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Mental Health Care

A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601).

Deadline for manuscript submissions: closed (30 June 2014) | Viewed by 148823

Special Issue Editors

Prof. Dr. Luis Salvador-Carulla

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Guest Editor
Centre for Disability Research and Policy Faculty of Health Sciences The University of Sydney 75 East Street, Lidcombe, NSW 2141, Australia
Prof. Alan Rosen

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Guest Editor
Brain and Mind Research Institute Sydney Medical School The University of Sydney PO Box 110 Balmain 2041, Australia
Dr. Ana Fernandez Sanchez

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Guest Editor
Postdoctoral Research Associate Centre for Disability Research and Policy Faculty of Health Sciences T313 Cumberland Campus The University of Sydney 75 East Street, Lidcombe, NSW 2141, Australia
Interests: prevention of mental disorders and promotion of mental health; mental health economics; knowledge transfer; development of support decision systems in mental health

Special Issue Information

Dear Colleagues,

The WHO Comprehensive Mental Health Action Plan 2013-2020 acknowledges that the global burden and costs  of mental disorders continues to grow and calls for a comprehensive, coordinated response from health and social sectors in all countries that address the promotion of mental health, prevention of mental disorders, early identification, care, support, treatment and recovery of persons with mental disorders. The Mental Health Atlas 2011 provided data on the gap between the need for treatment and its provision around the world. The percentage of people with severe mental illness who do not receive treatment ranged between 35-50% in high income countries and 76-85% in the rest of the world. On the other hand the progressive shift of health care to chronic care models, and community care systems has moved mental health from the margins of healthcare to become a paradigm of complex integrated care in the XXIst Century.

In the 1960’s and 1970’s mental health heralded community care, case management and coordination of social and medical care but these advances and their challenges  never reached general healthcare and where re-discovered decades later in other areas of medicine.  The new advances in the design, implementation,  analysis  and planning of mental health services and mental health systems which are taking  place around the world may have a major impact in transforming our understanding of health care provision.  Relevant contributors to this change include the new models of community care, the recovery movement and peer-support services, the introduction of individual budgets, person-centered health, patient reported outcomes and early intervention as well as the development of new indicator sets, assessment tools, and techniques of analysis. In this context mental health care is again at the cross-road debating between integration in the main stream of health care or following its own pace.

This special issue has a focus on the mental health gap and its consequences, the  recent advances in mental health care research and implementation, and their impact in other areas of health.  Papers addressing any issues relevant to novel services, programmes, planning,  policies and care models are invited and especially those addressing strategies to assess and monitor mental health systems in the context of person-centered integrated care and complexity and on the knowledge transfer between mental health and other areas of health and social care.

Prof. Dr. Luis Salvador-Carulla
Prof. Dr. Alan Rosen
Dr. Ana Fernandez
Guest Editors

Submission

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. Papers will be published continuously (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are refereed through a peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed Open Access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 1400 CHF (Swiss Francs).

Keywords

  • new models in mental health care
  • mental health indicators
  • mental health services
  • mental health systems
  • mental health economics and financing
  • mental health policy
  • mental health care gap and needs
  • balance of care
  • community mental healthcare
  • psychiatric rehabilitation and disability
  • person-centered integrated care in MH
  • recovery and mental health support
  • shared contracts and empowerment
  • early intervention in MH trauma informed care
  • primary mental health care
  • bridging and knowledge transfer between mental health and other fields

Published Papers (16 papers)

