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Carey K, Cole MB. Mental health care provision in community health centers and hospital emergency department utilization. Health Serv Res 2024; 59:e14283. [PMID: 38243709 PMCID: PMC10915469 DOI: 10.1111/1475-6773.14283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2024] Open
Abstract
OBJECTIVES To examine whether community health centers (CHCs) are effective in offsetting mental health emergency department (ED) visits. DATA SOURCES AND STUDY SETTING The HRSA Uniform Data System and the HCUP State ED Databases for Florida patients during 2012-2019. STUDY DESIGN We identified CHC-year-specific service areas using patient origin zip codes. We then estimated panel data models for number of ED mental health visits per capita in a CHC's service area. Models measured CHC mental health utilization as number of visits, unique patients, and intensity (visits per patient). PRINCIPAL FINDINGS CHC mental health utilization increased approximately 100% during 2012-2019. Increased CHC mental health provision was associated with small reductions in ED mental health utilization. An annual increase of 1000 CHC mental health care visits (5%) was associated with 0.44% fewer ED mental health care visits (p = 0.153), and an increase of 1000 CHC mental health care patients (15%) with 1.9% fewer ED mental health care visits (p = 0.123). An increase of 1 annual mental health visit per patient was associated with 16% fewer ED mental health care visits (p = 0.011). CONCLUSIONS Results suggest that mental health provision in CHCs may reduce reliance on hospital EDs, albeit minimally. Policies that promote alignment of services between CHCs and local hospitals may accelerate this effect.
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Affiliation(s)
- Kathleen Carey
- Department of Health Law, Policy and ManagementBoston University School of Public HealthBostonMassachusettsUSA
| | - Megan B. Cole
- Department of Health Law, Policy and ManagementBoston University School of Public HealthBostonMassachusettsUSA
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Williams B, Charleston R, Innes S, McIver S. Understanding collaborative and coordinated care in a mental health and well-being context: Essential elements for effective service integration. Int J Ment Health Nurs 2024; 33:397-408. [PMID: 37849028 DOI: 10.1111/inm.13244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Accepted: 10/03/2023] [Indexed: 10/19/2023]
Abstract
Multiple system reforms in Australia, including the National Disability Insurance Scheme (NDIS), are changing mental health (MH) and disability-related service provision, whilst policy drivers continue to require service integration. This has necessitated service providers discovering new ways of working collaboratively to achieve an integrated model of care. This qualitative study examined what does and does not work to support collaborative and coordinated care (CCC), as essential components of service integration. The study sample (n = 59) included four cohorts: health and community service leaders (n = 16), staff (n = 23); MH service consumers with complex needs (n = 10), and MH carers (n = 10). Thematic analysis from interviews was applied to data from each cohort to identify overarching themes that described the lived experience of current CCC delivery. COREQ and EQUATOR guidelines were applied to reporting the findings. Themes emphasized CCC is enabled by the development and sustainability of positive working relationships, and depth of knowledge across health and community services. Unnavigable service systems, stigmatization, perceived power differentials, multiple and rapid service reforms and Fee-For-Service (FFS) models provide significant barriers to CCC. Recommendations include the need for accessible service navigation, consumer-friendly service environments, a stable workforce, standardization of knowledge across sectors, outcome measures and funding attached to CCC as part of a raft of potential changes.
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Affiliation(s)
- Bronwyn Williams
- Adult Mental Health Program, Eastern Health, Box Hill, Victoria, Australia
| | - Rosemary Charleston
- Centre for Mental Health Learning, Melbourne University, Melbourne, Victoria, Australia
| | - Stanley Innes
- Adult Mental Health Program, Eastern Health, Box Hill, Victoria, Australia
| | - Shane McIver
- The Centre for Research in Assessment and Digital Learning (CRADLE), Deakin Learning Futures (DLF), Deakin University, Melbourne, Victoria, Australia
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Havilla S, Alanazi FK, Boon B, Patton D, Ho YC, Molloy L. Exploring the impact of a multilevel intervention focused on reducing the practices of seclusion and restraint in acute mental health units in an Australian mental health service. Int J Ment Health Nurs 2024; 33:442-451. [PMID: 37964469 DOI: 10.1111/inm.13255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Revised: 10/30/2023] [Accepted: 10/31/2023] [Indexed: 11/16/2023]
Abstract
Reducing and eliminating seclusion and restraint in inpatient settings has been a key area of focus in mental health policy and research for many years. To address this issue, numerous programmes aimed at minimising the use of these practices have been developed over the past two decades, with varying degrees of success. This article reports on research focused on the implementation of a localised, multilevel complex intervention that targeted both organisational and individual factors related to the use of seclusion and restraint. The researchers followed the impact of the intervention by interviewing medical, nursing and allied health staff who worked within the service (N = 12) and analysing the rates of seclusion and restraint over an 18-month period. Post-adoption, participants identified that there were clear changes in practice culture. Seclusion clearly became a practice of last resort and other options became prominent in staff's practice. Participants identified that there was a sense of shared purpose across the multidisciplinary team. The clinical environment was viewed as being more therapeutic for service users and less frightening for staff. There was a significant difference in the total number of seclusion events between pre- (Mean = 6.22, SD = 5.82) and post-implementation (Mean = 2.55, SD = 2.44, p = 0.002, d = 0.94), demonstrating a significantly lower number of seclusions was observed after the intervention. Similarly, a significant difference in restraint events between pre- (Mean = 5.50, SD = 3.77) and post-implementations (Mean = 3.38, SD = 3.21, p = 0.037, d = 0.62) was observed.
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Affiliation(s)
- Sizwile Havilla
- Illawarra Shoalhaven Local Health District Mental Health Service, Shellharbour, New South Wales, Australia
| | | | - Brad Boon
- Illawarra Shoalhaven Local Health District Mental Health Service, Shellharbour, New South Wales, Australia
| | - Declan Patton
- School of Nursing and Midwifery, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Yen-Chung Ho
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan ROC
| | - Luke Molloy
- School of Nursing, University of Wollongong, Wollongong, New South Wales, Australia
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4
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Carroll A, Brett A. Jailing is failing: psychiatry can help. BJPsych Bull 2024:1-5. [PMID: 38462897 DOI: 10.1192/bjb.2024.8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/12/2024] Open
Abstract
There is accumulating evidence that imprisonment is expensive but does little to address the underlying drivers of offending. At the same time, it is now recognised that a large proportion of prisoners are diagnosable with significant psychiatric disorders. In this piece we explore the potential role of psychiatry in addressing the societal challenge of a failing prison system. We argue that core psychiatric skills of engaging in balanced, values-based thinking and implementing sound clinical processes can play an important role in reducing reoffending risk. We briefly discuss some of the key challenges involved and outline several relevant service models.
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Affiliation(s)
- Andrew Carroll
- Swinburne University of Technology, Alphington, Australia
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Aschbacher K, Mather M, Lehrer P, Gevirtz R, Epel E, Peiper NC. Real-time heart rate variability biofeedback amplitude during a large-scale digital mental health intervention differed by age, gender, and mental and physical health. Psychophysiology 2024:e14533. [PMID: 38454612 DOI: 10.1111/psyp.14533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Revised: 12/06/2023] [Accepted: 01/08/2024] [Indexed: 03/09/2024]
Abstract
Heart rate variability biofeedback (HRVB) is an efficacious treatment for depression and anxiety. However, translation to digital mental health interventions (DMHI) requires computing and providing real-time HRVB metrics in a personalized and user-friendly fashion. To address these gaps, this study validates a real-time HRVB feedback algorithm and characterizes the association of the main algorithmic summary metric-HRVB amplitude-with demographic, psychological, and health factors. We analyzed HRVB data from 5158 participants in a therapist-supported DMHI incorporating slow-paced breathing to treat depression or anxiety symptoms. A real-time feedback metric of HRVB amplitude and a gold-standard research metric of low-frequency (LF) power were computed for each session and then averaged within-participants over 2 weeks. We provide HRVB amplitude values, stratified by age and gender, and we characterize the multivariate associations of HRVB amplitude with demographic, psychological, and health factors. Real-time HRVB amplitude correlated strongly (r = .93, p < .001) with the LF power around the respiratory frequency (~0.1 Hz). Age was associated with a significant decline in HRVB (β = -0.46, p < .001), which was steeper among men than women, adjusting for demographic, psychological, and health factors. Resting high- and low-frequency power, body mass index, hypertension, Asian race, depression symptoms, and trauma history were significantly associated with HRVB amplitude in multivariate analyses (p's < .01). Real-time HRVB amplitude correlates highly with a research gold-standard spectral metric, enabling automated biofeedback delivery as a potential treatment component of DMHIs. Moreover, we identify demographic, psychological, and health factors relevant to building an equitable, accurate, and personalized biofeedback user experience.
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Affiliation(s)
| | - Mara Mather
- Leonard Davis School of Gerontology, University of Southern California, Los Angeles, California, USA
- Department of Psychology, University of Southern California, Los Angeles, California, USA
- Department of Biomedical Engineering, University of Southern California, Los Angeles, California, USA
| | - Paul Lehrer
- Department of Psychiatry, Robert Wood Johnson Medical School, Rutgers University, Monmouth Junction, New Jersey, USA
| | - Richard Gevirtz
- Department of Clinical Psychology, California School of Professional Psychology, Alliant International University, San Diego, California, USA
| | - Elissa Epel
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, California, USA
| | - Nicholas C Peiper
- Meru Health, San Mateo, California, USA
- Department of Epidemiology and Population Health, University of Louisville, Louisville, Kentucky, USA
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6
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Gerstl B, Ahinkorah BO, Nguyen TP, John JR, Hawker P, Winata T, Brice F, Bowden M, Eapen V. Evidence-based long term interventions targeting acute mental health presentations for children and adolescents: systematic review. Front Psychiatry 2024; 15:1324220. [PMID: 38510802 PMCID: PMC10950959 DOI: 10.3389/fpsyt.2024.1324220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Accepted: 02/12/2024] [Indexed: 03/22/2024] Open
Abstract
Background Long term intervention services have proven to be effective in improving mental health (MH) outcomes and the quality of life for children and young people (CYP). Aim To synthesize evidence on the effectiveness of long-term interventions in improving MH outcomes for CYP, 0-17 years, presenting with MH conditions. Methods A systematic search was carried out and the methodological quality of included long term MH intervention studies were assessed. Six databases were searched for peer-reviewed articles between January 2000 and September 2022. Results We found 30 studies that reported on the effectiveness of a range of long-term MH interventions in the form of (i) group therapy, (ii) multisystemic behavior therapy, (iii) general services, (iv) integrated services, (v) psychotherapy, (vi) intensive intervention services, (vii) comprehensive collaborative care, (viii) parent training, and (ix) home outreach service. Among the included studies, seven were rated as high level of evidence based on the National Health and Medical Research Council (NHMRC) levels of evidence hierarchy scale and seven were of moderate quality evidence. Others were rated as lower-quality evidence. Among the studies providing high quality evidence, most were reported for group therapy, general services, and psychotherapy studies demonstrating beneficial effects. Conclusion This systematic review provides evidence to demonstrate the benefits of a range of long-term interventions, in a range of settings, can be effective in improving MH outcomes for CYP and their families. Systematic review registration https://www.crd.york.ac.uk/prospero/, identifier CRD42022323324.
