scholarly journals The use of pasung for people with mental illness: a systematic review and narrative synthesis

2020 ◽  
Vol 14 (1) ◽  
Author(s):  
Muhamad Taufik Hidayat ◽  
Sharon Lawn ◽  
Eimear Muir-Cochrane ◽  
Candice Oster
Keyword(s):  
Mental Health ◽  
Systematic Review ◽  
Mental Illness ◽  
Community Mental Health ◽  
Community Mental Health Services ◽  
Rehabilitation Program ◽  
Narrative Synthesis ◽  
Community Based ◽  
Cross Sectional ◽  
People With Mental Illness

Abstract Background Pasung is the term used in Indonesia and a number of other countries for seclusion and restraint of people with mental illness in the community, usually at home by their family. While pasung has been banned because it is contrary to human rights, its practice continues to exist within the community, particularly where community mental health services are limited, and in the absence of adequate social support, and pervasive negatives beliefs about mental illness. It is essential to understand the reasons for the ongoing use of pasung and to examine potential solutions. Methods A systematic review and narrative synthesis of peer-reviewed international literature was conducted to identify the socio-cultural contexts for pasung use, and interventions to address it. The analysis draws on the socio-ecological framework, which focused on relationships between the individual and their environment. Result Fifty published articles were included in the review; all studies were conducted in Asia and Africa, with 32 undertaken in Indonesia. Most studies were qualitative (n = 21). Others included one case–control study, one cross-sectional study, and seven surveys; only four studies examined the application of an intervention, and each used a pre and post methodology. Of these, two studies tested psychoeducational interventions which aimed to overcome family burden due to pasung, and each suggested a community mental health approach. The remaining two studies evaluated the intervention of ‘unlocking’; one study used a community-based culturally sensitive approach, and the other used a community-based rehabilitation program. Reasons for pasung given by family appear to be as a last resort and in the absence of other supports to help them care for the person with severe mental illness. Conclusion The findings highlight that a mixture of individual, interpersonal, community and policy interventions are needed to reduce the use of pasung. While consumer and carer involvement as part of a socio-ecological approach is understood to be effective in reducing pasung, an understanding of how to elaborate this in the management of pasung remains elusive. Review Registration CRD42020157543: CRD

scholarly journals Multidisciplinary team meetings in community mental health: a systematic review of their functions

2016 ◽  
Vol 21 (2) ◽  
pp. 119-140 ◽  
Author(s):  
Caoimhe Nic a Bháird ◽  
Penny Xanthopoulou ◽  
Georgia Black ◽  
Susan Michie ◽  
Nora Pashayan ◽  
...  
Keyword(s):  
Mental Health ◽  
Systematic Review ◽  
Community Mental Health ◽  
Multidisciplinary Team ◽  
Community Mental Health Services ◽  
Content Type ◽  
Team Members ◽  
Team Meetings ◽  
Unwarranted Variation ◽  
The Uk

Purpose – Previous research has identified a need for greater clarity regarding the functions of multidisciplinary team (MDT) meetings in UK community mental health services. The purpose of this paper is to identify the functions of these meetings by systematically reviewing both primary research and academic discussion papers. Design/methodology/approach – Papers relating to adult community mental health teams (CMHTs) in the UK and published between September 1999 and February 2014 were reviewed and appraised using NICE quality checklists. The search was broad in scope to include both general CMHTs and specialist CMHTs such as early intervention psychosis services and forensic mental health teams. A thematic synthesis of the findings was performed to develop an overarching thematic framework of the reported functions of MDT meetings. Findings – None of the 4,046 studies identified directly investigated the functions of MDT meetings. However, 49 mentioned functions in passing. These functions were categorised into four thematic domains: discussing the care of individual patients, teamwork, team management and learning and development. Several papers reported a lack of clarity about the purpose of MDT meetings and the roles of different team members which hindered effective collaboration. Practical implications – Without clearly agreed objectives for MDT meetings, monitoring their effectiveness is problematic. Unwarranted variation in their functioning may undermine the quality of care. Originality/value – This is the first systematic review to investigate the functions of CMHT MDT meetings in the UK. The findings highlight a need for empirical research to establish how MDT meetings are being used so that their effectiveness can be understood, monitored and evaluated.

