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Orsini LS, O'Connor SJ, Mohwinckel MT, Marwood L, Pahwa AS, Bryder MN, Dong X, Levine SP. Observational study to characterize treatment-resistant depression in Germany, France and the United Kingdom: analysis of real-world data collected through a survey of healthcare professionals. Curr Med Res Opin 2022; 38:2219-2226. [PMID: 36106382 DOI: 10.1080/03007995.2022.2113692] [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: 11/03/2022]
Abstract
OBJECTIVE This study describes treatment patterns, productivity, healthcare resource utilization and previous episodes of depression for patients with treatment-resistant depression (TRD). METHODS In this cross-sectional study, a quantitative survey was administered to 225 healthcare providers (HCPs) distributed evenly across Germany, France and the UK from July to August 2021. Each HCP was asked to answer based on medical records of five patients with TRD, defined as patients failing to respond to two or more treatments of adequate dose and duration in the same episode of major depressive disorder (MDD), which provided a sample size of 1125 patients. RESULTS Of the 1125 patients with TRD, 73.2% had two or more previous episodes of MDD, 46.3% had a history of suicidal ideation and 24.8% had attempted suicide. Only 26.8% of patients were employed either full-time or part-time. During the most recent/current TRD episode, 45.5% of patients received five or more lines of treatment, and 46.0% remained on monotherapy. For multiple pharmacological treatments, too many distinct combinations were used to discern trends. Overall, 60.6% of patients had at least one mental health-related hospitalization in the last 12 months; 35.0% had two or more hospitalizations. Half of TRD patients saw a doctor five or more times per year for their depression. CONCLUSIONS This study addresses the knowledge gap about treatment patterns and healthcare utilization in real-world practice for TRD patients in three European countries. It provides data that potentially could inform treatment guideline development and optimize patient-perceived benefits from the treatment of TRD.
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Affiliation(s)
| | | | | | | | - Ankit S Pahwa
- ICON PLC, ICON Commercialization and Outcomes, Bangalore, India
| | - Matti N Bryder
- ICON PLC, ICON Commercialization and Outcomes, Solna, Sweden
| | - Xinzhe Dong
- ICON PLC, ICON Commercialization and Outcomes, Vancouver, Canada
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Liu FF, Coifman J, McRee E, Stone J, Law A, Gaias L, Reyes R, Lai CK, Blair IV, Yu CL, Cook H, Lyon AR. A Brief Online Implicit Bias Intervention for School Mental Health Clinicians. Int J Environ Res Public Health 2022; 19:679. [PMID: 35055506 PMCID: PMC8776032 DOI: 10.3390/ijerph19020679] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/31/2021] [Revised: 12/24/2021] [Accepted: 12/25/2021] [Indexed: 02/01/2023]
Abstract
Clinician bias has been identified as a potential contributor to persistent healthcare disparities across many medical specialties and service settings. Few studies have examined strategies to reduce clinician bias, especially in mental healthcare, despite decades of research evidencing service and outcome disparities in adult and pediatric populations. This manuscript describes an intervention development study and a pilot feasibility trial of the Virtual Implicit Bias Reduction and Neutralization Training (VIBRANT) for mental health clinicians in schools-where most youth in the U.S. access mental healthcare. Clinicians (N = 12) in the feasibility study-a non-randomized open trial-rated VIBRANT as highly usable, appropriate, acceptable, and feasible for their school-based practice. Preliminarily, clinicians appeared to demonstrate improvements in implicit bias knowledge, use of bias-management strategies, and implicit biases (as measured by the Implicit Association Test [IAT]) post-training. Moreover, putative mediators (e.g., clinicians' VIBRANT strategies use, IAT D scores) and outcome variables (e.g., clinician-rated quality of rapport) generally demonstrated correlations in the expected directions. These pilot results suggest that brief and highly scalable online interventions such as VIBRANT are feasible and promising for addressing implicit bias among healthcare providers (e.g., mental health clinicians) and can have potential downstream impacts on minoritized youth's care experience.
