International Journal of Mental Health Systems via MedWorm.com

Shared care in mental illness: A rapid review to inform implementation

International Journal of Mental Health Systems — Mon, 21 Nov 2011 05:00:00 +0100

Conclusions: "Shared Care" models of mental health service delivery require attention to multiple levels (from organisational to individual clinicians), and complex service re-design. Re-evaluation of the roles of specialist mental health staff is a critical requirement. As expected, no one model of "shared" care fits diverse clinical groups. On the basis of the available evidence, we recommended a local trial that examined the process of implementation of core principles of shared care within primary care and specialist mental health clinical services. (Source: International Journal of Mental Health Systems)

Building Capacity in Mental Health Interventions in Low Resource Countries: An Apprenticeship Model for Training Local Providers

International Journal of Mental Health Systems — Fri, 18 Nov 2011 05:00:00 +0100

Conclusion: In our experience, the apprenticeship model provides a useful framework for implementation of mental health interventions in LMIC. Our goal in this paper is to provide sufficient details about the apprenticeship model to guide other training efforts in mental health interventions. (Source: International Journal of Mental Health Systems)

Identifying barriers to mental health system improvements: An examination of community participation in Assertive Community Treatment programs

International Journal of Mental Health Systems — Mon, 07 Nov 2011 05:00:00 +0100

Conclusions: The reasons for low compliance of ACT programs with community participation standards are complex and are tied to structural and human resources barriers (both internal and external to the ACT programs) as well as to the requirements of the standards themselves. In order for improvements to the mental health system to be achieved there is a need to identify and address these barriers. Failure to do so will result in less than optimal client, family and economic efficiency outcomes. (Source: International Journal of Mental Health Systems)

The integration of the treatment for common mental disorders in primary care: experiences of health care providers in the MANAS trial in Goa, India

International Journal of Mental Health Systems — Mon, 03 Oct 2011 04:00:00 +0100

Conclusion: The key factors which enhance the acceptability and integration of a LHC in primary care are training, systematic steps to build trust, the passage of time, the observable impacts on patient outcomes, and supervision by a visiting psychiatrist. Several practices by the control arm GPs approximated those of the LHC which may partly explain our findings that they were as effective as the MANAS intervention arm GPs in enabling recovery. (Source: International Journal of Mental Health Systems)

Validation of the Child Post Traumatic Stress Disorder-Reaction Index in Zambia

International Journal of Mental Health Systems — Sat, 24 Sep 2011 04:00:00 +0100

Conclusions: This study has shown that validating mental health assessment tools in a low-resource country is feasible, and that by taking the time to adapt a measure to the local context, a useful and valid Zambian version of the PTSD-RI was developed to detect traumatic stress among youth. This valid tool can now be used to appropriately measure treatment effectiveness, and more effectively and efficiently triage youth to appropriate services. (Source: International Journal of Mental Health Systems)

Using the needs of WHO to prioritise Cochrane reviews: the case of antipsychotic drugs

International Journal of Mental Health Systems — Sat, 24 Sep 2011 04:00:00 +0100

Conclusions: We have used the 'sample frame' of the WHO Essential drug list as a starting point. WHO prioritises for us those drugs that have universal accessibility but they may not be the compounds that are first choice if others are available. It is encouraging to see how many maintained reviews already exist to service those undertaking WHO guidelines. The needs of those guiding care can be taken as a means of prioritising research. For largest global impact WHO Essential Medicine list provides clear direction. By using this technique workload can be anticipated, prioritising can take place for new reviews and updates. (Source: International Journal of Mental Health Systems)

Using the World Health Organization's 4S-Framework to Strengthen National Strategies, Policies and Services to Address Mental Health Problems in Adolescents in Resource-Constrained Settings

International Journal of Mental Health Systems — Fri, 16 Sep 2011 04:00:00 +0100

Conclusion: The predominant endorsed action is not that dedicated mental health services for adolescents are required, but that mental health care should be integrated using cross-sectoral strategies into the communities in which adolescents live, the institutions they attend and the organisations in which they participate. (Source: International Journal of Mental Health Systems)

Determinants of parents' experiences with outpatient child and adolescent mental health services.

International Journal of Mental Health Systems — Thu, 15 Sep 2011 04:00:00 +0100

Conclusion: Accessibility to the clinic and involvement of the parents in treatment are much stronger predictors of parental experiences with outpatient CAMHS than are demographic and clinical variables. Accessibility and involvement are at least partly influenced by the clinics themselves, and hence parental satisfaction may be enhanced by making the clinics more accessible and by involving the parents/caregivers in the treatment. (Source: International Journal of Mental Health Systems)

Mental Health Law in the Community: Thinking About Africa

International Journal of Mental Health Systems — Tue, 13 Sep 2011 04:00:00 +0100

This article considers implementation of this approach in Africa. (Source: International Journal of Mental Health Systems)

Validation aspects of the Health of the Nation Outcome Scales

International Journal of Mental Health Systems — Tue, 06 Sep 2011 04:00:00 +0100

Conclusions: It was concluded that the Italian version of the HoNOS does not measure a single, underlying construct of mental health status. The internal structure validity analysis recommends a note of caution to use a summary index of the HoNOS scores, given the presence of multidimensionality and misfit. Nonetheless, the finding that the instrument is more multidimensional than unidimensional does not preclude the use of the HoNOS as a clinically valid tool for routine outcome assessment. In fact, item scores have demonstrated sufficient reliability (over diagnostic groups and care settings) and high precision in time, indicating that HoNOS items can be utilized as valid measurement instruments in longitudinal analyses. (Source: International Journal of Mental Health Systems)

Profiles of and practices in crisis resolution and home treatment teams in Norway: a longitudinal survey study

International Journal of Mental Health Systems — Mon, 29 Aug 2011 23:00:00 +0100

Conclusions: The diversity in the way CRHT teams are established and operate needs to be examined further in order to understand the reasons for such variations and their impact on the quality of services to service users and in relation to the total mental health service system in a community. (Source: International Journal of Mental Health Systems)

"No God and no Norway": Collective resource loss among members of Tamil NGO's in Norway during and after the last phase of the civil war in Sri Lanka.

