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Berk M, Agustini B, Forbes M, Jacka FN, Narayanaswamy JC, Penninx BWJH. Canadian Network for Mood and Anxiety Treatments (CANMAT) 2023: Towards Personalized Approaches to Depression Treatment. Can J Psychiatry 2024:7067437241248087. [PMID: 38644770 DOI: 10.1177/07067437241248087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/23/2024]
Affiliation(s)
- Michael Berk
- IMPACT-Institute for Mental and Physical Health and Clinical Translation, Deakin University, Barwon Health, Geelong, Victoria, Australia
| | - Bruno Agustini
- IMPACT-Institute for Mental and Physical Health and Clinical Translation, Deakin University, Barwon Health, Geelong, Victoria, Australia
| | - Malcolm Forbes
- IMPACT-Institute for Mental and Physical Health and Clinical Translation, Deakin University, Barwon Health, Geelong, Victoria, Australia
| | - Felice N Jacka
- IMPACT-Institute for Mental and Physical Health and Clinical Translation, Deakin University, Barwon Health, Geelong, Victoria, Australia
| | - Janardhanan C Narayanaswamy
- IMPACT-Institute for Mental and Physical Health and Clinical Translation, Deakin University, Barwon Health, Geelong, Victoria, Australia
- Goulburn Valley Health, Shepparton, Victoria, Australia
| | - Brenda W J H Penninx
- Department of Psychiatry, Amsterdam Neuroscience and Amsterdam Public Health Research Institute, Amsterdam University Medical Center, Amsterdam, The Netherlands
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Kasson E, Szlyk HS, Li X, Constantino-Pettit A, Smith AC, Vázquez MM, Wilfley DE, Taylor CB, Fitzsimmons-Craft EE, Cavazos-Rehg P. Eating disorder symptoms and comorbid mental health risk among teens recruited to a digital intervention research study via two online approaches. Int J Eat Disord 2024. [PMID: 38445416 DOI: 10.1002/eat.24186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Revised: 02/21/2024] [Accepted: 02/22/2024] [Indexed: 03/07/2024]
Abstract
INTRODUCTION It is crucial to identify and evaluate feasible, proactive ways to reach teens with eating disorders (EDs) who may not otherwise have access to screening or treatment. This study aimed to explore the feasibility of recruiting teens with EDs to a digital intervention study via social media and a publicly available online ED screen, and to compare the characteristics of teens recruited by each approach in an exploratory fashion. METHOD Teens aged 14-17 years old who screened positive for a clinical/subclinical ED or at risk for an ED and who were not currently in ED treatment completed a baseline survey to assess current ED symptoms, mental health comorbidities, and barriers to treatment. Bivariate analyses were conducted to examine differences between participants recruited via social media and those recruited after completion of a widely available online EDs screen (i.e., National Eating Disorders Association [NEDA] screen). RESULTS Recruitment of teens with EDs using the two online approaches was found to be feasible, with 934 screens completed and a total of 134 teens enrolled over 6 months: 77% (n = 103) via social media 23% (n = 31) via the NEDA screen. Mean age of participants (N = 134) was 16 years old, with 49% (n = 66) identifying as non-White, and 70% (n = 94) identifying as a gender and/or sexual minority. Teens from NEDA reported higher ED psychopathology scores (medium effect size) and more frequent self-induced vomiting and driven exercise (small effect sizes). Teens from NEDA also endorsed more barriers to treatment, including not feeling ready for treatment and not knowing where to find a counselor or other resources (small effect sizes). DISCUSSION Online recruitment approaches in this study reached a large number of teens with an interest in a digital intervention to support ED recovery, demonstrating the feasibility of these outreach methods. Both approaches reached teens with similar demographic characteristics; however, teens recruited from NEDA reported higher ED symptom severity and barriers to treatment. Findings suggest that proactive assessment and intervention methods should be developed and tailored to meet the needs of each of these groups. PUBLIC SIGNIFICANCE This study examined the feasibility of recruiting teens with EDs to a digital intervention research study via social media and NEDA's online screen, and demonstrated differences in ED symptoms among participants by recruitment approach.
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Affiliation(s)
- Erin Kasson
- Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Hannah S Szlyk
- Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Xiao Li
- Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Anna Constantino-Pettit
- Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Arielle C Smith
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
| | - Melissa M Vázquez
- Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Denise E Wilfley
- Department of Psychology, Washington University in St. Louis, St. Louis, Missouri, USA
| | - C Barr Taylor
- Department of Psychiatry and Behavioral Science, Stanford University School of Medicine, Stanford, California, USA
- Center for m2Health, Palo Alto University, Palo Alto, California, USA
| | | | - Patricia Cavazos-Rehg
- Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri, USA
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Cénat JM, Lashley M, Jarvis GE, Williams MT, Bernheim E, Derivois D, Rousseau C. The Burden of Psychosis in Black Communities in Canada: More than a Feeling, a Black Family Experience. Can J Psychiatry 2024; 69:10-12. [PMID: 37635288 PMCID: PMC10867408 DOI: 10.1177/07067437231197263] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/29/2023]
Affiliation(s)
- Jude Mary Cénat
- School of Psychology, University of Ottawa, Ottawa, Ontario, Canada
- Interdisciplinary Centre for Black Health, University of Ottawa, Ottawa, Ontario, Canada
- School of Psychology, University of Ottawa Research Chair on Black Health, University of Ottawa, Ottawa, Ontario, Canada
| | - Myrna Lashley
- Division of Social and Transcultural Psychiatry, McGill University, Montreal, Quebec, Canada
| | - G. Eric Jarvis
- Division of Social and Transcultural Psychiatry, McGill University, Montreal, Quebec, Canada
| | - Monnica T. Williams
- School of Psychology, University of Ottawa, Ottawa, Ontario, Canada
- Interdisciplinary Centre for Black Health, University of Ottawa, Ottawa, Ontario, Canada
| | - Emmanuelle Bernheim
- Interdisciplinary Centre for Black Health, University of Ottawa, Ottawa, Ontario, Canada
- Faculty of Civil Law, University of Ottawa, Ottawa, Ontario, Canada
| | - Daniel Derivois
- Department of Psychology, Université Bourgogne Franche Comté, Dijon, France
| | - Cécile Rousseau
- Division of Social and Transcultural Psychiatry, McGill University, Montreal, Quebec, Canada
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Uthurralt N, Ajwani S, Kiel R, Chandra S, Lama Rumba B, Day CA. Providing better access to oral health care for people receiving substance use treatment: A timely discussion. Drug Alcohol Rev 2024; 43:257-260. [PMID: 37718615 DOI: 10.1111/dar.13753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Revised: 08/28/2023] [Accepted: 09/05/2023] [Indexed: 09/19/2023]
Abstract
Substance use disorders are a risk factor for poor oral health which in turn impacts quality of life. Resultant oral problems contribute to chronic illness, premature mortality, social stigma, embarrassment and reduced opportunities for employment and social interaction. Providing dental services to people with substance use disorders is often difficult due to high rates of oral disease, anxiety, behavioural and drug use changes, and lifestyle factors. Previous studies have demonstrated that alcohol and other drug service clients find accessing and navigating oral health services complex and suggest a multidisciplinary care approach to improve outcomes. In this commentary, we describe individual and structural barriers that limit the use of oral health care among people with substance use disorders, alcohol and other drug clinicians' challenges to integrating oral health into their practice and identify key issues for oral health services in delivering care. We draw on our experience to recommend a multidisciplinary approach be used to develop strategies in order to increase access to oral health services at a standard similar to the general population for clients of alcohol and other drug services.
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Affiliation(s)
- Natalia Uthurralt
- Drug Health Services, Sydney Local Health District, Sydney, Australia
- Edith Collins Centre (Translational Research in Alcohol, Drugs and Toxicology), Sydney Local Health District, Sydney, Australia
- Sydney Dental Hospital, Sydney Local Health District, Sydney, Australia
- Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Shilpi Ajwani
- Sydney Dental Hospital, Sydney Local Health District, Sydney, Australia
- Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Roland Kiel
- Drug Health Services, Sydney Local Health District, Sydney, Australia
| | - Shivani Chandra
- Sydney Dental Hospital, Sydney Local Health District, Sydney, Australia
| | - Bijaya Lama Rumba
- Drug Health Services, Sydney Local Health District, Sydney, Australia
| | - Carolyn A Day
- Edith Collins Centre (Translational Research in Alcohol, Drugs and Toxicology), Sydney Local Health District, Sydney, Australia
- Speciality of Addiction Medicine, Central Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
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Duminuco A, Harrington P, Harrison C, Curto-Garcia N. Polycythemia Vera: Barriers to and Strategies for Optimal Management. Blood Lymphat Cancer 2023; 13:77-90. [PMID: 38146420 PMCID: PMC10749566 DOI: 10.2147/blctt.s409443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Accepted: 12/16/2023] [Indexed: 12/27/2023]
Abstract
Polycythemia vera (PV) is a subtype of myeloproliferative neoplasms characterized by impaired quality of life and severe complications. Despite the increasingly in-depth knowledge of this condition, it necessitates a multifaceted management approach to mitigate symptoms and prevent thrombotic and hemorrhagic events, ensuring prolonged survival. The therapeutic landscape has been revolutionized in recent years, where venesection and hydroxycarbamide associated with antiplatelet therapy have a central role and are now accompanied by other drugs, such as interferon and Janus kinase inhibitors. Ongoing research and advancements in targeted therapies hold promise for further enhancing the therapeutic choice for PV management.
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Affiliation(s)
- Andrea Duminuco
- Department of Haematology, Guy’s and St Thomas’ NHS Foundation Trust, London, UK
- Haematology with BMT Unit, A.O.U. Policlinico “G.Rodolico-San Marco”, Catania, Italy
| | - Patrick Harrington
- Department of Haematology, Guy’s and St Thomas’ NHS Foundation Trust, London, UK
| | - Claire Harrison
- Department of Haematology, Guy’s and St Thomas’ NHS Foundation Trust, London, UK
| | - Natalia Curto-Garcia
- Department of Haematology, Guy’s and St Thomas’ NHS Foundation Trust, London, UK
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Tuobenyiere J, Mensah GP, Korsah KA. Patient perspective on barriers in type 2 diabetes self-management: A qualitative study. Nurs Open 2023; 10:7003-7013. [PMID: 37488987 PMCID: PMC10495717 DOI: 10.1002/nop2.1956] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Revised: 05/21/2023] [Accepted: 07/12/2023] [Indexed: 07/26/2023] Open
Abstract
AIM To explore the perceived barriers in Type 2 Diabetes care among patients with diabetes. Design The study adopted a qualitative exploratory-descriptive design. METHODS A semi-structured interview guide was used to collect data from fifteen (15) purposively sampled patients with Type 2 Diabetes at a primary level health facility in the Bono East region. Participants' ages ranged between 42-72 years. The interviews were audio-recorded, transcribed verbatim and analysed using thematic content analysis. RESULTS Patients with Type 2 Diabetes encountered a range of barriers in diabetes care. These barriers included lack of knowledge of diabetes dietary management strategies, financial constraints, non-compliance to treatment, lack of glucometers, lack of social support, and increased waiting time at health care facilities. The findings indicate that more education on diabetes and dietary management is required as well as social support from peers, family, and non-governmental organizations. PATIENT OR PUBLIC CONTRIBUTION Diabetes self-management barriers as revealed by the patients who were participants of this study requires nurses and midwives to ensure that self-management education is well understood by patients and their relatives. This would empower the patients and bring clarity to their confusion about self-care practices.
