4 4QG, Exeter, UK
| | - Heather O'Mahen
- Mood Disorders Centre, University of Exeter, Washington Singer Building, EX4 4QG, Exeter, UK.
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von Hippel C, Brener L, Rose G. Lived Experience as a Protective Factor for Mental Health Workers. Psychiatr Serv 2022; 73:999-1004. [PMID: 35291818 DOI: 10.1176/appi.ps.202100468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE When clients do not seem to be improving, mental health workers have more negative job attitudes, experience higher levels of client-related burnout, and are more interested in leaving the field. Nonetheless, it is unclear whether all mental health workers are equally susceptible to burnout caused by feelings that their clients are not improving. Specifically, people with lived experience of mental illness are intimately familiar with their own recovery challenges and thus may be less susceptible to this source of burnout. METHODS To test this possibility, mental health providers (N=179) from a nongovernmental community mental health organization in Australia completed a survey assessing their perceptions of client improvement from treatment, their feelings of client-related burnout, and a range of organizational outcomes (job satisfaction, job engagement, workplace well-being, and intentions to resign). RESULTS Moderated mediation analyses revealed that although mental health providers who felt that their clients were not improving experienced client-related burnout, lived experience served as a buffer. Staff with lived experience were less susceptible to burnout associated with perceptions that their clients were not improving from treatment. Mental health providers with lived experience also reported more positive job attitudes compared with providers without lived experience. CONCLUSIONS Given the high rates of burnout in the mental health profession, future research should examine why lived experience appears to buffer staff from burnout when they believe that their clients are not improving. This knowledge could aid in the development of interventions to boost resilience, engagement, and longevity in the field.
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Affiliation(s)
- Courtney von Hippel
- Faculty of Health and Behavioural Sciences, School of Psychology, University of Queensland, Brisbane, Queensland, Australia (von Hippel); Centre for Social Research in Health, University of New South Wales, Kensington, New South Wales, Australia (Brener); Flourish Australia, Sydney, New South Wales, Australia (Rose)
| | - Loren Brener
- Faculty of Health and Behavioural Sciences, School of Psychology, University of Queensland, Brisbane, Queensland, Australia (von Hippel); Centre for Social Research in Health, University of New South Wales, Kensington, New South Wales, Australia (Brener); Flourish Australia, Sydney, New South Wales, Australia (Rose)
| | - Grenville Rose
- Faculty of Health and Behavioural Sciences, School of Psychology, University of Queensland, Brisbane, Queensland, Australia (von Hippel); Centre for Social Research in Health, University of New South Wales, Kensington, New South Wales, Australia (Brener); Flourish Australia, Sydney, New South Wales, Australia (Rose)
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115
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Effectiveness of personal recovery facilitators in adults with schizophrenia and other psychoses: A systematic review of reviews and narrative synthesis. Schizophr Res 2022; 246:132-147. [PMID: 35777151 DOI: 10.1016/j.schres.2022.06.018] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Revised: 06/14/2022] [Accepted: 06/19/2022] [Indexed: 01/12/2023]
Abstract
This review aimed to examine the evidence base for the use of personal recovery facilitators [non-psychopharmacological approaches] for adults with a diagnosis of schizophrenia and other psychoses. A systematic review (umbrella review) was conducted of reviews published in English between January 2010 and February 2022, which examined the effectiveness of personal recovery facilitators to support aspects of personal recovery as defined by the CHIME framework (connectedness, hope and optimism, identity, meaning and purpose, and empowerment). Twenty-one systematic reviews on thirteen different types of personal recovery facilitators [PRFs] were included in this umbrella review. Only one review sought to directly measure personal recovery processes according to the CHIME framework. Outcome measures mostly aligned with the processes of hope (21 reviews) and connectedness (19 reviews). Those related to empowerment (2 reviews), identity (5 reviews) and meaning and purpose (1 review) were less frequently the focus of PRFs. Yoga and music therapy showed the most promise as PRFs. Vocational treatments and integrated supported employment show good potential as personal recovery facilitators. However, together with narrative photovoice, art making and exhibition, they require further robust research to fully examine their impact. Personal recovery is only beginning to be considered as an intended outcome of interventions for persons with schizophrenia and other psychoses. This may be due in part to the continued predominance of the biomedical model approach to recovery within statutory services. Future evaluations of PRFs should include outcome measures that directly assess personal recovery according to the CHIME framework or other measures developed in consultation with recipients of these approaches. Review registration number and date: PROSPERO 2020 CRD42020215471: 10/11/20.
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116
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Luu KL, Witkamp FE, Nieboer D, Bakker EM, Kranenburg LW, van der Rijt CCD, Lorig K, van der Heide A, Rietjens JAC. Effectiveness of the "Living with Cancer" peer self-management support program for persons with advanced cancer and their relatives: study protocol of a non-randomized stepped wedge study. Palliat Care 2022; 21:107. [PMID: 35692043 PMCID: PMC9188837 DOI: 10.1186/s12904-022-00994-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Accepted: 05/30/2022] [Indexed: 11/13/2022] Open
Abstract
Background Persons with advanced cancer and their relatives experience physical, emotional, and psychosocial consequences of the illness. Most of the time, they must deal with these themselves. While peer self-management support programs may be helpful, there is little evidence on their value for this population. We present the research protocol of our SMART study that will evaluate the effectiveness of the “Living with Cancer” peer self-management support program, aimed at improving self-management behaviors, self-efficacy, and health-related quality of life of persons with advanced cancer and their relatives. Methods We will conduct a non-randomized stepped wedge study in the Netherlands. We will include 130 persons with advanced cancer and 32 relatives. Participants can choose to either start the program within 4 weeks after inclusion or after eight to 10 weeks. The “Living with Cancer” is a peer self-management support program, based on the Chronic Disease Self-Management Program. It consists of six 1,5 hours video-conferencing group meetings with eight to 12 participants, preceded by two or three preparatory audio clips with supportive text per session. The program has the following core components: the learning of self-management skills (action-planning, problem-solving, effective communication, and decision-making), discussing relevant themes (e.g. dealing with pain and fatigue, living with uncertainty, and future planning), and sharing experiences, knowledge, and best practices. The primary outcome for both persons with advanced cancer and relatives is self-management behavior assessed by the subscale “constructive attitudes and approaches” of the Health Education Impact Questionnaire. Secondary outcomes are other self-management behaviors, self-efficacy, health-related quality of life, symptoms, depression and anxiety, and loneliness. Participants complete an online questionnaire at baseline, and after eight and 16 weeks. After each session, they complete a logbook about their experiences. Group meetings will be video recorded. Discussion SMART aims to evaluate an innovative program building on an evidence-based self-management program. New features are its use for persons with advanced cancer, the inclusion of relatives, and the video-conferencing format for this population. The use of both quantitative and qualitative analyses will provide valuable insight into the effectiveness and value of this program. Trial registration This study was registered in the Dutch Trial Register on October 2021, identifier NL9806. Supplementary Information The online version contains supplementary material available at 10.1186/s12904-022-00994-5.
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Affiliation(s)
- K L Luu
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands.
| | - F E Witkamp
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands.,Center of Expertise Innovations in Care, Rotterdam University of Applied Sciences, Rotterdam, the Netherlands
| | - D Nieboer
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - E M Bakker
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - L W Kranenburg
- Department of Psychiatry, Section Medical Psychology and Psychotherapy, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - C C D van der Rijt
- Department of Medical Oncology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - K Lorig
- Stanford School of Medicine, CA, Stanford, USA
| | - A van der Heide
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - J A C Rietjens
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
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An Update of Peer Support/Peer Provided Services Underlying Processes, Benefits, and Critical Ingredients. Psychiatr Q 2022; 93:571-586. [PMID: 35179660 PMCID: PMC8855026 DOI: 10.1007/s11126-022-09971-w] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/14/2022] [Indexed: 01/20/2023]
Abstract
The purpose of this article is to delineate the current state-of-the-knowledge of peer support following the framework employed in the 2004 article (Solomon, Psychiatr Rehabil J. 2004;27(4):392-401 1). A scoping literature was conducted and included articles from 1980 to present. Since 2004, major growth and advancements in peer support have occurred from the development of new specializations to training, certification, reimbursement mechanisms, competency standards and fidelity assessment. Peer support is now a service offered across the world and considered an indispensable mental health service. As the field continues to evolve and develop, peer support is emerging as a standard of practice throughout various, diverse settings and shows potential to impact clinical outcomes for service users throughout the globe. While these efforts have enhanced the professionalism of the peer workforce, hopefully this has enhanced the positive elements of these services and not diluted them.
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118
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Smit D, Vrijsen JN, Broekman T, Groeneweg B, Spijker J. User Engagement within the Online Peer Support Community ‘Depression Connect’ and Recovery-related Changes in Empowerment: a Longitudinal User Survey (Preprint). JMIR Form Res 2022; 6:e39912. [DOI: 10.2196/39912] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Revised: 09/01/2022] [Accepted: 09/06/2022] [Indexed: 11/13/2022] Open
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Feriante J, Shayani A, Lauer E, Pressman A, Rubin E. Sibling Support Program: A Novel Peer Support Intervention for Parents, Caregivers and Siblings of Youth Experiencing Mental Illness. Healthcare (Basel) 2022; 10:healthcare10050908. [PMID: 35628046 PMCID: PMC9140975 DOI: 10.3390/healthcare10050908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 04/28/2022] [Accepted: 05/05/2022] [Indexed: 02/04/2023] Open
Abstract
Caregivers and siblings of youth with mental illness often experience role-related psychological challenges, and it is important to focus on the needs of these family members. Existing literature demonstrates that caregivers and affected children benefit from participation in peer support and family-centered programs. This paper describes the Sibling Support Program: A Family-Centered Mental Health Initiative (SSP), a novel intervention for families of youth with mental illness. The SSP distinguishes itself from existing family-centered programs in that it utilizes a unique combination of peer support, parent mentor guidance, and clinician-led group therapy. The paper details the structure of the treatment model and presents preliminary data from participant surveys. Results show preliminary indications that the program provides both emotional and practical benefits. Along with high satisfaction ratings, family members report decreased feelings of isolation, gains in knowledge, and more positive thinking after program participation. Caregivers report that the SSP helped improve their understanding about the impact of a child’s mental illness on family members, and that they learned about effective family management strategies and access to resources. Siblings report learning coping strategies and feeling better after meeting peers with shared experiences.
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Affiliation(s)
- Joshua Feriante
- Department of Psychiatry, UMass Chan Medical School, 55 N Lake Avenue, Worcester, MA 01655, USA; (J.F.); (A.S.); (E.L.)
| | - Ariella Shayani
- Department of Psychiatry, UMass Chan Medical School, 55 N Lake Avenue, Worcester, MA 01655, USA; (J.F.); (A.S.); (E.L.)
| | - Emily Lauer
- Department of Psychiatry, UMass Chan Medical School, 55 N Lake Avenue, Worcester, MA 01655, USA; (J.F.); (A.S.); (E.L.)
| | - Adele Pressman
- Cambridge Health Alliance, 1493 Cambridge Street, Cambridge, MA 02139, USA;
| | - Emily Rubin
- Department of Psychiatry, UMass Chan Medical School, 55 N Lake Avenue, Worcester, MA 01655, USA; (J.F.); (A.S.); (E.L.)
- Correspondence:
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120
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Zhen Z, Wang R, Zhu W. A deep learning based method for intelligent detection of seafarers' mental health condition. Sci Rep 2022; 12:7890. [PMID: 35551204 PMCID: PMC9098153 DOI: 10.1038/s41598-022-11207-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Accepted: 04/13/2022] [Indexed: 11/09/2022] Open
Abstract
Mental health monitoring of seafarers is an important part of achieving normal development of the ocean shipping industry. In this paper, a dual subjective-objective testing scheme is proposed to achieve a more effective and intelligent assessment of seafarers' mental health status. Firstly, a new seafarers' mental health test scale (SMHT) is revised based on fuzzy factor analysis and the test data of 283 marine practitioners are analyzed using SPSS v24 software; secondly, this paper proposes an intelligent framework module for immersive subjective emotion extraction based on natural language processing, namely semantic summary extraction (SSE), speech emotion extraction (SEE), using hybrid scoring mechanism to obtain semantic and emotion matching values and assist the seafarer mental health scale to obtain the final correction score. The results showed that the assessment results of the SMHT scale exhibited good reliability (Cronbach's alpha of 0.852 [Formula: see text] and retest reliability R of [Formula: see text]) and scale association validity (for SCL-90, ([Formula: see text]). In addition, the calibration rate of the subject-object dual test method was improved by approximately 12.05% compared to the traditional mental health scale. Finally, the advantages and disadvantages of this solution were compared with mental health testing techniques such as CAT, machine learning, SCL-90, and fMRI, and the method demonstrated more accurate psychological testing results, providing a simple and intelligent solution for standardized psychological testing of seafarers.
