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1.
Prax Kinderpsychol Kinderpsychiatr ; 69(5): 463-480, 2020 Sep.
Artigo em Alemão | MEDLINE | ID: mdl-32886047

RESUMO

Mental Disorders and Parenting: Challenges and Opportunities for Adult Mental Health Services Parenting can be a key element in the psychiatric rehabilitation process, but it may come with many challenges for parents with mental health problems. Illness symptoms, together with social and sociocultural factors, can have adverse effects on family life or parenting behaviors and entail severe consequences for a child's psychosocial development. Bidirectional interactions can increase parental burden and thus worsen a parent's course of illness. This vicious circle can be broken by the provision of early and adequate support of mothers and fathers with mental health problems. Adult mental health services can make an important yet often underestimated contribution here. This article refers to parents' resources and needs and introduces both opportunities and challenges for adult mental health services when it comes to dealing with parenting needs. Mental health professionals are in a pivotal position for extending adequate support to clients on their parental needs. These professionals' skills and knowledge regarding parenting are essential for the successful implementation of family-focused practices in adult mental health services. Beyond the individual level, there is a need for policies and guidelines stipulating the integration of family and child perspectives in adult mental health services. In a broader view, a program from Finland shows how mental health professionals as well as peers can support parents and their families during the treatment process.


Assuntos
Filho de Pais Incapacitados/psicologia , Transtornos Mentais/terapia , Serviços de Saúde Mental , Poder Familiar/psicologia , Pais/psicologia , Adulto , Criança , Suscetibilidade a Doenças , Feminino , Humanos , Masculino , Transtornos Mentais/prevenção & controle , Transtornos Mentais/reabilitação
2.
Prax Kinderpsychol Kinderpsychiatr ; 69(5): 426-442, 2020 Sep.
Artigo em Alemão | MEDLINE | ID: mdl-32886049

RESUMO

Assisting the Forgotten Ones - Interventions for Children of Parents with Psychological Disorders Mental diseases are associated with high levels of distress in various areas of life for those, who are affected. Taking a closer look at the social circumstances, not exclusively the people themselves but also their family members are affected, especially children. In adult treatment these children are often neglected, even if they have a higher risk of suffering a mental illness themselves. A huge amount of this risk is related to the special family environment children are often exposed to right after birth. We already find prevention programs helping these children and their parents to protect their mental health. These programs largely differ regarding parental psychopathology, setting or intensity. This article gives an overview of the special circumstances these children may be confronted with and hence derivates possible starting points to support affected families. A few existing programs will be described in detail. Empirical findings presented in the article give hope for the effectiveness of already existing programs and besides highlight the need for further research and changes in the care system.


Assuntos
Filho de Pais Incapacitados/psicologia , Transtornos Mentais/prevenção & controle , Transtornos Mentais/terapia , Pais/psicologia , Adulto , Criança , Suscetibilidade a Doenças , Humanos , Transtornos Mentais/reabilitação
3.
Prax Kinderpsychol Kinderpsychiatr ; 69(5): 416-425, 2020 Sep.
Artigo em Alemão | MEDLINE | ID: mdl-32886051

RESUMO

Early Childhood Intervention for Children of Parents with Mental Health Issues - Results of the Research Program of the National Center for Early Prevention In Germany, networks and measures of early childhood intervention (ECI) have been implemented nationwide. By specifically targeting families with multiple psychosocial challenges, ECI contributes to the enhancement of families' parenting skills, in order to promote equal opportunities for all children to grow up healthy and safe. In many families supported by ECI measures at least one parent shows symptoms of a mental health disorder, which poses a major challenge to ECI practitioners. Nevertheless, there is a lack of valid scientific knowledge about the proportion of young families living with symptoms of mental disorders, the degree to which parents' psychic burdens affect care in ECI measures and about the cooperation of different care providing systems. The National Center for Early Prevention (NCEP) monitors and evaluates the scaling up of ECI networks and measures in Germany. The present article compiles results of different NCEP studies focusing on parents with mental illness in Early Childhood Intervention. Results are discussed with regard to their relevance for further improving the care systems.


