The Relationship of Occupational Health Nurses’ Experiences with Associated Departments in Relation to Project Development of Mental Health Care for Primary Preventive Treatment

Purpose: The purpose of this study was to clarify the relationship and experiences of occupational health nurses (OHNs) and related departments in project development of mental health care for primary treatment in the Japanese occupational health setting. Method: A total of 235 OHNs who are members of the Japan Academy of Occupational Health Nursing were sent an anonymous self-administered questionnaire survey. The questionnaire included items on the following: the OHN’s background, whether the OHN had experience in project development, the communication between the associated departments, the Japanese version of the Work Engagement Scale (UWES-J), occupational assessments, workplace assessments, and the Transtheoretical Model (TTM) for health promotion in companies and the OHN’s working environment. We performed logistic regression analysis to examine the relationship between experience and these harmonious relationships with other associated departments. Result: Responses from 61 OHNs (valid response rate: 25.9%) were analyzed. The mean number of years of service as an OHN was 18.9, and 82% of respondents had experience in project development. The logistic analysis further revealed that OHNs who had experience in project development of mental health care usually had a harmonious relationship with other associated departments. Conclusion: To promote mental health care for workers, OHNs have the capability to create individual and workplace assessments, enhance their work engagement, and make further improvements to their working environment. .

Suicide Prevention in Mental Health Services—A Qualitative Study of a Web Based Program for Mental Health Care Staff

Background: Further strategies are needed to deal with the high losses to suicide. New modalities should be explored within the context of suicide prevention. Aim: The aim of the study was to evaluate participants’ experiences of a web based program for mental health care staff, including its potential clinical relevance. Methods: Nineteen participants participated in five focus groups. Data was analyzed using content analysis. Results: The analysis showed participants’ experiences of the program’s contents and format (“Web Based Modules”, “Discussion Groups”) and practical value (“Clinical Relevance and Use”, “Effects on Communication and Climate”). Conclusions: The program partly increased awareness about risk factors and the importance of inquiring about suicide ideation/plans and documenting suicide assessments. Experiences of the clinical value were varying and may be increased through potential enhancements.

Mental Health Care in Saudi Arabia: Past, Present and Future

We review the past, present and future state of mental health care in the Kingdom of Saudi Arabia (KSA). The past is reviewed prior to the modern era, discussing early explanations and treatments for mental health illness up through the establishment of the first mental hospital in the 1950s, tracking advances in mental health care over the past 60 years. The present is explored in terms of the current need for mental health care based on the prevalence of mental health problems in KSA. We also discuss the role of the family in caring for the needs of the mentally ill today. Finally, we look forward into the future, discuss the current education system that will produce the next generation of mental health professionals, examine areas of mental health care that need improvement, and provide a research agenda to guide the continued development of the mental health care system in KSA. Our goal is to present a blue print for the development of a state-of-the-art mental health that may serve as a model for other countries in the Middle East, while taking into account the political, cultural and religious factors that are unique to this region of the world.

The Affordable Care Act: Disparities in emergency department use for mental health diagnoses in young adults

BACKGROUND: There is little consensus as to the effects of insurance expansion on emergency department(ED) utilization for mental health purposes. We aimed to study the race specifi c association between the dependent coverage provision of the Affordable Care Act(ACA) and changes in young adults' usage of emergency department services for psychiatric diagnoses.METHODS: We utilized a Quasi-Experimental analysis of ED use in California from 2009–2011 for behavioral health diagnoses of individuals aged 19 to 31 years. Analysis used a difference-indifferences approach comparing those targeted by the ACA dependent provision(19–25 years) and those who were not(27 to 31 years), evaluating changes in ED visit rates per 1 000 in California. Primary outcomes measured included the quarterly ED visit rates with any psychiatric diagnosis. Subgroups were analyzed for differences based on race and gender.RESULTS: The ACA dependent provision was associated with 0.05 per 1 000 people fewer psychiatric ED visits among the treatment group(19–25 years) compared to the control group(27–31 years). Hispanics and Asian/Pacific Islanders were the only racial subgroups who did not see this significant reduction and were the only racial subgroups that did not see significant gains in the proportion of psychiatric ED visits covered by private insurance.CONCLUSION: The ACA dependent provision was associated with a modest reduction in the growth rate of ED use for psychiatric reasons, however, racial disparities in the effect of this provision exist for patients of Hispanic and Asian/Pacifi c Islander racial groups.

