Help seeking and service access

وَجَآءَ رَجُلࣱ مِّنۡ أَقۡصَا ٱلۡمَدِينَةِ يَسۡعَىٰ قَالَ يَٰمُوسَىٰٓ إِنَّ ٱلۡمَلَأَ يَأۡتَمِرُونَ بِكَ لِيَقۡتُلُوكَ فَٱخۡرُجۡ إِنِّي لَكَ مِنَ ٱلنَّٰصِحِينَ

Then a man came running from the furthest part of the city and said, ‘Moses, the authorities are talking about killing you, so leave- this is my sincere advice.’

وَقَاسَمَهُمَآ إِنِّي لَكُمَا لَمِنَ ٱلنَّٰصِحِينَ

and he swore to them, ‘I am giving you sincere advice’

أُبَلِّغُكُمۡ رِسَٰلَٰتِ رَبِّي وَأَنصَحُ لَكُمۡ وَأَعۡلَمُ مِنَ ٱللَّهِ مَا لَا تَعۡلَمُونَ

I am delivering my Lord’s messages to you and giving you sincere advice. I know things from God that you do not

فَتَوَلَّىٰ عَنۡهُمۡ وَقَالَ يَٰقَوۡمِ لَقَدۡ أَبۡلَغۡتُكُمۡ رِسَالَةَ رَبِّي وَنَصَحۡتُ لَكُمۡ وَلَٰكِن لَّا تُحِبُّونَ ٱلنَّٰصِحِينَ

So he turned away from them, saying, ‘My people, I delivered my Lord’s messages to you and gave you sincere advice, but you did not like those who gave sincere advice.’

فَتَوَلَّىٰ عَنۡهُمۡ وَقَالَ يَٰقَوۡمِ لَقَدۡ أَبۡلَغۡتُكُمۡ رِسَٰلَٰتِ رَبِّي وَنَصَحۡتُ لَكُمۡۖ فَكَيۡفَ ءَاسَىٰ عَلَىٰ قَوۡمࣲ كَٰفِرِينَ

so he turned away from them, saying, ‘My people, I delivered my Lord’s messages to you and gave you sincere advice, so why should I grieve for people who refused to believe?’

And he swore to both of them that is he swore to both of them by God ‘Truly I am a sincere adviser to you’ in this matter.

I convey to you read ublighkum or uballighukum the Messages of my Lord and I am advising you I desire good for you for I know from God what you know not.

So he turned his back on them Sālih left them and said ‘O my people I have conveyed to you the Message of my Lord and gave you sincere advice but you do not love sincere advisers’.

"And O Adam! Dwell you and your wife in Paradise, and eat thereof as you both wish, but approach not this tree otherwise you both will be of the wrongdoers (19)Then Shaytan whispered suggestions to them both in order to uncover that which was hidden from them of their private parts (before); he said: "Your Lord did not forbid you this tree save you should become angels or become of the immortals. (20)And he 'Qāsamahuma': "Verily, I am one of the sincere well-wishers for you both. (21) Shaytan's Deceit with Adam and Hawwa' and Their eating from the Forbidden Tree Allah states that He allowed Adam and his wife to dwell in Paradise and to eat from all of its fruits, except one tree. We have already discussed this in Surat Al-Baqarah. Thus, Shaytan envied them and plotted deceitfully, whispering and suggesting treachery. He wished to rid them of the various favors and nice clothes that the

Indeed, We sent Nuh to his people and he said: "O my people! Worship Allah! You have no other god but Him. Certainly, I fear for you the torment of a Great Day! (59)The leaders of his people said: "Verily, we see you in plain error. (60)[Nuh] said: "O my people! There is no error in me, but I am a Messenger from the Lord of all that exists (61)I convey unto you the Messages of my Lord and give sincere advice to you. And I know from Allah what you know not. (62) The Story of Nuh and His People After Allah mentioned the story of Adam in the beginning of this Surah, He started mentioning the stories of the Prophets, the first then the latter of them. Allah mentioned the story of Nuh, because he was the first Messenger Allah sent to the people of the earth after Adam. His name was Nuh bin Lamak bin Matushalakh bin Khanukh. And Khanukh was, as they claim, the Prophet Idris. And Idris was th

Then he [Salih] turned from them, and said: "O my people! I have indeed conveyed to you the Message of my Lord, and have given you good advice, but you like not good advisers. (79) These are the words of admonishment that Salih conveyed to his people after Allah destroyed them for defying Him, rebelling against Him, refusing to accept the truth, avoiding guidance, and preferring misguidance instead. Salih said these words of admonishment and criticism to them after they perished, and they heard him (as a miracle for Prophet Salih from Allah). Similarly, it is recorded in the Two Sahihs that after the Messenger of Allah ﷺ defeated the disbelievers in the battle of Badr, he remained in that area for three days, and then rode his camel, which was prepared for him during the latter part of the night. He went on until he stood by the well of Badr (where the corpses of the disbelievers were t

