David M. Ndetei and Patrick Gatonga
The aim of this paper is to review the history of mental health service improvement in Kenya, to discuss current provision of services, challenges to the provision of services and…
Abstract
Purpose
The aim of this paper is to review the history of mental health service improvement in Kenya, to discuss current provision of services, challenges to the provision of services and future needs for services.
Design/methodology/approach
The paper takes the form of a literature review.
Findings
Mental health care in Kenya has been a progressing field, though the momentum of progress has been less than desired. The reasons for this are complex including a lack of evidence of the size of the mental health burden which has undermined the political will to focus scarce resources in this area, lack of human resources, models of prevention, and robust mental health legislation. Traditional healers have a significant place in mental health care, these plus efforts to increase training on mental health, task shifting for other clinicians and also prevention may be important steps in improving access to care.
Research limitations/implications
The review highlights how much remains to be done to improve mental health services in Kenya. It demonstrates the need for good epidemiological and intervention data to support a multi‐level approach, involving government, non‐governmental organizations, communities, families, affected individuals and other stakeholders. Prevention and treatment strategies should be streamlined and emphasis put on stigma reduction as well as provision of accessible, acceptable, sustainable and affordable care.
Practical implications
A review of the literature is useful to highlight what is known but also what information is missing and is needed to go forward.
Originality/value
This is the first system level historical review of the development of mental health services in Kenya. It offers a model for investigation that may be useful for others.
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The purpose of this study is to investigate psychotherapists’ perspectives on collaborations with curanderxs that may improve patient outcomes. All participants have licensed…
Abstract
Purpose
The purpose of this study is to investigate psychotherapists’ perspectives on collaborations with curanderxs that may improve patient outcomes. All participants have licensed psychotherapists (marriage and family therapist, social work and psychology), between ages 40 and 60 years, and spoke both English and Spanish. They had a wide range of experience practicing in the field (5 to 33 years), the number of clients they had worked with of Mexican descent (10 to 2,000), and times they had collaborated with curanderxs (2 to 3 to more than 40). Interviews lasted 2 h.
Design/methodology/approach
Phenomenological methodology was followed in conducting interviews with eight mainstream mental health practitioners and in identifying codes and themes from the interviews.
Findings
Collaboration between psychotherapists and curanderxs is rare. Few mental health training programs provide basic information on curanderismo or on how clinicians might integrate concepts related to indigenous healing approaches into their practices or collaborate with traditional healers. Substantial mistrust between psychotherapists and curanderxs is apparent and impedes collaboration.
Originality/value
The authors believe this to be one of the first integrative models that can provide guidance to services providers who would like to collaborate with traditional healers, not only with Latinx populations but also populations that seek traditional healers for physical, psychological and spiritual healing. Based on study findings, the authors offer educational, clinical and public policy recommendations.
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Kamini Vasudev, Joel Lamoure, Michael Beyaert, Varinder Dua, David Dixon, Jason Eadie, Larissa Husarewych, Ragu Dhir and Jatinder Takhar
Research has shown that academic detailing (AD), which includes repeated in-person educational messages in an interactive format in a physician’s office, is among the most…
Abstract
Purpose
Research has shown that academic detailing (AD), which includes repeated in-person educational messages in an interactive format in a physician’s office, is among the most effective continuing medical education (CME) forms for improving prescribing practices and reducing drug costs. The purpose of this paper is to investigate AD’s feasibility and acceptability as an educational tool among psychiatrists and its ability to facilitate positive changes in antipsychotic prescribing.
Design/methodology/approach
All psychiatrists practicing in Southwestern Ontario, Canada were invited to participate. Participants (32/299(10.7 percent)) were provided with two educational sessions by a healthcare professional. Participants evaluated their AD visits and completed a pre- and post-AD questionnaire measuring various prescribing practice aspects.