Assuntos
Filho de Pais Incapacitados/psicologia , Transtornos Mentais/prevenção & controle , Pais/psicologia , Medicina Preventiva , Criança , Suscetibilidade a Doenças , Alemanha , Humanos , Transtornos Mentais/reabilitação , Saúde Mental , Poder Familiar/psicologia
5.
PLoS One ; 15(8): e0237664, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32817624

RESUMO

BACKGROUND: Mental health supported housing services are a key component in the rehabilitation of people with severe and complex needs. They are implemented widely in the UK and other deinstitutionalised countries but there have been few empirical studies of their effectiveness due to the logistic challenges and costs of standard research methods. The Clinical Record Interactive Search (CRIS) tool, developed to de-identify and interrogate routinely recorded electronic health records, may provide an alternative to evaluate supported housing services. METHODS: The feasibility of using the Camden and Islington NHS Foundation Trust CRIS database to identify a sample of users of mental health supported accommodation services. Two approaches to data interrogation and case identification were compared; using structured fields indicating individual's accommodation status, and iterative development of free text searches of clinical notes referencing supported housing. The data used were recorded over a 10-year-period (01-January-2008 to 31-December-2017). RESULTS: Both approaches were carried out by one full-time researcher over four weeks (150 hours). Two structured fields indicating accommodation status were found, 2,140 individuals had a value in at least one of the fields representative of supported accommodation. The free text search of clinical notes returned 21,103 records pertaining to 1,105 individuals. A manual review of 10% of the notes indicated an estimated 733 of these individuals had used a supported housing service, a positive predictive value of 66.4%. Over two-thirds of the individuals returned in the free text search (768/1,105, 69.5%) were identified via the structured fields approach. Although the estimated positive predictive value was relatively high, a substantial proportion of the individuals appearing only in the free text search (337/1,105, 30.5%) are likely to be false positives. CONCLUSIONS: It is feasible and requires minimal resources to use de-identified electronic health record search tools to identify large samples of users of mental health supported housing using structured and free text fields. Further work is needed to establish the availability and completion of variables relevant to specific clinical research questions in order to fully assess the utility of electronic health records in evaluating the effectiveness of these services.


Assuntos
Bases de Dados Factuais , Transtornos Mentais/epidemiologia , Saúde Mental , Processamento de Linguagem Natural , Adulto , Registros Eletrônicos de Saúde , Inglaterra/epidemiologia , Estudos de Viabilidade , Feminino , Habitação , Humanos , Masculino , Transtornos Mentais/patologia , Transtornos Mentais/psicologia , Transtornos Mentais/reabilitação , Serviços de Saúde Mental , Pessoa de Meia-Idade
6.
Artigo em Inglês | MEDLINE | ID: mdl-32824309

RESUMO

Mental illness remains as one of the most stigmatizing conditions in contemporary western societies. This study sheds light on how mental health professionals and rehabilitants perceive stigmatization. The qualitative study is based on stimulated focus group interviews conducted in five Finnish mental health rehabilitation centers that follow the Clubhouse model. The findings were analyzed through inductive content analysis. Both the mental health rehabilitants and the professionals perceived stigmatization as a phenomenon that concerns the majority of rehabilitants. However, whereas the professionals viewed stigma as something that is inflicted upon the mentally ill from the outside, the rehabilitants perceived stigma as something that the mentally ill themselves can influence by advancing their own confidence, shame management, and recovery. Improvements in treatment, along with media coverage, were seen as the factors that reduce stigmatization, but the same conceptualization did not hold for serious mental illnesses. As the average Clubhouse client was thought to be a person with serious mental illness, the rehabilitation context designed to normalize attitudes toward mental health problems was paradoxically perceived to enforce the concept of inevitable stigma. Therefore, it is important for professionals in rehabilitation communities to be reflexively aware of these tensions when supporting the rehabilitants.


Assuntos
Transtornos Mentais , Pessoas Mentalmente Doentes , Reabilitação Psiquiátrica , Estigma Social , Adulto , Finlândia , Humanos , Transtornos Mentais/reabilitação , Estereotipagem
7.
J Ment Health Policy Econ ; 23(2): 55-60, 2020 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-32621725