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Affiliation(s)
- Justin Tuobenyiere
- General Nursing Department, Holy Family Nursing and Midwifery Training CollegeTechimanGhana
| | | | - Kwadwo Ameyaw Korsah
- Department of Adult Health, School of Nursing and MidwiferyUniversity of GhanaAccraGhana
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Gliksberg O, Kushnir T, Sznitman SR, Lev-Ran S, Brill S, Amit BH, Feingold D. Negative experiences of patients using medicinal cannabis: A systematic review of qualitative studies. J Clin Nurs 2023; 32:5607-5618. [PMID: 36807590 DOI: 10.1111/jocn.16653] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Revised: 01/25/2023] [Accepted: 01/30/2023] [Indexed: 02/22/2023]
Abstract
AIMS AND OBJECTIVES In this study, we systematically reviewed qualitative studies concerning patients' experience with medicinal cannabis (MC) use, to gain insight into the negative effects of MC. BACKGROUND Over the past decades, the use of MC for therapeutic purposes has increased. However, there is conflicting and insufficient data on possible negative physiological and psychological effects of MC treatment. DESIGN A systematic review was conducted and the PRISMA guidelines were adopted. Literature searches were conducted using PubMed, PsycINFO and EMBASE. Critical Appraisal Skills Programme (CASP) qualitative checklist used to assess risk of bias in the included studies. METHODS We included studies focusing on conventional medical treatment using cannabis-based products, approved by a physician for a particular health issue. RESULTS Of the 1230 articles identified in the initial search, eight articles were included in the review. Following the compilation of themes in the eligible studies, six themes were identified: (1) MC approval; (2) administrative barriers; (3) social perception; (4) MC misuse/widespread effect; (5) adverse effects; and (6) dependence or addiction. These were grouped into two meta-themes: (1) administrative and social aspects of MC use; and (2) experiences of the effects of medicinal cannabis. CONCLUSIONS Our findings call for specific attention to unique consequences associated with MC use. Further research is needed in order to assess the degree to which negative experiences associated with MC use may affect various aspects of patients' medical condition. RELEVANCE TO CLINICAL PRACTICE Describing the complex experience of MC treatment and its spectrum of consequences for patients may enable physicians, therapists and researchers to provide more attentive and accurate MC treatment to their patients. PATIENT OR PUBLIC CONTRIBUTION In this review, patients' narratives were explored, yet the research methods did not directly involve patients or the public.
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Affiliation(s)
- Or Gliksberg
- Doctoral Program, Department of Psychology, Ariel University, Ariel, Israel
| | - Talma Kushnir
- Adelson School of Medicine, Ariel University, Ariel, Israel
- Department of Psychology, Ariel University, Ariel, Israel
| | | | - Shaul Lev-Ran
- Israel Center on Addiction, Netanya, Israel
- Lev Hasharon Medical Center, Netanya, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Silviu Brill
- Institute of Pain Medicine, Tel Aviv Medical Center, Tel Aviv, Israel
| | - Ben H Amit
- Cannabis Clinic, Reuth Rehabilitation Center, Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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Phillips DA, Ginsburg GS, Ehrenreich-May J, Jensen-Doss A. Treatment Engagement in Adolescents: The Associations of Sociodemographic Characteristics, Caregiver Perceived Barriers, and Clinical Impairment. J Clin Child Adolesc Psychol 2023:1-14. [PMID: 37347999 PMCID: PMC10739653 DOI: 10.1080/15374416.2023.2222387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/24/2023]
Abstract
OBJECTIVE To examine the associations between sociodemographic characteristics, perceived barriers to treatment, clinical impairment, and youth treatment engagement. METHOD Participants included 196 families (youth: ages 12 to 18; 64.3% cis-gender female; 23.5% Black, 60.7% White, and 12.2% Mixed/Other race; 41.3% Hispanic or Latinx ethnicity) recruited as part of a comparative effectiveness trial for adolescent anxiety and depression. Self-report measures of sociodemographic characteristics and caregiver perceived barriers were completed at intake. Youth clinical impairment was assessed at baseline via clinical interview. Measures of engagement were collected throughout treatment, including initiation status, session attendance, and termination status. Relationships were examined using analyses of variances and hierarchal linear and logistic modeling. RESULTS Perceived barriers did not differ by sociodemographic characteristics. Greater perceived stressors and obstacles predicted fewer sessions attended and a lower likelihood of successful termination. Youth of caregivers with an advanced degree and those with caregivers who were employed part time attended more sessions and were more likely to initiate and terminate treatment successfully compared to youth with caregivers of a lower education level or student or unemployed status. At higher levels of youth clinical impairment, greater perceived treatment demands and issues predicted reduced likelihood of treatment initiation. CONCLUSIONS Perceived barriers, sociodemographic characteristics, and clinical impairment were all associated with levels of engagement in the treatment process. Baseline and continued assessment of perceived and experienced barriers to treatment may promote individualized strategies for families identified as at-risk for reduced engagement.
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Affiliation(s)
| | - Golda S Ginsburg
- Department of Psychiatry, University of Connecticut School of Medicine
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Waldron I, Senger B, Cookey J, Crown M, Tibbo P. Addressing Stigma and Promoting Help-Seeking Among African Nova Scotian Youth Experiencing Psychosis and Other Mental Health Problems. Can J Psychiatry 2023; 68:200-207. [PMID: 36113102 PMCID: PMC9974652 DOI: 10.1177/07067437221125305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVES The purpose of this study was to gain an in-depth understanding of perceptions of mental illnesses (especially psychosis), help-seeking, barriers to help-seeking, and opportunities to facilitate help-seeking in the African Nova Scotian Community. METHODS A qualitative interpretive narrative approach, using the focus group method, was employed to engage African Nova Scotians in discussions on their perceptions and beliefs about mental illnesses and help-seeking in their communities. Youth in Early Intervention services, their caregivers, youth in the community, their caregivers, community leaders, and health service providers, were recruited from four locations in the Halifax Regional Municipality. A total of 75 individuals (37 female, 38 male) participated in the study. Narrative emplotment was used to analyse data from focus groups. RESULTS Findings from focus groups were categorized based on four areas of discussion: (a) perceptions about psychosis and other mental illnesses among youth, caregivers, service providers and community leaders (b) beliefs about help-seeking among youth, caregivers, services providers and community leaders; (c) barriers and facilitators to seeking help for mental illnesses; and (d) the content and format of educational resources to educate and support youth, families and communities. CONCLUSIONS Stigma surrounding mental illnesses in the community, lack of knowledge of illness and available services, concerns regarding negative involvement with police, or dismissal of difficulties by health care providers represent significant barriers to help-seeking in this community. Additionally, barriers include a lack of trust in health care services and a dearth of African Nova Scotian service providers. Bolstering capacity of community organizations to support and educate individuals around illness as well as fostering collaboration between health services and community organizations could reduce barriers to care. Future research should focus on examining ways to engage African Nova Scotians in collaboration with existing community organizations.
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Affiliation(s)
- Ingrid Waldron
- Department of History, 177373McMaster University, Hamilton, ON, Canada
| | - Brannon Senger
- Department of Psychology and Neuroscience, 3688Dalhousie University, Halifax, NS, Canada
| | - Jacob Cookey
- Department of Psychiatry, 3688Dalhousie University, Halifax, NS, Canada
| | - Margie Crown
- 432234Nova Scotia Health Authority, Halifax, NS, Canada
| | - Phil Tibbo
- Department of Psychology and Neuroscience, 3688Dalhousie University, Halifax, NS, Canada.,Department of Psychiatry, 3688Dalhousie University, Halifax, NS, Canada.,432234Nova Scotia Health Authority, Halifax, NS, Canada
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Skjåkødegård HF, Hystad S, Bruserud I, Conlon RPK, Wilfley D, Frisk B, Roelants M, Juliusson PB, Danielsen YS. Perceived barriers in family-based behavioural treatment of paediatric obesity - Results from the FABO study. Pediatr Obes 2023; 18:e12992. [PMID: 36468217 PMCID: PMC10078207 DOI: 10.1111/ijpo.12992] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Revised: 10/24/2022] [Accepted: 11/18/2022] [Indexed: 12/09/2022]
Abstract
BACKGROUND To date, few studies have investigated perceived barriers among those who participate in and drop out of family-based behavioural treatment (FBT) for paediatric obesity. Examining experienced barriers during treatment, and their role in participation and completion of treatment has important implications for clinical practice. OBJECTIVES To compare perceived barriers to participating in a family-based behavioural social facilitation treatment (FBSFT) for obesity among families who completed and did not complete treatment. METHODS Data were analysed from 90 families of children and adolescents (mean (M) age = 12.8 years, standard deviation (SD) = 3.05) with severe obesity enrolled in a 17-session FBSFT program. After completing 12 sessions or at the time of dropout, parents and therapists completed the Barriers to Treatment Participation Scale (BTPS), a 5-point Likert scale (1 = never a problem, 5 = very often a problem) which includes four subscales: 1. Stressors and obstacles that compete with treatment, 2. Treatment demands and issues, 3. Perceived relevance of treatment, 4. Relationship with the therapist. RESULTS Families who did not complete treatment scored significantly higher on the BTPS subscales stressors and obstacles that compete with treatment (M = 2.03, SD = 0.53 vs. M = 1.70, SD = 0.42), p = 0.010 and perceived relevance of treatment (M = 2.27, SD = 0.48 vs. M = 1.80, SD = 0.50), p < 0.001 than families who completed treatment. No other significant differences between groups were observed. CONCLUSION Families are more likely to drop out of FBSFT when experiencing a high burden from life stressors or when treatment is not meeting the expectations and perceived needs of the family.