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Affiliation(s)
- Zhu Zhen
- Laboratory of Marine Simulation and Control, Dalian Maritime University, Dalian, Liaoning Province, China
| | - Renda Wang
- Laboratory of Marine Simulation and Control, Dalian Maritime University, Dalian, Liaoning Province, China.
| | - Wei Zhu
- Navigation College of Dalian Maritime University, Dalian, Liaoning Province, China
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Memiah P, Wagner FA, Kimathi R, Anyango NI, Kiogora S, Waruinge S, Kiruthi F, Mwavua S, Kithinji C, Agache JO, Mangwana W, Merci NM, Ayuma L, Muhula S, Opanga Y, Nyambura M, Ikahu A, Otiso L. Voices from the Youth in Kenya Addressing Mental Health Gaps and Recommendations. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:5366. [PMID: 35564760 PMCID: PMC9104498 DOI: 10.3390/ijerph19095366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Revised: 03/24/2022] [Accepted: 04/14/2022] [Indexed: 11/16/2022]
Abstract
Studies including adolescents and young people (AYP) enhance the relevance of research results, benefit stakeholders, and inform future research. There exists a mental health gap in services for AYP living in low and middle-income countries. This study aims to identify mental health challenges faced by adolescents and young people in Kenya, develop practical recommendations to mitigate these issues, and reduce the mental health burden among this population. We convened an AYP-led meeting that involved 41 participants. The meeting objectives were to (1) identify efforts to support existing national and regional strategic priorities and review goals for addressing mental health needs among AYPs, (2) develop immediate action plans for strengthened mental health services, (3) review and strengthen country-level coordination mechanisms, and (4) identify how participating county experiences can inform mental health services in Kenya. Ministry of Health (MoH) officials from national and county levels, academic experts, and implementing partner agencies involved in mental health services participated in the meeting. The team, including AYP representatives, identified various mental health challenges among the AYA and recommended interventions aimed towards improving their mental health situation in the country. The challenges were clustered into three themes and comprehensively reviewed to establish the precipitating factors to mental health outcomes among AYPs in Kenya and provide recommendations. The themes included (1) legislative, (2) service provider/Ministry of Health, and (3) adolescent/individual-level factors. To bridge the mental health gap in the country and scale up mental health outcomes, the stakeholders recommended interventions within the context of the three clusters. The key suggestions included an increase in insurance financing, acceleration of community health interventions, the establishment of adolescent-friendly spaces, the training of adolescent youth champions, interactive service provision models, implementation of the existing mental health policies and structures, the development of comprehensive assessment tools, well equipped mental health departments in health facilities, the enhancement of telehealth services and digital villages, the mobilization of a functional mental health response team, and the development of a mental health database.
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Affiliation(s)
- Peter Memiah
- Division of Epidemiology and Prevention, Institute of Human Virology, University of Maryland Baltimore, Baltimore, MD 21201, USA
| | - Fernando A. Wagner
- School of Social Work, University of Maryland Baltimore, Baltimore, MD 21201, USA;
| | - Robert Kimathi
- LVCT Health, Nairobi P.O. Box 19835-00202, Kenya; (R.K.); (A.I.); (L.O.)
| | - Naomi Idah Anyango
- Ministry of Health Kenya, Nairobi P.O. Box 30016-00100, Kenya; (N.I.A.); (S.K.); (M.N.)
| | - Samuel Kiogora
- Ministry of Health Kenya, Nairobi P.O. Box 30016-00100, Kenya; (N.I.A.); (S.K.); (M.N.)
| | - Stella Waruinge
- Nairobi Metropolitan Services, Nairobi P.O. Box 30430-00100, Kenya; (S.W.); (F.K.); (S.M.)
| | - Faith Kiruthi
- Nairobi Metropolitan Services, Nairobi P.O. Box 30430-00100, Kenya; (S.W.); (F.K.); (S.M.)
| | - Shillah Mwavua
- Nairobi Metropolitan Services, Nairobi P.O. Box 30430-00100, Kenya; (S.W.); (F.K.); (S.M.)
| | - Celina Kithinji
- Mombasa County Department of Health, Mombasa P.O. Box 81599-80100, Kenya;
| | | | - Wincolyne Mangwana
- Youth Advisory Champions for Health, Nairobi Youth Advisory Council, Mombasa P.O. Box 81599-80100, Kenya; (W.M.); (N.M.M.); (L.A.)
| | - Niyibeshaho Marie Merci
- Youth Advisory Champions for Health, Nairobi Youth Advisory Council, Mombasa P.O. Box 81599-80100, Kenya; (W.M.); (N.M.M.); (L.A.)
| | - Leonidah Ayuma
- Youth Advisory Champions for Health, Nairobi Youth Advisory Council, Mombasa P.O. Box 81599-80100, Kenya; (W.M.); (N.M.M.); (L.A.)
| | - Samuel Muhula
- Amref Health Africa in Kenya, Nairobi P.O. Box 30125-00100, Kenya; (S.M.); (Y.O.)
| | - Yvonne Opanga
- Amref Health Africa in Kenya, Nairobi P.O. Box 30125-00100, Kenya; (S.M.); (Y.O.)
| | - Maureen Nyambura
- Ministry of Health Kenya, Nairobi P.O. Box 30016-00100, Kenya; (N.I.A.); (S.K.); (M.N.)
| | - Annrita Ikahu
- LVCT Health, Nairobi P.O. Box 19835-00202, Kenya; (R.K.); (A.I.); (L.O.)
| | - Lillian Otiso
- LVCT Health, Nairobi P.O. Box 19835-00202, Kenya; (R.K.); (A.I.); (L.O.)
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Balková M. A Qualitative Study of the Experience of Peer Workers in the Czech Republic. Community Ment Health J 2022; 58:429-436. [PMID: 33956264 DOI: 10.1007/s10597-021-00832-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Accepted: 04/28/2021] [Indexed: 10/21/2022]
Abstract
The study deals with the employment of people diagnosed with mental illness in the position of peer worker. The aim is to demonstrate through semi-structured interviews the involvement of peer workers in the social services for people diagnosed with mental illness and to identify the influences that affect the success of peer workers involvement in services. The results of the interviews were divided into two categories (Position Specifics, Ethical Aspects) and four subcategories (Professionalism, Risk Moments, Stigmatization, Shared Values) using the Coding Method. The individual subcategories were further subdivided in detail. The results show that the most negative influence on the successful involvement of peer workers is the unclear definition of the job role and responsibilities and further, from an ethical point of view, it is the fear of subsequent labelling (stigmatization) in the search for a new job. A positive ethical influence is the sharing of social values (hope, recovery, friendship, sharing, etc.), which supports the peer worker. The study could help anchor the role in practice and could be the basis for further research in human resources management, social work and management.
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Affiliation(s)
- Miluše Balková
- Department of Human Resource Management, Institute of Technology and Business in České Budějovice, Okružní 517/10, 370 01, České Budějovice, Czech Republic.
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123
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Shalaby R, Spurvey P, Knox M, Rathwell R, Vuong W, Surood S, Urichuk L, Snaterse M, Greenshaw AJ, Li XM, Agyapong VIO. Clinical Outcomes in Routine Evaluation Measures for Patients Discharged from Acute Psychiatric Care: Four-Arm Peer and Text Messaging Support Controlled Observational Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19073798. [PMID: 35409483 PMCID: PMC8997547 DOI: 10.3390/ijerph19073798] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Revised: 03/14/2022] [Accepted: 03/16/2022] [Indexed: 12/10/2022]
Abstract
Background: Peer support workers (PSW) and text messaging services (TxM) are supportive health services that are frequently examined in the field of mental health. Both interventions have positive outcomes, with TxM demonstrating clinical and economic effectiveness and PSW showing its utility within the recovery-oriented model. Objective: To evaluate the effectiveness of PSW and TxM in reducing psychological distress of recently discharged patients receiving psychiatric care. Methods: This is a prospective, rater-blinded, pilot-controlled observational study consisting of 181 patients discharged from acute psychiatric care. Patients were randomized into one of four conditions: daily supportive text messages only, peer support only, peer support plus daily text messages, or treatment as usual. Clinical Outcomes in Routine Evaluation—Outcome Measure (CORE-OM), a standardized measure of mental distress, was administered at four time points: baseline, six weeks, three months, and six months. MANCOVA was used to assess the impact of the interventions on participants’ scores on four CORE-OM subscales across the three follow-up time points. Recovery, clinical change, and reliable change in CORE-OM all-item analysis were examined across the four groups, and the prevalence of risk symptoms was measured. Results: A total of 63 patients completed assessments at each time point. The interaction between PSW and TxM was predictive of differences in scores on the CORE-OM functioning subscale with a medium effect size (F1,63 = 4.19; p = 0.045; ηp2 = 0.07). The PSW + TxM group consistently achieved higher rates of recovery and clinical and reliable improvement compared to the other study groups. Additionally, the text message group and the PSW + TxM group significantly reduced the prevalence of risk of self/other harm symptoms after six months of intervention, with 27.59% (χ2(1) = 4.42, p = 0.04) and 50% (χ2(1) = 9.03, p < 0.01) prevalence reduction, respectively. Conclusions: The combination of peer support and supportive text messaging is an impactful intervention with positive clinical outcomes for acute care patients. Adding the two interventions into routine psychiatric care for patients after discharge is highly recommended.
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Affiliation(s)
- Reham Shalaby
- Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB T6G 2B7, Canada; (R.S.); (A.J.G.); (X.-M.L.)
| | - Pamela Spurvey
- Alberta Health Services Addiction and Mental Health, Edmonton, AB T5J 3E4, Canada; (P.S.); (M.K.); (R.R.); (W.V.); (S.S.); (L.U.); (M.S.)
| | - Michelle Knox
- Alberta Health Services Addiction and Mental Health, Edmonton, AB T5J 3E4, Canada; (P.S.); (M.K.); (R.R.); (W.V.); (S.S.); (L.U.); (M.S.)
| | - Rebecca Rathwell
- Alberta Health Services Addiction and Mental Health, Edmonton, AB T5J 3E4, Canada; (P.S.); (M.K.); (R.R.); (W.V.); (S.S.); (L.U.); (M.S.)
| | - Wesley Vuong
- Alberta Health Services Addiction and Mental Health, Edmonton, AB T5J 3E4, Canada; (P.S.); (M.K.); (R.R.); (W.V.); (S.S.); (L.U.); (M.S.)
| | - Shireen Surood
- Alberta Health Services Addiction and Mental Health, Edmonton, AB T5J 3E4, Canada; (P.S.); (M.K.); (R.R.); (W.V.); (S.S.); (L.U.); (M.S.)
| | - Liana Urichuk
- Alberta Health Services Addiction and Mental Health, Edmonton, AB T5J 3E4, Canada; (P.S.); (M.K.); (R.R.); (W.V.); (S.S.); (L.U.); (M.S.)
| | - Mark Snaterse
- Alberta Health Services Addiction and Mental Health, Edmonton, AB T5J 3E4, Canada; (P.S.); (M.K.); (R.R.); (W.V.); (S.S.); (L.U.); (M.S.)
| | - Andrew J. Greenshaw
- Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB T6G 2B7, Canada; (R.S.); (A.J.G.); (X.-M.L.)
| | - Xin-Min Li
- Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB T6G 2B7, Canada; (R.S.); (A.J.G.); (X.-M.L.)
| | - Vincent I. O. Agyapong
- Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB T6G 2B7, Canada; (R.S.); (A.J.G.); (X.-M.L.)