International Journal of Mental Health Systems — Tue, 16 Aug 2011 23:00:00 +0100

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A mental health training program for community health workers in India: impact on knowledge and attitudes

International Journal of Mental Health Systems — Thu, 04 Aug 2011 23:00:00 +0100

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Schizophrenia in Malaysian families: A study on factors associated with quality of life of primary family caregivers

International Journal of Mental Health Systems — Tue, 07 Jun 2011 23:00:00 +0100

Conclusion: Caregivers with more social advantages such as higher educational level and physically healthier and dealing with less severe illness had significantly higher QOL in various aspects. Supporting the caregivers in some of these modifiable factors in clinical practice is important to achieve their higher level QOL. (Source: International Journal of Mental Health Systems)

Media awards for responsible reporting of suicide: Experiences from Australia, Belgium and Denmark

International Journal of Mental Health Systems — Thu, 02 Jun 2011 23:00:00 +0100

Conclusion: The experience from Australia, Belgium and Denmark suggests that media awards which recognize responsible reporting of suicide are extremely worthwhile. (Source: International Journal of Mental Health Systems)

Clinical and cognitive correlates of employment among patients with schizophrenia: a cross-sectional study in Malaysia

International Journal of Mental Health Systems — Sun, 29 May 2011 23:00:00 +0100

Conclusions: The results from this study support the role of cognitive function, particularly, attention, working memory and executive functioning on attaining and maintaining employment in persons with schizophrenia as measured by the RAVLT, Digit Span and Trail Making Tests. These findings may act as preliminary evidence suggesting the importance of integrating cognitive rehabilitation in the psychosocial rehabilitation program for patients with schizophrenia in Malaysia.Key words: schizophrenia, employment, cognitive function, Malaysia (Source: International Journal of Mental Health Systems)

Collaboration between General Practitioners and mental health care professionals: a qualitative study.

International Journal of Mental Health Systems — Sun, 22 May 2011 23:00:00 +0100

Conclusions: GPs and mental health professionals experience collaboration as important. GPs are the gate-keepers to specialised health care, and lack of collaboration seems to create problems for GPs, mental health professionals, and for the patients. Suggestions for improvement included identification of situations that could increase mutual knowledge, and making it easier for GPs to reach the right mental health care professional when needed. (Source: International Journal of Mental Health Systems)

Mental Health First Aid guidelines for helping a suicidal person: a Delphi consensus study in Japan

International Journal of Mental Health Systems — Wed, 18 May 2011 23:00:00 +0100

Conclusions: There are a number of actions that are considered to be useful for members of the Japanese public when they encounter someone who is experiencing suicidal thoughts or engaging in suicidal behaviour. Although the guidelines are designed for members of the public, they may also be helpful to health professionals working in health and welfare settings who do not have clinical mental health training. (Source: International Journal of Mental Health Systems)

Implementing recovery: an analysis of the key technologies in Scotland.

International Journal of Mental Health Systems — Sat, 14 May 2011 23:00:00 +0100

Conclusions: Our analysis of this process within the Scottish context will be valuable for policy makers and service coordinators wishing to implement recovery values within their own national mental health systems. (Source: International Journal of Mental Health Systems)

Aceh Free Pasung: Releasing the mentally ill from physical restraint

International Journal of Mental Health Systems — Fri, 13 May 2011 23:00:00 +0100

Conclusions: The Aceh Free Pasung program is an important mental health and human rights initiative that can serve to inform similar efforts in other parts of Indonesia and other low and middle-income countries where restraint and confinement of the mentally ill is receiving insufficient attention. (Source: International Journal of Mental Health Systems)

Communal proactive coping strategies among Tamil refugees in Norway: A case study in a naturalistic setting

International Journal of Mental Health Systems — Mon, 25 Apr 2011 23:00:00 +0100

Conclusions: We describe a form of coping previously not described in the scientific literature: Communal proactive coping strategies, defined as the process by which group members feel collectively responsible for their future well-being and co-operate to promote desired outcomes and prevent undesired changes. The study shows that proactive coping efforts occur in a dynamic social setting which may force people to use their accumulated proactive coping resources in reactive coping efforts. Theoretical and clinical implications are explored. (Source: International Journal of Mental Health Systems)

Lessons from case studies of integrating mental health into primary healthcare in South Africa and Uganda

International Journal of Mental Health Systems — Thu, 14 Apr 2011 23:00:00 +0100

Conclusions: A common implementation framework incorporating a community collaborative multi-sectoral, task shifting and self-help approach to integrating mental health into primary healthcare holds promise for closing the treatment gap for mental disorders in LMICs at district level. However, a minimum number of mental health specialists are still required to provide supervision of non-specialists as well as specialized referral treatment services. (Source: International Journal of Mental Health Systems)

Evaluating Outcomes of the Child and Adolescent Psychiatric Unit: A Prospective Study

International Journal of Mental Health Systems — Wed, 30 Mar 2011 23:00:00 +0100

Conclusions: This evaluation of children and adolescents in an inpatient unit demonstrated clinical improvement over time and identified factors associated with said improvement. (Source: International Journal of Mental Health Systems)

Developing and implementing mental health policy in Zanzibar, a low income country off the coast of East Africa

International Journal of Mental Health Systems — Mon, 14 Feb 2011 00:00:00 +0100

Conclusions: A multi-faceted and comprehensive programme can be effective in achieving considerable strengthening of mental health programmes and services even in extremely low resource settings, but requires sustained input and advocacy if gains are to be maintained and enhanced. (Source: International Journal of Mental Health Systems)

Youth mental health first aid: a description of the program and an initial evaluation