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Affiliation(s)
| | - Sigurd Hystad
- Department of Psychosocial Science, University of Bergen, Bergen, Norway
| | - Ingvild Bruserud
- Faculty of Health, VID Specialized University, Bergen, Norway
- Department of Pediatrics, Haukeland University Hospital, Bergen, Norway
| | - Rachel P K Conlon
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Denise Wilfley
- Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Bente Frisk
- Department of Health and Functioning, Western Norway University of Applied Sciences, Bergen, Norway
- Department of Physiotherapy, Haukeland University Hospital, Bergen, Norway
| | - Mathieu Roelants
- Department of Public Health and Primary Care, KU Leuven, University of Leuven, Leuven, Belgium
| | - Petur B Juliusson
- Department of Clinical Science, University of Bergen, Bergen, Norway
- Children and Youth Clinic, Haukeland University Hospital, Bergen, Norway
- Department of Health Registry Research and Development, Norwegian Institute of Public Health, Bergen, Norway
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Edwards J, Kamali M, Georgiades S, Waddell C, Georgiades K. Provincial and Territorial Variation in Barriers in Accessing Healthcare for Children and Youth With Mental and Neurodevelopmental Health Concerns in Canada. Can J Psychiatry 2022; 67:867-869. [PMID: 35938630 PMCID: PMC9561698 DOI: 10.1177/07067437221114005] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Jordan Edwards
- Department of Psychiatry and Behavioural Neurosciences, 3710McMaster University, Hamilton, Ontario, Canada.,Offord Centre for Child Studies, 3710McMaster University, Hamilton, Ontario, Canada
| | - Mahdis Kamali
- Department of Psychiatry and Behavioural Neurosciences, 3710McMaster University, Hamilton, Ontario, Canada.,Offord Centre for Child Studies, 3710McMaster University, Hamilton, Ontario, Canada
| | - Stelios Georgiades
- Department of Psychiatry and Behavioural Neurosciences, 3710McMaster University, Hamilton, Ontario, Canada.,Offord Centre for Child Studies, 3710McMaster University, Hamilton, Ontario, Canada
| | - Charlotte Waddell
- Children's Health Policy Centre, Faculty of Health Sciences, Simon Fraser University, Vancouver, British Columbia, Canada
| | - Katholiki Georgiades
- Department of Psychiatry and Behavioural Neurosciences, 3710McMaster University, Hamilton, Ontario, Canada.,Offord Centre for Child Studies, 3710McMaster University, Hamilton, Ontario, Canada
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Ahluwalia A, Rafizadeh R, White RF, Bahji A, Danilewitz M. Listening to the Patient's Voice: A Patient-Centred Approach to Treatment-Resistant Schizophrenia. Can J Psychiatry 2022; 67:235-237. [PMID: 34889122 PMCID: PMC8935595 DOI: 10.1177/07067437211066262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Amrit Ahluwalia
- University of Medicine and Health Sciences, Basseterre, St. Kitts and Nevis
| | - Reza Rafizadeh
- BC Psychosis Program, 60299British Columbia Mental Health & Substance Use Services, Vancouver, Canada
| | - Randall F White
- BC Psychosis Program, 60299British Columbia Mental Health & Substance Use Services, Vancouver, Canada.,Department of Psychiatry, 8166University of British Columbia, Vancouver, Canada
| | - Anees Bahji
- Department of Psychiatry, 2129University of Calgary, Calgary, Canada
| | - Marlon Danilewitz
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada.,25487 Ontario Shores Centre for Mental Health Sciences, Whitby, Ontario, Canada
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Rivera-Figueroa K, Marfo NYA, Eigsti IM. Parental Perceptions of Autism Spectrum Disorder in Latinx and Black Sociocultural Contexts: A Systematic Review. Am J Intellect Dev Disabil 2022; 127:42-63. [PMID: 34979034 PMCID: PMC8740628 DOI: 10.1352/1944-7558-127.1.42] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Accepted: 03/30/2021] [Indexed: 05/15/2023]
Abstract
Parents of children with autism spectrum disorder (ASD) face challenges in accessing diagnostic and treatment services; these challenges vary by race, ethnicity, and culture. This systematic review examines parental perceptions of ASD within Latinx and Black American communities. Findings indicate that interconnections with family and religious groups promoted positive coping and describe positive impacts of having a child with ASD. Relative to White families, community members reported reduced access to information and more inaccurate beliefs about ASD, higher levels of ASD-related stigma, and more negative experiences with healthcare providers, which serve to exacerbate healthcare disparities. Conclusions are limited by an underrepresentation of minority groups in research. We call for efforts to address the specific needs of racial and ethnic minorities.
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Affiliation(s)
- Karla Rivera-Figueroa
- Karla Rivera-Figueroa, Nana Yaa A. Marfo, and Inge-Marie Eigsti, University of Connecticut
| | - Nana Yaa A Marfo
- Karla Rivera-Figueroa, Nana Yaa A. Marfo, and Inge-Marie Eigsti, University of Connecticut
| | - Inge-Marie Eigsti
- Karla Rivera-Figueroa, Nana Yaa A. Marfo, and Inge-Marie Eigsti, University of Connecticut
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Filteau C, Simeone A, Ravot C, Dayde D, Falandry C. Cultural and Ethical Barriers to Cancer Treatment in Nursing Homes and Educational Strategies: A Scoping Review. Cancers (Basel) 2021; 13:3514. [PMID: 34298728 PMCID: PMC8305927 DOI: 10.3390/cancers13143514] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2021] [Revised: 06/30/2021] [Accepted: 07/05/2021] [Indexed: 01/15/2023] Open
Abstract
(1) Background: The aging of the population, the increase in the incidence of cancer with age, and effective chronic oncological treatments all lead to an increased prevalence of cancer in nursing homes. The aim of the present study was to map the cultural and ethical barriers associated with the treatment of cancer and educational strategies in this setting. (2) Methods: A systematic scoping review was conducted until April 2021 in MEDLINE, Embase, and CINAHL. All articles assessing continuum of care, paramedical education, and continuing education in the context of older cancer patients in nursing homes were reviewed. (3) Results: A total of 666 articles were analyzed, of which 65 studies were included. Many factors interfering with the decision to investigate and treat, leading to late- or unstaged disease, palliative-oriented care instead of curative, and a higher risk of unjustified transfers to acute care settings, were identified. The educational strategies explored in this context were generally based on training programs. (4) Conclusions: These results will allow the co-construction of educational tools intended to develop knowledge and skills to improve diagnostic and therapeutic decision-making, the consistency of care, and, ultimately, the quality of life of older cancer patients in nursing homes.
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Affiliation(s)
- Cynthia Filteau
- Service de Gériatrie, Centre Hospitalier Lyon Sud, Hospices Civils de Lyon, 69495 Pierre-Bénite, France; (C.R.); (C.F.)
- Département de Gériatrie, Hôpital Maisonneuve-Rosemont, Université de Montréal, Montréal, QC H1T 2M4, Canada
| | - Arnaud Simeone
- Université Lumière-Groupe de Recherche en Psychologie Sociale (UR GRePS) Institut de Psychologie, 69676 Bron, France;
| | - Christine Ravot
- Service de Gériatrie, Centre Hospitalier Lyon Sud, Hospices Civils de Lyon, 69495 Pierre-Bénite, France; (C.R.); (C.F.)
| | - David Dayde
- Plateforme de Recherche de l’Institut de Cancérologie des Hospices Civils de Lyon, Centre Hospitalier Lyon Sud, Hospices Civils de Lyon, 69495 Pierre-Bénite, France;
| | - Claire Falandry
- Service de Gériatrie, Centre Hospitalier Lyon Sud, Hospices Civils de Lyon, 69495 Pierre-Bénite, France; (C.R.); (C.F.)
- Laboratoire CarMeN, INSERM, INRAE, Université Claude Bernard Lyon-1, 69600 Oullins, France
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15
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Abstract
Background: Prevalence rates of posttraumatic stress disorder and depression are high among refugees in Germany. However, knowledge on subjective as well as objective need for psychotherapy and utilization of psychotherapeutic treatment is scarce. Both structural and personal barriers regarding utilization of mental health services must be addressed in order to increase treatment efficiency. Objective: The aim of this study was to determine the objective as well as the perceived need for treatment, the utilization of mental health care among refugees in the past 12 months, and the perceived barriers to treatment. Method: By means of face-to-face interviews, an unselected convenience sample of 177 adult refugees were interviewed in either Arabic, Farsi, Kurmancî, English, or German. The general sample was reached through social workers. In addition to the Refugee Health Screener-15 (RHS-15), utilization of psychotherapeutic and psychiatric care as well as the subjective needs and barriers to treatment were assessed. Results: According to the RHS-15 54.8% of participants (n = 97) suffered from relevant mental health problems. However, although 28 (28.9%) of the 97 participants who scored above the RHS-15 cut-off perceived a need for therapy, none of them had received psychotherapy as recommended by the German S3 Guidelines. Missing information about mental health and language difficulties were the most frequently cited barriers to mental health services. Conclusions: Psychologically distressed refugees do not receive sufficient treatment. The reduction of barriers to treatment as well as extension of mental health services to lower thresholds should be considered in the future.
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Affiliation(s)
- Victoria S Boettcher
- Department of Clinical Psychology and Psychotherapy, Bielefeld University, Bielefeld, Germany
| | - Anna C Nowak
- School of Public Health, Bielefeld University, Bielefeld, Germany
| | - Frank Neuner
- Department of Clinical Psychology and Psychotherapy, Bielefeld University, Bielefeld, Germany
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16
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Wouldes TA, Crawford A, Stevens S, Stasiak K. Evidence for the Effectiveness and Acceptability of e-SBI or e-SBIRT in the Management of Alcohol and Illicit Substance Use in Pregnant and Post-partum Women. Front Psychiatry 2021; 12:634805. [PMID: 34025470 PMCID: PMC8131659 DOI: 10.3389/fpsyt.2021.634805] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2020] [Accepted: 03/17/2021] [Indexed: 12/12/2022] Open
Abstract
Alcohol and illicit psychoactive drug use during pregnancy have increased worldwide, putting women and their children's health and development at risk. Multiple drug use, comorbid psychiatric disorders, sexual and physical abuse are common in women who use alcohol and drugs during pregnancy. The effects on the mother include poor reproductive and life-long health, legal, family, and social problems. Additionally, the exposed child is at increased risk of long-term physical health, mental health, and developmental problems. The stigma associated with substance use during pregnancy and some clinicians' reticence to inquire about substance use means many women are not receiving adequate prenatal, substance abuse, and mental health care. Evidence for mHealth apps to provide health care for pregnant and post-partum women reveal the usability and effectiveness of these apps to reduce gestational weight gain, improve nutrition, promote smoking cessation and manage gestational diabetes mellitus, and treat depression and anxiety. Emerging evidence suggests mHealth technology using a public health approach of electronic screening, brief intervention, or referral to treatment (e-SBIRT) for substance use or abuse can overcome the typical barriers preventing women from receiving treatment for alcohol and drug use during pregnancy. This brief intervention delivered through a mobile device may be equally effective as SBIRT delivered by a health care professional in preventing maternal drug use, minimizing the effects to the exposed child, and providing a pathway to therapeutic options for a substance use disorder. However, larger studies in more diverse settings with women who have co-morbid mental illness and a constellation of social risk factors that are frequently associated with substance use disorders are needed.
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Affiliation(s)
- Trecia A Wouldes
- Department of Psychological Medicine, Faculty of Medical and Health Science, University of Auckland, Auckland, New Zealand
| | - Andi Crawford
- Department of Psychological Medicine, Faculty of Medical and Health Science, University of Auckland, Auckland, New Zealand
- Te Ara Manapou, Parenting and Pregnancy Service, Hawke's Bay District Health Board, Hastings, New Zealand
| | - Suzanne Stevens
- Department of Psychological Medicine, Faculty of Medical and Health Science, University of Auckland, Auckland, New Zealand
| | - Karolina Stasiak
- Department of Psychological Medicine, Faculty of Medical and Health Science, University of Auckland, Auckland, New Zealand
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17
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Alavi N, Stephenson C, Rivera M. Effectiveness of Delivering Dialectical Behavioral Therapy Techniques by Email in Patients With Borderline Personality Disorder: Nonrandomized Controlled Trial. JMIR Ment Health 2021; 8:e27308. [PMID: 33835936 PMCID: PMC8122286 DOI: 10.2196/27308] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Revised: 03/04/2021] [Accepted: 03/09/2021] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Borderline personality disorder is a debilitating and prevalent mental health disorder, with often inaccessible treatment options. Electronically delivered dialectical behavioral therapy could be an efficacious and more accessible intervention. OBJECTIVE We aimed to evaluate the efficacy of electronic delivery of dialectical behavioral therapy in the treatment of individuals with symptoms of borderline personality disorder. METHODS Study participants diagnosed with borderline personality disorder were offered either an email-based or in-person group format dialectical behavioral therapy skill-building program. During each session, participants were provided with both the material and feedback regarding their previous week's homework. Electronically delivered dialectical behavioral therapy protocol and content were designed to mirror in-person content. Participants were assessed using the Self-Assessment Questionnaire (SAQ) and Difficulties in Emotion Regulation Scale (DERS). RESULTS There were significant increases in SAQ scores from pre- to posttreatment in the electronic delivery group (F1,92=69.32, P<.001) and in-person group (F1,92=60.97, P<.001). There were no significant differences observed between the groups at pre- and posttreatment for SAQ scores (F1,92=.05, P=.83). There were significant decreases in DERS scores observed between pre- and posttreatment in the electronic delivery group (F1,91=30.15, P<.001) and the in-person group (F1,91=58.18, P<.001). There were no significant differences observed between the groups for DERS scores pre- and posttreatment (F1,91=.24, P=.63). There was no significant difference in treatment efficacy observed between the 2 treatment arms (P<.001). CONCLUSIONS Despite the proven efficacy of in-person dialectical behavioral therapy in the treatment of borderline personality disorder, there are barriers to receiving this treatment. With the prevalence of internet access continuing to rise globally, delivering dialectical behavioral therapy with email may provide a more accessible alternative to treatment for individuals with borderline personality disorder without sacrificing the quality of care. TRIAL REGISTRATION ClinicalTrials.gov NCT04493580; https://clinicaltrials.gov/ct2/show/NCT04493580.