- Department of Psychiatry, Faculty of Medicine, Dalhousie University, Halifax, NS B3H 2E2, Canada
- Correspondence:
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Implementing a peer-to-peer, self-management intervention for young people with depression and anxiety in Denmark. BMC Psychol 2022; 10:70. [PMID: 35296363 PMCID: PMC8925241 DOI: 10.1186/s40359-022-00777-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Accepted: 03/07/2022] [Indexed: 11/27/2022] Open
Abstract
Background Depressive and anxiety disorders share major risk factors and can often be effectively prevented or treated with similar interventions. However, less than half of young people with mental health problems seek professional help and hence innovative approaches to support this group are needed. To this end Coping with Anxiety and Depression shows promise. The aim of this paper was to evaluate the implementation of Coping with Anxiety and Depression for young people aged 15–25 years showing symptoms of anxiety and/or depression in a Danish community setting. Methods The programme was implemented in 39 Danish municipalities. To evaluate the implementation of the programme, we collected quantitative and qualitative data simultaneously and subsequently we triangulated it in the data analysis. The qualitative data collection comprised semi-structured interviews in seven case municipalities. In each municipality we conducted interviews with a local municipality coordinator of the program, a group interview with two voluntary instructors facilitating the program and a group interview with two to seven participants in the programme. In total, seven local coordinators, 14 voluntary instructors and 23 participants (8 men and 15 women) were interviewed. We also carried out a baseline and post-intervention survey. Interview data was coded via an inductive and deductive analysis approach. Survey data was analysed via descriptive statistics in the statistical software programme STATA 16. Results The evaluation showed that the implementation of the programme is feasible, and that most participants (83%) were satisfied with the programme to a high/very high extent. In total, 84% of the participants strongly agreed/agreed that it was advantageous that instructors themselves had experience with anxiety and depression. Qualitative data showed that the participants were very positive about the group format. It also showed that recruitment and retention of participants and especially young instructors were challenging but doable. Thus our findings suggest that the programme can be implemented in a way that is perceived as useful and satisfying to young people. Conclusions Coping with Anxiety and Depression constitutes a feasible peer-to-peer, group-based community programme that is well-received by its target group. Recruitment and retention of participants and instructors is challenging but doable. Supplementary Information The online version contains supplementary material available at 10.1186/s40359-022-00777-w.
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Le SM, Trouiller P, Duong TH, Khuat THO, Pham MK, Vallo R, Rapoud D, Quillet C, Nguyen TL, Nguyen QD, Nham TTT, Hoang TG, Feelemyer J, Vu HV, Moles JP, Doan HQ, Laureillard D, Des Jarlais DC, Nagot N, Michel L. Development and assessment of a community-based screening tool for mental health disorders among people who inject drugs. Drug Alcohol Rev 2022; 41:697-705. [PMID: 34786755 PMCID: PMC10150937 DOI: 10.1111/dar.13402] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Revised: 09/29/2021] [Accepted: 10/03/2021] [Indexed: 01/04/2023]
Abstract
INTRODUCTION The prevalence of mental health disorders among people who use drugs is high and well documented. This hard-to-reach population faces a very low awareness and access to mental health care, especially in developing countries. The objectives of this study were to design and assess a quick screening tool (QST) that community-based organisations (CBO) could routinely apply to a Vietnamese population of people who inject drugs (PWID), in order to refer them appropriately to mental health specialists. METHODS We devised a tool that included nine questions covering anxiety, depression, suicide risk and psychotic symptomatology. Its use required no specific background and 2 h training. Specificity and sensitivity of the QST were assessed in a population of 418 PWID recruited via respondent driven sampling, using the Mini International Neuropsychiatric Interview questionnaire plus clinical evaluation as a reference standard. Acceptability was assessed using a self-administered anonymous questionnaire submitted to all CBO members who used the QST. RESULTS CBO members considered the QST easy to use, relevant and helpful to deal with mental health issues. Area under the curve for detection of any symptom using the QST was 0.770. The maximum sensitivity and specificity were reached with a cut-off of 2 [sensitivity was 71.1% (95% confidence interval 62.4, 78.8), specificity was 75.9% (70.5, 80.7)]. DISCUSSION AND CONCLUSIONS The QST appeared to be both efficient and well accepted. Given the burden of mental health problems among hard-to-reach PWID in developing countries, community-based screenings such as this one could be a particularly appropriate response.
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Affiliation(s)
- Sao M Le
- Hai Phong University of Medicine and Pharmacy, Hai Phong, Vietnam
| | - Philippe Trouiller
- CESP Inserm UMRS 1018, Paris Saclay University, Pierre Nicole Center, French Red Cross, Paris, France
| | - Thi H Duong
- Hai Phong University of Medicine and Pharmacy, Hai Phong, Vietnam
| | - Thi H O Khuat
- Supporting Community Development Initiatives, Hanoi, Vietnam
| | - Minh K Pham
- Hai Phong University of Medicine and Pharmacy, Hai Phong, Vietnam
| | - Roselyne Vallo
- Pathogenesis and Control of Chronic Infections, Inserm, Etablissement Français du Sang, University of Montpellier, Montpellier, France
| | - Delphine Rapoud
- Pathogenesis and Control of Chronic Infections, Inserm, Etablissement Français du Sang, University of Montpellier, Montpellier, France
| | - Catherine Quillet
- Pathogenesis and Control of Chronic Infections, Inserm, Etablissement Français du Sang, University of Montpellier, Montpellier, France
| | - Thuy L Nguyen
- Hai Phong University of Medicine and Pharmacy, Hai Phong, Vietnam
| | - Quang D Nguyen
- Hai Phong University of Medicine and Pharmacy, Hai Phong, Vietnam
| | | | - Thi G Hoang
- Hai Phong University of Medicine and Pharmacy, Hai Phong, Vietnam
| | | | - Hai V Vu
- Department of Infectious and Tropical Diseases, Viet Tiep Hospital, Hai Phong, Vietnam
| | - Jean-Pierre Moles
- Pathogenesis and Control of Chronic Infections, Inserm, Etablissement Français du Sang, University of Montpellier, Montpellier, France
| | - Hong Q Doan
- Hai Phong University of Medicine and Pharmacy, Hai Phong, Vietnam
| | - Didier Laureillard
- Pathogenesis and Control of Chronic Infections, Inserm, Etablissement Français du Sang, University of Montpellier, Montpellier, France
- Infectious Diseases Department, Caremeau University Hospital, Place du Professeur Robert Debré, Nîmes, France
| | | | - Nicolas Nagot
- Pathogenesis and Control of Chronic Infections, Inserm, Etablissement Français du Sang, University of Montpellier, Montpellier, France
| | - Laurent Michel
- CESP Inserm UMRS 1018, Paris Saclay University, Pierre Nicole Center, French Red Cross, Paris, France
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Abstract
Human-computer interaction (HCI) has contributed to the design and development of some efficient, user-friendly, cost-effective, and adaptable digital mental health solutions. But HCI has not been well-combined into technological developments resulting in quality and safety concerns. Digital platforms and artificial intelligence (AI) have a good potential to improve prediction, identification, coordination, and treatment by mental health care and suicide prevention services. AI is driving web-based and smartphone apps; mostly it is used for self-help and guided cognitive behavioral therapy (CBT) for anxiety and depression. Interactive AI may help real-time screening and treatment in outdated, strained or lacking mental healthcare systems. The barriers for using AI in mental healthcare include accessibility, efficacy, reliability, usability, safety, security, ethics, suitable education and training, and socio-cultural adaptability. Apps, real-time machine learning algorithms, immersive technologies, and digital phenotyping are notable prospects. Generally, there is a need for faster and better human factors in combination with machine interaction and automation, higher levels of effectiveness evaluation and the application of blended, hybrid or stepped care in an adjunct approach. HCI modeling may assist in the design and development of usable applications, and to effectively recognize, acknowledge, and address the inequities of mental health care and suicide prevention and assist in the digital therapeutic alliance.
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The Impact of Community Mental Health Programs for Australian Youth: A Systematic Review. Clin Child Fam Psychol Rev 2022; 25:573-590. [PMID: 35171386 PMCID: PMC8853061 DOI: 10.1007/s10567-022-00384-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/02/2022] [Indexed: 11/27/2022]
Abstract
Australia has undergone significant youth mental health reform over the past 10 years, leading to numerous studies examining the effects of community-based mental health care programs for Australian youth. However, no synthesis of this literature currently exists. Therefore, this systematic review aimed to: (1) describe the types of community-based mental health programs that have been delivered to Australian youth in the past 10 years; and (2) examine their impact in improving young people’s mental health symptomology and psychosocial functioning. A systematic search of the peer-reviewed literature was conducted. Studies were included if they evaluated the extent to which such programs improved mental health symptomology (e.g., depression, anxiety, substance use) and/or psychosocial outcomes (e.g., social functioning, school engagement, employment) for Australian youth aged 10–25 years. Thirty-seven studies were included. Four types of community-based youth mental health care programs were identified: therapy (n = 16), case management (n = 9), integrated ‘one-stop-shop’ (n = 6) and lifestyle (n = 6) programs. The majority of therapeutic programs were effective in reducing mental health symptomology. Case management and integrated approaches consistently yielded significant improvements in both symptomology and psychosocial outcomes. Lifestyle programs were effective in alleviating depressive symptoms, but inconclusive for other outcomes. This review provides support for youth-friendly, systemic, multidisciplinary and integrated assertive outreach models of community mental health care to improve outcomes for young Australians experiencing mental health concerns. Several recommendations for future research are provided to strengthen the local evidence-base supporting community mental health programs to ultimately enhance young people’s life trajectory.
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128
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McKenzie K, Gregory J, Hogg L. Mental Health Workers' Attitudes Towards Individuals With a Diagnosis of Borderline Personality Disorder: A Systematic Literature Review. J Pers Disord 2022; 36:70-98. [PMID: 34124949 DOI: 10.1521/pedi_2021_35_528] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
The attitudes of mental health workers toward individuals with mental health conditions can impact the quality of care they provide. Negative attitudes among mental health workers seem particularly common in response to people diagnosed with borderline personality disorder (BPD). The current review aimed to identify and review the literature regarding mental health workers' attitudes toward individuals diagnosed with BPD, specifically focusing on studies comparing workers' attitudes toward BPD with attitudes toward other mental health diagnoses. The findings suggest that mental health workers have more negative attitudes toward individuals labeled as having BPD than toward individuals with other diagnoses, such as depression. This is likely due to factors associated with the label itself, in addition to workers' perceptions of BPD symptoms and previous experiences of delivering treatment. The implications of these findings are considered, with a particular focus on how mental health services can effectively address negative attitudes toward BPD.
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Affiliation(s)
| | | | - Lorna Hogg
- Oxford Institute of Clinical Psychology Training and Research, University of Oxford, Oxford, U.K
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Abou Seif N, John-Baptiste Bastien R, Wang B, Davies J, Isaken M, Ball E, Pitman A, Rowe S. Effectiveness, acceptability and potential harms of peer support for self-harm in non-clinical settings: systematic review. BJPsych Open 2022; 8:e28. [PMID: 35034666 PMCID: PMC8811789 DOI: 10.1192/bjo.2021.1081] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Many people who have self-harmed prefer informal sources of support or support from those with lived experience. However, little is known about whether peer support improves outcomes for people who have self-harmed or about the risks of peer support interventions in non-clinical settings. AIMS The aims of this review were to examine the effectiveness, acceptability and potential risks of peer support for self-harm, and how these risks might be mitigated. METHOD We searched bibliographic databases and grey literature for papers published since 2000. We included peer support for self-harm that occurred in voluntary-sector organisations providing one-to-one or group support, or via moderated online peer support forums. RESULTS Eight of the ten papers included focused on peer support that was delivered through online media. No study compared peer support with other treatments or a control group, so limited conclusions could be made about its effectiveness. Peer support for self-harm was found to be acceptable and was viewed as having a range of benefits including a sense of community, empowerment, and access to information and support. The most commonly perceived risk associated with peer support was the potential for triggering self-harm. CONCLUSIONS Our findings highlighted a range of benefits of being part of a group with very specific shared experiences. Mitigations for potential risks include organisations using professional facilitators for groups, trigger warnings for online forums, and providing regular supervision and training so that peers are prepared and feel confident to support vulnerable people while maintaining their own emotional health.
