Mental health service status in Chengdu Communities / 中华全科医师杂志

A questionnaire survey was conducted among 319 mental health workers from 319 grassroots health institutions of 21 districts (cities,counties) in Chengdu in March 2013.The items of survey included general information of participants,subjective perceptions and status of community mental health services.Total 252 effective questionnaires were received,the average age of participants was (33.12 ± 9.39) years (19-61);59.5％ had clinical medicine and 16.3％ had public health background;most of them had educational levels of three-year college or below (84.9％);the average duration of working experience was 18 months;86.5％ was part-time;most of participants (87.4％) thought that the mental health service was a hard job and only 25.3％ expressed satisfaction with the work.Only 16.3％ of community health service centers had rehabilitation facilities for mental illness patients.Public health education was carried out for average (2.21 ± 1.62) times/year,the education for mental patients and family members was (1.62 ± 1.83) times/year.Between areas with sufficient detection rate of mental illness and those with insufficient detection rate,there was significant difference in training frequency of mental workers (P =0.012),there were no significant differences in having formal employment of mental workers (P =0.064),professional guidance,co-working with police officers,co-working with Disabled Persons' Federation,and the duration of working experience (all P ＞ 0.05).The results suggest that the capacity of mental health service in community levels is relatively weak in Chengdu,and the personnel training,public education and rehabilitation work of mental health need to be strengthened.

Processos de avaliação de serviços de saúde mental: uma revisão integrativa / Assessment procedures of mental health services: an integrative review

Esta revisão integrativa dos processos avaliativos em serviços de saúde mental, tanto em âmbito nacional como internacional, objetivou identificar fatores envolvidos nas avaliações; as dimensões em que os serviços foram avaliados e contribuições da avaliação para a atenção prestada em saúde mental. Realizou-se levantamento bibliográfico no período de fevereiro a maio de 2012. Prevaleceram os estudos avaliativos qualitativos tridimensionais. Os resultados revelam maior envolvimento dos profissionais, participação de usuários e familiares e busca por melhor qualidade da assistência como fatores relacionados ao grau de satisfação do usuário. Considerou-se a melhoria na qualidade da atenção em saúde a maior contribuição da avaliação.

This integrative review of assessing processes in mental health services, both nationwide and internationally, aimed to identify the dimensions by means of which the services have been evaluated and their contribution to the attention in mental health. Bibliographic survey was conducted during the period February-May 2012, noting the prevalence of three-dimensional qualitative assessing studies. The results reveal greater involvement of professionals, the participation of users and family and the search for better quality of care as factors related to the user's degree of satisfaction. The improvement in health care quality was considered the evaluation biggest contribution.

Community Mental Health Team In Singapore

Introduction: Mental disorder has been becoming a well-known disease which affects the function of both individuals and societies; however, the majority of mental illness patients from low or middle income countries have very little access to the treatment due to limited resources. Community mental health teams, on the other hand, provide more accessible and efficient care for patients with mental diseases. Objectives: To elaborate the service of the community mental health team in Institute of Mental Health by summarizing the personnel composition, working target, inclusion/exclusion/discharge criteria, and main services. To explore the current achievement by reviewing the data regarding number of referrals, number of active cases, and patients' performance (number of admission and length of inpatient stay) from 2008 to 2012. To discuss illness management and recovery model and motivational interview which are started to use in our service recently. Results: The composition of the community mental health team and the role of team members, the working target and criteria, the main service and recent development have been elaborated in the article. From 2008 to 2012, we had received 852 to 471 new referrals and managed up to 986 active cases each year, at the same time, number of admission had been reduced between 60% to 77% and length of inpatient stay had been decreased between 61% to 79% every year. Conclusion: The community mental health team is a multidisciplinary team which provides rehabilitation, psycho-education and support to the patients and their family, works towards motivating and training patients to be independent living and working in community.

Comparison between Users of Community Mental Health Services and Psychiatric Patients in Mental Health Related Facilities in Korea / 대한정신분열병학회지

OBJECTIVES: This study was conducted to compare the characteristics of psychiatric inpatients in mental health related facilities and community mental health services-utilizing patients by diverse factors in Korea. METHODS: Questionnaires were sent via mail to 140 standard mental health centers from October to December of 2008. 64 facilities responded and data of 461 mentally disabled who are registered at and utilize the services of these mental health centers were analyzed. T-test and cross-analysis were performed to determine the differences in the averages of the variables and the discrepancy in ratios, respectively. RESULTS: Differences between long-term psychiatric inpatients and community mental health services-utilizing patients were seen in characteristics such as gender, age, type of medical coverage, family support systems, diagnosis, age of onset, duration of hospitalization, community-dwelling period, and clinical symptoms and functions. It was significantly short in length of stay in facilities in users of community mental health services with comparison to institutionalized patients. CONCLUSION: The results of this study suggest that invigoration of community mental health services is an alternative that can help deter long-term hospitalization.

