Search results

This paper aims to provide new insights into and offer potential solutions to the challenges encountered by mental health services working with remote, rural or underserved communities in the UK.

In this paper, the authors reflect on the utility of integrating conventional clinical approaches, with preventive care and empowering work within the community, to provide culturally sensitive and accessible mental health services. The authors describe an example of community intervention from a mental health service in Ghana designed to enhance reach within remote and rural communities and identify potential lessons for practice in the UK.

The partnership between community mental health services and the rural communities, including families and existing social frameworks, applies collaborative care to overcome the lack of resources and facilitate the acceptability of mental health services to the local population. There are a series of important lessons from this experience including the importance of understanding the culture of a community to optimise reach and the importance of working IN the community and WITH the community.

This paper is novel because it provides learning from a model of care applied in the global south that has potential for implementation with underserved populations in the UK. The authors suggest a reframing of the notion of community care to encompass existing frameworks of community, not merely a biomedical conceptualisation.

This study aims to establish the perspectives of community providers on challenges and enablers in developing child mental health capacity in disadvantaged communities in South Africa.

The authors involved 29 community providers operating in a large urban-deprived area in the Gauteng Province, east of Johannesburg. Community providers had educational, social and health care backgrounds. Their perspectives were captured through three focus groups, two participatory workshops and reflective diaries. Data were integrated and subjected to inductive thematic analysis.

Three interlinked themes were identified. Community mobilization was viewed as pre-requisite through mental health awareness and strategies to engage children, youth and parents. Service provision should take into consideration contextual factors, predominantly inequalities, lack of basic needs and gender-based issues (domestic violence, teenage pregnancy and single motherhood). Participants referred to severe mental health needs, and related to physical health conditions, disabilities and impairments, rather than to common mental health problems or wellbeing. They proposed that capacity building should tap into existing resources and integrate with support systems through collaborative working.

Child mental health policy and service design in Majority World Countries (MWCs), should involve all informal and structural support systems and stakeholders. Contextual factors require consideration, especially in disadvantaged communities and low-resource settings, and should be addressed through joined up working.

Children’s mental health needs are largely unmet in MWC-disadvantaged communities. These findings capture the experiences and perspectives of various community providers on how to enhance mental health provision by mobilizing communities and resources.

The paper aims to describe and discuss the development of a new and innovative community based mental health service.

The paper demonstrates how a team developed its ethos, formed links and provided leadership in establishing a socially inclusive community model of mental health care provision in a suburban area of Cork City, Ireland. Key factors which influenced and facilitated the development and implementation of the initiative will be highlighted, including demographic details of the local area, the results of the internal audit, the resource implications, and the collaborative style of the team. The change model used by the team used will be briefly outlined. The key processes and outcomes will be described, discussed and reflected upon.

Flexible, creative and collaborative leadership qualities, together with a good appreciation of knowledge of local communities, can create positive synergies in establishing effective relationships across diverse groups in developing a socially inclusive community mental health service.

This paper adds value to appreciating and understanding the wealth of social capital in local communities in fostering community mental health care integration across diverse groups.

The purpose of this paper is to explore how conflict-affected communities in Ukraine (the Lugansk region) can develop sustainable mental health services in decentralised settings. The main interest focuses on community stakeholders’ perception of their problems and solutions that communities can create to achieve better mental health coverage.

A series of roundtables (RTs) (4 RTs, 62 participants overall), accompanied by interactive brainstorming techniques, were conducted with communities’ representatives/stakeholders from the East of Ukraine (Lugansk region, a government-controlled area) during the year 2021. Participants (health, mental health, social care workers and administration representatives) were provided with the opportunity to discuss mental health services’ development challenges and create affordable solutions for their communities. Results of discussions were submitted to qualitative analysis and offered for review by participants.

