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Isaacs A, Lambert C, Lawn S, Dyer A. Shortcomings of services for persons with severe and persistent mental health challenges: a qualitative study of service users and family carers. Front Psychiatry 2024; 15:1341248. [PMID: 38419901 PMCID: PMC10899316 DOI: 10.3389/fpsyt.2024.1341248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Accepted: 01/29/2024] [Indexed: 03/02/2024] Open
Abstract
Introduction The opinions of service users and carers are crucial to identifying ways to innovate and implement system change. This study aims to explore the views and experiences of service users and carerson the services they have used for their mental health challenges and their suggestions for service reform. Methods Twenty participants (15 carers and 5 service users) were interviewed for the study. Results Eight categories emerged from the data. They were: Several gaps in the system, Barriers to accessing services, Services are not fit for purpose, Services operate in isolation, System is not person focused, Service users and carers are treated poorly, Services are overloaded and under resourced and Recommendations for service reform. Respondents reported that a persistent lack of funding and resources for mental health services was a main cause of these shortcomings. Respondents also noted that innovations were needed to re-orient services to enable continuity of care, and training of mental health professionals was needed for a better understanding of the needs of service users and their carers. Discussion Additional research is needed with larger and more diverse samples to further explore these findings.
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Affiliation(s)
- Anton Isaacs
- School of Rural Health, Monash University, Warragul, VIC, Australia
| | - Caroline Lambert
- Tandem Inc., Abbotsford, VIC, Australia
- RMIT University, Melbourne, VIC, Australia
| | - Sharon Lawn
- Lived Experience Australia, Brighton, SA, Australia
- Flinders University, Adelaide, SA, Australia
| | - Anna Dyer
- Latrobe Regional Hospital, Traralgon, VIC, Australia
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Ellbin S, Lindegård A, Jonsdottir IH, Dahlborg E. Psychologists' involvement in and experiences of treating patients with stress-related exhaustion in primary care. BMC PRIMARY CARE 2024; 25:56. [PMID: 38347454 PMCID: PMC10860213 DOI: 10.1186/s12875-024-02287-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Accepted: 01/29/2024] [Indexed: 02/15/2024]
Abstract
BACKGROUND Primary health care is the setting for most patients with stress-related mental health problems. Good care processes are important for patients with stress-related mental health problems and the complex needs of these patients has become a challenge for primary care settings which is traditionally designed to manage acute episodes of one illness. The care process of these patients is thus interesting to investigate. The aim of this study was to explore psychologists´ involvement and experiences regarding the organisation of the care process and treatment of patients seeking care for stress-related exhaustion. METHOD Fifteen psychologists (14 women and 1 man, age range 27-72 years)c from fifteen different primary health care centres in the western part of Sweden, located in both rural and urban areas were included. Qualitative content analysis of individual semi-structured interviews was conducted. RESULTS The analysis resulted in eight subcategories within the two main categories studied illuminating psychologists' involvement and experiences regarding the organisation of the care process and challenges regarding treatment of patients seeking care for stress-related exhaustion. CONCLUSION The care process of patients with stress-related exhaustion is perceived to be ineffective and not congruent with the needs of the patients. A lack of holistic overview of the care process, a lack of collaboration and poor utilization of the health care professionals' competence leads to an unstructured process forcing the patients to be the carriers and coordinators of their own care.
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Affiliation(s)
- Susanne Ellbin
- The Institute of Stress Medicine, Carl Skottsbergs gata 22B, Gothenburg, SE-413 19, Sweden
| | - Agneta Lindegård
- The Institute of Stress Medicine, Carl Skottsbergs gata 22B, Gothenburg, SE-413 19, Sweden
- School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden
- Department of Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Ingibjörg H Jonsdottir
- The Institute of Stress Medicine, Carl Skottsbergs gata 22B, Gothenburg, SE-413 19, Sweden.
- School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden.
- Department of Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden.