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Affiliation(s)
- Brigitte Gerstl
- Academic Unit of Infant, Child, and Adolescent Psychiatry Services (AUCS), South Western Sydney Local Health District and Ingham Institute, Sydney, NSW, Australia
- Discipline of Psychiatry and Mental Health, School of Clinical Medicine, University of New South Wales (UNSW), Sydney, NSW, Australia
| | - Bright Opoku Ahinkorah
- Academic Unit of Infant, Child, and Adolescent Psychiatry Services (AUCS), South Western Sydney Local Health District and Ingham Institute, Sydney, NSW, Australia
- Discipline of Psychiatry and Mental Health, School of Clinical Medicine, University of New South Wales (UNSW), Sydney, NSW, Australia
- School of Public Health, University of Technology Sydney, Sydney, NSW, Australia
| | - Thomas P. Nguyen
- Academic Unit of Infant, Child, and Adolescent Psychiatry Services (AUCS), South Western Sydney Local Health District and Ingham Institute, Sydney, NSW, Australia
- Discipline of Psychiatry and Mental Health, School of Clinical Medicine, University of New South Wales (UNSW), Sydney, NSW, Australia
- Mental Health, School of Medicine, Western Sydney University, Sydney, NSW, Australia
| | - James Rufus John
- Academic Unit of Infant, Child, and Adolescent Psychiatry Services (AUCS), South Western Sydney Local Health District and Ingham Institute, Sydney, NSW, Australia
- Discipline of Psychiatry and Mental Health, School of Clinical Medicine, University of New South Wales (UNSW), Sydney, NSW, Australia
| | - Patrick Hawker
- Academic Unit of Infant, Child, and Adolescent Psychiatry Services (AUCS), South Western Sydney Local Health District and Ingham Institute, Sydney, NSW, Australia
- Discipline of Psychiatry and Mental Health, School of Clinical Medicine, University of New South Wales (UNSW), Sydney, NSW, Australia
| | - Teresa Winata
- Academic Unit of Infant, Child, and Adolescent Psychiatry Services (AUCS), South Western Sydney Local Health District and Ingham Institute, Sydney, NSW, Australia
- Discipline of Psychiatry and Mental Health, School of Clinical Medicine, University of New South Wales (UNSW), Sydney, NSW, Australia
- Infant, Child and Adolescent Mental Health Service (ICAMHS), South Western Sydney Local Health District, Sydney, NSW, Australia
| | - Febe Brice
- Academic Unit of Infant, Child, and Adolescent Psychiatry Services (AUCS), South Western Sydney Local Health District and Ingham Institute, Sydney, NSW, Australia
| | - Michael Bowden
- Child and Youth Mental Health, NSW Ministry of Health, Sydney, NSW, Australia
- Sydney Medical School, University of Sydney, Sydney, NSW, Australia
- Psychological Medicine, Sydney Children’s Hospitals Network, Sydney, NSW, Australia
| | - Valsamma Eapen
- Academic Unit of Infant, Child, and Adolescent Psychiatry Services (AUCS), South Western Sydney Local Health District and Ingham Institute, Sydney, NSW, Australia
- Discipline of Psychiatry and Mental Health, School of Clinical Medicine, University of New South Wales (UNSW), Sydney, NSW, Australia
- School of Public Health, University of Technology Sydney, Sydney, NSW, Australia
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Marbaniang I, Moodie EEM, Latimer E, Skakoon-Sparling S, Hart TA, Grace D, Moore DM, Lachowsky NJ, Jollimore J, Lambert G, Zhang T, Dvorakova M, Cox J. Using an intersectionality-based approach to evaluate mental health services use among gay, bisexual and other men who have sex with men in Montreal, Toronto and Vancouver. Epidemiol Psychiatr Sci 2024; 33:e10. [PMID: 38438301 PMCID: PMC10940056 DOI: 10.1017/s2045796024000143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Revised: 01/18/2024] [Accepted: 01/30/2024] [Indexed: 03/06/2024] Open
Abstract
AIMS To cope with homonegativity-generated stress, gay, bisexual and other men who have sex with men (GBM) use more mental health services (MHS) compared with heterosexual men. Most previous research on MHS among GBM uses data from largely white HIV-negative samples. Using an intersectionality-based approach, we evaluated the concomitant impact of racialization and HIV stigma on MHS use among GBM, through the mediating role of perceived discrimination (PD). METHODS We used baseline data from 2371 GBM enrolled in the Engage cohort study, collected between 2017 and 2019, in Montreal, Toronto and Vancouver, using respondent-driven sampling. The exposure was GBM groups: Group 1 (n = 1376): white HIV-negative; Group 2 (n = 327): white living with HIV; Group 3 (n = 577): racialized as non-white HIV-negative; Group 4 (n = 91): racialized as non-white living with HIV. The mediator was interpersonal PD scores measured using the Everyday Discrimination Scale (5-item version). The outcome was MHS use (yes/no) in the prior 6 months. We fit a three-way decomposition of causal mediation effects utilizing the imputation method for natural effect models. We obtained odds ratios (ORs) for pure direct effect (PDE, unmediated effect), pure indirect effect (PIE, mediated effect), mediated interaction effect (MIE, effect due to interaction between the exposure and mediator) and total effect (TE, overall effect). Analyses controlled for age, chronic mental health condition, Canadian citizenship, being cisgender and city of enrolment. RESULTS Mean PD scores were highest for racialized HIV-negative GBM (10.3, SD: 5.0) and lowest for white HIV-negative GBM (8.4, SD: 3.9). MHS use was highest in white GBM living with HIV (GBMHIV) (40.4%) and lowest in racialized HIV-negative GBM (26.9%). Compared with white HIV-negative GBM, white GBMHIV had higher TE (OR: 1.71; 95% CI: 1.27, 2.29) and PDE (OR: 1.68; 95% CI: 1.27, 2.24), and racialized HIV-negative GBM had higher PIE (OR: 1.09; 95% CI: 1.02, 1.17). Effects for racialized GBMHIV did not significantly differ from those of white HIV-negative GBM. MIEs across all groups were comparable. CONCLUSIONS Higher MHS use was observed among white GBMHIV compared with white HIV-negative GBM. PD positively mediated MHS use only among racialized HIV-negative GBM. MHS may need to take into account the intersecting impact of homonegativity, racism and HIV stigma on the mental health of GBM.
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Affiliation(s)
- Ivan Marbaniang
- Department of Epidemiology, McGill University, Montreal, QC, Canada
| | - Erica E. M. Moodie
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, QC, Canada
| | - Eric Latimer
- Mental Health and Society Division, Douglas Research Centre, Montreal, QC, Canada
- Department of Psychiatry, McGill University, Montreal, QC, Canada
| | - Shayna Skakoon-Sparling
- Department of Psychology, Toronto Metropolitan University, Toronto, ON, Canada
- Department of Psychology, University of Guelph, Guelph, ON, Canada
| | - Trevor A. Hart
- Department of Psychology, Toronto Metropolitan University, Toronto, ON, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Daniel Grace
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - David M. Moore
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, BC, Canada
- Department of Medicine, Division of Infectious Disease, University of British Columbia, Vancouver, BC, Canada
| | - Nathan J. Lachowsky
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, BC, Canada
- School of Public Health and Social Policy, University of Victoria, Victoria, BC, Canada
| | | | - Gilles Lambert
- Institut National de Santé Publique du Québec, Montreal, QC, Canada
| | - Terri Zhang
- Department of Psychology, Toronto Metropolitan University, Toronto, ON, Canada
| | - Milada Dvorakova
- Clinical Outcomes Research and Evaluation, Research Institute–McGill University Health Centre, Montreal, QC, Canada
| | - Joseph Cox
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, QC, Canada
- Clinical Outcomes Research and Evaluation, Research Institute–McGill University Health Centre, Montreal, QC, Canada
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Fowler L, Vara A, Ng L. Psychiatric trainees' experiences of workplace violence: qualitative analysis. BJPsych Bull 2024:1-6. [PMID: 38436095 DOI: 10.1192/bjb.2024.6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/05/2024] Open
Abstract
AIMS AND METHOD We aimed to explore experiences of workplace violence in a New Zealand sample of psychiatric trainees and to identify barriers to achieving safe practice and ways of enhancing workplace safety. In a qualitative study, we used interpretive description to inform and design in-depth exploration of participants' experiences. We interviewed 12 psychiatric trainees. Data were analysed using reflexive thematic analysis. RESULTS There were three main themes: (a) violence as 'part of the job', leading to a culture of silence; (b) empowering trainees to address a sense of learned helplessness; and (c) conflict embedded within the unique nature of psychiatry. CLINICAL IMPLICATIONS Organisation-led systems-based procedures are instrumental in promoting workplace safety. Specific measures include peer-based support and implementing clear, tailored safety protocols, particularly for situations of crisis assessment. Training should include culturally focused education with specific guidance to mitigate violence.
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Affiliation(s)
| | - Alisha Vara
- University of Auckland, Auckland, New Zealand
| | - Lillian Ng
- University of Auckland, Auckland, New Zealand
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Nikkhah A, Hallahan B, McDonald C. Opinions of key stakeholders regarding the inpatient Individual Care Plan. Ir J Psychol Med 2024; 41:11-22. [PMID: 33966680 DOI: 10.1017/ipm.2021.29] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVES In Ireland, regularly reviewed Individual Care Plans (ICPs) for inpatients at all acute psychiatric inpatient units are a requirement of the Mental Health Act . In this study, we comprehensively evaluated and compared opinions of key stakeholders in relation to the ICP as a care delivery tool. METHODS We employed a descriptive survey design. Questionnaires were distributed to 123 stakeholders (patients and mental health professionals (MHPs)) to evaluate and compare opinions regarding the impact of the ICP in relation to healthcare delivery and health outcomes, and regarding the structure and frequency of use of the ICP. RESULTS Ninety-eight stakeholders (80%) completed study questionnaires. Stakeholders (patients (58%) and MHPs (85%)) reported that the ICP assisted in healthcare delivery. However, different attitudes between groups were noted in relation to whether the ICP contributed towards healthcare outcomes, with 64% of patients, but only 41% of MHPs reporting that the ICP positively contributed to mental healthcare outcomes. Some free-text comments described patient dissatisfaction with the role of the ICP for healthcare delivery, and MHP dissatisfaction that the ICP was time-consuming and did not significantly enhance standard patient care. CONCLUSION Whilst the implementation of the ICP is generally viewed positively by both patients and MHPs, considerable dissatisfaction by MHPs was also noted with certain aspects of how the ICP was delivered in practice. Practical adjustments to the implementation of ICP in order to build more positive stakeholder experiences appear warranted and worthy of further research.
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Affiliation(s)
- A Nikkhah
- Department of Psychiatry, University Hospital Galway, Galway, Ireland
| | - B Hallahan
- Department of Psychiatry, University Hospital Galway, Galway, Ireland
- School of Medicine, College of Medicine, Nursing and Health Sciences, National University of Ireland Galway, Galway, Ireland
| | - C McDonald
- Department of Psychiatry, University Hospital Galway, Galway, Ireland
- School of Medicine, College of Medicine, Nursing and Health Sciences, National University of Ireland Galway, Galway, Ireland
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10
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Newman C, Roche M, Elliott D. Exposure to patient aggression and health outcomes for forensic mental health nurses: A cross-sectional survey. J Adv Nurs 2024; 80:1201-1211. [PMID: 37771198 DOI: 10.1111/jan.15885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 08/23/2023] [Accepted: 09/05/2023] [Indexed: 09/30/2023]
Abstract
AIMS The aims of the study were to determine the types and prevalence of forensic mental health nurse exposure to patient aggression and explore the impact of these exposures on their physical and mental health and work absences. DESIGN Cross-sectional survey conducted January to April 2020. METHODS All 205 nurses working in an Australian high-security inpatient forensic mental health hospital were invited to participate. An online survey included the Perception of Prevalence of Aggression Scale to measure respondent exposure to types of patient aggression, and the SF-36v2 to measure mental and physical health. Absence from work and other work and individual characteristics were also explored. RESULTS Sixty-eight respondents completed the survey. Verbal abuse was the most experienced aggression type, followed by physical violence and observing violence, patient self-harming behaviours and sexual violence. Nurses who worked in acute units experienced significantly more exposure to overall aggression than nurses in non-acute units. Higher level of aggression was associated with number of days sick leave taken and days off due to aggression or violence. Higher level of aggression was associated with poorer mental health, and patient self-harming behaviour was associated with poorer physical health. CONCLUSIONS Nurses in acute units experience higher levels of inpatient aggression and are therefore at increased risk of being impacted by the exposure. Findings indicate a psychological impact of exposure to frequent aggression and potential for an accumulative effect of exposure to traumatic events on nurse well-being. Nurses who are victim of, or witness, physical violence are most likely to take time off work. IMPACT This study provides further evidence that forensic mental health nurses are frequently exposed to various forms of patient aggression. For some nurses, this exposure to patient aggression negatively impacted their mental and physical health. Employing organizations should therefore prioritize provision of formal support for nurses. No patient or public contribution.
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Affiliation(s)
- Claire Newman
- University of Technology Sydney, Ultimo, New South Wales, Australia
| | - Michael Roche
- University of Technology Sydney, Ultimo, New South Wales, Australia
- University of Canberra, Bruce, Australian Capital Territory, Australia
| | - Doug Elliott
- University of Technology Sydney, Ultimo, New South Wales, Australia
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11
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Wootten JC, Rodrigues R, Gilliland J, Carter B, Shariff SZ, Zhong S, Archie S, Edwards J, Elton-Marshall T, Myran DT, Palaniyappan L, Perlman CM, Seabrook JA, Murray RM, Anderson KK. The effect of non-medical cannabis retailer proximity on use of mental health services for psychotic disorders in Ontario, Canada. Int J Soc Psychiatry 2024; 70:308-318. [PMID: 37886802 DOI: 10.1177/00207640231206053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2023]
Abstract
BACKGROUND Cannabis is associated with the onset and persistence of psychotic disorders. Evidence suggests that accessibility of substances is associated with an increased risk of use-related harms. We sought to examine the effect of residing in proximity to non-medical cannabis retailers on the prevalence of health service use for psychosis. METHODS We conducted a cross-sectional study using linked health administrative data, and used geospatial analyses to determine whether people in Ontario, Canada (aged 14-60 years) resided within walking (1.6 km) or driving (5.0 km) distance of non-medical cannabis retailers (open as of February-2020). We identified outpatient visits, emergency department (ED) visits, and hospitalizations for psychotic disorders between 01-April-2019 and 17-March-2020. We used zero-inflated Poisson regression models and gamma generalized linear models to estimate the association between cannabis retailer proximity and indicators of health service use. RESULTS Non-medical cannabis retailers were differentially located in areas with high levels of marginalization and pre-existing health service use for psychosis. People residing within walking or driving distance of a cannabis retailer had a higher rate of psychosis-related outpatient visits, ED visits, and hospitalizations, compared to people living outside these areas. This effect was stronger among those with no prior service use for psychosis. CONCLUSIONS Proximity to a non-medical cannabis retailer was associated with higher health service use for psychosis, even after adjustment for prior health service use. These findings suggest that opening of non-medical cannabis retailers could worsen the burden of psychosis on mental health services in areas with high-risk populations.