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Research

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712 KiB  
Article
Developing a Service Platform Definition to Promote Evidence-Based Planning and Funding of the Mental Health Service System
by Yong Yi Lee, Carla S. Meurk, Meredith G. Harris, Sandra Diminic, Roman W. Scheurer and Harvey A. Whiteford
Int. J. Environ. Res. Public Health 2014, 11(12), 12261-12282; https://doi.org/10.3390/ijerph111212261 - 26 Nov 2014
Cited by 3 | Viewed by 6057
Abstract
Ensuring that a mental health system provides ‘value for money’ requires policy makers to allocate resources to the most cost-effective interventions. Organizing cost-effective interventions into a service delivery framework will require a concept that can guide the mapping of evidence regarding disorder-level interventions [...] Read more.
Ensuring that a mental health system provides ‘value for money’ requires policy makers to allocate resources to the most cost-effective interventions. Organizing cost-effective interventions into a service delivery framework will require a concept that can guide the mapping of evidence regarding disorder-level interventions to aggregations of services that are meaningful for policy makers. The ‘service platform’ is an emerging concept that could be used to this end, however no explicit definition currently exists in the literature. The aim of this study was to develop a service platform definition that is consistent with how policy makers conceptualize the major elements of the mental health service system and to test the validity and utility of this definition through consultation with mental health policy makers. We derived a provisional definition informed by existing literature and consultation with experienced mental health researchers. Using a modified Delphi method, we obtained feedback from nine Australian policy makers. Respondents provided written answers to a questionnaire eliciting their views on the acceptability, comprehensibility and usefulness of a service platform definition which was subject to qualitative analysis. Overall, respondents understood the definition and found it both acceptable and useful, subject to certain conditions. They also provided suggestions for its improvement. Our findings suggest that the service platform concept could be a useful way of aggregating mental health services as a means for presenting priority setting evidence to policy makers in mental health. However, further development and testing of the concept is required. Full article
(This article belongs to the Special Issue Mental Health Care)
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728 KiB  
Article
Horizon 2020 Priorities in Clinical Mental Health Research: Results of a Consensus-Based ROAMER Expert Survey
by Iman Elfeddali, Christina M. Van der Feltz-Cornelis, Jim Van Os, Susanne Knappe, Eduard Vieta, Hans-Ulrich Wittchen, Carla Obradors-Tarragó and Josep Maria Haro
Int. J. Environ. Res. Public Health 2014, 11(10), 10915-10939; https://doi.org/10.3390/ijerph111010915 - 21 Oct 2014
Cited by 22 | Viewed by 7264
Abstract
Within the ROAMER project, which aims to provide a Roadmap for Mental Health Research in Europe, a two-stage Delphi survey among 86 European experts was conducted in order to identify research priorities in clinical mental health research. Expert consensus existed with regard to [...] Read more.
Within the ROAMER project, which aims to provide a Roadmap for Mental Health Research in Europe, a two-stage Delphi survey among 86 European experts was conducted in order to identify research priorities in clinical mental health research. Expert consensus existed with regard to the importance of three challenges in the field of clinical mental health research: (1) the development of new, safe and effective interventions for mental disorders; (2) understanding the mechanisms of disease in order to be able to develop such new interventions; and (3) defining outcomes (an improved set of outcomes, including alternative outcomes) to use for clinical mental health research evaluation. Proposed actions involved increasing the utilization of tailored approaches (personalized medicine), developing blended eHealth/mHealth decision aids/guidance tools that help the clinician to choose between various treatment modalities, developing specific treatments in order to better target comorbidity and (further) development of biological, psychological and psychopharmacological interventions. The experts indicated that addressing these priorities will result in increased efficacy and impact across Europe; with a high probability of success, given that Europe has important strengths, such as skilled academics and a long research history. Finally, the experts stressed the importance of creating funding and coordinated networking as essential action needed in order to target the variety of challenges in clinical mental health research. Full article