International Journal of Mental Health Systems — Thu, 27 Jan 2011 00:00:00 +0100

Conclusions: Initial evaluation suggests that the Youth Mental Health First Aid course improves participants' knowledge, attitudes and helping behaviour. The program has spread successfully both nationally and internationally.Trial registrationACTRN12609000033246 (Source: International Journal of Mental Health Systems)

Three models of community mental health services in low-income countries

International Journal of Mental Health Systems — Tue, 25 Jan 2011 00:00:00 +0100

Conclusions: Community mental health programs in low-income countries face a number of challenges. Using a case study methodology developed for this purpose, it is possible to compare programs and begin to assess the effectiveness of diverse service delivery models. (Source: International Journal of Mental Health Systems)

The Ha Noi Expert Statement: recognition of maternal mental health in resource-constrained settings is essential for achieving the Millennium Development Goals

International Journal of Mental Health Systems — Fri, 07 Jan 2011 00:00:00 +0100

Mental health problems in women during pregnancy and after childbirth and their adverse consequences for child health and development have received sustained detailed attention in high-income countries. In contrast, evidence has only been generated more recently in resource-constrained settings.In June 2007 the United Nations Population Fund, the World Health Organization, the Key Centre for Women's Health in Society, a WHO Collaborating Centre for Women's Health and the Research and Training Centre for Community Development in Vietnam convened the first international expert meeting on maternal mental health and child health and development in resource-constrained settings. It aimed to appraise the evidence about the nature, prevalence and risks for common perinatal mental disorders in wom...

Admissions to acute adolescent psychiatric units: A prospective study of clinical severity and outcome

International Journal of Mental Health Systems — Thu, 06 Jan 2011 00:00:00 +0100

Conclusions: Acute psychiatric in-patient units for adolescents effectively meet important needs for young people with suicidal risks or other severe mental health problems. These units may act in suicide prevention, stabilizing symptom severity at a lower level within a short stay. It is important to explore the differences in outcome, compulsory admissions, and length of stay between units. (Source: International Journal of Mental Health Systems)

Where there is no evidence: use of expert consensus methods to fill the evidence gap in low-income countries and cultural minorities

International Journal of Mental Health Systems — Tue, 21 Dec 2010 00:00:00 +0100

Conclusion: Consensus methods can provide a basis for decision-making and considered action when there is no evidence or when there are doubts about the applicability of evidence that has been generated from other populations or health system settings. (Source: International Journal of Mental Health Systems)

Mental Health First Aid guidelines for helping a suicidal person: a Delphi consensus study in the Philippines

International Journal of Mental Health Systems — Mon, 20 Dec 2010 00:00:00 +0100

Conclusions: There are a number of actions that are considered to be useful for members of the public when they encounter someone who is experiencing suicidal thoughts or engaging in suicidal behaviour. Although the guidelines are designed for members of the public, they may also be helpful to non-mental health professionals working in health and welfare settings. (Source: International Journal of Mental Health Systems)

Schizophrenia and quality of life: how important are symptoms and functioning?

International Journal of Mental Health Systems — Wed, 08 Dec 2010 00:00:00 +0100

Conclusion: The patients showed a fairly good satisfaction in regard to their QoL. The severity of psychiatric symptoms is one of the elements influencing QoL, together with personal and social functioning that plays a relevant role.Keywordsschizophrenia, outcomes, quality of life, satisfaction, global functioning. (Source: International Journal of Mental Health Systems)

Reduction in mental distress among substance users receiving inpatient treatment

International Journal of Mental Health Systems — Thu, 02 Dec 2010 00:00:00 +0100

Conclusions: The toxic and withdrawal effects of substances, level of education as well as gender, contributed to the differences in change in mental distress during treatment. Regression to the mean may in part explain some of the findings. (Source: International Journal of Mental Health Systems)

A preliminary taxonomy and a standard knowledge base for mental-health system indicators in Spain

International Journal of Mental Health Systems — Wed, 01 Dec 2010 00:00:00 +0100

Conclusions: The classification and hierarchical ordering of the mental health indicators, the evaluation according to their level of relevance and their incorporation into a knowledge base are crucial for the development of a basic list of indicators for use in mental health planning. (Source: International Journal of Mental Health Systems)

Does school attendance reduce the risk of youth homelessness in Tanzania?

International Journal of Mental Health Systems — Thu, 25 Nov 2010 00:00:00 +0100

Conclusions: This study supports the new concept of "multi-layered social resilience", providing evidence from research completed by one NGO on how community-based organizations can help enhance resilience in a broader social context, spanning individuals, households and community structures. (Source: International Journal of Mental Health Systems)

Additional funding mechanisms for Public Hospitals in Greece: the case of Chania Mental Health Hospital

International Journal of Mental Health Systems — Wed, 10 Nov 2010 00:00:00 +0100

Conclusions: Revenue generated from the long term lease of public hospital land is crucial to gradually eliminate hospital deficit. The Ministry of Health should encourage similar forms of Public Private Partnerships in order to ensure the sustainability of public (mental) hospitals. (Source: International Journal of Mental Health Systems)

Public perception of mental health in Iraq

International Journal of Mental Health Systems — Sun, 10 Oct 2010 23:00:00 +0100

Conclusions: This survey of public attitudes towards mental illness in Iraq has shown that community opinion about the aetiology of mental illness is broadly compatible with scientific evidence, but understanding of the nature of mental illness, its implications for social participation and management remains negative in general. (Source: International Journal of Mental Health Systems)

Mental health policy process: a comparative study of Ghana, South Africa, Uganda and Zambia

International Journal of Mental Health Systems — Sun, 01 Aug 2010 23:00:00 +0100

Conclusions: Mental health policy processes in all four countries were inadequate, leading to either weak or non-existent policies, with an impact on mental health services. Recommendations are provided to strengthen mental health policy processes in these and other African countries. (Source: International Journal of Mental Health Systems)

Collective trauma in the Vanni- a qualitative inquiry into the mental health of the Internally Displaced due to the civil war in Sri Lanka