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Affiliation(s)
- Jared C Wootten
- Department of Epidemiology and Biostatistics, Western University, London, ON, Canada
| | - Rebecca Rodrigues
- Department of Epidemiology and Biostatistics, Western University, London, ON, Canada
| | - Jason Gilliland
- Department of Epidemiology and Biostatistics, Western University, London, ON, Canada
- Department of Pediatrics, Western University, London, ON, Canada
- Department of Geography and Environment, Western University, London, ON, Canada
- Lawson Health Research Institute, London Health Sciences Centre, ON, Canada
| | | | - Salimah Z Shariff
- Lawson Health Research Institute, London Health Sciences Centre, ON, Canada
- ICES Western, London, ON, Canada
- Department of Nursing, Western University, London, ON, Canada
| | - Shiran Zhong
- Department of Geography and Environment, Western University, London, ON, Canada
| | - Suzanne Archie
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
| | - Jordan Edwards
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
| | - Tara Elton-Marshall
- Department of Epidemiology and Biostatistics, Western University, London, ON, Canada
- School of Epidemiology and Public Health, University of Ottawa, ON, Canada
- Institute of Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Dalla Lana School of Public Health, University of Toronto, ON, Canada
| | - Daniel Thomas Myran
- Department of Family Medicine, University of Ottawa, ON, Canada
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, ON, Canada
- ICES uOttawa, Ottawa Hospital Research Institute, ON, Canada
| | - Lena Palaniyappan
- Department of Psychiatry, Western University, London, ON, Canada
- Department of Psychiatry, Douglas Mental Health University Institute, McGill University, Montreal, PQ, Canada
| | | | - Jamie A Seabrook
- Department of Epidemiology and Biostatistics, Western University, London, ON, Canada
- Department of Pediatrics, Western University, London, ON, Canada
- Lawson Health Research Institute, London Health Sciences Centre, ON, Canada
- School of Food and Nutritional Sciences, Brescia University College, London, ON, Canada
| | - Robin M Murray
- Institute of Psychiatry, Psychology, and Neuroscience, King's College London, UK
| | - Kelly K Anderson
- Department of Epidemiology and Biostatistics, Western University, London, ON, Canada
- Lawson Health Research Institute, London Health Sciences Centre, ON, Canada
- ICES Western, London, ON, Canada
- Department of Psychiatry, Western University, London, ON, Canada
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12
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Santos J, Camplain C, Pollitt AM, Baldwin JA. A formative assessment of client characteristics associated with missed appointments in integrated primary care services in rural Arizona. J Eval Clin Pract 2024; 30:243-250. [PMID: 37933799 DOI: 10.1111/jep.13939] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2023] [Revised: 09/29/2023] [Accepted: 10/19/2023] [Indexed: 11/08/2023]
Abstract
INTRODUCTION Integrating primary care services in mental healthcare facilities is an uncommon model of care in the United States that could bring several benefits (e.g., improved access to physical healthcare) for vulnerable populations experiencing mental health conditions, especially those living in underserved regions like rural Arizona. AIM This formative assessment aimed to understand the sociodemographic and clinical characteristics of clients accessing integrated primary care (IPC) services implemented in 2021 at a community mental healthcare facility in rural Arizona and to explore the proportion of missed appointments. Additionally, we analysed the association between client characteristics and IPC missed appointments. METHODS The authors collaborated with a community mental health facility in rural Arizona, which provided deidentified data from 280 clients who accessed IPC services from June 2021 to February 2022. RESULTS Most clients were White and of vulnerable socioeconomic status, with a substantial proportion of Native Americans (23.58%). The majority of clients (55.75%) had a mental health disorder (MHD), 23.74% had a substance use disorder (SUD), and 15.10% had comorbid MHD and SUD. Linear regression revealed that experiencing comorbid MHD and SUD was significantly associated with missed appointments. Compared with White clients, Native Americans missed fewer appointments. CONCLUSION Future studies conducted from a culturally-centred perspective are crucial to guide strategies to reduce missed appointments in rural IPC services.
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Affiliation(s)
- Jeffersson Santos
- Center for Health Equity Research, Northern Arizona University, Flagstaff, Arizona, USA
| | - Carolyn Camplain
- Department of Community and Population Health, Lehigh University, Bethlehem, Pennsylvania, USA
| | - Amanda Marie Pollitt
- Center for Health Equity Research, Northern Arizona University, Flagstaff, Arizona, USA
| | - Julie Ann Baldwin
- Center for Health Equity Research, Northern Arizona University, Flagstaff, Arizona, USA
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13
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Molloy L, Wilson V, O'Connor M, Merrick TT, Guha M, Eason M, Roche M. Exploring safety culture within inpatient mental health units: The results from participant observation across three mental health services. Int J Ment Health Nurs 2024. [PMID: 38415309 DOI: 10.1111/inm.13312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Revised: 02/12/2024] [Accepted: 02/18/2024] [Indexed: 02/29/2024]
Abstract
In Australia, acute inpatient units within public mental health services have become the last resort for mental health care. This research explored barriers and facilitators to safe, person-centred, recovery-oriented mental health care in these settings. It utilised participant observations conducted by mental health nurses in acute inpatient units. These units were located in three distinct facilities, each serving different areas: a large metropolitan suburban area in a State capital, a mid-sized regional city, and a small city with a large rural catchment area. Our findings highlighted that, in the three inpatient settings, nurses tended to avoid common areas they shared with consumers, except for brief, task-related visits. The prioritisation of administrative tasks seemed to arise in a situation where nurses lacked awareness of alternative practices and activities. Consumers spent prolonged periods of the day sitting in communal areas, where the main distraction was watching television. Boredom was a common issue across these environments. The nursing team structure in the inpatient units provided a mechanism for promoting a sense of psychological safety for staff and were a key element in how safety culture was sustained.
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Affiliation(s)
- Luke Molloy
- School of Nursing, University of Wollongong, Wollongong, New South Wales, Australia
| | - Val Wilson
- Prince of Wales Hospital, South Eastern Sydney Local Health District, Sydney, New South Wales, Australia
| | - Michael O'Connor
- Mental Health Commission of New South Wales, Sydney, New South Wales, Australia
| | - Tammy Tran Merrick
- Illawarra Shoalhaven Local Health District Mental Health Service, Wollongong, New South Wales, Australia
| | - Monica Guha
- The Thriving Spirit Project, Orange, New South Wales, Australia
| | | | - Michael Roche
- University of Canberra & ACT Health, Canberra, Australian Capital Territory, Australia
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14
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Burnand L, Johnson D, Ferguson K. Care-experienced young people's views on what they want from mental health services. Clin Child Psychol Psychiatry 2024:13591045241233986. [PMID: 38400718 DOI: 10.1177/13591045241233986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/26/2024]
Abstract
This study explores what care-experienced young people want from mental health services. Six care-experienced young people were interviewed, and an interpretative phenomenological analysis applied. Three key themes emerged demonstrating that the way support is delivered, the people who deliver it, and the environment of mental health services are all important to care-experienced young people. Along with these findings, this study demonstrates that engaging vulnerable young people in research and service design is beneficial.
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Affiliation(s)
- Lily Burnand
- IVY Project, Kibble Education and Care Centre, Paisley, UK and Northern Ireland
| | - Dan Johnson
- Kibble Education and Care Centre, Paisley, UK and Northern Ireland
| | - Kirstin Ferguson
- SAFE project, Kibble Education and Care Centre, Paisley, UK and Northern Ireland
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15
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Basile VT, Newton-John T, Wootton BM. Treatment histories, barriers, and preferences for individuals with symptoms of generalized anxiety disorder. J Clin Psychol 2024. [PMID: 38384113 DOI: 10.1002/jclp.23665] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 11/20/2023] [Accepted: 02/05/2024] [Indexed: 02/23/2024]
Abstract
Generalized anxiety disorder (GAD) is a prevalent and chronic mental health condition, associated with considerable individual and economic burden. Despite the availability of effective treatments, many individuals do not access support. The current study explores treatment histories, barriers to help-seeking, and cognitive behavioral therapy (CBT) treatment preferences for individuals with clinically significant GAD symptoms. The utility of Health Belief Model (HBM) in predicting help-seeking is also examined. A cross-sectional design with 127 participants (Mage = 29.17; SD = 11.86; 80.3% female) was used. Sixty-two percent of participants reported previously seeking psychological treatment, and approximately 28% received CBT in the first instance. The most influential treatment barriers were a desire to solve the problem on one's own (M = 1.96, SD = 0.96), followed by affordability (M = 1.75, SD = 1.15) and feeling embarrassed or ashamed (M = 1.75, SD = 1.06). The most preferred treatment modes were in-person individual treatment (M = 7.59, SD = 2.86) followed by remote treatment via videoconferencing (M = 4.31, SD = 3.55). Approximately 38% of the variance in intention to seek treatment was associated with the HBM variables, with perceived benefit of treatment being the strongest predictor. Results have the potential to inform mental health service delivery by reducing treatment barriers and aligning public health campaigns with benefits of psychological treatments.
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Affiliation(s)
- Vesna Trenoska Basile
- Discipline of Clinical Psychology, Graduate School of Health, University of Technology Sydney, Ultimo, New South Wales, Australia
| | - Toby Newton-John
- Discipline of Clinical Psychology, Graduate School of Health, University of Technology Sydney, Ultimo, New South Wales, Australia
| | - Bethany M Wootton
- Discipline of Clinical Psychology, Graduate School of Health, University of Technology Sydney, Ultimo, New South Wales, Australia
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16
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Isaacs A, Lambert C, Lawn S, Dyer A. Shortcomings of services for persons with severe and persistent mental health challenges: a qualitative study of service users and family carers. Front Psychiatry 2024; 15:1341248. [PMID: 38419901 PMCID: PMC10899316 DOI: 10.3389/fpsyt.2024.1341248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Accepted: 01/29/2024] [Indexed: 03/02/2024] Open
Abstract
Introduction The opinions of service users and carers are crucial to identifying ways to innovate and implement system change. This study aims to explore the views and experiences of service users and carerson the services they have used for their mental health challenges and their suggestions for service reform. Methods Twenty participants (15 carers and 5 service users) were interviewed for the study. Results Eight categories emerged from the data. They were: Several gaps in the system, Barriers to accessing services, Services are not fit for purpose, Services operate in isolation, System is not person focused, Service users and carers are treated poorly, Services are overloaded and under resourced and Recommendations for service reform. Respondents reported that a persistent lack of funding and resources for mental health services was a main cause of these shortcomings. Respondents also noted that innovations were needed to re-orient services to enable continuity of care, and training of mental health professionals was needed for a better understanding of the needs of service users and their carers. Discussion Additional research is needed with larger and more diverse samples to further explore these findings.
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Affiliation(s)
- Anton Isaacs
- School of Rural Health, Monash University, Warragul, VIC, Australia
| | - Caroline Lambert
- Tandem Inc., Abbotsford, VIC, Australia
- RMIT University, Melbourne, VIC, Australia
| | - Sharon Lawn
- Lived Experience Australia, Brighton, SA, Australia
- Flinders University, Adelaide, SA, Australia
| | - Anna Dyer
- Latrobe Regional Hospital, Traralgon, VIC, Australia
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17
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Winsper C, Bhattacharya R, Bhui K, Currie G, Edge D, Ellard D, Franklin D, Gill P, Gilbert S, Khan N, Miller R, Motala Z, Pinfold V, Sandhu H, Singh SP, Weich S, Giacco D. The impact of reduced routine community mental healthcare on people from minority ethnic groups during the COVID-19 pandemic: qualitative study of stakeholder perspectives. Br J Psychiatry 2024:1-7. [PMID: 38344814 DOI: 10.1192/bjp.2024.11] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/25/2024]
Abstract
BACKGROUND Enduring ethnic inequalities exist in mental healthcare. The COVID-19 pandemic has widened these. AIMS To explore stakeholder perspectives on how the COVID-19 pandemic has increased ethnic inequalities in mental healthcare. METHOD A qualitative interview study of four areas in England with 34 patients, 15 carers and 39 mental health professionals from National Health Service (NHS) and community organisations (July 2021 to July 2022). Framework analysis was used to develop a logic model of inter-relationships between pre-pandemic barriers and COVID-19 impacts. RESULTS Impacts were largely similar across sites, with some small variations (e.g. positive service impacts of higher ethnic diversity in area 2). Pre-pandemic barriers at individual level included mistrust and thus avoidance of services and at a service level included the dominance of a monocultural model, leading to poor communication, disengagement and alienation. During the pandemic remote service delivery, closure of community organisations and media scapegoating exacerbated existing barriers by worsening alienation and communication barriers, fuelling prejudice and division, and increasing mistrust in services. Some minority ethnic patients reported positive developments, experiencing empowerment through self-determination and creative activities. CONCLUSIONS During the COVID-19 pandemic some patients showed resilience and developed adaptations that could be nurtured by services. However, there has been a reduction in the availability of group-specific NHS and third-sector services in the community, exacerbating pre-existing barriers. As these developments are likely to have long-term consequences for minority ethnic groups' engagement with mental healthcare, they need to be addressed as a priority by the NHS and its partners.