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Affiliation(s)
- Freda F. Liu
- Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, 6200 NE 74th Street, Suite 100, Seattle, WA 98115, USA; (J.C.); (E.M.); (R.R.); (H.C.); (A.R.L.)
| | - Jessica Coifman
- Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, 6200 NE 74th Street, Suite 100, Seattle, WA 98115, USA; (J.C.); (E.M.); (R.R.); (H.C.); (A.R.L.)
| | - Erin McRee
- Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, 6200 NE 74th Street, Suite 100, Seattle, WA 98115, USA; (J.C.); (E.M.); (R.R.); (H.C.); (A.R.L.)
| | - Jeff Stone
- Department of Psychology, University of Arizona, 1503 E University Blvd. Building 68, Tucson, AZ 85721, USA;
| | - Amy Law
- Learning Gateway, University of Washington School of Medicine, 850 Republican St., Bldg. C-4, Seattle, WA 98109, USA;
| | - Larissa Gaias
- Department of Psychology, University of Massachusetts, Lowell, 850 Broadway Street, Lowell, MA 01854, USA;
| | - Rosemary Reyes
- Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, 6200 NE 74th Street, Suite 100, Seattle, WA 98115, USA; (J.C.); (E.M.); (R.R.); (H.C.); (A.R.L.)
| | - Calvin K. Lai
- Department of Psychological and Brain Sciences, Washington University in St. Louis, CB 1125, One Brookings Drive, St. Louis, MO 63130, USA;
| | - Irene V. Blair
- Department of Psychology and Neuroscience, University of Colorado Boulder, Muenzinger D244, 345 UCB, Boulder, CO 80309, USA;
| | - Chia-li Yu
- Department of Psychology, Pennsylvania State University, 140 Moore Building, University Park, State College, PA 16802, USA;
| | - Heather Cook
- Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, 6200 NE 74th Street, Suite 100, Seattle, WA 98115, USA; (J.C.); (E.M.); (R.R.); (H.C.); (A.R.L.)
| | - Aaron R. Lyon
- Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, 6200 NE 74th Street, Suite 100, Seattle, WA 98115, USA; (J.C.); (E.M.); (R.R.); (H.C.); (A.R.L.)
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Feijt M, de Kort Y, Westerink J, Bierbooms J, Bongers I, IJsselsteijn W. Integrating technology in mental healthcare practice: A repeated cross-sectional survey study on professionals' adoption of Digital Mental Health before and during COVID-19. Front Psychiatry 2022; 13:1040023. [PMID: 36874171 PMCID: PMC9977803 DOI: 10.3389/fpsyt.2022.1040023] [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: 09/08/2022] [Accepted: 11/28/2022] [Indexed: 02/18/2023] Open
Abstract
As a consequence of the outbreak of the COVID-19 global pandemic in the spring of 2020, large-scale social distancing measures were implemented, resulting in the forced adoption of online or digital forms of psychological treatment. This sudden transition to digital care offered a unique opportunity to investigate if and how this experience impacted mental healthcare professionals' perceptions and use of Digital Mental Health tools. The current paper presents findings of a repeated cross-sectional study consisting of three iterations of a national online survey in the Netherlands. This survey contained open and closed questions on professionals' adoption readiness, frequency of use, perceived competency, and perceived value of Digital Mental Health collected in 2019 (before the pandemic), in 2020 (after the first wave), and in 2021 (after the second wave). The inclusion of data gathered prior to the COVID-19 pandemic offers a unique window to assess how professionals' adoption has developed through this transition from voluntary to mandatory use of Digital Mental Health tools. Our study also re-assesses the drivers, barriers, and needs of mental healthcare professionals after having gained experience with Digital Mental Health. In total, 1,039 practitioners completed the surveys (Survey 1: n = 432, Survey 2: n = 363, and Survey 3: n = 244). Results indicate that compared to the period before the pandemic, there was a particularly large increase in use, competency, and perceived value regarding videoconferencing. Small differences were also found for some other basic tools that were crucial to ensure the continuation of care, such as e-mail, text messaging, and online screening, but not for more innovative technologies, such as virtual reality and biofeedback. Many practitioners reported to have gained skills regarding Digital Mental Health and experienced several benefits of it. They expressed the intention to continue with a blended approach, using Digital Mental Health tools in combination with face-to-face care, focused on situations in which they found it to have specific added value, such as when clients are unable to travel. Others were less satisfied with the technology-mediated interactions and remained more reluctant to future use of DMH. Implications for broader implementation of Digital Mental Health and future research are discussed.