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Affiliation(s)
| | | | - Belinda Wang
- Division of Psychiatry, University College London, UK
| | | | | | | | - Alexandra Pitman
- Division of Psychiatry, University College London, and Camden and Islington NHS Foundation Trust, UK
| | - Sarah Rowe
- Division of Psychiatry, University College London, UK
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Le PD, Eschliman EL, Grivel MM, Tang J, Cho YG, Yang X, Tay C, Li T, Bass J, Yang LH. Barriers and facilitators to implementation of evidence-based task-sharing mental health interventions in low- and middle-income countries: a systematic review using implementation science frameworks. Implement Sci 2022; 17:4. [PMID: 35022081 PMCID: PMC8756725 DOI: 10.1186/s13012-021-01179-z] [Citation(s) in RCA: 38] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Accepted: 12/05/2021] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND Task-sharing is a promising strategy to expand mental healthcare in low-resource settings, especially in low- and middle-income countries (LMICs). Research on how to best implement task-sharing mental health interventions, however, is hampered by an incomplete understanding of the barriers and facilitators to their implementation. This review aims to systematically identify implementation barriers and facilitators in evidence-based task-sharing mental health interventions using an implementation science lens, organizing factors across a novel, integrated implementation science framework. METHODS PubMed, PsychINFO, CINAHL, and Embase were used to identify English-language, peer-reviewed studies using search terms for three categories: "mental health," "task-sharing," and "LMIC." Articles were included if they: focused on mental disorders as the main outcome(s); included a task-sharing intervention using or based on an evidence-based practice; were implemented in an LMIC setting; and included assessment or data-supported analysis of barriers and facilitators. An initial conceptual model and coding framework derived from the Consolidated Framework for Implementation Research and the Theoretical Domains Framework was developed and iteratively refined to create an integrated conceptual framework, the Barriers and Facilitators in Implementation of Task-Sharing Mental Health Interventions (BeFITS-MH), which specifies 37 constructs across eight domains: (I) client characteristics, (II) provider characteristics, (III) family and community factors, (IV) organizational characteristics, (V) societal factors, (VI) mental health system factors, (VII) intervention characteristics, and (VIII) stigma. RESULTS Of the 26,935 articles screened (title and abstract), 192 articles underwent full-text review, yielding 37 articles representing 28 unique intervention studies that met the inclusion criteria. The most prevalent facilitators occur in domains that are more amenable to adaptation (i.e., the intervention and provider characteristics domains), while salient barriers occur in domains that are more challenging to modulate or intervene on-these include constructs in the client characteristics as well as the broader societal and structural levels of influence (i.e., the organizational, mental health system domains). Other notable trends include constructs in the family and community domains occurring as barriers and as facilitators roughly equally, and stigma constructs acting exclusively as barriers. CONCLUSIONS Using the BeFITS-MH model we developed based on implementation science frameworks, this systematic review provides a comprehensive identification and organization of barriers and facilitators to evidence-based task-sharing mental health interventions in LMICs. These findings have important implications for ongoing and future implementation of this critically needed intervention strategy, including the promise of leveraging task-sharing intervention characteristics as sites of continued innovation, the importance of but relative lack of engagement with constructs in macro-level domains (e.g., organizational characteristics, stigma), and the need for more delineation of strategies for task-sharing mental health interventions that researchers and implementers can employ to enhance implementation in and across levels. TRIAL REGISTRATION PROSPERO CRD42020161357.
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Affiliation(s)
- PhuongThao D. Le
- grid.137628.90000 0004 1936 8753Department of Social and Behavioral Sciences, New York University School of Global Public Health, 708 Broadway, NY 10012 New York, USA
| | - Evan L. Eschliman
- grid.21107.350000 0001 2171 9311Department of Health, Behavior and Society, Johns Hopkins University Bloomberg School of Public Health, 615 North Wolfe St., Baltimore, MD 21205 USA
| | - Margaux M. Grivel
- grid.137628.90000 0004 1936 8753Department of Social and Behavioral Sciences, New York University School of Global Public Health, 708 Broadway, NY 10012 New York, USA
| | - Jeffrey Tang
- grid.137628.90000 0004 1936 8753Department of Psychology, New York University Graduate School of Arts and Science, One-Half Fifth Avenue, New York, NY 10003 USA
| | - Young G. Cho
- grid.21729.3f0000000419368729New York State Psychiatric Institute, Columbia University, 1051 Riverside Dr., New York, NY 10032 USA
| | - Xinyu Yang
- grid.21729.3f0000000419368729Department of Epidemiology, Columbia University Mailman School of Public Health, 722 West 168th St., New York, NY 10032 USA
| | - Charisse Tay
- grid.21729.3f0000000419368729Columbia University Teachers College, 525 West 120th Street, New York, NY 10027 USA
| | - Tingyu Li
- grid.21729.3f0000000419368729Columbia University Teachers College, 525 West 120th Street, New York, NY 10027 USA
| | - Judith Bass
- grid.21107.350000 0001 2171 9311Department of Mental Health, Johns Hopkins University Bloomberg School of Public Health, Hampton House, 8th Floor, 624 N. Broadway, Baltimore, MD 21205 USA
| | - Lawrence H. Yang
- grid.137628.90000 0004 1936 8753Department of Social and Behavioral Sciences, New York University School of Global Public Health, 708 Broadway, NY 10012 New York, USA ,grid.21729.3f0000000419368729Department of Epidemiology, Columbia University Mailman School of Public Health, 722 West 168th St., New York, NY 10032 USA
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Sims S, Hepsipa Omega Juliet S, Joseph J, Gopal S, Raghavan V, Venkatraman L, Padmavati R. Acceptability of Peer Support for People With Schizophrenia in Chennai, India: A Cross Sectional Study Amongst People With Lived Experience, Caregivers, and Mental Health Professionals. Front Psychiatry 2022; 13:797427. [PMID: 35370806 PMCID: PMC8965369 DOI: 10.3389/fpsyt.2022.797427] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Accepted: 01/18/2022] [Indexed: 11/13/2022] Open
Abstract
INTRODUCTION Establishing structured peer support in mental health, particularly for people with schizophrenia, as a psychosocial intervention is early in low and middle-income countries like India. Before implementing and understanding the effectiveness of peer support service and which mode of peer support delivery will be suitable for our culture, our study aimed to understand if peer support would be accepted by the different participants like persons with schizophrenia, caregivers and mental health professionals in a tertiary care center in Chennai, India. METHODS The study was conducted at the outpatient department (OPD) of a tertiary psychiatric care facility in Chennai, India. A cross-sectional study method was used. Consecutive persons diagnosed with schizophrenia and caregivers of persons with schizophrenia, who attended the outpatient department, and mental health professionals within and outside the facility who met the inclusion and exclusion criteria participated in the study. A structured questionnaire purposefully developed for the study was administered to the different study participants. Descriptive statistics were used to analyze the data. Categorical variables were expressed as frequency and percentages, while the continuous variables were expressed as mean and standard deviation. RESULTS A total of 155 participants (52 persons with schizophrenia, 50 caregivers and 53 mental health professionals) completed the survey. The majority of the participants (90.4% of persons with schizophrenia, 86% caregivers and all mental health professionals) welcomed peer support interventions. The participants wanted peers to help persons with schizophrenia achieve personal goals to enhance their mental health and day to day living with an emphasis on independent living and interpersonal and social relationships and help them achieve medication and treatment-related goals toward recovery. Understanding the role of a peer support volunteer and transitioning from a "person with schizophrenia" to a "peer support volunteer" by persons with schizophrenia was thought most challenging. CONCLUSION The results highlight the potential acceptability of peer support across several stakeholders in the care of schizophrenia in a low and middle-income country context. The results may guide the implementation of a peer support volunteer programme as an essential mechanism of delivering psychosocial interventions for persons with schizophrenia.
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Affiliation(s)
- Sonia Sims
- Department of Psychosocial Rehabilitation, Schizophrenia Research Foundation, Chennai, India
| | - S Hepsipa Omega Juliet
- Department of Psychosocial Rehabilitation, Schizophrenia Research Foundation, Chennai, India
| | - Jainey Joseph
- Department of Psychosocial Rehabilitation, Schizophrenia Research Foundation, Chennai, India
| | - Subhashini Gopal
- Department of Psychosocial Rehabilitation, Schizophrenia Research Foundation, Chennai, India
| | - Vijaya Raghavan
- Department of Psychosocial Rehabilitation, Schizophrenia Research Foundation, Chennai, India
| | - Lakshmi Venkatraman
- Department of Psychosocial Rehabilitation, Schizophrenia Research Foundation, Chennai, India
| | - Ramachandran Padmavati
- Department of Psychosocial Rehabilitation, Schizophrenia Research Foundation, Chennai, India
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Hyun MS, Kim H, Nam KA, Kim SY. Experience of Peer Support Work among People with Mental Illness in the Community: A Grounded Theory Approach. J Korean Acad Nurs 2022; 52:187-201. [DOI: 10.4040/jkan.21208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Revised: 01/14/2022] [Accepted: 02/21/2022] [Indexed: 11/09/2022]
Affiliation(s)
- Myung Sun Hyun
- College of Nursing, Ajou University, Suwon, Korea
- Research Institute of Nursing Science, Ajou University, Suwon, Korea
| | - Hyunlye Kim
- Department of Nursing, Chosun University, Gwangju, Korea
| | - Kyoung A Nam
- School of Nursing · Research Institute of Nursing Science, Hallym University, Chuncheon, Korea
| | - Su Young Kim
- College of Nursing, Ajou University, Suwon, Korea
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Patient and provider perceptions of a peer-delivered intervention (' Khanya') to improve anti-retroviral adherence and substance use in South Africa: a mixed methods analysis. Glob Ment Health (Camb) 2022; 9:439-447. [PMID: 36618732 PMCID: PMC9807005 DOI: 10.1017/gmh.2022.47] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 07/26/2022] [Accepted: 07/28/2022] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Despite a high prevalence of problematic substance use among people living with HIV in South Africa, there remains limited access to substance use services within the HIV care system. To address this gap, our team previously developed and adapted a six-session, peer-delivered problem-solving and behavioral activation-based intervention (Khanya) to improve HIV medication adherence and reduce substance use in Cape Town. This study evaluated patient and provider perspectives on the intervention to inform implementation and future adaptation. METHODS Following intervention completion, we conducted semi-structured individual interviews with patients (n = 23) and providers (n = 9) to understand perspectives on the feasibility, acceptability, and appropriateness of Khanya and its implementation by a peer. Patients also quantitatively ranked the usefulness of individual intervention components (problem solving for medication adherence 'Life-Steps', behavioral activation, mindfulness training, and relapse prevention) at post-treatment and six months follow-up, which we triangulated with qualitative feedback to examine convergence and divergence across methods. RESULTS Patients and providers reported high overall acceptability, feasibility, and appropriateness of Khanya, although there were several feasibility challenges. Mindfulness and Life-Steps were identified as particularly acceptable, feasible, and appropriate components by patients across methods, whereas relapse prevention strategies were less salient. Behavioral activation results were less consistent across methods. CONCLUSIONS Findings underscore the importance of examining patients' perspectives on specific intervention components within intervention packages. While mindfulness training and peer delivery models were positively perceived by consumers, they are rarely used within task-shared behavioral interventions in low- and middle-income countries.