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Affiliation(s)
- Catherine Winsper
- Department of Research and Innovation, Coventry and Warwickshire Partnership NHS Trust, Coventry, UK
| | | | - Kamaldeep Bhui
- Department of Psychiatry, Medical Sciences Division, University of Oxford, Oxford, UK
| | - Graeme Currie
- Warwick Business School, University of Warwick, Coventry, UK
| | - Dawn Edge
- Division of Psychology & Mental Health, University of Manchester, Manchester, UK
| | - David Ellard
- Warwick Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry, UK
| | - Donna Franklin
- School of Health Sciences, Institute of Mental Health, University of Nottingham, Nottingham, UK
| | - Paramjit Gill
- Department of Health Sciences, Warwick Medical School, University of Warwick, Coventry, UK
| | | | - Noreen Khan
- Department of Research and Innovation, Coventry and Warwickshire Partnership NHS Trust, Coventry, UK
| | - Robin Miller
- School of Social Policy, University of Birmingham, Birmingham, UK
| | - Zahra Motala
- Department of Sociology, University of Manchester, Manchester, UK
| | | | - Harbinder Sandhu
- Warwick Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry, UK
| | - Swaran P Singh
- Department of Research and Innovation, Coventry and Warwickshire Partnership NHS Trust, Coventry, UK; and Department of Health Sciences, Warwick Medical School, University of Warwick, Coventry, UK
| | - Scott Weich
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Domenico Giacco
- Department of Research and Innovation, Coventry and Warwickshire Partnership NHS Trust, Coventry, UK; and Department of Health Sciences, Warwick Medical School, University of Warwick, Coventry, UK
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18
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Grigaitė U, Azeredo-Lopes S, Žeimė E, Slotkus PY, Heitmayer M, Aluh DO, Pedrosa B, Silva M, Santos-Dias M, Cardoso G, Caldas-de-Almeida JM. Prevalence and acceptability of psychological and/or economic intimate partner violence, and utilization of mental health services by its survivors in Lithuania. J Public Health (Oxf) 2024:fdae015. [PMID: 38336363 DOI: 10.1093/pubmed/fdae015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 11/26/2023] [Accepted: 01/17/2024] [Indexed: 02/12/2024] Open
Abstract
BACKGROUND Lithuania has one of the highest averages in the European Union when it comes to psychological and/or economic intimate partner violence (PE-IPV). IPV survivors are several times more likely to have mental health conditions than those without IPV experiences. The aim of this article is to study the prevalence, characteristics and attitudes of PE-IPV survivors in Lithuania, and the predictors of them accessing mental health services. METHODS A cross-sectional study based on a national survey representative of the adult population. The survey was implemented by a third-party independent market research company employing an online survey panel. Logistic regression models were used in the analysis. RESULTS Almost 50% of women in Lithuania experience PE-IPV. Females are significantly more likely to experience it than males. The vast majority of women find PE-IPV unacceptable; however, only one-third of survivors seek any type of help. Only one-tenth approach mental health services, with divorcees being at higher odds of doing so. CONCLUSIONS Further research is needed to explore predictors and contextual factors of why IPV survivors seek mental healthcare, or not. Policy implications include the need to eliminate IPV and mental health stigma; develop accessible mental health services and effective treatment approaches.
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Affiliation(s)
- Ugnė Grigaitė
- Lisbon Institute of Global Mental Health, Comprehensive Health Research Centre/NOVA Medical School, National School of Public Health, Universidade NOVA de Lisboa, Rua do Instituto Bacteriológico 5, Edifício Amarelo, 1150-190 Lisboa, Portugal
| | - Sofia Azeredo-Lopes
- Comprehensive Health Research Centre (CHRC), NOVA Medical School, Faculdade de Ciências Médicas, NMS|FCM, Universidade Nova de Lisboa, 1150-190 Lisboa, Portugal
- Department of Statistics and Operational Research, Faculdade de Ciências, Universidade de Lisboa, 1749-016 Lisboa, Portugal
| | - Eglė Žeimė
- Behavioural Lab LT, LT-14247 Vilnius, Lithuania
| | - Paulius Yamin Slotkus
- Paris Institute for Advanced Study, 75004 Paris, France
- Department of Psychological and Behavioural Science, London School of Economics and Political Science, London WC2A 2AE, UK
| | - Maxi Heitmayer
- Department of Psychological and Behavioural Science, London School of Economics and Political Science, London WC2A 2AE, UK
- London College of Fashion, University of the Arts London, London W1G 0BJ, UK
| | - Deborah Oyine Aluh
- Lisbon Institute of Global Mental Health, Comprehensive Health Research Centre/NOVA Medical School, National School of Public Health, Universidade NOVA de Lisboa, 1150-190 Lisboa, Portugal
- Department of Clinical Pharmacy and Pharmacy Management, University of Nigeria Nsukka, 410105, Enugu, Nigeria
| | - Bárbara Pedrosa
- Lisbon Institute of Global Mental Health, Comprehensive Health Research Centre/NOVA Medical School, National School of Public Health, Universidade NOVA de Lisboa, 1150-190 Lisboa, Portugal
| | - Manuela Silva
- Lisbon Institute of Global Mental Health, Comprehensive Health Research Centre (CHRC), Nova Medical School, Nova University of Lisbon, 1150-190 Lisboa, Portugal
| | - Margarida Santos-Dias
- Lisbon Institute of Global Mental Health, Comprehensive Health Research Centre/NOVA Medical School, National School of Public Health, Universidade NOVA de Lisboa, 1150-190 Lisboa, Portugal
| | - Graça Cardoso
- Lisbon Institute of Global Mental Health, Comprehensive Health Research Centre (CHRC), Nova Medical School, Nova University of Lisbon, 1150-190 Lisboa, Portugal
| | - José Miguel Caldas-de-Almeida
- Lisbon Institute of Global Mental Health, Comprehensive Health Research Centre (CHRC), Nova Medical School, Nova University of Lisbon, 1150-190 Lisboa, Portugal
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19
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Joulaei H, Fatemi M, Joulaei R, Heydari MR, Pourmontaseri AR, Foroozanfar Z. Determinants of unmet needs for mental health services amongst adolescents in Shiraz, Iran: a cross-sectional study. Front Public Health 2024; 12:1265611. [PMID: 38379675 PMCID: PMC10876837 DOI: 10.3389/fpubh.2024.1265611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Accepted: 01/10/2024] [Indexed: 02/22/2024] Open
Abstract
Background Mental disorders are increasingly prevalent among adolescents without appropriate response. There are a variety of reasons for unmet mental health needs, including attitudinal and structural barriers. Accordingly, we investigated perceived mental health needs, using mental health services, and their barriers in adolescents. Method This cross-sectional study was conducted in 2022 in Shiraz, Iran. Demographic characteristics, the Adolescent Unmet Needs Checklist, and the Young Schema Questionnaire were administered to 348 adolescents aged 13-19 years. Adolescents were classified as having no needs, fully met needs, partially met needs, or wholly unmet needs. Logistic regression analysis was used to determine factors associated with perceived unmet need and refer participants to healthcare centers. Results 193 (55.5%) adolescents reported perceived need for mental healthcare out of whom, 21.6% reported fully and 21.6% partially unmet needs. Noticeably, only 12.4% of needy participants reported met need. "Reluctance to seek mental healthcare" and "asked but not receiving help" were common barriers to using the services. Conclusion The present study reveals unmet mental healthcare needs as a significant public health concern among the adolescents. To address this significant concern, reorientation of primary care, removing economic barriers from mental healthcare services, and improving health literacy in the community are recommended.
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Affiliation(s)
- Hassan Joulaei
- Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Maryam Fatemi
- HIV/AIDS Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Razieh Joulaei
- Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohammad Reza Heydari
- HIV/AIDS Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | - Zohre Foroozanfar
- HIV/AIDS Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
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20
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Souza L. Chronic mental health vulnerability: urgent need of transdiagnostic evidence-based intervations. Trends Psychiatry Psychother 2024. [PMID: 38314793 DOI: 10.47626/2965-6494-2023-0783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Accepted: 01/09/2024] [Indexed: 02/07/2024]
Affiliation(s)
- Luciano Souza
- Universidade Católica de Pelotas, Pelotas, RS, Brazil
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21
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Sami MB. A brief note from Pakistan: reflections from a British psychiatrist. BJPsych Int 2024; 21:12-13. [PMID: 38304404 PMCID: PMC10803772 DOI: 10.1192/bji.2023.28] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Accepted: 08/23/2023] [Indexed: 02/03/2024] Open
Abstract
A British general adult psychiatrist born and trained in the UK, who also considers himself Pakistani, had the opportunity to spend 2 weeks running a psychiatric clinic in a remote hospital in the Punjab province of Pakistan. In this article he offers some reflections on the unexpected culture shock he felt, on the hospital system, the patients he treated and their resilience in such a poor country.
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Affiliation(s)
- Musa Basseer Sami
- MRCP, MRCPsych, PhD, Clinical Associate Professor of Psychiatry, Institute of Mental Health, University of Nottingham, Nottingham, UK; and private practitioner, Nottingham, UK.
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22
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Fisher J, Jones E. The problem with resilience. Int J Ment Health Nurs 2024; 33:185-188. [PMID: 37665109 DOI: 10.1111/inm.13220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2023] [Accepted: 08/21/2023] [Indexed: 09/05/2023]
Abstract
The term 'resilience' has become a fashionable buzzword infiltrating mental health services globally. This latest ad nauseam has become both an irritation and insult to service users and mental health professionals alike. We argue resilience is a flawed Western theory of suffering aligned with neoliberal ideology. It is a double-edged sword indiscriminately yielded at both service users and staff. This paper examines the origins and evolution of resilience, and how mental health services have morphed resilience into a meaningless slogan, causing iatrogenic harm. We call for mental health professionals to consider their use of language and the intended or unintentional meaning behind their choice of words.
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Affiliation(s)
- Jane Fisher
- University of Central Lancashire, Preston, UK
| | - Emma Jones
- University of Central Lancashire, Preston, UK
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23
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Chawla N, Chadda RK. Challenges for setting up psychiatric services in a trauma centre in India. BJPsych Int 2024; 21:4-7. [PMID: 38304405 PMCID: PMC10803793 DOI: 10.1192/bji.2023.35] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2023] [Revised: 08/19/2023] [Accepted: 09/25/2023] [Indexed: 02/03/2024] Open
Abstract
Psychiatric sequelae may occur following traumatic injury irrespective of whether an insult has been caused to the brain. A range of psychiatric illnesses have been either causative of or associated with road traffic accidents and traumatic injuries, including depression, anxiety, post-traumatic stress disorder, substance use disorder and attention-deficit hyperactivity disorder. Despite literature on such associations, psychiatric intervention in the treatment of patients following traumatic injury is limited. The authors share their experience of challenges in addressing mental health problems in a tertiary care trauma centre located in North India. Steps in overcoming those challenges included: developing a semi-structured form to be completed for referrals and consultations, a psychiatrist attending weekly rounds with the surgeons, and initiating a psychiatry out-patient clinic for patients discharged from the trauma centre. It may be worthwhile in the future to set up a trauma psychiatry unit at the centre, involving a clinical psychologist, a psychiatric social worker and an occupational therapist for the comprehensive care of patients.
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Affiliation(s)
- Nishtha Chawla
- Assistant Professor, Department of Psychiatry, All India Institute of Medical Sciences, Delhi, India
| | - Rakesh K Chadda
- Professor and Head, Department of Psychiatry, All India Institute of Medical Sciences, Delhi, India.
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24
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Santos J, Acevedo-Morales A, Jones L, Bautista T, Camplain C, Keene CN, Baldwin J. Client perspectives on primary care integration in a rural-serving behavioral health center. J Integr Care (Brighton) 2024; 32:31-44. [PMID: 38516678 PMCID: PMC10954248 DOI: 10.1108/jica-08-2023-0061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/23/2024]
Abstract
Purpose Advancing behavioral health and primary care integration is a priority for helping clients overcome the complex health challenges impacting healthcare deserts like those in Arizona, United States of America (USA). This study aimed to explore the perspectives of people with a substance use disorder (SUD) on accessing integrated primary care (IPC) services in a rural-serving behavioral healthcare organization in Arizona. Design/methodology/approach Clients from a behavioral health facility in Arizona (n = 10) diagnosed with SUDs who also accessed IPC participated in a 45-min semi-structured interview. Findings The authors identified six overarching themes: (1) importance of IPC for clients being treated for SUDs, (2) client low level of awareness of IPC availability at the facility, (3) strategies to increase awareness of IPC availability at the behavioral health facility, (4) cultural practices providers should consider in care integration, (5) attitudes and perceptions about the experience of accessing IPC and (6) challenges to attending IPC appointments. The authors also identified subthemes for most of the main themes. Originality/value This is the first study in rural Arizona to identify valuable insights into the experiences of people with SUDs accessing IPC, providing a foundation for future research in the region on care integration.
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Affiliation(s)
- Jeffersson Santos
- Center for Health Equity Research, Northern Arizona University, Flagstaff, AZ
| | | | - Lillian Jones
- Department of Clinical Psychology, Northern Arizona University, Flagstaff, AZ
| | | | - Carolyn Camplain
- Department of Community and Population Health, Lehigh University, Bethlehem, PA
| | | | - Julie Baldwin
- Center for Health Equity Research, Northern Arizona University, Flagstaff, AZ
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Kim A, Luo R, Ng L. A bite of dark chocolate? Black humour in mental health services. Australas Psychiatry 2024; 32:68-73. [PMID: 38128076 PMCID: PMC10809729 DOI: 10.1177/10398562231222815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2023]
Abstract
OBJECTIVE Black humour permits expression of what may otherwise be unspeakable and is observed and used by staff working in mental health services. The aim of this study was to identify how humour, particularly black humour, was perceived by different health professionals in psychiatric practice. METHODS Participants were invited to complete a survey. Data was collated and statistically analysed by a biostatistician. Chi square and univariate tests were performed to identify associations between categories. RESULTS The sub-question relating to the benefits of black humour was analysed. Main findings were that the majority of staff perceived black humour to be beneficial in psychiatric practice (n = 564 of 710 total; 79.4%), particularly if they used general and black humour with patients, families and colleagues. Those who observed black humour being used collegially about patients and families were more likely to find black humour beneficial; and even those uncomfortable with black humour being used by colleagues were more likely to see the benefits of black humour. CONCLUSION Black humour was perceived to be beneficial in mental health settings when used mindfully, sensitively and in context. Further study with patients and relatives may shed light on how widely the perception of benefit is shared.
