Economic Evaluation of Mental Health Care Interventions. A Review

Due to rising costs, the economic aspects of the mental health care sector are receiving increasing attention. This article scrutinizes 91 published studies in the field of mental health care, applying methodological criteria drawn from epidemiology and economics. The purpose of this study is to provide some insight into the quality of economic evaluation in the field of mental health care. The article shows that few good full economic evaluations studies have been undertaken in the domain of mental health care. One reason for this could be that the measurement of effectiveness in mental health care is complicated because of the known difficulties with the reliability of psychiatric diagnosis and the lack of consensus about the etiology and appropriate treatment for many psychiatric illnesses. © 1997 by John Wiley & Sons, Ltd.     

Parenting Interventions and Secondary Outcomes Related to Maternal Mental Health: A Systematic Review

Maternal and Child Health Journal - Perinatal mood and anxiety disorders can have far reaching negative impact on both maternal mental health and child growth and development. Multimodal group...     

Early Child Development and Nutrition: A Review of the Benefits and Challenges of Implementing Integrated Interventions

Poor nutrition (substandard diet quantity and/or quality resulting in under- or overnutrition) and the lack of early learning opportunities contribute to the loss of developmental potential and life-long health and economic disparities among millions of children aged <5 y. Single-sector interventions representing either early child development (ECD) or nutrition have been linked to positive child development and/or nutritional status, and recommendations currently advocate for the development and testing of integrated interventions. We reviewed the theoretical and practical benefits and challenges of implementing integrated nutrition and ECD interventions along with the evidence for best practice and benefit-cost and concluded that the strong theoretical rationale for integration is more nuanced than the questions that the published empirical evidence have addressed. For example, further research is needed to 1) answer questions related to how integrated messaging influences caregiver characteristics such as well-being, knowledge, and behavior and how these influence early child nutrition and development outcomes; 2) understand population and nutritional contexts in which integrated interventions are beneficial; and 3) explore how varying implementation processes influence the efficacy, uptake, and cost-benefit of integrated nutrition and ECD interventions.     

Prenatal and Postnatal Maternal Mental Health and School-Age Child Development: A Systematic Review

One in six children entering school experiences developmental delay. Maternal mental health represents one of the earliest, modifiable influences in a child’s life. The objective of the review was to evaluate the association between maternal mental health and school-age child development, and we hypothesized there would be a negative association. Five databases were searched (Embase, CINAHL, Eric, PsycInfo, Medline). Key journals and reference lists were hand-searched. Two reviewers assessed studies based on inclusion criteria: (1) the exposure was any form of maternal mental health occurring during pregnancy or postpartum periods; (2) the outcome was child development (>48 months to 8 years); (3) the study recruited participants from developed countries; and (4) publication was in English between January, 1990 and December, 2012. Disagreements were resolved by consensus. Study quality was assessed by two reviewers using the Scottish Intercollegiate Guideline Network and disagreements were resolved by consensus. Data extraction was conducted by one reviewer using standardized forms. Maternal mental health problems in pregnancy and/or the postpartum period increased the likelihood that school-age children experienced suboptimal global, behavioral, cognitive, and socio-emotional development. The findings highlight the need for maternal mental health assessment during the prenatal, postnatal, and early childhood periods.     

Interventions for Young Bereaved Children: A Systematic Review and Implications for School Mental Health Providers

Background

Many young children experience the death of a family member and they may be at risk for developing psychological and behavioral problems, but not much is known about how to help young children cope with such a stressful and painful experience.

Objective

The purposes of this study are to identify the interventions for bereaved young children and examine the effectiveness of the interventions.

Methods

A systematic review of the literature was performed to investigate the effects of interventions for preschool-age children (3–5 years) who experience the death of a family member.

Results

Seventeen studies that met the inclusion criteria for the purpose of this review were identified. All of the studies involved a small sample, and majority of the studies mixed preschool children with other older children in the sample. Play-based therapies were the most common interventions for grieving young children. Involving parents in the interventions, regardless of their therapeutic orientation, was a critical ingredient.

