A Case-Based Approach to Public Psychiatry

2017 ◽  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Health Workers ◽  
Systems Of Care ◽  
Rapid Development ◽  
Age Groups ◽  
Cultural Humility ◽  
Health Care Environment ◽  
Optimal Care ◽  
Public Psychiatry

Expert public psychiatrists use case studies to share best practice strategies in this clinically oriented introduction to community mental health. Today, the majority of psychiatrists work with people who suffer not only from mental illness but also from poverty, trauma, social isolation, and discrimination. Psychiatrists cannot do this work alone but, instead, are part of teams of behavioral health workers navigating larger health care and social service systems. In an increasingly complex health care environment, mental health clinicians need to master systems-based practice in order to provide optimal care to their patients. The rapid development of public psychiatry training programs is a response to the learning needs of psychiatrists in an evolving system. This book begins with seven foundational principles of public psychiatry—recovery, trauma-informed care, integrated care, cultural humility, harm reduction, systems of care, and financing care—using cases to bring these concepts to life. Then, using a population health framework, cases are used to explore the typical needs of different age groups or vulnerable populations and to illustrate evidence-based/best practices that have been employed to meet these needs. Common to all of the chapters is a focus on the potential of each person, regardless of illness, to achieve personal goals, supported by a clinician who is also an advocate, activist, and leader.

scholarly journals Challenges in measuring outcomes for caregivers of people with mental health problems

2014 ◽  
Vol 16 (2) ◽  
pp. 159-169 ◽  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Disorders ◽  
Mental Health Problems ◽  
Health Workers ◽  
Systems Of Care ◽  
Daily Practice ◽  
Patient Reported ◽  
Measurement Tools ◽  
The Impact

Patient-reported outcomes (PROs) are increasingly important in health care and mental health research. Furthermore, caregivers become partners in care for patients with mental disorders, and health workers are more attentive to the expectations and needs of caregivers. A number of outcomes for caregivers are measured and used in daily practice in order to promote actions to improve health care systems and progress in research on the impact of mental disorders on their caregivers. This paper proposes an inventory of the different outcomes and different measurement tools used to assess the impact of disorders, raising a number of methodological and conceptual issues that limit the relevance of measurement tools and complicate their use. Finally, we propose some recommendations promoting the development of relevant outcome measures for caregivers and their integration into current systems of care.

Workplace Stress Among Non-doctor Trainees in Psychiatric Rehabilitation

2017 ◽  
Vol 41 (S1) ◽  
pp. S63-S63
Author(s):  
U. Volpe
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Health Workers ◽  
Positive Impact ◽  
Psychiatric Morbidity ◽  
Maslach Burnout Inventory ◽  
Personal Accomplishment ◽  
Psychological Wellbeing ◽  
Health Care Environment ◽  
Significant Difference

Mental health care settings have long been associated to a specific and long-standing emotional involvement, eventually determining professional stress and burnout in psychiatrists. However, recent evidence demonstrated that also non-doctor mental health workers may be at high risk of developing job dissatisfaction. Previous studies also suggested that the longer exposure to psychiatric settings the higher the levels of burnout. We report here data from a survey conducted among first-year students of rehabilitation courses in psychiatry (n = 44) and logopedics (n = 39), before and after the first exposure to an health care environment over a 6-month term. We investigated their psychological wellbeing and risk of psychiatric morbidity (by means of GHQ-12), levels of burnout (with the Maslach Burnout Inventory) and knowledge about mental health (by means of the MAKS schedule). The two groups were comparable as for the main socio-demographic characteristics as well as for their knowledge about mental health before training. We found a significant difference between students in mental and general health care, with significantly higher emotional exhaustion and depersonalization and lower personal accomplishment levels in the former group, after 6-month training. Such changes were significantly correlated to variations in knowledge about mental health issues and risk of psychiatric morbidity. The implementation of a specific peer support group was perceived as extremely useful by the majority of the students (96%) and had a positive impact on their burnout levels and psychological wellbeing.Disclosure of interestThe author has not supplied his declaration of competing interest.