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Affiliation(s)
- Nazanin Alavi
- Department of Psychiatry, Queen's University, Kingston, ON, Canada.,Centre for Neuroscience Studies, Faculty of Health Sciences, Queen's University, Kingston, ON, Canada
| | - Callum Stephenson
- Department of Psychiatry, Queen's University, Kingston, ON, Canada.,Centre for Neuroscience Studies, Faculty of Health Sciences, Queen's University, Kingston, ON, Canada
| | - Margo Rivera
- Personality Disorder Services, Queen's University, Kingston, ON, Canada
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18
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Gratzer D, Torous J, Lam RW, Patten SB, Kutcher S, Chan S, Vigo D, Pajer K, Yatham LN. Our Digital Moment: Innovations and Opportunities in Digital Mental Health Care. Can J Psychiatry 2021; 66:5-8. [PMID: 32603188 PMCID: PMC7890581 DOI: 10.1177/0706743720937833] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- David Gratzer
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada.,Department of Psychiatry, University of Toronto, Ontario, Canada
| | - John Torous
- Department of Psychiatry, 1859Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Raymond W Lam
- Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada
| | - Scott B Patten
- Departments of Psychiatry and Community Health Sciences, 2129University of Calgary, Alberta, Canada
| | - Stanley Kutcher
- Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada.,Senate of Canada, Ottawa, Ontario, Canada
| | - Steven Chan
- Department of Psychiatry, Stanford University School of Medicine, Stanford, CA, USA.,Palo Alto VA Health, Palo Alto, CA, USA
| | - Daniel Vigo
- Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada.,Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA
| | - Kathleen Pajer
- Department of Psychiatry, University of Ottawa, Ontario, Canada
| | - Lakshmi N Yatham
- Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada
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19
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McCausland J, Paparo J, Wootton BM. Treatment barriers, preferences and histories of individuals with symptoms of body dysmorphic disorder. Behav Cogn Psychother 2021; 49:582-95. [PMID: 33161929 DOI: 10.1017/S1352465820000843] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Individuals with mental health concerns face many barriers when accessing psychological treatment. Even when patients overcome these barriers, they often do not receive an evidence-based treatment. Although the current literature highlights these issues clearly across psychological disorders, the research is limited in relation to body dysmorphic disorder (BDD). AIM The aim of this study was to examine psychological treatment barriers, treatment delivery preferences and treatment histories of individuals with symptoms of BDD. METHOD A total of 122 participants with clinically significant BDD symptoms (94% female; mean age = 34.19 years, SD = 10.86) completed the cross-sectional study. RESULTS The most frequently reported barriers to accessing psychological treatment for individuals with BDD symptoms were the cost of treatment (41%) and the belief that the symptoms did not warrant treatment (36%). Although 69% of treatment-seeking participants reported previously receiving cognitive behavioural therapy (CBT) for BDD, only 13% of participants appeared to receive best-practice CBT. The preferred modality of future psychological treatment delivery was face-to-face treatment with a therapist once a week (63%), rather than accelerated or remote treatment approaches. CONCLUSIONS The study suggests that there are significant barriers to accessing CBT for BDD. Reducing these barriers, as well as increasing consumer mental health literacy, is required to improve treatment access and treatment outcomes for individuals with BDD.
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20
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Affiliation(s)
- Emmanuel Stip
- Department of Psychiatry and Behavioral Science, United Arab Emirates University, Abu Dhabi, United Arab Emirates.,Department of Pharmacology, Université de Montréal, Quebec, Canada
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21
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Al‐Habeeb A, Altwaijri YA, Al‐Subaie AS, Bilal L, Almeharish A, Sampson NA, Liu H, Kessler RC. Twelve-month treatment of mental disorders in the Saudi National Mental Health Survey. Int J Methods Psychiatr Res 2020; 29:e1832. [PMID: 32519421 PMCID: PMC7507396 DOI: 10.1002/mpr.1832] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Accepted: 04/12/2020] [Indexed: 01/11/2023] Open
Abstract
OBJECTIVES To estimate treatment rates of 12-month mental disorders in the Saudi National Mental Health Survey (SNMHS). METHODS The SNMHS is a face-to-face community epidemiological survey in a nationally representative household sample of citizens ages 15-65 in the Kingdom of Saudi Arabia (KSA) (n = 4,004). The World Health Organization Composite International Diagnostic Interview (CIDI) was used to produce estimates of 12-month prevalence and treatment of common DSM-IV mental disorders. RESULTS About one eighth (13.7%) of respondents with a 12-month DSM-IV/CIDI disorder received 12-month treatment. The highest proportion of treatment occurred in the general medical sector (53.0%). Close to half (45.2%) of patients received treatment rated at least minimally adequate using standard treatment guidelines. Although serious disorders were significantly more likely to be treated (20.2%) than mild or moderate disorders (8.5-10.7%), no association was found between disorder severity and probability of receiving adequate treatment. Sociodemographic correlates were for the most part nonsignificant. CONCLUSIONS A high level of unmet need for treatment of mental disorders exists in KSA. Further analyses of the SNMHS data might provide insights into modifiable barriers to treatment and policy options to address the problem of unmet need for treatment.
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Affiliation(s)
| | - Yasmin A. Altwaijri
- King Salman Center for Disability ResearchRiyadhSaudi Arabia
- Biostatistics, Epidemiology and Scientific Computing DepartmentKing Faisal Specialist Hospital and Research CentreRiyadhSaudi Arabia
- SABIC Psychological Health Research & Applications Chair (SPHRAC), College of Medicine King Saud UniversityRiyadhSaudi Arabia
| | - Abdullah S. Al‐Subaie
- SABIC Psychological Health Research & Applications Chair (SPHRAC), College of Medicine King Saud UniversityRiyadhSaudi Arabia
- Edrak Medical CenterRiyadhSaudi Arabia
| | - Lisa Bilal
- King Salman Center for Disability ResearchRiyadhSaudi Arabia
- Biostatistics, Epidemiology and Scientific Computing DepartmentKing Faisal Specialist Hospital and Research CentreRiyadhSaudi Arabia
- SABIC Psychological Health Research & Applications Chair (SPHRAC), College of Medicine King Saud UniversityRiyadhSaudi Arabia
| | - Amani Almeharish
- Biostatistics, Epidemiology and Scientific Computing DepartmentKing Faisal Specialist Hospital and Research CentreRiyadhSaudi Arabia
| | - Nancy A. Sampson
- Department of Health Care PolicyHarvard Medical SchoolBostonMassachusettsUSA
| | - Howard Liu
- Department of Health Care PolicyHarvard Medical SchoolBostonMassachusettsUSA
| | - Ronald C. Kessler
- Department of Health Care PolicyHarvard Medical SchoolBostonMassachusettsUSA
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22
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Bohr Y, Bimm M, Bint Misbah K, Perrier R, Lee Y, Armour L, Sockett-DiMarco N. The Crying Clinic: Increasing accessibility to Infant Mental Health services for immigrant parents at risk for peripartum depression. Infant Ment Health J 2020; 42:140-156. [PMID: 32644229 DOI: 10.1002/imhj.21879] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Peripartum depression (PPD) is considered a major public health concern due to its profound impact on families, including infants. In this paper, we report on a pilot initiative designed to reduce barriers and stigma related to the use of traditional infant mental health services for immigrant parents deemed at high risk of PPD. The Crying Clinic (CC) is an innovative walk-in service offered in a culturally diverse Canadian community to support maternal well-being and healthy parent-infant relationships. The CC was designed to be a gateway to existing infant mental health services, through its emphasis on accessibility and cultural sensitivity. Support for concrete concerns, such as anxiety about normative infant behaviors like crying, is underscored in this approach to attract vulnerable families who would otherwise not access mental health support. A review of 44 users, utilization, plans for the use of additional services, and client evaluations suggests that the CC accomplished most of its goals. We conclude that gateway service models such as the CC have the potential to enhance traditional infant mental health programs by creatively addressing the challenge of engaging highly vulnerable parents from culturally diverse backgrounds.
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Affiliation(s)
- Y Bohr
- Department of Psychology, York University, Toronto, Canada
| | - M Bimm
- Department of Psychology, York University, Toronto, Canada
| | - K Bint Misbah
- Department of Psychology, York University, Toronto, Canada
| | - R Perrier
- Department of Psychology, University of Montreal, Montreal, Canada
| | - Y Lee
- Department of Psychology, York University, Toronto, Canada
| | - L Armour
- Aisling Discoveries Child and Family Centre, Scarborough, Canada
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23
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Isaacs DS, Tehee M, Green J, Straits KJE, Ellington T. When psychologists take a stand: Barriers to trauma response services and advocacy for American Indian communities. J Trauma Dissociation 2020; 21:468-483. [PMID: 32584708 DOI: 10.1080/15299732.2020.1770148] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
American Indians and other Indigenous groups face numerous traumas resulting from civil rights infractions. Often, these infractions began in historical contexts and continue into modern experiences. The Dakota Access Pipeline (DAPL) and subsequent activist response at Standing Rock are a prime example of how movements asserting human rights are met with resistance from dominant majority groups. Generally, this resistance turns violent as police and security responses from the dominant culture escalate despite the peaceful nature of demonstrations. This impacts mental health among oppressed populations. As #NoDAPL progressed, Indigenous psychologists felt moved to "Stand with Standing Rock" by supporting Water Protectors in need of trauma services. This was met with institutional and systemic barriers to treatment and lack of support from key professional organizations. This article addresses barriers faced by mental health professionals providing services on the frontlines and lists potential resolutions including the development of a crisis response team, infrastructure for communication with individuals onsite, culturally congruent healing, community-building, and prayer. The article serves as a case study for trauma provision among American Indian communities in crisis and is a reminder of the resilience and empowerment that occurs when Indigenous peoples from all over the world come together for a shared cause. This case study format can be a guiding example for service providers choosing to take a stand with marginalized communities asserting social change.
