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2.
BMC Health Serv Res ; 22(1): 406, 2022 Mar 27.
Article in English | MEDLINE | ID: covidwho-1793949

ABSTRACT

BACKGROUND: Mental health disparities between Indigenous and non-Indigenous people in Canada are related to underlying economic, social, and political inequities that are legacies of colonization and the oppression of Indigenous cultures. It also widely acknowledged that mental health services currently available may not be culturally appropriate in supporting the health needs of Indigenous Canadians. A two-day Indigenous mental health forum examined mental health needs and gaps among Indigenous communities across the Regional Municipality of Wood Buffalo (RMWB) on Treaty 8 territory, in northern Alberta, Canada. This paper outlines the insights generated by stakeholder engagement at the forum to identify and prioritize directions for Indigenous mental health and build a vision and strategy for improving mental health services and programs for the region's diverse Indigenous population. METHODS: We applied a modified nominal group technique (NGT) consensus method embedded within Indigenous knowledge to determine key priorities and directions for Indigenous-focused mental health and synthesize information from discussions that occurred at the forum. Following the NGT, a participatory community visioning exercise was conducted with participants to develop a vision, guiding principles, and components of an action plan for an Indigenous mental health strategy for the RMWB. RESULTS: Four key themes for setting priorities and directions for Indigenous mental health emerged from roundtable group discussions: 1) understand the realities of mental health experiences for Indigenous peoples, 2) design a holistic and culturally rooted mental health system, 3) foster cross-sectoral engagement and collaboration on mental health service delivery, and 4) focus on children and youth. The community visioning exercise helped stakeholders to visualize a direction or path forward for addressing existing gaps in the mental health system and opportunities for strengthening Indigenous mental health in the region. CONCLUSIONS: Forum participants described mental health and well-being around holistic concepts of social and emotional well-being. Addressing Indigenous mental health and wellness involves multi-sectoral action in various settings including community and school through programs, policies, and other interventions that promote mental health for all Indigenous peoples, as well as for those at greater risk such as children and youth.


Subject(s)
Mental Disorders , Mental Health Services , Adolescent , Alberta , Consensus , Humans , Mental Disorders/therapy , Mental Health
3.
Front Public Health ; 9: 736624, 2021.
Article in English | MEDLINE | ID: covidwho-1775880

ABSTRACT

Background: Women, and migrant women in particular, are at increased risk of many common mental disorders, which may potentially impact their labor market participation and their work-related income. Previous research found that mental disorders are associated with several work-related outcomes such as loss of income, however, not much is known about how this varies with migrant background. This study investigated the change in work-related income following the uptake of outpatient mental healthcare (OPMH) treatment, a proxy for mental disorder, in young women with and without migrant background. Additionally, we looked at how the association varied by income level. Methods: Using data from four national registries, the study population consisted of women aged 23-40 years residing in Norway for at least three consecutive years between 2006 and 2013 (N = 640,527). By using a stratified linear regression with individual fixed effects, we investigated differences between majority women, descendants and eight migrant groups. Interaction analysis was conducted in order to examine differences in income loss following the uptake of OPMH treatment among women with and without migrant background. Results: Results showed that OPMH treatment was associated with a decrease in income for all groups. However, the negative effect was stronger among those with low income. Only migrant women from Western and EU Eastern Europe with a high income were not significantly affected following OPMH treatment. Conclusion: Experiencing a mental disorder during a critical age for establishment in the labor market can negatively affect not only income, but also future workforce participation, and increase dependency on social welfare services and other health outcomes, regardless of migrant background. Loss of income due to mental disorders can also affect future mental health, resulting in a vicious circle and contributing to more inequalities in the society.


Subject(s)
Mental Disorders , Transients and Migrants , Adult , Female , Humans , Mental Disorders/epidemiology , Mental Disorders/therapy , Mental Health , Norway/epidemiology , Young Adult
6.
J Child Adolesc Psychopharmacol ; 30(4): 203-204, 2020 05.
Article in English | MEDLINE | ID: covidwho-1758599
7.
BMJ Open ; 12(3): e055289, 2022 Mar 21.
Article in English | MEDLINE | ID: covidwho-1752877