The future of specialist community teams in the care of those with severe mental illness

2007 ◽  
Vol 16 (3) ◽  
pp. 225-230 ◽  
Author(s):  
Peter Tyrer
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Mental Health Services ◽  
Community Mental Health ◽  
Health Services ◽  
Severe Mental Illness ◽  
Community Mental Health Services ◽  
Community Services ◽  
Crisis Resolution ◽  
Crisis Resolution Teams

SummaryAims – Specialist interventions in community psychiatry for severe mental illness are expanding and their place needs to be re-examined. Methods – Recent literature is reviewed to evaluate the advantages and disadvantages of specialist teams. Results – Good community mental health services reduce drop out from care, prevent suicide and unnatural deaths, and reduce admission to hospital. Most of these features have been also demonstrated by assertive community outreach and crisis resolution teams when good community services are not available. In well established community services assertive community teams do not reduce admission but both practitioners and patients prefer this service to other approaches and it leads to better engagement. Crisis resolution teams appear to be more successful than assertive community teams in preventing admission to hospital, although head- to-head comparisons have not yet been made. All specialist teams have the potential of fragmenting services and thereby reducing continuity of care. Conclusions – The assets of improved engagement and greater satisfaction with assertive, crisis resolution and home treatment teams are clear from recent evidence, but to improve integration of services they are probably best incorporated into community mental health services rather than standing alone.Declaration of Interest: The author has been the sole consultant in two assertive outreach teams since 1994 and might there- fore be expected to be in favour of this genre of service. He has received grants for evaluation of different services models from the Department of Health (UK) and the Medical Research Council (UK).

The development and results of the European Mental Health Integration Index (2014)

2015 ◽  
Vol 14 (4) ◽  
pp. 205-210
Author(s):  
Peter John Huxley
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Best Practice ◽  
Mental Health Problems ◽  
Community Mental Health Services ◽  
Health Problems ◽  
Community Services ◽  
Content Type ◽  
People With Mental Illness ◽  
Mental Health Integration

Purpose – The purpose of this paper is to report on the development and results of the Mental Health Inclusion Index. Design/methodology/approach – Data gathering and interviews with key policy makers in 30 countries in Europe (the EU28 plus Switzerland and Norway). Data gathered enabled the production of an 18 indicator benchmarking index ranking the 30 countries based on their commitment to integrating people with mental illness. Findings – The main findings were: mental illness exacts a substantial human and economic toll on Europe, and there is a substantial treatment gap, especially for people with common mental health problems. Germany’s generous social provision and strong healthcare system put it number one in the Mental Health Integration Index. The UK and Scandinavian states come next. The lowest-scoring countries in the index are from Europe’s south-east, where there is a long history of neglect of mental illness and poorly developed community services. One needs to understand that the leading countries are not the only ones providing examples of best practice in integrating those with mental illness. Employment is the field of greatest concern for people with mental illness, but employment is also the area with the most inconsistent policies across Europe. A distinction can be made between countries whose policies are aspirational and those where implantation is support by substantial and most importantly sustained, resource investment. Europe as a whole is only in the early stages of the journey from institution- to community-based care. Lack of data makes greater understanding of this field difficult, and improvement can only be demonstrated by repeated surveys of this kind, based on more substantial, comprehensive and coherent information. Research limitations/implications – Usual caveats about the use of surveys. Missing data due to non-response and poverty of mental health inclusion data in many European countries. Practical implications – The author reflects on the findings and considers areas for future action. The main implications are: better services result from substantial, but most importantly, sustained investment; and that employment is most important to people with mental health problems, but is one of the most inconsistent policy areas across Europe. Social implications – Supports the need for consistent investment in community mental health services and more consistent employment policies in Europe. Originality/value – This survey is the first of its kind in Europe, and was conducted by the Economist Intelligence Unit in London, and sponsored by Janssen.

