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De la Cruz-Torralva K, Escobar-Agreda S, Riega López P, Amaro J, Reategui-Rivera CM, Rojas-Mezarina L. Assessment of a Pilot Program for Remote Support on Mental Health for Young Physicians in Rural Settings in Peru: Mixed Methods Study. JMIR Form Res 2024; 8:e54005. [PMID: 39255480 DOI: 10.2196/54005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2023] [Revised: 03/27/2024] [Accepted: 04/18/2024] [Indexed: 09/12/2024] Open
Abstract
BACKGROUND Telemedicine-based interventions show promise in addressing mental health issues among rural populations, yet evidence regarding their impact among the health care workforce in these contexts remains limited. OBJECTIVE This study aimed to evaluate the characteristics and the responses and perceptions of recently graduated physicians who work in rural areas of Peru as part of the Servicio Rural Urbano Marginal en Salud (Rural-Urban Marginal Health Service [SERUMS], in Spanish) toward a telehealth intervention to provide remote orientation and accompaniment in mental health. METHODS A mixed methods study was carried out involving physicians who graduated from the Universidad Nacional Mayor de San Marcos and participated in the Mental Health Accompaniment Program (MHAP) from August 2022 to February 2023. This program included the assessment of mental health conditions via online forms, the dissemination of informational materials through a website, and, for those with moderate or high levels of mental health issues, the provision of personalized follow-up by trained personnel. Quantitative analysis explored the mental health issues identified among physicians, while qualitative analysis, using semistructured interviews, examined their perceptions of the services provided. RESULTS Of 75 physicians initially enrolled to the MHAP, 30 (41.6%) opted to undergo assessment and use the services. The average age of the participants was 26.8 (SD 1.9) years, with 17 (56.7%) being female. About 11 (36.7%) reported have current or previous mental health issues, 17 (56.7%) indicating some level of depression, 14 (46.7%) indicated some level of anxiety, 5 (16.6%) presenting a suicidal risk, and 2 (6.7%) attempted suicide during the program. Physicians who did not use the program services reported a lack of advertising and related information, reliance on personal mental health resources, or neglect of symptoms. Those who used the program expressed a positive perception regarding the services, including evaluation and follow-up, although some faced challenges accessing the website. CONCLUSIONS The MHAP has been effective in identifying and managing mental health problems among SERUMS physicians in rural Peru, although it faced challenges related to access and participation. The importance of mental health interventions in this context is highlighted, with recommendations to improve accessibility and promote self-care among participants.
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Affiliation(s)
- Kelly De la Cruz-Torralva
- Unidad de Telesalud, Facultad de Medicina, Universidad Nacional Mayor de San Marcos, Cercado de Lima, Peru
| | - Stefan Escobar-Agreda
- Unidad de Telesalud, Facultad de Medicina, Universidad Nacional Mayor de San Marcos, Cercado de Lima, Peru
| | - Pedro Riega López
- Unidad de Telesalud, Facultad de Medicina, Universidad Nacional Mayor de San Marcos, Cercado de Lima, Peru
| | - James Amaro
- Unidad de Telesalud, Facultad de Medicina, Universidad Nacional Mayor de San Marcos, Cercado de Lima, Peru
| | - C Mahony Reategui-Rivera
- Unidad de Telesalud, Facultad de Medicina, Universidad Nacional Mayor de San Marcos, Cercado de Lima, Peru
- Department of Biomedical Informatics, University of Utah, Salt Lake City, UT, United States
| | - Leonardo Rojas-Mezarina
- Unidad de Telesalud, Facultad de Medicina, Universidad Nacional Mayor de San Marcos, Cercado de Lima, Peru
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Fitzgerald S, Chronister J, Zheng QM, Chou CC. The Meaning of Social Support for Mental Health Service-Users: The Case Managers' Perspective. Community Ment Health J 2024:10.1007/s10597-024-01349-5. [PMID: 39230859 DOI: 10.1007/s10597-024-01349-5] [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: 05/07/2024] [Accepted: 08/18/2024] [Indexed: 09/05/2024]
Abstract
This study sought to understand the unique types of social support salient to mental health service-users from the perspective of case managers. The sample consisted of case managers working in county mental health agencies in the southwest and west coast. Data was gathered from three focus groups and analyzed using NVivo 10 and Consensual Qualitative Research. Six themes were described including relational support, consistency support, validation and affirmation support, social connection support, day-to-day living support and vocational support. While the social support domains described in this study share conceptual underpinnings with traditional conceptualizations of support, our findings reveal unique types of support from the perspective of case managers. Findings from this study offer an important perspective-case managers-to the extant body of research investigating the meaning of social support for people with lived mental health experiences. Of particular interest is the finding that relational support, affirmative and validation support, and consistency support are salient case manager functions.