RESUMO

BACKGROUND: The approach to care for persons with an acute illness is different from that for a person with a chronic disease. Whilst the goal of treatment for an acute illness is to cure the disease, a chronic condition has no cure as such, and hence management requires a team approach that is aimed at achieving goals that are jointly set by service users and providers. Severe and persistent mental illness (SPMI) is a chronic disease. However, in many mental health services, the approach to care for persons with SPMI is similar to those who have an acute mental illness. AIM: The aims of this paper are twofold: (i) to make an argument for recovery oriented services to focus on meeting clients' needs rather than on symptom reduction, (ii) to propose a model of service provision where clinical mental health services form a part rather than the mainstay of care for people with SPMI. RESULTS: Using examples from Australia's Partner's in Recovery initiative and other recovery literature, we start by describing how SPMI should be treated as a chronic disease that focuses on recovery. We then highlight how mental health services continue to monitor outcomes based on clinical rather than personal recovery. Next, we diagrammatically illustrate how needs can be aligned with the recovery process and illustrate how care coordination can be the hub of service delivery in a hub and spoke model. We conclude with comments on workforce requirements and costs of a needs-based recovery oriented service. DISCUSSION: In a needs based model, the role of the specialist mental health service will move from being at the centre of care to being one of the components of care and the role of the care coordinator will become central. Although, there are as yet no randomised controlled trials to show that meeting needs of persons with SPMI will significantly contribute to their recovery, preliminary studies show that it is possible. IMPLICATIONS FOR HEALTHCARE PROVISION AND USE: The role of the care coordinator becomes the hub of service provision collaborating with agencies such as family practices, specialist mental health services, legal, housing, employment, education, and community services. IMPLICATIONS FOR HEALTH POLICIES: A shift from the current model of care to a needs based approach requires a revolutionary change in the way we do business and will have to be the largest shake up of the mental health service system since deinstitutionalisation. IMPLICATIONS FOR FURTHER RESEARCH: It is a long journey from the status quo to a needs based approach. The first step would be to gather more evidence on the usefulness of addressing people's needs in achieving recovery.


Assuntos
Prestação Integrada de Cuidados de Saúde/organização & administração , Transtornos Mentais/reabilitação , Serviços de Saúde Mental/organização & administração , Equipe de Assistência ao Paciente , Austrália , Doença Crônica , Comportamento Cooperativo , Habitação , Humanos , Transtornos Mentais/psicologia
9.
Artigo em Inglês | MEDLINE | ID: mdl-32698470

RESUMO

The cost-benefit and cost-effectiveness of a work-directed intervention implemented by the occupational health service (OHS) for employees with common mental disorders (CMD) or stress related problems at work were investigated. The economic evaluation was conducted in a two-armed clustered RCT. Employees received either a problem-solving based intervention (PSI; n = 41) or care as usual (CAU; n = 59). Both were work-directed interventions. Data regarding sickness absence and production loss at work was gathered during a one-year follow-up. Bootstrap techniques were used to conduct a Cost-Benefit Analysis (CBA) and a Cost-Effectiveness Analysis (CEA) from both an employer and societal perspective. Intervention costs were lower for PSI than CAU. Costs for long-term sickness absence were higher for CAU, whereas costs for short-term sickness absence and production loss at work were higher for PSI. Mainly due to these costs, PSI was not cost-effective from the employer's perspective. However, PSI was cost-beneficial from a societal perspective. CEA showed that a one-day reduction of long-term sickness absence costed on average €101 for PSI, a cost that primarily was borne by the employer. PSI reduced the socio-economic burden compared to CAU and could be recommended to policy makers. However, reduced long-term sickness absence, i.e., increased work attendance, was accompanied by employees perceiving higher levels of production loss at work and thus increased the cost for employers. This partly explains why an effective intervention was not cost-effective from the employer's perspective. Hence, additional adjustments and/or support at the workplace might be needed for reducing the loss of production at work.


Assuntos
Serviços de Saúde do Trabalhador/economia , Saúde do Trabalhador/estatística & dados numéricos , Estresse Ocupacional/prevenção & controle , Licença Médica/economia , Análise Custo-Benefício , Custos de Cuidados de Saúde/estatística & dados numéricos , Humanos , Transtornos Mentais/prevenção & controle , Transtornos Mentais/reabilitação , Serviços de Saúde do Trabalhador/métodos , Retorno ao Trabalho , Licença Médica/estatística & dados numéricos
10.
Prax Kinderpsychol Kinderpsychiatr ; 69(3): 218-235, 2020 May.
Artigo em Alemão | MEDLINE | ID: mdl-32394820

