A Cost-Effectiveness Analysis to Evaluate a System Change in Mental Healthcare in the Netherlands for Patients with Depression or Anxiety

Mental health policy reactions during the first year of the COVID-19 pandemic in two worst-hit WHO European countries: a narrative review and lessons for the aftermath of mental health care

Introduction: The COVID-19 pandemic has been challenging the health care systems and public wellbeing unprecedentedly. The United Kingdom and Turkiye were the countries worst hit by the pandemic in the World Health Organization European region. Purpose: This review investigated the mental health policies in these countries which draw a contrasting pattern of mental health care, sociodemographic background, and income level. Following the investigation, we recommended the possible directions to be pursued by European policymakers Methodology: The documents were picked from the health policy sections from the websites of international organizations (European Parliament, OECD, WHO, UN), online data and policy reports of national ministerial bodies, and general web search. Later, the papers were reviewed and the author identified the main concepts of the responses to discuss after policy review. The study was designed as a review; therefore, no statistical framework was conducted. Results: Identified concepts were as follows: a) continuing service provision for people with mental health conditions, b) digital mental health care interventions, c) building psychological resilience for citizens. Conclusions: A strategy only focusing on treating mental health conditions will not be sustainable during the post-pandemic era. It is essential to address mental health in all policies to foster a strong mental health care system

Curative effect of pop light music on depression patients based on improved fuzzy algorithm

With the aggravation of many social psychological and psychological stress factors, the high incidence rate of depression and depression has become a major problem which puzzles people’s health and even endangers life. Non drug therapy has become an effective alternative to drug therapy, which is in line with the new trend of natural medicine in the world. This paper will use the real world research method (RWS) to conduct a clinical trial of pop light music in the treatment of depression. Based on the fuzzy algorithm, a comprehensive evaluation system for the treatment of depression was established. By comparing and analyzing the main efficacy indexes between music group and traditional medicine group, we found that the cure rate, clinical control rate, significant efficiency, effective rate and ineffective rate of music therapy group were significantly better than those of drug group. Through the analysis of seven factors of HAMD (Hamilton Depression Scale) scale, we found that pop light music can improve the sleep status and physical symptoms of patients, and the improvement degree of music therapy is significantly better than that of drug therapy.

Impact of COVID‐19 social distancing measures on routine mental health care provision and treatment outcome for common mental disorders in the Netherlands

Objective

The uptake of digital interventions in mental health care (MHC) has been slow, as many therapists and patients believe that in‐person contact is essential for establishing a good working relationship and good outcomes in treatment. The public health policies regarding social distancing during the coronavirus disease‐2019 (COVID‐19) pandemic forced an abrupt transformation of MHC provisions for outpatients: Since mid‐March 2020, nearly all in‐person contact was replaced with videoconferencing. The COVID‐19 crisis offered a unique opportunity to investigate whether MHC with videoconferencing yields inferior results as compared to in‐person interventions.

Method

In a large urban MHC facility in the Netherlands, measurement‐based care is routine practice. Outcome data are regularly collected to support shared decision making and monitor patient progress. For this study, pretest and post‐test data were used to compare outcomes for three cohorts: treatments performed prior to, partially during and entirely during the COVID‐19 lockdown. Outcomes were compared in two large data sets: Basic MHC (N = 1392) and Specialized MHC (N = 1040).

Results

Therapeutic outcomes appeared robust for COVID‐19 conditions across the three cohorts: No differences in outcomes were found between treatments that were conducted during lockdown compared to in‐person treatments prior to COVID‐19, or treatments which started in‐person, but needed to be continued by means of videoconferencing.

Discussion

Videoconferencing care during the COVID‐19 pandemic had similar outcomes compared to traditional in‐person care. These real‐world results corroborate findings of previous randomized controlled studies and meta‐analyses in which videoconferencing and in‐person care has been directly compared in terms of clinical effectiveness.

Professionals' perceptions of the establishment of a specialized brief therapy unit in a district psychiatric centre - a qualitative study

Background

Increasing mental health problems and scarce treatment resources put pressure on mental health services to make innovations in service provision, such as developing differentiated services adapted to different needs. One innovation in differentiated service provision is brief or short-term treatment to patients with moderate mental health problems. Implementing a new unit in an organization usually faces many potential barriers and facilitators, and knowledge on how the professionals providing the services perceive the implementation of innovative approaches in mental health services is scarce. The aim of this study was therefore to explore the professionals’ perceptions of how the establishment of a specialized brief therapy unit had affected the organization, especially the everyday work in the outpatient clinics.

Methods

Eleven professionals, five men and six women, took part in individual interviews. All participants were between 40 and 60 years old and had leading or coordinating positions in the organization. Their professional backgrounds were within psychology, nursing and medicine, most of them specialists in their field. Data was analyzed according to Systematic text condensation.

Results

The professionals’ experiences represented four main themes: (1) The brief therapy unit was perceived as successful and celebrated. (2) The general outpatient clinics, on the other hand, were described as “forgotten”. (3) The establishment process had elucidated different views on treatment in the outpatient clinics - and had set off (4) a discussion regarding the criteria for prioritizing in mental health services.

Conclusion

Providing targeted treatment to patients with moderate mental health problems, while having a concurrent aim to solve broader problems in mental health services, entails a discussion regarding resource use and the appropriate level of treatment provision. Professionals should be more involved when innovative efforts are implemented, and the criteria for success must be conceptualized and evaluated. Longitudinal research on the implementation of innovative efforts in the services should include professionals’ and service users’ perspectives.

Personal-recovery-oriented community mental healthcare: qualitative evaluation of a developmental project

OBJECTIVES

Mental healthcare is commonly aimed at reducing symptoms in individual service users. When only symptomatic recovery is addressed, not all service users experience sufficient recovery, and when care is aimed only at individuals (instead of the neighbourhood), not all people in need of mental healthcare are reached. This study evaluated a project that aimed to improve mental healthcare in a neighbourhood, by improving healthcare providers' outreach to the residents living in the neighbourhood, by improving collaboration among healthcare providers and focussing on the residents' personal recovery. This project was carried out by several public health services. It aimed to change the goal of mental healthcare provided in the neighbourhood from symptom reduction to personal recovery.

DESIGN

The study included qualitative focus groups and inductive content analysis.

SETTING

Primary and secondary mental healthcare that healthcare workers from different healthcare services provided.

PARTICIPANTS

The evaluation was conducted through three focus group interviews with services users, their friends and relatives, neighbourhood residents, neighbourhood representatives and the healthcare services that were involved (n = 24).

RESULTS

Evaluation indicated that the most valued part of the project was the utilisation of peer workers at the initiation of mental healthcare. Improved communication among healthcare providers that the project fostered was also highly regarded. The aim of the project to align it with existing initiatives in the neighbourhood was also considered important, although it was difficult to achieve.

CONCLUSIONS

The project did not find a panacea for recovery-oriented community mental healthcare. A variety of its components did, however, contribute to the mental health of the community residents.