ABSTRACT

INTRODUCTION: Recovery colleges (RCs) are mental health centres aimed at equipping people with skills to live a meaningful life despite the presence of mental distress. Unique to them is the aspect of cocreation; RCs are designed collaboratively with people of lived experiences of mental health and addictions and care providers. Despite established benefits, there remains a lack of empirical evidence on how RCs work and on their impact. AIMS: We aim to address this gap by designing a cocreated evaluation framework for RCs. This will be accomplished by engaging RC student/facilitators to provide perspectives on RCs/RC evaluation and cocreate a scoping review identifying evaluation gaps in the literature. Themes identified through these processes will form the evaluation framework. METHODS AND ANALYSIS: Two methodologies will be used to explore RC evaluation: student/facilitator engagement and a scoping review of current published and grey literature on RC evaluation. Engagement will be achieved using a participatory action research approach consisting of informant interviews of ~25 RC students/facilitators across Canada, which will be thematically analysed. The scoping review will follow methodology described by Arksey and O'Malley modified to support cocreation. Concurrent conducting of the engagement process and scoping review will allow RC students and peer facilitators the opportunity to shape RC evaluations, address gaps in the literature and codesign an evaluation framework focused on recovery-oriented processes and outcomes mattering most to RCs students/facilitators. ETHICS AND DISSEMINATION: Ethics approval was received for the RC student/facilitator engagement component from the Centre for Addictions and Mental Health Research Ethics Board (#042-2020) and Ontario Shores Centre for Mental Health Sciences (#20-013-B). Scoping review results will be copresented through national and international medical education conferences and published in open-access peer-reviewed journals. Furthermore, a dissemination strategy on evaluation for the national RC community will be created.


Subject(s)
Mental Disorders , Stakeholder Participation , Humans , Mental Disorders/therapy , Mental Health , Ontario , Research Design , Review Literature as Topic
8.
Int J Environ Res Public Health ; 19(5)2022 03 01.
Article in English | MEDLINE | ID: covidwho-1736911

ABSTRACT

While young Saudi adults are reportedly prone to experiencing a variety of mental health problems, they tend to delay seeking mental health support. Therefore, this study aimed to explore the barriers and facilitators of seeking mental health support among young adults in Saudi Arabia. A qualitative research design was implemented using semi-structured interviews with 12 young adult participants in Saudi Arabia, recruited through social media platforms, and the interviews were then analyzed using thematic analysis. Two major themes emerged: barriers that impede the process of mental health help-seeking and facilitators that assist individuals in seeking mental health support. The barriers included public stigma and lack of awareness, unprofessional mental health practitioners, lack of accessibility to services and information, unsupportive families, intrapersonal dilemmas, and misconceptions based on religious beliefs. Facilitators of help-seeking included increasing societal and family awareness, promoting the accessibility of services, enhancing sources of external support, personal motivation to change, and online therapy. The findings of this study emphasize the importance of promoting mental health literacy among the Saudi public, particularly with regard to young adults and their unique mental health needs. Exploring facilitators and barriers may also assist mental health providers in developing tailored mental health campaigns and interventions directed at young adults.


Subject(s)
Mental Disorders , Mental Health Services , Humans , Mental Disorders/therapy , Mental Health , Patient Acceptance of Health Care/psychology , Qualitative Research , Saudi Arabia , Social Stigma , Young Adult
9.
Int J Environ Res Public Health ; 19(6)2022 03 08.
Article in English | MEDLINE | ID: covidwho-1732046

ABSTRACT

The management of patients with immuno-rheumatological diseases has profoundly changed during the COVID-19 pandemic and telemedicine has played an important role in the disease follow-up. In addition to monitoring disease activity and any adverse events, especially infectious events, assessing the psychological situation of the patient can be fundamental. Furthermore, COVID-19 has a serious impact on mental health and, since the beginning of the pandemic, a significantly higher incidence of anxiety disorders and depressive symptoms especially in younger people was observed. In this study, we evaluated the incidence of depressive disorders, anxiety, and fibromyalgia (FM) in our patients with rheumatoid arthritis and psoriatic arthritis during the lockdown period due to the COVID-19 pandemic and we validate the use of telemedicine in the clinical management of these patients. Mental and physical stress during the COVID-19 pandemic can greatly worsen FM symptoms and intensify patients' suffering without a clinical flare of the inflammatory disease for patients affected by rheumatoid arthritis. Telemedicine has allowed us to identify patients who needed a face-to-face approach for therapeutic reevaluation even if not related to a flare of the inflammatory disease. Even if our data does not allow us to draw definitive conclusions regarding the effectiveness of telemedicine as greater than or equal to the standard face-to-face approach, we continue to work by modifying our approach to try to ensure the necessary care in compliance with safety and, optimistically, this tool will become an important part of rheumatic disease management.