RESUMO

Do Children and Adolescents with Different Reasons for Admission Equally Benefit from Institutional Care? Currently, almost 150.000 children and adolescents are placed in institutional care in Germany with the aim to improve their living conditions. Various studies showed positive effects concerning the development of those institutionalized children and adolescents. Within the present study, 500 children and adolescents in institutional care were examined regarding the improvement of quality of life and social competencies during their care placement depending on the respective reason for admission (group A: admission due to mental health and behavior problems; group S: problems in the context of the school; group O: no mental health problems, but other reasons). Furthermore, differences in the development of children and adolescents who initiated the placement by themselves and those who did not were examined. Results show that over a period of 18-24 months, all three groups developed effectively equally. Group A had a lower initial level regarding quality of life and social competencies compared to group S and group O and therefore reached lower outcomes within the investigation period. Development was irrespective of whether or not children and adolescents initiated the institutional placement by themselves. The results demonstrate that all three groups were able to benefit from institutional care, although children and adolescents with mental health problems had a notable potential for further development.


Assuntos
Criança Institucionalizada/psicologia , Transtornos Mentais/psicologia , Transtornos Mentais/reabilitação , Comportamento Problema/psicologia , Qualidade de Vida , Habilidades Sociais , Adolescente , Criança , Alemanha , Humanos , Saúde Mental
12.
Ir J Psychol Med ; 37(3): 169-171, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32434627

RESUMO

Specialised rehabilitation units offer inpatient multi-disciplinary rehabilitation for individuals with severe and enduring mental illness. A cornerstone of therapy is the work in the community through further education and community organisations. However, coronavirus restrictions have meant that such external supports are no longer available for the duration of the crisis. This has led to opportunities for developing new ways of offering rehabilitation within hospital environments. This article describes some of the new initiatives developed. The benefits of the lockdown for service users are also discussed. Many found the cessation of visits from family members with whom they had an ambivalent relationship helpful. The lockdown improved relationships between patients on the unit and encouraged a greater feeling of community. The lockdown has also emphasised the importance of team self-awareness and an awareness of the nature of the treatments offered.


Assuntos
Betacoronavirus , Infecções por Coronavirus/psicologia , Hospitais Psiquiátricos , Pacientes Internados/psicologia , Transtornos Mentais/reabilitação , Pneumonia Viral/psicologia , Quarentena/psicologia , Humanos , Transtornos Mentais/psicologia , Pandemias
13.
J Clin Nurs ; 29(15-16): 3012-3024, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32353905

RESUMO

AIMS AND OBJECTIVES: This paper explores the conditions for the possibilities of recovery in a Danish mental healthcare practice, expressed from the perspective of nurses. The results and discussion of the study help to make visible and explore the muddle of conceptualisations of recovery in mental healthcare practice. BACKGROUND: Few studies examine the possibilities of recovery for inpatients and outpatients in mental health centres from a nursing perspective. DESIGN: A qualitative design using a critical social constructionist frame of understanding, in which the real world is considered as a series of social constructions. METHOD: A Fairclough-inspired critical discourse analysis was chosen as the analytical strategy. The analysis is comprised of ten interviews in mental health care and notes, written by nurses, in medical records of ten patients with a mental illness admitted to a mental healthcare centre in 2016-2017. The Consolidated Criteria for Reporting Qualitative Research checklist was used as a guideline to secure accurate and complete reporting of the study (See Appendix S1). RESULTS: From the findings of the textual analysis and the analysis of the discourse practice, it seems clear that the social relations and structures relating to recovery in Danish psychiatry are steered and controlled by discourses that reflect, in general terms, the essence of the core of neoliberal ideology. CONCLUSION: Recovery is generally articulated from an overall discourse of neoliberalism with its embedded discourses of paternalism, biomedicine, self-care and holism. All these discourses coexist in nursing practice, but the paternalistic discourse becomes the framework for the conditions for the possibility of how recovery is expressed in practice. RELEVANCE TO CLINICAL PRACTICE: Nurses need to be supported to seek clarity in the understanding and operationalisation of a recovery-oriented approach, if the agenda is to be truly adopted and strengthened.