Attitudes of Healthcare Professionals towards Mental Illness: A Survey Study in Ras Al Khaimah

Background: Negative and stigmatizing attitudes and behaviours towards people with mental health problems have the potential to lead to a lack of access to care, under-treatment, social marginalization, and can undermine the relationship between the patient and provider. The study aimed to measure attitude of healthcare professionals towards mental illness. Methods: Across sectional descriptive study was conducted over one month from April to May 2019 at Ras Al khaimah medical and health Science University and affiliated health care facilities. Mental Illness Clinicians’ Attitudes Scale version 4 Questionnaire was used to collect data from participants after obtaining their informed consent with assured confidentiality. Results: The study included 113 health care professionals. The mean score of attitude of health care professionals towards mental illness was 57.8 ± 10.8 out of 96. Negative attitudes were reported about the dangerousness, respect and suspicion over recovery of people with mental health problems, interactions with them in clinical practice, and fear of disclosure to colleagues or friends about mental health problems and confidence in capabilities of assessing mental health problems in primary care. The significant positive attitude was found among participants who were university faculty than those who worked in hospitals and Primary care centres (P = 0.04). Health care professionals who were university faculty and have reported more than 10 years of experience as health professionals reported significantly higher mean scores (P < 0.05). Neither age nor gender, or nationality appeared to be related to overall attitudinal responses towards mental illness. Conclusion: Educational programs might be useful to raise awareness towards the stigmatizing attitudes towards mental health and mental illnesses.

Case-finding for mental distress in primary health care: An evaluation of the performance of a five-item screening instrument

Background: There is an increased interest in developing better and more accurate methods to recognize and manage mental health problems in primary care settings. Abbreviated screening instruments for mental distress are useful tools for research and clinical practice. The present study seeks to investigate whether only a few questionnaire items from the Self-Reporting- Questionnaire-10 (SRQ-10) can be a robust method in the screening for Mental Distress in Primary Health care. Methods: We compared the screening accuracy of a short, five-item (SRQ-5) version of the SRQ-10 with that of the SRQ-20, General Health Questionnaire 12 (GHQ-12) using the DSM-IV axis as a gold standard and analyzed its performance in different diagnostic entities. We also assessed the correlation, sensitivity and specificity between the 4 instruments. All the instruments were administered to 400 primary health care attendees. Results: The estimated prevalence of mental distress was 13.6% in the study sample (Depression 11%, anxiety disorders 1.8%). The SRQ-5 was highly correlated to SRQ-10 (0.923, p < 0.001), SRQ-20 (0.764, p < 0.001) and only moderately correlated to GHQ-12 (0.417, p < 0.001). The SRQ-5 had high properties for identifying mental distress. The AUC for overall mental distress was 0.925 while that for depression and anxiety were 0.915 and 0.849 respectively. Conclusion: This validation showed that in moving from SRQ with 10 or 20 items to one with merely 5 items, we do not seem to lose the screening prowess of the instrument. The SRQ-5 represents a simplified and less time-consuming screening instrument with strong performance characteristics. We therefore recommend it for inclusion into existing patient assessment protocols, thus enhancing case finding at primary health care level.