Decentralisation in Ukraine led to allocating funds alongside responsibilities for developing the services to communities. Most of the communities appear not to be ready to acknowledge the role of mental health services, entirely relying on the existing weak psychiatric hospital-based system. Awareness-raising interactive capacity-building activities for the community leaders and decision-makers effectively promote community-based mental health services development. Five clusters of challenges were identified: leadership, coordination and collaboration problems; infrastructure, physical accessibility and financial problems; mental health and primary health-care workforce shortage and lack of competencies; low awareness of mental health and available services and high stigma; war, crises and pandemic-related problems. Communities stakeholders foresaw seven domains of action: increasing the role of communities and service users in the initiatives of governmental bodies; establishing in the communities local coordination/working groups dedicated to mental health service development; developing the community-based spaces (hubs) for integrated services provision; embedding the mental health services in the existing services (social, administrative and health care); mental health advocacy and lobbying led by local leaders and service users; increasing capacity of communities in financial management, fundraising; developing services by combining efforts and budgets of neighbouring communities.

The study has potential limitations. Participants of the roundtables were mostly appointed by local authorities, so some of them didn`t have a motivation for mental health services development. Service users were involved only from the facilitators` side, not from the side of communities; therefore, it was impossible to include their view of problems and solutions. Obtained data were limited to the opinion of local professionals, administration workers and other local stakeholders. The human rights aspect was not clearly articulated in the tasks of the roundtables.

To the best of the authors’ knowledge, the paper is original in terms of its topic (connecting decentralisation and local stakeholders’ engagement for understanding the challenges of mental health services development) and research strategy (engagement of Ukrainian communities, qualitative analysis of the discussion results and applying the best practices and international recommendations to the local context).

Drawing on the notion of “mental health policy participation”, the purpose of this paper is to describe and reflect on a regional case study of a community engagement approach that explored community perspectives on mental health and the factors that influence it. It established three expectations, that: the development of the Dumfries and Galloway Public Mental Health Strategy is informed by project outputs; services and innovations are based on what people want; active involvement of local people in decision making around mental health services and strategy is achieved.

A “participatory appraisal” approach was used to engage with communities. A three-day “Training of Trainers” exercise was undertaken. These individuals then accessed a number of community groups. Data collection was based on five key questions. A total of 443 were engaged in the process. Insights were reviewed by 20 stakeholders from a range of services to identify key actions. This led to the development of the mental health forum and, in turn, a Public Mental Health Strategy for Dumfries and Galloway. Community members were further included in processes through feedback mechanisms.

Factors of resilience, support of families and friends, social inclusion, access to social and leisure opportunities were most important. This was followed by structural issues like fear of judgement, lack of transport, discrimination and financial support. Finally, individual factors (sleep, meaningful hobbies and health) were highlighted.

This approach sought to go beyond a traditional focus to explore broader community perspectives on mental health and the factors that influence it.

There are many barriers to effective mental health promotion with mothers living in socially disadvantaged communities. These include failure to take account of local cultural knowledge, community values and identities; feelings arising from experiences of poor health and disadvantage; mistrust of health professionals, and lack of engagement with services. Qualitative methodologies were used to explore maternal mental health and service delivery to people living in poor social conditions. Individual interviews and group discussions were undertaken with nine mothers living in a disadvantaged community. Further data were obtained from fieldwork contacts with seven health professionals working in the community. The research identified four discursive strategies used by participants when they and others encountered difficulties in relation to stigma, mental health and their daily lives as mothers within the community. These strategies were othering, counteracting, blaming, and resisting. The analysis offers a resource to community initiatives seeking to examine how mothers can deal most effectively with a lack of control and power in their lives.

Working in mental health services has always been recognised as a stressful occupation and many studies have attested to the high levels of stress and burnout. This study examined comparative levels of stress among inpatient and community mental health staff across five European countries.Using a quasi experimental pre‐test post‐test design, data was collected from staff at baseline, six months and 12 months. This paper examines data from the baseline period. Staff working in acute inpatient wards and community mental health teams in Denmark (Aarhus, Storstrøm), Finland (Tampere), Norway (Bodo), Poland (Warsaw) and the UK (Cambridge), were asked to complete the Maslach Burnout Inventory (MBI) (Maslach, & Jackson, 1986), the Mental Health Professional Stress Scale (Cushway, Tyler & Nolan, 1996) and a demographic questionnaire designed for this study. Results on the MBI are reported in this article. Both community and inpatient teams reported high levels of burnout. There was evidence to suggest that burnout differed by site but not by team type. The English teams scored highest in emotional exhaustion and depersonalisation. Relatively high levels of work‐related personal accomplishment were reported across all of the sites.