Subject(s)
Arthritis, Psoriatic , Arthritis, Rheumatoid , COVID-19 , Fibromyalgia , Mental Disorders , Rheumatic Diseases , Telemedicine , Arthritis, Psoriatic/complications , Arthritis, Psoriatic/epidemiology , Arthritis, Psoriatic/therapy , Arthritis, Rheumatoid/complications , Arthritis, Rheumatoid/epidemiology , Arthritis, Rheumatoid/therapy , COVID-19/epidemiology , COVID-19/therapy , Communicable Disease Control , Fibromyalgia/diagnosis , Fibromyalgia/epidemiology , Fibromyalgia/therapy , Humans , Incidence , Mental Disorders/epidemiology , Mental Disorders/therapy , Pandemics , Rheumatic Diseases/epidemiology
10.
J Gerontol Nurs ; 48(3): 11-16, 2022 Mar.
Article in English | MEDLINE | ID: covidwho-1726165

ABSTRACT

Various factors impact end-of-life (EOL) for older adults. This period is more complex for older adults with severe and persistent mental illness (SPMI). The current article aims to explore a non-exhaustive list of person-level and environmental factors that may impact EOL for older adults with SPMI. [Journal of Gerontological Nursing, 48(3), 11-16.].


Subject(s)
Hospice Care , Mental Disorders , Terminal Care , Aged , Chronic Disease , Humans , Mental Disorders/therapy , Patient-Centered Care
12.
Psychiatr Clin North Am ; 45(1): 71-80, 2022 03.
Article in English | MEDLINE | ID: covidwho-1712927

ABSTRACT

Integrated behavioral care, and in particular, the collaborative care model, has been working to improve access and treatment for people with mental health disorders. Integrated care allows for adaptable, scalable, and sustainable practice that addresses the mental health needs of the public. During the pandemic several challenges emerged to delivering integrated care. This disruption happened at a systems level, team-based care level, scope of care level, and patient access level. This article looks through the lens of those various levels to identify and some of the lessons learned to help build a more resilient and flexible integrated care program.


Subject(s)
Delivery of Health Care, Integrated , Mental Disorders , Mental Health Services , Psychiatry , Humans , Mental Disorders/therapy , Primary Health Care
13.
Psychiatr Clin North Am ; 45(1): 191-210, 2022 03.
Article in English | MEDLINE | ID: covidwho-1665399

ABSTRACT

The COVID-19 pandemic exerted an extraordinary impact on public mental health to an extent not yet fully understood. Risk perception shaped psychological and behavioral responses, including experiences of distress, psychiatric disorders, and engagement in pandemic-related health behaviors. COVID-19 created unique aspects of evolving risk with various communities disproportionately impacted. The unique nature and duration of the pandemic required public-private partnerships that leveraged and adapted promising practices to promote essential elements that foster well-being after disasters. Early findings are reviewed, and further research will inform on best practices for protecting public mental health during future pandemics.


Subject(s)
COVID-19 , Mental Disorders , Humans , Mental Disorders/epidemiology , Mental Disorders/therapy , Mental Health , Pandemics , SARS-CoV-2
14.
J Contin Educ Nurs ; 53(2): 70-76, 2022 Feb.
Article in English | MEDLINE | ID: covidwho-1662730

ABSTRACT

BACKGROUND: The objective of this study was to implement an educational intervention on an inpatient, behavioral health care unit with the goal of reducing the number of crisis interventions of seclusion or restraint. METHOD: A quasi-experimental pretest and posttest design using De-escalate Anyone, Anywhere, Anytime training was employed with a focus of an increased understanding of a range of de-escalation techniques to use instead of restraint and seclusion. RESULTS: A convenience sample of 21 mental health employees participated in the training. The rates of restraint declined from a mean of 6 preintervention to 2 postintervention. The number of seclusions on the designated unit declined from a mean of 4.33 preintervention to a mean of 1.667 postintervention. CONCLUSION: These data suggest that an educational intervention to increase the knowledge of direct care staff in a broad range of de-escalation techniques resulted in a reduction in the use of restraint and seclusion. Ongoing training for nursing staff may reassure them of the efficacy of alternative methods for dealing with aggressive patients. [J Contin Educ Nurs. 2022;53(2):70-76.].