Conclusions

Limited empirical evidence of positive intervention outcomes for preschool-age bereaved children was available. Surviving parents were seen as an important agent to help young children grieve and cope with the experience of loss. Implications for school mental health practice and research are provided.

     

Interventions for Improving Population Health Literacy: Insights From a Rapid Review of the Evidence

The promotion of health literacy is critical to active and informed participation in health promotion, disease prevention, and health care. This article reports on a rapid review of the evidence concerning effective strategies for improving health literacy. This review was undertaken as part of a series of evidence reviews commissioned by the European Centre for Disease Prevention and Control through the Translating Health Communications Project. The authors searched a range of electronic databases and identified six evidence reviews published between 2000 and 2011. A narrative synthesis of the findings was then conducted. The majority of the published research originated in the United States, and the studies reviewed mainly focused on functional health literacy interventions that occurred in clinical settings. Considerable gaps in the evidence exist regarding the most effective population-level health literacy interventions, particularly with regard to communicable diseases. There is a paucity of intervention studies conducted on this topic in Europe. Implications of the findings for improving population health literacy on the prevention and control of communicable diseases in Europe are considered.     

Burnout in the Mental Health Workforce: A Review

There are enormous concerns regarding the recruitment, retention, training, and performance of the behavioral health workforce. Paramount among these concerns is turnover, which causes disruption in continuity of care, diminishes access to care while a position remains vacant, and poses financial hardship on the provider organization through costs related to recruitment, orientation, and training of a new hire. There is frequent mention of burnout within the literature and among behavioral health managers as a potential cause of turnover. However, there is no recent or comprehensive review of burnout that examines the evidence surrounding its validity, utility, and potential relationship to turnover. The purpose of this paper is to provide such a review by examining the construct of burnout, methodological and measurement issues, its prevalence in the mental health workforce, correlates of burnout, and interventions to decrease it. The implications for provider organizations and recommendations for future research are identified.     

Scientific Evidence of Interventions Using the Mediterranean Diet: A Systematic Review

The Mediterranean Diet has been associated with greater longevity and quality of life in epidemiological studies, the majority being observational. The application of evidence-based medicine to the area of public health nutrition involves the necessity of developing clinical trials and systematic reviews to develop sound recommendations. The purpose of this study was to analyze and review the experimental studies on Mediterranean diet and disease prevention. A systematic review was made and a total of 43 articles corresponding to 35 different experimental studies were selected. Results were analyzed for the effects of the Mediterranean diet on lipoproteins, endothelial resistance, diabetes and antioxidative capacity, cardiovascular diseases, arthritis, cancer, body composition, and psychological function. The Mediterranean diet showed favorable effects on lipoprotein levels, endothelium vasodilatation, insulin resistance, metabolic syndrome, antioxidant capacity, myocardial and cardiovascular mortality, and cancer incidence in obese patients and in those with previous myocardial infarction. Results disclose the mechanisms of the Mediterranean diet in disease prevention, particularly in cardiovascular disease secondary prevention, but also emphasize the need to undertake experimental research and systematic reviews in the areas of primary prevention of cardiovascular disease, hypertension, diabetes, obesity, infectious diseases, age-related cognitive impairment, and cancer, among others. Interventions should use food scores or patterns to ascertain adherence to the Mediterranean diet. Further experimental research is needed to corroborate the benefits of the Mediterranean diet and the underlying mechanisms, and in this sense the methodology of the ongoing PREDIMED study is explained.     

肥胖儿童心理状况及健康干预研究

目的了解肥胖对儿童心理健康的危害，为建立有效的健康教育及健康促进模式提供科学依据。方法随机抽取贵阳市3所（好、中、差各1所）学校肥胖儿童106名与相应对照组儿童进行心理指标检测，并对肥胖儿童进行为期1a的健康干预，干预措施包括饮食结构调整、生活方式改善、体能训练指导、及时心理指导等。结果重度肥胖女孩智力水平低于对照组。人格测定肥胖儿童P分高于对照组，E分低于对照组。行为问题测定女生肥胖组总分高于对照组；男生以多动、攻击性因子得分高于对照组；女生违纪因子分低于对照组，分裂样，强迫性因子高于对照组：干预前后除人格测定E分提高外，其余变化不明显。结论单纯性肥胖症导致儿童少年的行为、人格改变，形成了内向、多疑、易激惹、攻击性强等特征，重度肥胖儿童更为明显。干预前后各项心理指标改善不明显。     

