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1 – 10 of over 1000Laura Häkkilä, Piia Seppälä, Juulia Hietamäki and Timo Toikko
The study covers two different forms of financial support for households, income support for single parents and reimbursements for depression medicines, and explores their…
Abstract
Purpose
The study covers two different forms of financial support for households, income support for single parents and reimbursements for depression medicines, and explores their relationships with the demand for child protection services.
Design/methodology/approach
The data were retrieved from the Sotkanet, the Finnish Indicator Bank, and included 292 Finnish municipalities. It was hypothesised that the effect of income support for single-parent households on the need for child protection is mediated by reimbursements for depression medicines. The hypotheses were tested by using a conditional process analysis program, PROCESS (Model 4).
Findings
It was found that income support reduces the proportion of reimbursements for depression medicines in a municipality, which in turn reduces the need for child protection services. At the level of social policy, the study tentatively suggests that the social welfare system may affect the demand for child protection by investing in income support for single-parent households.
Research limitations/implications
The choice of variables does not fully explain the effect of the mechanism. The relationships that are found in this study can have hidden factors which affect them. Further, the data have only 292 cases, which is quite a small sample, and is limited to Finland.
Originality/value
The study suggests that the social welfare system may affect the demand for child protection by investing in income support for single-parent households.
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Blender Muzvondiwa and Roy Batterham
Gweru District, Zimbabwe faces a major challenge of noncommunicable diseases (NCDs). Globally, health systems have not responded successfully to problems in prevention and…
Abstract
Purpose
Gweru District, Zimbabwe faces a major challenge of noncommunicable diseases (NCDs). Globally, health systems have not responded successfully to problems in prevention and management of NCDs. Despite numerous initiatives, reorienting health services has been slow in many countries. Gweru District has similar challenges. The purpose of this paper is to explore what the health systems in Zimbabwe have done, and are doing to respond to increasing numbers of NCD cases in adults in the nation, especially in the district of Gweru
Design/methodology/approach
The study employed a descriptive narrative review of the academic and grey literature, supplemented by semi-structured key informant interviews with 14 health care staff and 30 adults living with a disease or caring for an adult with a disease in Gweru District.
Findings
Respondents identified many limitations to the response in Gweru. Respondents said that screening and diagnosis cease to be helpful when it is difficult securing medications. Nearly all community respondents reported not understanding why they are not freed of the diseases, showing poor understanding of NCDs. The escalating costs and scarcity of medications have led people to lose trust in services. Government and NGO activities include diagnosis and screening, provision of health education and some medication. Health personnel mentioned gaps in transport, medication shortages, poor equipment and poor community engagement. Suggestions include: training of nurses for a greater role in screening and management of NCDs, greater resourcing, outreach activities/satellite clinics and better integration of diverse NCD policies.
Originality/value
This research offers an understanding of NCD strategies and their limitations from the bottom-up, lived experience perspective of local health care workers and community members.
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Jude Stansfield, Nick Cavill, Louise Marshall, Claire Robson and Harry Rutter
This paper aims to use systems mapping as a tool to develop an organisation-wide approach to public mental health to inform strategic direction within a national public health…
Abstract
Purpose
This paper aims to use systems mapping as a tool to develop an organisation-wide approach to public mental health to inform strategic direction within a national public health agency.
Design/methodology/approach
Two workshops were facilitated with internal staff from a wide range of public health policy teams working in small groups to produce paper-based maps. These were collated and refined by the project team and digitised.
Findings
The approach engaged a range of teams in forming a shared understanding and producing a complex system map of the influences on population mental health and well-being, where current policy initiatives were addressing them and what the gaps and priorities were. Participants valued the approach which led to further study and organisational commitment to the whole system working as part of national public mental health strategy.
Research limitations/implications
The approach was limited to internal stakeholders and wider engagement with other sectors and community members would help further the application of complex system approaches to public mental health.
Originality/value
It was a valuable process for developing a whole-organisation approach and stimulating thinking and practice in complex system approaches. The paper provides a practical example of how to apply systems mapping and its benefits for organising public mental health practice.