Subject(s)
Mental Disorders , Patient Isolation , Hospitals, Psychiatric , Humans , Inpatients , Mental Disorders/therapy , Restraint, Physical
15.
JAMA Netw Open ; 5(1): e2145677, 2022 01 04.
Article in English | MEDLINE | ID: covidwho-1653130

ABSTRACT

Importance: Little is known about changes in care for individuals with severe mental illness during the COVID-19 pandemic. Objective: To examine changes in mental health care during the pandemic and the use of telemedicine in outpatient care among Medicare beneficiaries with severe mental illness. Design, Setting, and Participants: This population-based cohort study included Medicare beneficiaries (age ≥18 years) diagnosed with schizophrenia and schizophrenia-related disorders or bipolar I disorder. Care patterns during January to September 2020 for a cohort defined in 2019 were compared with those during January to September 2019 for a cohort defined in 2018. Exposures: Start of COVID-19 pandemic in the United States, defined as week 12 of 2020. Main Outcomes and Measures: Use of mental health-related outpatient visits, emergency department visits, inpatient care, and oral prescription fills for antipsychotics and mood stabilizers during 4-week intervals. Multivariable logistic regression analyses examined whether the pandemic was associated with differential changes in outpatient care across patient characteristics. Results: The 2019 cohort of 686 214 individuals included 389 245 (53.8%) women, 114 073 (15.8%) Black and 526 301 (72.8%) White individuals, and 477 353 individuals (66.0%) younger than 65 years; the 2020 cohort of 723 045 individuals included 367 140 (53.5%) women, 106 699 (15.6%) Black and 497 885 (72.6%) White individuals, and 442 645 individuals (64.5%) younger than 65 years. Compared with 2019, there were large decreases during the pandemic's first month (calendar weeks 12-15) in individuals with outpatient visits (265 169 [36.7%] vs 200 590 [29.2%]; 20.3% decrease), with antipsychotic and mood stabilizer medication prescription fills (216 468 [29.9%] vs 163 796 [23.9%]; 20.3% decrease), with emergency department visits (12 383 [1.7%] vs 8503 [1.2%]; 27.7% decrease), and with hospital admissions (11 564 [1.6%] vs 7912 [1.2%]; 27.9% decrease). By weeks 32 to 35 of 2020, utilization rebounded but remained lower than in 2019, ranging from a relative decrease of 2.5% (outpatient visits) to 12.9% (admissions). During the full pandemic period (weeks 12-39) in 2020, 1 556 403 of 2 743 553 outpatient visits (56.7%) were provided via telemedicine. In multivariable analyses, outpatient visit use during weeks 12 to 25 of 2020 was lower among those with disability (odds ratio, 0.95; 95% CI, 0.93-0.96), and during weeks 26 to 39 of 2020, it was lower among Black vs non-Hispanic White individuals (OR, 0.97; 95% CI, 0.95-0.99) and those with dual Medicaid eligibility (OR, 0.96; 95% CI, 0.95-0.98). Conclusions and Relevance: In this cohort study, despite greater use of telemedicine, individuals with severe mental illness experienced large disruptions in care early in the pandemic. These narrowed but persisted through September 2020. Disruptions were greater for several disadvantaged populations.


Subject(s)
COVID-19 , Health Services Accessibility , Medicare , Mental Disorders , Pandemics , Patient Acuity , Adolescent , Adult , Aged , Cohort Studies , Female , Humans , Male , Mental Disorders/therapy , Middle Aged , Patient Acceptance of Health Care/statistics & numerical data , SARS-CoV-2 , United States , Young Adult
17.
Lancet Psychiatry ; 9(2): 169-182, 2022 02.
Article in English | MEDLINE | ID: covidwho-1641764