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Ao MQ, Xia L, Wang XQ, Fang S, Yang BX, Liu Q, Chen J, Zhou SC, Li XY, Sun T, Lu B, Bao A, Luo D, Ruan J. Help-Seeking Intentions for Depression from Mental Health Professionals Among Community-Dwelling Persons in Central China. ADMINISTRATION AND POLICY IN MENTAL HEALTH AND MENTAL HEALTH SERVICES RESEARCH 2023; 50:901-911. [PMID: 37277690 DOI: 10.1007/s10488-023-01277-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/22/2023] [Indexed: 06/07/2023]
Abstract
Understanding the intention of community residents to seek help from mental health professionals (MHPs) is essential in targeting interventions that promote the prevention and treatment of depression. This study aimed to investigate the current status of Chinese community populations' depression help-seeking intentions from MHPs and explore factors influencing the intentions. Data were used from a survey conducted in a city in central China (n = 919 aged 38.68 ± 17.34, 72.1% female). Help-seeking intentions, help-seeking attitude, depression stigma, family function and depressive symptoms were measured. The total mean score on the intent to seek help from MHPs was 11.01 ± 7.78 and most of respondents were unwilling to seek professional help. Multiple linear regression showed that participants who were students, held a positive help-seeking attitude and had low personal stigma were more likely to have the intention to seek help from MHPs. It is necessary to utilize effective interventions to improve community residents' intention to seek professional help. These include promoting the importance of seeking professional assistance, optimizing the quality of mental health services and altering residents' prejudice to seeking professional help.
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Affiliation(s)
- Meng Qin Ao
- School of Nursing, Wuhan University, Wuhan, 430071, China
| | - Lin Xia
- School of Nursing, Wuhan University, Wuhan, 430071, China
| | - Xiao Qin Wang
- School of Nursing, Wuhan University, Wuhan, 430071, China
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, China
| | - Shu Fang
- Department of Hepatopancreatobiliary Surgery, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Bing Xiang Yang
- School of Nursing, Wuhan University, Wuhan, 430071, China
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, China
- Population and Health Research Center, Wuhan University, Wuhan, China
| | - Qian Liu
- School of Nursing, Wuhan University, Wuhan, 430071, China
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, China
- Population and Health Research Center, Wuhan University, Wuhan, China
| | - Jie Chen
- College of Nursing, Florida State University, Tallahassee, USA
| | - Si Chen Zhou
- School of Nursing, Wuhan University, Wuhan, 430071, China
| | - Xin Yi Li
- School of Nursing, Wuhan University, Wuhan, 430071, China
| | - Ting Sun
- Department of Nursing, Renmin Hospital of Wuhan University, Wuhan, China
| | - Baili Lu
- Wuhan Mental Health Center, Wuhan, China
| | - Anyu Bao
- Department of Clinical Laboratory, Renmin Hospital of Wuhan University, Wuhan, 430060, China.
| | - Dan Luo
- School of Nursing, Wuhan University, Wuhan, 430071, China.
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, China.
- Population and Health Research Center, Wuhan University, Wuhan, China.
| | - Juan Ruan
- Wuhan Mental Health Center, Wuhan, China.
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Cleary M, West S, Hungerford C. Mental Health Nurses Overcoming Adversity: A Discursive Review. Issues Ment Health Nurs 2023; 44:944-950. [PMID: 37616589 DOI: 10.1080/01612840.2023.2236698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/26/2023]
Abstract
The mental health nursing profession has experienced various challenges since its inception. This discursive review considers these challenges, including how mental health nurses have and can continue to overcome adversity as individuals and as a profession. The discussion examines the influence of the profession's historical involvement in institutionalization and coercive care; the continuing impact of stigma; and the increasing demand for mental health services, amidst chronic staff shortages. Collectively, mental health nurses must harness strong therapeutic relationships, intra- and multi-disciplinary collaboration, personal and professional resilience, education that prepares them for the future, and sector-wide planning and innovation, to respond positively to these challenges. These approaches will support mental health nurses to overcome adversity and achieve positive outcomes for the profession and people with the lived experience of mental illness.