Task sharing in psychotherapy as a viable global mental health approach in resource-poor countries and also in high-resource settings

A global disparity exists between the burden of mental ill-health and the resources available to address this issue.Common mental disorders,such as mild-to-moderate depression,anxiety disorders and post-traumatic stress disorder,are associated with a significant decline in health and functioning and contribute significantly to the overall burden of disease.In view of a shortage of mental health professionals in most low-and middle-income countries,task sharing(task shifting)can make an important contribution to improving access to mental health services.Task sharing involves non-specialists in the delivery of health care.The use of lay health workers is premised on the assumption that the shorter training required for non professionals will allow an increase in the provision of required care without the need for an increase in resources and will strengthen and scale-up sustainable health systems.The need for low-tech support in the management of conunon mental disorders is widespread,and the core resource is humans trained to identify and treat those requiring mental health care.There is a strong evidence base for the effectiveness of task sharing in psychotherapy,and talk therapies,e.g.cognitive behavioral therapy,can easily be delegated to non-specialists,including non-specialist health workers,peer helpers and lay people.A(cost-)effective model of mental health care in low-resource settings as well as in high-income countries may include the medical school-based training of some psychiatrists and clinical psychologists in the treatment of referred patients with serious mental illness.These professional mental health specialists would also be trainers and supervisors of non-specialist health workers who would identify common mental health disorders and provide psychotherapy to people with these conditions in a community-based setting.Community-based generalism including task sharing rather than centralized specialism may be capable of preventing and treating many common mental disorders with minor financial expenditure.

Nurses’ Perceptions of Patient Safety in Community Mental Health Settings: A Qualitative Study

Mental health care has moved from hospital settings to community mental health settings, and there is a need to explore the perceptions of patient safety among registered nurses working in this field. Patient safety is to include everyone and to be the goal in all aspects of health care. The aim of the study was to explore registered nurses’ perceptions of patient safety in community mental health settings for people with serious mental illness. The study was qualitative and descriptive in nature and interviews were carried out during spring 2012, with seven registered nurses working in community mental health settings for people with serious mental illness in five municipalities in the middle of Sweden. The sampling was purposive and data were analysed using qualitative content analysis. The findings showed that the registered nurses understood patient safety as providing support to people with serious mental illness in regaining and maintaining health through good treatment and respecting self-determination and avoiding coercion. The terms of daily living in small community mental health settings within the a large community health care organization, communication, sufficient knowledge of psychiatric disabilities among people in the residents’ network, and national laws and regulations, all had implications for patient safety. The registered nurses perceived patient safety as involving a wide range of issues that in other areas of care are more often discussed in terms of quality of care. Determining the boundaries of patient safety in community mental health settings for people with serious mental illness can be a first step in establishing workable routines that ensure safe patient care.

Pattern of mental health service use and risk of injury: A longitudinal study

Objective: The aim of this study is to investigate the association between mental health treatment patterns and risk of injuries among a Western Australian male birth cohort. Method: A population-based birth-cohort of males born between 1980 and 1984 in Western Australia was followed up using linked health data. Results: Participants with mental health conditions were at an increased risk of injury. Those with a continuous mental health treatment pattern without interruption or window periods had lower risk of injury compared to those with treatment interruption or window periods. The adjusted incidence rate ratios (95% confidence interval) for injury among participants: 1) without a mental condition, 2) with a previous mental condition, 3) with a mental condition in the last four years and without interruption in their mental health treatment, and 4) with a mental condition in the last four years with interruptions in mental health service, were 0.38 (0.35 - 0.40), 0.77 (0.71 - 083), 1.0 (reference group) and 2.06 (1.72 - 2.47) respectively. Conclusion: Increasing resources for mental health services and enabling sufficient continuous mental health services and follow-up may reduce the risk of injury among populations with mental health conditions.

