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1.
Background
Collaborative pediatric mental health and primary care is increasingly recognized as optimal for meeting the needs of children with mental health problems. This paper describes the challenges faced by freestanding specialty mental health clinics and pediatric health practices to provide such coordinated mind-and-body treatment. It describes critical elements of a proactive approach to achieving collaborative pediatric care under real-world circumstances using the patient-centered medical home neighborhood (PCMH-N) model.Objective
The current study evaluates the field test of the practitioner-informed model to facilitate interdisciplinary collaboration (PIM-FIC), a systematic approach to improving inter-professional collaboration by building relationships and enhancing communication between pediatric mental health and primary care practices.Methods
Thirty-nine providers at two mental health and two pediatric primary care practices participated in a pilot project and completed surveys prior to and following their participation. Key informant interviews were also conducted prior to the project.Results
Participating practitioners’ survey and interview responses indicate that the quantity and quality of communication between pediatric mental and medical health care providers increased post-project, as did satisfaction with overall collaboration.Conclusions
Improving relationships and communication are first steps in building the infrastructure to support effective coordinated care. Project results highlight practical and easily implemented strategies that pediatric mental health and primary care practices can take to strengthen their collaboration. Findings also suggest a need for collaborative care policies and competencies for child mental health providers working in freestanding practices within the PCMH-N.2.
Lisanne Warmerdam Marko Barendregt Edwin de Beurs 《Zeitschrift fur Gesundheitswissenschaften》2017,25(3):311-319
Aim
A meaningful comparison of clinical outcomes of mental health care providers requires risk adjustment of case mix variables that affect treatment outcome. The first goal of the present study was to describe the risk adjustment method we applied to routine outcome monitoring data in The Netherlands. Second, the consequences of risk adjustment for the ranking of providers were investigated.Subject and methods
Using an observational study design, pre- and posttest self-report assessments of symptoms were obtained for 31,849 adults with common mental health problems, such as mood and anxiety disorders. Regression analyses were performed to predict the posttest symptom level using socio-demographics and clinical characteristics as predictors.Results
Results showed that the posttest level of symptoms was best predicted by the symptom level at baseline, followed by the baseline level of functioning, age, socioeconomic status and some diagnoses. For the majority of the providers, risk adjustment did not markedly change their ranking.Conclusion
The baseline level of symptoms is the best predictor of the posttest level. The other investigated case mix variables only have a modest influence on the performance of providers. Risk adjustment is particularly necessary when consequences are related to the performance of an individual provider. These results contribute to the limited literature on risk adjustment in mental health care by using a large national data set.3.
Background
The nursing sector is characterized by high sick leave and fluctuation rates due to work-related stress. There is a need to raise manager’s awareness in the care sector for goal-oriented operational health management.Objectives
Is a serious game a suitable instrument to change nursing care managers’ behaviors and attitudes and increase their knowledge regarding prevention and health promoting management behavior?Materials and methods
Preliminary investigation into the stress of care providers, evaluation of the initial situation in nursing care services, conception of a serious game including training concept, testing and evaluation in the field.Results
In most companies health promotion is not perceived as important (74%); thus, it is expected that “Serious Games for Health” (SGH) will be an effective and suitable instrument to train managers regarding preventive and health promoting management behavior.Conclusions
Operational health management should be anchored as a management task in the nursing care sector. The innovative educational concept “Stress-Rekord” can counteract multifactorial stress in the workplace.4.
Background
In the context of a generalized epidemic and criminalization of homosexuality, men who have sex with men (MSM) in Malawi have a disproportionate burden of HIV compared to other adults. Past research has documented low uptake of HIV prevention and health services among MSM, self-reported fear of seeking health services, and concerns of disclosure of sexual orientation and discrimination in health settings. Qualitative research was conducted among MSM and health service providers in Blantyre, Malawi to understand underlying factors related to disclosure and health seeking behaviors and inform the development of a community-based comprehensive HIV prevention intervention.Methods
Using peer recruitment, eight MSM participants representing a range of ages, orientations, and social and behavioral characteristics were enrolled for in-depth interviews. Five service providers were recruited from the district hospital, local health and STI clinics, and a HIV prevention service organization. We use the Health Belief Model as a framework to interpret the influential factors on 1) health seeking and uptake among MSM, and 2) influences on provision of services by healthcare providers for MSM.Results
Results highlight disclosure fears among MSM and, among providers, a lack of awareness and self-efficacy to provide care in the face of limited information and political support. Service providers reported concerns of adverse repercussions related to the provision of services to men in same sex sexual relationships. Some MSM demonstrated awareness of HIV risk but believed that within the wider MSM community, there was a general lack of HIV information for MSM, low awareness of appropriate prevention, and low perception of risks related to HIV infection.Conclusions
Qualitative research highlights the need for appropriate information on both HIV risks and acceptable, effective HIV prevention options for MSM. Information and educational opportunities should be available to the wider MSM community and the health sector. Health sector interventions may serve to increase cultural and clinical competency to address health problems experienced by MSM. To ensure availability and use of services in light of the criminalization and stigmatization of same sex practices, there is need to increase the safety of uptake and provision of these services for MSM.5.