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Affiliation(s)
- Michelle Cleary
- School of Nursing, Midwifery & Social Sciences, Central Queensland University, Sydney, NSW, Australia
| | - Sancia West
- School of Nursing, Midwifery & Social Sciences, Central Queensland University, Sydney, NSW, Australia
| | - Catherine Hungerford
- School of Nursing, Midwifery & Social Sciences, Central Queensland University, Sydney, NSW, Australia
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Murray JK, Knudson S. Mental health treatment and access for emerging adults in Canada: a systematic review. Front Public Health 2023; 11:1088999. [PMID: 37501945 PMCID: PMC10370273 DOI: 10.3389/fpubh.2023.1088999] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Accepted: 06/19/2023] [Indexed: 07/29/2023] Open
Abstract
Introduction Research into the mental healthcare of emerging adults (18-25) in Canada has been limited, despite this developmental period being widely considered a vulnerable time of life. As such, we aimed to identify the greatest barriers emerging adults faced in accessing mental healthcare in Canada, particularly in relation to the Canadian healthcare system which operates on a universal funding model but is challenged by funding shortfalls and a complex relationship to the provinces. Methods We systematically examined 28 pieces of literature, including academic and technical literature and publications from government organizations, focused on emerging adults and the Canadian mental healthcare system. Results Findings demonstrated that stigma, a lack of mental health knowledge, cost, and interpersonal factors (e.g., one's parental, peer, and romantic supports demonstrating negative views toward mental healthcare may deter treatment; emerging adults demonstrating concerns that accessing mental healthcare may lead to peer rejection) acted as barriers to help-seeking in emerging adults. Additionally, a lack of national institutional cohesion and a lack of policy pertaining to emerging adult healthcare acted as barriers to adequate mental healthcare in this demographic. Discussion Improving mental health education early in life shows promise at reducing many of the barriers emerging adults face in accessing mental healthcare. Further, policies directed at ensuring a cohesive national mental health system, as well as policies directly designed to care for emerging adult mental health needs, could act as the next steps toward ensuring an accessible and effective Canadian mental healthcare system that can serve as a model for other nations.
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Affiliation(s)
- Jonah Kynan Murray
- Department of Psychology & Health Studies, University of Saskatchewan, Saskatoon, SK, Canada
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Halamová J, Mihaľo J, Bakoš L. Emotion-Focused Mobile App for Promoting Self-Compassion, Self-Protection, and Self-Criticism. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13759. [PMID: 36360637 PMCID: PMC9658678 DOI: 10.3390/ijerph192113759] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 10/03/2022] [Accepted: 10/19/2022] [Indexed: 06/16/2023]
Abstract
The COVID-19 pandemic has changed our daily lives and restricted access to traditional psychological interventions. Hence there is an immediate and growing demand for accessible and scalable mental health solutions. Emotion-focused training for self-compassion and self-protection was developed and distributed using mobile phone technologies, and its effectiveness was tested. The available research sample consisted of 97 participants with a mean age of 26.06 years and a standard deviation of 10.53. Participants using the mobile app underwent a 14-day program aimed at reducing self-criticism while increasing self-compassion and self-protection. Pre- and post-measurements were collected. The results showed a statistically significant medium effect on self-compassion, self-criticism, and self-protection performance and a significant small effect on self-protection distress. The finding that a 14-day mobile app was able to foster well-being in the form of self-compassion, self-protection, and self-criticism is promising. It indicates the potential for individuals to obtain help through the use of remote tools such as MHapps for a fraction of the usual cost, at their own pace, and without other restrictions.