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Affiliation(s)
- Aram Kim
- The University of Auckland, Auckland, New Zealand and Health New Zealand Te Whatu Ora Waitemata, Auckland, New Zealand
| | - Rosie Luo
- The University of Auckland, Auckland, New Zealand
| | - Lillian Ng
- The University of Auckland, Auckland, New Zealand and Health New Zealand Te Whatu Ora Counties Manukau, Auckland, New Zealand
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Heffernan S, O'Malley M, Curtin M, Hawkins A, Murphy R, Goodwin J, Barry K, Taylor A, Happell B, O' Donovan Á. An evaluation of a trauma-informed educational intervention to enhance therapeutic engagement and reduce coercive practices in a child and adolescent inpatient mental health unit. Int J Ment Health Nurs 2024. [PMID: 38291645 DOI: 10.1111/inm.13299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Revised: 01/10/2024] [Accepted: 01/15/2024] [Indexed: 02/01/2024]
Abstract
High-risk behaviours are sometimes encountered in Child and Adolescent inpatient mental health units and can prompt the use of coercive practices to maintain safety. Coercive practices may lead to re-traumatisation of young people and deteriorating therapeutic relationships. Trauma-informed practice (TIP) has successfully reduced coercive practices. While education is identified as foundational to implementation, evaluations of programmes remain minimal. The aim of this study was to explore mental health professionals' views and experiences of a trauma-informed education programme and its likely impact on their approach to practice. Five mental health professionals agreed to participate, four contributed in a focus group and one in an individual interview. Data were analysed thematically using the Braun and Clarke Framework. Three main themes were identified. Firstly, shifting attitudes and perceptions of trauma-informed practice. Participants believed they had developed more compassion towards clients and these attitudes were reflected in their clinical practice. Secondly, challenges associated with trauma-informed practice educational intervention. Staffing issues and shift work made it difficult for participants to attend education sessions regularly. Participants identified barriers to practicing in a trauma-informed manner in the current clinical environment. Finally, the need for interdisciplinary communication and support was identified. Participants saw the need for all professionals, not only nurses, to take responsibility for changing practice, and for stronger support at the organisational level. Trauma-informed practice is crucial to recovery-focused mental health nursing practice. These findings highlight the importance of TIP education and suggest areas for further improvement to enhance positive mental health outcomes for young people.
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Affiliation(s)
- Sinéad Heffernan
- School of Nursing and Midwifery, Brookfield Health Sciences Complex, University College Cork, Cork, County Cork, Ireland
| | - Maria O'Malley
- School of Nursing and Midwifery, Brookfield Health Sciences Complex, University College Cork, Cork, County Cork, Ireland
| | - Margaret Curtin
- School of Nursing and Midwifery, Brookfield Health Sciences Complex, University College Cork, Cork, County Cork, Ireland
| | - Andrew Hawkins
- School of Nursing and Midwifery, Brookfield Health Sciences Complex, University College Cork, Cork, County Cork, Ireland
| | - Rachel Murphy
- School of Nursing and Midwifery, Brookfield Health Sciences Complex, University College Cork, Cork, County Cork, Ireland
| | - John Goodwin
- School of Nursing and Midwifery, Brookfield Health Sciences Complex, University College Cork, Cork, County Cork, Ireland
| | - Karen Barry
- Eist Linn, Child and Adolescent Mental Health Services, Cork and Kerry Healthcare, Health Service Executive, Cork, Ireland
| | - Alice Taylor
- Eist Linn, Child and Adolescent Mental Health Services, Cork and Kerry Healthcare, Health Service Executive, Cork, Ireland
| | - Brenda Happell
- School of Nursing and Midwifery, Brookfield Health Sciences Complex, University College Cork, Cork, County Cork, Ireland
- Faculty of Health, Southern Cross University, East Lismore, New South Wales, Australia
| | - Áine O' Donovan
- School of Nursing and Midwifery, Brookfield Health Sciences Complex, University College Cork, Cork, County Cork, Ireland
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Solis Araya C. [Intersections between climate change and mental health: New challenges for the development of care services]. Medwave 2024; 24:e2809-e2809. [PMID: 38290010 DOI: 10.5867/medwave.2024.01.2809] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2024] Open
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Ward RN, Lind LM, Rose SG, Brown LM. Depression and Anxiety in Long-Term Care Residents During the COVID-19 Pandemic: The Influence of Telehealth Availability, Cognitive Status, and Trauma History. Clin Gerontol 2024:1-10. [PMID: 38277139 DOI: 10.1080/07317115.2024.2305876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2024]
Abstract
OBJECTIVES The present study investigates the impact of disrupted mental health services during the COVID-19 pandemic on depression and anxiety symptoms in long-term care (LTC) residents. METHODS The study examined clinical data from 5,645 residents who received at least two psychological services in a long-term care (LTC) or assisted living (AL) setting between March 2019 and March 2021. A series of multiple regressions were run to explore the effects of the COVID-19 shutdown on depression and anxiety symptoms while examining the effects of COVID-19-related facility closure and facility telehealth capabilities. Follow-up regression analyses explored the impact of cognitive impairment and positive trauma history on depression and anxiety symptoms. RESULTS Post-COVID levels of anxiety and depression were higher for residents with higher levels of pre-COVID anxiety and depression. The interaction between facility closure and availability of telehealth services and trauma history predicted self-report anxiety symptoms. Clinician-observed anxiety symptoms were predicted by cognitive impairment. Residents with a history of trauma had an increase in self-reported anxiety symptoms. CONCLUSIONS Telehealth appeared to mitigate anxiety during the pandemic for residents with higher pre-COVID anxiety. CLINICAL IMPLICATIONS For those individuals with severe anxiety, results suggest the importance of ensuring that mental health services are available to mitigate symptoms via telehealth when infection control disrupts the usual delivery of treatment.
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Affiliation(s)
- Rachel N Ward
- Department of Clinical Psychology, Palo Alto University, Palo Alto, California, USA
| | - Lisa M Lind
- Deer Oaks Behavioral Health, San Antonio, Texas, USA
| | - Savannah G Rose
- Department of Clinical Psychology, Palo Alto University, Palo Alto, California, USA
| | - Lisa M Brown
- Department of Clinical Psychology, Palo Alto University, Palo Alto, California, USA
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, California, USA
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Pettitt AK, Nelson BW, Forman-Hoffman VL, Goldin PR, Peiper NC. Longitudinal outcomes of a therapist-supported digital mental health intervention for depression and anxiety symptoms: A retrospective cohort study. Psychol Psychother 2024. [PMID: 38270220 DOI: 10.1111/papt.12517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Accepted: 01/08/2024] [Indexed: 01/26/2024]
Abstract
PURPOSE This study examined treatment outcomes (depression and anxiety symptoms) up to 24 months after completion of a therapist-supported digital mental health intervention (DMHI). METHODS The sample consisted of 380 participants who participated in an eight-week DMHI from February 6, 2017 to May 20, 2019. Participants reported depression and anxiety symptoms at eight timepoints from baseline to 24 months. Mixed-effects modelling was used to investigate symptom changes over time. The proportion of participants meeting criteria for treatment response, clinically significant change, and remission of depression and anxiety symptoms were calculated, including proportions demonstrating each outcome sustained up to each timepoint. RESULTS Multivariate analyses yielded statistically significant reductions in depression (β = -5.40) and anxiety (β = -3.31) symptoms from baseline to end of treatment (8 weeks). Symptom levels remained significantly reduced from baseline through 24 months. The proportion of participants meeting criteria for clinical treatment outcomes remained constant over 24 months, although there were linear decreases in the proportions experiencing sustained clinical outcomes. CONCLUSIONS Treatment gains were made for depression and anxiety symptoms at the end of treatment and up to 24 months. Future studies should determine the feasibility of integrating post-treatment programmes into DMHIs to address symptom deterioration.
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Affiliation(s)
- Adam K Pettitt
- Meru Health, San Mateo, California, USA
- Center for Digital Mental Health, University of Oregon, Eugene, Oregon, USA
| | - Benjamin W Nelson
- Meru Health, San Mateo, California, USA
- Department of Psychology and Neuroscience, University of North Carolina Chapel Hill, Chapel Hill, North Carolina, USA
| | - Valerie L Forman-Hoffman
- Meru Health, San Mateo, California, USA
- Department of Epidemiology, The University of Iowa, Iowa City, Iowa, USA
| | - Philippe R Goldin
- Betty Irene Moore School of Nursing, University of California Davis, Sacramento, California, USA
| | - Nicholas C Peiper
- Meru Health, San Mateo, California, USA
- Department of Epidemiology and Population Health, University of Louisville, Louisville, Kentucky, USA
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Soneson E, White SR, Howarth E, Ford T, Fazel M, Jones PB. Access to and perceived unmet need for mental health services and support in a community sample of UK adolescents with and without experience of childhood adversity. Epidemiol Psychiatr Sci 2024; 33:e1. [PMID: 38264958 PMCID: PMC7615639 DOI: 10.1017/s2045796024000027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Revised: 11/24/2023] [Accepted: 12/06/2023] [Indexed: 01/25/2024] Open
Abstract
AIMS Children and adolescents with a history of adverse childhood experiences (ACEs) are more likely than their peers to develop mental health difficulties, but not enough is known about their help-seeking behaviours and preferences. We aimed to determine whether ACEs are associated with access to and perceived unmet need for mental health services and support amongst secondary school students. METHODS We used multi-level logistic regression with data from the 2020 OxWell Student Survey to assess whether ACEs were associated with (1) prior access to mental health support and (2) perceived unmet need for mental health services in a community sample of English secondary school students. We assessed ACEs as a cumulative score from the Center for Youth Wellness Adverse Childhood Experiences Questionnaire: Teen Self-Report version and accounted for current mental health difficulties as measured by the 25-item Revised Children's Anxiety and Depression Scale (RCADS). RESULTS Our analysis included 2018 students across 64 schools, of whom 29.9% (598/2002) reported prior access to mental health support. Of those not reporting prior access, 34.1% (469/1377) reported a perceived unmet need for services. In the unadjusted models, cumulative ACE scores were significantly positively associated with both prior access to mental health support (odds ratio (OR) = 1.36; 95% confidence interval (CI): 1.29-1.43) and perceived unmet need for mental health services (OR = 1.47; 95% CI: 1.37-1.59), meaning that students who had experienced adversity had a greater chance of having previously accessed support as well as perceiving an unmet need for services. After adjusting for mental health difficulties and other sociodemographic variables, cumulative ACE scores were positively associated with prior access (adjusted OR (aOR) = 1.25; 95% CI: 1.17-1.34 with a significant interaction between RCADS and ACE scores, aOR = 0.88; 95% CI: 0.84-0.93) as well as perceived unmet need (aOR = 1.32; 95% CI: 1.21-1.43 with a significant interaction between RCADS and ACE scores, aOR = 0.85; 95% CI: 0.78-0.91). CONCLUSIONS Although it is encouraging that adolescents with experience of adversity are more likely than their peers with similar levels of depression and anxiety symptoms to have accessed mental health support, there remains a concern that those who have not accessed support are more likely to perceive an as-yet unmet need for it. Mental health support must be available, accessible and acceptable to all who need it, especially for those groups that traditionally have not accessed services, including the more marginalised and vulnerable populations.
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Affiliation(s)
- E. Soneson
- Department of Psychiatry, University of Oxford, Oxford, UK
| | - S. R. White
- Department of Psychiatry, University of Cambridge, Cambridge, UK
- MRC Biostatistics Unit, University of Cambridge, Cambridge, UK
| | - E. Howarth
- School of Psychology, University of Sussex, Brighton, UK
| | - T. Ford
- Department of Psychiatry, University of Cambridge, Cambridge, UK
| | - M. Fazel
- Department of Psychiatry, University of Oxford, Oxford, UK
| | - P. B. Jones
- Department of Psychiatry, University of Cambridge, Cambridge, UK
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Calear AL, Batterham PJ, McCallum SM, Banfield M, Moore E, Johnson N, Morse AR. Designing a Web-Based Navigation Tool to Support Access to Youth Mental Health Services: Qualitative Study. JMIR Form Res 2024; 8:e48945. [PMID: 38236625 PMCID: PMC10835581 DOI: 10.2196/48945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Revised: 10/23/2023] [Accepted: 11/22/2023] [Indexed: 01/19/2024] Open
Abstract
BACKGROUND Many young people with mental health problems do not readily seek help or receive treatment and support. One way to address low help-seeking behavior is to improve access to information on mental health services and how to navigate the mental health system via a web-based tool. Seeking input from the end users (young people and parents or caregivers) on key features of the tool is imperative to ensure that it is relevant, engaging, and likely to meet their needs and expectations. OBJECTIVE This study aims to investigate young person and parent or caregiver views on the design, content, functioning, and user experience of a web-based mental health navigation tool to support connection to mental health services for children and young people aged up to 25 years. METHODS A total of 4 online focus groups were conducted: 2 with young people aged 16 years and older (total n=15) and 2 with parents or caregivers (total n=13). Focus groups were structured around a series of guiding questions to explore participants' views on content, features, user experience, and design of a mental health navigation website. Focus groups were audio recorded with detailed notes taken. In addition, 53 young people aged 16-25 years and 97 parents or caregivers completed an online survey, comprising closed- and open-ended questions; open-ended responses were included with the focus group data in the qualitative analysis. All qualitative data were analyzed using thematic analysis. RESULTS A total of 2 topic areas and 7 themes were developed. The first topic area covered the types of information needs of young people and parents. Identified themes concerned the scope of the navigation website, as well as the provision of up-to-date and practical information on how to navigate the whole help-seeking process. The second topic area covered website features that would be beneficial and included the consideration of the website design; search engines; supported navigation; and forums, reviews, and user accounts. CONCLUSIONS This study provides important insights into the navigation needs of young people and parents or caregivers in seeking mental health services. Key findings identified through this research have directly informed the development of MindMap, a web-based youth navigation tool providing a searchable database of local services, including a clear description, their location, and potential wait times. The website can be navigated independently or with support.
