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Book part
Publication date: 5 October 2004

Carole Roan Gresenz and Roland Sturm

It is well known that mental health disorders cause substantial functional limitations and disability (Surgeon General, 1999). Less well known is the central role that…

Abstract

It is well known that mental health disorders cause substantial functional limitations and disability (Surgeon General, 1999). Less well known is the central role that mental health plays in economic disparities. The prevalence of depressive disorders is almost 3 times as high among individuals in the bottom 20% than among individuals in the top 20% of the income distribution, a much steeper gradient than for hypertension, heart disease, arthritis, chronic pain, or the number of medical problems (Sturm & Gresenz, 2002). In addition, individuals with mental disorders are less likely to have savings than individuals with physical health problems and the disparity widens with advancing age (Gresenz & Sturm, 2000).

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The Economics of Gender and Mental Illness
Type: Book
ISBN: 978-0-76231-111-8

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Article
Publication date: 17 October 2018

Gustavo Santos, Célia Soares, Raquel Rebelo and Paula Ferreira

While awaiting resolution of their legal process, undocumented migrants (UM) face several challenges, including limited access to public health care. The purpose of this…

Abstract

Purpose

While awaiting resolution of their legal process, undocumented migrants (UM) face several challenges, including limited access to public health care. The purpose of this paper is to survey UM attending a detention centre in Oporto (Portugal) to estimate the prevalence of mental health disorders in this population.

Design/methodology/approach

A retrospective chart review was performed with the relevant sociodemographic and clinical data of all UM in the process of coercive removal from Portuguese territory, observed by Doctors of the World, during three years (2014–2016). The Tenth Version of International Classification of Mental and Behavioural Disorders was used for nosological classification.

Findings

In total, 393 detainees were eligible for the study. Most detainees were male (84 per cent) and 76 months was the mean length of stay in Portugal before detention. In total, 29 per cent of detainees were diagnosed with a mental and behavioural disorder. The most prevalent diagnosis was neurotic, stress-related and somatoform disorders (47 per cent). UM with dual diagnosis (28 per cent) led to the articulation with the integrated centres of drug addiction, which provided and monitored opioid substitution therapy. Female UM were more prone to develop any mental and behavioural disorder when compared to men (χ2=7,017; p<0.05).

Research limitations/implications

In total, 9 per cent of the detainees were excluded from this study due to incomplete data on their medical charts. Some detainees presented oppositional behaviour, hostility towards others and refused to be assessed by the medical team. Both situations could have biased the prevalence of mental disorders. Finally, the appropriateness of the western model of mental health disorders (ICD-10) in the study population is controversial, considering the culture-bound phenomenology and syndromes.

Originality/value

This paper identified the most prevalent mental health disorders in UM detained in Portugal. The most prevalent mental health disorders were either stress-related (associated with the detention itself) or related to previous patterns of substance abuse. Given the study outcomes, it is highly recommended to mobilise human and technical resources to provide specialized mental health care to UM at least while detention policies could not be changed.

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Journal of Public Mental Health, vol. 17 no. 4
Type: Research Article
ISSN: 1746-5729

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Article
Publication date: 11 October 2021

Shannon C. King, Amanda L. Rebar, Paul Oliveri and Robert Stanton

Australian paramedics regularly encounter patients experiencing mental illness. However, some paramedics hold negative attitudes towards the use of emergency services in…

Abstract

Purpose

Australian paramedics regularly encounter patients experiencing mental illness. However, some paramedics hold negative attitudes towards the use of emergency services in providing care for these patients. Thus, the purpose of the present study was to examine the mental health literacy (MHL) of Australian paramedic students, and the training and experiential factors associated with MHL.

Design/methodology/approach

A cross-sectional online survey was delivered to paramedic students across Australia. A total of 94 paramedic students completed the survey examining MHL, mental health first aid (MHFA) intentions, confidence in providing help, personal and perceived stigma and willingness to interact with a person experiencing mental illness.

Findings

Participants generally had poor MHFA intentions in spite of good recognition of mental health disorders and good knowledge about mental health. Participants also demonstrated low stigmatising attitudes towards mental illness; however, they expressed a lack of willingness to interact with a person experiencing mental illness.

Originality/value

Our findings propose a combination of work-based experience and specific MHFA training may be beneficial to paramedic students to improve care for patients experiencing mental illness.

Details

The Journal of Mental Health Training, Education and Practice, vol. ahead-of-print no. ahead-of-print
Type: Research Article
ISSN: 1755-6228

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Article
Publication date: 3 October 2019

Kusrini Semarwati Kadar, Andriani Andriani and Darmita Noria Tandi

Mental health should be getting more attention, as mental health problems are increasing and they pose a significant health burden. Government plays an important role in…

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Abstract

Purpose

Mental health should be getting more attention, as mental health problems are increasing and they pose a significant health burden. Government plays an important role in supporting the implementation of mental health program. The purpose of this paper is to overview the implementation of mental health programs in North Toraja Regency, South Sulawesi Province, Indonesia.