Telepsychiatry for the Rohingya refugees (Preprint)

2018 ◽  
Author(s):  
Tanjir Rashid Soron
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Service ◽  
Health Service ◽  
Mental Health Care ◽  
Social Networking Sites ◽  
Health Workers ◽  
Mobile Apps ◽  
The Social ◽  
Health Need

UNSTRUCTURED Though health and shelter are two basic human rights, millions of refugees around the world are deprived of these basic needs. Moreover, the mental health need is one of least priority issues for the refugees. Bangladesh a developing country in the Southeast Asia where the health system is fragile and the sudden influx of thousands of Rohingya put the system in a more critical situation. It is beyond the capacity of the country to provide the minimum mental health care using existing resource. However, the refuges need immediate and extensive mental health care as the trauma, torture and being uprooted from homeland makes them vulnerable for various mental. Telepsychiatry (using technology for mental health service) opened a new window to provide mental health service for them. Mobile phone opened several options to reach to the refugees, screen them with mobile apps, connect them with self-help apps and system, track their symptoms, provide distance intervention and train the frontline health workers about the primary psychological supports. The social networking sites give the opportunity to connect the refugees with experts, create peer support group and provide interventions. Bangladesh can explore and can use the telepsychiatry to provide mental health service to the rohingya people.

scholarly journals Developing and Using Vignettes to Explore the Relationship Between Risk Management Practice and Recovery-Oriented Care in Mental Health Services

2017 ◽  
Vol 28 (3) ◽  
pp. 371-380 ◽  
Author(s):  
Jessica Holley ◽  
Steven Gillard
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Services ◽  
Health Services ◽  
Focus Groups ◽  
Health Workers ◽  
Management Practice ◽  
Health Care Research ◽  
Empirical Literature ◽  
Care Research

There is a lack of literature evaluating the development and use of vignettes to explore contested constructs in qualitative health care research where a conventional interview schedule might impose assumptions on the data collected. We describe the development and validation of vignettes in a study exploring mental health worker and service user understandings of risk and recovery in U.K. mental health services. Focus groups with mental health workers and service users explored study questions from experiential perspectives. Themes identified in the groups were combined with existing empirical literature to develop a set of vignettes. Feedback focus groups were conducted to validate and amend the vignettes. Following use in research interviews, results suggested that the vignettes had successfully elicited data on issues of risk and recovery in mental health services. Further research using creative, comparative methods is needed to fully understand how vignettes can best be used in qualitative health care research.

Global psychiatry

2017 ◽  
pp. 674-680
Author(s):  
Paul Harrison ◽  
Philip Cowen ◽  
Tom Burns ◽  
Mina Fazel
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Health Workers ◽  
Global Mental Health ◽  
Scale Up ◽  
Mental Health Workers ◽  
Middle Income ◽  
Humanitarian Emergencies ◽  
Psychiatric Illnesses ◽  
Aids Pandemic

‘Global psychiatry’ discusses the global mental health movement. Across the globe, and especially in low- and middle-income settings, there is a high prevalence of untreated psychiatric illness. In lower resourced settings there is often the need to address the added influence of poverty. The chapter discusses the question of how to scale up services and models, including using lay mental health workers and also integration of mental health care into primary health care settings to better meet the needs of those suffering from psychiatric illnesses across the globe. Four areas are discussed in more detail—the HIV/AIDS pandemic, perinatal mental illness, child and adolescent mental health, and humanitarian emergencies.