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Singh SP, Menon S, Singh S, Nadeau AJ, Jiao J. Perceived Depression, Anxiety, and Stress Outcomes Among Students of Early Entrance College Programs. Cureus 2021; 13:e20360. [PMID: 35028236 PMCID: PMC8751760 DOI: 10.7759/cureus.20360] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/12/2021] [Indexed: 11/25/2022] Open
Abstract
Introduction Mental health disorders affect adolescents and children and have resulted in many academic institutions now recognizing and taking steps to reduce the pressure they place on students. Early Entrance to College Programs (EECP) is a small subset of academic institutions focused on providing an accelerated higher education path, and these students are held to high academic standards. It is important to research the effects of these programs on the students' mental health, as younger children are extremely susceptible to mental disorders that may last into adulthood. Methods This study analyzed a three-part survey given to alumni of various EECPs. The survey is a combination of Generalized Anxiety Disorder-7 (GAD-7), Patient Health Questionnaire-9 (PHQ-9), and yes/no questions regarding the participants' demographics. A longitudinal study was also conducted on current students in EECPs. These students were given a survey consisting of the 21-item Depression, Anxiety, and Stress Scale (DASS-21) questionnaire, which was completed two times throughout the academic year, three months later. Results The results displayed that there was a significant impact of academic rigor on the mental health of these students. In both the one-time and longitudinal studies, a majority of participants recorded having higher levels of anxiety and depression than before they were in the program. Conclusions The association between mental health and academic rigor is similar to what is seen among both high school and college cohort students with a greater emphasis on the social environment as a modulating factor.
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Affiliation(s)
- Som P Singh
- Department of Internal Medicine, University of Missouri-Kansas City School of Medicine, Kansas City, USA
| | - Shreya Menon
- Department of Internal Medicine, University of Missouri-Kansas City School of Medicine, Kansas City, USA
| | - Shipra Singh
- Department of Psychiatry, Central Michigan University College of Medicine, Saginaw, USA
| | - Alexander J Nadeau
- Department of Internal Medicine, University of Missouri-Kansas City School of Medicine, Kansas City, USA
| | - Jianwei Jiao
- Department of Psychiatry, University of Missouri-Kansas City, Kansas City, USA
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Coughlin LN, Blow FC, Walton M, Ignacio RV, Walters H, Massey L, Barry KL, McCormick R. Predictors of Booster Engagement Following a Web-Based Brief Intervention for Alcohol Misuse Among National Guard Members: Secondary Analysis of a Randomized Controlled Trial. JMIR Ment Health 2021; 8:e29397. [PMID: 34698652 PMCID: PMC8579213 DOI: 10.2196/29397] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Revised: 07/22/2021] [Accepted: 08/05/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Alcohol misuse is a major health concern among military members. Reserve component members face unique barriers as they live off base with limited access to behavioral health services. Web and app-based brief interventions are a promising means to improve access to treatment for those who misuse alcohol, with the use of booster sessions to enhance effectiveness, solidify gains, and reinforce changes. However, little is known about who will engage in booster sessions. OBJECTIVE This study aims to evaluate booster engagement across booster delivery modalities (Web and Peer) and identify participant-specific factors associated with booster session engagement. METHODS Following a brief web-based alcohol misuse intervention in National Guard members (N=739), we examined engagement in a series of three booster sessions. Using unadjusted and adjusted models, demographic and clinical characteristics that may serve as predictors of booster session engagement were examined across the 2 arms of the trial with different types of booster sessions: peer-delivered (N=245) and web-delivered (N=246). RESULTS Booster session completion was greater for Peer than Web Booster sessions, with 142 (58%) service members in the Peer Booster arm completing all three boosters compared with only 108 (44%) of participants in the Web Booster arm (χ23=10.3; P=.006). In a model in which the 2 groups were combined, socioeconomic factors predicted booster engagement. In separate models, the demographic and clinical predictors of booster engagement varied between the 2 delivery modalities. CONCLUSIONS The use of peer-delivered boosters, especially among subsets of reserve members at risk of lack of engagement, may foster greater uptake and improve treatment outcomes. TRIAL REGISTRATION ClinicalTrials.gov NCT02181283; https://clinicaltrials.gov/ct2/show/NCT02181283.
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Affiliation(s)
- Lara N Coughlin
- Addiction Center, Department of Psychiatry, University of Michigan, Ann Arbor, MI, United States.,Injury Prevention Center, University of Michigan, Ann Arbor, MI, United States
| | - Frederic C Blow
- Addiction Center, Department of Psychiatry, University of Michigan, Ann Arbor, MI, United States.,VA Center for Clinical Management Research, Department of Veteran Affairs Healthcare System, Ann Arbor, MI, United States
| | - Maureen Walton
- Addiction Center, Department of Psychiatry, University of Michigan, Ann Arbor, MI, United States.,Injury Prevention Center, University of Michigan, Ann Arbor, MI, United States
| | - Rosalinda V Ignacio
- Department of Biostatistics, School of Public Health, University of Michigan, Ann Arbor, MI, United States
| | - Heather Walters
- VA Center for Clinical Management Research, Department of Veteran Affairs Healthcare System, Ann Arbor, MI, United States
| | - Lynn Massey
- Injury Prevention Center, University of Michigan, Ann Arbor, MI, United States
| | - Kristen L Barry
- Addiction Center, Department of Psychiatry, University of Michigan, Ann Arbor, MI, United States
| | - Richard McCormick
- Center for Healthcare Research and Policy, MetroHealth/Case Western Reserve University, Cleveland, OH, United States
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136
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Piat M, Wainwright M, Cherkas D, Leblanc S, Sofouli E, Rivest MP, Albert H, Casey R, O'Rourke JJ, Labonté L. Identifying and understanding the contextual factors that shaped mid-implementation outcomes during the COVID-19 pandemic in organizations implementing mental health recovery innovations into services. Implement Sci Commun 2021; 2:101. [PMID: 34526136 PMCID: PMC8441235 DOI: 10.1186/s43058-021-00206-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Accepted: 08/25/2021] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Seven housing and health services organizations were guided through a process of translating Chapter Six of the Canadian Guidelines for Recovery-Oriented Practice into a recovery-oriented innovation and plan for its implementation. At the time of the COVID-19 outbreak and lockdown measures, six of the seven organizations had begun implementing their chosen innovation (peer workers, wellness recovery action planning facilitator training, staff training and a family support group). This mid-implementation study used the Consolidated Framework for Implementation Research (CFIR) to identify contextual factors that influenced organizations to continue or postpone implementation of recovery-oriented innovations in the early months of the COVID-19 pandemic. METHODS Twenty-seven semi-structured 45-min interviews were conducted between May and June 2020 (21 implementation team members and six providers of the innovation (trainers, facilitators, peer workers). Interview guides and analysis were based on the CFIR. Content analysis combined deductive and inductive approaches. Summaries of coded data were given ratings based on strength and valence of the construct's impact on implementation. Ratings were visualized by mid-implementation outcome and recovery innovation to identify constructs which appear to distinguish between sites with a more or less favorable mid-implementation outcomes. RESULTS Four mid-implementation outcomes were observed at this snapshot in time (from most to least positive): continued implementation with adaptation (one site), postponement with adaptation and estimated relaunch date (four sites), indefinite postponement with no decision on relaunch date (one site), and no implementation of innovation yet (one site). Two constructs had either a negative influence (external policies and incentives-renamed COVID-19-related external policy for this study) or a positive influence (leadership engagement), regardless of implementation outcome. Four factors appeared to distinguish between more or less positive mid-implementation outcome: adaptability, implementation climate and relative priority, available resources, and formally appointed internal implementation leaders (renamed "engaging implementation teams during the COVID-19 pandemic" for this study). CONCLUSIONS The COVID-19 pandemic is an unprecedented outer setting factor. Studies that use the CFIR at the mid-implementation stage are rare, as are studies focusing on the outer setting. Through robust qualitative analysis, we identify the key factors that shaped the course of implementation of recovery innovations over this turbulent time.
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Affiliation(s)
- Myra Piat
- Department of Psychiatry, McGill University and Douglas Mental Health University Institute, 6875, boul. LaSalle, Montréal, Québec, H4H 1R3, Canada.
| | - Megan Wainwright
- Department of Anthropology, Durham University, Dawson Building, South Road, Durham, DH1 3LE, UK
| | - Danielle Cherkas
- Factor-Inwentash Faculty of Social Work, University of Toronto, 246 Bloor St W, Toronto, Ontario, M5S 1V4, Canada
| | - Sébastien Leblanc
- École de travail social, Université de Moncton, 18, avenue Antonine-Maillet, Moncton, Nouveau-Brunswick, E1A 3E9, Canada
| | - Eleni Sofouli
- Department of Psychiatry, McGill University, Ludmer Research & Training Building, 1033 Avenue des Pins, Montréal, QC, H3A 1A1, Canada
| | - Marie-Pier Rivest
- École de travail social, Université de Moncton, 18, avenue Antonine-Maillet, Moncton, Nouveau-Brunswick, E1A 3E9, Canada
| | - Hélène Albert
- École de travail social, Université de Moncton, 18, avenue Antonine-Maillet, Moncton, Nouveau-Brunswick, E1A 3E9, Canada
| | - Regina Casey
- Department of Occupational Science and Occupational Therapy, Faculty of Medicine, The University of British Columbia, T-325, 2211 Westbrook Mall, Vancouver, British Columbia, V6T 2B5I, Canada
| | - Joseph J O'Rourke
- Department of Occupational Science and Occupational Therapy, Faculty of Medicine, The University of British Columbia, T-325, 2211 Westbrook Mall, Vancouver, British Columbia, V6T 2B5I, Canada
| | - Lise Labonté
- Douglas Mental Health University Institute, 6875, boul. LaSalle, Montréal, Québec, H4H 1R3, Canada
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137
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Brasier C, Roennfeldt H, Hamilton B, Martel A, Hill N, Stratford A, Buchanan-Hagen S, Byrne L, Castle D, Cocks N, Davidson L, Brophy L. Peer support work for people experiencing mental distress attending the emergency department: Exploring the potential. Emerg Med Australas 2021; 34:78-84. [PMID: 34490720 DOI: 10.1111/1742-6723.13848] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Revised: 07/29/2021] [Accepted: 08/01/2021] [Indexed: 11/28/2022]
Abstract
OBJECTIVE This study explored the benefits and limitations of employing peer support workers, who utilise their own lived experience of mental distress and recovery, to support people experiencing mental distress who are attending the ED. METHODS This co-produced qualitative study utilised four phases: (i) assemble a collaborative multi-disciplinary research team and Expert Panel, of which at least half identified as having lived experience; (ii) a site visit to an ED; (iii) focus groups with consumers, support persons and ED staff; and (iv) a learning workshop for peer workers. RESULTS Focus groups were run for consumers (n = 7), support persons (n = 5) and ED staff (n = 7). Eleven consumer peer workers participated in the learning workshop. Four themes were identified and triangulated: the individual in distress, peer support work, a 'Peers in EDs' service and the ED context. Overall, findings suggest that peer support workers contribute important skills including listening, de-escalation, relationship-building and empathy. CONCLUSIONS This study identified that peer support workers would bring important skills to an ED (e.g. empathetic support, de-escalation). However, significant workforce and organisational support would be required.