International Journal of Mental Health Systems — Tue, 27 Jul 2010 23:00:00 +0100

Conclusions: Considering the severity of family and community level adverse effects and implication for resettlement, rehabilitation, and development programmes; interventions for healing of memories, psychosocial regeneration of the family and community structures and processes are essential. (Source: International Journal of Mental Health Systems)

In the shadow of a new smoke free policy: A discourse analysis of health care providers' engagement in tobacco control in community mental health

International Journal of Mental Health Systems — Tue, 27 Jul 2010 23:00:00 +0100

Conclusions: This study provides insights into the complex factors that shape tobacco control practices in the mental health field and reinforces the need to see practice change as a matter that extends beyond the individual. The study findings highlight discourses structured by power and powerlessness in environments in which health care providers are both imposing and resisting the smoke free policy (Source: International Journal of Mental Health Systems)

Mental health policy in Kenya -an integrated approach to scaling up equitable care for poor populations

International Journal of Mental Health Systems — Sun, 27 Jun 2010 23:00:00 +0100

Conclusions: The project has demonstrated the importance of using a multi-faceted and comprehensive programme to promote sustainable system change, key elements of which include a focus on the use of rapid appropriate assessment and treatment at primary care level, strengthening the referral system, interministerial and intersectoral liaison, rehabilitation, social inclusion, promotion and advocacy to mobilize community engagement. (Source: International Journal of Mental Health Systems)

Mental health policy and development in Egypt. Integrating mental health into health sector reforms 2001 to 9

International Journal of Mental Health Systems — Wed, 23 Jun 2010 23:00:00 +0100

Conclusions: The bilateral collaboration programme initiated a reform programme which has been sustained beyond the end of the funding. The project has demonstrated the importance of using a multi-faceted and comprehensive programme to promote sustainable system change, key elements of which include a focus on the use of rapid appropriate treatment at primary care level, strengthening the referral system, interministerial and intersectoral liaison, rehabilitation, and media work to mobilize community engagement. (Source: International Journal of Mental Health Systems)

Mental health first aid training for the Chinese community in Melbourne, Australia: effects on knowledge about and attitudes toward people with mental illness

International Journal of Mental Health Systems — Wed, 23 Jun 2010 23:00:00 +0100

Conclusion: The MHFA training course for general members of the Chinese community in Melbourne produced significant positive change in the level of mental health literacy and reductions in stigmatizing attitudes. The evidence from this study, together with the accumulated evidence of the benefits of MHFA training in the general Australian community, suggests that this approach should be scaled up to a level where it can have an impact on the whole of the Chinese community in Australia. (Source: International Journal of Mental Health Systems)

Rehabilitation of torture survivors in five countries: common themes and challenges

International Journal of Mental Health Systems — Thu, 17 Jun 2010 23:00:00 +0100

Conclusions: Data showed that the torture survivors seen in these five centres had high levels of exposure to torture events and high rates of clinical symptoms. In order to provide effective services to torture survivors, health professionals at torture rehabilitation centres in low income countries need to be supported to collect relevant data to document the needs of torture survivors and to evaluate the centres' interventions. (Source: International Journal of Mental Health Systems)

Development of a multi-layered psychosocial care system for children in areas of political violence

International Journal of Mental Health Systems — Tue, 15 Jun 2010 23:00:00 +0100

Few psychosocial and mental health care systems have been reported for children affected by political violence in low- and middle income settings and there is a paucity of research-supported recommendations. This paper describes a field tested multi-layered psychosocial care system for children (focus age between 8-14 years), aiming to translate common principles and guidelines into a comprehensive support package. This community-based approach includes different overlapping levels of interventions to address varying needs for support. These levels provide assessment and management of problems that range from the social-pedagogic domain to the psychosocial, the psychological and the psychiatric domains. Specific intervention methodologies and their rationale are described within the conte...

The Child Behaviour Assessment Instrument: development and validation of a measure to screen for externalising child behavioural problems in community setting

International Journal of Mental Health Systems — Mon, 07 Jun 2010 23:00:00 +0100

Conclusions: Preliminary data obtained from the study indicate that the Child Behaviour Assessment Instrument is a valid and reliable screening instrument for early identification of young children at risk of behavioural problems in the community setting. (Source: International Journal of Mental Health Systems)

Development of the Nursing Relationships Scale: a measure of interpersonal approaches in nursing care

International Journal of Mental Health Systems — Thu, 27 May 2010 23:00:00 +0100

Conclusions: Psychometric evaluation of the NRS suggests it is a reliable instrument for measuring four key dimensions of the nurse-patient relationship and enables the study of this relationship in large samples. (Source: International Journal of Mental Health Systems)

Mapping Mental Health Finances in Ghana, Uganda, Sri Lanka, India and Lao PDR

International Journal of Mental Health Systems — Wed, 26 May 2010 23:00:00 +0100

Conclusions: Mental health budget information should be tracked and made publically accessible. Governments can adapt WHO AIMS indicators for reviewing national mental health finances. Funding allocations work more effectively through decentralization. Mental health financing should reflect new ideas emerging from community based practice in LMICs. (Source: International Journal of Mental Health Systems)

Australian rural football club leaders as mental health advocates: an investigation of the impact of the Coach the Coach project

International Journal of Mental Health Systems — Tue, 18 May 2010 23:00:00 +0100

Conclusions: Rural football clubs appear to be appropriate social structures to promote rural mental health awareness. Club leaders, including many coaches, benefit from MHFA training, reporting increased skills and confidence. Benefit to club players from this approach was less obvious. However, the generally positive findings of this study suggest further research in this area is desirable. (Source: International Journal of Mental Health Systems)

Health care models guiding mental health policy in Kenya 1965 to 1997

International Journal of Mental Health Systems — Tue, 27 Apr 2010 23:00:00 +0100

Conclusions: Integration of the national mental health policy with the general health policy and other sector policies would be appropriate and is now underway. (Source: International Journal of Mental Health Systems)

Determinants of psychological morbidity in survivors of the earthquake and tsunami in Aceh and Nias