حَدَّثَنِي عَبْدُ اللَّهِ بْنُ مُحَمَّدٍ، حَدَّثَنَا عَبْدُ الْمَلِكِ بْنُ عَمْرٍو، حَدَّثَنَا زُهَيْرُ بْنُ مُحَمَّدٍ، عَنْ مُحَمَّدِ بْنِ عَمْرِو بْنِ حَلْحَلَةَ، عَنْ عَطَاءِ بْنِ يَسَارٍ، عَنْ أَبِي سَعِيدٍ الْخُدْرِيِّ، وَعَنْ أَبِي هُرَيْرَةَ، عَنِ النَّبِيِّ صلى الله عليه وسلم قَالَ ‏ "‏ مَا يُصِيبُ الْمُسْلِمَ مِنْ نَصَبٍ وَلاَ وَصَبٍ وَلاَ هَمٍّ وَلاَ حُزْنٍ وَلاَ أَذًى وَلاَ غَمٍّ حَتَّى الشَّوْكَةِ يُشَاكُهَا، إِلاَّ كَفَّرَ اللَّهُ بِهَا مِنْ خَطَايَاهُ ‏"‏‏.‏

Narrated Abu Sa`id Al-Khudri and Abu Huraira:The Prophet (ﷺ) said, "No fatigue, nor disease, nor sorrow, nor sadness, nor hurt, nor distress befalls a Muslim, even if it were the prick he receives from a thorn, but that Allah expiates some of his sins for that

حَدَّثَنَا إِبْرَاهِيمُ بْنُ الْمُنْذِرِ، قَالَ حَدَّثَنِي مُحَمَّدُ بْنُ فُلَيْحٍ، قَالَ حَدَّثَنِي أَبِي، عَنْ هِلاَلِ بْنِ عَلِيٍّ، مِنْ بَنِي عَامِرِ بْنِ لُؤَىٍّ عَنْ عَطَاءِ بْنِ يَسَارٍ، عَنْ أَبِي هُرَيْرَةَ ـ رضى الله عنه ـ قَالَ قَالَ رَسُولُ اللَّهِ صلى الله عليه وسلم ‏ "‏ مَثَلُ الْمُؤْمِنِ كَمَثَلِ الْخَامَةِ مِنَ الزَّرْعِ مِنْ حَيْثُ أَتَتْهَا الرِّيحُ كَفَأَتْهَا، فَإِذَا اعْتَدَلَتْ تَكَفَّأُ بِالْبَلاَءِ، وَالْفَاجِرُ كَالأَرْزَةِ صَمَّاءَ مُعْتَدِلَةً حَتَّى يَقْصِمَهَا اللَّهُ إِذَا شَاءَ ‏"‏‏.‏

Narrated Abu Huraira:Allah's Messenger (ﷺ) said, "The example of a believer is that of a fresh tender plant; from whatever direction the wind comes, it bends it, but when the wind becomes quiet, it becomes straight again. Similarly, a believer is afflicted with calamities (but he remains patient till Allah removes his difficulties.) And an impious wicked person is like a pine tree which keeps hard and straight till Allah cuts (breaks) it down when He wishes." (See Hadith No. 558, Vol)

حَدَّثَنَا مُحَمَّدُ بْنُ يَحْيَى، قال حَدَّثَنَا إِسْحَاقُ بْنُ مُحَمَّدٍ الْفَرْوِيُّ، قال حَدَّثَنَا إِسْمَاعِيلُ بْنُ جَعْفَرٍ، عَنْ عُمَارَةَ بْنِ غَزِيَّةَ، عَنْ عَاصِمِ بْنِ عُمَرَ بْنِ قَتَادَةَ، عَنْ مَحْمُودِ بْنِ لَبِيدٍ، عَنْ قَتَادَةَ بْنِ النُّعْمَانِ، أَنَّ رَسُولَ اللَّهِ صلى الله عليه وسلم قَالَ ‏ "‏ إِذَا أَحَبَّ اللَّهُ عَبْدًا حَمَاهُ الدُّنْيَا كَمَا يَظَلُّ أَحَدُكُمْ يَحْمِي سَقِيمَهُ الْمَاءَ ‏"‏ ‏.‏ قَالَ أَبُو عِيسَى وَفِي الْبَابِ عَنْ صُهَيْبٍ وَأُمِّ الْمُنْذِرِ ‏.‏ وَهَذَا حَدِيثٌ حَسَنٌ غَرِيبٌ ‏.‏ وَقَدْ رُوِيَ هَذَا الْحَدِيثُ عَنْ مَحْمُودِ بْنِ لَبِيدٍ عَنِ النَّبِيِّ صلى الله عليه وسلم مُرْسَلاً ‏.‏ حَدَّثَنَا عَلِيُّ بْنُ حُجْرٍ، قال أَخْبَرَنَا إِسْمَاعِيلُ بْنُ جَعْفَرٍ، عَنْ عَمْرِو بْنِ أَبِي عَمْرٍو، عَنْ عَاصِمِ بْنِ عُمَرَ بْنِ قَتَادَةَ، عَنْ مَحْمُودِ بْنِ لَبِيدٍ، عَنِ النَّبِيِّ صلى الله عليه وسلم نَحْوَهُ وَلَمْ يَذْكُرْ فِيهِ عَنْ قَتَادَةَ بْنِ النُّعْمَانِ ‏.‏ قَالَ أَبُو عِيسَى وَقَتَادَةُ بْنُ النُّعْمَانِ الظَّفَرِيُّ هُوَ أَخُو أَبِي سَعِيدٍ الْخُدْرِيِّ لأُمِّهِ وَمَحْمُودُ بْنُ لَبِيدٍ قَدْ أَدْرَكَ النَّبِيَّ صلى الله عليه وسلم وَرَآهُ وَهُوَ غُلاَمٌ صَغِيرٌ ‏.‏