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Affiliation(s)
- Catherine Brasier
- Social Work and Social Policy, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, Australia
| | - Helena Roennfeldt
- Centre for Mental Health Nursing, The University of Melbourne, Melbourne, Victoria, Australia
| | - Bridget Hamilton
- Centre for Mental Health Nursing, The University of Melbourne, Melbourne, Victoria, Australia
| | - Andrew Martel
- Faculty of Architecture, Building and Planning, The University of Melbourne, Melbourne, Victoria, Australia
| | - Nicole Hill
- Department of Social Work, Melbourne School of Health Sciences, The University of Melbourne, Melbourne, Victoria, Australia
| | | | - Sally Buchanan-Hagen
- School of Nursing and Midwifery, Deakin University, Melbourne, Victoria, Australia
| | - Louise Byrne
- School of Management, College of Business and Law, RMIT University, Melbourne, Victoria, Australia.,School of Medicine, Yale University, New Haven, Connecticut, USA
| | - David Castle
- Centre for Complex Interventions, Centre for Addictions and Mental Health, Toronto, Ontario, Canada.,Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Nadine Cocks
- Mind Australia Limited, Melbourne, Victoria, Australia
| | - Larry Davidson
- School of Medicine, Yale University, New Haven, Connecticut, USA
| | - Lisa Brophy
- Social Work and Social Policy, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, Australia.,The Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
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138
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Shalaby R, Hrabok M, Spurvey P, Abou El-Magd RM, Knox M, Rude R, Vuong W, Surood S, Urichuk L, Snaterse M, Greenshaw AJ, Li XM, Agyapong VIO. Recovery Following Peer and Text Messaging Support After Discharge From Acute Psychiatric Care in Edmonton, Alberta: Controlled Observational Study. JMIR Form Res 2021; 5:e27137. [PMID: 34477565 PMCID: PMC8449293 DOI: 10.2196/27137] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Revised: 04/08/2021] [Accepted: 06/14/2021] [Indexed: 12/25/2022] Open
Abstract
Background Peer support is an emotional, social, and practical help provided by nonprofessionals to assist others in sustaining health behaviors. Peer support is valued in recovery-oriented models of mental health and is becoming increasingly implemented at the organizational level. Text messaging is a relatively low-cost, high-impact, and easily scalable program that uses existing technology, is devoid of geographic barriers, and is easily accessible to end users. Objective This study aims to evaluate the effectiveness of an innovative peer support system plus a supportive text messaging program on the recovery of discharged patients from acute psychiatric care. Methods This prospective, rater blinded, controlled observational study included 181 patients who were discharged from acute psychiatric care. Patients were randomized to one of four conditions: treatment as usual (follow-up care), daily supportive text messages only, peer support only, or peer support plus daily supportive text messages. A standardized self-report measure of recovery (Recovery Assessment Scale [RAS]) was completed at baseline, 6 weeks, 3 months, and 6 months. Descriptive analysis, one-way analysis of variance, and repeated measures multivariate analysis of covariance were used to examine the changes in the RAS among the study groups and over the follow-up time points. Results A total of 65 patients completed the assessments at each time point. For the overall sample, higher scores were found for the peer support plus text message condition compared with the text message only and treatment as usual condition on several scales (ie, willingness to ask for help and personal confidence and hope) and total score on the RAS, after 6 months of intervention. Conclusions Peer support plus supportive text messaging seems to result in improved recovery compared with other interventions. It may be advisable to incorporate the two interventions as part of routine practice for patients with psychiatric disorders upon hospital discharge.
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Affiliation(s)
- Reham Shalaby
- Department of Psychiatry, University of Alberta, Edmonton, AB, Canada
| | - Marianne Hrabok
- Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Pamela Spurvey
- Alberta Health Services, Addiction and Mental Health, Edmonton, AB, Canada
| | | | - Michelle Knox
- Alberta Health Services, Addiction and Mental Health, Edmonton, AB, Canada
| | - Rebecca Rude
- Alberta Health Services, Addiction and Mental Health, Edmonton, AB, Canada
| | - Wesley Vuong
- Alberta Health Services, Addiction and Mental Health, Edmonton, AB, Canada
| | - Shireen Surood
- Alberta Health Services, Addiction and Mental Health, Edmonton, AB, Canada
| | - Liana Urichuk
- Alberta Health Services, Addiction and Mental Health, Edmonton, AB, Canada
| | - Mark Snaterse
- Alberta Health Services, Addiction and Mental Health, Edmonton, AB, Canada
| | | | - Xin-Min Li
- Department of Psychiatry, University of Alberta, Edmonton, AB, Canada
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139
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Hooley C, Graaf G, Gopalan G. Scaling up evidence-based treatments in youth behavioral healthcare: Social work licensing influences on task-shifting opportunities. HUMAN SERVICE ORGANIZATIONS, MANAGEMENT, LEADERSHIP & GOVERNANCE 2021; 45:375-388. [PMID: 35284593 PMCID: PMC8916749 DOI: 10.1080/23303131.2021.1970069] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Youth behavioral healthcare workforce shortages have inhibited the scale-up of evidence-based treatments to address longstanding unmet needs andinequitable service coverage. Task-shifting is a strategy that could bolster workforce shortages. Legal and regulatory barriers, such as scope of practice licensing regulations, have hampered the use of task-shifting. Social workers make up the majority of the behavioral healthcare workforce in the U.S. and most social workers provide services to children and families. As such, social workers would play a pivotal role in any scale-up effort. In this guest editorial, we discuss the importance of social work licensing and use a case example to illustrate the unintended consequences that certain licensing regulations have on scaling-up evidence-based treatments via task-shifting. We conclude with recommendations on how social workers could be involved in taskshifting efforts to scale-up evidence-based treatments.
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Affiliation(s)
- Cole Hooley
- School of Social Work, Brigham Young University
| | | | - Geetha Gopalan
- Silberman School of Social Work, Hunter College, City University of New York
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140
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A Longitudinal Qualitative Analysis of the Way Peer Support Specialist Roles Change Over Time in a Psychiatric Hospital Setting in Asia. ADMINISTRATION AND POLICY IN MENTAL HEALTH AND MENTAL HEALTH SERVICES RESEARCH 2021; 49:226-236. [PMID: 34390425 PMCID: PMC8850219 DOI: 10.1007/s10488-021-01158-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/31/2021] [Indexed: 12/03/2022]
Abstract
The current study seeks to determine how peer support roles change as peer support specialists’ positions within organizations and departments mature. We followed ten peer support specialists over the course of a year, interviewing them at three points, starting approximately three months after they began working as peer support specialists. We used an inductive process to analyze our data and followed guidelines on the structuring of longitudinal qualitative trajectories to divide the data into watershed moments. Our participants worked in a variety of departments in the hospital, and their service use experiences generally echo those of their service users. Participants appear to pass through four phases over the course of their employment as peers: early beginnings, establishing the role, role narrowing, and role sustainability. Services wishing to integrate new peers must be aware of the time required for integration. Having general job descriptions limited to specifying that peers are expected to use their lived experience to support current service users may lead to uncertainty amongst new and existing staff. Without role clarity, peers may struggle to find their place. Pairing new staff with mentors may limit this burden. As roles consolidate, boundaries may emerge. If these boundaries narrow the role of the PSS, they may no longer find the role appealing. They may then choose other caregiver roles with wider or different spheres of influence. Organizations may benefit by clearly indicating if they expect peer support positions to be static or transitionary.
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141
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Baumgartner-Dupuits M, Sep SJS, Verbunt J, Bosma H, van Eijk J. Peer Support to Enhance Social and Emotional Self-Management Following Acquired Brain Injury Rehabilitation: Design of a Pre-post Study With Process Evaluation. Front Neurol 2021; 12:647773. [PMID: 34393968 PMCID: PMC8360636 DOI: 10.3389/fneur.2021.647773] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Accepted: 06/28/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Specialized rehabilitation following acquired brain injury provides intensive multidisciplinary treatment to individuals with complex disabilities for optimizing recovery and supporting a safe transition to the community. Post-specialist rehabilitation, patients and caregivers have reported a need for support. We present the design of an implementation study to evaluate a new self-management support service for individuals with acquired brain injury and their caregivers. Methods: This is a pre–post intervention study with a mixed-method design. The study population comprises individuals aged ≥18 years with acquired brain injury living independently following specialized rehabilitation in the Southern part of the Netherlands. All participants receive a post-rehabilitation support service. The support service consists of several house visits by a peer support volunteer in the first weeks after specialized rehabilitation treatment. The peer support volunteers are trained according to an adapted version of the previously developed Self-Management Support (SMS) program. The SMS program is directed at improving social and emotional self-management. Patient outcomes are assessed by questionnaire pre-, directly post-, and 6 months post-intervention. The primary patient outcome measure is self-efficacy. Secondary outcomes are perceived autonomy, quality of life, and psychological well-being. A process evaluation will be performed to gain insight into barriers and facilitators for the implementation of peer-led SMS by combining both quantitative, questionnaire data and qualitative data derived from focus groups with peer supporters and patients. In a workshop with relevant stakeholders, possibilities for dissemination and sustainability will be explored. Discussion: This paper describes the design of a practice-based study on feasibility, barriers, and facilitators to the implementation of a home-based, peer-led self-management support intervention for patients with acquired brain injury. We will quantitatively and qualitatively evaluate the change in relevant patient outcomes pre- and post-intervention and the barriers and facilitators related to the implementation of the intervention. Following a positive evaluation, the final stage of the study aims to facilitate deployment and utilization of the intervention.
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Affiliation(s)
- Milou Baumgartner-Dupuits
- Care and Public Health Research Institute (Caphri), Faculty of Health, Medicine and Life Sciences, University Maastricht, Maastricht, Netherlands.,Department of Rehabilitation Medicine, Faculty of Health, Medicine and Life Sciences, University Maastricht, Maastricht, Netherlands.,Department of Social Medicine, Faculty of Health, Medicine and Life Sciences, University Maastricht, Maastricht, Netherlands.,Adelante, Centre of Expertise in Rehabilitation and Audiology, Hoensbroek, Netherlands
| | - Simone J S Sep
- Care and Public Health Research Institute (Caphri), Faculty of Health, Medicine and Life Sciences, University Maastricht, Maastricht, Netherlands.,Department of Rehabilitation Medicine, Faculty of Health, Medicine and Life Sciences, University Maastricht, Maastricht, Netherlands.,Adelante, Centre of Expertise in Rehabilitation and Audiology, Hoensbroek, Netherlands
| | - Jeanine Verbunt
- Care and Public Health Research Institute (Caphri), Faculty of Health, Medicine and Life Sciences, University Maastricht, Maastricht, Netherlands.,Department of Rehabilitation Medicine, Faculty of Health, Medicine and Life Sciences, University Maastricht, Maastricht, Netherlands.,Adelante, Centre of Expertise in Rehabilitation and Audiology, Hoensbroek, Netherlands
| | - Hans Bosma
- Care and Public Health Research Institute (Caphri), Faculty of Health, Medicine and Life Sciences, University Maastricht, Maastricht, Netherlands.,Department of Social Medicine, Faculty of Health, Medicine and Life Sciences, University Maastricht, Maastricht, Netherlands
| | - Jacques van Eijk
- Care and Public Health Research Institute (Caphri), Faculty of Health, Medicine and Life Sciences, University Maastricht, Maastricht, Netherlands.,Department of Social Medicine, Faculty of Health, Medicine and Life Sciences, University Maastricht, Maastricht, Netherlands
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142
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Kuek JHL, Chua HC, Poremski D. Barriers and facilitators of peer support work in a large psychiatric hospital: a thematic analysis. Gen Psychiatr 2021; 34:e100521. [PMID: 34222796 PMCID: PMC8212403 DOI: 10.1136/gpsych-2021-100521] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2021] [Accepted: 05/19/2021] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Peer support workers are an important addition to the mental healthcare profession. However, much of the literature and knowledge of the peer support role is derived from western countries. This concept is relatively new in Asian countries. AIMS The study sought to improve the understanding of the barriers and facilitators of peer support work in a large psychiatric hospital in Singapore. METHODS This study used qualitative data from a larger mixed-methods study. Thematic analysis was conducted based on the five steps recommended by Braun and Clarke (2006): (1) familiarisation of data whereby transcripts were read and reread, (2) generating initial codes, (3) searching for themes by gathering relevant codes, (4) reviewing themes and (5) defining and naming themes. RESULTS Four subthemes under the broader notion of facilitators (supportive figures, defined role, opportunities for personal growth and identifying personalised coping strategies) and three subthemes under the concept of barriers (unclear role, hostility from non-peer-support-specialist staff and unsupportive working environments) were identified. CONCLUSION Our findings echoed those of previous studies conducted in western countries providing some evidences for the cross-cultural nature of these barriers and facilitators. However, the way their impact can be mitigated or enhanced is likely to be different owing to cultural barriers, such as the general consensus and acceptance of larger personal recovery ideologies. Further research is required in community settings to better understand the boundaries and limitations of our findings. This information will allow us to continue improving peer support worker integration in diverse mental healthcare settings.