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Affiliation(s)
- Sandra Fitzgerald
- Department of Counseling, San Francisco State University, 1600 Holloway Avenue, San Francisco, CA, 94132, USA.
| | - Julie Chronister
- Department of Counseling, San Francisco State University, 1600 Holloway Avenue, San Francisco, CA, 94132, USA
| | | | - Chih-Chin Chou
- Rehabilitation and Mental Health Counseling Program, University of South Florida, Tampa, USA
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Brooks H, Devereux-Fitzgerald A, Richmond L, Caton N, Cherry MG, Bee P, Lovell K, Downs J, Edwards BM, Vassilev I, Bush L, Rogers A. Exploring the use of social network interventions for adults with mental health difficulties: a systematic review and narrative synthesis. BMC Psychiatry 2023; 23:486. [PMID: 37420228 PMCID: PMC10329398 DOI: 10.1186/s12888-023-04881-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Accepted: 05/17/2023] [Indexed: 07/09/2023] Open
Abstract
BACKGROUND People with mental health difficulties often experience social isolation. The importance of interventions to enhance social networks and reduce this isolation is increasingly being recognised. However, the literature has not yet been systematically reviewed with regards to how these are best used. This narrative synthesis aimed to investigate the role of social network interventions for people with mental health difficulties and identify barriers and facilitators to effective delivery. This was undertaken with a view to understanding how social network interventions might work best in the mental health field. METHODS Systematic searches using combinations of synonyms for mental health difficulties and social network interventions were undertaken across 7 databases (MEDLINE, Embase, PsycINFO, CINAHL, Cochrane Library, Web of Science) and 2 grey literature databases (EThoS and OpenGrey) from their inception to October 2021. We included studies reporting primary qualitative and quantitative data from all study types relating to the use of social network interventions for people with mental health difficulties. The quality of included studies was assessed using the Mixed Methods Appraisal Tool. Data were extracted and synthesised narratively. RESULTS The review included 54 studies, reporting data from 6,249 participants. Social network interventions were generally beneficial for people with mental health difficulties but heterogeneity in intervention type, implementation and evaluation made it difficult to draw definitive conclusions. Interventions worked best when they (1) were personalised to individual needs, interests and health, (2) were delivered outside formal health services and (3) provided the opportunity to engage in authentic valued activities. Several barriers to access were identified which, without careful consideration could exacerbate existing health inequalities. Further research is required to fully understand condition-specific barriers which may limit access to, and efficacy of, interventions. CONCLUSIONS Strategies for improving social networks for people with mental health difficulties should focus on supporting engagement with personalised and supported social activities outside of formal mental health services. To optimise access and uptake, accessibility barriers should be carefully considered within implementation contexts and equality, diversity and inclusion should be prioritised in intervention design, delivery and evaluation and in future research.
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Affiliation(s)
- Helen Brooks
- Mental Health Research Group, Division of Nursing, Midwifery and Social Work, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, M13 9PL, UK.