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Ian F. Walker, Jude Stansfield, Lily Makurah, Helen Garnham, Claire Robson, Cam Lugton, Nancy Hey and Gregor Henderson
Mental health is an emerging health policy priority globally. The emphasis on closing the treatment gap in psychiatric services is now being complemented by an increasing focus on…
Abstract
Purpose
Mental health is an emerging health policy priority globally. The emphasis on closing the treatment gap in psychiatric services is now being complemented by an increasing focus on prevention and health promotion. The purpose of this paper is to describe the programmes and delivery of public mental health in England led by Public Health England (PHE), an arms-length body of the Department of Health and Social Care.
Design/methodology/approach
This technical paper outlines the general approach PHE has taken in delivering national work in public mental health and describes several key areas of work: children and young people, suicide prevention, workplace and workforce, strategic engagement with stakeholders, data and information and evidence synthesis.
Findings
A description of the various programmes and guidance documents that PHE have produced are described and referenced, which form a substantial body of work in public mental health.
Practical implications
The outputs from PHE may assist in informing the approach to public mental health that other government agencies could consider adopting. The resources described and signposted within this technical paper are publicly available for readers.
Originality/value
England is one of a small group of countries that have a track record in delivering public mental health at a national level. This paper gives a unique and detailed insight into this work.
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In South Africa, the majority of the population struggles to access care and support for mental health challenges. Drawing on challenges faced by asylum seekers and refugees in…
Abstract
Purpose
In South Africa, the majority of the population struggles to access care and support for mental health challenges. Drawing on challenges faced by asylum seekers and refugees in the urban margins of Johannesburg, this paper aims to explore the relationship between migration and mental health through a lens of heightened vulnerability, precarious urban spaces and unmet basic needs.
Design/methodology/approach
Remote interviews were conducted with respondents working in the mental health-care sector (public and private) and with migrant communities in Johannesburg. Respondents were identified via purposive sampling and interviews were conducted in English. Key findings were identified using thematic analysis.
Findings
Effective responses to asylum seekers and refugees facing mental health challenges are based on an understanding of context, of crisis and of the need to meet basic needs such as paying rent, finding employment and providing for families. These “daily stressors” not only compound “extreme traumatisation” but are a form of trauma in and of itself.
Originality/value
This paper shows how alternative responses determined by an understanding of context, of crisis and of the need to meet basic needs provide critical and potentially far-reaching interventions. Locating trauma in the unmet needs, precarious urban spaces and marginalisation opens up space to further question the ways that migration and mental health shape and reshape one another.
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Sarah Wigham, Eileen Kaner, Jane Bourne, Kanar Ahmed and Simon Hackett
Mental well-being is associated with positive outcomes throughout the life course. This study aims to examine interventions delivered by allied health professionals (AHPs) to…
Abstract
Purpose
Mental well-being is associated with positive outcomes throughout the life course. This study aims to examine interventions delivered by allied health professionals (AHPs) to alleviate community stressors adversely impacting public mental health and well-being.
Design/methodology/approach
Review inclusion criteria comprised experimental and qualitative process evaluations of public mental health interventions delivered by AHPs. Electronic searches in Cinahl, Embase, Medline, PsycINFO and the Cochrane Library, were combined with grey literature searches of National Institute for Health and Care Excellence public health guidance. A narrative synthesis and the Effective Public Health Practice Project appraisal tool were used to evaluate the evidence.
Findings
A total of 45-articles were included in the review describing AHP-delivered interventions addressing social disadvantage, trauma, bullying, loneliness, work-related stress, transitional stress, intersectionality, pain and bereavement. No articles were identified evaluating interventions delivered by operating department practitioners or orthoptists. A conceptual map was developed summarising the stressors, and a typology of public mental health interventions defined including: place-based interventions, discrete/one-off interventions, multi-component lifestyle and social connector interventions and interventions targeting groups at risk of mental health conditions.
Research limitations/implications
Many mental health conditions begin in childhood, and a strength of the review is the life course perspective. A further strength is compiling a compendium of public mental health outcome measures used by AHPs to inform future research. The authors excluded many articles focussed on clinical interventions/populations, which did not meet review inclusion criteria. While playing a key role in delivering public mental health interventions, clinical psychologists are not defined as AHPs and were excluded from the review, and this may be construed a limitation. Given heterogeneity of study designs and interventions evaluated numerical analyses of pooled findings was not appropriate.