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Affiliation(s)
- Milou Feijt
- Human-Technology Interaction Group, Eindhoven University of Technology, Eindhoven, Netherlands
| | - Yvonne de Kort
- Human-Technology Interaction Group, Eindhoven University of Technology, Eindhoven, Netherlands
| | - Joyce Westerink
- Human-Technology Interaction Group, Eindhoven University of Technology, Eindhoven, Netherlands.,Philips Research, Eindhoven, Netherlands
| | - Joyce Bierbooms
- TRANZO Digital, Tilburg University, Tilburg, Netherlands.,Erasmus School of Health Policy and Management, Erasmus University Rotterdam, Rotterdam, Netherlands
| | - Inge Bongers
- TRANZO Digital, Tilburg University, Tilburg, Netherlands.,Mental Healthcare Eindhoven, Eindhoven, Netherlands
| | - Wijnand IJsselsteijn
- Human-Technology Interaction Group, Eindhoven University of Technology, Eindhoven, Netherlands
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Aass LK, Moen ØL, Skundberg-Kletthagen H, Lundqvist LO, Schröder A. Family support and quality of community mental health care: Perspectives from families living with mental illness. J Clin Nurs 2021; 31:935-948. [PMID: 34240499 DOI: 10.1111/jocn.15948] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [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: 06/25/2020] [Revised: 05/26/2021] [Accepted: 06/04/2021] [Indexed: 11/28/2022]
Abstract
AIM AND OBJECTIVES Describe patients' and family members' perceptions of family support from nurses and other mental healthcare professionals, and quality of care in community mental healthcare service. Further, compare the perceptions of patients and family members. BACKGROUND While patients value family involvement, family members feel unprepared and lack the necessary skills to be supportive. Since healthcare professionals predominantly focus on patients, they may fail to understand the complex needs of families. Family perceived support and quality of community mental health care may vary across patients and family members. DESIGN AND METHODS Cross-sectional study with patients suffering from mental illness and family members in community mental healthcare services in Norway. Altogether 86 participants, of whom 33 patients and 33 family members had a family relationship-paired samples. Participants filled in the translated version of the Iceland Family Perceived Support Questionnaire (FPSQ-N) and Quality in Psychiatric Care-Community Out-Patient (QPC-COP) and Community Out-Patient Next of Kin (QPC-COPNK). STROBE checklist was used. RESULTS Family members scored family perceived support and quality of community mental health care lower than patients. Family members feel the loss of support. Patient and family members found the Patient-healthcare professionals' relationship to be of high quality, while family members gave low score to being respected and invited to take part in care by nurses and other mental healthcare professionals. CONCLUSION Family members' unmet need of support highlights the need for nurses and other community mental healthcare professionals to assess complex family needs and to intervene. Barriers to collaboration exist, and family members need to be respected and invited into community mental health care. RELEVANCE TO CLINICAL PRACTICE Contributes knowledge of how to meet the family's needs and provides a basis for further care and treatment development in similar contexts nationally and internationally.
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Affiliation(s)
- Lisbeth Kjelsrud Aass
- Department of Health Sciences, Faculty of Medicine and Health Sciences (MH), Norwegian University of Science and Technology (NTNU), Gjøvik, Norway
| | - Øyfrid Larsen Moen
- Department of Health Sciences, Faculty of Medicine and Health Sciences (MH), Norwegian University of Science and Technology (NTNU), Gjøvik, Norway
| | - Hege Skundberg-Kletthagen
- Department of Health Sciences, Faculty of Medicine and Health Sciences (MH), Norwegian University of Science and Technology (NTNU), Gjøvik, Norway
| | - Lars-Olov Lundqvist
- Faculty of Medicine and Health, University Health Care Research Center, Örebro University, Örebro, Sweden
| | - Agneta Schröder
- Department of Health Sciences, Faculty of Medicine and Health Sciences (MH), Norwegian University of Science and Technology (NTNU), Gjøvik, Norway.,Faculty of Medicine and Health, University Health Care Research Center, Örebro University, Örebro, Sweden
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Mc Sharry P, O' Grady T. How coaching can assist the mental healthcare professional in the operationalization of the recovery approach. Perspect Psychiatr Care 2021; 57:844-851. [PMID: 32964511 DOI: 10.1111/ppc.12625] [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: 08/28/2019] [Revised: 03/13/2020] [Accepted: 09/09/2020] [Indexed: 11/28/2022] Open
Abstract
PURPOSE The purpose of this article is to explore how the concept of coaching can assist mental healthcare professionals (MHCP's) in applying the recovery approach. DESIGN AND METHODS The development of recovery as the central approach to mental healthcare is explored, as is the concept of recovery. The synergies between the concepts of coaching and recovery are highlighted. FINDINGS The concept of coaching for recovery is put forward as a strategy to empower mental health clients in their recovery journey. It is contended that the application of a coaching approach by MHCP's will aid them in applying the recovery approach to care within their work. IMPLICATIONS Coaching is proposed as a mechanism/strategy to make the philosophy of recovery a reality in mental health practice.
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Affiliation(s)
- Patsy Mc Sharry
- Department of Nursing and Health Studies, St. Angela's College Lough Gill Sligo, Sligo, Ireland
| | - Tom O' Grady
- Department of Nursing and Health Studies, St. Angela's College Lough Gill Sligo, Sligo, Ireland
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