| | - Angela Devereux-Fitzgerald
- Mental Health Research Group, Division of Nursing, Midwifery and Social Work, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, M13 9PL, UK
| | - Laura Richmond
- Mental Health Research Group, Division of Nursing, Midwifery and Social Work, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, M13 9PL, UK
- Department of Clinical, Education & Health Psychology, University College London, London, UK
| | - Neil Caton
- Patient and Public Involvement Contributor, University of Manchester, Manchester, UK
| | - Mary Gemma Cherry
- Department of Primary Care and Mental Health, Institute of Population Health, University of Liverpool, Liverpool, UK
- Linda McCartney Centre, Liverpool University Hospitals NHS Trust, Prescot St, Liverpool, UK
| | - Penny Bee
- Mental Health Research Group, Division of Nursing, Midwifery and Social Work, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, M13 9PL, UK
| | - Karina Lovell
- Mental Health Research Group, Division of Nursing, Midwifery and Social Work, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, M13 9PL, UK
- Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
| | - James Downs
- Patient and Public Involvement Contributor, Cambridge, UK
| | | | - Ivaylo Vassilev
- NIHR CLAHRC Wessex, Faculty of Health Sciences, University of Southampton, Southampton, UK
| | | | - Anne Rogers
- NIHR CLAHRC Wessex, Faculty of Health Sciences, University of Southampton, Southampton, UK
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Soilemezi D, Palmar‐Santos A, Navarta‐Sánchez MV, Roberts HC, Pedraz‐Marcos A, Haahr A, Sørensen D, Bragstad LK, Hjelle EG, Haavaag SB, Portillo MC. Understanding support systems for Parkinson's disease management in community settings: A cross-national qualitative study. Health Expect 2023; 26:670-682. [PMID: 36573594 PMCID: PMC10010098 DOI: 10.1111/hex.13691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Revised: 09/27/2022] [Accepted: 12/09/2022] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Health and social care systems face difficulties in managing multimorbidity, disease burden and complex needs in long-term conditions such as Parkinson's disease. OBJECTIVE This study aimed to develop a European understanding of how health and social care professionals can collaborate with stakeholders from different organizations and sectors to enhance the management of Parkinson's disease in a community setting by identifying the existing gaps in this process and how people with Parkinson's disease and their family carers could benefit from these partnerships. METHODS A mixed-methods sequential study was conducted in Denmark, Norway, Spain and the United Kingdom. The findings from the qualitative phase are presented. Individual semistructured interviews were analysed using Braun's and Clarke's thematic analysis. A meta-ethnography approach was used to analyse and synthesize cross-national findings. RESULTS A total of 41 healthcare professionals and 39 stakeholders from different disciplines and sectors were interviewed in the four countries. The participants acknowledged a lack of awareness of available resources and poor communication between the different support systems in the management of Parkinson's disease. To promote multiagency collaborations, the participants highlighted the need to organize services along the Parkinson's disease journey, patient involvement and strategic involvement of carers in organizing resources and Parkinson's disease care pathways. According to the participants, the benefits from multiagency partnerships could lead to an enhanced continuity of care and specialized knowledge, mobilization of resources in the community, personalized support and improved access to services. CONCLUSIONS Policymakers are called upon to create formal structures that facilitate multisectoral collaborations to promote an integrated system of care for the management of Parkinson's disease in the community. To address this challenge, we propose five strategies showing how organizations can work together to optimize the use of resources and enhance the management of Parkinson's disease throughout the illness trajectory. PATIENT OR PUBLIC CONTRIBUTION Patient and Public Involvement groups made up of stakeholders, healthcare professionals, patients with Parkinson's disease and family carers participated in the design of the study, the development of the interview guides and the validation of the findings.
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Affiliation(s)
- Dia Soilemezi
- Department of Psychology, Faculty of Science and HealthUniversity of PortsmouthPortsmouthUK
| | - Ana Palmar‐Santos
- Nursing Department, Faculty of MedicineUniversidad Autónoma de MadridMadridSpain
| | | | - Helen C. Roberts
- National Institute for Health Research Applied Research Collaboration Wessex, Long Term Conditions, SouthamptonUK
- Academic Geriatric Medicine, Faculty of MedicineUniversity of SouthamptonSouthamptonUK
| | - Azucena Pedraz‐Marcos
- Unidad de Investigación en Cuidados y Sistemas de SaludThe Carlos III Health Institute (ISCIII)MadridSpain
- Grupo de investigación ISCiiiResearch Network on Chronicity, Primary Care, and Health Promotion (RICAPPS)TenerifeSpain
| | - Anita Haahr
- Research Centre for Health and Welfare Technology, Programme for Rehabilitation, VIA University CollegeAarhusDenmark
- Nursing and Healthcare, Department of Public HealthAarhus UniversityAarhusDenmark
| | - Dorthe Sørensen