International Journal of Mental Health Systems — Mon, 26 Apr 2010 23:00:00 +0100

Conclusions: Negative changes in a person's life circumstances following a disaster appear to have as important an effect on psychopathology as the direct experience of the disaster. Ameliorating the extent and duration of post-disaster negative changes in life circumstances may play an important role in prevention of post-disaster psychological morbidity. (Source: International Journal of Mental Health Systems)

Time-trends in the utilization of decentralized mental health services in Norway - A natural experiment: The VELO-project

International Journal of Mental Health Systems — Tue, 30 Mar 2010 23:00:00 +0100

Conclusions: Geographical availability is not important as a filter in patients` pathway to inpatient care, and the association between distance to hospital and utilization of psychiatric beds may be an historical artefact. Under a public health-insurance system, local psychiatric personnel as gatekeepers for inpatient care may be of greater importance than the availability of local psychiatric beds. Specialist psychiatric beds and highly supported municipality units for people with mental health problems do not work together in terms of utilization. Outpatient and day-hospital services may be filters in the pathway to inpatient care, however this depends on the structure of the whole service-system. Local integration of psychiatric services may bring about additive, rather than substituti...

Mental Health First Aid guidelines for helping a suicidal person: a Delphi consensus study in India

International Journal of Mental Health Systems — Fri, 19 Feb 2010 00:00:00 +0100

Psychologists experience of Cognitive Behaviour Therapy in a developing country: a qualitative study from Pakistan

International Journal of Mental Health Systems — Thu, 28 Jan 2010 00:00:00 +0100

Conclusions: For CBT to be acceptable, accessible and effective in Non Western cultures numerous adjustments need to be made, taking into consideration; factors related to service structure and delivery, patient's knowledge and beliefs about health and the therapy itself. Interviews with the psychologists in these countries can give us insights which can guide development of therapy and manuals to support its delivery. (Source: International Journal of Mental Health Systems)

An overview of Uganda's mental health care system: results from an assessment using the World Health Organization's Assessment Instrument for Mental Health Systems (WHO-AIMS)

International Journal of Mental Health Systems — Wed, 20 Jan 2010 00:00:00 +0100

Conclusion: Although there have been important developments in Uganda's mental health policy and services, there remains a number of shortcomings, especially in terms of resources and service delivery. There is an urgent need for more research on the current burden of mental disorders and the functioning of mental health programs and services in Uganda. (Source: International Journal of Mental Health Systems)

De-institutionalisation and trans-institutionalisation - changing trends of inpatient care in Norwegian mental health institutions 1950-2007

International Journal of Mental Health Systems — Fri, 25 Dec 2009 00:00:00 +0100

Conclusions: De-institutionalisation means fewer beds but not fewer patients treated, neither in institutions in general nor in psychiatric hospitals. The periods represent different kinds of de-, trans-, and even re-institutionalisation. Expansion of the welfare state, increased professional focus on active treatment and increased focus on patients' preferences are the factors that best explain de-institutionalisation in Norway. (Source: International Journal of Mental Health Systems)

Parental HIV/AIDS status and death, and children's psychological wellbeing

International Journal of Mental Health Systems — Tue, 24 Nov 2009 00:00:00 +0100

Background: Ghana has an estimated one million orphans, 250,000 are due to AIDS parental deaths. This is the first study that examined the impact of parental HIV/AIDS status and death on the mental health of children in Ghana. Methods: In a cross-sectional survey, 4 groups of 200 children (children whose parents died of AIDS, children whose parents died of causes other than AIDS, children living with parents infected with HIV/AIDS, and non-orphaned children whose parents are not known to be infected with HIV/AIDS) aged between 10 and 19 were interviewed on their hyperactivity, emotional, conduct, and peer problems using the Strengths and Difficulties Questionnaire. Results: Children whose parents died of AIDS showed very high levels of peer problems [F (3,196) = 7.34, p < .001] whilst both...

Factors affecting mental fitness for work in a sample of mentally ill patients

International Journal of Mental Health Systems — Thu, 19 Nov 2009 00:00:00 +0100

Conclusion: There are many factors affecting the mental fitness the most important are the characteristics of work environment and the most serious is the overall safety of patient to self and others. A lot of ethical and legal issues should be kept in mind during such assessment as patient's rights, society's rights, and the laws applied to unfit people. (Source: International Journal of Mental Health Systems)

Medication management and practices in prison for people with mental health problems: a qualitative study

International Journal of Mental Health Systems — Mon, 19 Oct 2009 23:00:00 +0100

Conclusion: Changes to medication management which accompany entry to prison appear to contribute to poor relationships with prison health staff, disrupts established self-medication practices and discourages patients from taking greater responsibility for their own conditions and detrimentally affects the mental health of many prisoners at a time when they are most vulnerable. Such practices are likely to inhibit the integration and normalisation of mental health management protocols in prison as compared with those operating in the wider community and may hinder progress towards improving the standard of mental health care available to prisoners suffering from mental disorder. (Source: International Journal of Mental Health Systems)

Pathway for inpatients with depressive episode in Flemish psychiatric hospitals: a qualitative study

International Journal of Mental Health Systems — Sun, 18 Oct 2009 23:00:00 +0100

Conclusions: This study was a first charting of current practice outlined as a pathway for Flemish inpatients with depressive episodes. Within the context of surveillance of quality and quantity of care, this study may encourage hospitals to consider developing clinical pathways. (Source: International Journal of Mental Health Systems)

Health services utilization by school going Omani adolescents and youths with DSM IV mental disorders and barriers to service use.

International Journal of Mental Health Systems — Thu, 24 Sep 2009 23:00:00 +0100

This study focuses on the health services utilization and the barriers to the service use among school going adolescents and youths with DSM IV disorders in the country Oman, whose population is predominantly youthful. Method: Representative sample of secondary school Omani adolescents and youths were concurrently interviewed for the (i) presence of DSM IV mental disorders using the face-to-face interview, World Mental Health-Composite International Diagnostic Interview (WMH-CIDI), (ii) tendency for health care utilization and (iii) predictors of utilization with clinical and demographic background. Results: The proportions of lifetime cases having ever made treatment contact are low, being 5.2% for Any Anxiety Disorder and 13.2% for Any Mood Disorder category. None of these anxiety cases ...