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Affiliation(s)
| | | | - Julii Green
- Clinical Psychology, Alliant International University , San Diego, USA
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24
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Alangari AS, Knox SS, Kristjansson AL, Wen S, Innes KE, Bilal L, Alhabeeb A, Al-Subaie AS, Altwaijri YA. Barriers to Mental Health Treatment in the Saudi National Mental Health Survey. Int J Environ Res Public Health 2020; 17:E3877. [PMID: 32486182 PMCID: PMC7311952 DOI: 10.3390/ijerph17113877] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 05/27/2020] [Accepted: 05/28/2020] [Indexed: 02/07/2023]
Abstract
Objectives: To examine barriers to initiation and continuation of treatment among individuals with common mental disorders in the Saudi National Mental Health Survey (SNMHS). Methods: The SNMHS is a community-based epidemiological survey in a nationally representative household sample of respondents aged 15-65 in the Kingdom of Saudi Arabia. The World Health Organization Composite International Diagnostic Interview (CIDI) 3.0 was used. Predictors of barriers to treatment were analyzed with multivariable logistic regression. Results: Among participants with a 12-month DSM-IV/CIDI disorder (n = 711), 86.1% reported no service use. Of those (n = 597), 50.7% did not think they needed any help (categorized as "low perceived need") and 49.3% did perceive need. Of those who perceived need (n = 309), the majority (98.9%) reported attitudinal barriers to initiation. In contrast, 10.3% of those with a perceived need reported structural barriers. Respondents who were previously married or indicated below-average income were more likely to believe they needed help. Conclusions: Among people with a diagnosed mental disorder, low perceived need and attitudinal barriers are the primary barriers to mental health treatment in the KSA. The results suggest that addressing poor mental health literacy may be essential factor in reducing the unmet need for mental health treatment in the KSA.
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Affiliation(s)
- Abdulaziz S. Alangari
- Department of Epidemiology, School of Public Health, West Virginia University, Morgantown, WV 26506, USA; (S.S.K.); (K.E.I.)
- Department of Epidemiology and Biostatistics, College of Public Health and Health Informatics, King Saud bin Abdulaziz University for Health Sciences, Riyadh 11481, Saudi Arabia
| | - Sarah S. Knox
- Department of Epidemiology, School of Public Health, West Virginia University, Morgantown, WV 26506, USA; (S.S.K.); (K.E.I.)
| | - Alfgeir L. Kristjansson
- Department of Social and Behavioral Sciences, School of Public Health, West Virginia University, Morgantown, WV 26506, USA;
| | - Sijin Wen
- Department of Biostatistics, School of Public Health, West Virginia University, Morgantown, WV 26506, USA;
| | - Kim E. Innes
- Department of Epidemiology, School of Public Health, West Virginia University, Morgantown, WV 26506, USA; (S.S.K.); (K.E.I.)
| | - Lisa Bilal
- Biostatistics, Epidemiology and Scientific Computing Department, King Faisal Specialist Hospital and Research Centre, Riyadh 11211, Saudi Arabia; (L.B.); (Y.A.A.)
- King Salman Center for Disability Research, Riyadh 12512, Saudi Arabia
- SABIC Psychological Health Research & Applications Chair (SPHRAC), College of Medicine, King Saud University, Riyadh 12372, Saudi Arabia;
| | - Abdulhameed Alhabeeb
- National Center for Mental Health Promotion, Ministry of Health, Riyadh 11525, Saudi Arabia;
| | - Abdullah S. Al-Subaie
- SABIC Psychological Health Research & Applications Chair (SPHRAC), College of Medicine, King Saud University, Riyadh 12372, Saudi Arabia;
- Edrak Medical Center, Riyadh 12281, Saudi Arabia
| | - Yasmin A. Altwaijri
- Biostatistics, Epidemiology and Scientific Computing Department, King Faisal Specialist Hospital and Research Centre, Riyadh 11211, Saudi Arabia; (L.B.); (Y.A.A.)
- King Salman Center for Disability Research, Riyadh 12512, Saudi Arabia
- SABIC Psychological Health Research & Applications Chair (SPHRAC), College of Medicine, King Saud University, Riyadh 12372, Saudi Arabia;
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25
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Hoffmann D, Rask CU, Hedman-Lagerlöf E, Eilenberg T, Frostholm L. Accuracy of self-referral in health anxiety: comparison of patients self-referring to internet-delivered treatment versus patients clinician-referred to face-to-face treatment. BJPsych Open 2019; 5:e80. [PMID: 31496462 PMCID: PMC6737511 DOI: 10.1192/bjo.2019.54] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
BACKGROUND Severe health anxiety is a chronic and costly disorder if untreated. Patient self-referral may lower barriers to treatment and decrease diagnostic delay. AIMS This study evaluated the accuracy of self-referral for severe health anxiety and compared characteristics of patients self-referred to internet-delivered treatment with patients referred by a clinician to face-to-face treatment. METHOD Two trials in the same clinic employed different referral methods for health anxiety, namely self-referral and clinician-referral (trial registration: clinicaltrials.gov: NCT01158430 and NCT02735434). The trials were conducted at different time points but with largely comparable eligibility criteria. The accuracy of the recruitment methods was compared by looking at the number of eligible patients in the two trials. Patients completed a baseline questionnaire and subsequently underwent a diagnostic interview by experienced clinicians. Mean differences in self-report and clinical data explored between-group demographic and clinical characteristics. RESULTS In total, 101/151 (67%) self-referred patients were eligible compared with 126/254 (50%) clinician-referred patients (P = 0.001). Self-referred patients were 3.4 years older (P = 0.008) and had a somewhat higher educational level (P = 0.030). Patients who self-referred reported significantly higher levels of health anxiety, emotional distress and somatic symptoms compared with clinician-referred patients. Yet, they had less clinician-assessed comorbid anxiety disorders (P<0.001) and better physical health-related quality of life (P<0.001) suggesting a more distinct symptom profile. CONCLUSIONS Self-referral was found to be an accurate method to recruit highly relevant patients with treatment-demanding health anxiety. Thus, both self-referral and clinician-referral seem feasible and valid referral methods, but they may recruit patients with slightly different characteristics. DECLARATION OF INTEREST None.
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Affiliation(s)
- Ditte Hoffmann
- Postdoctoral Researcher, The Research Clinic for Functional Disorders and Psychosomatics, Aarhus University Hospital, Denmark
| | - Charlotte Ulrikka Rask
- Professor, Child and Adolescent Psychiatric Centre, Risskov, Aarhus University Hospital, Denmark
| | - Erik Hedman-Lagerlöf
- Associate Professor, Department of Clinical Neuroscience, Karolinska Institute, Sweden
| | - Trine Eilenberg
- Clinical Psychologist, Department of Occupational Medicine, Aarhus University Hospital, Denmark
| | - Lisbeth Frostholm
- Associate Professor, The Research Clinic for Functional Disorders and Psychosomatics, Aarhus University Hospital, Denmark
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26
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Affiliation(s)
- David Gratzer
- Centre for Addiction and Mental Health, Toronto, Ontario
- Department of Psychiatry, University of Toronto, Toronto, Ontario
| | - David Goldbloom
- Centre for Addiction and Mental Health, Toronto, Ontario
- Department of Psychiatry, University of Toronto, Toronto, Ontario
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27
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Abstract
BACKGROUND As opioid use increases in the United States, especially in the correctional population, the most effective treatment approaches need to be utilized. Research has shown that medication-assisted treatment (MAT) provides better outcomes than traditional treatment approaches alone, but is underutilized among correctional-supervised populations. OBJECTIVE This article looks at how previously identified barriers to implementing MAT can create potential biases regarding the intent to refer individuals to either buprenorphine or methadone among treatment and correctional staff within community corrections. The varying advantages of each medication are discussed to highlight the importance of individualized treatment planning. METHODS Data were collected from 959 treatment specialists and community-corrections officers between 2010 and 2013. The participants were employed by one of 20 community corrections agencies that were selected and randomized within a cluster design. The data were part of a larger study that tested how the experimental condition of organizational linkages impacted the use of MAT in the criminal justice system. In order to analyze the data, multinomial logistic regression was used. RESULTS Results showed that some community corrections employees were likely to refer clients to use methadone, but not buprenorphine (or vice versa) which was influenced by work setting, level of education, training, and negative perceptions of MAT as a substitute addiction. However, these biases could be minimized by proper training. CONCLUSION These findings suggest that proper training should be mandatory for these employees and include information about various MATs while also addressing the negative perception that MAT is a substitute addiction.
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Affiliation(s)
- S E Streisel
- a Department of Sociology and Criminal Justice , University of Delaware , Newark , Delaware , USA
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Sølund C, Hallager S, Pedersen MS, Fahnøe U, Ernst A, Krarup HB, Røge BT, Christensen PB, Laursen AL, Gerstoft J, Bélard E, Madsen LG, Schønning K, Pedersen AG, Bukh J, Weis N. Direct acting antiviral treatment of chronic hepatitis C in Denmark: factors associated with and barriers to treatment initiation. Scand J Gastroenterol 2018; 53:849-856. [PMID: 29720023 DOI: 10.1080/00365521.2018.1467963] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
OBJECTIVES We describe factors associated with and barriers to initiation of Direct Acting Antiviral (DAA) treatment in patients with chronic hepatitis C, who fulfill national fibrosis treatment guidelines in Denmark. MATERIALS AND METHODS In this nationwide cohort study, we included patients with chronic hepatitis C from The Danish Database for Hepatitis B and C (DANHEP) who fulfilled fibrosis treatment criteria. Factors associated with treatment initiation and treatment failure were determined by logistic regression analyses. Medical records were reviewed from patients who fulfilled fibrosis treatment criteria, but did not initiate DAA treatment to determine the cause. RESULTS In 344 (49%) of 700 patients, who fulfilled treatment criteria, factors associated with DAA treatment initiation were transmission by other routes than injecting drug use odds ratio (OR) 2.13 (CI: 1.38-3.28), previous treatment failure OR 2.58 (CI: 1.84-3.61) and ALT above upper limit of normal OR 1.60 (CI: 1.18-2.17). The most frequent reasons for not starting treatment among 356 (51%) patients were non-adherence to medical appointments (n = 107/30%) and ongoing substance use (n = 61/17%). Treatment failure with viral relapse occurred in 19 (5.5%) patients, who were more likely to have failed previous treatment OR 4.53 (CI: 1.59-12.91). CONCLUSIONS In this nationwide cohort study, we found non-adherence to medical appointments and active substance use to be major obstacles for DAA treatment initiation. Our findings highlight the need for interventions that can overcome these barriers and increase the number of patients who can initiate and benefit from curative DAA treatment.
