The effect of a community mental health training program for multidisciplinary staff

Challenges faced when living with schizophrenia in the community: A narrative inquiry

BACKGROUND

Schizophrenia is a chronic and severe mental disorder. People with schizophrenia have transferred from hospital-based care to community-based care with the support of mental health legal policies. Challenges faced in the community should be emphasized. Limited qualitative studies have explored the challenges of living with schizophrenia.

AIMS

To explore the challenges of people living with schizophrenia in the community.

METHODS

A narrative method was used, including semi-structured, face-to-face interviews. Thematic analysis approach was used to analyze data.

RESULTS

Ten clients and their family members participated in the study. Analysis revealed three main themes related to their challenges in the community: deficits in self-management of illness; insufficient community mental health care; and the influence of policy. These challenges prevent those with schizophrenia from effectively managing their illness, returning to a productive role in society, and improving their quality of life.

CONCLUSIONS

There are challenges in mental health rehabilitation and social reintegration of individuals with schizophrenia. There is a need for continuous community mental rehabilitation services, appropriate policy support, and the need to educate the public to reduce social bias and discrimination which allows individuals with schizophrenia to assume a productive role in the community.

Mental health training programs for community pharmacists, pharmacy staff and students: A systematic review

BACKGROUND

Primary care is often the first point of contact for people living with mental disorders. Community pharmacists, pharmacy staff and students are increasingly being trained to deliver mental health care. However, there is still a gap in the literature exploring the characteristics of all available mental health training programs and their components and their influence on pharmacists, pharmacy staff and students' outcomes.

OBJECTIVES

To summarize the evidence evaluating mental health training programs completed by community pharmacists, pharmacy staff and students. More specifically, to explore the components of mental health training programs and identify those that facilitate significant improvements in outcomes.

METHODS

A systematic review was conducted following the Cochrane handbook and reported according to PRISMA guidelines. A search for published literature was conducted in three databases (PubMed, Scopus, and Web of Science) in July 2021. Eligible studies were included if they described and evaluated the impact of mental health training programs delivered to community pharmacists, pharmacy staff and pharmacy students regardless of design or comparator. The methodological quality of included studies was appraised using both the NIH quality assessment, to evaluate studies with an uncontrolled pre-post design, and the Cochrane EPOC risk of bias assessment, to evaluate studies with a controlled (randomized and non-randomized) study design.

RESULTS

Thirty-three studies were included. Most of the identified mental health training programs contained knowledge-based components and active learning activities. Changes in participants' attitudes, stigma, knowledge, confidence and skills were frequently assessed. An extensive range of self-assessment and observational instruments used to evaluate the impact of the training programs were identified. Positive improvements in participants' attitudes, knowledge and stigma were frequently identified following participation in training programs.

CONCLUSIONS

This systematic review highlights the importance of mental health training programs in increasing pharmacists', pharmacy staff and pharmacy students' skills and confidence to deliver mental health care in community pharmacy. Future research should build upon this basis and further focus on finding the most efficient measures to evaluate these training programs and assess their long-term effectiveness, allowing comparison between programs.

Variables Impacting the Quality of Care Provided by Professional Caregivers for People with Mental Illness: A Systematic Review

People with mental illness may need the support of caregivers in certain areas of their lives, and there is an increasing need for quality care for people with mental health problems by qualified health professionals. Often, these professionals may develop so-called burnout syndrome, although some authors point out that positive emotions may also arise. In addition, several variables can act as both protectors and stressors. Therefore, the main aim of the current study is to identify variables related to the professional care of people with mental illness (i.e., protective or stressor variables) through a systematic review. The review was conducted according to the PRISMA guidelines with a final selection of 20 articles found in the Web of Science, PubMed, ScienceDirect and Dialnet databases between the months of October and November 2019, and updated in June 2022. The results show that job satisfaction is a strong predictor of the quality of care, and that congruence between personal and organizational values is a very important factor. Meanwhile, working in the same job for successive years, working in community mental health teams and experiencing burnout act as stressors and reduce the quality of care provided.