Qatadah bin An-Nu'man narrated that the Messenger of Allah (s.a.w) said:"When Allah loves a slave, He prevents him from the world, just as one of you prevents his sick from water." Another chain reports a similar narration

حَدَّثَنَا عَبَّاسُ بْنُ مُحَمَّدٍ الدُّورِيُّ، قال حَدَّثَنَا يُونُسُ بْنُ مُحَمَّدٍ، قال حَدَّثَنَا فُلَيْحُ بْنُ سُلَيْمَانَ، عَنْ عُثْمَانَ بْنِ عَبْدِ الرَّحْمَنِ التَّيْمِيِّ، عَنْ يَعْقُوبَ بْنِ أَبِي يَعْقُوبَ، عَنْ أُمِّ الْمُنْذِرِ، قَالَتْ دَخَلَ عَلَىَّ رَسُولُ اللَّهِ صلى الله عليه وسلم وَمَعَهُ عَلِيٌّ وَلَنَا دَوَالٍ مُعَلَّقَةٌ قَالَتْ فَجَعَلَ رَسُولُ اللَّهِ صلى الله عليه وسلم يَأْكُلُ وَعَلِيٌّ مَعَهُ يَأْكُلُ ‏.‏ فَقَالَ رَسُولُ اللَّهِ صلى الله عليه وسلم لِعَلِيٍّ ‏"‏ مَهْ مَهْ يَا عَلِيُّ فَإِنَّكَ نَاقِهٌ ‏"‏ ‏.‏ قَالَ فَجَلَسَ عَلِيٌّ وَالنَّبِيُّ صلى الله عليه وسلم يَأْكُلُ ‏.‏ قَالَتْ فَجَعَلْتُ لَهُمْ سِلْقًا وَشَعِيرًا فَقَالَ النَّبِيُّ صلى الله عليه وسلم ‏"‏ يَا عَلِيُّ مِنْ هَذَا فَأَصِبْ فَإِنَّهُ أَوْفَقُ لَكَ ‏"‏ ‏.‏ قَالَ أَبُو عِيسَى هَذَا حَدِيثٌ حَسَنٌ غَرِيبٌ لاَ نَعْرِفُهُ إِلاَّ مِنْ حَدِيثِ فُلَيْحٍ ‏.‏ وَيُرْوَى عَنْ فُلَيْحٍ عَنْ أَيُّوبَ بْنِ عَبْدِ الرَّحْمَنِ ‏.‏ حَدَّثَنَا مُحَمَّدُ بْنُ بَشَّارٍ، قال حَدَّثَنَا أَبُو عَامِرٍ، وَأَبُو دَاوُدَ قَالاَ حَدَّثَنَا فُلَيْحُ بْنُ سُلَيْمَانَ، عَنْ أَيُّوبَ بْنِ عَبْدِ الرَّحْمَنِ، عَنْ يَعْقُوبَ، عَنْ أُمِّ الْمُنْذِرِ الأَنْصَارِيَّةِ، فِي حَدِيثِهِ قَالَتْ دَخَلَ عَلَيْنَا رَسُولُ اللَّهِ صلى الله عليه وسلم فَذَكَرَ نَحْوَ حَدِيثِ يُونُسَ بْنِ مُحَمَّدٍ إِلاَّ أَنَّهُ قَالَ ‏"‏ أَنْفَعُ لَكَ ‏"‏ ‏.‏ وَقَالَ مُحَمَّدُ بْنُ بَشَّارٍ وَحَدَّثَنِيهِ أَيُّوبُ بْنُ عَبْدِ الرَّحْمَنِ ‏.‏ هَذَا حَدِيثٌ جَيِّدٌ غَرِيبٌ ‏.‏

Umm Al-Mundhir said:"The Messenger of Allah (ﷺ) entered upon me, while `Ali was with him, and we had a cluster of unripe dates hanging." She said: "The Messenger of Allah (ﷺ) began eating, and `Ali ate with him. The Messenger of Allah (ﷺ) said to `Ali: 'Stop, stop, for you are still recovering.' So `Ali sat and the Prophet (ﷺ) ate." She said: "I made some chard and barley for them, so the Prophet (ﷺ) said: 'O `Ali eat from this, for indeed it will be more suitable for you." Another chain reports a similar narration