Assuntos
Atitude do Pessoal de Saúde , Transtornos Mentais/enfermagem , Relações Enfermeiro-Paciente , Adulto , Idoso , Dinamarca , Feminino , Humanos , Masculino , Transtornos Mentais/reabilitação , Pessoa de Meia-Idade , Enfermagem Psiquiátrica/organização & administração , Pesquisa Qualitativa
14.
BMC Public Health ; 20(1): 497, 2020 Apr 15.
Artigo em Inglês | MEDLINE | ID: mdl-32295561

RESUMO

BACKGROUND: Recovery Education Centres (RECs) are increasingly implemented to support the process of recovery for individuals experiencing mental health challenges. However, the evidence on key REC mechanisms and outcomes, particularly for diverse subpopulations or service delivery contexts is scant. This study identified mechanisms and outcomes of an REC focused on adults with mental health challenges transitioning from homelessness. METHODS: Qualitative methods were used to explore in-depth the experiences of homeless and unstably housed participants experiencing mental health challenges in Toronto, Canada. Twenty service users participated in semi-structured interviews between July 2017 and June 2018, six to 14 months following REC enrollment. A realist informed interview guide explored participants' perspectives on key REC mechanisms and outcomes. Interviews were audio-recorded, transcribed verbatim and analyzed using inductive thematic analysis. Investigator triangulation and member checking processes enhanced analytical rigour. RESULTS: Participants perceived that program participation supported the process of recovery through several mechanisms: a judgment-free environment; supportive relationships, mutuality and role modelling; deconstruction of self-stigma; and reclaiming of one's power. Participants described several outcomes at the personal, interpersonal and social levels, including improvements in health and well-being; self-esteem, confidence and identity; sense of empowerment, control and personal responsibility; as well as improvements in interpersonal skills, pro-social behaviours and ability to self-advocate; and increased goal development and future orientation. CONCLUSIONS: Findings suggest RECs can support the process of recovery among people transitioning from homelessness and can successfully support subpopulations experiencing mental health challenges and social disadvantage.


Assuntos
Pessoas em Situação de Rua/psicologia , Transtornos Mentais/reabilitação , Serviços de Saúde Mental , Educação de Pacientes como Assunto/métodos , Adulto , Canadá , Feminino , Pessoas em Situação de Rua/estatística & dados numéricos , Humanos , Masculino , Pessoa de Meia-Idade , Pobreza , Avaliação de Programas e Projetos de Saúde , Pesquisa Qualitativa
15.
Int J Qual Stud Health Well-being ; 15(1): 1744926, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-32228393

RESUMO

PURPOSE: Community Health Centres (CHCs) are an essential component of primary health care (PHC) in Canada. This article examines health providers' understandings and experiences regarding stigma towards mental health and substance use (MHSU) issues, as well as their ideas for an effective intervention to address stigma and discrimination, in three CHCs in Toronto, Ontario. METHODS: Using a phenomenological approach, we conducted twenty-three interviews with senior staff members and peer workers, and three focus groups with front-line health providers. Ahybrid approach to thematic analysis was employed, entailing a combination of emergent and a priori coding. RESULTS: The findings indicate that PHC settings are sites where multiple forms of stigma create health service barriers. Stigma and discrimination associated with MHSU also cohere around intersecting experiences of gender, race, class, age and other issues including the degree and visibility of distress. Clients may find social norms to be alienating, including behavioural expectations in Canadian PHC settings. CONCLUSIONS: Given the turmoil in clients' lives, systematic efforts to mitigate stigma were inhibited by myriad proximate factors that demanded urgent response. Health providers were enthusiastic about implementing anti-stigma/recovery-based approaches that could be integrated into current CHC services. Their recommendations for interventions centred around communication and education, such as training, CHC-wide meetings, and anti-stigma campaigns in surrounding communities.


Assuntos
Pessoal de Saúde/psicologia , Transtornos Mentais/psicologia , Determinantes Sociais da Saúde , Discriminação Social , Estigma Social , Transtornos Relacionados ao Uso de Substâncias/psicologia , Canadá/epidemiologia , Centros Comunitários de Saúde , Feminino , Grupos Focais , Humanos , Entrevistas como Assunto , Masculino , Transtornos Mentais/reabilitação , Pesquisa Qualitativa , Transtornos Relacionados ao Uso de Substâncias/reabilitação
16.
Int J Qual Stud Health Well-being ; 15(1): 1748942, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-32249690