Emphasizing mindfulness training in acceptance relieves anxiety and depression during pregnancy

Mindfulness intervention, which trains participants to monitor momentary experiences with an accepting attitude, is effective for reducing maternal anxiety and depression. Monitoring and acceptance are two central components of mindfulness training. The aim of the study is to clarify whether adding acceptance component to monitoring training can help improve the mental health of pregnant people by comparing the effects between mindfulness training on monitoring with an emphasis on acceptance training and training on monitoring alone. Pregnant people with depressive or anxious symptoms (N = 149) were randomized to either a 4-week online intervention of (1) monitoring training (MT), (2) monitoring with an emphasis on acceptance training (MAT), or (3) emotional regulation course conditions as an active control group. All mindfulness training was based on the WeChat platform. We used the Generalized Anxiety Disorder Scale (GAD-7), Patient Health Questionnaire (PHQ-9), Five Facets of Mindfulness Questionnaire (FFMQ), and Regulatory Emotional Self-Efficacy Scale (RESE) to evaluate symptoms of anxiety and depression, mindfulness monitoring and acceptance skills, and the self-efficacy of emotional regulation pre-and postintervention. Of the 149 people enrolled in this study, 10 in the MT training group, 9 in the MAT group, and 15 in the control group did not complete the intervention. Monitoring with an emphasis on acceptance training significantly reduced symptoms of anxiety and depression and improved perceived self-efficacy in managing depression/distress compared with the monitoring training alone and the control group. In addition, participants in the monitoring group showed a downward trend in GAD-7 scores and an upward trend in scores of perceived self-efficacy in managing anger/irritation. This study not only shows that the 4-week online mindfulness training could be a promising technique to help people improve mental health; moreover, it provides evidence that emphasizing acceptance skills on mindfulness training may play a critical role because of its positive effects. We suggest that the online mindfulness intervention should be added as part of psychological care and recommend emphasizing acceptance training during pregnancy.

Evaluation of global health capacity building initiatives in low-and middle-income countries: A systematic review

BACKGROUND

Low- and middle-income countries (LMICs) are in dire need to improve their health outcomes. Although Global Health Capacity Building (GHCB) initiatives are recommended approaches, they risk being ineffective in the absence of standardized evaluation methods. This study systematically reviews evaluation approaches for GHCB initiatives in LMICs.

METHODS

We searched the Medline (OVID), PubMed, Scopus, and Embase.com databases for studies reporting evaluation of a GHCB initiative in a LMIC from January 1, 2009 until August 15, 2019. To differentiate them from intervention, prevention, and awareness initiatives, included articles reported at least one approach to evaluate their learning modality. We excluded cross-sectional studies, reviews, and book chapters that only assessed the effect of interventions. Data identifying the learning modality, and evaluation method, level, time interval, and approach were extracted from articles as primary outcomes.

RESULTS

Of 8324 identified studies, 63 articles were eligible for analysis. Most studies stemmed from Africa and Asia (69.8%), were delivered and evaluated face-to-face (74.6% and 76.2%), mainly to professionals (57.1%) and community workers (20.6%). Although the use of online and blended modalities showed an increase over the past 4 years, only face-to-face initiatives were evaluated long-term beyond individual-level. GHCB evaluations in general lacked standardization especially regarding the tools.

CONCLUSION

This is an important resource for evaluating GHCB initiatives in LMICs. It synthesizes evaluation approaches, offers recommendations for improvement, and calls for the standardization of evaluations, especially for long-term and wider impact assessment of online and blended modalities.

Applying a general systems theory framework in mental health treatment pathways: the case of the Hellenic Center of Mental Health and Research

Language, socio-emotional and cognitive development in children and adolescents with mental health issues is getting increased attention over the last years. Establishing communication patterns and addressing behavioural diversities among this population should be of priority, along with a better understanding in a large variety of patient characteristics within the operational framework of mental healthcare centers. Therefore, the relationships between provided services and operational capability should become more evident. As integrated systems’ approaches are still missing to predict the efficiency of treatment services in a macroscopic scale, a General Systems Theory framework is hereby proposed. This framework is applied and tested against the operational framework of the Hellenic Center of Mental Health and Research, in order to identify the need of such an approach and the strong cooperation between medical and population interactions. Using such frameworks as a prerequisite to identify important factors affecting population states can lead to evaluating their impact on the treatment outcome and depict the complexity of pathways potentially related to the children’s development.