قال أبو حاتم رضى الله عنه لا أنس آنس من استشارة عاقل ودود ولا وحشة أوحش من مخالفته لأن المشاورة والمناظرة بابا بركة ومفتاحا رحمة من استشير فليشر بالنصيحة وليجتهد بالرأي وليلزم الحق وقصد السبيل وليجعل المستشير كنفسه بترك الخيانه وبذل النصيحه وليكن كما أنشدني على ابن محمد البسامي % ومن الرجال إذا زكت أحلامهم % من يستشار إذا أستشير فيطرق % % حتى يجول بكل واد قلبه % فيرى ويعرف ما يقول وينطق % % إن الحليم إذا تفكر لم يكد % يخفي عليه من الأمور الأوفق % $

ألا قل لهم قول عبد % نصوح وحق النصيحة أن تستمع

فلا أحسن من هذه النصيحة وهذا الإرشاد والتعليم الذي لو أخذ به الناس لم يضع في الأكثر حق أحد ولم يتمكن المبطل من الجحود والنسيان

وحق الله تعالى في الطاعة ستة أمور تقدمت وهي : الإخلاص في العمل والنصيحة لله فيه ومتابعة الرسول فيه وشهود مشهد الإحسان فيه وشهود منة الله عليه وشهود تقصيره فيه بعد ذلك كله

وقيل مجالسة العارف تدعوك من ست إلى ست من الشك إلى اليقين ومن الرياء إلى الإخلاص ومن الغفلة إلى الذكر ومن الرغبة في الدنيا إلى الرغبة في الآخرة ومن الكبر إلى التواضع ومن سوء الطوية إلى النصيحة

وكل قبول في الناس وتعظيم ومحبة له اتصل به خضوع للرب وذل وانكسار ومعرفة بعيب النفس والعمل وبذل النصيحة للخلق فهو منة وإلا فهو حجة

Mental health care utilisation and access among refugees and asylum seekers in Europe: A systematic review.: Background: Refugees and asylum seekers often have increased mental health needs, yet may face barriers in accessing mental health and psychosocial support (MHPSS) services in destination countries. The aim of this systematic review is to examine evidence on MHPSS service utilisation and access among refugees and asylum seekers in European Union Single Market countries. Methods: Four peer-reviewed and eight grey literature databases were searched for quantitative and qualitative literature from

Perceived barriers and facilitators to mental health help-seeking in young people: a systematic review.: Background: Adolescents and young adults frequently experience mental disorders, yet tend not to seek help. This systematic review aims to summarise reported barriers and facilitators of help-seeking in young people using both qualitative research from surveys, focus groups, and interviews and quantitative data from published surveys. It extends previous reviews through its systematic research methodology and by the inclusion of published studies describing what young people themselves perceive

What are the barriers, facilitators and interventions targeting help-seeking behaviours for common mental health problems in adolescents? A systematic review.: Background: Increasing rates of mental health problems among adolescents are of concern. Teens who are most in need of mental health attention are reluctant to seek help. A better understanding of the help-seeking in this population is needed to overcome this gap. Methods: Five databases were searched to identify the principal barriers, facilitators and interventions targeting help-seeking for common mental health problems in adolescents aged 10-19 years. The search was performed in June 2018 an

Delays in help seeking at the onset of the symptoms of rheumatoid arthritis: a systematic synthesis of qualitative literature.: A systematic review of qualitative peer-reviewed publications was conducted to identify drivers of and barriers to help-seeking behaviour in adults with new-onset rheumatoid arthritis (RA). 1058 abstracts were searched to identify relevant publications. 21 relevant publications were identified assessed for quality and subjected to analysis informed by thematic and grounded theory frameworks. Several interacting themes were identified including the early experience of symptoms in relation to dise

Efficacy, cost-effectiveness and acceptability of self-help interventions for anxiety disorders: systematic review.: Background: Self-help interventions for psychiatric disorders represent an increasingly popular alternative to therapist-administered psychological therapies, offering the potential of increased access to cost-effective treatment. Aims: To determine the efficacy, cost-effectiveness and acceptability of self-help interventions for anxiety disorders. Method: Randomised controlled trials (RCTs) of self-help interventions for anxiety disorders were identified by searching nine online databases. Stud

Health beliefs and perceived need for mental health care of anxiety and depression--the patients' perspective explored.: Patients' illness representations and beliefs about treatment for depression and anxiety, as well as their perceived needs, are important for treatment. A systematic review was conducted of 71 studies describing the beliefs or perceived needs of patients and non-patients. Patients give multi-dimensional explanations for depression and see both psychological and medication treatment as helpful. People who suffer from depression have more positive beliefs about biological etiology and medication t

Recovery and economy; salary and allowances: a 10-year follow-up of income for persons diagnosed with first-time psychosis.