Practical implications
The review highlights the breadth of community stressors on which AHPs can intervene and contribute in public mental health contexts, stressors which correspond to those identified in UK Government guidance as currently important and relevant to address. The findings can inform developing community public mental health pathways that align with the UK National Health Service (NHS) Long Term Plan, on prevention and early intervention to protect community mental health and well-being. Further can inform the NHS strategic direction for AHPs including informing ways of increasing utilisation of core AHP skills to optimise contributions in public mental health agendas.
Social implications
It is surprising there were not more AHP delivered evaluations of interventions for other stressors important to address in public mental health settings, for example gambling, domestic violence or that used digital technology, and these are areas for future research. Future research should identify the most active/effective dimensions of multi-component interventions which could be informed by frameworks to guide complex intervention development. The relative paucity of research identified, highlights the predominant focus of research to date on interventions for clinical mental health conditions and populations. The lack of preventative approaches is evident, and an important area for future research to align with UK health and social care priorities.
Originality/value
The review highlights AHP-delivered interventions impacting diverse community stressors across the life course. The findings can inform developing public mental health pathways aligned with government health service priorities to protect mental health and well-being, prioritise prevention and early intervention and increase utilisation of AHP skills across public mental health settings.
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Walter Leal Filho, Murukesan Krishnapillai, Aprajita Minhas, Sannia Ali, Gabriela Nagle Alverio, Medhat Sayed Hendy Ahmed, Roselyn Naidu, Ravinesh R. Prasad, Navjot Bhullar, Ayyoob Sharifi, Gustavo J. Nagy and Marina Kovaleva
This paper aims to address a gap in investigating specific impacts of climate change on mental health in the Pacific region, a region prone to extreme events. This paper reports…
Abstract
Purpose
This paper aims to address a gap in investigating specific impacts of climate change on mental health in the Pacific region, a region prone to extreme events. This paper reports on a study on the connections between climate change, public health, extreme weather and climate events (EWEs), livelihoods and mental health, focusing on the Pacific region Islands countries.
Design/methodology/approach
This paper deploys two main methods. The first is a bibliometric analysis to understand the state of the literature. For example, the input data for term co-occurrence analysis using VOSviewer is bibliometric data of publications downloaded from Scopus. The second method describes case studies, which outline some of the EWEs the region has faced, which have also impacted mental health.
Findings
The results suggest that the increased frequency of EWEs in the region contributes to a greater incidence of mental health problems. These, in turn, are associated with a relatively low level of resilience and greater vulnerability. The findings illustrate the need for improvements in the public health systems of Pacific nations so that they are in a better position to cope with the pressures posed by a changing environment.
Originality/value
This paper contributes to the current literature by identifying the links between climate change, extreme events, environmental health and mental health consequences in the Pacific Region. It calls for greater awareness of the subject matter of mental health among public health professionals so that they may be better able to recognise the symptoms and relate them to their climate-related causes and co-determinant factors.
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Emma Foreman, Sara McMillan and Amanda Wheeler
The community-managed mental health sector needs to meet growing workforce demands. Yet, limited research has explored professional development opportunities and effective…
Abstract
Purpose
The community-managed mental health sector needs to meet growing workforce demands. Yet, limited research has explored professional development opportunities and effective recruitment and retention strategies to support sector growth. One strategy is the use of a scholarship program to increase skills and training, via a University qualification. The purpose of this paper is to explore the progress of 19 mental health scholarship students and the impact of the scholarship on career intentions.
Design/methodology/approach
A mixed-methods approach comprising scholarship applications, questionnaires and semi-structured interviews was used to explore the students’ university experiences between February 2013 and January 2015. Course convenors of the Mental Health Program were interviewed. Data were collected across three time-points over 24 months, with each collection informing the next research phase. Data analysis involved thematic analysis and descriptive statistics.
Findings
Deeper knowledge, recognition of experience, new career pathways and improved work practice were benefits. Managing time and study, and work-life balance were the greatest challenges. Completing students displayed a range of internal attributes and accessed external supports. At the time of the study, the scholarships maintained student motivation and intention to work in the sector.
Originality/value
This research provides a deeper understanding of the demographics of the sector’s workforce. Insight into the attributes of completing students was obtained. The benefits realized and the challenges faced by the scholarship recipients will inform ongoing workforce development programs for the community-managed mental health sector.
