Whether and how people reach care.
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801 to 825 of 2,047Stafford N, Colom F (2013)reviewMEDLINE-indexed journal, not yet read by usActa psychiatrica Scandinavica. Supplementum29 citations Purpose and effectiveness of psychoeducation in patients with bipolar disorder in a bipolar clinic setting.
Objective: This article reviews psychological therapies in the treatment of bipolar disorder, in particular psychoeducation, and how the inclusion of four fundamental principles - patient/therapist communication, flow of information, patient involvement and a trusting relationship - can improve patient outcomes.
Method: The content of this article is based on the proceedings of a 1-day standalone symposium in November 2011 exploring how to establish a bipolar clinic within the context of existing services in the UK's National Health Service.
Results: Certain psychological interventions have emerged as beneficial add-on treatments to pharmacotherapy in bipolar disorder and are associated with greater stabilisation of symptoms, fewer relapses and longer time to relapse. Psychoeducation is a simple approach to support prevention of future episodes by delivering behavioural training to impro…
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Self-management in bipolar disorder: the story so far.
Background: Research suggests that psychoeducation, relapse prevention and recovery are all the key aspects of psychological treatment for bipolar disorder and the common components of self-management programmes.
Aims: This review traces the origins of self-management interventions as it appears in physical health research and evaluates the current evidence associated with self-management interventions for depression and more specifically for bipolar disorder.
Method: Literature review.
Results: Despite significant clinical and cost benefits associated with self-management programmes for physical and mental health problems, to date there has been less progress in the development of self-management interventions for bipolar disorder. Preliminary evidence indicates that people with bipolar disorder will engage with self-management support.
Conclusion: The rapid development and evaluation o…
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Suicide attempts: prevention of repetition.
Objective: To present an overview of promising strategies to prevent repetition of suicidal behaviours.
Method: This literature review on tertiary preventive interventions of suicide attempts was produced using the computerized databases PubMed and PsycINFO from January 1966 to September 2010, using French- and English-language limits and the key words: suicid* or deliberate self-harm and treatment* or therapy or intervention* or management.
Results: Thirteen of the 35 included studies showed statistically significant effects of fewer repeated attempts or suicides in the experimental condition. Overall, 22 studies focused on more traditional approaches, that is, pharmacological or psychological approaches. Only 2 of the 6 pharmacological treatments proved significantly superior to a placebo- a study of lithium with depression and flupenthixol with personality disorders. Eight out of 16 p…
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Mobile mental health: review of the emerging field and proof of concept study.
Background: The ubiquitous nature of mobile phones and their increasing functionality make them an ideal medium for the delivery of large-scale public health information and interventions. While mobile phones have been used to this end in behavioural and physical health settings, their role in monitoring and managing mental health is in its infancy.
Aims: The purpose of this paper is (1) to provide an overview of the field of mobile mental health and (2) by way of illustration, describe an initial proof of concept study carried out to assess the potential utility and effectiveness of a newly developed mobile phone and web-based program in the management of mild-to-moderate stress, anxiety and depression.
Methods: Over 6 weeks, participants were given access to "myCompass": an interactive self-help program, which includes real-time self-monitoring with short message service prompts and br…
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Repper J, Carter T (2011)reviewMEDLINE-indexed journal, not yet read by usJournal of mental health (Abingdon, England)491 citations A review of the literature on peer support in mental health services.
Background: Although mutual support and self-help groups based on shared experience play a large part in recovery, the employment of peer support workers (PSWs) in mental health services is a recent development. However, peer support has been implemented outside the UK and is showing great promise in facilitating recovery.
Aims: This article aims to review the literature on PSWs employed in mental health services to provide a description of the development, impact and challenges presented by the employment of PSWs and to inform implementation in the UK.
Method: An inclusive search of published and grey literature was undertaken to identify all studies of intentional peer support in mental health services. Articles were summarised and findings analysed.
Results: The literature demonstrates that PSWs can lead to a reduction in admissions among those with whom they work. Additionally, assoc…
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Mental disorders, health inequalities and ethics: A global perspective.