(This article belongs to the Special Issue Mental Health Care)
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688 KiB  
Article
Staying the Course? Challenges in Implementing Evidence-Based Programs in Community Mental Health Services
by Urban Markström
Int. J. Environ. Res. Public Health 2014, 11(10), 10752-10769; https://doi.org/10.3390/ijerph111010752 - 16 Oct 2014
Cited by 13 | Viewed by 5630
Abstract
This paper focuses on the second phase of the deinstitutionalisation of mental health care in which the development of community-based interventions are supposed to be implemented in local community mental health care systems. The challenge to sustainable implementation is illustrated by the Swedish [...] Read more.
This paper focuses on the second phase of the deinstitutionalisation of mental health care in which the development of community-based interventions are supposed to be implemented in local community mental health care systems. The challenge to sustainable implementation is illustrated by the Swedish case where the government put forward a national training program that sought to introduce Assertive Community Treatment (ACT) for people with severe mental illness. This study is based on document analysis and qualitative interviews with actors at the national, regional, and local levels covering a total of five regions and 15 municipalities that participated in the program. The analysis of the national experiences is put in relation to both research on public administration and policy analysis as well as to current research on implementation of evidence-based programs. The results showed a “drift” of the original model, which had already begun at the policy formulation stage and ended up in a large number of different local arrangements where only a few of the original components of ACT remained. We conclude that issues with implementation can only be fully understood by considering factors at different analytical levels. Full article
(This article belongs to the Special Issue Mental Health Care)
756 KiB  
Article
Predictors of Healthcare Service Utilization for Mental Health Reasons
by Marie-Josée Fleury, André Ngamini Ngui, Jean-Marie Bamvita, Guy Grenier and Jean Caron
Int. J. Environ. Res. Public Health 2014, 11(10), 10559-10586; https://doi.org/10.3390/ijerph111010559 - 15 Oct 2014
Cited by 74 | Viewed by 9659
Abstract
This study was designed to identify: (1) predictors of 12-month healthcare service utilization for mental health reasons, framed by the Andersen model, among a population cohort in an epidemiological catchment area; and (2) correlates associated with healthcare service utilization for mental health reasons [...] Read more.
This study was designed to identify: (1) predictors of 12-month healthcare service utilization for mental health reasons, framed by the Andersen model, among a population cohort in an epidemiological catchment area; and (2) correlates associated with healthcare service utilization for mental health reasons among individuals with and without mental disorders respectively. Analyses comprised univariate, bivariate, and multiple regression analyses. Being male, having poor quality of life, possessing better self-perception of physical health, and suffering from major depressive episodes, panic disorder, social phobia, and emotional problems predicted healthcare service utilization for mental health reasons. Among individuals with mental disorders, needs factors (psychological distress, impulsiveness, emotional problems, victim of violence, and aggressive behavior) and visits to healthcare professionals were associated with healthcare service utilization for mental health reasons. Among individuals without mental disorders, healthcare service utilization for mental health reasons is strongly associated with enabling factors such as social support, income, environmental variables, and self-perception of the neighborhood. Interventions facilitating social cohesion and social solidarity in neighborhood settings may reduce the need to seek help among individuals without mental disorders. Furthermore, in their capacity as frontline professionals, general practitioners should be more sensitive in preventing, detecting, and treating mental disorders in routine primary care. Full article
(This article belongs to the Special Issue Mental Health Care)
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577 KiB  
Article
Does Primary Care Mental Health Resourcing Affect the Use and Costs of Secondary Psychiatric Services?
by Minna Sadeniemi, Sami Pirkola, Maiju Pankakoski, Grigori Joffe, Raija Kontio, Maili Malin, Taina Ala-Nikkola and Kristian Wahlbeck
Int. J. Environ. Res. Public Health 2014, 11(9), 8743-8754; https://doi.org/10.3390/ijerph110908743 - 26 Aug 2014
Cited by 13 | Viewed by 6228
Abstract