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Affiliation(s)
- Alison L Calear
- Centre for Mental Health Research, The Australian National University, Canberra, Australia
| | - Philip J Batterham
- Centre for Mental Health Research, The Australian National University, Canberra, Australia
| | - Sonia M McCallum
- Centre for Mental Health Research, The Australian National University, Canberra, Australia
| | - Michelle Banfield
- Centre for Mental Health Research, The Australian National University, Canberra, Australia
- ALIVE National Centre for Mental Health Research Translation, Melbourne, Australia
| | - Elizabeth Moore
- Office for Mental Health and Wellbeing, ACT Health, Canberra, Australia
| | - Natalie Johnson
- Office for Mental Health and Wellbeing, ACT Health, Canberra, Australia
| | - Alyssa R Morse
- Centre for Mental Health Research, The Australian National University, Canberra, Australia
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Hyam L, Torkelson C, Richards K, Semple A, Allen KL, Owens J, Jackson A, Semple L, Glennon D, Di Clemente G, Schmidt U. "Early intervention isn't an option, it's a necessity": learning from implementation facilitators and challenges from the rapid scaling of an early intervention eating disorders programme in England. Front Health Serv 2024; 3:1253966. [PMID: 38304576 PMCID: PMC10830832 DOI: 10.3389/frhs.2023.1253966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Accepted: 12/21/2023] [Indexed: 02/03/2024]
Abstract
Introduction The First Episode Rapid Early Intervention for Eating Disorders (FREED) service has shown promising outcomes for young people with an eating disorder, leading to national scaling and implementation across England. Between 2020 and 2023, the national implementation of FREED was supported by the Academic Health Science Networks (AHSNs), which are publicly funded organisations with the mission to spread innovations at scale and pace. This study aimed to investigate the views and experiences of AHSN programme leads on the national roll-out of FREED and the perceived sustainability of the model. Methods and results Semi-structured interviews were conducted with 13 programme leads across the AHSNs with direct experience supporting the national implementation of FREED. Thematic analysis was adopted using a critical realist approach. Initial sub-themes were inductively generated and then organised under seven larger themes representing the domains of the Non-adoption, Abandonment, and Challenges to Scale-Up, Spread and Sustainability (NASSS) framework. Each sub-theme was classified as a facilitator and/or barrier and then each larger theme/domain was assessed for its complexity (simple, complicated, complex). Data analysis revealed 28 sub-themes, 10 identified as facilitators, 13 as barriers, and five as both. Two domains were classed as simple, three as complicated, and two as complex. Sub-themes ranged from illness-related complexities to organisational pressures. Key facilitators included a high-value proposition for FREED and a supportive network. Key barriers included staffing issues and illness-related factors that challenge early intervention. Discussion Participants described broad support for FREED but desired sustained investment for continued provision and improving implementation fidelity. Future development areas raised by participants included enlarging the evidence base for early intervention, increasing associated training opportunities, and widening the reach of FREED. Results offer learning for early intervention in eating disorders and the scaling of new health initiatives.
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Affiliation(s)
- Lucy Hyam
- Centre for Research in Eating and Weight Disorders, Department of Psychological Medicine, King’s College London, Institute of Psychiatry, Psychology and Neuroscience, London, United Kingdom
| | - Claire Torkelson
- Department of Psychosis Studies, King’s College London, Institute of Psychiatry, Psychology and Neuroscience, London, United Kingdom
| | - Katie Richards
- Centre for Implementation Science, King’s College London, Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, London, United Kingdom
| | - Amy Semple
- Health Innovation Network, Academic Health Science Network South London, London, United Kingdom
| | - Karina L. Allen
- Centre for Research in Eating and Weight Disorders, Department of Psychological Medicine, King’s College London, Institute of Psychiatry, Psychology and Neuroscience, London, United Kingdom
- South London and Maudsley NHS Foundation Trust, London, United Kingdom
| | - Jill Owens
- Health Innovation Network, Academic Health Science Network South London, London, United Kingdom
| | - Aileen Jackson
- Health Innovation Network, Academic Health Science Network South London, London, United Kingdom
| | - Laura Semple
- Eating Disorders Outpatients Service, Maudsley Hospital, South London and Maudsley NHS Foundation Trust, London, United Kingdom
| | - Danielle Glennon
- South London and Maudsley NHS Foundation Trust, London, United Kingdom
| | | | - Ulrike Schmidt
- Centre for Research in Eating and Weight Disorders, Department of Psychological Medicine, King’s College London, Institute of Psychiatry, Psychology and Neuroscience, London, United Kingdom
- South London and Maudsley NHS Foundation Trust, London, United Kingdom
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Laurell AAS, Venkataraman AV, Schmidt T, Montagnese M, Mueller C, Stewart R, Lewis J, Mundell C, Isaacs JD, Krishnan MS, Barber R, Rittman T, Underwood BR. Estimating demand for potential disease-modifying therapies for Alzheimer's disease in the UK. Br J Psychiatry 2024:1-7. [PMID: 38235531 DOI: 10.1192/bjp.2023.166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2024]
Abstract
BACKGROUND Phase three trials of the monoclonal antibodies lecanemab and donanemab, which target brain amyloid, have reported statistically significant differences in clinical end-points in early Alzheimer's disease. These drugs are already in use in some countries and are going through the regulatory approval process for use in the UK. Concerns have been raised about the ability of healthcare systems, including those in the UK, to deliver these treatments, considering the resources required for their administration and monitoring. AIMS To estimate the scale of real-world demand for monoclonal antibodies for Alzheimer's disease in the UK. METHOD We used anonymised patient record databases from two National Health Service trusts for the year 2019 to collect clinical, demographic, cognitive and neuroimaging data for these cohorts. Eligibility for treatment was assessed using the inclusion criteria from the clinical trials of donanemab and lecanemab, with consideration given to diagnosis, cognitive performance, cerebrovascular disease and willingness to receive treatment. RESULTS We examined the records of 82 386 people referred to services covering around 2.2 million people. After applying the trial criteria, we estimate that a maximum of 906 people per year would start treatment with monoclonal antibodies in the two services, equating to 30 200 people if extrapolated nationally. CONCLUSIONS Monoclonal antibody treatments for Alzheimer's disease are likely to present a significant challenge for healthcare services to deliver in terms of the neuroimaging and treatment delivery. The data provided here allows health services to understand the potential demand and plan accordingly.
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Affiliation(s)
- Axel A S Laurell
- Department of Psychiatry, University of Cambridge, UK; and Older People and Adult Community Directorate, Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK
| | - Ashwin V Venkataraman
- Department of Old Age Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK; Centre for Neuroimaging Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK; and South London and Maudsley NHS Foundation Trust, London, UK
| | - Tatjana Schmidt
- Department of Clinical Neurosciences, University of Cambridge, UK
| | | | - Christoph Mueller
- Department of Old Age Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK; and South London and Maudsley NHS Foundation Trust, London, UK
| | - Robert Stewart
- Department of Old Age Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK; and South London and Maudsley NHS Foundation Trust, London, UK
| | - Jonathan Lewis
- Informatics Department, Cambridgeshire and Peterborough NHS Foundation Trust, UK
| | - Clare Mundell
- Pharmacy Department, Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK
| | - Jeremy D Isaacs
- Department of Neurology, Atkinson Morley Regional Neuroscience Centre, St George's University Hospitals NHS Foundation Trust, London, UK; and Molecular and Clinical Sciences Research Institute, St George's, University of London, UK
| | - Mani S Krishnan
- Department of Old Age Psychiatry, Tees, Esk and Wear Valleys NHS Foundation Trust, Darlington, UK
| | - Robert Barber
- Department of Old Age Psychiatry, Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust, Newcastle, UK
| | - Timothy Rittman
- Department of Clinical Neurosciences, University of Cambridge, UK
| | - Benjamin R Underwood
- Department of Psychiatry, University of Cambridge, UK; and Older People and Adult Community Directorate, Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK
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Ouliaris C, Gill N, Castan M, Sundram S. OPCAT: How an international treaty regarding torture is relevant to the Australian mental health system. Aust N Z J Psychiatry 2024:48674231221419. [PMID: 38217424 DOI: 10.1177/00048674231221419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/15/2024]
Abstract
The United Nations Subcommittee on the Prevention of Torture visits signatory nations to the Optional Protocol to the Convention against Torture and other Cruel, Inhuman or Degrading Treatment or Punishment (OPCAT). Its role is to monitor and support signatory nations in implementing and complying with the Convention against Torture and other Cruel, Inhuman or Degrading Treatment or Punishment (CAT). In October 2022, the United Nations Subcommittee on the Prevention of Torture visited Australia but was barred from visiting mental health wards in Queensland and all detention facilities in New South Wales leading to the termination of its visit. This breach of Australia's obligations under the OPCAT presents a significant setback for the rights of people with mental illness and other involuntarily detained populations. This piece sets out to demonstrate the relevance of OPCAT to the mental health system in Australia. Individuals who are detained for compulsory treatment in locked facilities such as acute psychiatric inpatient wards and forensic mental health facilities are deprived of their liberty, often out of public view. Thus, it highlights the ethical and professional obligations of all mental health professionals, especially psychiatrists, to safeguard the human rights of individuals being detained in mental health facilities as enshrined in Australia's international legal obligations under the OPCAT. Adhering to these obligations diminishes the risk of future human rights violations of people with mental illness.
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Affiliation(s)
- Calina Ouliaris
- Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, NSW, Australia
- Training Program, The Royal Australian & New Zealand College of Psychiatrists, Melbourne, VIC, Australia
| | - Neeraj Gill
- Mental Health Policy Unit, Health Research Institute, University of Canberra, Canberra, ACT, Australia
- School of Medicine and Dentistry, Griffith University, Gold Coast, QLD, Australia
- Mental Health and Specialist Services, Gold Coast Health, Southport, QLD, Australia
| | - Melissa Castan
- Faculty of Law, Monash University, Clayton, VIC, Australia
- Castan Centre for Human Rights Law, Monash University, Clayton, VIC, Australia
- Australian Academy of Law, Sydney, NSW, Australia
| | - Suresh Sundram
- Department of Psychiatry, School of Clinical Sciences, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, VIC, Australia
- Mental Health Program, Monash Health, Clayton, VIC, Australia
- Cabrini Outreach, Malvern, VIC, Australia
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Witt K, McGill K, Leckning B, Hill NTM, Davies BM, Robinson J, Carter G. Global prevalence of psychosocial assessment following hospital-treated self-harm: systematic review and meta-analysis. BJPsych Open 2024; 10:e29. [PMID: 38205598 PMCID: PMC10790226 DOI: 10.1192/bjo.2023.625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 10/04/2023] [Accepted: 11/17/2023] [Indexed: 01/12/2024] Open
Abstract
BACKGROUND Hospital-treated self-harm is common, costly and associated with repeated self-harm and suicide. Providing a comprehensive psychosocial assessment following self-harm is recommended by professional bodies and may improve outcomes. AIMS To review the provision of psychosocial assessments after hospital-presenting self-harm and the extent to which macro-level factors indicative of service provision explain variability in these estimates. METHOD We searched five electronic databases to 3 January 2023 for studies reporting data on the proportion of patients and/or events that were provided a psychosocial assessment. Pooled weighted prevalence estimates were calculated with the random-effects model. Random-effects meta-regression was used to investigate between-study variability. RESULTS 119 publications (69 unique samples) were included. Across ages, two-thirds of patients had a psychosocial assessment (0.67, 95% CI 0.58-0.76). The proportion was higher for young people and older adults (0.75, 95% CI 0.36-0.99 and 0.83, 95% CI 0.48-1.00, respectively) compared with adults (0.64, 95% CI 0.54-0.73). For events, around half of all presentations had these assessments across the age range. No macro-level factor explained between-study heterogeneity. CONCLUSIONS There is room for improvement in the universal provision of psychosocial assessments for self-harm. This represents a missed opportunity to review and tailor aftercare supports for those at risk. Given the marked unexplained heterogeneity between studies, the person- and system-level factors that influence provision of psychosocial assessments after self-harm should be studied further.