Design/methodology/approach

This paper presents an audit conducted to examine the practice of mental health staff delivering mental health programs in community centers in one sub-district area in Indonesia and describes key areas of work, including promotive, preventative, curative and rehabilitation intervention. Responds from the respondents then was compared to guidelines for mental health practice in community based on Mental Health Law No. 18 (2014). The respondents were all mental health program staff (26 staff) from all community health centers (26 Puskesmas) in the North Toraja region, South Sulawesi (each Puskesmas has one staff responsible for mental health program).

Findings

This study explored programs and services provided for community mental health programs and roles of health staff in implementing programs and delivering services in one rural area. Although most health staff had provided mental health services according to the government guidelines, this study did not identify what the staff actually did in performing this work. Health staff cannot work alone in providing healthcare services, thus support from other sectors and from government is needed to deliver more effective healthcare to people with mental health disorders in the community. For further study, qualitative design is needed to explore more about the actual practice of the mental health staff in Puskesmas.

Originality/value

There is no published information regarding this topic in Indonesia to date. This information is really important for the government to evaluate the implementation of mental health program in Indonesia. However, these findings may only apply in this area, thus cannot be generalized for other regions in Indonesia, even if similar condition occurs in other areas.

Details

Journal of Public Mental Health, vol. 19 no. 2
Type: Research Article
ISSN: 1746-5729

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Article
Publication date: 1 June 2005

Yvonne Walsh and Alan Frankland

Abstract

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Mental Health Review Journal, vol. 10 no. 2
Type: Research Article
ISSN: 1361-9322

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Article
Publication date: 18 December 2020

Esme Elsden and Brenda Roe

The purpose of this study is to explore whether engaging with arts and culture affect depression in adults. This is because depression is the most common mental health

Abstract

Purpose

The purpose of this study is to explore whether engaging with arts and culture affect depression in adults. This is because depression is the most common mental health disorder. Diversification of mental health services, initiatives in arts in health and social prescribing are providing emerging evidence of benefits relating to depression outcomes.

Design/methodology/approach

A systematic review design adhering to the preferred reporting items for systematic reviews and meta-analyses reporting guidelines. MEDLINE®, Embase and American psychology association PsycINFO were searched and six studies were deemed eligible. Data extraction and quality appraisal enabled a narrative descriptive summary comparing study design, characteristics, populations and key results relating arts and cultural engagement to depression outcomes.

Findings

The total number of participants across the studies were 49,197. Three studies reported mean age, 58.78 years (15–99 years). Gender reported by five studies was 52.4% (n = 24,689) female and 47.6% (n = 22,439) male. Five studies found that engaging with arts decreased your odds of having depression.

Originality/value

This systematic review found emerging evidence that arts and cultural engagement benefits a wider population by reducing depression incidence. Establishing and understanding the association between arts engagement and decreasing depression incidence in a population is relevant to health-care providers, the general population and policymakers alike.

Details

Journal of Public Mental Health, vol. 20 no. 3
Type: Research Article
ISSN: 1746-5729

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Article
Publication date: 11 September 2017

Lilisbeth Perestelo-Perez, Amado Rivero-Santana, Yolanda Alvarez-Perez, Yaara Zisman-Ilani, Emma Kaminskiy and Pedro Serrano Aguilar

Shared decision making (SDM) is a model of health care in which patients are involved in the decision-making process about their treatment, considering their preferences…

Abstract

Purpose

Shared decision making (SDM) is a model of health care in which patients are involved in the decision-making process about their treatment, considering their preferences and concerns in a deliberative process with the health care provider. Many existing instruments assess the antecedents, process, or the outcomes of SDM. The purpose of this paper is to identify the SDM-related measures applied in a mental health context.

Design/methodology/approach

The authors performed a systematic review in several electronic databases from 1990 to October 2016. Studies that assessed quantitatively one or more constructs related to SDM (antecedents, process, and outcomes) in the field of mental health were included.

Findings

The authors included 87 studies that applied 48 measures on distinct SDM constructs. A large majority of them have been developed in the field of physical diseases and adapted or directly applied in the mental health context. The most evaluated construct is the SDM process in consultation, mainly by patients’ self-report but also by external observer measures, followed by the patients’ preferences for involvement in decision making. The most applied instrument was the Autonomy Preference Index, followed by the Observing Patient Involvement in Decision Making (OPTION) and the Control Preferences Scale (CPS). The psychometric validation in mental health samples of the instruments identified is scarce.

Research limitations/implications

The bibliographic search is comprehensive, but could not be completely exhaustive. Effort should be invested in the development of new SDM for mental health tools that will reflect the complexity and specific features of mental health care.

