Search results for ‘Subject term:"mental health problems"’ Sort:
Results 1 - 10 of 27
Review of eating disorder services in Northern Ireland
- Author:
- REGULATION AND QUALITY IMPROVEMENT AUTHORITY
- Publisher:
- Regulation and Quality Improvement Authority
- Publication year:
- 2015
- Pagination:
- 74
- Place of publication:
- Belfast
This review profiles the eating disorder services in Northern Ireland, assessing how they meet the needs of adults and children/young people and examining their organisational structure, staffing levels, and skills and capacity available to respond to assessed needs. A number of key themes emerge from this review: people with eating disorders are not a homogeneous group and often present with other disorders and issues - eating disorders can be difficult to identify early and therefore more challenging to treat; there is a need for a review of the physical health monitoring of patients and a review of the commissioning of this service to ensure early access to and greater parity of service provision across all trusts; care pathways need to be developed for young people and adults, by harnessing the views of experts by experience and professionals involved in commissioning and providing care; the HSC Board should review the current staffing levels in HSC trusts and the skills and competencies available while further work is required to develop clinical outcome measures that should be routinely recorded and used to inform clinical practice; a disparity was noted across trusts with respect to provision of an appropriate skill mix and qualifications of staff, with a low level of employment of psychological and occupational therapy staff, particularly in adult services; quality improvement is likely to be more effective if it is addressed at a whole system level, rather than as a number of disconnected initiatives in a number of trusts; and across all of the services there is a need for clear and effective communication. (Edited publisher abstract)
Complementary therapies
- Author:
- WALLCRAFT Jan
- Journal article citation:
- Mental Health and Learning Disabilities Care, 2(10), June 1999, pp.351-354.
- Publisher:
- Pavilion
Complementary therapies may have much to offer even people in very severe mental distress. Reviews the evidence.
Alcohol habits and health care use in patients with psychiatric disorders
- Authors:
- NEHLIN Christina, et al
- Journal article citation:
- Journal of Dual Diagnosis, 13(4), 2017, pp.247-253.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
Objective: It is common for persons with psychiatric disorders to also have alcohol problems. Studies in the general population as well as in clinical samples have found hazardous or harmful alcohol habits to be particularly prevalent in the presence of psychiatric disorders. This study sought to explore the relationships between drinking habits and health care utilisation (psychiatric as well as general medical) in persons seeking psychiatric treatment and to investigate the associations among age, sex, and type or number of diagnoses and health care use and costs. For the planning of targeted interventions, the authors also sought to identify subgroups with a high prevalence of hazardous drinking habits. Methods: From a psychiatric clinic for affective disorders at a university hospital in Sweden, patients who had been screened for hazardous drinking (N = 609) were selected. Patients with primary psychosis or substance use disorder receive treatment at other clinics and did not participate. Medical records data were grouped and compared. The International Statistical Classification of Diseases and Related Health Problems, 10th Revision (ICD-10) was used for diagnoses and the Alcohol Use Disorders Identification Test for screening. Patients were grouped by drinking habits and sex, age, and diagnosis group, and their psychiatric as well as general medical health care use was compared. Results: Abstainers used psychiatric care more than all other drinking groups (p < .001). Psychiatric health care costs were higher in abstainers and low-risk drinkers (1.64 to 1). No differences in general medical care could be identified between drinking groups. Specific subgroups with higher rates of hazardous drinking could not be identified (44% of all males and 34% of all females reported such habits). Inconclusive results from previous research are most likely due to different methods used to classify drinking problems. Conclusions: Abstainers and low-risk drinkers used psychiatric health care to a higher cost than the other drinking groups. Possible explanations are discussed from a clinical and scientific perspective. This study clarifies the need for uniform measures when classifying alcohol use in studies of relationships between alcohol use and health care use. There is also a need to separate former drinkers from abstainers in future studies. (Publisher abstract)
Internet-based cognitive behaviour therapy and physical exercise – effects studied by automated telephone assessments in mental ill-health patients; a randomized controlled trial
- Authors:
- STRID Catharina, et al
- Journal article citation:
- British Journal of Clinical Psychology, 55(4), 2016, p.414–428.