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Affiliation(s)
- Katrina Witt
- Centre for Youth Mental Health, The University of Melbourne, Australia; and Orygen, Parkville, Australia
| | - Katie McGill
- School of Medicine and Public Health, The University of Newcastle, Australia; and Hunter New England Local Health District, Waratah, Australia
| | - Bernard Leckning
- Menzies School of Health Research, Charles Darwin University, Australia
| | - Nicole T. M. Hill
- School of Population and Global Health, The University of Western Australia, Australia; and Telethon Kids Institute, Nedlands, Australia
| | | | - Jo Robinson
- Centre for Youth Mental Health, The University of Melbourne, Australia; and Orygen, Parkville, Australia
| | - Gregory Carter
- School of Medicine and Public Health, The University of Newcastle, Australia
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Alotaibi R, Halbesma N, Wild SH, Jackson CA. Severe depression and all-cause and cause-specific mortality in Scotland: 20 year national cohort study. BJPsych Open 2024; 10:e28. [PMID: 38205603 PMCID: PMC10790224 DOI: 10.1192/bjo.2023.633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Revised: 11/10/2023] [Accepted: 11/23/2023] [Indexed: 01/12/2024] Open
Abstract
BACKGROUND Understanding cause of death in people with depression could inform approaches to reducing premature mortality. AIM To describe all-cause and cause-specific mortality for people with severe depression in Scotland, by sex, relative to the general population. METHOD We performed a retrospective cohort study, using psychiatric hospital admission data linked to death data, to identify adults (≥18 years old) with severe depression and ascertain cause-specific deaths, during 2000-2019. We estimated relative all-cause and cause-specific mortality for people with severe depression using standardised mortality ratios (SMRs), stratified by sex using the whole Scottish population as the standard. RESULTS Of 28 808 people with severe depression, 7903 (27.4%) died during a median follow-up of 8.7 years. All-cause relative mortality was over three times higher than expected (SMR, both sexes combined: 3.26, 95% CI 3.19-3.34). Circulatory disease was the leading cause of death, and, among natural causes of death, excess relative mortality was highest for circulatory diseases (SMR 2.51, 2.40-2.66), respiratory diseases (SMR 3.79, 3.56-4.01) and 'other' causes (SMR 4.10, 3.89-4.30). Among circulatory disease subtypes, excess death was highest for cerebrovascular disease. Both males and females with severe depression had higher all-cause and cause-specific mortality than the general population. Suicide had the highest SMR among both males (SMR 12.44, 95% CI 11.33-13.54) and females (22.86, 95% CI 20.35-25.36). CONCLUSION People with severe depression have markedly higher all-cause mortality than the general population in Scotland, with relative mortality varying by cause of death. Effective interventions are needed to reduce premature mortality for people with severe depression.
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Affiliation(s)
- Raied Alotaibi
- Usher Institute, University of Edinburgh, Edinburgh, UK; and Prince Sultan College for Emergency Medical Services, King Saud University, Riyadh, Saudi Arabia
| | | | - Sarah H. Wild
- Usher Institute, University of Edinburgh, Edinburgh, UK
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Brown P, Scrivener A, Calnan M. The co-construction and emotion management of hope within psychosis services. Front Sociol 2024; 8:1270539. [PMID: 38260114 PMCID: PMC10802842 DOI: 10.3389/fsoc.2023.1270539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Accepted: 10/30/2023] [Indexed: 01/24/2024]
Abstract
Introduction There is a growing acknowledgement of the salience of hope for mental health service-users, in influencing care outcomes and recovery. Understandings of the processes through which hopes are co-constructed, alongside specific conceptualisations of experiences of hoping, remain limited however. Methods This qualitative study explored how a range of stakeholders experienced and dealt with uncertainty within three purposively selected psychosis services in southern England. In this article we focus particularly on the co-construction of hope within participants' narratives and how this emotion work shaped experiences of hoping. In-depth interviews (n = 23) with service-users, professionals, managers and other stakeholders were analysed following a phenomenological approach. Findings Hope was spontaneously identified by participants as a fundamental mechanism through which service-users and professionals managed uncertainty when vulnerable. Professionals were influential in shaping users' hopes, both intentionally and unwittingly, while some professionals also referred to managing their own hopes and those of colleagues. Such management of expectations and emotions enabled motivation and coping amidst uncertainty, for users and professionals, but also entailed difficulties where hope was undermined, exaggerated, or involved tensions between desires and expectations. Discussion Whereas, hope is usually reflected in the caring studies literature as distinctly positive, our findings point to a more ambivalent understanding of hope, as reflected in the accounts of both service-users and professionals where elevated hopes were described as unrealistic and harmful, to the well-being of professionals as well as of service-users. It is concluded that a greater awareness within care contexts of how hopes are co-constructed by professionals and service-users, explicitly and implicitly, can assist in improving health care and healthcare outcomes.
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Affiliation(s)
- Patrick Brown
- Department of Sociology, University of Amsterdam, Amsterdam, Netherlands
| | | | - Michael Calnan
- School of Sociology, Social Policy and Social Research, University of Kent, Canterbury, United Kingdom
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Davy B, Riosa PB, Ghassemi E. Understanding the Mental Health Perspectives and Experiences of Migrants to Canada. Int J Soc Determinants Health Health Serv 2024; 54:52-64. [PMID: 36798040 DOI: 10.1177/27551938231156032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
Few researchers have explored Canadian migrants' experiences of mental health and service access. We interviewed 10 migrants to Canada from a local settlement organization about mental health and services and 5 organization staff about their experiences supporting migrants' mental health and service access. Our interviews with migrants revealed cultural perceptions of mental health and unmet service needs. Our focus group with staff indicated challenges experienced by migrants and the tension between their openness with mental health difficulties and stigmatization from their cultural communities. A call to restructure existing mental health support for this underserved population is needed.
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Affiliation(s)
- Brittany Davy
- Department of Applied Disability Studies, Brock University, St. Catharines, ON, Canada
- Health and Society, McMaster University, Hamilton, ON, Canada
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Doyle E, Carey E, Rossouw J, Booth A, Rickwood D, O'Reilly A. Examining the psychometric properties of the headspace Youth (mental health) Service Satisfaction Scale in a mental health service in Ireland. Child Care Health Dev 2024; 50:e13220. [PMID: 38265133 DOI: 10.1111/cch.13220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Revised: 10/05/2023] [Accepted: 11/21/2023] [Indexed: 01/25/2024]
Abstract
INTRODUCTION Evaluating service quality and satisfaction is central to the provision of accessible and developmentally appropriate youth mental health services. However, there are limited suitable measures and a lack of published evidence on the psychometric properties of measures to assess young people's satisfaction with youth mental health services. The headspace Youth (Mental Health) Service Satisfaction Scale (YSSS) was designed and implemented to assess young people's satisfaction with headspace mental health services in Australia. This study examined the reliability and factor structure of the YSSS in a youth mental health service in Ireland. METHODS The sample comprised 1449 young people (66.2% female) aged 12-25 years (M = 16.48, SD = 2.97). Participants completed the YSSS after their final brief intervention session through Jigsaw-The National Centre for Youth Mental Health. Confirmatory factor analysis (CFA) was performed on one- and four-factor models to test findings from previous studies. Reliability was also examined. RESULTS CFA supported a single-factor structure of the YSSS, and all items were suitable for inclusion. The internal consistency of the measure was deemed acceptable (α = 0.89). CONCLUSIONS Findings suggest that the YSSS is a reliable measure for monitoring satisfaction with youth mental health services in an Irish context. The measure demonstrated a unidimensional construct of satisfaction. These findings support the broader application of the YSSS and add to existing knowledge on measuring satisfaction within youth mental health services.
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Affiliation(s)
- Elizabeth Doyle
- Jigsaw, The National Centre for Youth Mental Health, Dublin, Ireland
| | - Eleanor Carey
- Jigsaw, The National Centre for Youth Mental Health, Dublin, Ireland
| | - Johannes Rossouw
- Jigsaw, The National Centre for Youth Mental Health, Dublin, Ireland
| | - Ailbhe Booth
- Jigsaw, The National Centre for Youth Mental Health, Dublin, Ireland
- UCD School of Psychology, University College Dublin, Dublin, Ireland
| | - Debra Rickwood
- Faculty of Health, University of Canberra, Canberra, Australian Capital Territory, Australia
- headspace National Youth Mental Health Foundation, Melbourne, Victoria, Australia
| | - Aileen O'Reilly
- UCD School of Psychology, University College Dublin, Dublin, Ireland
- ALONE, Dublin, Ireland
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Hickling LM, Dabrowski J, Williams S. Expanding the early intervention offer: A new care pathway for children's wellbeing practitioners in a south London child and adolescent mental health service. Clin Child Psychol Psychiatry 2024; 29:155-167. [PMID: 37688480 PMCID: PMC10748444 DOI: 10.1177/13591045231201195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/11/2023]
Abstract
Child and Adolescent Mental Health Services (CAMHS) have been under recent increased demand, with increasingly limited resources, contributing to longer waiting lists, and a growing proportion of rejected referrals due to limited capacity and increasing thresholds. Child and Wellbeing Practitioners (CWPs) provide an opportunity to meet the needs of rejected referrals. We aimed to determine the feasibility of a new and direct referral route within a South London CAMHS. All referrals rejected to the local CAMHS in one year were assessed for inclusion to an embedded child and youth wellbeing in schools team (CYWS), and data collected on reasons for rejection, demographics and eligibility for the CYWS team. Of the 1,322 referrals made to CAMHS in this period, 317 were rejected. The most common reason for referral rejection was not meeting the severity threshold. One third of rejected referrals were judged to be eligible for inclusion to the CYWS team. Therefore, a significant number of children and young people (CYP) being rejected by CAMHS would be eligible for assessment and possible treatment under the CYWS team, making a new referral route potentially feasible, allowing more CYP to access mental health support and have a positive impact on waiting times.
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Affiliation(s)
- Lauren M Hickling
- Department of Psychology, King’s College London, Institute of Psychiatry Psychology & Neuroscience, London, UK
- South London and Maudsley NHS Foundation Trust, Bethlem Royal Hospital, Beckenham, UK
| | - Julia Dabrowski
- South London and Maudsley NHS Foundation Trust, Bethlem Royal Hospital, Beckenham, UK
| | - Sadie Williams
- South London and Maudsley NHS Foundation Trust, Bethlem Royal Hospital, Beckenham, UK
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Liu X, Chen Q, Yang M, Liu J, Yin Y, Liang Y. A Qualitative Study on the Psychological Experience of Emergency Department Medical Staff Caring for Patients with Suicide Attempts in Northeastern Sichuan. Arch Suicide Res 2024; 28:372-383. [PMID: 36799286 DOI: 10.1080/13811118.2023.2178350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
Abstract
The purpose of this study was to explore the psychological experiences of emergency department staff in northeastern Sichuan when treating patients with suicide attempts and to provide a theoretical basis for developing appropriate clinical interventions and improving mental health services for suicidal patients. Sixteen emergency department staff members who met recruitment requirements at two hospitals in Nanchong, China, were interviewed using Colizzi descriptive phenomenological analysis. The interviews were in-depth and semi-structured. The qualitative analysis of this study revealed three main themes: (1) aspects of the emotional experience that may be detrimental to helping people in crisis (e.g., sympathy and regret, confusion and bewilderment, worry and stress); (2) aspects of the cognitive experience (e.g., inability to deal with patients' psychological issues and having new perspective on the medical profession); and (3) raising awareness of mental health services. Future reform efforts should consider training medical staff in suicide prevention knowledge and communication skills, using a compassion-centered approach to alleviate the suffering of patients who attempt suicide, using the Safety Screening Scale (PSS-3), providing counselors for patients, developing family-focused interventions, and involving family members in suicide risk prevention and treatment.
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Drever S, Foord R, Mendoza Diaz A, Eapen V, Jairam R. Outcomes for young people in out of home care accessing tiered mental health services in Sydney, Australia. Clin Child Psychol Psychiatry 2024; 29:116-126. [PMID: 37485848 DOI: 10.1177/13591045231191443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/25/2023]
Abstract
Young people in OOHC have complex mental health concerns, therefore the South Western Sydney Local Health District (SWSLHD) has trialled a tiered model of mental health care. Under this model the OOHC mental health team (OOHC-MHT) provides specialist tier four service delivery for those with the most severe, intense mental health needs. OOHC consumers with a reduced level of severity access services at a tier three centre-based iCAMHS. This study aims to understand the characteristics of young people in OOHC accessing different service provision options in Sydney, Australia. Sixty-six OOHC consumers 8-17 years accessing mental health services across SWSLHD from January 2020-December 2021 participated in the study. Group differences in OOHC-MHT and iCAMHS outcome measures were compared. HoNOSCA scores were significantly worse for OOHC-MHT than iCAMHS, indicating more severe psychopathology for OOHC-MHT at baseline. In OOHC-MHT, HoNOSCA decreased significantly from admission to discharge and scores on the CGAS increased significantly, indicating significant improvements in psychopathology and functioning. In the iCAMHS group scores on the HoNOSCA significantly decreased indicating improved psychopathology over this period. These findings support a tiered model of service delivery for OOHC consumers, with this tailored level of care resulting in significantly improved outcomes across a range of complexity.
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Affiliation(s)
- Saskia Drever
- South Western Sydney Local Health District (SWSLHD), Australia
| | - Rachael Foord
- Western Sydney Local Health District (WSLHD), Australia
| | - Antonio Mendoza Diaz
- Discipline of Psychiatry and Mental Health, School of Clinical Medicine, University of New South Wales, Australia
| | - Valsa Eapen
- School of Psychiatry, Faculty of Medicine, University of New South Wales, Australia
| | - Rajeev Jairam
- South Western Sydney Local Health District (SWSLHD), Australia
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Shah RH, Blake D, Celso B, Bell C, Turner A. Does Samaritan, a Digital Support Platform, Help Improve Social Determinants of Health for Mental Health Offenders in Jacksonville, Florida? Cureus 2024; 16:e52915. [PMID: 38406034 PMCID: PMC10893824 DOI: 10.7759/cureus.52915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Accepted: 01/24/2024] [Indexed: 02/27/2024] Open
Abstract
Background The objective of this study is to evaluate if access to Samaritan, a digital support platform, improves the social determinants of health (SDOH) needs for patients enrolled in a jail diversion program in Jacksonville, FL. Methodology A total of 59 patients who were enrolled in a jail diversion program for homeless mentally ill misdemeanor offenders in Jacksonville, FL, participated in the study. Of the 59 patients, 47 individuals consented to participate in Samaritan while 12 declined participation. Demographics and the Health Leads Social Needs Screening Tool scores from the electronic health record were compared between groups along with average financial support from Samaritan. These non-normally distributed variables were compared using Wilcoxon rank-sum tests. Results The majority of study participants were male (92%, n = 43). The average age of study participants was 42 years. The average income from donors on the platform over three months for those who opted in was $48.80 (SD = 53.75). Among the individual Health Leads Social Needs Screening Tool questions, intact Housing was statistically significant (Z = -2.002, p = 0.045), suggesting access to a digital technology such as Samaritan might help improve SDOH needs. Conclusions Access to digital technologies, such as Samaritan, might help offenders with mental illness adjust to the many challenges they face upon reentry into the community. As such, these devices may represent one means for improving SDOH needs for disadvantaged mental health patients.