Collaborative care models for treatment of depression and anxiety disorders in primary care have been shown to be effective. The aim of this study was to investigate at the municipal level to what extent investment in mental health personnel at primary care health [...] Read more.
Collaborative care models for treatment of depression and anxiety disorders in primary care have been shown to be effective. The aim of this study was to investigate at the municipal level to what extent investment in mental health personnel at primary care health centres in the study area is reflected in the costs and use of secondary psychiatric services. Furthermore, we analysed whether the service provision and use of secondary psychiatric care correlates with the socioeconomic indicators of need. We found significant variation in the amount of mental health personnel provided at the health centres, uncorrelated with the indicators of need nor with the costs of secondary psychiatric care. The amount of mental health nurses at the health centres correlated inversely with the number of secondary psychiatric outpatient visits, whereas its relation to inpatient days and admission was positive. The costs of secondary psychiatric care correlated with level of psychiatric morbidity and socioeconomic indicators of need. The results suggest that when aiming at equal access of care and cost-efficiency, the primary and secondary care should be organized and planned with integrative collaboration. Full article
(This article belongs to the Special Issue Mental Health Care)
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779 KiB  
Article
Size Matters — Determinants of Modern, Community-Oriented Mental Health Services
by Taina Ala-Nikkola, Sami Pirkola, Raija Kontio, Grigori Joffe, Maiju Pankakoski, Maili Malin, Minna Sadeniemi, Minna Kaila and Kristian Wahlbeck
Int. J. Environ. Res. Public Health 2014, 11(8), 8456-8474; https://doi.org/10.3390/ijerph110808456 - 19 Aug 2014
Cited by 17 | Viewed by 6721
Abstract
Governances, structures and contents of mental health services are being reformed across countries. There is a need for data to support those changes. The aim of this study was to explore the quality, i.e., diversity and community orientation, and quantity, i.e., [...] Read more.
Governances, structures and contents of mental health services are being reformed across countries. There is a need for data to support those changes. The aim of this study was to explore the quality, i.e., diversity and community orientation, and quantity, i.e., personnel resources, of mental health and substance abuse services (MHS) and evaluate correlation between population needs and quality and quantity of MHS. The European Service Mapping Schedule—Revised (ESMS-R) was used to classify mental health and substance abuse services in southern Finland. Municipal-level aggregate data, local data on unemployment rate, length of education, age of retirement, proportion of single households, alcohol sales and a composite mental health index were used as indicators of population mental health needs. Population size correlated strongly with service diversity, explaining 84% of the variance. Personnel resources did not associate with diversity or community orientation. The indicators of mental health services need did not have the expected association with quality and quantity of services. In terms of service organization, the results may support larger population bases, at least 150,000 adult inhabitants, when aiming for higher diversity. Full article
(This article belongs to the Special Issue Mental Health Care)
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432 KiB  
Article
Assessing Program Efficiency: A Time and Motion Study of the Mental Health Emergency Care — Rural Access Program in NSW Australia
by Emily Saurman, David Lyle, Sue Kirby and Russell Roberts
Int. J. Environ. Res. Public Health 2014, 11(8), 7678-7689; https://doi.org/10.3390/ijerph110807678 - 31 Jul 2014
Cited by 19 | Viewed by 8795
Abstract
The Mental Health Emergency Care-Rural Access Program (MHEC-RAP) is a telehealth solution providing specialist emergency mental health care to rural and remote communities across western NSW, Australia. This is the first time and motion (T&M) study to examine program efficiency and capacity for [...] Read more.
The Mental Health Emergency Care-Rural Access Program (MHEC-RAP) is a telehealth solution providing specialist emergency mental health care to rural and remote communities across western NSW, Australia. This is the first time and motion (T&M) study to examine program efficiency and capacity for a telepsychiatry program. Clinical services are an integral aspect of the program accounting for 6% of all activities and 50% of the time spent conducting program activities, but half of this time is spent completing clinical paperwork. This finding emphasizes the importance of these services to program efficiency and the need to address variability of service provision to impact capacity. Currently, there is no efficiency benchmark for emergency telepsychiatry programs. Findings suggest that MHEC-RAP could increase its activity without affecting program responsiveness. T&M studies not only determine activity and time expenditure, but have a wider application assessing program efficiency by understanding, defining, and calculating capacity. T&M studies can inform future program development of MHEC-RAP and similar telehealth programs, both in Australia and overseas. Full article