Purpose: Persons with severe mental health problems (SMHP) point out financial strain as one of their main problems. De-institutionalisation in welfare countries has aimed at normalisation of their living conditions. The aim of the study was to follow the changes in income and source of income during a 10-year period for persons with a first-time psychosis diagnosis (FTPD). Methods: Data were gathered from different registers. Data from persons with FTPD were compared to data on the general population. Two groups with different recovery paths were also compared: one group without contact with the mental health services during the last five consecutive years of the 10-year follow-up, and the other with contact with both 24/7 and community-based services during the same period. Results: SMHP led to poverty, even if the financial effects of SMHP were attenuated by welfare interventions. Eve…

matched on Mental Health Services (mesh)

The Collaborative Chronic Care Model for Mental Health Conditions: From Evidence Synthesis to Policy Impact to Scale-up and Spread.

Background: Extensive evidence indicates that Collaborative Chronic Care Models (CCMs) improve outcome in chronic medical conditions and depression treated in primary care. Beginning with an evidence synthesis which indicated that CCMs are also effective for multiple mental health conditions, we describe a multistage process that translated this knowledge into evidence-based health system change in the US Department of Veterans Affairs (VA). Evidence synthesis: In 2010, recognizing that there had been numerous CCM trials for a wide variety of mental health conditions, we conducted an evidence synthesis compiling randomized controlled trials of CCMs for any mental health condition. The systematic review demonstrated CCM effectiveness across mental health conditions and treatment venues. Cumulative meta-analysis and meta-regression further informed our approach to subsequent CCM implementa…

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Clinical Stage Transitions in Persons Aged 12 to 25 Years Presenting to Early Intervention Mental Health Services With Anxiety, Mood, and Psychotic Disorders.

Importance: The large contribution of psychiatric disorders to premature death and persistent disability among young people means that earlier identification and enhanced long-term care for those who are most at risk of developing life-threatening or chronic disorders is critical. Clinical staging as an adjunct to diagnosis to address emerging psychiatric disorders has been proposed for young people presenting for care; however, the longer-term utility of this system has not been established. Objectives: To determine the rates of transition from earlier to later stages of anxiety, mood, psychotic, or comorbid disorders and to identify the demographic and clinical characteristics that are associated with the time course of these transitions. Design, setting, and participants: A longitudinal, observational study of 2254 persons aged 12 to 25 years who obtained mental health care at 2 early…

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Muslims and mental health concerns: A social ecological model perspective.

Muslims in the United States experience many psychosocial issues and underutilize mental health services. This study sought to systematically identify the common issues and strengths of the Muslims affiliated with a college in the Southeast region of the United States and address them accordingly. A survey comprising 33 items and 2 open-ended questions regarding common issues and strengths was constructed. A total of 116 participants completed the survey. The overall rating for items was quite high, whereas the satisfaction rating was very low. The most important item was, "You have prayer places/rugs, ablution stations, and water in restrooms," with an importance rating of 94.52% and a satisfaction rating of 20.50%. Four items regarding mental health were rated as the least important, and participants reported lack of knowledge regarding mental health services. This is the first study t…

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Enhancing prevention and intervention for youth concurrent mental health and substance use disorders: The Research and Action for Teens study.

Background: Concurrent mental health and substance use disorders among youth are associated with functional impairment in developmentally salient domains, yet research on prevention and intervention for this vulnerable population is sparse. This paper describes the rationale and design of the Research and Action for Teens study, an initiative designed to strengthen the evidence base for prevention, screening, treatment and service delivery for youth concurrent mental health and substance use concerns. Methods: Four sub-studies were developed: (1) a cohort study examining the emergence of mental health and substance use concerns from early to mid-adolescence; (2) a screening and diagnosis study validating screening tools with a diagnostic interview; (3) a treatment study examining the feasibility and effectiveness of dialectical behaviour therapy skills training interventions for youth an…

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Implementation of the Safewards model in public mental health facilities: A qualitative evaluation of staff perceptions.

Background: The Safewards model is gaining increasing acceptance in the mental health field in Australia and overseas. One of the most important goals of inpatient psychiatric services is to provide a safe and therapeutic environment for both patients and staff. However, this goal can be difficult to achieve if staff-patient interaction is not conducive to preventing violence and aggression. Objective: The purpose of this study was to explore nursing staff perceptions of the factors impacting on their capacity to establish Safewards in acute adult inpatient wards. Design: This study was guided by a phenomenological approach to develop a rich understanding of staff perceptions using semi-structured interviews. Setting and sample: The setting was three acute mental health wards attached to general hospitals; one in a large provincial hospital and two in metropolitan hospitals in south-east…

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WHO World Mental Health Surveys International College Student Project: Prevalence and distribution of mental disorders.