- Research Centre for Health and Welfare Technology, Programme for Rehabilitation, VIA University CollegeAarhusDenmark
| | - Line K. Bragstad
- Department of Nursing Science and Research Center for Habilitation and Rehabilitation Services and Models (CHARM)University of OsloOsloNorway
- Department of Occupational Therapy, Prosthetics and OrthoticsOslo Metropolitan UniversityOsloNorway
| | - Ellen G. Hjelle
- Department of Nursing Science and Research Center for Habilitation and Rehabilitation Services and Models (CHARM)University of OsloOsloNorway
- Department of Occupational Therapy, Prosthetics and OrthoticsOslo Metropolitan UniversityOsloNorway
| | | | - Mari Carmen Portillo
- National Institute for Health Research Applied Research Collaboration Wessex, Long Term Conditions, SouthamptonUK
- Faculty of Environmental and Life Sciences, School of Health SciencesUniversity of SouthamptonSouthamptonUK
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Zabeen S, Phua D, Mohammadi L, Lawn S. Family involvement to support cardiovascular self-management care for people with severe mental illness: a systematic review. J Ment Health 2023; 32:290-306. [PMID: 32924668 DOI: 10.1080/09638237.2020.1818194] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
BACKGROUND Family members play a pivotal role in supporting cardiovascular self-management-based care of community-living adults with severe mental illness (SMI). However, little is known about what strategies caregivers employ as part of their caring roles. AIM This paper aims to explore what caregiving strategies work (or not), why and how by collating and synthesising existing evidence on this issue. METHODS A systematic search of peer-reviewed qualitative and mixed-method studies published between 2000 and 2019 was employed. This comprehensive process generated only nine papers for subsequent meta-synthesis of qualitative data. RESULTS Findings suggested that caregivers have a complex yet comprehensive role to play in initiating and perpetuating self-management-based cardiovascular care. The elements of recovery such as promoting hope, normality, autonomy and identity were flagged as critical underpinning factors that motivated the person with SMI to adopt a healthy lifestyle. However, it was evident that caregivers needed to walk alongside the person, at times, to help them reach their maximum potential in sustaining improved self-management behaviours. CONCLUSION Caregivers sit in a favourable bridging position between healthcare systems and community-living individuals with SMI, to support their cardiovascular health. However, this powerful but invisible 'workforce' clearly needs further support involving finance, skill-development and acknowledgement.
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Affiliation(s)
- Sara Zabeen
- College of Medicine and Public Health, Flinders University, Bedford Park, Australia
| | - Delphine Phua
- College of Medicine and Public Health, Flinders University, Bedford Park, Australia
| | - Leila Mohammadi
- College of Medicine and Public Health, Flinders University, Bedford Park, Australia
| | - Sharon Lawn
- College of Medicine and Public Health, Flinders University, Bedford Park, Australia
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Bonagura AG, Widom CS. Child Maltreatment and Psychiatric Disorders Increase Risk for Stalking Victimization. JOURNAL OF INTERPERSONAL VIOLENCE 2023; 38:NP60-NP83. [PMID: 35236175 DOI: 10.1177/08862605221078889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Stalking is a serious public health problem, estimated to affect about 15% of women and 6% of men. Victims of stalking have been reported to be at increased risk for psychological distress, depression, lowered social and daily functioning, and other forms of victimization. The present study sought to determine whether individuals with documented histories of childhood maltreatment and those with psychiatric disorders are at increased risk for stalking victimization. Participants included maltreated children and matched controls (N = 892) from a Midwestern, metropolitan area who were followed up into adulthood. Psychiatric disorders (major depressive disorder, post-traumatic stress disorder, antisocial personality disorder, and substance use disorders) were assessed at mean age 29 and borderline personality disorder at age 39. Participants reported lifetime stalking using the Lifetime Trauma and Victimization History instrument and based on a separate measure, past year intimate partner stalking victimization. Analyses controlled for sex, race, and age. Depression, PTSD, antisocial, and borderline personality disorders were associated with increased lifetime risk for stalking victimization. Childhood maltreatment, neglect, and psychiatric disorders (substance use, PTSD, antisocial personality, and borderline personality) predicted increased risk for past year stalking victimization. Findings indicated sex differences in lifetime risk of stalking victimization and race differences in past-year stalking victimization. Although the results reveal relationships among child maltreatment, psychiatric disorders, and stalking victimization, the impact of childhood maltreatment is most salient in terms of past year intimate partner stalking victimization, and particularly for individuals with histories of neglect. Future research is needed to better understand these race and sex differences in stalking victimization.