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Affiliation(s)
- Christina Sølund
- a Department of Infectious Diseases , Copenhagen University Hospital , Hvidovre , Denmark.,b Copenhagen Hepatitis C Program (CO-HEP), Department of Infectious Diseases, Copenhagen University Hospital, Hvidovre and Department of Immunology and Microbiology, Faculty of Health and Medical Sciences , University of Copenhagen , Copenhagen , Denmark
| | - Sofie Hallager
- a Department of Infectious Diseases , Copenhagen University Hospital , Hvidovre , Denmark
| | - Martin S Pedersen
- b Copenhagen Hepatitis C Program (CO-HEP), Department of Infectious Diseases, Copenhagen University Hospital, Hvidovre and Department of Immunology and Microbiology, Faculty of Health and Medical Sciences , University of Copenhagen , Copenhagen , Denmark.,c Department of Clinical Microbiology , Copenhagen University Hospital , Hvidovre , Denmark.,d Department of Science and Environment , Roskilde University , Roskilde , Denmark
| | - Ulrik Fahnøe
- b Copenhagen Hepatitis C Program (CO-HEP), Department of Infectious Diseases, Copenhagen University Hospital, Hvidovre and Department of Immunology and Microbiology, Faculty of Health and Medical Sciences , University of Copenhagen , Copenhagen , Denmark
| | - Anja Ernst
- e Department of Molecular Diagnostics , Aalborg University Hospital , Aalborg , Denmark
| | - Henrik B Krarup
- e Department of Molecular Diagnostics , Aalborg University Hospital , Aalborg , Denmark.,f Department of Medical Gastroenterology , Aalborg University Hospital , Aalborg , Denmark
| | - Birgit T Røge
- g Department of Medicine , Lillebaelt Hospital , Kolding , Denmark
| | - Peer B Christensen
- h Department of Infectious Diseases , Odense University Hospital , Odense , Denmark.,i Department of Clinical Research, Faculty of Health Sciences , University of Southern Denmark , Odense , Denmark
| | - Alex L Laursen
- j Department of Infectious Diseases , Aarhus University Hospital , Skejby , Denmark
| | - Jan Gerstoft
- k Department of Infectious Diseases , Copenhagen University Hospital, Rigshospitalet , Copenhagen , Denmark.,l Department of Clinical Medicine, Faculty of Health and Medical Sciences , University of Copenhagen , Copenhagen , Denmark
| | - Erika Bélard
- m Department of Gastroenterology , Copenhagen University Hospital , Herlev , Denmark
| | - Lone G Madsen
- l Department of Clinical Medicine, Faculty of Health and Medical Sciences , University of Copenhagen , Copenhagen , Denmark.,n Department of Medical Gastroenterology , Zealand University Hospital , Køge , Denmark
| | - Kristian Schønning
- c Department of Clinical Microbiology , Copenhagen University Hospital , Hvidovre , Denmark.,l Department of Clinical Medicine, Faculty of Health and Medical Sciences , University of Copenhagen , Copenhagen , Denmark
| | - Anders G Pedersen
- o DTU Bioinformatics , Technical University of Denmark , Lyngby , Denmark
| | - Jens Bukh
- a Department of Infectious Diseases , Copenhagen University Hospital , Hvidovre , Denmark.,b Copenhagen Hepatitis C Program (CO-HEP), Department of Infectious Diseases, Copenhagen University Hospital, Hvidovre and Department of Immunology and Microbiology, Faculty of Health and Medical Sciences , University of Copenhagen , Copenhagen , Denmark
| | - Nina Weis
- a Department of Infectious Diseases , Copenhagen University Hospital , Hvidovre , Denmark.,l Department of Clinical Medicine, Faculty of Health and Medical Sciences , University of Copenhagen , Copenhagen , Denmark
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Filion-Quenneville A, Bédard-Charette K, Brault J, Millaud F. [Bill C-14: Important Modifications to the Criminal Code. Example of the First Case in Canada]. Can J Psychiatry 2018; 63:679-682. [PMID: 29699416 PMCID: PMC6187438 DOI: 10.1177/0706743718773708] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
| | - Kim Bédard-Charette
- Psychiatre légiste, chef du département, Institut Philippe-Pinel, professeure adjointe de clinique, Département de psychiatrie, Université de Montréal, Montreal, Quebec, Canada
| | - Jocelyne Brault
- Psychiatre légiste, adjointe au chef du département, Institut Philippe-Pinel, professeure adjointe de clinique, Département de psychiatrie, Université de Montréal, Montreal, Quebec, Canada
| | - Frédéric Millaud
- Psychiatre Institut Philippe-Pinel, professeur titulaire, Département de psychiatrie, Université de Montréal, Montreal, Quebec, Canada
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Malla A, Shah J, Iyer S, Boksa P, Joober R, Andersson N, Lal S, Fuhrer R. Youth Mental Health Should Be a Top Priority for Health Care in Canada. Can J Psychiatry 2018; 63. [PMID: 29528719 PMCID: PMC5894919 DOI: 10.1177/0706743718758968] [Citation(s) in RCA: 82] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
In this article we have provided a perspective on the importance and value of youth mental health services for society and argued that advancing youth mental health services should be the number one priority of health services in Canada. Using the age period of 12-25 years for defining youth, we have provided justification for our position based on scientific evidence derived from clinical, epidemiological and neurodevelopmental studies. We have highlighted the early onset of most mental disorders and substance abuse as well as their persistence into later adulthood, the long delays experienced by most help seekers and the consequence of such delays for young people and for society in general. We have also provided a brief review of the current gross inadequacies in access and quality of care available in Canada. We have argued for the need for a different conceptual framework of youth mental disorders as well as for a transformation of the way services are provided in order not only to reduce the unmet needs but also to allow a more meaningful exploration of the nature of such problems presenting in youth and the best way to treat them. We have offered some ideas based on previous work completed in this field as well as current initiatives in Canada and elsewhere. Any transformation of youth mental health services in Canada must take into consideration the significant geographic, cultural and political diversity across the provinces, territories and indigenous peoples across this country.
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Affiliation(s)
- Ashok Malla
- 1 Department of Psychiatry, McGill University, Montreal, QC, Canada.,2 Douglas Mental Health University Institute, Verdun, QC, Canada.,3 ACCESS Open Minds Network, Montreal, QC, Canada
| | - Jai Shah
- 1 Department of Psychiatry, McGill University, Montreal, QC, Canada.,2 Douglas Mental Health University Institute, Verdun, QC, Canada
| | - Srividya Iyer
- 1 Department of Psychiatry, McGill University, Montreal, QC, Canada.,2 Douglas Mental Health University Institute, Verdun, QC, Canada.,3 ACCESS Open Minds Network, Montreal, QC, Canada
| | - Patricia Boksa
- 1 Department of Psychiatry, McGill University, Montreal, QC, Canada.,2 Douglas Mental Health University Institute, Verdun, QC, Canada
| | - Ridha Joober
- 2 Douglas Mental Health University Institute, Verdun, QC, Canada.,4 Program of Early intervention and Prevention of Psychoses, Montreal, QC, Canada
| | - Neil Andersson
- 5 Department of Family, Medicine, McGill University, Montreal, QC, Canada.,6 Community Information and Epidemiological Technologies (CIET) Institute and Participatory Research at McGill (PRAM), Montreal, QC, Canada.,7 McGill Institute of Human Development and Well-being, McGill University, Montreal, QC, Canada
| | - Shalini Lal
- 2 Douglas Mental Health University Institute, Verdun, QC, Canada.,8 School of Rehabilitation, Faculty of Medicine, University of Montreal, QC, Canada.,9 Health Innovation and Assessment Hub, University of Montreal Hospital Research Center (CRCHUM), Montreal, QC, Canada
| | - Rebecca Fuhrer
- 10 Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, QC, Canada
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Abstract
PURPOSE This study aimed to assess responses to a structured measure of perceived need for treatment to understand whether differences in treatment uptake across age groups are related to differences in: (1) perceived need for mental health care; (2) perceptions of treatment needs being met; and/or (3) perceived attitudinal and structural treatment barriers. METHODS Data from a nationally representative sample of the Australian population (2007 National Survey of Mental Health and Wellbeing) were analysed using logistic and multinomial regression. All participants potentially benefiting from mental health services were included in analyses; including those reporting symptoms of mental disorders, using mental health services, or self-reporting significant mental health problems in the past 12 months (n = 5733). All regression analyses were adjusted for gender, the presence of chronic physical health conditions, disorder type, and disorder severity. RESULTS Older adults were the least likely to report any perceived need for mental health care, and specifically reported lower needs for psychotherapy, information about available services, and support improving their ability to work. Older adults perceiving a need for mental health care were also the most likely to report having these needs met. There were no differences in attitudinal and structural barriers to treatment across age groups. CONCLUSIONS These results highlight that age needs to be considered in strategies for improving engagement and efficacy of mental health services, as well as the need for further research to understand what drives age differences in perceived need for mental health care.
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Affiliation(s)
- M K Forbes
- a Department of Psychology, Centre for Emotional Health , Macquarie University , Sydney , Australia.,b Department of Psychology, NHMRC Centre for Research Excellence in Mental Health and Substance Use , Macquarie University , Sydney , Australia
| | - E Crome
- a Department of Psychology, Centre for Emotional Health , Macquarie University , Sydney , Australia.,b Department of Psychology, NHMRC Centre for Research Excellence in Mental Health and Substance Use , Macquarie University , Sydney , Australia
| | - M Sunderland
- c NHMRC Centre for Research Excellence in Mental Health and Substance Use, National Drug and Alcohol Research Centre , University of New South Wales Sydney , Australia
| | - V M Wuthrich
- a Department of Psychology, Centre for Emotional Health , Macquarie University , Sydney , Australia
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Dillon KH, Crawford EF, Kudler H, Straits-Troster KA, Elbogen EB, Calhoun PS. An Investigation of Treatment Engagement Among Returning Veterans With Problematic Anger. J Nerv Ment Dis 2017; 205:119-26. [PMID: 28098580 DOI: 10.1097/NMD.0000000000000651] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Anger is a commonly reported problem among returning veterans, yet little attention has been devoted to studying treatment engagement among veterans who report anger problems but do not have posttraumatic stress disorder (PTSD). This study compares Iraq-Afghanistan veterans with anger/no PTSD (n = 159) to others reporting significant PTSD symptoms (n = 285) and those reporting neither anger nor PTSD (n = 716) on rates of treatment utilization, perceived barriers to treatment, and preferences for care. Relative to the PTSD group, the anger/no-PTSD group was significantly less likely to have received mental health treatment in the last year, despite endorsing barriers to treatment at a lower rate. Furthermore, the anger/no-PTSD group endorsed fewer preferences than the PTSD group. Results suggest that the anger/no-PTSD group is a unique subgroup that may be less likely to identify a need for treatment. Implications are discussed.
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Abstract
Background Over the last 20 years, behavioral addictions (e.g., addictions to gambling, playing video games, work, etc.) have become more accepted among both public and scientific communities. Addiction to sex is arguably a more controversial issue, but this does not take away from the fact that some individuals seek professional help for problematic excessive sex, irrespective of how the behavior is conceptualized. Empirical evidence suggests that among treatment seekers, men are more likely than women to seek help for sex addiction (SA). Methods Using the behavioral addiction literature and the authors' own expertise in researching female SA, this paper examines potential barriers to the treatment for female sex addicts. Results Four main types of barriers for female sex addicts not seeking treatment were identified. These comprised (a) individual barriers, (b) social barriers, (c) research barriers, and (d) treatment barriers. Conclusions Further research is needed to either confirm or disconfirm the identified barriers that female sex addicts face when seeking treatment, and if conformation is found, interested stakeholders should provide better awareness and/or see ways in which such barriers can be overcome to aid better uptake of SA services.