- Publisher:
- Wiley
Objectives: Mental ill-health has become a large health problem and it is important for caregivers to provide effective treatment alternatives. REGASSA is a randomized controlled study performed in primary care to study the effects of 12 weeks of Internet-based cognitive behaviour therapy (ICBT) and physical exercise (PE) compared with treatment as usual (TAU) in patients with mild-to-moderate mental ill-health. The present study aimed to examine the results of these treatment alternatives on psychological functioning, stress, and sleep disturbances. Methods: The study comprised 879 patients with mental ill-health taking part in the REGASSA study. Data were collected by Interactive Voice Response (IVR), a computerised, automated telephone technique. The treatments were compared at baseline, twice during treatment, at the end of treatment and at three follow-ups after treatment. Measures used were the Outcome Questionnaire-45, the short versions of the Perceived Stress Scale, and the Karolinska Sleep Questionnaire. Results: Linear mixed models showed that the patients in ICBT and PE had better results than in TAU on psychological functioning and sleep disturbances, p < .001, with weak-to-moderate effect sizes. On stress there were no differences; all groups made improvements. Women had stronger effects than men. More patients recovered on psychological functioning (OQ-45) in ICBT and PE than in TAU. Conclusions: Internet-based cognitive behaviour therapy and PE proved to be effective treatment alternatives for patients with mild-to-moderate mental ill-health in improving psychological functioning, stress, and sleep disturbances and could be useful alternatives in primary care. Practitioner points: a) Internet-based cognitive behaviour therapy and physical exercise proved to be effective treatment alternatives for mental ill-health patients in primary care. Automated techniques (Interactive Voice Response) could be useful for following treatment course in large groups of patients in the health care; b) It is important to use measures that capture different aspects of patients’ health problems; c) The recruitment of participants was based on patients’ interest and inclusion criteria which may have affect the generalisability. (Edited publisher abstract)
Living a meaningful life with serious mental illness: defining and understanding personal medicine
- Author:
- RADOHL Tamara
- Journal article citation:
- Journal of the Society for Social Work and Research, 7(2), 2016, p.345–369.
- Publisher:
- Society for Social Work and Research
Objective: Shared decision making (SDM) is an approach adapted from the health care field for use in mental health treatment because SDM promotes collaborative decision making of providers and consumers regarding treatment options and goals. Personal medicine, defined as “self-initiated, non-pharmaceutical self-care activities that serve to decrease symptoms, avoid undesirable outcomes such as hospitalisation, and improve mood, thoughts, behaviours, and overall sense of well-being” (Deegan, 2005, p. 31), has been incorporated into SDM when applied in mental health settings. This exploratory, qualitative study investigates how mental health consumers define and use personal medicine. Method: A sample of 14 consumers with severe and persistent mental illness were selected from a local community mental health agency using purposeful sampling. Participants used Common Ground, a software programme that formalises SDM and uses the concept of personal medicine. Participants were interviewed using a naturalistic inquiry approach and a semi-structured interview protocol of open-ended questions. Interviews were transcribed and coded, and findings were corroborated with consultant panels. Comprehensive member checks ensured trustworthiness. Results: Personal medicine might be a larger concept than can be explained by any single modality. Several factors contribute to the use of personal medicine, including the individualisation of personal medicine by consumers, how consumers define the concept of personal medicine, and the purposes and benefits of personal medicine. Conclusions: Participants report personal medicine to have benefit, value, and purpose that impact recovery. These findings support current literature and practical implications that might inform the ways in which professionals use personal medicine. (Edited publisher abstract)
Needs and fears of young people presenting at accident and emergency department following an act of self-harm: secondary analysis of qualitative data
- Authors:
- OWENS Christabel, et al
- Journal article citation:
- British Journal of Psychiatry, 208(3), 2016, pp.286-291.
- Publisher:
- Cambridge University Press
Background: Needs and fears of young people presenting at accident and emergency department following an act of self-harm: secondary analysis of qualitative data. Presentation at an accident and emergency (A&E) department is a key opportunity to engage with a young person who self-harms. The needs of this vulnerable group and their fears about presenting to healthcare services, including A&E, are poorly understood. Aims: To examine young people's perceptions of A&E treatment following self-harm and their views on what constitutes a positive clinical encounter. Method: Secondary analysis of qualitative data from an experimental online discussion forum. Threads selected for secondary analysis represent the views of 31 young people aged 16–25 with experience of self-harm. Results: Participants reported avoiding A&E whenever possible, based on their own and others' previous poor experiences. When forced to seek emergency care, they did so with feelings of shame and unworthiness. These feelings were reinforced when they received what they perceived as punitive treatment from A&E staff, perpetuating a cycle of shame, avoidance and further self-harm. Positive encounters were those in which they received ‘treatment as usual’, i.e. non-discriminatory care, delivered with kindness, which had the potential to challenge negative self-evaluation and break the cycle. Conclusions: The clinical needs of young people who self-harm continue to demand urgent attention. Further hypothesis testing and trials of different models of care delivery for this vulnerable group are warranted. (Publisher abstract)
Does the use of health care and special school services, prior to admission for psychiatric inpatient treatment, differ between adolescents housed by child welfare services and those living with their biological parent(s)?