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Hurley J, Lakeman R, Linsley P, Ramsay M, Mckenna-Lawson S. Utilizing the mental health nursing workforce: A scoping review of mental health nursing clinical roles and identities. Int J Ment Health Nurs 2022; 31:796-822. [PMID: 35156291 PMCID: PMC9303738 DOI: 10.1111/inm.12983] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Revised: 01/17/2022] [Accepted: 01/21/2022] [Indexed: 01/15/2023]
Abstract
Despite rising international needs for mental health practitioners, the mental health nursing workforce is underutilized. This is in part due to limited understandings of their roles, identities, and capabilities. This paper aimed to collate and synthesize published research on the clinical roles of mental health nurses in order to systematically clarify their professional identity and potential. We searched for eligible studies, published between 2001 and 2021, in five electronic databases. Abstracts of retrieved studies were independently screened against exclusion and inclusion criteria (primarily that studies reported on the outcomes associated with mental health nursing roles). Decisions of whether to include studies were through researcher consensus guided by the criteria. The search yielded 324 records, of which 47 were included. Retained papers primarily focused on three themes related to mental health nursing clinical roles and capabilities. Technical roles included those associated with psychotherapy, consumer safety, and diagnosis. Non-technical roles and capabilities were also described. These included emotional intelligence, advanced communication, and reduction of power differentials. Thirdly, the retained papers reported the generative contexts that influenced clinical roles. These included prolonged proximity with consumers with tensions between therapeutic and custodial roles. The results of this scoping review suggest the mental health nurses (MHNs) have a wide scope of technical skills which they employ in clinical practice. These roles are informed by a distinctive cluster of non-technical capabilities to promote the well-being of service users. They are an adaptable and underutilized component of the mental health workforce in a context of escalating unmet needs for expert mental health care.
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Affiliation(s)
- John Hurley
- Faculty of Health, Southern Cross University, Coffs Harbour, New South Wales, Australia
| | - Richard Lakeman
- Faculty of Health, Southern Cross University, Lismore, New South Wales, Australia
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Trane K, Aasbrenn K, Rønningen M, Odden S, Lexén A, Landheim AS. Flexible Assertive Community Treatment in Rural and Remote Areas: A Qualitative Study of the Challenges and Adaptations of the Model. Front Public Health 2022; 10:913159. [PMID: 35983354 PMCID: PMC9379540 DOI: 10.3389/fpubh.2022.913159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Accepted: 06/20/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundFlexible assertive community treatment (FACT) is an innovative model for providing long-term treatment to people with severe mental illness. The model was developed in the Netherlands but is now used in other countries, including Norway, which has a geography different from the Netherlands, with many rural and remote areas. Implementation of innovations is context dependent. The FACT model's potential in rural and remote areas has not been studied. Therefore, we aimed to gain knowledge regarding the challenges and modifications of the model in rural and remote contexts and discuss how they can affect the model's potential in such areas. This knowledge can improve the understanding of how FACT or similar services can be adapted to function most optimally in such conditions. We sought to address the following questions: Which elements of the FACT model do team leaders of the rural FACT teams find particularly challenging due to the context, and what modifications have the teams made to the model?MethodsDigital interviews were conducted with five team leaders from five rural FACT teams in different parts of Norway. They were selected using purposive sampling to include team leaders from some of the most rural teams in Norway. The interviews were analyzed using thematic text analysis.ResultsThe following three themes described elements of the FACT model that were experienced particularly challenging in the rural and remote context: multidisciplinary shared caseload approach, intensive outreach and crisis management. The following eight themes described the modifications that the teams had made to the model: intermunicipal collaboration, context-adaptive planning, delegation of tasks to municipal services, part-time employment, different geographical locations of staff, use of digital tools, fewer FACT board meetings, and reduced caseload.ConclusionsRural and remote contexts challenge the FACT model's potential. However, modifications can be made, some of which can be considered innovative modifications that can increase the model's potential in such areas, while others might move the teams further away from the model.