RESUMO

Purpose: This study explored whether the holistic theory of salutogenesis may be a suitable theoretical framework for the Clubhouse model of psychosocial rehabilitation, a pioneer among psychosocial rehabilitation programmes.Methods: A systematic examination of elements of the Clubhouse model, as prescribed by the Clubhouse standards, was performed within the context of the theory of salutogenesis including its basic salutogenic orientation and the main concepts of sense of coherence and resistance resources.Results: We found that several standards and practices within the Clubhouse model can be understood as applications of salutogenesis. We have hypothesized that the Clubhouse model promotes peoples' sense of coherence and mental health. However, our investigation also showed that, to enhance the recovery of Clubhouse members, more explicitly incorporating some salutogenic principles, such as "appropriate challenges" and "active adaptation as the ideal in treatment", may benefit Clubhouse practice.Conclusions: The Clubhouse model of psychosocial rehabilitation is very consistent with the salutogenic orientation and main salutogenic concepts. The present study suggests that salutogenesis may be a suitable theoretical framework for the Clubhouse model and possibly in the psychosocial rehabilitation field in general.


Assuntos
Transtornos Mentais/reabilitação , Reabilitação Psiquiátrica/métodos , Senso de Coerência , Serviços Comunitários de Saúde Mental , Humanos , Modelos Organizacionais
17.
Epidemiol Psychiatr Sci ; 29: e109, 2020 Mar 11.
Artigo em Inglês | MEDLINE | ID: mdl-32157987

RESUMO

AIMS: Community care units (CCUs) are a model of residential psychiatric rehabilitation aiming to improve the independence and community functioning of people with severe and persistent mental illness. This study examined factors predicting improvement in outcomes among CCU consumers. METHODS: Hierarchical regression using data from a retrospective cohort (N = 501) of all consumers admitted to five CCUs in Queensland, Australia between 2005 and 2014. The primary outcome was changed in mental health and social functioning (Health of the Nation Outcome Scale). Secondary outcomes were disability (Life Skills Profile-16), service use, accommodation instability, and involuntary treatment. Potential predictors covered service, consumer, and treatment characteristics. Group-level and individualised change were assessed between the year pre-admission and post-discharge. Where relevant and available, the reliable and clinically significant (RCS) change was assessed by comparison with a normative sample. RESULTS: Group-level analyses showed statistically significant improvements in mental health and social functioning, and reductions in psychiatry-related bed-days, emergency department (ED) presentations and involuntary treatment. There were no significant changes in disability or accommodation instability. A total of 54.7% of consumers demonstrated reliable improvement in mental health and social functioning, and 43.0% showed RCS improvement. The majority (60.6%) showed a reliable improvement in psychiatry-related bed-use; a minority demonstrated reliable improvement in ED presentations (12.5%). Significant predictors of improvement included variables related to the CCU care (e.g. episode duration), consumer characteristics (e.g. primary diagnosis) and treatment variables (e.g. psychiatry-related bed-days pre-admission). Higher baseline impairment in mental health and social functioning (ß = 1.12) and longer episodes of CCU care (ß = 1.03) increased the likelihood of RCS improvement in mental health and social functioning. CONCLUSIONS: CCU care was followed by reliable improvements in relevant outcomes for many consumers. Consumers with poorer mental health and social functioning, and a longer episode of CCU care were more likely to make RCS improvements in mental health and social functioning.


Assuntos
Serviços Comunitários de Saúde Mental/estatística & dados numéricos , Transtornos Mentais/reabilitação , Transtornos Mentais/terapia , Reabilitação Psiquiátrica/organização & administração , Centros Comunitários de Saúde Mental , Humanos , Transtornos Mentais/psicologia , Tratamento Domiciliar , Estudos Retrospectivos
18.
Artigo em Inglês | MEDLINE | ID: mdl-32121636

RESUMO

Aims: Community integration is the catalyst for recovery that is provided by mental health services to persons with mental disorders. This study explores the impact of socio-demographic variables on the level of community integration in persons with mental disorders compared to the general population living in the same communities and the difference in community integration level between the two groups. Methods: A total of 224 persons with mental disorders (M age = 45.0, SD = 12.84, male 51.8%, female 48.2%) in communities and 247 individuals (M age = 44.6, SD = 11.41, male 50.6%, female 49.4%) of the general population in the same communities participated in the evaluation of levels of physical, psychological, and social integration. The effects of socio-demographic variables on the three types of community integration on both groups were evaluated using multiple regression analyses. Differences in the three types of community integration between the two groups were tested using multivariate analysis of covariance (MANCOVA) by controlling for socio-demographic variables as covariates. Results: The effects of socio-demographic variables on the three types of community integration differed between the two groups. In addition, the two groups differed significantly in terms of social rather than physical or psychological integration when the level of community integration was compared while controlling socio-demographic variables. The results also show that persons with mental disorders had smaller social networks and fewer social contacts than the general population. Conclusions: Based on the findings, we recommended that service providers provide incentives for consumers to strengthen social relationships and social skills training in order to maintain relationships.