- Authors:
- LAUKKANEN Matti, et al
- Journal article citation:
- Community Mental Health Journal, 49(5), 2013, pp.528-539.
- Publisher:
- Springer
The researchers examined whether the use of health care and special school services, prior to admission for psychiatric inpatient treatment, differed between adolescents from child welfare units and those living at their parental home. 208 boys and 300 girls aged 12–17 years were admitted for psychiatric hospital between 2001 and 2006. Child welfare adolescents had used more health services/treatments prior to psychiatric hospital admission than adolescents living with their biological family. The best discriminating factors between study groups for both genders, were previous psychiatric hospitalisations, unemployed parents, use of special school services and self-perceived serious anxiety/tension or trouble controlling violent behaviour. Repeated school grades and previous use of psychotropic medications were discriminating factors only in girls. Adolescents in child welfare deserve adequate mental health evaluations at an early stage, with referral to appropriate adolescent psychiatric services if required. Appropriate service provision and properly planned treatments may reduce the amount of intensive and sometimes unnecessary psychiatric inpatient treatments. (Publisher abstract)
A narrative review: arguments for a collaborative approach in mental health between traditional healers and clinicians regarding spiritual beliefs
- Author:
- POUCHLY Cara A.
- Journal article citation:
- Mental Health Religion and Culture, 15(1), 2012, pp.65-85.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
This article discusses a collaborative approach between mental health clinicians and traditional healers, from a clinical psychology perspective, for clients with spiritual beliefs. Spiritual beliefs are incorporated into the identity and functioning of clients within a cultural context. It is argued that working collaboratively would address many access difficulties to mental health services and support for this is shown in a number of studies and case reports across cultures. This approach appears to be in accordance with current theories of acculturation. The problems in the current system when working non-collaboratively are also explored. Counter arguments and difficulties of collaboration are discussed. The author concludes that research in the United Kingdom is limited and it is suggested that more research is needed.
Depression in adults with a chronic physical health problem: treatment and management
- Author:
- NATIONAL INSTITUTE FOR HEALTH AND CLINICAL EXCELLENCE
- Publisher:
- National Institute for Health and Clinical Excellence
- Publication year:
- 2009
- Pagination:
- 397p., bibliog.
- Place of publication:
- London
This draft national clinical practice guideline was commissioned by the National Institute for Health and Clinical Excellence (NICE) and developed within the National Collaborating Centre for Mental Health (NCCMH). The guideline is intended for adults with depression and chronic health problems and covers the care provided by primary, community, secondary, tertiary and other healthcare professionals who have contact with, and make decisions concerning the care of, adults with depression and chronic health problems. It makes recommendations for the treatment and management of people with depression and chronic health problems, starting with an introduction to the topic of depression and chronic physical health problems and an explanation of the methods used to develop the guideline, and then providing the evidence that underpins the recommendations about the treatment and management of people with depression and chronic health problems, including personal accounts from service users and carers offering an insight into their experience, and looking at the identification of depression in people with chronic physical health problems, service-led interventions, psychosocial interventions, and pharmacological interventions.
An integrated, multidimensional treatment model for individuals living with HIV, mental illness, and substance misuse
- Authors:
- BOUIS Stephanie, et al
- Journal article citation:
- Health and Social Work, 32(4), November 2007, pp.268-278.
- Publisher:
- Oxford University Press
The challenge of providing effective treatment services for the growing population of HIV-positive individuals who are also dually diagnosed with substance use and mental disorders has only recently been recognized as an important public health concern affecting both HIV treatment and prevention. This article describes a treatment model that was created for a study of integrated treatment for HIV-positive individuals with substance use and mental disorders. The treatment model was based on the transtheoretical model of behaviour change as well as evidence-based practices that are widely used in the treatment of individuals dually diagnosed with substance use and mental disorders. The model involved collaboration between medical and behavioural health care professionals and emphasized the importance of goal reinforcement across disciplines. Furthermore, it included the development and enhancement of client motivation to modify medical and behavioural health-risk behaviours using individual readiness for change and offered comprehensive care addressing a continuum of client needs that may influence treatment outcomes. Treatment modalities included individual therapy, group therapy, and psychiatric medication management. This treatment intervention was associated with positive outcomes in the integrated treatment study and can be adapted for use in a variety of psychiatric or medical treatment settings.