Findings
A total of 26 out of 32 (81.3 percent) participants completed the post-AD evaluation; most of them (61.5 percent, n=16) felt that AD gave noteworthy information on tools for monitoring side-effects and 50.0 percent (n=13) endorsed using these in practice. In total, 13 participants (50.0 percent) felt that the AD sessions gave them helpful information on tools for documenting polypharmacy use, which 46.2 percent (n=12) indicated they would implement in their practice. No significant differences were found between participants’ pre- and post-assessment prescribing behaviors.
Practical implications
There is great need for raising AD program’s awareness and improving physician engagement in this process locally, provincially and nationally.
Originality/value
To the authors’ knowledge, this is the first AD program in Canada to target specialists solely. Participant psychiatrists accepted the AD intervention and perceived it as a feasible CME method.
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Eva Cyhlarova, David Crepaz-Keay, Rachel Reeves, Kirsten Morgan, Valentina Iemmi and Martin Knapp
– The purpose of this paper is to establish the effectiveness of self-management training as an intervention for people using secondary mental health services.
Abstract
Purpose
The purpose of this paper is to establish the effectiveness of self-management training as an intervention for people using secondary mental health services.
Design/methodology/approach
A self-management and peer support intervention was developed and delivered by secondary mental health service users to 262 people with psychiatric diagnoses living in the community. Data on wellbeing and health-promoting behaviour were collected at three time points (baseline, six, and 12 months).
Findings
Participants reported significant improvements in wellbeing and health-promoting lifestyle six and 12 months after self-management training. Peer-led self-management shows potential to improve long-term health outcomes for people with psychiatric diagnoses.
Research limitations/implications
Due to the lack of a control group, the positive changes cannot definitively be attributed to the intervention. Other limitations were reliance on self-report measures, and the varying numbers of completers at three time points. These issues will be addressed in future studies.
Practical implications
The evaluation demonstrated the effectiveness of self-management training for people with psychiatric diagnoses, suggesting self-management training may bring significant wellbeing gains for this group.
Social implications
This study represents a first step in the implementation of self-management approaches into mental health services. It demonstrates the feasibility of people with psychiatric diagnoses developing and delivering an effective intervention that complements existing services.
Originality/value
This is the first study to investigate the effectiveness of a self-management training programme developed and delivered by mental health service users in the UK.
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Despite a plethora of research on diversity and inclusion, workplace-related issues pertaining to individuals with schizophrenia (SCZ) remain grossly underexplored. This paper…
Abstract
Purpose
Despite a plethora of research on diversity and inclusion, workplace-related issues pertaining to individuals with schizophrenia (SCZ) remain grossly underexplored. This paper seeks to develop a relational, multilevel perspective of issues and challenges faced by individuals with SCZ in the work and career.
Design/methodology/approach
The research draws on the findings from in-depth, qualitative interviews with schizophrenic individuals, individuals’ family members, healthcare professionals and nongovernmental organization (NGO) representatives.
Findings
The findings highlight the interconnected nature of multilevel issues faced by schizophrenic individuals and indicate that at the societal level, social stigma, economic conditions and inadequate government policies are the key challenges faced by them. At the organizational level workplace support and job suitability and design affect individuals’ employment. At the individual level, self-stigma affects the employability in a negative way whereas personal motivation and resilience, family and social support and realization of illness are the facilitating factors.
Originality/value
The study adds to disability and diversity literature by developing a relational perspective that holistically captures the issues faced by schizophrenic individuals and suggests that the work and employment-related issues may be simultaneously addressed at multiple levels.
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Thomas Flamini, Natasha R. Matthews, George S. Castle and Elliot M. Jones-Williams
The purpose of this paper is to investigate perceptions towards a career in psychiatry among medical students and psychiatrists and identify how recruitment into the specialty may…
Abstract
Purpose
The purpose of this paper is to investigate perceptions towards a career in psychiatry among medical students and psychiatrists and identify how recruitment into the specialty may be improved.
Design/methodology/approach
This study locally compares medical student and psychiatric doctor responses to a structured online survey and structured interviews with key managerial figures in the Humber NHS Foundation Trust.