(This article belongs to the Special Issue Mental Health Care)
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349 KiB  
Article
Mental and Behavioral Disorders Due to Substance Abuse and Perinatal Outcomes: A Study Based on Linked Population Data in New South Wales, Australia
by Michelle R. Bonello, Fenglian Xu, Zhuoyang Li, Lucy Burns, Marie-Paule Austin and Elizabeth A. Sullivan
Int. J. Environ. Res. Public Health 2014, 11(5), 4991-5005; https://doi.org/10.3390/ijerph110504991 - 08 May 2014
Cited by 14 | Viewed by 9439
Abstract
Background: The effects of mental and behavioral disorders (MBD) due to substance use during peri-conception and pregnancy on perinatal outcomes are unclear. The adverse perinatal outcomes of primiparous mothers admitted to hospital with MBD due to substance use before and/or during pregnancy were [...] Read more.
Background: The effects of mental and behavioral disorders (MBD) due to substance use during peri-conception and pregnancy on perinatal outcomes are unclear. The adverse perinatal outcomes of primiparous mothers admitted to hospital with MBD due to substance use before and/or during pregnancy were investigated. Method: This study linked birth and hospital records in NSW, Australia. Subjects included primiparous mothers admitted to hospital for MBD due to use of alcohol, opioids or cannabinoids during peri-conception and pregnancy. Results: There were 304 primiparous mothers admitted to hospital for MBD due to alcohol use (MBDA), 306 for MBD due to opioids use (MBDO) and 497 for MBD due to cannabinoids (MBDC) between the 12 months peri-conception and the end of pregnancy. Primiparous mothers admitted to hospital for MBDA during pregnancy or during both peri-conception and pregnancy were significantly more likely to give birth to a baby of low birthweight (AOR = 4.03, 95%CI: 1.97–8.24 for pregnancy; AOR = 9.21, 95%CI: 3.76–22.57 both periods); preterm birth (AOR = 3.26, 95% CI: 1.52–6.97 for pregnancy; AOR = 4.06, 95%CI: 1.50–11.01 both periods) and admission to SCN or NICU (AOR = 2.42, 95%CI: 1.31–4.49 for pregnancy; AOR = 4.03, 95%CI: 1.72–9.44 both periods). Primiparous mothers admitted to hospital for MBDO, MBDC or a combined diagnosis were almost three times as likely to give birth to preterm babies compared to mothers without hospital admissions for psychiatric or substance use disorders. Babies whose mothers were admitted to hospital with MBDO before and/or during pregnancy were six times more likely to be admitted to SCN or NICU (AOR = 6.29, 95%CI: 4.62–8.57). Conclusion: Consumption of alcohol, opioids or cannabinoids during peri-conception or pregnancy significantly increased the risk of adverse perinatal outcomes. Full article
(This article belongs to the Special Issue Mental Health Care)
227 KiB  
Article
Lessons from Community Mental Health to Drive Implementation in Health Care Systems for People with Long-Term Conditions
by Michele Tansella, Graham Thornicroft and Heidi Lempp
Int. J. Environ. Res. Public Health 2014, 11(5), 4714-4728; https://doi.org/10.3390/ijerph110504714 - 30 Apr 2014
Cited by 13 | Viewed by 7160
Abstract
This paper aims to identify which lessons learned from the evidence and the experiences accruing from the transformation in mental health services in recent decades may have relevance for the future development of healthcare for people with long-term physical conditions. First, nine principles [...] Read more.
This paper aims to identify which lessons learned from the evidence and the experiences accruing from the transformation in mental health services in recent decades may have relevance for the future development of healthcare for people with long-term physical conditions. First, nine principles are discussed which we first identified to guide mental health service organisation, and all of which can be potentially applied to long term care as well (autonomy, continuity, effectiveness, accessibility, comprehensiveness, equity, accountability, co-ordination, and efficiency). Second, we have outlined innovative operational aspects of service user participation, many of which were first initiated and consolidated in the mental health field, and some of which are now also being implemented in long term care (including case management, and crisis plans). We conclude that long term conditions, whether mental or physical, deserve a long-term commitment from the relevant health services, and indeed where continuity and co-ordination are properly funded implemented, this can ensure that the symptomatic course is more stable, quality of life is enhanced, and the clinical outcomes are more favourable. Innovations such as self-management for long-term conditions (intended to promote autonomy and empowerment) need to be subjected to the same level of rigorous scientific scrutiny as any other treatment or service interventions. Full article