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Affiliation(s)
- Kristin Trane
- The Norwegian National Advisory Unit on Concurrent Substance Abuse and Mental Health Disorders, Inland Hospital Trust, Hamar, Norway
- *Correspondence: Kristin Trane
| | | | | | - Sigrun Odden
- The Norwegian National Advisory Unit on Concurrent Substance Abuse and Mental Health Disorders, Inland Hospital Trust, Hamar, Norway
| | | | - Anne Signe Landheim
- The Norwegian National Advisory Unit on Concurrent Substance Abuse and Mental Health Disorders, Inland Hospital Trust, Inland Norway University of Applied Sciences, Hamar, Norway
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Wormdahl I, Hatling T, Husum TL, Kjus SHH, Rugkåsa J, Brodersen D, Christensen SD, Nyborg PS, Skolseng TB, Ødegård EI, Andersen AM, Gundersen E, Rise MB. The ReCoN intervention: a co-created comprehensive intervention for primary mental health care aiming to prevent involuntary admissions. BMC Health Serv Res 2022; 22:931. [PMID: 35854270 PMCID: PMC9296016 DOI: 10.1186/s12913-022-08302-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Accepted: 07/05/2022] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND Reducing involuntary psychiatric admissions is a global concern. In Norway, the rate of involuntary admissions was 199 per 100,000 people 16 years and older in 2020. Individuals' paths towards involuntary psychiatric admissions usually unfold when they live in the community and referrals to such admissions are often initiated by primary health care professionals. Interventions at the primary health care level can therefore have the potential to prevent such admissions. Interventions developed specifically for this care level are, however, lacking. To enhance the quality and development of services in a way that meets stakeholders' needs and facilitates implementation to practice, involving both persons with lived experience and service providers in developing such interventions is requested. AIM To develop a comprehensive intervention for primary mental health care aiming to prevent involuntary admissions of adults. METHODS This study had an action research approach with a participatory research design. Dialogue conferences with multiple stakeholders in five Norwegian municipalities, inductive thematic analysis of data material from the conferences, and a series of feedback meetings were conducted. RESULTS The co-creation process resulted in the development of the ReCoN (Reducing Coercion in Norway) intervention. This is a comprehensive intervention that includes six strategy areas: [1] Management, [2] Involving Persons with Lived Experience and Family Carers, [3] Competence Development, [4] Collaboration across Primary and Specialist Care Levels, [5] Collaboration within the Primary Care Level, and [6] Tailoring Individual Services. Each strategy area has two to four action areas with specified measures that constitute the practical actions or tasks that are believed to collectively impact the need for involuntary admissions. CONCLUSIONS The ReCoN intervention has the potential for application to both national and international mental health services. The co-creation process with the full range of stakeholders ensures face validity, acceptability, and relevance. The effectiveness of the ReCoN intervention is currently being tested in a cluster randomised controlled trial. Given positive effects, the ReCoN intervention may impact individuals with a severe mental illness at risk of involuntary admissions, as more people may experience empowerment and autonomy instead of coercion in their recovery process.
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Affiliation(s)
- Irene Wormdahl
- grid.458589.d Norwegian Resource Centre for Community Mental Health, NTNU Social Research, Trondheim, Norway ,grid.5947.f0000 0001 1516 2393Department of Mental Health, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
| | - Trond Hatling
- grid.458589.d Norwegian Resource Centre for Community Mental Health, NTNU Social Research, Trondheim, Norway
| | - Tonje Lossius Husum
- grid.5510.10000 0004 1936 8921Centre for Medical Ethics, Institute for Health & Society, University of Oslo, Oslo, Norway ,grid.412414.60000 0000 9151 4445Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
| | - Solveig Helene Høymork Kjus
