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Saunders V, McCalman J, Tsey S, Askew D, Campbell S, Jongen C, Angelo C, Spurling G, Cadet-James Y. Counting what counts: a systematic scoping review of instruments used in primary healthcare services to measure the wellbeing of Indigenous children and youth. BMC PRIMARY CARE 2023; 24:51. [PMID: 36803458 PMCID: PMC9936129 DOI: 10.1186/s12875-023-02001-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Accepted: 02/02/2023] [Indexed: 02/19/2023]
Abstract
BACKGROUND Primary healthcare services have principal responsibility for providing child and youth wellbeing and mental health services, but have lacked appropriate measurement instruments to assess the wellbeing of Indigenous children and youth or to evaluate the effectiveness of programs and services designed to meet their needs. This review assesses the availability and characteristics of measurement instruments that have been applied in primary healthcare services in Canada, Australia, New Zealand and the United States (CANZUS countries) to assess the wellbeing of Indigenous children and youth. METHODS Fifteen databases and 12 websites were searched in December 2017 and again in October 2021. Pre-defined search terms pertained to Indigenous children and youth, CANZUS country names, and wellbeing or mental health measures. PRISMA guidelines were followed, with eligibility criteria guiding screening of titles and abstracts, and selected full-text papers. Results are presented based on the characteristics of documented measurement instruments assessed according to five desirability criteria: development for Indigenous youth populations, adherence to relational strength-based constructs, administration by child and or youth self-report, reliability and validity, and usefulness for identifying wellbeing or risk levels. RESULTS Twenty-one publications were found that described the development and or use by primary healthcare services of 14 measurement instruments, employed across 30 applications. Four of the 14 measurement instruments were developed specifically for Indigenous youth populations, four focused solely on strength-based wellbeing concepts but none included all Indigenous wellbeing domains. CONCLUSION There is a diversity of measurement instruments available, but few fit our desirability criteria. Although it is possible that we missed relevant papers and reports, this review clearly supports the need for further research to develop, refine or adapt instruments cross-culturally to measure the wellbeing of Indigenous children and youth.
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Affiliation(s)
- Vicki Saunders
- Jawun Research Centre, Central Queensland University, Cnr Shields and Aplin St, Cairns, QLD, 4870, Australia.
| | - Janya McCalman
- grid.1023.00000 0001 2193 0854Jawun Research Centre, Central Queensland University, Cnr Shields and Aplin St, Cairns, QLD 4870 Australia
| | - Sena Tsey
- grid.1023.00000 0001 2193 0854Jawun Research Centre, Central Queensland University, Cnr Shields and Aplin St, Cairns, QLD 4870 Australia
| | - Deborah Askew
- grid.1003.20000 0000 9320 7537General Practice Clinical Unit and School of Public Health, Faculty of Medicine, University of Queensland, Level 2, Public Health Building, 288 Herston Road, Brisbane, QLD 4006 Australia
| | - Sandy Campbell
- grid.1043.60000 0001 2157 559XMolly Wardaguga Research Centre, Charles Darwin University, Level 11, 410 Ann St, Brisbane, QLD 4000 Australia
| | - Crystal Jongen
- grid.1023.00000 0001 2193 0854Jawun Research Centre, Central Queensland University, Cnr Shields and Aplin St, Cairns, QLD 4870 Australia
| | - Candace Angelo
- grid.1013.30000 0004 1936 834XAboriginal and Torres Strait Islander Public Health, Sydney School of Public Health, Faculty of Medicine and Health, University of Sydney, Edward Ford Building, Fisher Road, Sydney, NSW 2006 Australia
| | - Geoff Spurling
- grid.1003.20000 0000 9320 7537General Practice Clinical Unit and School of Public Health, Faculty of Medicine, University of Queensland, Level 2, Public Health Building, 288 Herston Road, Brisbane, QLD 4006 Australia
| | - Yvonne Cadet-James
- Yvonne Cadet-James, Apunipima Cape York Health Council, 186 McCoombe St, Cairns, QLD 4870 Australia
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Mseke EP, Jessup B, Barnett T. A systematic review of the preferences of rural and remote youth for mental health service access: Telehealth versus face-to-face consultation. Aust J Rural Health 2023. [PMID: 36606417 DOI: 10.1111/ajr.12961] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 11/29/2022] [Accepted: 12/20/2022] [Indexed: 01/07/2023] Open
Abstract
INTRODUCTION Telehealth has become an increasingly popular method to deliver mental health services to rural and remote youth who are challenged by distance and service availability. However, it remains unclear whether rural and remote youth would prefer to access mental health services via telehealth or by attending services in person. OBJECTIVE To systematically review the preferences of rural and remote youth for mental health service access via telehealth versus face-to-face consultation. DESIGN Systematic review of published research papers cited in databases CINAHL, MEDLINE and PubMed databases between 2000 and 2021. FINDINGS From a total of 225 articles identified, four were found to meet inclusion criteria. Three studies reported rural and remote youth preferred to access mental health services face-to-face over telehealth. However, three studies also reported youth viewed telehealth as an important adjunct to in person attendance, especially in situations of large travel times. DISCUSSION Although telehealth can facilitate mental health service access, rural and remote youth may prefer to see a mental health professional in person, with telehealth regarded as an adjunct to, not a replacement for, face-to-face consultation. CONCLUSION Whilst rural and remote youth may prefer to access mental health services in person rather than via telehealth, further well designed research is needed to better understand under what circumstances this preference holds true and why. Caution should be exercised in generalising this finding because of the few studies that met the inclusion criteria and different conditions under which youth made their choice to access mental health services.