Mental Health Problems Affecting People Who Have HIV and AIDS in Malawi: A Review

Malawi is located in the southern part of Africa with a population of more than 16 million people. The country is ravaged with HIV and AIDS epidemic of which the prevalence rate is at 14%. The people who have HIV/AIDS are also affected by mental and psychological disorders. Nevertheless, very little is known about mental health care of people who have HIV and AIDS in Malawi. We did literature search using AJOL, Proquest, PsychINFO, Google Scholar and HINARI search engines and the search yielded scanty (12) research studies on the mental health of people with HIV and AIDS that were conducted in Malawi between 2006-2014. Twelve (12) studies that were reviewed focused on prevalence of mental disorders among people who have HIV and AIDS;nurses’ knowledge and skills for providing mental health care to people living with HIV and AIDS (PLWHA);perceived risk of HIV infection among people who have mental health problems;substance abuse and HIV/AIDS issues and awareness of interaction between HIV/AIDS and Mental health. In conclusion, the review shows that people with HIV infection are also affected by mental health problems such as depression and substance abuse. They receive some mental health care in general settings at ART clinics because mental health care is integrated into general health care delivery system. Therefore, it is necessary that health professionals who are generalists should be equipped with adequate knowledge and skills for providing mental health care to care to people with HIV and AIDS.

Epidemiological Profile of Mental Health Program Patients in a Health Unit

Aim: To verify the epidemiological profile of patients enrolled in the Mental Health Program at a Family Health Unit, as well as the most prevalent disorders, age and comorbidities. Methods: After analyzing the medical records, the following variables were obtained: diagnosis of mental health status, gender, age group, associated comorbidities and medication in use. Results: There was a prevalence of 61.3% in women and 38.7% in men;patients aged 30 to 39 years were the most affected (22.6%);the most common disorders were epilepsy (36%), depression (14%), anxiety disorder (8.6%) and schizophrenia (8.6%);the most common comorbidities were systemic arterial hypertension (30%) and insomnia (15%) and the most commonly used psychotropic drugs were amitriptyline, carbamazepine and phenobarbital (10.2% each). Conclusion: There was a high prevalence of females, mainly at 30 to 39 years old and the most prevalent diagnoses were epilepsy, depression and anxiety disorder. About medications, antidepressants and anticonvulsants were the most prescribed.

Women’s Experiences with Gender Violence and the Mental Health Impact: Qualitative Findings

The purpose of this study was to describe women’s experiences with gender violence and the impact on mental health. The research was a qualitative observational study. Participants were n = 72 women clients of (02) Primary Health Centers at the University of Carabobo-Venezuela. The technique to gather the information was focus group discussion (FGD). The interpretation of data was an analytical process based on Mayring’s approach. The principal findings showed that, women clients of primary health centers experienced different levels of violence in everyday life. Physical violence was the most frequent abuse reported by victims. Death threats were the most frequent conduct used by the partners in terms of psychological violence. Women expressed being under the control of a dominant partner without physical aggression or threats, but they felt a lack of autonomy. Additionally, women who experienced different levels of abuse specified some symptoms that could suggest an impact on mental health. In conclusion, women naturalized dominance and control because they understood this kind of abuse as normal behavior between relationship partners.

Experiences on Participation in Literary Activities: Intellectual Stimuli Empower People with Mental Health Problems

Some research acknowledges engagement in creative and literary activities as constructively impacting rehabilitation and recovery. Nevertheless, there is a deficit of literature describing experiences of participation in literary activities. This study examined how members of a non-profit association for mental health, with experiences of mental problems or illnesses, experienced group-based literary activities facilitated of a bi-disciplinary research team during one semester. This study held a constructive/naturalistic design and used a qualitative methodology with a latent analysis to describe how participants experienced literary activities (creative writing, reading and conversations about published and own written poetry and prose texts). Both individual and focus-group interviews were performed early 2014. Despite previous negative experiences, the findings showed that the participants perceived the literary activities empowering. Four categories were created: Presumptions of personal literacy, leadership role, participants’ role, and literacy development. These were abstracted and interpreted into three themes: Identifying a reading and writing self-image, challenging and redefining one’s reading and writing identity, and strengthening one’s intellectual and humanistic capacity. Literary activities seemed to positively change the participants’ attitudes towards writing and reading, and also enhanced their literacy skills. We argue that literacy skills are interconnected with health literacy. Involvement of literary activities into rehabilitation in mental health practice may be beneficial for some groups, and merits further studies.