- grid.458589.d Norwegian Resource Centre for Community Mental Health, NTNU Social Research, Trondheim, Norway
| | - Jorun Rugkåsa
- grid.411279.80000 0000 9637 455XHealth Service Research Unit, Akershus University Hospital, Lørenskog, Norway ,grid.463530.70000 0004 7417 509XCentre for Care Research, University of South-Eastern Norway, Porsgrunn, Norway
| | - Dorte Brodersen
- Department of Health Care, Ullensaker Municipality, Ullensaker, Norway
| | | | - Petter Sundt Nyborg
- Department of Mental Health and Addiction, Elverum Municipality, Elverum, Norway
| | | | - Eva Irene Ødegård
- Department of Mental Health and Addiction, Grimstad Municipality, Grimstad, Norway
| | | | | | - Marit B. Rise
- grid.5947.f0000 0001 1516 2393Department of Mental Health, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
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Integration of Care in Complex and Fragmented Service Systems: Experiences of Staff in Flexible Assertive Community Treatment Teams. Int J Integr Care 2022; 22:17. [PMID: 35651735 PMCID: PMC9139156 DOI: 10.5334/ijic.6011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Accepted: 05/16/2022] [Indexed: 11/28/2022] Open
Abstract
Introduction: To provide more integrated care, several countries have implemented the Flexible Assertive Community Treatment (FACT) model. However, this model does not guarantee full integration, especially in complex and fragmented service systems like in Norway. Hence, we investigated which barriers that might reduce the potential for integrated care in the Norwegian system, as described by staff in FACT teams, and how they adjust their way of working to increase the opportunities for integration. Methods: Online focus group interviews involving 35 staff members of five Norwegian FACT teams were conducted using a semi-structured interview guide. The material was analysed using thematic text analysis. Results: Six themes described the barriers to integrated care in the service system: fragmentation, different legislation and digital systems, challenges in collaboration, bureaucracy and limited opening hours. Three themes described adjustments in the teams’ way of working to enhance integration: working as the responsible co-ordinator, being a collaborator, and the only entry channel into the service system. Conclusion: The FACT team staff described several barriers to integration within the system. However, they made some adjustments in their way of working that might provide opportunities for integrated care within complex and fragmented service systems.
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Koutra K, Mavroeides G, Triliva S. Mental Health Professionals' Attitudes Towards People with Severe Mental Illness: Are they Related to Professional Quality of Life? Community Ment Health J 2022; 58:701-712. [PMID: 34251575 PMCID: PMC8273846 DOI: 10.1007/s10597-021-00874-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Accepted: 07/05/2021] [Indexed: 11/25/2022]
Abstract
The present study examines whether attitudes of mental health professionals (MHPs) towards severe mental illness are associated with professional quality of life. The Attitudes towards Severe Mental Illness (ASMI), the Maslach Burnout Inventory (MBI), and the Professional Quality of Life Scale-5 (ProQOL-5) were completed by 287 MHPs in Greece (25.4% males, 74.6% females). The results indicate that MHPs hold predominantly positive attitudes towards people with severe mental illness. Nonetheless, MHPs' attitudes are deemed to be stereotypical according to ASMI concerning treatment duration, prospects of recovery, and whether patients are similar to other people. Higher scores in emotional exhaustion, depersonalization, compassion fatigue and ProQOL-5 burn out dimension were significantly associated with MHPs' unfavorable attitudes, whereas higher scores in compassion satisfaction and personal accomplishment were associated with MHPs' positive attitudes. Assessing compassion fatigue, compassion satisfaction and burnout levels could help identify the processes involved in the development or maintenance of MHPs' stigmatizing attitudes.
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Affiliation(s)
- Katerina Koutra
- Department of Psychology, School of Social Sciences, University of Crete, Gallos Campus, 74100, Rethymno, Crete, Greece.