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Affiliation(s)
- Alexandra Grace Bonagura
- Psychology Department, 217454John Jay College of Criminal Justice of The City University of New York and the Graduate Center of the City University of New York, New York, NY, USA
| | - Cathy Spatz Widom
- Psychology Department, 217454John Jay College of Criminal Justice of The City University of New York and the Graduate Center of the City University of New York, New York, NY, USA
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Dixon K, Fossey E, Petrakis M. Using photovoice to explore women's experiences of a women-only prevention and recovery care service in Australia. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:e5839-e5847. [PMID: 36069171 PMCID: PMC10087405 DOI: 10.1111/hsc.14015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Revised: 07/21/2022] [Accepted: 08/20/2022] [Indexed: 06/15/2023]
Abstract
Women should be able to access mental health services that are safe, free from harassment and abuse. Yet, research indicates that women experiencing mental health issues are often not safe in mixed gender environments, and especially in inpatient settings. This qualitative study draws on a photo-elicitation method ('photovoice') and semi-structured interviews to explore women's experiences of a sub-acute women-only prevention and recovery care (PARC) service in Australia. Twelve women experiencing mental health issues were recruited via an aftercare peer support group for recent service participants. The women took photographs guided by the central question: 'What were your experiences of a women-only prevention and recovery care service?' They then shared these photographs with the researchers and each other, and described them in detail. Four key themes were identified by thematic analysis of the photovoice visual and narrative data: (a) Only women can understand what women go through; (b) I feel safer with no men around due to my history of trauma; (c) This environment feels safe, making it easier to talk and (d) Staff are accessible and make time for me to talk about difficult topics. Woven throughout the women's narratives was the expressed desire to feel safe and supported during the process of recovering. Aspects of service delivery that contributed to these feelings and facilitated shared support were also valued in this setting. These findings indicate that access to women-only services and peer support are not only valued by women experiencing mental health issues, but need to be more widely available to support their recovery. They also underline the importance of a trauma-informed approach for improving the gender sensitivity of services.
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Affiliation(s)
- Karen Dixon
- Department of Occupational Therapy, School of Primary and Allied Health Care, Faculty of Medicine, Nursing & Health SciencesMonash UniversityFrankstonVictoriaAustralia
| | - Ellie Fossey
- Department of Occupational Therapy, School of Primary and Allied Health CareMonash UniversityFrankstonVictoriaAustralia
- Living with Disability Research Centre, School of Allied HealthLa Trobe UniversityBundooraVictoriaAustralia
| | - Melissa Petrakis
- Social Work InnovationTransformation and Collaboration in Health (SWITCH) Research GroupCaulfield EastVictoriaAustralia
- School of Primary and Allied Health Care, Faculty of Medicine, Nursing and Health SciencesMonash UniversityCaulfield EastVictoriaAustralia
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Li C, Yang F, Yang BX, Chen W, Wang Q, Huang H, Liu Q, Luo D, Wang XQ, Ruan J. Experiences and challenges faced by community mental health workers when providing care to people with mental illness: a qualitative study. BMC Psychiatry 2022; 22:623. [PMID: 36131269 PMCID: PMC9490980 DOI: 10.1186/s12888-022-04252-z] [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: 05/05/2022] [Accepted: 09/05/2022] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Mental illness is a major burden of disease worldwide. Community Mental Health Services (CMHS) are key to achieving community-based recovery for people with mental illness. In China, even though the community management of patients with mental illness is improving, the barriers faced by Community Mental Health Workers (CMHWs) are unclear. This study explores the difficulties and challenges in CMHS from the perspective of CMHWs. The results of this study may provide a practical basis for the training of CMHWs. METHODS We carried out a qualitative study using an empirical phenomenological approach. Nine CMHWs were recruited from nine communities in Wuhan, Hubei Province, using purposive and snowball sampling. Face to face semi-structured in-depth interviews were conducted with them from December 27 to 28, 2019. Interview recordings were converted to text content by Nvivo 11.0 software and analyzed using Colaizzi's phenomenological method. RESULTS Three main themes were identified in this study: 1) Lack of role orientation leads to role ambiguity, 2) Failure to establish a therapeutic trust relationship with patients, and 3) Lack of communication and collaboration with various departments and peers. Seven sub themes were also identified. In these themes, CMHWs emphasized the importance of role clarity, therapeutic trusting relationships, and effective communication and coordination mechanisms. CONCLUSION Although China has made great efforts on the road to improving the quality of CMHS, several salient issues regarding CMHWs must be addressed to optimize the quality of services provided by CMHWs. Community mental health institutions should help CMHWs overcome these difficulties, by maximizing its value and promoting the development of CMHS.