Prevalence of Mental Disorders and Health Service Utilization among Individuals with Turkish Migration Backgrounds in Germany: A Study Protocol for an Epidemiological Investigation

Background: There is a lack of reliable epidemiological data on prevalence and comorbidity rates of mental disorders in the migrant population in Germany. Despite existing national and international data on the extent of psychosocial burdens in migrant populations the prevalence among the study population remains unclear. The aim of this study was to collect prevalence data for the largest migrant population in Germany-individuals with Turkish migration backgrounds—using a culturally and linguistically sensitive approach. Methods: The study employs a cross-sectional design. The multi-centre study (Hamburg, Berlin) is based on a sample of individuals with Turkish migration backgrounds living in the two cities stratified by age, gender, and education. The study programme consists of three phases: 1) a qualitative focus group to collect information on how to increase the participation rate of the target population as a minority group in Germany;2) a translation phase to create culture and linguistic sensitive versions of the assessment tools (e.g., the Composite International Diagnostic Interview (CIDI) for Turkish speaking individuals;and 3) a baseline community study to assess the lifetime, 12-month and four-week prevalence and comorbidity rates of mental disorder, health care utilization and help-seeking behaviour in individuals of Turkish migration backgrounds living in Germany. Discussion: The study provides important data on the lifetime prevalence of mental disorders and health care utilization of individuals with Turkish migration backgrounds. Furthermore, the study is an important step towards gaining a better understanding of potential barriers to participation, creating resources for difficult-to- reach minorities, and understanding the need for assessing mental disorders in migrant populations. These results can offer a starting point for the initiation of the necessary structural changes for mental health care services and policies for groups with migration backgrounds.

Community Perceptions of Indigenous Healers and Mental Disorders in Zimbabwe

The World Health Organisation has made recommendations for partnerships between indigenous healing (IH) and biomedical therapy (BT) in the delivery of health services as a way of creating cultural sensitivity in mental health care (Bank, 2001). Yet, literature on prevalence, distribution, burden, and unmet needs for treatment of the mental disorders often exclude the role played by indigenous healing practitioners (IHPs). This study aimed to analyze mental health care from the perspective of communities on mental health care by IHPs to reveal their possible role in the surveillance studies of mental disorders in a settlement north-east of Harare in Zimbabwe through an exploratory qualitative methodology. Thirty in-depth interviews and three focus group discussions with key-informants were conducted to gather community perceptions of the nature of mental disorders treated by IHPs in Zimbabwe. Gathered data were coded using Constant Comparison Method with multiple members of the research team, enhancing validity and reliability. The results of the study reveal that while some patients presented with some mental disorders that were consistent with the BT diagnoses such as schizophrenia (Chirwere chepfungwa), depression (Kufungisisa), anxiety (Buka), post-traumatic stress disorder (Kurotomoka) somatisation (shungu), etc., other patients reported the disorders that were not recognised from a biomedical point of view such as the supernatural, cultural or social problems in IH. The findings were similar to the results of the first 17 world mental health surveys which show that the mental disorders are commonly occurring in all participating countries. This implied that the IHPs were treating common mental disorders reported in the low-income countries. More importantly, the IHPs treated a unique category which affected the majority of Zimbabwean patients. This study highlights the importance of the IHPs as complementary to BT in the management of the mental disorders. The IHPs should be included in mental health surveillance with the BTPs in order to obtain realistic figures that enable proper planning and management of mental health disorders. Policies on integrating IHPs’ work into mental health care must be drawn and published in national guidelines. More research is needed on integration guidelines.