What Works to Prevent Child Marriage: A Review of the Evidence

This article reviews 23 child marriage prevention programs carried out in low‐income countries and employing a range of programmatic approaches and evaluation strategies. We document the types of child marriage programs that have been implemented, assess how they have been evaluated, describe the main limitations of these evaluations, summarize the evaluation results, and make recommendations to improve future prevention efforts. The evidence suggests that programs offering incentives and attempting to empower girls can be effective in preventing child marriage and can foster change relatively quickly. Methodological limitations of the reviewed studies, however, underscore that more needs to be learned about how the programs prevent child marriage and whether impact is sustained beyond program implementation.     

Putting Mental Health on the Agenda for HIV+ Women: A Review of Evidence from Sub-Saharan Africa

This article reviews the scientific literature regarding mental health services for poor HIV-infected women in sub-Saharan Africa and argues that they should constitute part of the healthcare agenda for these women. Key evidence points to the growing feminization of the HIV epidemic, as well as the differential social and economic impact of HIV on women. Further, HIV and poverty, both disproportionately affecting women, contribute independently and cumulatively to the risk for poor mental health. The limited empirical evidence regarding the mental health of this population is discussed. Multi-level psychosocial services, integrated within general health provision, are required to ensure long-term psychological benefits for HIV-infected women in the region.     

A Review of: “Occupational Therapy Evidence in Practice for Mental Health (2006)”

ABSTRACT

Stigmatizing attitudes can undermine the quality of health care. This study examines the attitudes and beliefs of 189 occupational therapy students toward clients who are obese. Results indicate that the occupational therapy students were more likely to make negative evaluations of clients who were obese. The univariate between-subjects analysis of the Attitudes Toward Obesity—Prejudicial Evaluation and Social Interaction Scale scores found that the difference between the means for overweight and average-weight clients for Social Distance and Judgment were statistically significant (t₍₁₈₇₎ = 2.06, p = .04; t₍₁₈₇₎ = ?2.008, p = .04). There was also a statistically significant difference between the Social Distance score means for female and male clients (t₍₁₈₇₎ = ?2.12, p = .03). The explicit measures, the Attitudes Toward Obese Persons and the Beliefs About Obese Persons scores, showed that many students in the sample had stereotypical beliefs and, to a lesser extent, had negative attitudes about obesity. These results add support to the inclusion in occupational therapy curricula content that specifically addresses the awareness of stigmatizing stereotypes and attitudes toward clients who are obese.     

Culturally Sensitive Interventions and Health and Behavioral Health Youth Outcomes: A Meta-Analytic Review

Despite Census Bureau projections that youth from minority cultures will comprise the majority of the nation's youth in approximately a decade, little research has been conducted on culturally sensitive interventions (CSIs). Accordingly, this study sought to determine: (1) the effectiveness of CSIs designed to address health and behavioral health outcomes, (2) whether effectiveness varies depending on the class or type of outcome, and (3) whether race/ethnicity moderates effectiveness. The results suggest that CSIs (n = 21) are modestly effective (Hedges' g = .239, 95% C.I. = .139 to .339, p < .001). Effectiveness did not vary significantly by outcome class or by race/ethnicity. Especially in the latter case, however, the pattern of point estimates raises the possibility of moderation with an increase in power. Suggestions for future research conclude the article.     

Transforming the Mental Health Field: The Early History of the National Association for Mental Health

The paper begins by noting the absence of any sustained analysis of post-war mental health pressure groups and movements. This is deemed problematic because such movements and groups have had a strong presence during this period and because movements, as such, are afforded a central role in much contemporary sociology on account of their role in the process of social change. Next the paper considers how such analysis should be conducted, and suggests a three-phase model for periodising the activity of the groups and movements of the post-war era. The largest part of the paper is then devoted to an examination of one particular aspect of the first phase: the birth of the National Association For Mental Health and their activities in their first ten years of life. Much can be learned from the study of this group.