The global burden of neuropsychiatry diseases and related mental health conditions is enormous, underappreciated and under resourced, particularly in the developing nations. The absence of adequate and quality mental health infrastructure and workforce is increasingly recognized. The ethical implications of inequalities in mental health for people and nations are profound and must be addressed in efforts to fulfil key bioethics principles of medicine and public health: respect for individuals, justice, beneficence, and non-malfeasance. Stigma and discrimination against people living with mental disorders affects their education, employment, access to care and hampers their capacity to contribute to society. Mental health well-being is closely associated to several Millennium Development Goals and economic development sectors including education, labour force participation, and productivi…
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The stigma of childhood mental disorders: a conceptual framework.
Objective: To describe the state of the literature on stigma associated with children's mental disorders and highlight gaps in empirical work.
Method: We reviewed child mental illness stigma articles in (English only) peer-reviewed journals available through Medline and PsychInfo. We augmented these with adult-oriented stigma articles that focus on theory and measurement. A total of 145 articles in PsychInfo and 77 articles in MEDLINE met search criteria. The review process involved identifying and appraising literature convergence on the definition of critical dimensions of stigma, antecedents, and outcomes reported in empirical studies.
Results: We found concurrence on three dimensions of stigma (negative stereotypes, devaluation, and discrimination), two contexts of stigma (self, general public), and two targets of stigma (self/individual, family). Theory and empirics on institutional…
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Family support in children's mental health: a review and synthesis.
A comprehensive review of structured family support programs in children's mental health was conducted in collaboration with leadership from key national family organizations. The goals were to identify typologies of family support services for which evaluation data existed and identify research gaps. Over 200 programs were examined; 50 met criteria for inclusion. Programs were categorized by whether they were delivered by peer family members, clinicians, or teams. Five salient components of family support were identified: (a) informational, (b) instructional, (c) emotional, (d) instrumental, and (e) advocacy. Clinician-led programs were heavily represented (n = 33, 66%), followed by family-led (n = 11, 22%), and team-delivered (n = 6, 12%) programs. Key differences between programs delivered by clinicians or by peer family members were found in the degree of emphasis, research methodolo…
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Confronting a neglected epidemic: tobacco cessation for persons with mental illnesses and substance abuse problems.
Tobacco use exerts a huge toll on persons with mental illnesses and substance abuse disorders, accounting for 200,000 of the annual 443,000 annual tobacco-related deaths in the United States. Persons with chronic mental illness die 25 years earlier than the general population does, and smoking is the major contributor to that premature mortality. This population consumes 44% of all cigarettes, reflecting very high prevalence rates plus heavy smoking by users. The pattern reflects a combination of biological, psychosocial, cultural, and tobacco industry-related factors. Although provider and patient perspectives are changing, smoking has been a historically accepted part of behavioral health settings. Additional harm results from the economic burden imposed by purchasing cigarettes and enduring the stigma attached to smoking. Tailored treatment for this population involves standard cessat…
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Barriers to improvement of mental health services in low-income and middle-income countries.
Despite the publication of high-profile reports and promising activities in several countries, progress in mental health service development has been slow in most low-income and middle-income countries. We reviewed barriers to mental health service development through a qualitative survey of international mental health experts and leaders. Barriers include the prevailing public-health priority agenda and its effect on funding; the complexity of and resistance to decentralisation of mental health services; challenges to implementation of mental health care in primary-care settings; the low numbers and few types of workers who are trained and supervised in mental health care; and the frequent scarcity of public-health perspectives in mental health leadership. Many of the barriers to progress in improvement of mental health services can be overcome by generation of political will for the or…
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Scale up services for mental disorders: a call for action.
We call for the global health community, governments, donors, multilateral agencies, and other mental health stakeholders, such as professional bodies and consumer groups, to scale up the coverage of services for mental disorders in all countries, but especially in low-income and middle-income countries. We argue that a basic, evidence-based package of services for core mental disorders should be scaled up, and that protection of the human rights of people with mental disorders and their families should be strengthened. Three questions are critical to the scaling-up process. What resources are needed? How can progress towards these goals be monitored? What should be the priorities for mental health research? To address these questions, we first estimated that the amount needed to provide services on the necessary scale would be US$2 per person per year in low-income countries and $3-4 in…
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Patel V, Araya R, Chatterjee S, Chisholm D, Cohen A, De Silva M, Hosman C, McGuire H, Rojas G, van Ommeren M (2007)reviewMEDLINE-indexed journal, not yet read by usLancet (London, England)520 citations Treatment and prevention of mental disorders in low-income and middle-income countries.