Assuntos
Integração Comunitária , Serviços Comunitários de Saúde Mental , Transtornos Mentais , Serviços de Saúde Mental , Adulto , Feminino , Humanos , Masculino , Transtornos Mentais/reabilitação , Pessoa de Meia-Idade
19.
Epidemiol Psychiatr Sci ; 29: e105, 2020 Feb 26.
Artigo em Inglês | MEDLINE | ID: mdl-32100662

RESUMO

There is growing interest in digital mental health as well as accumulating evidence of the potential for technology-based tools to augment traditional mental health services and to potentially overcome barriers to access and use of mental health services. Our research group has examined how people with mental illnesses think about and make use of technology in their everyday lives as a means to provide insight into the emerging paradigm of digital mental health. This research has been guided by anthropological approaches that emphasise lived experience and underscore the complexity of psychiatric recovery. In this commentary I describe how an anthropological approach has motivated us to ask how digital technology can be leveraged to promote meaningful recovery for people with mental illnesses and to develop a new approach to the integration of technology-based tools for people with mental illnesses.


Assuntos
Serviços Comunitários de Saúde Mental/organização & administração , Transtornos Mentais/reabilitação , Telemedicina/organização & administração , Humanos , Transtornos Mentais/psicologia , Saúde Mental
20.
BMC Psychiatry ; 20(1): 51, 2020 02 07.
Artigo em Inglês | MEDLINE | ID: mdl-32028913

RESUMO

BACKGROUND: Supporting personal recovery in people with mental health difficulties is central to mental health services. This study aimed to develop the Japanese version of INSPIRE and Brief INSPIRE measure of staff support for personal recovery and to evaluate its reliability and validity. METHODS: A questionnaire survey was conducted from October to December 2015. The authors asked users to participate in the survey of 14 community mental health services in the Kanto region of Japan. The service users completed self-administered questionnaires that include the Japanese version of INSPIRE, the Recovery Assessment Scale, the Client Satisfaction Questionnaire, the patient version of the Scale to Assess Therapeutic Relationship in Community Mental Health care and the Short Form Health Survey. Internal consistency was assessed using Cronbach's alpha coefficient, and test-retest reliability was assessed using the intraclass correlation coefficient (ICC) and weighted kappa. Convergent validity was examined by assessing correlation with other scales. Factor validity was evaluated by exploratory factor analysis (EFA) with generalized least-squares mean and oblimin rotation. In addition, confirmatory factor analysis was used to check the fitness of the factor structure models derived from the EFA. RESULTS: A total of 195 out of 212 users gave written informed consent and participated in the study. Data from 190 respondents were analyzed (response rate 89.6%). INSPIRE, Brief INSPIRE, and the subscales all showed Cronbach's alpha coefficient over 0.78. ICC and weighted kappa derived more than 0.92 for subscales and Brief INSPIRE. These numerical values indicated good reliability. The convergent validity of Brief INSPIRE and the subscales was significantly positively correlated with the other scales. Different from the previous study, the factor structure was extracted using EFA. Both factor structures were checked by CFA, but the degree of fitness index was not good in either. Therefore, the factor analysis did not show goodness of fit. CONCLUSIONS: This study found the Japanese version of INSPIRE and Brief INSPIRE to be reliable and valid for use among community mental health service users in Japan.


Assuntos
Serviços Comunitários de Saúde Mental/métodos , Transtornos Mentais/reabilitação , Avaliação de Resultados em Cuidados de Saúde/métodos , Psicometria , Autoimagem , Adulto , Feminino , Humanos , Japão , Masculino , Saúde Mental , Psicometria/métodos , Psicometria/normas , Reprodutibilidade dos Testes , Traduções
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