Findings
Comparison across two main areas (pre-decision exposure to psychiatry and reasons for considering a psychiatric career) found that both students and doctors were influenced to make a choice about a career in psychiatry during medical school. Medical students found compatibility with family life to be more important when considering psychiatry, whereas doctors cited content-based reasons as significant pull factors. Stigma and fear of being harmed deterred some students from choosing a career in psychiatry. Structured interview responses reiterated the importance of pre-medical school and undergraduate mentorship in bolstering future recruitment to psychiatry.
Practical implications
Medical students perceive certain career issues differently to their postgraduate counterparts. Widening the content-based appeal of psychiatry and optimising the medical school experience of the specialty via varied and high-quality placements may be a key step towards tackling the national shortfall in qualified psychiatrists.
Originality/value
This is the first published study comparing medical student and psychiatric doctor perceptions of a career in psychiatry.
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Rubina Begum, Fahad Riaz Choudhry, Tahir Mehmood Khan, Faizah Safina Bakrin, Yaser Mohammed Al-Worafi and Khadeeja Munawar
The term “Mental health literacy” is defined as knowledge and beliefs about mental disorders which aid their recognition, management or prevention. The importance of health…
Abstract
Purpose
The term “Mental health literacy” is defined as knowledge and beliefs about mental disorders which aid their recognition, management or prevention. The importance of health literacy for physical health is widely studied; however, the area of mental health literacy in Pakistan has been comparatively neglected. The purpose of this paper is to address the knowledge about mental health in people living in Pakistan.
Design/methodology/approach
Relevant literature relating to mental health literacy was identified through various database searches. The databases searched included: PubMed, Cochrane database of Systemic Reviews, PsycINFO using the terms mental health, mental health literacy, mental health education, Pakistan.
Findings
Literature suggests that there is dearth of knowledge about mental illnesses and their treatment among public. This review also highlights the importance of mental health literacy among professionals working in the field of health care. In Pakistan, due to low literacy rate, a high percentage of poverty and dearth of trained professionals warrants an emendation in approaches established for attaining the goal of public health and psychiatric care.
Practical implications
Findings have implications for practitioners in the field of mental health care as well as designing targeted interventions for enhancing mental health literacy and help-seeking behavior in the future.
Originality/value
A limited understanding and lack of improvement in mental health literacy may interfere with society’s acceptance of evidence-based mental health care which may hamper the delivery of adequate mental health services to the needy.
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Yaser Khajebishak, Amir Hossein Faghfouri, Ali Molaei, Vahid Rahmani, Samira Amiri, Mohammad Asghari Jafarabadi and Laleh Payahoo
This paper aims to investigate the potential relationship between depression, diabetes knowledge and self-care management with quality of life in diabetic patients.
Abstract
Purpose
This paper aims to investigate the potential relationship between depression, diabetes knowledge and self-care management with quality of life in diabetic patients.
Design/methodology/approach
This analytical cross-sectional study was conducted on 309 diabetic patients in Tabriz, Iran in 2015-2017. Quality of life was assessed by a validated questionnaire. The Persian version of the Beck Aeron questionnaire was used to assess the depression status. Knowledge and self-care management was evaluated by the health belief model questionnaire. Simple and multiple regression models were used to determine the relationship between the mentioned factors and the quality of life in diabetic patients.
Findings
Thirty-six per cent of the patients suffered from depression. The mean score of the total quality of life was 33.75 ± 8.72. The scores of the three domains of the quality of life were less than the normal range (“complication of diabetes” domain: 9.93 ± 3.16, “diagnosis, therapy and follow-up” domain: 10.91 ± 3.31, “psycho-social effect of diabetes” domain: 12.93 ± 4.41). The score of “complication of diabetes” score in males was significantly higher than females (p = 0.001). There was a significant relationship between depression (p < 0.001), self-care management (p = 0.019) and two parameters of knowledge (diet: p = 0.006 and diabetes: p = 0.004) with quality of life of diabetic patients.
Originality/value
The obtained results presented an unfavorable status of knowledge, physical and mental health in diabetic patients and a strong relationship between health-related factors with quality of life. Therefore, it is suggested to hold community-based health-promoting programs to enhance the overall life satisfaction in people with diabetes.