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Affiliation(s)
- Chaoyang Li
- grid.257143.60000 0004 1772 1285Hubei University of Chinese Medicine, School of Nursing, Wuhan, China
| | - Fen Yang
- grid.257143.60000 0004 1772 1285Hubei University of Chinese Medicine, School of Nursing, Wuhan, China
| | - Bing Xiang Yang
- grid.49470.3e0000 0001 2331 6153Wuhan University, School of Nursing, Wuhan, China
| | - Wencai Chen
- grid.33199.310000 0004 0368 7223Wuhan Mental Health Center, Wuhan, China
| | - Qinyu Wang
- grid.13394.3c0000 0004 1799 3993Department of Psychology, The Fourth Affiliated Hospital of Xinjiang Medical University, Urumqi, China
| | - Haishan Huang
- grid.33199.310000 0004 0368 7223Huazhong University of Science and Technology, Tongji Hospital Affiliated to Tongji Medical college, Wuhan, China
| | - Qian Liu
- grid.49470.3e0000 0001 2331 6153Wuhan University, School of Nursing, Wuhan, China
| | - Dan Luo
- Wuhan University, School of Nursing, Wuhan, China.
| | | | - Juan Ruan
- Wuhan Mental Health Center, Wuhan, China.
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Brooks H, Devereux-Fitzgerald A, Richmond L, Caton N, Newton A, Downs J, Lovell K, Bee P, Cherry MG, Young B, Vassilev I, Rotheram C, Rogers A. Adapting a social network intervention for use in secondary mental health services using a collaborative approach with service users, carers/supporters and health professionals in the United Kingdom. BMC Health Serv Res 2022; 22:1140. [PMID: 36085063 PMCID: PMC9461266 DOI: 10.1186/s12913-022-08521-1] [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: 04/26/2022] [Accepted: 08/30/2022] [Indexed: 12/03/2022] Open
Abstract
Background Social integration, shared decision-making and personalised care are key elements of mental health and social care policy. Although these elements have been shown to improve service user and service-level outcomes, their translation into practice has been inconsistent and social isolation amongst service users persists. Aim To co-adapt, with service users, carers/supporters and health professionals, a web-based social network intervention, GENIE™, for use in secondary mental health services. The intervention is designed to support social activity and preference discussions between mental healthcare professionals and service users as a means of connecting individuals to local resources. Methods In Phase 1 (LEARN), we completed two systematic reviews to synthesise the existing evidence relating to the i) effectiveness and ii) the implementation of social network interventions for people with mental health difficulties. We undertook semi-structured interviews with a convenience sample of 15 stakeholders previously involved in the implementation of the intervention in physical healthcare settings. Interviews were also conducted with 5 national key stakeholders in mental health (e.g., policy makers, commissioners, third sector leads) to explore wider implementation issues. In Phase 2 (ADAPT), we worked iteratively with eight service users, nine carers, six professionals/volunteers and our patient and public advisory group. We drew on a framework for experience-based co-design, consisting of a series of stakeholder consultation events, to discuss the use of the social network intervention, in mental health services. Participants also considered factors that could serve as enablers, barriers, and challenges to local implementation. Results Across the stakeholder groups there was broad agreement that the social network intervention had potential to be useful within mental health services. In terms of appropriate and effective implementation, such an intervention was predicted to work best within the care planning process, on discharge from hospital and within early intervention services. There were indications that the social connection mapping and needs assessment components were of most value and feasible to implement which points to the potential utility of a simplified version compared to the one used in this study. The training provided to facilitators was considered to be more important than their profession and there were indications that service users should be offered the opportunity to invite a carer, friend, or family member to join them in the intervention. Conclusion The GENIE™ intervention has been co-adapted for use in mental health services and a plan for optimal implementation has been co-produced. The next phase of the programme of work is to design and implement a randomised controlled trial to evaluate clinical and cost effectiveness of a simplified version of the intervention. Supplementary Information The online version contains supplementary material available at 10.1186/s12913-022-08521-1.
