Transitioning Concussion Care to Mental Health Care: A Case Study of an Elite Athlete

2021 ◽  
Vol 5 (1) ◽  
pp. 135-144
Author(s):  
Natalie S. Sherry ◽  
Abigail Feder ◽  
Raymond Pan ◽  
Shawn R. Eagle ◽  
Anthony P. Kontos
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Biopsychosocial Model ◽  
Elite Athlete ◽  
Clinical Presentation ◽  
Health Changes ◽  
Memory Problems ◽  
Treatment Focus

Athletes with recent concussion experience a constellation of physical (e.g., headache, nausea), cognitive (e.g., memory problems, difficulty concentrating), sleep, and emotional (e.g., anxiety, depressed mood) symptoms after injury. Mental health changes may also be a product of typical maturation in adolescents/young adults, making mood disruption difficult to disentangle from concussion sequelae. In this case study, we present the case of a high-achieving 18-year-old female rower whose concussion clinical trajectory exhibits this type of difficulty. Specifically, we provide a detailed chronological summary of the athlete’s visits with a multidisciplinary concussion team. We highlight in this case study (a) an individualized, biopsychosocial model of concussion care and (b) subtle aspects of her clinical presentation that led the clinical team to transition her treatment focus from concussion specific to formal mental health care.

scholarly journals Implementation of a Mental Health Care Package for Children in Areas of Armed Conflict: A Case Study from Burundi, Indonesia, Nepal, Sri Lanka, and Sudan

PLoS Medicine ◽  
2013 ◽  
Vol 10 (1) ◽  
pp. e1001371 ◽  
Author(s):  
Mark J. D. Jordans ◽  
Wietse A. Tol ◽  
Dessy Susanty ◽  
Prudence Ntamatumba ◽  
Nagendra P. Luitel ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Sri Lanka ◽  
Mental Health Care ◽  
Armed Conflict ◽  
Care Package

scholarly journals Implementing practice guidelines for anxiety disorders in secondary mental health care: a case study

2012 ◽  
Vol 6 (1) ◽  
pp. 20 ◽  
Author(s):  
Maarten K van Dijk ◽  
Marc JPM Verbraak ◽  
Desiree B Oosterbaan ◽  
Anton JLM van Balkom
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Anxiety Disorders ◽  
Mental Health Care ◽  
Practice Guidelines

scholarly journals Pathways to mental health care in Nepal: a 14-center nationwide study

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Anoop Krishna Gupta ◽  
Sulochana Joshi ◽  
Bikram Kafle ◽  
Ranjan Thapa ◽  
Manisha Chapagai ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Mental Health Professionals ◽  
Clinical Presentation ◽  
Service Providers ◽  
Mental Illnesses ◽  
World Health ◽  
Pathways To Care ◽  
Duration Of Untreated Illness

Abstract Background Pathways to care studies are feasible and tested means of finding the actual routes taken by patients before reaching proper care. In view of the predominance of nonprofessional service providers and the lack of previous large studies on pathways in Nepal, this multicenter study is needed. The aim of the study was to trace the various pathways and carers involved in mental health care; assess clinical variables such as the duration of untreated illness, clinical presentation and treatment; and compare geographically and culturally diverse landscapes. Methods This was a cross-sectional, convenience sampling study performed at 14 centers where new cases were being taken. The World Health Organization Study of the Pathways-to-Care Schedule was applied. The Nepali version of the encounter form was used. The data were collected between 17 September and 16 October 2020 and were analyzed using the Statistical Package for the Social Sciences (SPSS). Additionally, perspectives from local investigators were collected and discussed. Results Most of the first carers were native/religious faith healers (28.2%), followed by psychiatrists (26%). The median duration for the first psychiatric consultation was 3 weeks. The duration of untreated illness was 30.72 ± 80.34 (median: 4) weeks, and the time taken for this journey was 94.99 ± 274.58 (median: 30) min. The longest delay from the onset of illness to psychiatric care was for epilepsy {90.0 ± 199.0 (median: 25.5)} weeks, followed by neurotic illness {22.89 ± 73.45 (median: 2)} and psychotic illness {10.54 ± 18.28 (median: 2)} weeks. Overall, most patients with severe mental illnesses (SMIs) had their first contact with faithhealers (49%), then met with medical doctors (13%) or psychiatrists (28%). Marked differences in clinical presentation surfaced when hilly centers were compared with the Terai belt. Conclusions Faith healers, general practitioners and hospital doctors are major carers, and the means of educating them for proper referral can be considered. The investigators see several hindrances and opportunities in the studied pathways. The employment of more mental health professionals and better mental health advocacy, public awareness programs and school education are suggested strategies to improve proper mental health care.

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