Trauma-related psychological disorders among Palestinian children and adults in Gaza and West Bank, 2005-2008

International Journal of Mental Health Systems — Tue, 22 Sep 2009 23:00:00 +0100

Context: Trauma from war and violence has led to psychological disorders in individuals living in the Gaza strip and West Bank. Few reports are available on the psychiatric disorders seen in children and adolescents or the treatment of affected populations.ObjectiveTo describe the occurrence and treatment of psychiatric disorders in the Palestinian populations of the Gaza strip and Nablus district in the West Bank.Design, Setting, and Participants: From 2005 to 2008, 1369 patients aged more than 1 year were identified through a local mental health and counseling health network. All were clinically assessed using a semi-structured interview based on the DSM-IV-TR criteria. Results: Among 1254 patients, 23.2% reported post-traumatic stress disorder [PTSD], 17.3% anxiety disorder (other than ...

Attitude of young psychiatrists toward coercive measures in psychiatry: a case vignette study in Japan

International Journal of Mental Health Systems — Mon, 21 Sep 2009 23:00:00 +0100

Conclusion: Our results may reflect the current dilemma in Japanese psychiatry wherein psychiatrists must initiate coercive measures to shorten hospitalization stays. This study prompted its subject psychiatrists to consider coercive psychiatric treatments. (Source: International Journal of Mental Health Systems)

Evaluation of Mental Health First Aid training with members of the Vietnamese community in Melbourne, Australia

International Journal of Mental Health Systems — Sun, 06 Sep 2009 23:00:00 +0100

Conclusions: A two-day, MHFA training course for general members of the Vietnamese community in Melbourne demonstrated significant reductions in stigmatising attitudes, improved knowledge of mental disorders and improved knowledge about appropriate forms of assistance to give to people in the community with mental disorder. There is sufficient evidence to scale up to a population level program for the Vietnamese community, and a need for longitudinal evaluation of such a scaled up program. (Source: International Journal of Mental Health Systems)

Pattern of mental ill health morbidities following hysterectomy for benign gynaecological disorders among Nigerian women

International Journal of Mental Health Systems — Wed, 29 Jul 2009 23:00:00 +0100

Conclusion: This study suggests that mental ill health may complicates hysterectomy for benign uterine pathology among Nigerian women, and that anxiety related disorders increases after operation with the highest proportion in those with clinical diagnosis of Uterine Fibroid. We recommend adequate preoperative counseling using properly trained psychologists when affordable to minimize these morbidities. (Source: International Journal of Mental Health Systems)

Mental health treatment outcomes in a humanitarian emergency: a pilot model for the integration of mental health into primary care in Habilla, Darfur

International Journal of Mental Health Systems — Mon, 20 Jul 2009 23:00:00 +0100

Background: There is no description of outcomes for patients receiving treatment for mental illnesses in humanitarian emergencies.MSF has developed a model for integration of mental health into primary care in a humanitarian emergency setting based on the capacity of community health workers, clinical officers and health counsellors under the supervision of a psychiatrist trainer.Our study aims to describe the characteristics of patients first attending mental health services and their outcomes on functionality after treatment. Methods: A total of 114 patients received mental health care and 81 adult patients were evaluated with a simplified functionality assessment instrument at baseline, one month and 3 months after initiation of treatment. Results: Most patients were diagnosed with epil...

The change in attitude and knowledge of health care personnel and general population following trainings provided during integration of mental health in Primary Health Care in Iran: a systematic review

International Journal of Mental Health Systems — Wed, 24 Jun 2009 23:00:00 +0100

Conclusion: A short term training improved knowledge and attitude of the population and health personnel immediately after the intervention. There is also evidence for a long term change in the attitude and knowledge of general population after short term training. (Source: International Journal of Mental Health Systems)

Human rights of persons with mental illness in Indonesia: more than legislation is needed

International Journal of Mental Health Systems — Thu, 18 Jun 2009 23:00:00 +0100

Conclusions: More than legislation is needed to protect the human rights of persons with mental illness. Improving the human rights situation for persons with mental illness in Indonesia will require action by governments at national, provincial and district levels, substantial increases in the level of investment in mental health services, coordinated action by mental health professionals and consumer and carer organisations, and a central role for the National Human Rights Commission in protecting the rights of persons with mental illness. (Source: International Journal of Mental Health Systems)

Psychiatric morbidity among adult patients in a semi-urban primary care setting in Malaysia

International Journal of Mental Health Systems — Wed, 17 Jun 2009 23:00:00 +0100

Background: Screening for psychiatric disorders in primary care can improve the detection rate and helps in preventing grave consequences of unrecognised and untreated psychiatric morbidity. This is relevant to the Malaysian setting where mental health care is now also being provided at primary care level. The aim of this paper is to report the prevalence of psychiatric illness in a semi-urban primary care setting in Malaysia using the screening tool Patient Health Questionnaire (PHQ). Methods: This is a cross-sectional study carried out in a semi-urban primary healthcare centre located south of Kuala Lumpur. Systematic random sampling was carried out and a total of 267 subjects completed the PHQ during the study period. Results: The proportion of respondents who had at least one PHQ posit...