| | - Georgios Mavroeides
- Department of Psychology, School of Social Sciences, University of Crete, Gallos Campus, 74100, Rethymno, Crete, Greece
| | - Sofia Triliva
- Department of Psychology, School of Social Sciences, University of Crete, Gallos Campus, 74100, Rethymno, Crete, Greece
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Tudor Car L, Teng YS, How JW, Nazri NNBM, Tan ALX, Quah J, Peckham S, Smith H. Priorities for family physician and general practitioner recruitment and retention in Singapore: a PRIORITIZE study. BMC FAMILY PRACTICE 2021; 22:229. [PMID: 34784892 PMCID: PMC8596925 DOI: 10.1186/s12875-021-01570-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Accepted: 10/20/2021] [Indexed: 11/28/2022]
Abstract
Background A shortage of primary care physicians has been reported in many countries. Primary care systems are diverse and the challenges leading to a decline in workforce are at times context-specific and require tailored solutions. Inviting frontline clinicians to share their insights can help identify optimal strategies for a particular setting. To determine priorities for family physicians’ and general practitioners’ recruitment and retention in Singapore, we invited primary care physicians to rank pertinent strategies using PRIORITIZE, a transparent, systematic priority-setting approach. Methods The study advisory board, consisting of representatives of Singapore’s key primary care stakeholders, determined the criteria for prioritising of general practitioners (GPs) and family physicians (FPs) recruitment and retention strategies in Singapore. A comprehensive list of GPs and FPs recruitment and retention strategies was extracted from a recent systematic review of the relevant literature. A questionnaire listing the strategies and the scoring criteria was administered online to doctors practicing in public and private sector in Singapore. Respondents’ scores were combined to create a ranked list of locally most relevant strategies for improving GPs and FPs recruitment and retention. Results We recruited a diverse sample of 50 GPs and FPs practicing in a variety of primary care settings, many with a range of additional professional responsibilities. Around 60 and 66% of respondents thought that there was a problem with recruitment and retention of GPs and FPs in Singapore, respectively. Strategies focusing on promoting primary care by emphasizing the advantages and enhancing the status of the profession as well as training-related strategies, such as sub-specialisation and high-quality rotations were considered priorities for improving recruitment. For retention of GPs and FPs, improving working conditions by increasing GPs’ and FPs’ salary and recognition, as well as varying or reducing time commitment, were seen as the most important strategies. The ranking between physicians working in public and private sector was mostly similar, with nine out of the top ten recruitment and retention strategies being the same. Conclusion Primary care physicians’ ranking of recruitment and retention strategies for GPs and FPs in Singapore provide important insight into the challenges and the solutions as seen by the members of the profession themselves. This information can guide future policy and decision making in this area. Supplementary Information The online version contains supplementary material available at 10.1186/s12875-021-01570-1.
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Affiliation(s)
- Lorainne Tudor Car
- Lee Kong Chian School of Medicine, Nanyang Technological University, 11 Mandalay Road, Singapore, Singapore. .,Department of Primary Care and Public Health, School of Public Health, Imperial College London, London, UK.
| | - Yee Sean Teng
- Lee Kong Chian School of Medicine, Nanyang Technological University, 11 Mandalay Road, Singapore, Singapore
| | - Jin Wei How
- Lee Kong Chian School of Medicine, Nanyang Technological University, 11 Mandalay Road, Singapore, Singapore
| | | | - Amy Li Xian Tan
- Lee Kong Chian School of Medicine, Nanyang Technological University, 11 Mandalay Road, Singapore, Singapore
| | - Joanne Quah
- SingHealth Polyclinics, Singapore, Singapore
| | - Stephen Peckham
- Centre for Health Services Studies, University of Kent, Canterbury, UK
| | - Helen Smith
- Lee Kong Chian School of Medicine, Nanyang Technological University, 11 Mandalay Road, Singapore, Singapore
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Trane K, Aasbrenn K, Rønningen M, Odden S, Lexén A, Landheim A. Flexible assertive community treatment teams can change complex and fragmented service systems: experiences of service providers. Int J Ment Health Syst 2021; 15:38. [PMID: 33892769 PMCID: PMC8067287 DOI: 10.1186/s13033-021-00463-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Accepted: 04/15/2021] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Implementing innovative health service models in existing service systems is complicated and context dependent. Flexible assertive community treatment (FACT) is a multidisciplinary service model aimed at providing integrated care for people with severe mental illness. The model was developed in the Netherlands and is now used in several countries, such as Norway. The Norwegian service system is complex and fragmented, with challenges in collaboration. Limited research has been performed on FACT teams and other new integrative health service models as part of such systems. However, such knowledge is important for future adjustments of innovation processes and service systems. Our aim was to explore how FACT teams are integrated into the existing formal public service system, how they function and affect the system, and describe some influencing factors to this. We sought to address how service providers in the existing service system experience the functioning of FACT teams in the system. METHODS Five focus group interviews were undertaken 3 years after the FACT teams were implemented. Forty service providers representing different services from both levels of administration (primary and specialist healthcare) from different Norwegian regions participated in this study. Team leaders of the FACT teams also participated. Service providers were recruited through purposeful sampling. Interviews were analysed using thematic text analysis. RESULTS The analysis revealed five main themes regarding FACT teams: (1) They form a bridge between different services; (2) They collaborate with other services; (3) They undertake responsibility and reassure other services; (4) They do not close all gaps in service systems; and (5) They are part of a service system that hampers their functioning. CONCLUSIONS The FACT teams in this study contributed to positive changes in the existing service system. They largely contributed to less complex and fragmented systems by forming a bridge and undertaking responsibility in the system and by collaborating with and reassuring other services; this has reduced some gaps in the system. The way FACT teams function and needs of the existing system appear to have contributed positively to these findings. However, complexity and fragmentation of the system partly hamper functioning of the FACT teams.