(This article belongs to the Special Issue Mental Health Care)
733 KiB  
Article
Length of Stay for Mental and Behavioural Disorders Postpartum in Primiparous Mothers: A Cohort Study
by Fenglian Xu, Marie-Paule Austin, Nicole Reilly, Lisa Hilder and Elizabeth A Sullivan
Int. J. Environ. Res. Public Health 2014, 11(4), 3540-3552; https://doi.org/10.3390/ijerph110403540 - 27 Mar 2014
Cited by 4 | Viewed by 7753
Abstract
Background: Previous research showed that there was a significant increase in psychiatric hospital admission of postpartum mothers. The aim of the current study is to describe the length of hospital stays and patient days for mental and behavioural disorders (MBD) of new [...] Read more.
Background: Previous research showed that there was a significant increase in psychiatric hospital admission of postpartum mothers. The aim of the current study is to describe the length of hospital stays and patient days for mental and behavioural disorders (MBD) of new mothers in the first year after birth. Method: This was a cohort study based on linked population data between the New South Wales (NSW) Midwives Data Collection (MDC) and the NSW Admitted Patients Data Collection (APDC). The study population included primiparous mothers aged from 18 to 44 who gave birth between 1 July 2000 and 31 December 2005. The Kaplan–Meier method was used to describe the length of hospital stay for MBD. Results: For principal diagnoses of MBD, the entire length of hospital stay in the first year postpartum was 11.38 days (95% CI: 10.70–12.06) for mean and 6 days (95% CI: 5.87–6.13) for median. The length of hospital stay per admission was 8.47 days (95% CI: 8.03–8.90) for mean and 5 days (95% CI: 4.90–5.10) for median. There were 5,129 patient days of hospital stay per year for principal diagnoses of postpartum MBD in new mothers between 1 July 2000 and 31 December 2005 in NSW, Australia. Conclusions: MBD, especially unipolar depressions, adjustment disorders, acute psychotic episodes, and schizophrenia, or schizophrenia-like disorders during the first year after birth, placed a significant burden on hospital services due to long hospital stays and large number of admissions. Full article
(This article belongs to the Special Issue Mental Health Care)
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335 KiB  
Article
Health-Related Quality of Life and Utility Scores in People with Mental Disorders: A Comparison with the Non-Mentally Ill General Population
by Amélie Prigent, Ane Auraaen, Blaise Kamendje-Tchokobou, Isabelle Durand-Zaleski and Karine Chevreul
Int. J. Environ. Res. Public Health 2014, 11(3), 2804-2817; https://doi.org/10.3390/ijerph110302804 - 07 Mar 2014
Cited by 20 | Viewed by 6878
Abstract
There is a lack of comparable health-related quality of life (HRQoL) and utility data across all mental disorders and all inpatient and outpatient settings. Our objective was to investigate the HRQoL and utility scores of people with mental disorders in France, treated in [...] Read more.
There is a lack of comparable health-related quality of life (HRQoL) and utility data across all mental disorders and all inpatient and outpatient settings. Our objective was to investigate the HRQoL and utility scores of people with mental disorders in France, treated in outpatient and inpatient settings, and to identify the HRQoL and utility score losses attributable to mental disorders compared to the non-mentally ill general population. A cross-sectional survey was conducted to assess HRQoL (SF-12) and utility scores of patients with mental disorders and followed in four psychiatric sectors in France. Scores were described by demographic and clinical characteristics and were then adjusted on age and gender and compared with those of the non-mentally ill general population. Median HRQoL and utility scores were significantly lower in patients with mental disorders than in the non-mentally ill general population; median differences amounted to 5.4 for the HRQoL physical score, to 11.8 for the HRQoL mental score and to 0.125 for the utility score. Our findings underscore the negative impact of mental disorders on HRQoL in France and provide a baseline to assess the global impact of current and future organizational changes in the mental health care system. Full article
(This article belongs to the Special Issue Mental Health Care)
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Review