Background
Suicide is a leading cause of death among youth. Suicide screening programs aim to identify mental health issues and prevent death by suicide.Objective
The present study evaluated outcomes of a multi-stage screening program implemented over 3 school years in a moderately-sized Midwestern high school.Methods
One hundred ninety-three 9th-grade students were screened in the program. Students who screened positive were referred to mental health services and followed. Suicide-related thoughts and behaviors among 9th-grade students in the school with screening were compared to those of students in a similar school without screening.Results
There was a significant increase in utilization of mental health services among students who screened positive and a decrease in rates of suicidal ideation and attempts among 9th-grade students at the school with screening.Conclusions
This multi-stage screening program shows promise in addressing suicide-related behaviors in schools. Randomized trials are needed to confirm program efficacy.6.
Jerry Ngwena Zaid Hosany Irrah Sibindi 《Zeitschrift fur Gesundheitswissenschaften》2017,25(2):123-134
Background
Suicide is a national and global phenomenon with its rate increasing every year inspite of clinicians, policy makers and researchers grappling with suicide prevention and investing heavily in risk assessment, prevention and reduction. There seems to be a gap in the understanding of suicide and its associated behaviours.Aim
The aim of this review was to undertake a concept analysis of suicide and behaviour.Method
The Walker and Avant eight-step method was adopted. Search engines including Academic Search Elite, CINAHL, Ovid Online embracing Embase and Ovid Medline were utilised to access articles published in the last 10 years, written in English, with abstracts and full text.Results
The concept of suicide require understanding of implicity and explicity of suicidal intent and how these relate to suicide behaviour. Areas of risk assessment such as thwarted belongingness and perceived burdensomeness should be considered. Associated with suicide are internal and external hazards, which tend to create vulnerability leading to suicidal behaviour. Clinicians should differentiate between suicide in the presence of mental illness and when there is a predicament. Risk assessment tools should not be taken as absolute as they do not provide 100 % detection of intent.Conclusion
Understanding the concept of suicide would help clinicians comprehend their patients and suicidal behaviour and improve intervention methods.7.
Adverse Childhood Experiences,Coping Resources,and Mental Health Problems among Court-Involved Youth
Patricia Logan-Greene Robert L. Tennyson Paula S. Nurius Sharon Borja 《Child & youth care forum》2017,46(6):923-946
Background
Mental health problems are gaining attention among court-involved youth with emphasis on the role of childhood adversity, but assessment lags.Objective
The present study uses a commonly delivered assessment tool to examine mental health problems (current mental health problem, mental health interfered with probation goals, and suicide ideation) as a function of an expanded set of adverse childhood experiences (ACEs; childhood maltreatment, family dysfunction, and social disadvantage). Adaptive coping resources–impulse control, aspirations, and social support–were tested as both direct contributors and moderators of the influence of ACEs on mental health.Methods
Using a diverse sample of youth on probation (N = 5378), this study utilized logistic regression models to test contributions of the three domains of childhood adversity–childhood maltreatment, family dysfunction, and social disadvantage. These models also examined the moderating roles of coping resources.Results
Childhood maltreatment emerged as the strongest contributor to mental health problems, with significant moderation from social support. Youth aspirations were inversely related to mental health problems and moderated the relation with ACEs and mental health problems that interfered with probation.Conclusions
Assessment and mitigation of the detrimental effects of childhood maltreatment are important considerations in the intervention programs that target mental health outcomes of court-involved youth. Intervention programs to prevent recidivism and improve mental health should improve impulse control and aspirations.8.