Illness Experience in a Very Low Income/Poor District of Rio de Janeiro, Brazil: Tuberculosis, Medication Adherence and Common Mental Disorders

Introduction: Tuberculosis is a global health problem. Improving medication adherence is an important attribute concerning the outcome of tuberculosis treatment. This study investigates illness experience of patients belonging to a low-income district within Manguinhos catchment area. Narrative studies are able to unfold features concerning patient adherence and co-occurrence of depressive symptoms. Methods: Twenty-three patients under treatment were interviewed using McGill Illness Narrative Interview (MINI-McGILL), besides depression screening with “Self-Report Questionnaire-20” (SRQ-20) and “Beck Depression Inventory” (BDI). Results: Explanatory models disregarded airborne microorganism contagion, known but not considered relevant while bohemian or deviant lifestyle was rather perceived as a causal model. Patients mentioned contiguous events suggesting pneumonia or influenza misdiagnosis before final tuberculosis diagnosis (testing or suspicion). Therapeutic pathways were erratic, suggesting low literacy level and postponed or inadequate diagnosis accuracy. Emergency units or private services usually stood for primary care units considered first choice by planners. Expressions such as “dreadful/shameful disease” or “very heavy illness” acknowledged stigma. Research data detected the importance of social network role, highlighting the family through financial and affective support. Hopelessness and depression were closely related to illness suffering and adversities. The percentage of patients for positive common mental disorder and depression approaches 30%. Conclusion: Tuberculosis remains a stigmatizing disease. Building effective health services networks, comprising treatment facilities, community and family resources are very important to improve medication adherence. Effective tuberculosis management through health teams training seems necessary. Incorporating simple screening instruments for depression assessment might promote well-being and patient adherence.

合理信念替代疗法对冠心病患者心理弹性和自护能力的影响

目的:分析合理信念替代疗法对冠心病患者心理弹性和自护能力的影响。方法:按照入院顺序将某院2021年8月-2022年8月收治的102例冠心病患者分为对照组(n=51,常规干预)和干预组(n=51,常规干预+合理信念替代疗法);对比两组患者干预前后心理弹性[心理弹性量表(CD-RISC)]、自护能力[自我护理能力量表(ESCA)]、健康行为[健康促进生活方式量表Ⅱ(HPLP-II)]、生活质量[西雅图心绞痛量表(SAQ)]及满意度。结果:干预后,两组CD-RISC量表坚韧、乐观、自强各维度得分及总分均升高(P<0.05),且干预组均高于对照组(t=4.371,5.404,3.883,6.574;P<0.05);干预后,两组ESCA量表中自我概念、健康知识水平、自我护理技能、自我护理责任感各维度得分及ESCA量表总分均高于干预前(P<0.05),且干预组均高于对照组(t=7.252,3.908,5.848,5.643,10.496;P<0.05);干预后,两组HPLP-Ⅱ量表人际关系、运动锻炼、自我实现、压力管理、健康责任、营养各维度得分及总分均高于干预前(P<0.05),且干预组均高于对照组(t=2.624,3.883,3.378,3.642,3.610,2.828;P<0.05);干预后,两组SAQ各维度评分均升高(P<0.05),且干预组心绞痛稳定状况、疾病认知程度、治疗满意度、心绞痛发作频率、躯体受限程度五大维度评分较对照组高(t=2.122,2.340,3.699,2.976,2.766;P<0.05);两组满意度比较,干预组为96.08%,高于对照组的84.31%(χ^(2)=3.991,P<0.05)。结论:对冠心病患者采用合理信念替代疗法效果显著,可增强患者心理弹性,提高自护能力、健康行为水平和生活质量,获得较高的满意度。

精神卫生机构开放式心理病区人文关怀护理研究进展

对精神卫生机构实施人文关怀的意义、护理措施、培训现状进行综述,并分析既往研究的贡献、优点与不足,以期实践和发展开放式心理病区人文关怀护理,为病人身心整合和康复提供思路。

中医治未病理论指导下的音乐疗法用于自我心理保健探讨

阐述在中医治未病理论指导下应用音乐疗法进行自我心理保健的意义,以及音乐治疗在情志病中的防治作用,并提出根据阴阳五行之理辨证施乐,在未病、欲病、已病、瘥后不同阶段的音乐干预等具体方法,提出“每个人都可以成为自己的音乐治疗师”新理念,推动音乐治疗在自我心理保健中的应用,在健康中国战略中发挥更大的作用。