We review the evidence on effectiveness of interventions for the treatment and prevention of selected mental disorders in low-income and middle-income countries. Depression can be treated effectively in such countries with low-cost antidepressants or with psychological interventions (such as cognitive-behaviour therapy and interpersonal therapies). Stepped-care and collaborative models provide a framework for integration of drug and psychological treatments and help to improve rates of adherence to treatment. First-generation antipsychotic drugs are effective and cost effective for the treatment of schizophrenia; their benefits can be enhanced by psychosocial treatments, such as community-based models of care. Brief interventions delivered by primary-care professionals are effective for management of hazardous alcohol use, and pharmacological and psychosocial interventions have some bene…
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Green J (2006)reviewMEDLINE-indexed journal, not yet read by usJournal of child psychology and psychiatry, and allied disciplines63 citations Annotation: the therapeutic alliance--a significant but neglected variable in child mental health treatment studies.
Background: There has been relatively little research into therapeutic alliance in child and adolescent mental health and virtually no incorporation of alliance measures as a variable in treatment trials in Child and Adolescent Mental Health Services (CAMHS).
Method: A selective literature review on studies in therapeutic alliance in adulthood and childhood along with a theoretical formulation of possible mechanisms of alliance.
Results: Therapeutic alliance is reliably measurable both by observation and questionnaire methods at all points in the treatment cycle. In both adult and child studies it shows a consistent, albeit modest, association with treatment outcome. In specific adult studies it has shown a high predictive validity in relation to outcome compared to other variables. In child studies alliance is particularly salient in externalising disorder and predicts outcome of inpati…
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Skodol AE, Gunderson JG, Shea MT, McGlashan TH, Morey LC, Sanislow CA, Bender DS, Grilo CM, Zanarini MC, Yen S, Pagano ME, Stout RL (2005)reviewMEDLINE-indexed journal, not yet read by usJournal of personality disorders210 citations The Collaborative Longitudinal Personality Disorders Study (CLPS): overview and implications.
The Collaborative Longitudinal Personality Disorders Study (CLPS; Gunderson et al., 2000) was developed to fill gaps in our understanding of the nature, course, and impact of personality disorders (PDs). Here, we review published findings to date, discuss their implications for current conceptualizations of PDs, and raise questions that warrant future consideration. We have found that PDs are more stable than major depressive disorder, but that meaningful improvements are possible and not uncommon. We have confirmed also that PDs constitute a significant public health problem, with respect to associated functional impairment, extensive treatment utilization, negative prognostic impact on major depressive disorder, and suicide risk. At the same time, we have demonstrated that dimensional models of PDs have clinical validity that categories do not, especially greater temporal stability. Fu…
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Kazak AE (2005)reviewMEDLINE-indexed journal, not yet read by usJournal of pediatric psychology109 citations Evidence-based interventions for survivors of childhood cancer and their families.
Objective: To summarize existing empirical reports of psychological interventions for children with cancer and their families and to outline directions for future work.
Methods: Research accomplishments related to four areas were summarized: understanding and reducing procedural pain; realizing long-term consequences; appreciating distress at diagnosis and over time; and knowing the importance of social relationships. Recommendations for future research in this field were discussed in three domains: balancing competence and psychopathology; integrating research-based interventions into clinical care; future directions).
Results and conclusions: Interventions related to procedural pain and distress have strong empirical support. Although most survivors of childhood cancer and their families adjust quite well as they complete treatment, evidence-based interventions during and after treatme…
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Explaining non-help-seeking amongst young adults with mental distress: a dynamic interpretive model of illness behaviour.