Aim
The main aim of this study was to assess the psychological consequences that displacement brings into the lives of India’s tribal populations, specifically, in the form of mental illness.Subject and methods
Literature review.Results
The impact of forced displacement on the mental state of tribal populations is significant and multi-faceted. In spite of sufficient evidence indicating the extent of mental health challenges, the Governmental response in India has been completely missing. Some of the challenges in the path of Indian health providers are poor diagnostic facilities, lack of psychiatric epidemiological data for tribal populations, and culturally inappropriate instruments. Scientists and practitioners can play an important role in bridging the knowledge gap in the field.Conclusion
It is necessary to perceive the mental health status of displaced tribal populations within the larger framework of social justice. A strictly biomedical approach is insufficient when the individuals seeking help are under constant stress. Thus, a mental health program is needed for tribal people that offers a perspective broad enough to address the needs of individuals and the local worlds in which they live.9.
Jason Bantjes Leslie Swartz Pieter Niewoudt 《BMC international health and human rights》2017,17(1):29
Background
During the era of apartheid in South Africa, a number of mental health professionals were vocal about the need for socio-economic and political reform. They described the deleterious psychological and social impact of the oppressive and discriminatory Nationalist state policies. However, they remained optimistic that democracy would usher in positive changes. In this article, we consider how mental health professionals working in post-apartheid South Africa experience their work.Methods
Our aim was to describe the experience of mental health professionals working in prisons who provide care to suicidal prisoners. Data were collected from in-depth semi-structured interviews and were analyzed using thematic content analysis.Results
Findings draw attention to the challenges mental health professionals in post-apartheid South Africa face when attempting to provide psychological care in settings where resources are scarce and where the environment is anti-therapeutic. Findings highlight the significant gap between current policies, which protect prisoners’ human rights, and every-day practices within prisons.Conclusions
The findings imply that there is still an urgent need for activism in South Africa, particularly in the context of providing mental health care services in settings which are anti-therapeutic and inadequately resourced, such as prisons.10.
Background
Maternal mental health care is a neglected area in low and middle income countries (LAMIC) such as South Africa, where maternal and child health care priorities are focused on reducing maternal and infant mortality and promoting infant physical health. In the context of a paucity of mental health specialists, the aim of this study was to understand the explanatory models of illness held by women with maternal depression with the view to informing the development of an appropriate counselling intervention using a task sharing approach.Methods
Twenty semi-structured qualitative interviews were conducted with mothers from a poor socio-economic area who were diagnosed with depression at the time of attending a primary health care facility. Follow-up interviews were conducted with 10 participants in their homes.Results
Dimensions of poverty, particularly food and financial insecurity and insecure accommodation; unwanted pregnancy; and interpersonal conflict, particularly partner rejection, infidelity and general lack of support were reported as the causes of depression. Exacerbating factors included negative thoughts and social isolation. Respondents embraced the notion of task sharing, indicating that counselling provided by general health care providers either individually or in groups could be helpful.Conclusion
Counselling interventions drawing on techniques from cognitive behavioural therapy and problem solving therapy within a task sharing approach are recommended to build self-efficacy to address their material conditions and relationship problems in poorly resourced primary health care facilities in South Africa.11.
12.
13.
Background
The epidemiology of obesity in primary care populations has not been thoroughly explored. This study contributes to filling this gap by investigating the relationship between obesity and different sources of personal stress, mental health, exercise, and demographic characteristics.Methods
A cross-sectional survey using a convenience sample. Five hundred women who attended family planning clinics were surveyed and 274 provided completed answers to all of the questions analyzed in this study. Exercise, self-rated mental health, stress, social support, and demographic variables were included in the survey. Multiple logistic regression analysis was performed.Results
After adjusting for mental health, exercise, and demographic characteristics of subjects, analysis of the data indicated that that being having a large family and receiving no support from parents were related to obesity in this relatively young low-income primary care sample, but self-reported stress and most types of social support were not significant.Conclusion
Obesity control programs in primary care centers directed at low-income women should target women who have large families and who are not receiving support from their parents.14.