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Affiliation(s)
| | - Hong Choon Chua
- Health Intelligence Unit, Institute of Mental Health, Singapore
| | - Daniel Poremski
- Health Intelligence Unit, Institute of Mental Health, Singapore
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143
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Penas P, Uriarte JJ, Gorbeña S, Slade M, Moreno-Calvete MC, Iraurgi I. Discrepancy between experience and importance of recovery components in the symptomatic and recovery perceptions of people with severe mental disorders. BMC Psychiatry 2021; 21:277. [PMID: 34059038 PMCID: PMC8168040 DOI: 10.1186/s12888-021-03287-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Accepted: 05/13/2021] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND Personal recovery has become an increasingly important approach in the care of people with severe mental disorders and consequently in the orientation of mental health services. The objective of this study was to assess the personal recovery process in people using mental health services, and to clarify the role of variables such as symptomatology, self-stigma, sociodemographic and treatment. METHODS Standardised measures of personal recovery process, clinical recovery, and internalized stigma were completed by a sample of 312 participants in a Severe Mental Disorder program. RESULTS Users valued most the recovery elements of: improving general health and wellness; having professionals who care; hope; and sense of meaning in life. Significant discrepancies between perceived experience and relative importance assigned to each of the components of the REE were observed. Regression modeling (χ2 = 6.72, p = .394; GFI = .99, SRMR = .03) identified how positive discrepancies were associated with a higher presence of recovery markers (β = .12, p = .05), which in turn were negatively related to the derived symptomatology index (β = -.33, p < .001). Furthermore, the relationship between clinical and personal recovery was mediated by internalized stigma. CONCLUSIONS An improvement in psychiatric services should be focused on recovery aspects that have the greatest discrepancy between importance and experience, in particular social roles, basic needs and hope. Personal and clinical recovery are correlated, but the relationship between them is mediated by internalized stigma, indicating the need for clinical interventions to target self-stigma.
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Affiliation(s)
- Patricia Penas
- University of Deusto, Avda. de las Universidades 24, 48007, Bilbao, Spain.
| | - Jose-Juan Uriarte
- Biocruces Bizkaia Health Research Institute. Basque Health Service, Bizkaia Mental Health Network, Plaza de Cruces 12, 48903 Barakaldo, Bizkaia Spain
| | - Susana Gorbeña
- grid.14724.340000 0001 0941 7046University of Deusto, Avda. de las Universidades 24, 48007 Bilbao, Spain
| | - Mike Slade
- grid.4563.40000 0004 1936 8868School of Health Sciences, Institute of Mental Health, University of Nottingham, Nottingham, UK
| | - María-Concepción Moreno-Calvete
- Biocruces Bizkaia Health Research Institute. Basque Health Service, Bizkaia Mental Health Network, Plaza de Cruces 12, 48903 Barakaldo, Bizkaia Spain
| | - Ioseba Iraurgi
- grid.14724.340000 0001 0941 7046University of Deusto, Avda. de las Universidades 24, 48007 Bilbao, Spain
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Charles A, Nixdorf R, Ibrahim N, Meir LG, Mpango RS, Ngakongwa F, Nudds H, Pathare S, Ryan G, Repper J, Wharrad H, Wolf P, Slade M, Mahlke C. Initial Training for Mental Health Peer Support Workers: Systematized Review and International Delphi Consultation. JMIR Ment Health 2021; 8:e25528. [PMID: 34042603 PMCID: PMC8193486 DOI: 10.2196/25528] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Revised: 01/15/2021] [Accepted: 03/10/2021] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Initial training is essential for the mental health peer support worker (PSW) role. Training needs to incorporate recent advances in digital peer support and the increase of peer support work roles internationally. There is a lack of evidence on training topics that are important for initial peer support work training and on which training topics can be provided on the internet. OBJECTIVE The objective of this study is to establish consensus levels about the content of initial training for mental health PSWs and the extent to which each identified topic can be delivered over the internet. METHODS A systematized review was conducted to identify a preliminary list of training topics from existing training manuals. Three rounds of Delphi consultation were then conducted to establish the importance and web-based deliverability of each topic. In round 1, participants were asked to rate the training topics for importance, and the topic list was refined. In rounds 2 and 3, participants were asked to rate each topic for importance and the extent to which they could be delivered over the internet. RESULTS The systematized review identified 32 training manuals from 14 countries: Argentina, Australia, Brazil, Canada, Chile, Germany, Ireland, the Netherlands, Norway, Scotland, Sweden, Uganda, the United Kingdom, and the United States. These were synthesized to develop a preliminary list of 18 topics. The Delphi consultation involved 110 participants (49 PSWs, 36 managers, and 25 researchers) from 21 countries (14 high-income, 5 middle-income, and 2 low-income countries). After the Delphi consultation (round 1: n=110; round 2: n=89; and round 3: n=82), 20 training topics (18 universal and 2 context-specific) were identified. There was a strong consensus about the importance of five topics: lived experience as an asset, ethics, PSW well-being, and PSW role focus on recovery and communication, with a moderate consensus for all other topics apart from the knowledge of mental health. There was no clear pattern of differences among PSW, manager, and researcher ratings of importance or between responses from participants in countries with different resource levels. All training topics were identified with a strong consensus as being deliverable through blended web-based and face-to-face training (rating 1) or fully deliverable on the internet with moderation (rating 2), with none identified as only deliverable through face-to-face teaching (rating 0) or deliverable fully on the web as a stand-alone course without moderation (rating 3). CONCLUSIONS The 20 training topics identified can be recommended for inclusion in the curriculum of initial training programs for PSWs. Further research on web-based delivery of initial training is needed to understand the role of web-based moderation and whether web-based training better prepares recipients to deliver web-based peer support.
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Affiliation(s)
- Ashleigh Charles
- School of Health Sciences, Institute of Mental Health, University of Nottingham, Nottingham, United Kingdom
| | - Rebecca Nixdorf
- Department of Psychiatry, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Nashwa Ibrahim
- School of Health Sciences, Institute of Mental Health, University of Nottingham, Nottingham, United Kingdom
- Psychiatric and Mental Health Nursing Department, Faculty of Nursing, Mansoura University, Masoura, Egypt
| | - Lion Gai Meir
- Department of Social Work, Ben Gurion University of the Negev, Beer Sheva, Israel
| | - Richard S Mpango
- Butabika National Referral Hospital, Butabika, Uganda
- School of Health Sciences, Soroti University, Soroti, Uganda
- MRC/UVRI and LSHTM Uganda Research Unit, Entebbe, Uganda
| | - Fileuka Ngakongwa
- Ifakara Health Institute, Dar es Salaam, United Republic of Tanzania
- Department of Psychiatry and Mental Health, Muhimbili University of Health and Allied Sciences, Dar es Salaam, United Republic of Tanzania
| | - Hannah Nudds
- School of Health Sciences, Institute of Mental Health, University of Nottingham, Nottingham, United Kingdom
| | - Soumitra Pathare
- Centre for Mental Health Law and Policy, Indian Law Society, Pune, India
| | - Grace Ryan
- Centre for Global Mental Health, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Julie Repper
- ImROC, Nottinghamshire Healthcare NHS Foundation Trust, Nottingham, United Kingdom
| | - Heather Wharrad
- Faculty of Medicine and Health Sciences, University of Nottingham, Nottingham, United Kingdom
| | - Philip Wolf
- Department of Psychiatry II, Ulm University II, Ulm, Germany
| | - Mike Slade
- School of Health Sciences, Institute of Mental Health, University of Nottingham, Nottingham, United Kingdom
| | - Candelaria Mahlke
- Department of Psychiatry, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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145
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Northcott S, Behn N, Monnelly K, Moss B, Marshall J, Thomas S, Simpson A, McVicker S, Flood C, Goldsmith K, Hilari K. "For them and for me": a qualitative exploration of peer befrienders' experiences supporting people with aphasia in the SUPERB feasibility trial. Disabil Rehabil 2021; 44:5025-5037. [PMID: 34027757 DOI: 10.1080/09638288.2021.1922520] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
PURPOSE Peer-befriending, where support is offered by someone with shared lived experience, is an intervention that may facilitate successful adjustment in people experiencing post-stroke aphasia. This paper explores the experiences of the peer-befrienders. MATERIALS AND METHODS People with aphasia were recruited as peer-befrienders within the SUPERB trial investigating befriending for people with post-stroke aphasia. The intervention comprised six visits over three months. Peer-befrienders were matched with at least one befriendee and received training and ongoing supervision. They were invited to participate in in-depth interviews which were analysed using framework analysis. RESULTS All 10 befrienders participated in interviews, reporting on 19 matches. Seven main themes emerged: content of the sessions; befriender-befriendee relationship; negotiating the visits; handling boundaries and endings; positive impact of the befriending for befrienders and befriendees; and beliefs about the nature and value of peer support. While befrienders described challenges, such as negotiating journeys and witnessing distress, the role was perceived as a "secure challenge" due to the support and training received. CONCLUSIONS Befrienders perceived the role as enjoyable and rewarding, and felt they were making a positive difference. They were unanimous in believing that people with aphasia can offer unique and valuable support to others with aphasia. TRIAL REGISTRATION ClinicalTrials.gov identifier NCT02947776, registered 28th October 2016.Implications for rehabilitationPeople with lived experience of stroke and aphasia were able to offer emotional and social peer support to others with aphasia within the SUPERB trial.Although there were challenges, peer befrienders perceived the role as rewarding and satisfying.Peer befrienders valued the training and ongoing supervision and support they received to deliver the intervention.It is recommended that rehabilitation professionals considering offering peer-befriending schemes provide training and ongoing supervision to support peer-befrienders fulfil their role, as well as practical support with, e.g., arranging visits.
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Affiliation(s)
- S Northcott
- Centre for Language and Communication Science Research, School of Health Sciences, University of London, London, UK.,School of Health Sciences, University of East Anglia, Norwich, UK
| | - N Behn
- Centre for Language and Communication Science Research, School of Health Sciences, University of London, London, UK
| | - K Monnelly
- Centre for Language and Communication Science Research, School of Health Sciences, University of London, London, UK
| | - B Moss
- Centre for Language and Communication Science Research, School of Health Sciences, University of London, London, UK
| | - J Marshall
- Centre for Language and Communication Science Research, School of Health Sciences, University of London, London, UK
| | - S Thomas
- Division of Rehabilitation, Ageing and Wellbeing, School of Medicine, University of Nottingham, Nottingham, UK
| | - A Simpson
- Health Service and Population Research and Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care, King's College London, London, UK
| | - S McVicker
- Centre for Language and Communication Science Research, School of Health Sciences, University of London, London, UK
| | - C Flood
- Department of Mental Health and Learning Disabilities, School of Health and Social Care, London South Bank University, London, UK
| | - K Goldsmith
- Department of Biostatistics and Health Informatics, King's College London, London, UK
| | - K Hilari
- Centre for Language and Communication Science Research, School of Health Sciences, University of London, London, UK
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146
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Andalibi N, Flood MK. Considerations in Designing Digital Peer Support for Mental Health: Interview Study Among Users of a Digital Support System (Buddy Project). JMIR Ment Health 2021; 8:e21819. [PMID: 33393909 PMCID: PMC7813628 DOI: 10.2196/21819] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 10/08/2020] [Accepted: 10/25/2020] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Peer support is an approach to cope with mental illness, and technology provides a way to facilitate peer support. However, there are barriers to seeking support in offline and technology-mediated contexts. OBJECTIVE This study aims to uncover potential ways to design digital mental health peer support systems and to outline a set of principles for future designers to consider as they embark on designing these systems. By learning how existing systems are used by people in daily life and by centering their experiences, we can better understand how to design mental health peer support technologies that foreground people's needs. One existing digital peer support system is Buddy Project, the case study in this paper. METHODS This paper reports on an interview study with Buddy Project users (N=13). Data were analyzed using the constant comparative approach. RESULTS Individuals matched through Buddy Project developed supportive friendships with one another, leading them to become each other's peer supporters in their respective journeys. It was not only the mental health peer support that was important to participants but also being able to connect over other parts of their lives and identities. The design of Buddy Project provided a sense of anonymity and separation from pre-existing ties, making it easier for participants to disclose struggles; moreover, the pairs appreciated being able to browse each other's social media pages before connecting. Buddy Project has an explicit mission to prevent suicide and demonstrates this mission across its online platforms, which helps reduce the stigma around mental health within the peer support space. Pairs were matched based on shared interests and identities. This choice aided the pairs in developing meaningful, compatible, and supportive relationships with each other, where they felt seen and understood. However, the pairs were concerned that matching based on a shared mental health diagnosis may lead to sharing unhealthy coping mechanisms or comparing themselves and the severity of their experiences with their peers. CONCLUSIONS The results of this study shed light on desirable features of a digital mental health peer support system: matching peers based on interests and identities that they self-identify with; having an explicit mental health-related mission coupled with social media and other web-based presences to signal that discussing mental health is safe within the peer support ecosystem; and not matching peers based on a broad mental health diagnosis. However, if the diagnosis is important, this matching should account for illness severity and educate peers on how to provide support while avoiding suggesting unhelpful coping mechanisms; allowing for some degree of anonymity and control over how peers present themselves to each other; and providing relevant information and tools to potential peers to help them decide if they would like to embark on a relationship with their matched peer before connecting with them.