ABSTRACT

Mental disorders account for at least 18% of global disease burden, and the associated annual global costs are projected to be US$6 trillion by 2030. Evidence-based, cost-effective public mental health (PMH) interventions exist to prevent mental disorders from arising, prevent associated impacts of mental disorders (including through treatment), and promote mental wellbeing and resilience. However, only a small proportion of people with mental disorders receive minimally adequate treatment. Compared with treatment, there is even less coverage of interventions to prevent the associated impacts of mental disorders, prevent mental disorders from arising, or promote mental wellbeing and resilience. This implementation failure breaches the right to health, has increased during the COVID-19 pandemic, and results in preventable suffering, broad impacts, and associated economic costs. In this Health Policy paper, we outline specific actions to improve the coverage of PMH interventions, including PMH needs assessments, collaborative advocacy and leadership, PMH practice to inform policy and implementation, training and improvement of population literacy, settings-based and integrated approaches, use of digital technology, maximising existing resources, focus on high-return interventions, human rights approaches, legislation, and implementation research. Increased interest in PMH in populations and governments since the onset of the COVID-19 pandemic supports these actions. Improved implementation of PMH interventions can result in broad health, social, and economic impacts, even in the short-term, which support the achievement of a range of policy objectives, sustainable economic development, and recovery.


Subject(s)
COVID-19 , Health Policy , Mental Disorders/therapy , Mental Health Services/organization & administration , Mental Health Services/standards , Mental Health/standards , Public Health/standards , Humans
18.
Curr Opin Psychiatry ; 34(4): 434-443, 2021 07 01.
Article in English | MEDLINE | ID: covidwho-1637741

ABSTRACT

PURPOSE OF REVIEW: To reduce the spread of infection from the coronavirus disease 2019 (COVID-19), mental healthcare facilities were forced to make the rapid transition from face-to-face services to virtual care. This systematic review aims to synthesize the extant literature reporting on barriers of telemental health (TMH) during the COVID-19 pandemic and how facilities have worked to overcome these barriers, to inform best practices for TMH delivery. RECENT FINDINGS: Most recent findings came from case studies from mental health professionals which reported on barriers related to institutional, provider and patient factors, and how these barriers were overcome. Common barriers identified in the literature include: technological difficulties; issues regarding safety, privacy and confidentiality; therapeutic delivery and the patient-provider relationship; and a loss of sense of community. Studies also reported on the benefits to TMH interventions/tools, as well as suggestions for improvements in the delivery of TMH services. SUMMARY: As the COVID-19 pandemic evolves, mental healthcare providers continue to find creative and feasible solutions to overcome barriers to the delivery of TMH. Dissemination of these solutions is imperative to ensure the best quality of mental healthcare for patients across the globe.


Subject(s)
COVID-19/prevention & control , Health Services Accessibility/statistics & numerical data , Mental Disorders/therapy , Mental Health Services , Quality Improvement , Telemedicine/methods , COVID-19/psychology , Humans , Mental Disorders/psychology , Pandemics , SARS-CoV-2
19.
Int J Psychiatry Clin Pract ; 25(2): 107-108, 2021 Jun.
Article in English | MEDLINE | ID: covidwho-1594667
20.
Int J Environ Res Public Health ; 18(24)2021 12 09.
Article in English | MEDLINE | ID: covidwho-1598579

ABSTRACT

Common mental health disorders (CMDs) represent a major public health concern and are particularly prevalent in people experiencing disadvantage or marginalisation. Primary care is the first point of contact for people with CMDs. Pharmaceutical interventions, such as antidepressants, are commonly used in the treatment of CMDs; however, there is concern that these treatments are over-prescribed and ineffective for treating mental distress related to social conditions. Non-pharmaceutical primary care interventions, such as psychological therapies and "social prescribing", provide alternatives for CMDs. Little is known, however, about which such interventions reduce social inequalities in CMD-related outcomes, and which may, unintentionally, increase them. The aim of this protocol (PROSPERO registration number CRD42021281166) is to describe how we will undertake a systematic review to assess the effects of non-pharmaceutical primary care interventions on CMD-related outcomes and social inequalities. A systematic review of quantitative, qualitative and mixed-methods primary studies will be undertaken and reported according to the PRISMA-Equity guidance. The following databases will be searched: Assia, CINAHL, Embase, Medline, PsycInfo and Scopus. Retrieved records will be screened according to pre-defined eligibility criteria and synthesised using a narrative approach, with meta-analysis if feasible. The findings of this review will guide efforts to commission more equitable mental health services.


Subject(s)
Mental Disorders , Mental Health , Humans , Mental Disorders/epidemiology , Mental Disorders/therapy , Meta-Analysis as Topic , Primary Health Care , Qualitative Research , Socioeconomic Factors , Systematic Reviews as Topic
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