Mental disorder is common amongst young adults and is associated with many adverse outcomes. Data, however, indicate that young adults are particularly unlikely to seek help for such distress. This paper describes a qualitative study of 23 young adults (aged 16 to 24 years) with mental distress. Interviewing was used to obtain detailed narratives of illness behaviour and to explore reasons for non-help-seeking. Help-seekers and non-help-seekers were interviewed. The findings allowed development of an explanatory model - the cycle of avoidance (COA) - which contributes towards attempts to provide a dynamic understanding of help-seeking behaviour. Dominant approaches tend to be deterministic and static and to account for non-help-seeking in terms of 'barriers' to care, which although easily translated into targets for policy intervention, are superficial representations of complex issues. …
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Torres AR, Prince MJ, Bebbington PE, Bhugra D, Brugha TS, Farrell M, Jenkins R, Lewis G, Meltzer H, Singleton N (2006)MEDLINE-indexed journal, not yet read by usThe American journal of psychiatry231 citations Obsessive-compulsive disorder: prevalence, comorbidity, impact, and help-seeking in the British National Psychiatric Morbidity Survey of 2000.
Objective: There is little information about obsessive-compulsive disorder in large representative community samples. The authors aimed to establish obsessive-compulsive disorder prevalence and its clinical typology among adults in private households in Great Britain and to obtain generalizable estimates of impairment and help-seeking.
Method: Data from the British National Psychiatric Morbidity Survey of 2000, comprising 8,580 individuals, were analyzed using appropriate measurements. The study compared individuals with obsessive-compulsive disorder, individuals with other neurotic disorders, and a non-neurotic comparison group. ICD-10 diagnoses were derived from the Clinical Interview Schedule-Revised.
Results: The authors identified 114 individuals (74 women, 40 men) with obsessive-compulsive disorder, with a weighted 1-month prevalence of 1.1%. Most individuals (55%) in the obsessive…
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Predictors of help-seeking behaviour in people with mental health problems: a 3-year prospective community study.
Background: The majority of people with mental illness do not seek help at all or only with significant delay. To reduce help-seeking barriers for people with mental illness, it is therefore important to understand factors predicting help-seeking. Thus, we prospectively examined potential predictors of help-seeking behaviour among people with mental health problems (N = 307) over 3 years.
Methods: Of the participants of a 3-year follow-up of a larger community study (response rate: 66.4%), data of 307 (56.6%) persons with any mental health problems (age-at-baseline: 16-40 years) entered a structural equation model of the influence of help-seeking, stigma, help-seeking attitudes, functional impairments, age and sex at baseline on subsequent help-seeking for mental health problems.
Results: Functional impairment at baseline was the strongest predictor of follow-up help-seeking in the model…
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Illness perceptions and health beliefs in persons with common mental disorders.
Introduction: Help seeking is crucial in the context of illness management and care. Various psychological factors impact this process of help-seeking. In this background, the present study explored illness perceptions, attitudes to help-seeking, work and social adjustment in addition to clinical correlates, in a sample of 63 treatment seeking individuals.
Methods: The study adopted a cross-sectional single group design. Participants were assessed on the Brief Illness Perception Questionnaire, Attitudes Toward Seeking Professional Psychological Help Scale, General Self-efficacy Scale, Internalized Stigma and Work and Social Adjustment Scale.
Results: Majority had illness duration of about 6 years and had delayed seeking treatment for about one and half years. Participants reported higher emotional reactions to illness, concerns regarding effectiveness of treatment and understanding and m…
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Individuals with currently untreated mental illness: causal beliefs and readiness to seek help.
Aims: Many people with mental illness do not seek professional help. Beliefs about the causes of their current health problem seem relevant for initiating treatment. Our aim was to find out to what extent the perceived causes of current untreated mental health problems determine whether a person considers herself/himself as having a mental illness, perceives need for professional help and plans to seek help in the near future.
Methods: In a cross-sectional study, we examined 207 untreated persons with a depressive syndrome, all fulfilling criteria for a current mental illness as confirmed with a structured diagnostic interview (Mini International Neuropsychiatric Interview). The sample was recruited in the community using adverts, flyers and social media. We elicited causal explanations for the present problem, depression literacy, self-identification as having a mental illness, perceive…
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Evaluation of an anti-stigma campaign related to common mental disorders in rural India: a mixed methods approach.