Mental health and human rights: never waste a serious crisis

International Journal of Mental Health Systems — Mon, 15 Jun 2009 23:00:00 +0100

A serious health and human rights crisis is unfolding in Indonesia. Media reports in the Jakarta press have highlighted the high death rates in shelters for people with mental illness that are run by the Jakarta Social Agency. This crisis represents an opportunity to bring about systematic and substantial changes in the Indonesian mental health system. In order to realise this opportunity the necessary elements of an approach are presented and briefly discussed. (Source: International Journal of Mental Health Systems)

Designing a knowledge transfer and exchange strategy for the Alberta Depression Initiative: contributions of qualitative research with key stakeholders

International Journal of Mental Health Systems — Thu, 11 Jun 2009 23:00:00 +0100

Conclusion: Interest in KTE on the part of ADI has led to the development of a strategy for engaging decision makers, researchers, and other mental health stakeholders in an on-going network related to depression programs and policy. A similarly engaged process might benefit other policy areas. (Source: International Journal of Mental Health Systems)

Decentralization matters - Differently organized mental health services relationship to staff competence and treatment practice: the VELO study

International Journal of Mental Health Systems — Mon, 18 May 2009 04:00:00 +0100

Conclusions: The implications of the differences found, and the possibility that these differences influences the treatment mode for patients with similar psychiatric problems from the two catchment areas, are discussed. (Source: International Journal of Mental Health Systems)

International Observatory on Mental Health Systems: structure and operation

International Journal of Mental Health Systems — Fri, 03 Apr 2009 04:00:00 +0100

IntroductionSustained cooperative action is required to improve the mental health of populations, particularly in low and middle-income countries where meagre mental health investment and insufficient human and other resources result in poorly performing mental health systems. The Observatory The International Observatory on Mental Health Systems aims to support the establishment of a mental health systems research and development network that will support low and middle-income countries to develop high quality mental health systems. The mental health systems research work will be done primarily by mental health systems research groups located in collaborating organisations, which will be supported by the IOMHS Secretariat, the International IOMHS Steering Group and a Technical Reference G...

Evaluation of psychological support for victims of sexual violence in a conflict setting: results from Brazzaville, Congo

International Journal of Mental Health Systems — Wed, 01 Apr 2009 04:00:00 +0100

Conclusion: We found the benefits of post-rape psychological support to be present and lasting in this conflict situation. However, we were unable to evaluate all women for the long-term impact, underscoring the difficulty of leading evaluation studies in unstable contexts. Future research is needed to validate these findings in other settings. (Source: International Journal of Mental Health Systems)

Community perceptions of mental health needs: a qualitative study in the Solomon Islands

International Journal of Mental Health Systems — Fri, 13 Mar 2009 04:00:00 +0100

Conclusions: Communities identify and are responding to a wide range of mental health challenges; the health system generally can do more to learn about how this is being done, and build more comprehensive services and policy on this foundation. The findings underscore the need to promote awareness of those services which are available, to extend mental health care beyond urban centres to rural villages where the majority of the population live, and to promote community input to policy so as to ensure that it 'fits' the context. (Source: International Journal of Mental Health Systems)

Knowledge, attitudes and practice pertaining to depression among primary health care workers in Tanzania

International Journal of Mental Health Systems — Wed, 25 Feb 2009 05:00:00 +0100

Conclusion: The findings suggest a need to strengthen the training of primary health care workers in Tanzania about the detection of depression, pharmacological and psychological treatments, and psychosocial interventions. (Source: International Journal of Mental Health Systems)

Mental health and the workplace: issues for developing countries

International Journal of Mental Health Systems — Fri, 20 Feb 2009 05:00:00 +0100

The capacity to work productively is a key component of health and emotional well-being. Common Mental Disorders (CMDs) are associated with reduced workplace productivity. It is anticipated that this impact is greatest in developing countries. Furthermore, workplace stress is associated with a significant adverse impact on emotional wellbeing and is linked with an increased risk of CMDs. This review will elaborate on the relationship between workplace environment and psychiatric morbidity. The evidence for mental health promotion and intervention studies will be discussed. A case will be developed to advocate for workplace reform and research to improve mental health in workplaces in developing countries in order to improve the wellbeing of employees and workplace productivity. (Source: In...

Is psychiatric emergency service (PES) use increasing over time?

International Journal of Mental Health Systems — Tue, 03 Feb 2009 05:00:00 +0100

Conclusions: Long observation periods are required in order to detect stable changes in PES utilization rates over time. As such, population growth may be but one of several factors underlying these increases. Organizational changes in mental health care delivery in the vicinity of the services that showed an increase could also have contributed. These latter would simply have redistributed (to the PES) the pre existing pool of metal health care patients, resulting in an increase that is more apparent than real. (Source: International Journal of Mental Health Systems)

International Observatory on Mental Health Systems: a mental health research and development network

International Journal of Mental Health Systems — Thu, 22 Jan 2009 05:00:00 +0100

Background: While the mental health situation for most people in low and middle-income countries is unsatisfactory, there is a renewed commitment to focus attention on the mental health of populations and on the scaling up of mental health services that have the capacity to respond to mental health service needs. There is general agreement that scaling up activities must be evidence-based and that the effectiveness of such activities must be evaluated. If these requirements are to be realised it will be essential to strengthen capacity in countries to conduct rigorous monitoring and evaluation of system development projects and to demonstrate sustained benefit to populations.The ObservatoryThe International Observatory on Mental Health Systems (IOMHS) will build capacity to measure and to ...

International Observatory on Mental Health Systems: a research and mental health systems development network

International Journal of Mental Health Systems — Thu, 22 Jan 2009 05:00:00 +0100

Background: While the mental health situation for most people in low and middle-income countries is unsatisfactory, there is a renewed commitment to focus attention on the mental health of populations and on the scaling up of mental health services that have the capacity to respond to mental health service needs. There is general agreement that scaling up activities must be evidence-based and that the effectiveness of such activities must be evaluated. If these requirements are to be realised it will be essential to strengthen capacity in countries to conduct rigorous monitoring and evaluation of system development projects and to demonstrate sustained benefit to populations. The Observatory The International Observatory on Mental Health Systems (IOMHS) will build capacity to measure and t...