Dirk Lehr Elena Heber Bernhard Sieland Andreas Hillert Burkhardt Funk David Daniel Ebert 《Pr?vention und Gesundheitsf?rderung》2016,11(3):182-192
Background
Occupational eMental Health covers a wide variety of interventions using the potential of information and communication technology for the purpose of prevention and health promotion in employees. Based on extensive research in psychotherapy, internet-based interventions are increasingly being developed for chronically stressed employees.Objectives
To review the evidence on the efficacy of internet-based interventions for the promotion of mental health in teachers.Methods
A systematic literature search and meta-analysis on randomized controlled trials were conducted.Results
A total of 4155 abstracts were screened and four were included in the meta-analysis. Internet-based interventions led to a reduction in depressive symptoms (d = 0.68), improved quality of sleep (d = 1.03), reduced perseverative thinking in terms of improved mental detachment (d = 0.76), and reduced worrying (d = 0.60) compared with nonactive control groups. After 6 months, the effects for depression (d = 0.75), insomnia (d = 0.96), mental detachment (d = 0.83), and worrying (d = 0.63) remained stable. The effects for absenteeism were d = 0.18 (4.9 days) and for presenteeism d = 0.15 (4.3 days).Conclusion
Internet-based interventions are an effective and sustainable method for mental health preservation in teachers. They have the potential to reach target groups that have not been reached before by established interventions. The effects are similar to those observed for established interventions. More evidence from replication studies is needed, especially in the area of universal prevention and routine care.15.
Anita L. Hansen G. Ambroziak D. Thornton L. Dahl B. Grung 《The journal of nutrition, health & aging》2018,22(4):513-518
Objectives
To investigate the effect of a long-term fatty fish intervention on a pure cognitive mechanism important for self-regulation and mental health, i.e. working memory (WM), controlling for age and IQ.Design
A randomized controlled trial.Setting
A forensic facility.Participants
Eighty-four young to middle aged male forensic inpatients with psychiatric disorders.Intervention
Consumption of farmed salmon or control meal (meat) three times a week during 23 weeks.Measurement
Performance on WM tasks, both accuracy and mean reaction time, were recorded pre and post intervention.Results
Performance on a cognitive functioning tasks taxing WM seemed to be explained by age and IQ.Conclusion
Fatty fish consumption did not improve WM performance in a group of young to middle aged adults with mental health problems, as less impressionable factors such as aging and intelligence seemed to be the key components. The present study improves the knowledge concerning the interaction among nutrition, health and the aging process.16.
17.
Christina Dahl 《Pr?vention und Gesundheitsf?rderung》2018,13(2):131-137
Background
Changes in our working environment result in increased mental demands and make it necessary to consider ways to prevent negative consequences such as stress and burnout.Objectives
The aim of this paper is to discuss the preventive benefit of self-care regarding increased mental demands in current working environments.Materials and methods
Initially, current changes in the working environment and their possible consequences for health are depicted. The idea of “self-care” is presented. In order to illustrate the benefit of self-care, a study is presented that deals with the promotion of self-care in social workers.Results
The findings suggest that the practice of self-care seems to have a preventive effect. Self-care helps to prevent work-related strain and to promote mental health. The analyses revealed a reduction of perceived stress and exhaustion among social workers, after attending a self-care seminar. Varied positive changes reported by the participants concerning their self-care, their experience of stress and their well-being, strengthen the results.Conclusions
The present findings lead to a plea for more self-care. The appeal for more responsibility of the individual does not exempt employers from their responsibility to create healthy working conditions. But—when it comes to our health and well-being—primarily the individual should take care of him-/herself.18.
19.
Background
Hospitalisation of acutely ill nursing home residents is associated with health risks such as infections, complications, or falls, and results in high costs for the health care system. Taking the case of pneumonia, nursing homes generally can ensure care according to guidelines.Aim
Extrapolation of overall expenditures for the German statutory health insurance system from the hospitalisation of nursing home residents with respiratory infection/pneumonia; developing alternative cost scenarios to compare nursing home care with hospital care in consideration of patients’ condition.Methods
Data provided by health insurance funds were extrapolated to the German statutory health insurance system and weighted via German-DRG case values. Care processes (hospital vs. nursing home) were modelled, and treatment steps were divided into cost categories. The patient’s condition was standardised via the Barthel Index.Results
Total expenditures of € 163.3 million were incurred for inpatient care of nursing home residents transferred to hospitals for respiratory infection/pneumonia in 2013 in Germany. Process modelling reveals lower direct costs for nursing home care as well as better development of patients’ condition. Looking at operators of nursing homes, both care scenarios necessitate additional services without reimbursement.Conclusion
Expenditure projections for the hospital care of nursing home residents with pneumonia reveal high saving potential. Avoidance of hospital admission serves to considerably reduce the insurers’ expenditures but also the duration and severity of illness. The study illustrates economic incentive structures for health care providers and indicates courses of action for health policy and nursing homes operators.20.
Aideen Maguire John Moriarty Dermot O’Reilly Mark McCann 《Quality of life research》2017,26(5):1251-1262