Effects of a Depression Prevention Program on Depression, Self-esteem, and Quality of Life in a Community Population / 정신간호학회지

PURPOSE: This study was conducted to test the effects of a community-based depression prevention program on community people and the effectiveness was measured by assessing depression, self-esteem, and quality of life. The theoretical framework supporting the program was Ellis' REBT (Rational Emotive Behavior Therapy) theory (1962). METHODS: A nonequivalent control group pretest-posttest design was used. Study participants were 29 community residents (experimental: 14, control: 15). The depression prevention program consisted of music activity, bibliotherapy, and cognitive behavior therapy and was provided for 6 weeks (a twelve-session). Data were collected before and after the program and 3 months later for follow-up testing. Data were analyzed using the SPSS/WIN 12.0. RESULTS: There were no differences in outcome variables between the experimental and control groups. From the additional analyses, statistically significant differences by time point were observed for Self-esteem and Quality of life at 3 months later for experimental group. And 50% of the participants with depression symptoms no longer scored in the depression symptoms in the experimental group. CONCLUSION: The study findings indicate that depression prevention programs are positive in reducing depression in people suffering from depression symptoms. However some modifications are required to increase effectiveness.

Developing a Psychosocial Rehabilitation Model for Persons with Chronic Mental Illness / 간호학회지

PURPOSE: The purpose of this study was to identify factors influencing the outcome of psychosocial rehabilitation for persons with chronic mental illness and to suggest a hypothetical model of psychosocial rehabilitation which is based on the relationship between influencing factors and then to test its fitness empirically. METHOD: Data was collected from persons with a chronic mental illness using a self-report questionnaire, and from their case managers using an observed rating questionnaire. A total of 220 cases were used in the final analysis, and a hypothetical model was verified through covariance structure analysis using LISREL. RESULT: 1) The fitness indices of the model were chi-square=133.77 (df=48, p=.00), GFI = 0.93, AGFI = 0.87, RMR = 2.32, NNFI = 0.95 and NFI = 0.95. Twelve paths among fifteen proved to be significant. 2) Psychosocial rehabilitation was influenced directly by symptoms, daily living skill and self-concept, and was influenced indirectly by the psychosocial rehabilitation program service. Psychosocial rehabilitation accounted for 32% of variance of these factors. CONCLUSION: This study is expected to contribute to understanding the psychosocial rehabilitation phenomena. Besides it will provide basic information for developing strategies of bio-psycho-sociological interventions and evaluations in regard to influential factors of psychosocial rehabilitation.

A Day Care Model for Chronic Psychotic Patients in Community Mental Health Center / 신경정신의학

OBJECTIVES: The purposes of this study were as follows: introducing general structure and management of a day care model practiced in Community Mental Helth Center where a psychiatrist participates weekly as a consultant analyzing; the results after performing this model and then verifying appropriateness and validity; brooding the possibility of generalization as an effective day care model in Community Mental Health Service of a small city and promoting maintenance, rehabilitation and returning to community of chronic psychotic patients. METHODS: We performed this model from May 1997 to December 1998 for about 20 months. The subjects were composed of 33 psychotic patients. PANSS (Positve and Negative Sydrom Scale), QLS (Quality of Life Scale), LSSS (Life Satisfaction Self-Rating Scale) were administered twice before starting and after 6 months of participation in this program. RESULTS: 1) This model helped the maintenance and rehabilitation of chronic psychotic patients, reducing symptoms and increasing quality of life; 2) This model was useful in integrating multi-disciplinary personnel and therapeutic methods as a whole with a psychiatrist intervening the least; 3) This model enabled a psychiatrist as a consultant to manage and control all Community Mental Health Service with him participating weekly; 4) It is possible for this model to be easily applied to Community Mental Health Service in a small city. CONCLUSION: model will be likely to be applied effectively and efficiently to the Community Mental Health Service in a small city for maintenance, rehabilitation and returning to community of chronic psychotic patients.