The purpose of this paper is to update the Global Model of Public Mental Health (GMPMH) in light of the WHO QualityRights project.

Being able to refer to international conventions and human rights standards is a key component of a genuine global approach that is supportive of individuals and communities in their quest for recovery and full citizenship. The GMPMH was inspired by the ecological approach in health promotion programs, adding to that approach the individuals as agents of mental health policies and legislation transformation. The GMPMH integrates recovery- and citizenship-oriented psychiatric practices through the Ottawa Charter for Health Promotion (WHO, 1986).

Updating the GMPMH through the WHO QualityRights Toolkit highlights the need for a new form of governance body, namely the Civic Forum, which is inclusive of local communities and persons in recovery. People with mental health disabilities, intellectual disabilities, and substance use conditions can be “included in the community” (UN Convention on the Rights of Persons with Disabilities, Article 19) only if the community is informed and welcoming, for instance through a Civic Forum and its organizing Local Council of Mental Health.

Transition from social marginalization to full citizenship represents a daunting challenge in public mental health care. An approach that focuses primarily on individuals is not sufficient in creating access to valued roles those individuals will be able to occupy in community settings. Instead, public intervention and debate are required to promote and monitor the bond of citizenship that connects people to their communities.

The GMPMH is the result of a conceptual cross-breeding between recovery and health promotion (WHO, 1986). The GMPMH is an offspring of the ecological approach in health promotion programs, adding to that approach individuals as agents of mental health transformation. It refers to international conventions and human rights standards as a central component of a genuine global approach. A community-based participatory research design is well suited, which includes a Civic Forum for local communities to become involved and supportive of service users in their quality and human rights assessments.

The purpose of this paper is to investigate Keyes’ (2007) model of mental health, the presence (flourishing) or absence (languishing) of social, emotional and psychological wellbeing, in the context of drug and alcohol misuse and the frequency and pattern of community participation (engaging in society).

Participants were 1,815 individuals (70 per cent male) who entered residential substance misuse treatment provided by The Salvation Army. Questionnaires were completed at intake assessments with The Salvation Army staff. The data were compared with population norms of community participation utilising t-tests, while multiple linear regression was used to examine continuous mental health.

Although participants have lower levels of community participation compared to Australian population norms, those participants who were experiencing flourishing mental health had higher rates of community participation than Australian norms. Keeping in touch with friends and family was the most common form of participation. Informal social connectedness and civic engagement were the strongest predictors of mental health over and above more traditional substance use outcomes such as cravings.

This is one of the first studies to describe the relationships between community participation, substance use and mental health in participants seeking treatment for substance misuse. Despite having a drug or alcohol addiction requiring treatment, those participants with flourishing mental health have higher levels of community participation than community norms. Furthermore, community participation predicts mental health. This offers promise for interventions that increase community participation but further research using longitudinal designs is needed to replicate and clarify the direction of these relationships.

This paper explores issues surrounding the under‐representation of people from the Gujarati community in mental health statistics and services in the UK and asks why people from the Gujarati communities are less likely to seek assistance for mental health problems. It is well known that members of the African‐Caribbean community are over‐represented in mental health statistics, and this is attributed to factors such as racial discrimination, social adversity and stress of migration. However, members of the Gujarati community have also been exposed to these hardships, but are not similarly represented in the mental health statistics. The paper explores a selection of the key literature. Two questions are considered: first, whether this group genuinely has very good mental health (and if so why); and second, whether there are any factors that hold members of this community back from seeking help.