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Affiliation(s)
- Rishubh H Shah
- Psychiatry, University of Florida College of Medicine, Gainesville, USA
| | - Dionne Blake
- Psychiatry, University of Florida College of Medicine, Gainesville, USA
| | - Brian Celso
- Surgery, University of Florida College of Medicine - Jacksonville, Jacksonville, USA
| | - Colleen Bell
- Psychiatry, HCA Florida Orange Park Hospital, Jacksonville, USA
| | - Ana Turner
- Psychiatry, University of Florida College of Medicine - Jacksonville, Jacksonville, USA
- Psychiatry, University of Florida, Gainesville, USA
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Woon LSC, Maguire PA, Reay RE, Looi JCL. Telepsychiatry in Australia: A Scoping Review. Inquiry 2024; 61:469580241237116. [PMID: 38462906 DOI: 10.1177/00469580241237116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/12/2024]
Abstract
Telepsychiatry formed part of the Australian mental health response to COVID-19, but relevant reviews pre- and post-pandemic are sparse. This scoping review aimed to map the literature on telepsychiatry in Australia and identify key research priorities. We searched databases (Medline, PubMed, PsycINFO, Scopus, Web of Science, EBSCO Psychology & Behavioral Sciences Collection, Proquest databases, and Cochrane Central Register of Controlled Trials) and reference lists from January 1990 to December 2022. Keywords included telepsychiatry, videoconferencing, telephone consultation, psychiatry, mental health, and Australia. Two reviewers independently screened titles, abstracts, and full texts. We identified 96 publications, one-third of which appeared since 2020. Extracted data included article types, service types, usage levels, outcome measures, perceptions, and research gaps. Most publications were quantitative studies (n = 43) and narrative reports of services (n = 17). Seventy-six papers reported mostly publicly established services. Videoconferencing alone was the most common mode of telepsychiatry. There was increased use over time, with the emergence of metropolitan telepsychiatry during the pandemic. Few papers used validated outcome measures (n = 5) or conducted economic evaluations (n = 4). Content analysis of the papers identified perceptions of patient (and caregiver) benefits, clinical care, service sustainability, and technology capability/capacity. Benefits such as convenience and cost-saving, clinical care issues, and implementation challenges were mentioned. Research gaps in patient perspectives, outcomes, clinical practice, health economics, usage patterns, and technological issues were identified. There is consistent interest in, and growth of, telepsychiatry in Australia. The identified perception themes might serve as a framework for future research on user perspectives and service integration. Other research areas include usage trends, outcome measures, and economic evaluation.
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Affiliation(s)
- Luke Sy-Cherng Woon
- Academic Unit of Psychiatry and Addiction Medicine, School of Medicine aAustralian National University, Canberra, ACT, Australia
- Department of Psychiatry, Faculty of Medicine, The National University of Malaysia, Kuala Lumpur, Malaysia
| | - Paul A Maguire
- Academic Unit of Psychiatry and Addiction Medicine, School of Medicine aAustralian National University, Canberra, ACT, Australia
- Consortium of Australian-Academic Psychiatrists for Independent Policy Research and Analysis, Canberra, ACT, Australia
| | - Rebecca E Reay
- Academic Unit of Psychiatry and Addiction Medicine, School of Medicine aAustralian National University, Canberra, ACT, Australia
| | - Jeffrey C L Looi
- Academic Unit of Psychiatry and Addiction Medicine, School of Medicine aAustralian National University, Canberra, ACT, Australia
- Consortium of Australian-Academic Psychiatrists for Independent Policy Research and Analysis, Canberra, ACT, Australia
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Puntis S, Pappa S, Lennox B. What happens after early intervention? Mapping early intervention in psychosis care pathways in the 12 months after discharge. Early Interv Psychiatry 2024; 18:49-57. [PMID: 37220964 DOI: 10.1111/eip.13433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Revised: 04/19/2023] [Accepted: 05/05/2023] [Indexed: 05/25/2023]
Abstract
AIM Early intervention services are the established and evidence-based treatment option for individuals with first-episode psychosis. They are time-limited, and care pathways following discharge from these services have had little investigation. We aimed to map care pathways at the end of early intervention treatment to determine common trajectories of care. METHODS We collected health record data for all individuals treated by early intervention teams in two NHS mental health trusts in England. We collected data on individuals' primary mental healthcare provider for 52 weeks after the end of their treatment and calculated common trajectories of care using sequence analysis. RESULTS We identified 2224 eligible individuals. For those discharged to primary care we identified four common trajectories: Stable primary care, relapse and return to CMHT, relapse and return to EIP, and discontinuity of care. We also identified four trajectories for those transferred to alternative secondary mental healthcare: Stable secondary care, relapsing secondary care, long-term inpatient and discharged early. The long-term inpatient trajectory (1% of sample) accounted for 29% of all inpatient days in the year follow-up, with relapsing secondary care (2% of sample and 21% of inpatient days), and Relapse and return to CMHT (5% of sample, 15% of inpatient days) the second and third most frequent. CONCLUSIONS Individuals have common care pathways at the end of early intervention in psychosis treatment. Understanding common individual and service features that lead to poor care pathways could improve care and reduce hospital use.
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Affiliation(s)
- Stephen Puntis
- Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, UK
| | - Sofia Pappa
- West London NHS Trust, London, UK
- Department of Psychiatry, Imperial College London, London, UK
| | - Belinda Lennox
- Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, UK
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Stewart R, Chaturvedi J, Roberts A. Natural language processing - relevance to patient outcomes and real-world evidence. Expert Rev Pharmacoecon Outcomes Res 2024; 24:5-9. [PMID: 37874661 DOI: 10.1080/14737167.2023.2275670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Accepted: 10/23/2023] [Indexed: 10/26/2023]
Affiliation(s)
- Robert Stewart
- King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK
- South London and Maudsley NHS Foundation Trust, London, UK
| | - Jaya Chaturvedi
- King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK
| | - Angus Roberts
- King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK
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Spaducci G, Oram S, Thiara R, Robson D, Peeren S, Gibbs A, Trevillion K. The mental health and substance use treatment experiences of racially and ethnically minoritised women who have experienced sexual violence. Int J Ment Health Nurs 2023. [PMID: 38131433 DOI: 10.1111/inm.13276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 11/09/2023] [Accepted: 11/30/2023] [Indexed: 12/23/2023]
Abstract
The mental health and substance use treatment experiences of racially and ethnically minoritised women who have experienced sexual violence is not well understood. To address this we conducted a systematic review and meta-synthesis of qualitative studies. Our search strategy included electronic searches of 18 databases and grey literature, citation tracking and reference list screening. Studies were eligible if they presented qualitative data from racially and/or ethnically minoritised women or girls, who had experienced sexual violence at any age and described their experiences of receiving treatment from statutory mental health and/or substance use services. Studies were analysed using meta-ethnography. Fourteen papers based on 12 individual studies were included. Analysis developed three main themes: (1) understanding minoritised women holistically, (2) processing the trauma and beginning the healing and (3) the need for social connectedness and empowering relationships. For minoritised women to benefit from treatment, mental health and substance use services need to challenge the dynamics of the multiple traumas minoritised women experience. Knowledge and understanding of the racial trauma minoritised women experience is limited and many are subjected to further harm from racist practices occurring in some treatment services. Offering culturally safe, trauma-informed care which promotes anti-racist practices may help improve mental health and substance use service responses to minoritised women who have experienced sexual violence.
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Affiliation(s)
- Gilda Spaducci
- Health Services and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Sian Oram
- Health Services and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | | | - Debbie Robson
- Addictions Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Siofra Peeren
- Health Services and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | | | - Kylee Trevillion
- Health Services and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
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Brill J, Zacay G, Raviv G, Tsamir J, Heymann AD. Continuity of care after attempted suicide: the primary care physicians' role. Fam Pract 2023; 40:776-781. [PMID: 37053085 DOI: 10.1093/fampra/cmad045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/14/2023] Open
Abstract
BACKGROUND Suicide prevention is an important public health concern, and primary care physicians (PCPs) often serve as the first point of contact for individuals at risk. Few interventions in the primary care setting have been linked to reduced suicide attempt (SA) rates. The Continuity of Care (COC) protocol was developed to improve the primary care treatment of high-risk suicidal patients. OBJECTIVES This study examined PCPs' awareness of the COC protocol, its perceived effectiveness, and PCPs' attitudes towards post-SA-discharge visits. METHODS A survey was administered to 64 PCPs who had a recent office visit with a patient who had attempted suicide. Data were collected between May and July 2021 and analyzed anonymously. RESULTS Thirty of the 64 PCPs answered the questionnaires, giving a response rate of 47%. Most were unaware of the COC protocol. Seventeen physicians (57%) felt that the visit strengthened their physician-patient relationship, and while nearly half of the physicians (47%, n = 14) agreed they had the knowledge and tools to manage a post-SA-discharge visit, 43% of them (n = 13) preferred that the visit would have been handled by a mental health professional rather than a PCP. Analysis of open-ended questions uncovered three themes: knowledge gap, system limitation, and the PCP's role in maintaining the COC. CONCLUSION The findings of this study highlighted the important role PCPs can play to prevent future SAs, as well as exposed gaps in the knowledge and system constraints that impede them from carrying out this role as effectively as possible.
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Affiliation(s)
- Jonathan Brill
- Department of Family Medicine, Meuhedet Health Maintenance Organization, Tel Aviv, Israel
| | - Galia Zacay
- Department of Family Medicine, Meuhedet Health Maintenance Organization, Tel Aviv, Israel
- Department of Family Medicine, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Gil Raviv
- Directorate of Mental Health, Meuhedet Health Maintenance Organization, Tel Aviv, Israel
| | - Judith Tsamir
- Meuhedet Health Maintenance Organization, Tel Aviv, Israel
| | - Anthony D Heymann
- Department of Family Medicine, Meuhedet Health Maintenance Organization, Tel Aviv, Israel
- Department of Family Medicine, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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Dewa CS. Editorial: Advancements and challenges in mental health services: 2022. Front Health Serv 2023; 3:1348169. [PMID: 38179217 PMCID: PMC10764615 DOI: 10.3389/frhs.2023.1348169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Accepted: 12/12/2023] [Indexed: 01/06/2024]
Affiliation(s)
- Carolyn S. Dewa
- Department of Psychiatry and Behavioral Sciences, University of California, Davis, Sacramento, CA, United States
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Matsumoto R, Motomura E, Shiroyama T, Okada M. Impact of the Japanese Government's 'General Principles of Suicide Prevention Policy' on youth suicide from 2007 to 2022. BJPsych Open 2023; 10:e16. [PMID: 38112073 PMCID: PMC10755549 DOI: 10.1192/bjo.2023.616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Revised: 10/05/2023] [Accepted: 10/27/2023] [Indexed: 12/20/2023] Open
Abstract
BACKGROUND The Japanese Government programme 'General Principles of Suicide Prevention Policy' (GPSPP) contributed to decreasing suicide mortality rates (SMRs) before the COVID-19 pandemic, but they increased after the pandemic. AIMS To identify risk factors for youth suicide and the impact of GPSPP on youth suicide. METHOD Annual suicide numbers during 2007-2022 were obtained from government databases. SMRs of student and non-student youths were analysed with a linear mixed-effects model. Interrupted time-series analysis was conducted to investigate temporal relations between three GPSPP periods and SMRs with 52 suicide motives among high school, special vocational school and university students. Multiple regression analysis was conducted to investigate the influence of grade repetition on university student SMRs. RESULTS Non-student youth SMRs were higher than student SMRs. School-related (worrying about the future/underachievement), health-related (mainly mental illness) and family-related (conflict with parent and severe verbal reprimands) motives were major motives for student SMRs. During the first GPSPP period (2007-2012), no student SMRs decreased. During the second period (2012-2017), university and special vocational school student SMRs increased, but high school student SMRs were unchanged. In contrast, during the third period (2017-2022), with the exception of male special vocational school students, all SMRs increased. Unexpectedly, long-term grade repetition was negatively associated with health-related SMRs. CONCLUSIONS These findings suggest that GPSPP-supported programmes in schools partially contributed to student suicide prevention. To suppress increasing student SMRs, social/life support specialists should participate in in-school support services to bolster the social standing and lives of students who repeat grades or experience setbacks.
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Affiliation(s)
- Ryusuke Matsumoto
- Department of Neuropsychiatry, Division of Neuroscience, Graduate School of Medicine, Mie University, Japan
| | - Eishi Motomura
- Department of Neuropsychiatry, Division of Neuroscience, Graduate School of Medicine, Mie University, Japan
| | - Takashi Shiroyama
- Department of Neuropsychiatry, Division of Neuroscience, Graduate School of Medicine, Mie University, Japan
| | - Motohiro Okada
- Department of Neuropsychiatry, Division of Neuroscience, Graduate School of Medicine, Mie University, Japan
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