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376 KiB  
Review
New Roles for Pharmacists in Community Mental Health Care: A Narrative Review
by Maria Rubio-Valera, Timothy F. Chen and Claire L. O'Reilly
Int. J. Environ. Res. Public Health 2014, 11(10), 10967-10990; https://doi.org/10.3390/ijerph111010967 - 21 Oct 2014
Cited by 134 | Viewed by 16224
Abstract
Medicines are a major treatment modality for many mental illnesses, and with the growing burden of mental disorders worldwide pharmacists are ideally positioned to play a greater role in supporting people with a mental illness. This narrative review aims to describe the evidence [...] Read more.
Medicines are a major treatment modality for many mental illnesses, and with the growing burden of mental disorders worldwide pharmacists are ideally positioned to play a greater role in supporting people with a mental illness. This narrative review aims to describe the evidence for pharmacist-delivered services in mental health care and address the barriers and facilitators to increasing the uptake of pharmacist services as part of the broader mental health care team. This narrative review is divided into three main sections: (1) the role of the pharmacist in mental health care in multidisciplinary teams and in supporting early detection of mental illness; (2) the pharmacists’ role in supporting quality use of medicines in medication review, strategies to improve medication adherence and antipsychotic polypharmacy, and shared decision making; and (3) barriers and facilitators to the implementation of mental health pharmacy services with a focus on organizational culture and mental health stigma. In the first section, the review presents new roles for pharmacists within multidisciplinary teams, such as in case conferencing or collaborative drug therapy management; and new roles that would benefit from increased pharmacist involvement, such as the early detection of mental health conditions, development of care plans and follow up of people with mental health problems. The second section describes the impact of medication review services and other pharmacist-led interventions designed to reduce inappropriate use of psychotropic medicines and improve medication adherence. Other new potential roles discussed include the management of antipsychotic polypharmacy and involvement in patient-centered care. Finally, barriers related to pharmacists’ attitudes, stigma and skills in the care of patients with mental health problems and barriers affecting pharmacist-physician collaboration are described, along with strategies to reduce mental health stigma. Full article
(This article belongs to the Special Issue Mental Health Care)
235 KiB  
Review
How Should Community Mental Health of Intellectual Disability Services Evolve?
by Colin Hemmings, Nick Bouras and Tom Craig
Int. J. Environ. Res. Public Health 2014, 11(9), 8624-8631; https://doi.org/10.3390/ijerph110908624 - 25 Aug 2014
Cited by 12 | Viewed by 6190
Abstract
Services for people with Intellectual Disability (ID) and coexisting mental health problems remain undeveloped; research into their effectiveness has been lacking. Three linked recent studies in the UK have provided evidence on essential service provision from staff, service users and carers. Interfaces with [...] Read more.
Services for people with Intellectual Disability (ID) and coexisting mental health problems remain undeveloped; research into their effectiveness has been lacking. Three linked recent studies in the UK have provided evidence on essential service provision from staff, service users and carers. Interfaces with mainstream mental health services were seen as problematic: the area of crisis response was seen as a particular problem. Further services’ research is needed, focusing on service components rather than whole service configurations. There was not support for establishing more intensive mental health services for people with ID only. The way forward is in developing new ways of co-working with staff in “mainstream” mental health services. Mental health of ID staff might often be best situated directly within these services. Full article
(This article belongs to the Special Issue Mental Health Care)
689 KiB  
Review
E-Health Interventions for Suicide Prevention
by Helen Christensen, Philip J. Batterham and Bridianne O'Dea
Int. J. Environ. Res. Public Health 2014, 11(8), 8193-8212; https://doi.org/10.3390/ijerph110808193 - 12 Aug 2014
Cited by 101 | Viewed by 18266
Abstract