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Tine Nordgreen, Fazle Rabbi, Jim Torresen, Yngvar Sigmund Skar, Frode Guribye, Yavuz Inal, Eivind Flobakk, Jo Dugstad Wake, Suresh Kumar Mukhiya, Amin Aminifar, Sunniva Myklebost, Astri J. Lundervold, Robin Kenter, Åsa Hammar, Emilie Nordby, Smiti Kahlon, Ragnhild J. Tveit Sekse, Kristine Fonnes Griffin, Petter Jakobsen, Minh H. Pham, Ulysse Côté-Allard, Farzan Majeed Noori and Yngve Lamo
Mental illness presents a huge individual, societal and economic challenges, currently accounting for 20% of the worldwide burden of disease. There is a gap between the need for…
Abstract
Purpose
Mental illness presents a huge individual, societal and economic challenges, currently accounting for 20% of the worldwide burden of disease. There is a gap between the need for and access to services. Digital technology has been proven effective in e-mental health for preventing and treating mental health problems. However, there is a need for cross-disciplinary efforts to increase the impact of e-mental health services. This paper aims to report key challenges and possible solutions for cross-disciplinary and cross-sectorial research teams within the domain of e-mental health.
Design/methodology/approach
The key challenges and possible solutions will be discussed in light of the literature on effective cross-disciplinary research teams.
Findings
Six topics have been key challenges in our cross-disciplinary and cross-sectorial research team: to develop a shared understanding of the domain; to establish a common understanding of key concepts among the project participants; to involve the end-users in the research and development process; to collaborate across sectors; to ensure privacy and security of health data; and to obtain the right timing of activities according to project dependencies.
Research limitations/implications
This study focuses to increase knowledge and training in cross-disciplinary and cross-sectorial research, as this is often referred to as an important tool when developing sustainable solutions for major societal challenges.
Practical implications
This study needs to include theory and skills training in cross-disciplinary research in research training.
Social implications
Cross-disciplinary teams have the potential to address major societal challenges, including more perspectives and more stakeholders than single disciplinary research teams.
Originality/value
Major societal challenges require complex and sustainable solutions. However, there is a lack of knowledge about how cross-disciplinary and cross-sectorial research teams may work productively to solve these challenges. This paper shares experiences regarding the challenges and possible solutions for productive collaboration in cross-disciplinary and cross-sectorial research teams within the domain of e-mental health services.
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Andrew Healey, Alexandra Melaugh, Len Demetriou, Tracey Power, Nick Sevdalis, Megan Pritchard and Lucy Goulding
Many patients referred by their GP for an assessment by secondary mental health services are unlikely to ever meet eligibility thresholds for specialist treatment and support. A…
Abstract
Purpose
Many patients referred by their GP for an assessment by secondary mental health services are unlikely to ever meet eligibility thresholds for specialist treatment and support. A new service was developed to support people in primary care. “the authors evaluate” whether the phased introduction of the Lambeth Living Well Network (LWN) Hub to a population in south London led to: a reduction in the overall volume of patients referred from primary care for a secondary mental health care assessment; and an increase in the proportion of patients referred who met specialist service eligibility criteria, as indicated by the likelihood of being accepted in secondary care.
Design/methodology/approach
The evaluation applied a quasi-experimental interrupted time series design using electronic patient records data for a National Health Service (NHS) provider of secondary mental health services in south London.
Findings
Scale-up of the Hub to the whole of the population of Lambeth led to an average of 98 fewer secondary care assessments per month (95% CI −118 to −78) compared to an average of 203 assessments per month estimated in the absence of the Hub; and an absolute incremental increase in the probability of acceptance for specialist intervention of 0.20 (95% CI; 0.14 to 0.27) above an average probability of acceptance of 0.57 in the absence of the Hub.
Research limitations/implications
Mental health outcomes for people using the service and system wide-service impacts were not evaluated preventing a more holistic evaluation of the effectiveness and cost-effectiveness of the LWN Hub.
Practical implications
Providing general practitioners with access to service infrastructure designed to help people whose needs cannot be managed within specialist mental health services can prevent unnecessary referrals into secondary care assessment teams.
Social implications
Reducing unnecessary referrals through provision of a primary-care linked mental health service will reduce delay in access to professional support that can address specific mental-health related needs that could not be offered within the secondary care services and could prevent the escalation of problems.
Originality/value
The authors use NHS data to facilitate the novel application of a quasi-experimental methodology to deliver new evidence on whether an innovative primary care linked mental health service was effective in delivering on one of its key aims.
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