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Affiliation(s)
- Edwin Paul Mseke
- Centre for Rural Health, University of Tasmania, Launceston, Tasmania, Australia.,Department of Mathematics and Statistics, University of Dodoma, Dodoma, Tanzania
| | - Belinda Jessup
- Centre for Rural Health, University of Tasmania, Launceston, Tasmania, Australia
| | - Tony Barnett
- Centre for Rural Health, University of Tasmania, Launceston, Tasmania, Australia
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Oostermeijer S, Williamson M, Nicholas A, Machlin A, Bassilios B. Implementing and Delivering Youth Mental Health Services: Approaches Taken by the Australian Primary Health Network 'Lead Sites'. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:10494. [PMID: 36078211 PMCID: PMC9517850 DOI: 10.3390/ijerph191710494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Revised: 08/15/2022] [Accepted: 08/18/2022] [Indexed: 06/15/2023]
Abstract
AIM This paper aims to report on effective approaches for, and early impacts of, implementing and delivering services for youth with, or at risk of, severe mental illness commissioned by 10 Primary Health Network (PHN) Lead Sites (reform leaders) in Australia. METHODS The following qualitative data sources were analyzed using a thematic approach: focus group consultations with 68 Lead Site staff and 70 external stakeholders from Lead Site regions; and observational data from one Lead Site meeting with a focus on services for youth with, or at risk of, severe mental illness and one national symposium that was attended by Lead Site staff and service providers. RESULTS The Lead Site staff described common effective strategies for implementing and delivering youth enhanced services as follows: building on existing youth services, establishing effective linkages with other local youth enhanced services, and providing complementary clinical and non-clinical services. Early impacts of youth enhanced services that were described by Lead Site staff and external stakeholders included: improved service quality and access, positive effects on consumers and/or carers (e.g., reduced symptomology), and sector-wide impacts such as improved service integration. Staff members from two Lead Sites also mentioned negative impacts (e.g., uncertainty of continued funding). Suggestions for future improvements by Lead Site staff and external stakeholders included: involving young people in service design and planning, improving service access, addressing clinical workforce shortages, improving data collection and usage, and establishing greater service integration. CONCLUSIONS These findings highlight the necessity for collaborative and localized responses as well as service models that combine clinical and non-clinical care to address the needs of young people with, or at risk of, severe mental illness. Early impacts that were reported by stakeholders indicated that PHN-commissioned youth-enhanced services had positive impacts for consumers, carers, and the wider service sector.