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Brooks H, Devereux-Fitzgerald A, Richmond L, Bee P, Lovell K, Caton N, Cherry MG, Edwards BM, Downs J, Bush L, Vassilev I, Young B, Rogers A. Assessing the effectiveness of social network interventions for adults with a diagnosis of mental health problems: a systematic review and narrative synthesis of impact. Soc Psychiatry Psychiatr Epidemiol 2022; 57:907-925. [PMID: 35138427 PMCID: PMC9042995 DOI: 10.1007/s00127-022-02242-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Accepted: 01/22/2022] [Indexed: 01/20/2023]
Abstract
BACKGROUND Social connections have been linked to the genesis and amelioration of mental health problems and thus have potential therapeutic value. PURPOSE To identify the current evidence base, assess risk of bias and synthesise findings on the effectiveness of social network interventions for people with mental health problems. METHODS Electronic databases (MEDLINE, Embase, PsycINFO, CINAHL, Cochrane Library, Web of Science, Scopus) and grey literature databases were systematically searched from inception to October 2021 using free text syntax combining synonyms for 'mental health problems' and 'social network interventions'. Articles were eligible for inclusion if they reported data from randomised controlled trials on the effectiveness of interventions designed to improve social networks for adults (18+) with mental health problems. Papers were independently reviewed for inclusion with conflicts resolved through consensus. Included papers were quality assessed and data extracted and synthesized narratively. Risk of bias was assessed using the Cochrane Risk of Bias Tool. RESULTS Nine studies randomising 2226 participants were included. Four focused on those with a diagnosis of schizophrenia or psychosis, one on major depressive disorder and four included all types of mental health diagnoses. The current evidence base is of unclear quality. However, interventions which focused on supporting social activities appear to hold the most promise for enhancing social networks. Data on cost-effectiveness and research acceptability were limited, but suggest the potential economic feasibility of and acceptability for evaluating these interventions. CONCLUSION There is emerging evidence that social network interventions can be effective in improving social connections for people with mental health problems. However, further evaluations with robust methodological approaches are required to inform evidence-based recommendations for health services.
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Affiliation(s)
- Helen Brooks
- Mental Health Research Group, Jean McFarlane Building, Division of Nursing, Midwifery and Social Work, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, M13 9PL, UK.
| | - Angela Devereux-Fitzgerald
- Mental Health Research Group, Jean McFarlane Building, Division of Nursing, Midwifery and Social Work, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, M13 9PL UK
| | - Laura Richmond
- Mental Health Research Group, Jean McFarlane Building, Division of Nursing, Midwifery and Social Work, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, M13 9PL UK
| | - Penny Bee
- Mental Health Research Group, Jean McFarlane Building, Division of Nursing, Midwifery and Social Work, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, M13 9PL UK
| | - Karina Lovell
- Mental Health Research Group, Jean McFarlane Building, Division of Nursing, Midwifery and Social Work, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, M13 9PL UK ,Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
| | - Neil Caton
- Patient and Public Involvement Contributor, University of Manchester, Manchester, UK
| | - Mary Gemma Cherry
- Department of Primary Care and Mental Health, Institute of Population Health, University of Liverpool, Liverpool, UK ,Linda McCartney Centre, Liverpool University Hospitals NHS Trust, Prescot St, Liverpool, UK
| | - Bethan Mair Edwards
- Patient and Public Involvement Contributor, University of Manchester, Manchester, UK
| | - James Downs
- Patient and Public Involvement Contributor, University of Manchester, Manchester, UK
| | - Laura Bush
- Patient and Public Involvement Contributor, Cambridge, UK
| | - Ivaylo Vassilev
- Faculty of Health Sciences, University of Southampton, Southampton, England
| | - Bridget Young
- Department of Public Health, Policy and Systems, Institute of Population Health, University of Liverpool, Liverpool, UK
| | - Anne Rogers
- Faculty of Health Sciences, University of Southampton, Southampton, England