A certificate in youth psychiatry: meeting the training needs of psychiatrists

2020 ◽  
pp. 103985622094301
Author(s):  
Iain Macmillan ◽  
Andrew Thompson ◽  
Megan Kalucy ◽  
Daniel Pellen ◽  
Eóin Killackey ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Young People ◽  
Mental Disorders ◽  
Mental Health Care ◽  
Youth Mental Health ◽  
Training Needs ◽  
Specialty Training ◽  
Optimal Care ◽  
Adult Psychiatry

Objective: This paper provides the rationale for the development of sub-specialty training in youth psychiatry. Method: Training needs for youth psychiatry are discussed and the opportunities provided by sub-specialisation in youth psychiatry are presented. Results: The majority of mental disorders have their onset prior to 25 years. There has been substantial recent growth in services to meet the clinical needs of young people. The development of these services has exposed gaps in current training for psychiatrists, which varies considerably between child and adolescent, and adult psychiatry. Competencies acquired by psychiatrists in youth mental health are non-standardised, which may hinder optimal care. Conclusions: Sub-specialty training in youth psychiatry is needed to meet workforce demands. The development of a certificate in youth psychiatry, by the RANZCP Section for Youth Mental Health, is underway. This will complement existing training and provide trainees and psychiatrists the opportunity to develop specialist skills in the provision of mental health care for young people negotiating the transition between adolescence and adulthood.

Program Implementation Approaches to Build and Sustain Health Care Coordination for Type 2 Diabetes

2016 ◽  
Vol 18 (2) ◽  
pp. 306-313 ◽  
Author(s):  
Tania M. Fitzgerald ◽  
Pam A. Williams ◽  
Julia A. Dodge ◽  
Martha Quinn ◽  
Christina L. Heminger ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Health Care ◽  
Care Coordination ◽  
Program Implementation ◽  
Health Workers ◽  
Implementation Strategies ◽  
Framework Analysis ◽  
Health Care Environment ◽  
Quality Health Care

Background: As more people enter the U.S. health care system under the Affordable Care Act (ACA), it is increasingly critical to deliver coordinated, high-quality health care. The ACA supports implementation and sustainability of efficient health care models, given expected limits in available resources. This article highlights implementation strategies to build and sustain care coordination, particularly ones consistent with and reinforced by the ACA. It focuses on disease self-management programs to improve the health of patients with type 2 diabetes, exemplified by grantees of the Alliance to Reduce Disparities in Diabetes. Method: We conducted interviews with grantee program representatives throughout their 5-year programs and conducted a qualitative framework analysis of data to identify key themes related to care coordination. Results: The most promising care coordination strategies that grantee programs described included establishing clinic–community collaborations, embedding community health workers within care management teams, and sharing electronic data. Establishing provider buy-in was crucial for these strategies to be effective. Discussion: This article adds new insights into strategies promoting effective care coordination. The strategies that grantees implemented throughout the program align with ACA requirements, underscoring their relevance to the changing U.S. health care environment and the likelihood of further support for program sustainability.

A Capabilities Approach to Mental Health Transformation: A Conceptual Framework for the Recovery Era

2009 ◽  
Vol 28 (2) ◽  
pp. 35-46 ◽  
Author(s):  
Larry Davidson ◽  
Priscilla Ridgway ◽  
Melissa Wieland ◽  
Maria O'Connell
Keyword(s):  
Mental Health ◽  
United States ◽  
Health Care ◽  
Conceptual Framework ◽  
Systems Of Care ◽  
The United States ◽  
Capabilities Approach ◽  
Mental Illnesses ◽  
The Past ◽  
Serious Mental Illnesses

Recent commissions in Canada and the United States have stipulated recovery to be the overarching aim of mental health care and have called for systems of care to be transformed to be made consistent with this aim. If these efforts are not simply to repeat the mistakes of the past, a new conceptual framework will be needed to provide an alternative foundation for rethinking the nature of care for people with serious mental illnesses. In this paper, the authors identify the limitations of the conceptual framework of the deinstitutionalization movement and then offer the capabilities approach developed by Sen (1992, 1999) and others as a more adequate framework for the post-institutional era.

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