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Hamilton C, Filia K, Lloyd S, Prober S, Duncan E. ‘More than just numbers on a page?’ A qualitative exploration of the use of data collection and feedback in youth mental health services. PLoS One 2022; 17:e0271023. [PMID: 35857762 PMCID: PMC9299353 DOI: 10.1371/journal.pone.0271023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Accepted: 06/21/2022] [Indexed: 11/18/2022] Open
Abstract
Objectives This study aimed to explore current data collection and feedback practice, in the form of monitoring and evaluation, among youth mental health (YMH) services and healthcare commissioners; and to identify barriers and enablers to this practice. Design Qualitative semi-structured interviews were conducted via Zoom videoconferencing software. Data collection and analysis were informed by the Theoretical Domains Framework (TDF). Data were deductively coded to the 14 domains of the TDF and inductively coded to generate belief statements. Setting Healthcare commissioning organisations and YMH services in Australia. Participants Twenty staff from healthcare commissioning organisations and twenty staff from YMH services. Results The umbrella behaviour ‘monitoring and evaluation’ (ME) can be sub-divided into 10 specific sub-behaviours (e.g. planning and preparing, providing technical assistance, reviewing and interpreting data) performed by healthcare commissioners and YMH services. One hundred belief statements relating to individual, social, or environmental barriers and enablers were generated. Both participant groups articulated a desire to improve the use of ME for quality improvement and had particular interest in understanding the experiences of young people and families. Identified enablers included services and commissioners working in partnership, data literacy (including the ability to set appropriate performance indicators), relational skills, and provision of meaningful feedback. Barriers included data that did not adequately depict service performance, problems with data processes and tools, and the significant burden that data collection places on YMH services with the limited resources they have to do it. Conclusions Importantly, this study illustrated that the use of ME could be improved. YMH services, healthcare commissioners should collaborate on ME plans and meaningfully involve young people and families where possible. Targets, performance indicators, and outcome measures should explicitly link to YMH service quality improvement; and ME plans should include qualitative data. Streamlined data collection processes will reduce unnecessary burden, and YMH services should have the capability to interrogate their own data and generate reports. Healthcare commissioners should also ensure that they provide meaningful feedback to their commissioned services, and local and national organisations collecting youth mental health data should facilitate the sharing of this data. The results of the study should be used to design theory-informed strategies to improve ME use.
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Affiliation(s)
| | - Kate Filia
- Orygen, Melbourne, Australia
- Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia
| | | | | | - Eilidh Duncan
- Health Services Research Unit, Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, United Kingdom
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Wang B, Feldman I, Chkonia E, Pinchuk I, Panteleeva L, Skokauskas N. Mental health services in Scandinavia and Eurasia: comparison of financing and provision. Int Rev Psychiatry 2022; 34:118-127. [PMID: 35699102 DOI: 10.1080/09540261.2022.2065190] [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: 02/04/2023]
Abstract
The aim of this study was to compare financial and human resources for mental health services in selected Scandinavian and Eurasian countries. A cross-sectional descriptive and analytical approach was adopted to analyse questionnaire data provided by members of the Ukraine-Norway-Armenia Partnership Project. We compared Scandinavia (Sweden and Norway) and Eurasia (Armenia, Georgia, Kyrgyzstan and Ukraine). Health expenditure in Eurasia was generally below 4% of gross domestic product, with the exception of Georgia (10.2%), compared with 11% in Scandinavia. Inpatient hospital care commonly exceeded 50% of the mental health budget. The central governments in Eurasia paid for over 50% of the health expenditure, compared to 2% in Scandinavia. The number of mental health personnel per head of population was much smaller in Eurasia than Scandinavia. Financial and human resources were limited in Eurasia and mainly concentrated on institutional services. Health activities were largely managed by central governments. Community-based mental healthcare was poorly implemented, compared to Scandinavia, especially for children and adolescents.
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Affiliation(s)
- Bo Wang
- Department of Mental Health, Regional Centre for Child and Youth Mental Health and Child Welfare (RKBU Central Norway), Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Inna Feldman
- Department of Public Health and Caring Sciences, Social Medicine (CHAP), Uppsala University, Uppsala, Sweden
| | - Eka Chkonia
- Department of Psychiatry, Georgia University Hospital - Tbilisi Mental Health Center, Tbilisi State Medical University, Tbilisi, Georgia
| | - Irina Pinchuk
- Institute of Psychiatry, Taras Shevchenko National University of Kyiv, Kyiv, Ukraine
| | - Lilia Panteleeva
- Department of Medical Psychology, Psychiatry and Psychotherapy, Kyrgyzstan-Russian Slavic University Named After B. N. Yeltsin, Bishkek, Kyrgyzstan
| | - Norbert Skokauskas
- Department of Mental Health, Regional Centre for Child and Youth Mental Health and Child Welfare (RKBU Central Norway), Norwegian University of Science and Technology (NTNU), Trondheim, Norway
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