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Shand C, Crozier S, Vassilev I, Penn-Newman D, Dhuria P, Cooper C, Rogers A, Baird J, Vogel C. Resources in women's social networks for food shopping are more strongly associated with better dietary quality than people: A cross-sectional study. Soc Sci Med 2021; 284:114228. [PMID: 34325327 DOI: 10.1016/j.socscimed.2021.114228] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Revised: 07/08/2021] [Accepted: 07/12/2021] [Indexed: 02/05/2023]
Abstract
When healthy people are part of an individual's social network, those individuals will have better dietary quality. Little, however, is known about whether social networks for food shopping, including both people and resources (e.g. recipes, weight loss programmes and food advertisements) are associated with dietary quality. The aim of this study was to explore the relationship between social networks for food shopping and dietary quality, and whether this differs for people and resources, among women aged 18-45 years. A total of 129 participants completed a cross-sectional questionnaire including an ego-centric Social Network Exposure tool and short Food Frequency Questionnaire. Associations between dietary quality and type of network member, perceived healthiness and support for healthy shopping choices were explored using linear regression models. Analyses revealed that participants who nominated people in their food shopping social network that eat healthily or support healthy food shopping had better dietary quality (β = 0.16 SD per 1-point change on a 4-point scale, 95%CI -0.06, 0.39; β = 0.20, 95%CI -0.07, 0.46, respectively). Resources in participants' food shopping social networks which promote healthy eating or support healthy shopping were associated with better dietary quality. These associations remained robust after adjustment for confounding variables identified using a directed acyclic graph (β = 0.31 SD per 1-point change on a 4-point scale, 95%CI 0.03, 0.58; β = 0.44, 95%CI 0.09, 0.79 respectively). The results were strengthened when the outcome was multiplied by frequency of contact (β = 0.33, 95%CI 0.05, 0.61; β = 0.47, 95%CI 0.11, 0.83 respectively). This study suggests that resources which promote healthy eating and healthy food shopping have a stronger association with dietary quality than social support from people. Further research is required in a larger sample, including multiple time-points, to confirm these findings.
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Affiliation(s)
- Calum Shand
- Medical Research Council Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Tremona Road, Southampton, SO16 6YD, UK.
| | - Sarah Crozier
- Medical Research Council Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Tremona Road, Southampton, SO16 6YD, UK; NIHR Applied Research Collaboration Wessex, Southampton Science Park, Innovation Centre, 2 Venture Road, Chilworth, Southampton, SO16 7NP, UK
| | - Ivaylo Vassilev
- National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care, School of Health Sciences, Faculty of Environmental & Life Sciences, University of Southampton, Southampton, United Kingdom
| | - Daniel Penn-Newman
- Medical Research Council Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Tremona Road, Southampton, SO16 6YD, UK
| | - Preeti Dhuria
- Medical Research Council Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Tremona Road, Southampton, SO16 6YD, UK
| | - Cyrus Cooper
- Medical Research Council Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Tremona Road, Southampton, SO16 6YD, UK; National Institute for Health Research Southampton Biomedical Research, Centre, University of Southampton and University Hospital Southampton, NHS Foundation Trust, Southampton, SO16 6YD, UK
| | - Anne Rogers
- National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care, School of Health Sciences, Faculty of Environmental & Life Sciences, University of Southampton, Southampton, United Kingdom
| | - Janis Baird
- Medical Research Council Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Tremona Road, Southampton, SO16 6YD, UK; National Institute for Health Research Southampton Biomedical Research, Centre, University of Southampton and University Hospital Southampton, NHS Foundation Trust, Southampton, SO16 6YD, UK; NIHR Applied Research Collaboration Wessex, Southampton Science Park, Innovation Centre, 2 Venture Road, Chilworth, Southampton, SO16 7NP, UK
| | - Christina Vogel
- Medical Research Council Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Tremona Road, Southampton, SO16 6YD, UK; National Institute for Health Research Southampton Biomedical Research, Centre, University of Southampton and University Hospital Southampton, NHS Foundation Trust, Southampton, SO16 6YD, UK; NIHR Applied Research Collaboration Wessex, Southampton Science Park, Innovation Centre, 2 Venture Road, Chilworth, Southampton, SO16 7NP, UK.
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