Increasingly, colleges across the world are contending with rising rates of mental disorders, and in many cases, the demand for services on campus far exceeds the available resources. The present study reports initial results from the first stage of the WHO World Mental Health International College Student project, in which a series of surveys in 19 colleges across 8 countries (Australia, Belgium, Germany, Mexico, Northern Ireland, South Africa, Spain, United States) were carried out with the aim of estimating prevalence and basic sociodemographic correlates of common mental disorders among first-year college students. Web-based self-report questionnaires administered to incoming first-year students (45.5% pooled response rate) screened for six common lifetime and 12-month DSM-IV mental disorders: major depression, mania/hypomania, generalized anxiety disorder, panic disorder, alcohol us…

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The impact of waiting time on patient outcomes: Evidence from early intervention in psychosis services in England.

Recently, new emphasis was put on reducing waiting times in mental health services as there is an ongoing concern that longer waiting time for treatment leads to poorer health outcomes. However, little is known about delays within the mental health service system and its impact on patients. We explore the impact of waiting times on patient outcomes in the context of early intervention in psychosis (EIP) services in England from April 2012 to March 2015. We use the Mental Health Services Data Set and the routine outcome measure the Health of the Nation Outcome Scale. In a generalised linear regression model, we control for baseline outcomes, previous service use, and treatment intensity to account for possible endogeneity in waiting time. We find that longer waiting time is significantly associated with a deterioration in patient outcomes 12 months after acceptance for treatment for patie…

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Quality of life in family caregivers of schizophrenia patients in Spain: caregiver characteristics, caregiving burden, family functioning, and social and professional support.

Objective: Caregivers experience physical and mental stress that ends up lowering their quality of life (QoL). Our goal was to research (a) the level of caregivers QoL; (b) the relationships between the demographic characteristics of the caregivers, their caregiving burden, their family functioning, their social and professional support and their QoL and (c) the best predictors of caregivers QoL. Methods: 100 key caregivers (70% parents, 8% spouses, 17% siblings and 5% children) were studied using the world health organization quality of life-Bref (WHOQOL-BREF) to research their QoL, the Zarit Scale to assess their perception of their caregiving burden, the Social Network Questionnaire to examine their social support, the Family APGAR to assess the satisfaction with social support from the family and a professional support scale (Escala de Apoyo Profesional) to determine the professional…

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"It was the whole picture" a mixed methods study of successful components in an integrated wellness service in North East England.

Background: A growing number of Local Authorities (LAs) have introduced integrated wellness services as part of efforts to deliver cost effective, preventive services that address the social determinants of health. This study examined which elements of an integrated wellness service in the north east of England were effective in improving health and wellbeing (HWB). Methods: The study used a mixed-methods approach. In-depth semi-structured interviews (IVs) were conducted with integrated wellness service users (n = 25) and focus groups (FGs) with group based service users (n = 14) and non-service users (n = 23) to gather the views of stakeholders. Findings are presented here alongside analysis of routine monitoring data. The different data were compared to examine what each data source revealed about the effectiveness of the service. Results: Findings suggest that integrated wellness serv…

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Maternal Mental Health after Custody Loss and Death of a Child: A Retrospective Cohort Study Using Linkable Administrative Data.

Objective: The objective was to compare mental illness diagnoses and treatment use among mothers who lost custody of their child through involvement with child protection services and those seen in mothers dealing with the death of a child. Methods: We studied mental health outcomes of a cohort of women whose first child was born in Manitoba, Canada between 1 April 1997 and 31 March 2015. Of these women, 5,792 had a child taken into care, and 1,143 mothers experienced the death of a child (<18 y old) before 31 March 2015. Adjusted relative rates (ARR) of 3 mental health diagnoses and 3 mental health treatment use outcomes between these 2 groups were examined. Results: Mothers with a child taken into care had significantly greater ARR of depression (ARR = 1.90; 95% CI, 1.82 to 1.98), anxiety (ARR = 2.51; 95% CI, 2.40 to 2.63), substance use (ARR = 8.54; 95% CI, 7.49 to 9.74), physician vi…

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A benchmarking study of father involvement in Australian child mental health services.

Fathers are underrepresented in interventions focussing on child well-being, yet research suggests their involvement may be critical to enhancing intervention effectiveness. This study aimed to provide the first Australian benchmark of rates of father attendance across several child mental health services. Retrospective casefile reviews were conducted to obtain data on father and mother attendance at 10 Australian child mental health services. A total of 2128 casefile records were retrospectively examined to extract family-level data. The main outcome measures were rates of father and mother attendance at sessions involving parents, and rates of father- and mother-instigated referral to services. Across services, fathers attended on average 48.2% (range 39.7% to 72.0%) of total parent sessions, with an average of 68.4% (range 53.1% to 88.1%) of fathers attending at least one session. Mot…

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Cultural Identity Among Afghan and Iraqi Traumatized Refugees: Towards a Conceptual Framework for Mental Health Care Professionals.