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Affiliation(s)
- Nazanin Andalibi
- University of Michigan School of Information, Ann Arbor, MI, United States
| | - Madison K Flood
- Department of History of Art, University of Michigan, Ann Arbor, MI, United States
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147
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Leendertse JCP, Wierdsma AI, van den Berg D, Ruissen AM, Slade M, Castelein S, Mulder CL. Personal Recovery in People With a Psychotic Disorder: A Systematic Review and Meta-Analysis of Associated Factors. Front Psychiatry 2021; 12:622628. [PMID: 33708145 PMCID: PMC7940758 DOI: 10.3389/fpsyt.2021.622628] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Accepted: 01/13/2021] [Indexed: 12/26/2022] Open
Abstract
Background: Personal recovery (PR) is a subjective, multidimensional concept, and quantitative research using PR as an outcome is rapidly increasing. This systematic review is intended to support the design of interventions that contribute to PR in psychotic disorders, by providing an overview of associated factors and their weighted importance to PR: clinical factors, social factors, and socio-demographic characteristics are included, and factors related to the concept of PR (organized into CHIME dimensions). Methods: A systematic literature search was conducted from inception to March 2020. Quantitative studies that had used a validated questionnaire assessing the concept of PR were included. Mean effect sizes for the relationship between PR-scale total scores and related factors were calculated using meta-analyses. Sources of heterogeneity were examined using meta-regression tests. Results: Forty-six studies, that used (a total of) eight PR measures, showed that in clinical factors, affective symptoms had a medium negative association with PR-scale total scores (r = -0.44, 95%CI -0.50 to -0.37), while positive, negative and general symptoms had small negative correlations. No association was found with neuro-cognition. Social factors (support, work and housing, and functioning) showed small positive correlations. Gender and age differences had barely been researched. Large associations were found for PR-scale total scores with the CHIME dimensions hope (r = 0.56, 95%CI 0.48-0.63), meaning in life (r = 0.48, 95%CI 0.38-0.58) and empowerment (r = 0.53, 95%CI 0.42-0.63); while medium associations were found with connectedness (r = 0.34, 95%CI 0.43-0.65) and identity (r = 0.43, 95%CI 0.35-0.50). Levels of heterogeneity were high, sources included: the variety of PR measures, variations in sample characteristics, publication bias, variations in outcome measures, and cultural differences. Discussion: Most interventions in mental healthcare aim to reduce symptoms and improve functioning. With regard to stimulating PR, these interventions may benefit from also focusing on enhancing hope, empowerment, and meaning in life. The strength of these findings is limited by the challenges of comparing separate CHIME dimensions with questionnaires assessing the concept of PR, and by the high levels of heterogeneity observed. Future research should focus on the interaction between elements of PR and clinical and social factors over time.
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Affiliation(s)
- J C P Leendertse
- Emergis Institute for Mental Healthcare, Kloetinge, Netherlands.,Department of Psychiatry, Erasmus University Medical Centre, Rotterdam, Netherlands
| | - A I Wierdsma
- Department of Psychiatry, Erasmus University Medical Centre, Rotterdam, Netherlands
| | - D van den Berg
- Department of Clinical Psychology, VU University and Amsterdam Public Health Research Institute, Amsterdam, Netherlands.,Research and Innovation, Parnassia Psychiatric Institute, The Hague, Netherlands
| | - A M Ruissen
- Emergis Institute for Mental Healthcare, Kloetinge, Netherlands.,Department of Psychiatry, Erasmus University Medical Centre, Rotterdam, Netherlands.,Department of Psychiatry, Haaglanden Medical Centre, The Hague, Netherlands
| | - M Slade
- School of Health Sciences, Institute of Mental Health, University of Nottingham, Nottingham, United Kingdom
| | - S Castelein
- Lentis Research, Lentis Psychiatric Institute, Groningen, Netherlands.,Faculty of Behavioural and Social Sciences, Clinical Psychology, University of Groningen, Groningen, Netherlands
| | - C L Mulder
- Department of Psychiatry, Erasmus University Medical Centre, Rotterdam, Netherlands.,Research and Innovation, Parnassia Psychiatric Institute, The Hague, Netherlands
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148
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Mertan E, Croucher L, Shafran R, Bennett SD. An investigation of the information provided to the parents of young people with mental health needs on an internet forum. Internet Interv 2020; 23:100353. [PMID: 33365258 PMCID: PMC7749433 DOI: 10.1016/j.invent.2020.100353] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Revised: 11/02/2020] [Accepted: 11/11/2020] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Access to Children and Adolescent Mental Health Services (CAMHS) can be difficult, with lengthy wait times. Many of the young people and their parents are not signposted to any form of support during their wait for initial assessment or treatment and people are increasingly turning towards web-based resources for help and advice. However, there are some concerns about the quality of the information shared online. Research on the use and quality of information shared on online platforms for mental health inquiries is limited. AIMS We aimed to investigate the content and quality of the responses shared by forum users on an online forum for parents of young people with mental health needs (Mumsnet 'Talk'). Forum users were primarily parents, but 8 posts were written by posters identifying as a healthcare worker, teacher, or autism spectrum specialist. METHODS Qualitative methodology was adopted for this study. Forum content from Mumsnet was extracted in an anonymised form and thematic analysis was conducted to explore the content. Information shared in the online forum was assessed for quality by comparing the responses with clinical guidelines. RESULTS Thread topics related to 16 mental health problems. "Autistic Traits/Autism Spectrum Disorder", "Obsessions and Intrusive Thoughts/ Obsessive Compulsive Disorder" and "Comorbid Anxiety and Depression" were the most prevalent thread topics, consisting 38.3% of the extracted content. The investigation focused on "Information Offered" as the general dimension. Based on the thematic analysis, there were four second-order themes regarding the information offered by forum users; referral, advice, anecdotal information and opinion on case. The quantitative assessment of responses found that 58.3% of the knowledge exchange on Mumsnet was congruent with evidence-based clinical guidelines. CONCLUSIONS Themes indicate that parents of children and young people with mental health needs seem to use online fora for informational support. It is promising that a significant proportion of the information shared within the extracted forum content is congruent with evidence-based knowledge. However, further investigation is needed to generate better understanding of the overall quality of mental health information available on online platforms.
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149
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Mahomed F, Bhabha J, Stein MA, Pūras D. Establishing Good Practice for Human Rights-Based Approaches to Mental Health Care and Psychosocial Support in Kenya. Health Hum Rights 2020; 22:139-153. [PMID: 33390703 PMCID: PMC7762899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
A human rights-based approach (HRBA) to health has long been seen as an important way in which to address public health needs in a manner that is equitable and conducive to social justice. Yet the actual content of an HRBA to health remains unspecific, and therefore implementation remains heterogeneous. This situation is even more challenging in the field of mental health, where human rights considerations are particularly complex and have emerged out of a history of myriad violations. Even when research has been conducted into mental health, it has focused predominantly on the Global North, raising questions of contextual and cultural relevance. Accordingly, this study examined the issue from the perspectives of stakeholders in Kenya who consider their work or the services they use to be rights based. It explored the key principles and interventions deemed to constitute an HRBA to mental health care and psychosocial support, the perceived benefits of such approaches, and the main barriers and supports relevant for implementation. The results produced seven key principles and corresponding interventions. Among other things, it highlighted the importance of economic well-being and self-efficacy, as well as the reduction of barriers to implementation, such as stigma and lack of adequate resourcing. Two key tensions were apparent-namely, the un/acceptability of coercion and the role of traditional and faith-based modalities in an HRBA to mental health care and psychosocial support.
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Affiliation(s)
- Faraaz Mahomed
- Program Officer for Mental Health and Rights at the Open Society Foundations, New York, USA; Research Associate at the Harvard Law School Project on Disability, Cambridge, USA; and Visiting Research Fellow at the Centre for Applied Legal Studies, University of the Witwatersrand, Johannesburg, South Africa
| | - Jacqueline Bhabha
- Professor of the Practice of Health and Human Rights at the Harvard T.H. Chan School of Public Health, Director of Research at the François-Xavier Bagnoud Center for Health and Human Rights at Harvard University, and Jeremiah Smith Jr. Lecturer at Harvard Law School, Cambridge, USA
| | - Michael Ashley Stein
- Executive Director of the Harvard Law School Project on Disability and Visiting Professor at Harvard Law School, Cambridge, USA; and Extraordinary Professor at the Centre for Human Rights, University of Pretoria, South Africa
| | - Dainius Pūras
- Professor at the Clinic of Psychiatry, Vilnius University, Lithuania, and the United Nations Special Rapporteur on the Right to Health
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150
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Gabet M, Grenier G, Cao Z, Fleury MJ. Implementation of three innovative interventions in a psychiatric emergency department aimed at improving service use: a mixed-method study. BMC Health Serv Res 2020; 20:854. [PMID: 32917199 PMCID: PMC7488576 DOI: 10.1186/s12913-020-05708-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Accepted: 09/02/2020] [Indexed: 11/16/2022] Open
Abstract
Background Emergency department (ED) use is often viewed as an indicator of health system quality. ED use for mental health (MH) reasons is increasing and costly for health systems, patients, and their families. Patients with mental disorders (MD) including substance use disorders (SUD) and suicidal behaviors are high ED users. Improving ED services for these patients and their families, and developing alternatives to ED use are thus key issues. This study aimed to: (1) describe the implementation of three innovative interventions provided by a brief intervention team, crisis center team, and family-peer support team in a Quebec psychiatric ED, including the identification of implementation barriers, and (2) evaluate the impacts of these ED innovations on MH service use and response to needs. Method Using mixed methods with data triangulation, the implementation and impact of the three above-named ED interventions were studied. Quantitative data were collected from 101 participants (81 patients, 20 family members) using a user questionnaire and patient medical records. Qualitative data were gathered from focus groups (n = 3) with key intervention staff members (n = 14). The user questionnaire also included open-ended questions. Descriptive, comparative and content analyses were produced. Results Key implementation issues were identified in relation to system, organizational and patient profiles, similar to results identified in most studies in the ED implementation literature aimed at improving responsiveness to patients with MD. Results were encouraging, as the innovations had a significant impact for improved patient MH service use and adequacy of care. Services also seemed adapted to patient profiles. Family members were grateful for the help received in the ED. Conclusions Before implementing innovations, managers need to recognize the basic issues common to all new healthcare interventions: the need for staff training and strong involvement, particularly among physicians, development of collaborative tools especially in cases of potential cultural clash between staff and organizations, and continuous quality assessment. Future research needs to confirm the pertinence of these interventions, especially use of family-peer support teams in ED, as a highly innovative intervention. Broader ED strategies could also be deployed to improve MH services and decrease ED use for MH reasons.
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Affiliation(s)
- Morgane Gabet
- Management, Evaluation and Health Policies Department, School of Public Health, Université de Montréal, 7101 av. du Parc, Montreal, QC, H3X1X9, Canada.,Research Center, Douglas Mental Health University Institute, 6875 LaSalle Blvd, Montreal, QC, H4H 1R3, Canada
| | - Guy Grenier
- Research Center, Douglas Mental Health University Institute, 6875 LaSalle Blvd, Montreal, QC, H4H 1R3, Canada
| | - Zhirong Cao
- Research Center, Douglas Mental Health University Institute, 6875 LaSalle Blvd, Montreal, QC, H4H 1R3, Canada
| | - Marie-Josée Fleury
- Management, Evaluation and Health Policies Department, School of Public Health, Université de Montréal, 7101 av. du Parc, Montreal, QC, H3X1X9, Canada. .,Research Center, Douglas Mental Health University Institute, 6875 LaSalle Blvd, Montreal, QC, H4H 1R3, Canada. .,Department of Psychiatry, McGill University, 1033, Pine Avenue West, Montreal, QC, H3A 1A1, Canada.
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