Many people at risk of suicide do not seek help before an attempt, and do not remain connected to health services following an attempt. E-health interventions are now being considered as a means to identify at-risk individuals, offer self-help through web interventions or [...] Read more.
Many people at risk of suicide do not seek help before an attempt, and do not remain connected to health services following an attempt. E-health interventions are now being considered as a means to identify at-risk individuals, offer self-help through web interventions or to deliver proactive interventions in response to individuals’ posts on social media. In this article, we examine research studies which focus on these three aspects of suicide and the internet: the use of online screening for suicide, the effectiveness of e-health interventions aimed to manage suicidal thoughts, and newer studies which aim to proactively intervene when individuals at risk of suicide are identified by their social media postings. We conclude that online screening may have a role, although there is a need for additional robust controlled research to establish whether suicide screening can effectively reduce suicide-related outcomes, and in what settings online screening might be most effective. The effectiveness of Internet interventions may be increased if these interventions are designed to specifically target suicidal thoughts, rather than associated conditions such as depression. The evidence for the use of intervention practices using social media is possible, although validity, feasibility and implementation remains highly uncertain. Full article
(This article belongs to the Special Issue Mental Health Care)
485 KiB  
Review
Technologies as Support Tools for Persons with Autistic Spectrum Disorder: A Systematic Review
by Nuria Aresti-Bartolome and Begonya Garcia-Zapirain
Int. J. Environ. Res. Public Health 2014, 11(8), 7767-7802; https://doi.org/10.3390/ijerph110807767 - 04 Aug 2014
Cited by 158 | Viewed by 19896
Abstract
This study analyzes the technologies most widely used to work on areas affected by the Autistic Spectrum Disorder (ASD). Technologies can focus on the strengths and weaknesses of this disorder as they make it possible to create controlled environments, reducing the anxiety produced [...] Read more.
This study analyzes the technologies most widely used to work on areas affected by the Autistic Spectrum Disorder (ASD). Technologies can focus on the strengths and weaknesses of this disorder as they make it possible to create controlled environments, reducing the anxiety produced by real social situations. Extensive research has proven the efficiency of technologies as support tools for therapy and their acceptation by ASD sufferers and the people who are with them on a daily basis. This article is organized by the types of systems developed: virtual reality applications, telehealth systems, social robots and dedicated applications, all of which are classified by the areas they center on: communication, social learning and imitation skills and other ASD-associated conditions. 40.5% of the research conducted is found to be focused on communication as opposed to 37.8% focused on learning and social imitation skills and 21.6% which underlines problems associated with this disorder. Although most of the studies reveal how useful these tools are in therapy, they are generic tools for ASD sufferers in general, which means there is a lack of personalised tools to meet each person’s needs. Full article
(This article belongs to the Special Issue Mental Health Care)
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Project Report
Measuring Quality of Mental Health Care: An International Comparison
by Brigitta Spaeth-Rublee, Harold Alan Pincus, Fran Silvestri and Janet Peters
Int. J. Environ. Res. Public Health 2014, 11(10), 10384-10389; https://doi.org/10.3390/ijerph111010384 - 10 Oct 2014
Cited by 10 | Viewed by 5667
Abstract
The International Initiative for Mental Health Leadership (IIMHL) (www.iimhl.com) is a unique international collaborative that focuses on improving mental health and addiction services. IIMHL is a collaboration of eight countries including Australia, England, Canada, New Zealand, Republic of Ireland, Scotland, Sweden and USA.[...] [...] Read more.
The International Initiative for Mental Health Leadership (IIMHL) (www.iimhl.com) is a unique international collaborative that focuses on improving mental health and addiction services. IIMHL is a collaboration of eight countries including Australia, England, Canada, New Zealand, Republic of Ireland, Scotland, Sweden and USA.[...] Full article
(This article belongs to the Special Issue Mental Health Care)
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