Cultural identity in relation with mental health is of growing interest in the field of transcultural psychiatry. However, there is a need to clarify the concept of cultural identity in order to make it useful in clinical practice. The purpose of this study is to unravel the complexity and many layers of cultural identity, and to assess how stress and acculturation relate to (changes in) cultural identity. As part of a larger study about cultural identity, trauma, and mental health, 85 patients from Afghanistan and Iraq in treatment for trauma-related disorders were interviewed with a Brief Cultural Interview. The interviews were analysed through qualitative data analysis using the procedures of grounded theory. The analysis resulted in three domains of cultural identity: personal identity, ethnic identity and social identity. Within each domain relationships with stress and acculturatio…

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Collective narrative practice with unaccompanied refugee minors: "The Tree of Life" as a response to hardship.

During the summer of 2016, in the midst of one of the biggest refugee crises in centuries, the author of this article joined the team from a shelter for unaccompanied refugee minors on Samos, Greece, in an effort to provide young boys seeking asylum in Europe with an opportunity to engage in speaking about the difficulties they have encountered in life. The team used a collective narrative methodology called the "Tree of Life", originally developed by Ncube-Mlilo and Denborough. In addition to traditional psychological treatments, collective narrative practice creates a secure foundation for addressing trauma, suffering, and hardship. This approach takes into consideration cultural differences and is easy to access for refugees with perceived stigma of traditional mental health services. The Tree of Life is a minimum of 8-hour workshop involving a strength-based narrative methodology, us…

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Identification and treatment of offenders with attention-deficit/hyperactivity disorder in the prison population: a practical approach based upon expert consensus.

Background: Around 25% of prisoners meet diagnostic criteria for attention-deficit/hyperactivity disorder (ADHD). Because ADHD is associated with increased recidivism and other functional and behavioural problems, appropriate diagnosis and treatment can be a critical intervention to improve outcomes. While ADHD is a treatable condition, best managed by a combination of medication and psychological treatments, among individuals in the criminal justice system ADHD remains both mis- and under-diagnosed and consequently inadequately treated. We aimed to identify barriers within the prison system that prevent appropriate intervention, and provide a practical approach to identify and treat incarcerated offenders with ADHD. Methods: The United Kingdom ADHD Partnership hosted a consensus meeting to discuss practical interventions for youth (< 18 years) and adult (≥18 years) offenders with ADHD. …

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Peer Workers in the Behavioral and Integrated Health Workforce: Opportunities and Future Directions.

The growth of the peer workforce in behavioral health services is bringing opportunities to organizations and institutions that serve people living with mental and substance use disorders and their families. Peer workers are defined as people in recovery from mental illness or substance use disorders or both that possess specific peer support competencies. Similar roles are identified for families of people in recovery. Peer support has been implemented in a vast range of behavioral health services, including in the relatively new use of peer support in criminal justice and emergency service environments. Behavioral health services are striving to integrate peer workers into their workforce to augment existing service delivery, in part because peer support has demonstrated effectiveness in helping people with behavioral health conditions to connect to, engage in, and be active participan…

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What can we learn from unaccompanied refugee adolescents' perspectives on mental health care in exile?

Unaccompanied refugee adolescents who have fled war and persecution often have poor mental health. Yet, little is known about their own perspectives on what can relieve their mental health problems. The aim was to explore unaccompanied refugee adolescents' perspectives on healing and the mental healthcare offered to them when resettled. The study was based on methodical triangulation of participant observation in a Danish municipal institution for unaccompanied refugee minors, semi-structured individual interviews with experts, social workers and male refugee minors and a focus group interview with refugee minors. Results show that the refugee adolescents associated traditional conversational therapy with discussing negative and stigmatising aspects of their past and carrying risks of re-traumatisation. Instead, alternative activities were proposed, through which resources could be accum…

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Perception of inpatients following remission of a manic episode in bipolar I disorder on a group-based Psychoeducation program: a qualitative study.

Background: This forms the first study of a group-based psychoeducation program for inpatients following remission of a manic episode in patients suffering from bipolar I disorder in a Chinese population. The aim was to explore the patient's perspectives of the program and their suggestions regarding ways to improve the intervention in the future. Methods: Semi-structured and in-depth interviews were conducted with 15 participants who had participated in 8 sessions of a group psychoeducation program over 2 weeks. The verbatim transcripts of those interviews were analysed using thematic analysis. Results: Five themes emerged from the data, including the patients' perception of participating in the program, their perception of the setting, perception of participating in a group program, perception of the learning content and of the outcome of participating in the program. Conclusions: The …

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Traumatic exposure, acculturative stress and cultural orientation: the influence on PTSD, depressive and anxiety symptoms among refugees.

Objective: Acculturation studies conducted with refugees have predominantly concentrated on investigating the impact of acculturative stress on mental health, and have neglected to investigate the impact of cultural orientations towards the host and ethnic cultures. Furthermore, exposure to traumas is highly prevalent in refugees and strongly associated with mental health outcomes, however, rarely included in investigations of acculturative process of refugees. Method: Using structural equation modelling, this study tested an integrated model of the relationship between traumatic exposure, acculturative stress, host and ethnic cultural orientations and posttraumatic stress disorder (PTSD), depression and anxiety symptoms among 138 Bosnian refugees resettled in Australia and Austria. Results: The model showed an overall good fit and noteworthy amount of variance indicating that traumatic …

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A Qualitative Examination of VA Chaplains' Understandings and Interventions Related to Moral Injury in Military Veterans.