scholarly journals Impact of Jointly Using an e–Mental Health Resource (Self-Management And Recovery Technology) on Interactions Between Service Users Experiencing Severe Mental Illness and Community Mental Health Workers: Grounded Theory Study

10.2196/25998 ◽  
2021 ◽  
Vol 8 (6) ◽  
pp. e25998
Author(s):  
Anne Williams ◽  
Ellie Fossey ◽  
John Farhall ◽  
Fiona Foley ◽  
Neil Thomas
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Grounded Theory ◽  
Community Mental Health ◽  
Severe Mental Illness ◽  
Health Workers ◽  
Health Resources ◽  
Community Mental Health Services ◽  
Discovery Process ◽  
Mental Health Resource

Background e–Mental health resources are increasingly available for people who experience severe mental illness, including those who are users of community mental health services. However, the potential for service users (SUs) living with severe mental illness to use e–mental health resources together with their community mental health workers (MHWs) has received little attention. Objective This study aims to identify how jointly using an interactive website called Self-Management And Recovery Technology (SMART) in a community mental health context influenced therapeutic processes and interactions between SUs and MHWs from their perspective. Methods We conducted a qualitative study using a constructivist grounded theory methodology. Data were collected through individual semistructured interviews with 37 SUs and 15 MHWs who used the SMART website together for 2 to 6 months. Data analysis involved iterative phases of coding, constant comparison, memo writing, theoretical sampling, and consultation with stakeholders to support the study’s credibility. Results A substantive grounded theory, discovering ways to keep life on track, was developed, which portrays a shared discovery process arising from the SU-worker-SMART website interactions. The discovery process included choosing to use the website, revealing SUs’ experiences, exploring these experiences, and gaining new perspectives on how SUs did and could keep their lives on track. SUs and MHWs perceived that their three-way interactions were enjoyable, beneficial, and recovery focused when using the website together. They experienced the shared discovery process as relationship building—their interactions when using the website together were more engaging and equal. Conclusions Jointly using an e–mental health resource elicited recovery-oriented interactions and processes between SUs and MHWs that strengthened their therapeutic relationship in real-world community mental health services. Further work to develop and integrate this novel use of e–mental health in community mental health practice is warranted.

scholarly journals Making community based comprehensive mental health services work

1996 ◽  
Vol 20 (2) ◽  
pp. 93-96 ◽  
Author(s):  
Karen White ◽  
Maresa Ness ◽  
Tom Craig ◽  
Gary McNamee
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Community Mental Health ◽  
Health Services ◽  
Mental Health Problems ◽  
Psychiatric Service ◽  
Community Mental Health Services ◽  
Health Problems ◽  
Community Based ◽  
Inner Setting

There hat boon until recently a dearth of descriptions of locally targeted community mental health services. Such a service, developed by changing a traditional psychiatric service in an inner setting, is described. The service addresses the needs of those with predominantly severe/enduring mental health problems, by increasingly using research based treatments in an ordinary district setting.

scholarly journals Mental illness stigma research in Argentina

2015 ◽  
Vol 12 (4) ◽  
pp. 86-88 ◽  
Author(s):  
Martin Agrest ◽  
Franco Mascayano ◽  
Sara Elena Ardila-Gómez ◽  
Ariel Abeldaño ◽  
Ruth Fernandez ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Mental Health Professionals ◽  
Mental Illness Stigma ◽  
Future Research ◽  
Community Perceptions ◽  
Community Based ◽  
People With Mental Illness ◽  
National Mental Health ◽  
Community Based Services

Studies regarding stigma towards mental illness in Argentina blossomed after the first National Mental Health Law was passed in 2010. Methodological limitations and contradictory results regarding community perceptions of stigma hinder comparisons across domestic and international contexts but some lessons may still be gleaned. We examine this research and derive recommendations for future research and actions to reduce stigma. These include tackling culture-specific aspects of stigma, increasing education of the general population, making more community-based services available and exposing mental health professionals to people with mental illness who are on community paths to recovery.

Sign in / Sign up

Export Citation Format

Share Document