Originality/value

The authors highlight several limitations and challenges for the measurement of SDM in mental health care.

Details

Mental Health Review Journal, vol. 22 no. 3
Type: Research Article
ISSN: 1361-9322

Keywords

Content available
Article
Publication date: 4 December 2020

Kyaw Lin, Sun Lin and Than Tun Sein

Myanmar has an insufficient number of mental health workers with few institutional facilities resulting in a significant treatment gap. Although few mental health services…

Abstract

Purpose

Myanmar has an insufficient number of mental health workers with few institutional facilities resulting in a significant treatment gap. Although few mental health services are integrated into primary health care (PHC), the challenges are unknown. This study aimed to assess the challenges perceived by providers in the service delivery of satellite mental health care (SMHC) in two sample townships in Yangon.

Design/methodology/approach

The research was based on a case study design by applying a qualitative approach using in-depth interviews (IDIs). In the three types of service providers, a total of six staff participated as interviewees. These consisted of two team leaders, two clinical specialists providing consultations to clients and two mental health nurses.

Findings

Providers perceived the following as major challenges in the provision of services: unstable financial resources and management, insufficient human resources and capacity of service providers, restricted outpatient services, the lack of a functional referral system, overcrowding, inadequate individual consultation time, long-waiting hours, finite opening days and hours and poor setting of infrastructure, resulting in lack of privacy.

Research limitations/implications

In the absence of similar studies in Myanmar, findings could not be placed in the context of the national literature for comparison. Further, the study involved a limited number of respondents, which may have affected the findings.

Originality/value

Although the challenges revealed were not uncommon in mental health services in developing countries, this study focused on a specific model of mental health care integrated into general healthcare settings in Myanmar. The findings offer a benchmark on efforts to develop decentralized mental health services in Myanmar and provide input for future in-depth studies.

Details

Journal of Health Research, vol. ahead-of-print no. ahead-of-print
Type: Research Article
ISSN: 0857-4421

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Article
Publication date: 9 January 2019

Joanna Khoo, Helen Hasan and Kathy Eagar

The purpose of this paper is twofold: first, to present patient-level utilisation patterns of hospital-based mental health services funded by private health insurers; and…

Abstract

Purpose

The purpose of this paper is twofold: first, to present patient-level utilisation patterns of hospital-based mental health services funded by private health insurers; and second, to examine the implications of the findings for planning and delivering private mental health services in Australia.

Design/methodology/approach

Analysing private health insurance claims data, this study compares differences in demographic and hospital utilisation characteristics of 3,209 patients from 13 private health insurance funds with claims for mental health-related hospitalisations and 233,701 patients with claims for other types of hospitalisations for the period May 2014 to April 2016. Average number of overnight admissions, length of stay and per patient insurer costs are presented for each group, along with overnight admissions vs same-day visits and repeat services within a 28-day period following hospitalisation. Challenges in analysing and interpreting insurance claims data to better understand private mental health service utilisation are discussed.

Findings

Patients with claims for mental health-related hospitalisations are more likely to be female (62.0 per cent compared to 55.8 per cent), and are significantly younger than patients with claims for other types of hospitalisations (32.6 per cent of patients aged 55 years and over compared to 57.1 per cent). Patients with claims for mental health-related hospitalisations have significantly higher levels of service utilisation than the group with claims for other types of hospitalisations with a mean length of stay per overnight admission of 15.0 days (SD=14.1), a mean of 1.3 overnight admissions annually (SD=1.2) and mean hospital costs paid by the insurer of $13,192 per patient (SD=13,457) compared to 4.6 days (SD=7.3), 0.8 admissions (SD=0.6) and $2,065 per patient (SD=4,346), respectively, for patients with claims for other types of hospitalisations. More than half of patients with claims for mental health-related hospitalisations only claim for overnight admissions. However, the findings are difficult to interpret due to the limited information collected in insurance claims data.

Practical implications

This study shows the challenges of understanding utilisation patterns with one data source. Analysing insurance claims reveals information on mental health-related hospitalisations but information on community-based care is lacking due to the regulated role of the private health insurance sector in Australia. For mental health conditions, and other chronic health conditions, multiple data sources need to be integrated to build a comprehensive picture of health service use as care tends to be provided in multiple settings by different medical and allied health professionals.

Originality/value

This study contributes in two areas: patient-level trends in hospital-based mental health service utilisation claimed on private health insurance in Australia have not been previously reported. Additionally, as the amount of data routinely collected in health care settings increases, the study findings demonstrate that it is important to assess the quality of these data sources for understanding service utilisation.

Details

Journal of Health Organization and Management, vol. 33 no. 1
Type: Research Article
ISSN: 1477-7266

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Article
Publication date: 1 June 2004

Peter Wilson

Abstract

Details

Mental Health Review Journal, vol. 9 no. 2
Type: Research Article
ISSN: 1361-9322

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