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Affiliation(s)
- Manpreet K. Dhuffar
- Psychology Department, University of Exeter, Exeter, United Kingdom
- Psychology Department, Nottingham Trent University, Nottingham, United Kingdom
| | - Mark D. Griffiths
- Psychology Department, University of Exeter, Exeter, United Kingdom
- Psychology Department, Nottingham Trent University, Nottingham, United Kingdom
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Sheffer C, Brackman S, Lercara C, Cottoms N, Olson M, Panissidi L, Pittman J, Stayna H. When Free Is Not for Me: Confronting the Barriers to Use of Free Quitline Telephone Counseling for Tobacco Dependence. Int J Environ Res Public Health 2015; 13:ijerph13010015. [PMID: 26703662 PMCID: PMC4730406 DOI: 10.3390/ijerph13010015] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/14/2015] [Revised: 10/27/2015] [Accepted: 10/30/2015] [Indexed: 11/16/2022]
Abstract
Remarkable disparities in smoking rates in the United States contribute significantly to socioeconomic and minority health disparities. Access to treatment for tobacco use can help address these disparities, but quitlines, our most ubiquitous treatment resource, reach just 1%-2% of smokers. We used community-based participatory methods to develop a survey instrument to assess barriers to use of the quitline in the Arkansas Mississippi delta. Barriers were quitline specific and barriers to cessation more broadly. Over one-third (34.9%) of respondents (n = 799) did not have access to a telephone that they could use for the quitline. Respondents reported low levels of knowledge about the quitline, quitting, and trust in tobacco treatment programs as well as considerable ambivalence about quitting including significant concerns about getting sick if they quit and strong faith-based beliefs about quitting. These findings suggest quitlines are not accessible to all lower socioeconomic groups and that significant barriers to use include barriers to cessation. These findings suggest targets for providing accessible tobacco use treatment services and addressing concerns about cessation among lower income, ethnic minority, and rural groups.
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Affiliation(s)
- Christine Sheffer
- Sophie Davis School of Biomedical Education, City College of New York, New York, NY 10031, USA.
- Fay W Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA.
| | - Sharon Brackman
- Fay W Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA.
| | - Charnette Lercara
- Sophie Davis School of Biomedical Education, City College of New York, New York, NY 10031, USA.
| | - Naomi Cottoms
- Walnut Street Works, Inc., Helena-West Helena, AR 72342, USA.
| | - Mary Olson
- Walnut Street Works, Inc., Helena-West Helena, AR 72342, USA.
| | - Luana Panissidi
- Sophie Davis School of Biomedical Education, City College of New York, New York, NY 10031, USA.
| | - Jami Pittman
- Sophie Davis School of Biomedical Education, City College of New York, New York, NY 10031, USA.
| | - Helen Stayna
- Sophie Davis School of Biomedical Education, City College of New York, New York, NY 10031, USA.
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Isobell D, Kamaloodien K, Savahl S. A qualitative study of referring agents' perceptions of access barriers to inpatient substance abuse treatment centres in the Western Cape. Harm Reduct J 2015; 12:36. [PMID: 26410817 PMCID: PMC4583734 DOI: 10.1186/s12954-015-0064-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2014] [Accepted: 09/10/2015] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Despite empirical support for the individual and public health benefits of treating substance use disorders (SUDs) , access to these services is impeded by several barriers. Although many studies on access barriers have been put forward in the literature, few have explored the barriers to accessing state-funded inpatient substance abuse treatment or the views of referral agents. METHODS A qualitative study was conducted to explore referring agents' perceptions of the barriers to accessing state-funded inpatient substance abuse treatment centres in the Western Cape Province of South Africa. Six individual in-depth interviews were conducted and analysed using theoretical thematic analysis. RESULTS The key barriers to emerge from the analysis pertained to referring agents' perceptions of the following: service users, the substance abuse referral and treatment system and community dynamics. CONCLUSIONS Recommendations are made for interventions to address the identified barriers.
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Affiliation(s)
- Deborah Isobell
- Psychology Department, University of the Western Cape, Robert Sobukwe Road, Cape Town, South Africa.
| | - Kamal Kamaloodien
- Psychology Department, University of the Western Cape, Robert Sobukwe Road, Cape Town, South Africa.
| | - Shazly Savahl
- Psychology Department, University of the Western Cape, Robert Sobukwe Road, Cape Town, South Africa.
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Abstract
BACKGROUND Older adults with mental health disorders underutilize mental health services more than other adults. While there are well known general barriers to help seeking across the population, specific barriers for older adults include difficulties with transportation, beliefs that it is normal to be anxious and depressed in old age, and beliefs by referrers that psychological therapy is less likely to be effective. This study examined barriers related to identifying the need for help, seeking help and participating in therapy in a clinical population of older adults. METHOD Sixty older adults (aged 60-79 years) with comorbid anxiety and unipolar mood disorders completed barriers to treatment questionnaires before and after psychological group treatment, as well as measures of cognitive ability, anxiety, depression, and quality of life at baseline. RESULTS The greatest barriers to help seeking related to difficulties identifying the need for help, with 50% of the sample reporting their belief that their symptoms were normal as a major barrier. Other major barriers identified were related to: self-reliance, cost of treatment, and fear of medication replicating previous findings. The main barriers reported for difficulties in continuing therapy included not finding therapy helpful, cost of treatment, and thinking that the therapist did not understand their issues. CONCLUSIONS The main barriers identified related to issues with identifying the need to seek help. More attention is needed to educate older adults and professionals about the need for, and effectiveness of, psychological therapies for older adults with anxiety and depression to reduce this barrier to help seeking.
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Abstract
Veterans underutilize mental health services. We investigated the association between treatment seeking stigma and utilization of mental health services in a sample of 812 young adult veterans. Higher perceived public stigma of treatment seeking was significantly related to lower treatment utilization. Although many veterans were concerned about negative perceptions if they were to seek treatment, a much smaller number of them endorsed that they would judge a fellow veteran negatively in similar situation. Targeting perceived public stigma of treatment seeking, through perceived norms interventions, might help in narrowing the gap between the need and receipt of help among veterans.
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Affiliation(s)
- Magdalena Kulesza
- Associate Behavioral/Social Scientist, RAND Corporation, 1776 Main Street, Santa Monica, CA 90407., , phone: 310-393-0411
| | - Eric Pedersen
- Behavioral/Social Scientist, RAND Corporation, 1776 Main Street, Santa Monica, CA 90407., , phone: 310-393-0411
| | - Patrick Corrigan
- Distinguished Professor of Psychology, Illinois Institute of Technology, 3424 S. State Street, Chicago, IL 60616, , phone: 312-567-6751
| | - Grant Marshall
- Senior Behavioral Scientist, RAND Corporation, 1776 Main Street, Santa Monica, CA 90407., , phone: 310-393-0411
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Brown CH, Medoff D, Dickerson FB, Fang LJ, Lucksted A, Goldberg RW, Kreyenbuhl J, Himelhoch S, Dixon LB. Factors influencing implementation of smoking cessation treatment within community mental health centers. J Dual Diagn 2015; 11:145-50. [PMID: 25985201 PMCID: PMC4727176 DOI: 10.1080/15504263.2015.1025025] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVE Consumers with serious mental illness smoke more and are at higher risk for smoking-related illness. We examined provider and consumer factors influencing the implementation of the evidence-based "5 A's" (ask, advise, assess, assist, arrange) in six community mental health centers in greater Baltimore. METHODS Data collected as part of a larger study examining the effectiveness of delivery of the 5 A's at patient visits. First, we examined responses to a survey administered to 49 clinicians on barriers and attitudes toward delivering the 5 A's. Second, we used multilevel models to examine variance between patients (n = 228), patient factors, and variance between their psychiatrists (n = 28) in the delivery of the 5 A's (and first 3 A's). RESULTS The most strongly endorsed barrier was perceived lack of patient interest in smoking cessation. Psychiatrists and patients both accounted for significant variance in the delivery of the 5 A's and 3 A's. Patient "readiness to change" predicted delivery of the full 5 A's, while smoking severity predicted delivery of the first 3 A's. CONCLUSIONS There is a critical need for creative and collaborative solutions, policies, and clinician training to address actual and perceived obstacles to the delivery of evidence-based smoking cessation treatment in the mental health care setting.
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Kolves K, Arnautovska U, Gioannis AD, De Leo D. Community care of individuals at risk of suicide: the life promotion clinic model. Ment Illn 2013; 5:e12. [PMID: 25478134 PMCID: PMC4253392 DOI: 10.4081/mi.2013.e12] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2013] [Revised: 08/26/2013] [Accepted: 09/01/2013] [Indexed: 11/22/2022] Open
Abstract
Assistance to suicidal patients is problematic both at the hospital and community care level. Inadequacy of facilities, pressured personnel, long waiting time, and professional and social stigmatization are just some of the many issues that interfere with successful treatment. The goal of this paper is to present the functioning of the Life Promotion Clinic (LPC), Australia, and describe its users. The LPC is the first specialized outpatient service in Australia dedicated to the treatment of individuals with suicidal thoughts and behaviors. A description of the service and characteristics of its clients (demographic, psychopathology, risk of suicide) are herein presented. Data were collected for 63 male and 175 female patients who attended the LPC over a three-year period. Patients were mostly single females, aged up to 44 years, poorly educated, unemployed or on a pension/benefit. The majority of patients reported at least one suicide attempt, severe depression and anxiety scores, moderate-severe feelings of hopelessness, and high impulsiveness scores. Compared to females, male patients presented with more active desire to kill themselves and higher level of suicidal ideation. We can conclude that establishing a specialist service for treatment of individuals at increased risk for suicide requires consideration of both patient and clinicians needs. The LPC presents an innovative model of community service, capable of engaging patients with serious mental health issues, while making the service accessible to people from various social categories.
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Affiliation(s)
- Kairi Kolves
- Life Promotion Clinic, Australian Institute for Suicide Research and Prevention, Griffith University , Australia
| | - Urska Arnautovska
- Life Promotion Clinic, Australian Institute for Suicide Research and Prevention, Griffith University , Australia
| | - Angelo De Gioannis
- Life Promotion Clinic, Australian Institute for Suicide Research and Prevention, Griffith University , Australia
| | - Diego De Leo
- Life Promotion Clinic, Australian Institute for Suicide Research and Prevention, Griffith University , Australia
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Farmer C, Farrand P, O’Mahen H. 'I am not a depressed person': how identity conflict affects help-seeking rates for major depressive disorder. BMC Psychiatry 2012; 12:164. [PMID: 23031330 PMCID: PMC3568063 DOI: 10.1186/1471-244x-12-164] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2012] [Accepted: 09/20/2012] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND There is a significant treatment gap for patients with depression. A third of sufferers never seek help, and the vast majority of those who do only do so after considerable delay. Little is understood regarding poor help-seeking rates amongst people with depression, with existing research mainly focussed on the impact of barriers to treatment. The current study explored psychological factors affecting help-seeking behaviour in clinically depressed individuals. METHODS Semi-structured interviews were conducted with 20 current or previously clinically depressed participants who either had or had not sought professional help. Thematic analysis was used to analyse results. RESULTS The onset of depressive symptoms created conflict with participants' identity and personal goals. Delays in seeking help were primarily attributed to the desire to protect identity and goals from the threat of depressive symptoms. Participants used avoidance strategies to reduce the perceived threat of depressive symptoms on identity. These strategies interfered with help-seeking. Help-seeking was only undertaken once participants reached a point of acceptance and began to make concessions in their identity and goals, at which time they reduced their use of avoidance. CONCLUSIONS Difficulties resolving conflict between identity and depressive symptoms may account for significant delays in seeking help for depression. The results have implications for predicting health behaviour and improving treatment uptake for depression, and may inform existing help-seeking models.