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Affiliation(s)
- Kristin Trane
- Inland Hospital Trust, The Norwegian National Advisory Unit on Concurrent Substance Abuse and Mental Health Disorders, Hamar, Norway.
| | | | | | - Sigrun Odden
- Inland Hospital Trust, The Norwegian National Advisory Unit on Concurrent Substance Abuse and Mental Health Disorders, Hamar, Norway
| | - Annika Lexén
- Department of Health Sciences, Lund University, Lund, Sweden
| | - Anne Landheim
- Inland Hospital Trust, The Norwegian National Advisory Unit on Concurrent Substance Abuse and Mental Health Disorders, Hamar, Norway
- Inland Norway University of Applied Sciences, Hamar, Norway
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van Zyl LE, Zondervan-Zwijnenburg MAJ, Dickens LR, Hulshof IL. Exploring meaning in life through a brief photo-ethnographic intervention using Instagram: a Bayesian growth modelling approach. Int Rev Psychiatry 2020; 32:723-745. [PMID: 33016795 DOI: 10.1080/09540261.2020.1809357] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
The 4th Industrial Revolution has provided several digital platforms through which to disseminate scalable and cost-effective interventions (e.g. Apps and Social media). Instagram, a popular visual-ethnographic social media platform, could be employed to implement and scale interventions aimed at aiding individuals in discovering meaning in life and gratitude through capturing and reflecting upon photographs of meaningful moments. The purpose of this study was to evaluate the long-term effectiveness of a brief photo-ethnographic meaningful-moments intervention aimed at enhancing wellbeing (life satisfaction) and managing common mental health problems (stress/depression/anxiety) through Instagram. A 4 × 1 treatment-only intervention design was used to assess the immediate and long-term changes in meaning, gratitude, life satisfaction, and depression/stress/anxiety. Within-person development on the subscales was evaluated with Bayesian level and shape models. The results showed significant improvements in all factors directly after the intervention. Over the long term, significant changes with baseline measures for the presence of meaning, appreciation for others, and life satisfaction was found. Participants also reported a significant but small change in depression over the long term. Instagram could therefore be an interesting tool to consider when the aim is to enhance wellbeing and manage common mental health problems in the short-, medium- and long-term.
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Affiliation(s)
- Llewellyn E van Zyl
- Department of Industrial Engineering, University of Eindhoven, Eindhoven, the Netherlands.,Optentia Research Focus Area, North-West University (VTC), Vanderbijlpark, South Africa.,Department of Human Resource Management, University of Twente, Enschede, the Netherlands.,Department of Social Psychology, Institut für Psychologie, Goethe University, Frankfurt am Main, Germany
| | | | - Leah R Dickens
- Department of Psychology, Kenyon College, Gambier, OH, USA
| | - Inge L Hulshof
- Department of Industrial Engineering, University of Eindhoven, Eindhoven, the Netherlands.,Department of Work and Organisational Psychology, Open University, Heerlen, the Netherlands
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