This study examines VA chaplains' understandings of moral injury (MI) and preferred intervention strategies. Drawing qualitative responses with a nationally-representative sample, content analyses indicated that chaplains' definitions of MI comprised three higher order clusters: (1) MI events, (2) mechanisms in development of MI, and (3) warning signs of MI. Similarly, chaplains' intervention foci could be grouped into three categories: (1) pastoral/therapeutic presence, (2) implementing specific interventions, and (3) therapeutic processes to promote moral repair. Findings are discussed related to emerging conceptualizations of MI, efforts to adapt existing evidence-based interventions to better address MI, and the potential benefits of better integrating chaplains into VA mental health service delivery.

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A file study of refugee children referred to specialized mental health care: from an individual diagnostic to an ecological perspective.

The past years have been characterized by a large refugee crisis across the globe. The exposure to preflight, flight, and resettlement stressors puts refugee children and their families at risk of developing emotional and behavioral disorders. A unique Western-based approach of mental health problems seems to be insufficient to address the complexity of interactions between individual vulnerabilities and more ecological surrounding systems. We looked into (1) the reasons for referral; and (2) the process diagnostic outcomes after ethnopsychiatric and psychological assessment. We conducted a thematic content analysis on 93 files of refugee children. The findings suggest that mental health care professionals need to hold into account the multiplicity and intertwining of ongoing challenges to the well-being of refugee children. The integration of a Western-based psychiatric assessment with …

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Meeting the mental health needs of today's college student: Reinventing services through Stepped Care 2.0.

A new stepped care model developed in North America reimagines the original United Kingdom model for the modern university campus environment. It integrates a range of established and emerging online mental health programs systematically along dimensions of treatment intensity and associated student autonomy. Program intensity can be either stepped up or down depending on level of client need. Because monitoring is configured to give both provider and client feedback on progress, the model empowers clients to participate actively in care options, decisions, and delivery. Not only is stepped care designed to be more efficient than traditional counseling services, early observations suggest it improves outcomes and access, including the elimination of service waitlists. This paper describes the new model in detail and outlines implementation experiences at 3 North American universities. Wh…

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Exploring the effectiveness of combined mentalization-based group therapy and dialectical behaviour therapy for inpatients with borderline personality disorder - A pilot study.

Objectives: Borderline personality disorder (BPD) is characterized by emotional instability, interpersonal dysfunction, and other features that typically develop before a background of insecure attachment and traumatic experiences. Dialectical behaviour therapy (DBT) has proven highly effective in reducing self-harm and improving emotion regulation, whereby problems concerning social cognition, which are also characteristic of BPD, may need additional approaches such as mentalization-based treatment (MBT). Methods: Here, we examined, in a pilot study, the effectiveness of MBT given adjunct to DBT, compared to DBT alone, in an inpatient sample with BPD, whereby mentalization was measured using a novel cartoon-based task. Results: Both treatments were highly effective in reducing symptom severity. The combination of DBT and MBT was superior in reducing fearful attachment and in improving a…

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Effectiveness of Mindfulness Intervention in Reducing Stress and Burnout for Mental Health Professionals in Singapore.

Introduction: Stress and burnout have been shown to be a concern among mental health professionals in several countries including Singapore, and can affect quality of care and staff turnover. The aim of this study was to examine the effectiveness of a mindfulness program in increasing mindfulness and compassion, and reducing stress and burnout, among mental health professionals in Singapore. Methods: The study utilized data from a prospective pre-post study design with follow-up. A total of 37 mental health professionals participated in the program, which was conducted in three cohorts over nine months. The program consisted of six, two-hour sessions offered once a week over six weeks, and used a range of mindfulness techniques to teach participants to cultivate compassionate and non-judgemental attitudes toward their inner experiences. Data were collected at three stages: pre- and post-…

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LGBT Identity, Untreated Depression, and Unmet Need for Mental Health Services by Sexual Minority Women and Trans-Identified People.

Background: Previous studies have found that transgender, lesbian, and bisexual people report poorer mental health relative to heterosexuals. However, available research provides little information about mental health service access among the highest need groups within these communities: bisexual women and transgender people. This study compared past year unmet need for mental health care and untreated depression between four groups: heterosexual cisgender (i.e., not transgender) women, cisgender lesbians, cisgender bisexual women, and transgender people. Materials and methods: This was a cross-sectional Internet survey. We used targeted sampling to recruit 704 sexual and gender minority people and heterosexual cisgendered adult women across Ontario, Canada. To ensure adequate representation of vulnerable groups, we oversampled racialized and low socioeconomic status (SES) women. Results…

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