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Affiliation(s)
| | - Paul Farrand
- Mood Disorders Centre, University of Exeter, Exeter, UK
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Abstract
African Americans are underrepresented in OCD treatment centers and less likely to experience a remission of symptoms. This study examines the barriers that prevent African Americans with OCD from receiving treatment. Seventy-one adult African Americans with OCD were recruited and administered the modified Barriers to Treatment Participation Scale (BTPS) and the Barriers to Treatment Questionnaire (BTQ). Comparing the BTQ between a European American Internet sample (N=108) and the African American OCD sample (N=71) revealed barriers unique to African Americans, including not knowing where to find help and concerns about discrimination. A Mokken Scale Analysis of the BTPS in the African American participants identified seven major barriers, including the cost of treatment, stigma, fears of therapy, believing that the clinician will be unable to help, feeling no need for treatment, and treatment logistics (being too busy or treatment being too inconvenient). Pearson and point-biserial correlations of the scales and demographic and psychological variables were conducted. Significant relationships emerged between age, gender, income, education, insurance status, and ethnic affirmation/belonging among several of the Mokken scales. A one-way ANOVA demonstrated that concerns about cost were significantly greater for those without insurance, versus those with public or private plans. Suggestions for overcoming barriers are presented, including community education, affordable treatment options, and increasing cultural competence among mental health providers.
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Affiliation(s)
- M.T. Williams
- University of Louisville, Department of Psychological & Brain Sciences, 2301 South Third Street, Louisville, KY 40292,
| | - J. Domanico
- University of Pennsylvania, Department of Psychology, Philadelphia, PA, 19104,
| | - L. Marques
- Center for Anxiety and Traumatic Stress Disorders, Massachusetts General Hospital, 1 Bowdoin Square, Boston, MA, 02114,
| | - N.J. Leblanc
- Center for Anxiety and Traumatic Stress Disorders, Massachusetts General Hospital, 1 Bowdoin Square, Boston, MA, 02114,
| | - E. Turkheimer
- University of Virginia, Department of Psychology, Box 400400, Charlottesville, VA, 22904,
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Abstract
Engaging and retaining families in mental health prevention and intervention programs is critically important to insure maximum public health impact. We evaluated randomized-controlled trials testing methods to improve family engagement and retention in child mental health programs published since 1980 (N = 17). Brief, intensive engagement interventions in which providers explicitly addressed families' practical (e.g. schedules, transportation) and psychological (e.g. family members' resistance, beliefs about the treatment process) barriers as they entered treatment were effective in improving engagement in early sessions. The few interventions found to produce long-term impact on engagement and retention integrated motivational interviewing, family systems, and enhanced family stress and coping support strategies at multiple points throughout treatment. Few interventions have been tested in the context of prevention programs. There are promising approaches to increasing engagement and retention; they should be replicated and used as a foundation for future research in this area.
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Affiliation(s)
- Erin M. Ingoldsby
- Prevention Research Center for Family and Child Health, Department of Pediatrics, University of Colorado Denver, Mail Stop #8410, 13121 E. 17th Ave., Room 5303, Aurora, CO 80045, USA
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Fong TW, Tsuang J. Asian-americans, addictions, and barriers to treatment. Psychiatry (Edgmont) 2007; 4:51-59. [PMID: 20428303 PMCID: PMC2860518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
Asian-American Pacific Islanders (AAPI) are one of the fastest growing minority groups in America. Due to model minority stereotypes and a lack of empirical data, AAPI have been thought to have lower than expected rates of substance use disorders and behavioral addictions. Recent data demonstrated that this conception is not true for all AAPI subgroups. As an example, rates of alcohol use disorders remain close to that of non-AAPI populations, even among AAPI that experience the flushing syndrome thought to protect from alcoholism. Another example of emerging data shows that methamphetamine dependence is particularly high (approximately 10%) among the Pacific Islander population, which is a startling figure. One behavioral addiction gaining more attention among AAPI is pathological gambling. Recent community surveys have shown that pathological gambling rates among AAPI vary but can be strikingly high. Despite the growing body of evidence that shows that addictive disorders in AAPI are significant and are not absent, there remain many barriers to treatment. These barriers include cultural values, individual factors, and practical issues. This article will review current epidemiological rates of addictive disorders among AAPI, will describe the current treatment barriers that face this population, and will provide practical solutions to breaking down these barriers.
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Affiliation(s)
- Timothy W Fong
- Dr. Fong is with the David Geffen School of Medicine at UCLA, Semel Institute of Neuroscience and Behavior, Department of Psychiatry and Biobehavioral Sciences, Assistant Clinical Professor, Director of the Impulse Control Disorders Clinic, and Co-Director of the UCLA Gambling Studies Program, Los Angeles, California
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Morrill JA, Shrestha M, Grant RW. Barriers to the treatment of hepatitis C. Patient, provider, and system factors. J Gen Intern Med 2005; 20:754-8. [PMID: 16050887 PMCID: PMC1490173 DOI: 10.1111/j.1525-1497.2005.0161.x] [Citation(s) in RCA: 154] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2005] [Revised: 03/21/2005] [Accepted: 03/21/2005] [Indexed: 12/18/2022]
Abstract
BACKGROUND Hepatitis C virus (HCV) infection is both prevalent and undertreated. OBJECTIVE To identify barriers to HCV treatment in primary care practice. DESIGN Cross-sectional study. SETTING AND PARTICIPANTS A cohort of 208 HCV-infected patients under the care of a primary care physician (PCP) between December 2001 and April 2004 at a single academically affiliated community health center. MEASUREMENTS Data were collected from the electronic medical record (EMR), the hospital clinical data repository, and interviews with PCPs. MAIN RESULTS Our cohort consisted of 208 viremic patients with HCV infection. The mean age was 47.6 (+/-9.7) years, 56% were male, and 79% were white. Fifty-seven patients (27.4% of the cohort) had undergone HCV treatment. Independent predictors of not being treated included: unmarried status (adjusted odds ratio [aOR] for treatment 0.36, P=.02), female gender (aOR 0.31, P=.01), current alcohol abuse (aOR 0.08, P=.0008), and a higher ratio of no-shows to total visits (aOR 0.005 per change of 1.0 in the ratio of no-shows to total visits, P=.002). The major PCP-identified reasons not to treat included: substance abuse (22.5%), patient preference (16%), psychiatric comorbidity (15%), and a delay in specialist input (12%). For 13% of the untreated patients, no reason was identified. CONCLUSIONS HCV treatment was infrequent in our cohort of outpatients. Barriers to treatment included patient factors (patient preference, alcohol use, missed appointments), provider factors (reluctance to treat past substance abusers), and system factors (referral-associated delays). Multimodal interventions may be required to increase HCV treatment rates.
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Affiliation(s)
- James A Morrill
- General Medicine Division, Department of Medicine, Massachusetts General Hospital, Boston, MA, USA.
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Hickling J, Rogers S, Nazareth I. Barriers to detecting and treating hypercholesterolaemia in patients with ischaemic heart disease: primary care perceptions. Br J Gen Pract 2005; 55:534-8. [PMID: 16004739 PMCID: PMC1472780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/03/2023] Open
Abstract
BACKGROUND Treating hypercholesterolaemia in patients with ischaemic heart disease can significantly reduce vascular deaths and events. Many such patients, however, do not receive effective treatment for hypercholesterolaemia. AIM To ascertain the barriers to the detection and treatment of hypercholesterolaemia in patients with ischaemic heart disease as seen by primary care teams. DESIGN OF STUDY Qualitative study using the nominal group technique. SETTING General practice teams in the North Thames region of the Medical Research Council General Practice Research Framework. METHOD The main outcomes measures used were identification of the barriers to the detection and treatment of hypercholesterolaemia together with relative rankings. RESULTS Fourteen individual barriers were identified. The main barriers were: organisational barriers within general practices; confusing and conflicting guidelines from external sources; errors and omissions by GPs; communication problems at the interface between secondary and primary care; and reluctance by patients to take medication. CONCLUSIONS The reasons for suboptimal detection and treatment of hypercholesterolaemia are complex and act at various levels. Interventions to improve the management of this condition must address these barriers in order to be successful.
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Affiliation(s)
- James Hickling
- Department of Primary Care and Population Sciences, Royal Free and University College Medical School, University College London.
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D’Onofrio G, Degutis LC. Screening and brief intervention in the emergency department. Alcohol Res Health 2004; 28:63-72. [PMID: 19006993 PMCID: PMC6601646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Many patients visiting hospital emergency departments (EDs) or admitted to trauma centers have alcohol problems. Therefore, it is plausible that all ED and trauma patients should be screened for unhealthy alcohol use so that optimal care can be provided and treatment initiated, if necessary, for these patients. In addition, brief interventions offered directly in the ED or trauma unit could be useful for many patients. Some studies have found such interventions to be feasible and effective in this setting. However, all efforts in this regard must take into consideration the specific challenges associated with screening and intervention in EDs, such as time constraints, ethical and legal issues, and concerns regarding insurance coverage. Innovative approaches to screening may address at least some of these problems, although more research is needed to determine how screening can be better incorporated and implemented in the ED setting.
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Lapham S. Screening and brief intervention in the criminal justice system. Alcohol Res Health 2004; 28:85-93. [PMID: 19006996 PMCID: PMC6601649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
A large proportion of offenders in the criminal justice system have alcohol-related problems. Therefore, it makes sense to implement alcohol screening and brief intervention programs for people in this setting, particularly for impaired driving offenders, who are likely to be alcohol dependent. Although most States mandate screening for impaired drivers, not much effort has been put forth to determine how the screening process could be improved and expanded to the entire criminal justice population. For example, more research is needed on the potential therapeutic benefit of the screening process and on how brief motivational interventions could be incorporated into this process to improve outcomes. To address this, more emphasis should be placed on developing and implementing national standards for screening programs in the criminal justice system, evaluating existing programs, and assuring that these programs provide adequate treatment services to offenders.
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Abstract
OBJECTIVE To determine whether depressed older adults who attribute becoming depressed to "old age" rather than illness are more likely to believe it is not important to seek treatment for depression. DESIGN Cross-sectional mailed survey. SETTING Academically affiliated primary care physicians' network. PARTICIPANTS Surveys were mailed to 588 patients age > or =65 years who were randomly identified from patient lists of 20 physicians. Surveys were returned by 429 patients (73%). Patients were eligible for this study if they scored > or =2 points on the 5-item Geriatric Depression Scale (n = 94) and were not missing key variables (final n = 90). MEASUREMENTS AND MAIN RESULTS Of the 90 depressed patients, 48 (53%) believed that feeling depressed was very important to discuss with a doctor. In unadjusted analysis, older adults who did not believe it is very important to discuss feeling depressed with a doctor were more likely to attribute becoming depressed to aging (41% vs 17%; P =.012). In a logistic regression model adjusting for sociodemographic characteristics, number of impairments in basic and instrumental activities of daily living, medical comorbidity, and physical (PCS-12) and mental (MCS-12) component summary scores from the Medical Outcomes Study Short-Form-12, depressed older adults who attributed depression to aging had a 4.3 times greater odds than those who attributed depression to illness to not believe it is very important to discuss depression with a doctor (odds ratio [OR], 4.3; 95% confidence interval [CI], 1.3 to 14.5). CONCLUSIONS Among older persons with depression, attributing feeling depressed to old age may be an important barrier to care seeking.
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Affiliation(s)
- Catherine A Sarkisian
- Division of Geriatrics, Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA 90095-1687, USA.
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