Psychological distress and associated factors among the attendees of traditional healing practices in Jinja and Iganga districts, Eastern Uganda: a cross-sectional study

International Journal of Mental Health Systems — Tue, 23 Dec 2008 05:00:00 +0100

Conclusion: This study provides evidence that a substantial proportion of attendees of traditional healing practices suffer from psychological distress. Associated factors include poverty, number of children, polygamy, reason for visiting the healer and use of both traditional healing and biomedical health units. These findings may be useful for policy makers and biomedical health workers for the engagement with traditional healers. (Source: International Journal of Mental Health Systems)

Psychological distress and associated factors among the attendees of traditional healing practices in Jinja and Iganga districts,Eastern Uganda: a cross sectional study.

International Journal of Mental Health Systems — Tue, 23 Dec 2008 05:00:00 +0100

Pathway to Psychiatric Care in Japan: a multicenter observational study

International Journal of Mental Health Systems — Fri, 26 Sep 2008 04:00:00 +0100

Conclusions: This first pathway to psychiatric care study in Japan demonstrated that referral pathway in Japan heavily relies on medical resources. The study indicates possible fields and gives indications, underlining the importance of improving skills and knowledge that will facilitate the recognition of psychiatric disorders presenting with somatic and depressive symptoms in the general health care system and by private practitioners. (Source: International Journal of Mental Health Systems)

Hope, despair and transformation: climate change and the promotion of mental health and wellbeing

International Journal of Mental Health Systems — Wed, 17 Sep 2008 04:00:00 +0100

Conclusions: We conclude with some thoughts about implications of these reflections for future policy, practice and research in the fields of mental health and mental health promotion. (Source: International Journal of Mental Health Systems)

Community mental health in India: A rethink

International Journal of Mental Health Systems — Mon, 14 Jul 2008 04:00:00 +0100

Conclusions: Community based initiatives in the management of mental disorders however well intentioned will not be sustainable unless the family and the community are involved in the intervention program with support being provided regularly by mental health professionals. (Source: International Journal of Mental Health Systems)

Does community care work? A model to evaluate the effectiveness of mental health services

International Journal of Mental Health Systems — Sat, 05 Jul 2008 04:00:00 +0100

The aim of this paper is to evaluate the effectiveness of community Mental Health Departments in Lombardy (Italy), and analyse the eventual differences in outcome produced by different packages of care. The survey was conducted in 2000 on 4,712 patients treated in ten Mental Health Departments. Patients were assessed at least twice in a year with HoNOS (Health of the Nation Outcome Scales). Data on treatment packages were drawn from the regional mental health information system, which includes all outpatient and day-care contacts, as well as general hospital and inpatient admissions provided by Mental Health Departments. Multilevel growth models were used for outcomes statistical analysis, expressed in terms of change of the total HoNOS score. On the whole, Mental Health Departments were e...

Pasung: Physical restraint and confinement of the mentally ill in the community

International Journal of Mental Health Systems — Mon, 16 Jun 2008 04:00:00 +0100

ConclusionThe provision of basic community mental health services, where there were none before, enabled the majority of the people who had been restrained to receive psychiatric treatment and to be released from pasung. (Source: International Journal of Mental Health Systems)

Tangata whaiora/consumers perspectives on current psychiatric classification systems

International Journal of Mental Health Systems — Thu, 12 Jun 2008 04:00:00 +0100

Conclusion: Overall, people thought that in terms of their recovery, the classification systems were tools and their utility depended on how they were used. They suggested that whatever tool was used it needed to help them make sense of their distress and provide them with a variety of supports, not just medication, to assist them to live lives that were meaningful to them. (Source: International Journal of Mental Health Systems)

Providing support to psychiatric patients living in the community in Japan: patient needs and care providers perceptions

International Journal of Mental Health Systems — Thu, 29 May 2008 04:00:00 +0100

Conclusion: Results of this study suggest that social services geared towards specific tasks of daily living form an important component of comprehensive care for psychiatric patients living in community settings in Japan. (Source: International Journal of Mental Health Systems)

Reducing stigma and discrimination: Candidate interventions

International Journal of Mental Health Systems — Sun, 13 Apr 2008 04:00:00 +0100

This paper proposes that stigma in relation to people with mental illness can be understood as a combination of problems of knowledge (ignorance), attitudes (prejudice) and behaviour (discrimination). From a literature review, a series of candidate interventions are identified which may be effective in reducing stigmatisation and discrimination at the following levels: individuals with mental illness and their family members; the workplace; and local, national and international. The strongest evidence for effective interventions at present is for (i) direct social contact with people with mental illness at the individual level, and (ii) social marketing at the population level. (Source: International Journal of Mental Health Systems)

First aid guidelines for psychosis in Asian countries: A Delphi consensus study

International Journal of Mental Health Systems — Thu, 21 Feb 2008 05:00:00 +0100

Conclusion: Despite the diversity of the countries involved, there was consensus on a core set of first aid items that were considered as suitable for assisting a psychotic person. Future work is needed to develop guidelines for specific countries. (Source: International Journal of Mental Health Systems)

Cotard's syndrome and delayed diagnosis in Kashmir, India

International Journal of Mental Health Systems — Fri, 11 Jan 2008 05:00:00 +0100

We present a case of a young pregnant woman suffering from Cotard's syndrome. This is the first report of this syndrome in a pregnant woman. The case was diagnosed late, due to lack of awareness of psychiatric problems in primary care physicians resulting in undue suffering, loss of precious time and resources for the patient. Besides highlighting the rare combination of pregnancy and Cotard's syndrome this report delineates the difficulties faced by patients with such symptoms in a low resource setting. (Source: International Journal of Mental Health Systems)

Classification in Psychiatry: Does it deliver in schizophrenia and depression?

International Journal of Mental Health Systems — Mon, 03 Dec 2007 05:00:00 +0100

DiscussionIn the major groupings of schizophrenia and depression, experience over the last 50 years has highlighted particular inadequacies in the utility and validity of available classifications.SummaryAdvances in psychiatric knowledge and practice notwithstanding, present classification systems would be enhanced by the incorporation of dimensional components. Minor tinkering with current systems will reflect only a missed opportunity. Improving classification will facilitate quality improvement of mental health systems. (Source: International Journal of Mental Health Systems)