Background: Stigma related to mental health is a major barrier to help-seeking resulting in a large treatment gap in low- and middle-income countries (LMIC). This study assessed changes in knowledge, attitude and behaviour, and stigma related to help-seeking among participants exposed to an anti-stigma campaign.
Method: The campaign, using multi-media interventions, was part of the SMART Mental Health Project, conducted for 3 months, across 42 villages in rural Andhra Pradesh, in South India. Mixed-methods evaluation was conducted in two villages using a pre-post design.
Results: A total of 1576 and 2100 participants were interviewed, at pre- and post-intervention phases of the campaign. Knowledge was not increased. Attitudes and behaviours improved significantly (p < 0.01). Stigma related to help-seeking reduced significantly (p < 0.05). Social contact and drama were the most beneficial…
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Social determinants for understanding Muslims' intentions toward seeking mental health help based on the Theory of Planned Behavior.
Background: Many have found that minorities seek help for mental health problems less than the general population. Such findings are surprising considering that minorities experience higher rates of mental health issues compared to the general population.
Objectives: Employing the Theory of Planned Behavior (TPB), this study aimed to explore the intentions of Muslims living in California and Israel pertaining seeking mental health help (SMHH).
Method and design: A qualitative approach involving semi-structured interviews guided by TPB principles was conducted with 78 participants. Thematic analysis was implemented to identify key themes.
Results: Five major themes were identified: 1 - Attitudes: Normalization of SMHH entangled with fear; causes and attributions of mental health disorders; perspectives on treatment. 2 - Subjective norms: Support groups; stigma and social norms. 3 - Percei…
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Resettlement Workforce Perspectives on Mental Health Care of Refugees.
Background: To identify the mental health care needs of resettled refugees, researchers have studied the perspectives of mental health service providers but have paid limited attention to the perspectives of individuals who work directly in resettlement agencies or in agencies that exclusively provide services to promote refugees' self-sufficiency and integration-the refugee resettlement workforce-who routinely provide support, make referrals, and coordinate mental health care. To better inform programming and service delivery, this qualitative case study focuses on the perspectives of the resettlement workforce.
Methods: Focus group interviews conducted with 48 refugee resettlement workforce members were analyzed for their perspectives on refugee mental health needs and care.
Results: Thematic analysis revealed that their perspectives centered on barriers to (i.e., resettlement challeng…
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Topçu MT, Mösko M (2025)MEDLINE-indexed journal, not yet read by usInternational journal for equity in health1 citations Building trust and relationship across language barriers: a qualitative study of interpreter-mediated psychotherapy with therapists, interpreters and patients.
Background: Among a variety of barriers to accessing and providing mental health care for migrant and refugee populations, language barriers play a crucial role. Interpreter-mediated psychotherapy (IMP) has emerged as an effective approach to overcoming these challenges and promoting equitable access to mental health care. However, IMP also introduces a more complex relationship structure: the classical therapist-patient dyad evolves into a triad. Relational qualities such as trust, empathy, and mutual understanding are known to be key indicators of a positive therapeutic relationship. Despite the utilisation of interpreters, research on the relational qualities of IMP remains limited. While several qualitative studies have explored relational dynamics in IMP, few have examined these from the perspective of all parties, particularly by incorporating patient's perspectives. Therefore, thi…
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Medications for opioid use disorder and other evidence-based service offerings in faith-affiliated treatment centers: Implications for implementation partnerships.
Introduction: Amidst an ongoing surge of opioid use disorder (OUD) incidence, clinicians and policymakers are seeking partnerships with faith communities - including with faith-affiliated treatment centers (FATCs) - to expand access to evidence-based OUD treatment. However, little is known whether FATCs differentially offer such evidence-based treatment services, particularly medications for opioid use disorder (MOUD) and co-occurring mental health care.
Methods: We use the 2021 National Substance Use and Mental Health Services Survey (N-SUMHSS) to examine differences in provision of several OUD services, including MOUD, psychological treatments, mental health services, medical services, recovery support services, and services related to treatment accessibility, between self-identified FATCs and non-FATCs. We also explored differences in characteristics related to insurance, licensure, a…
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