Community Mental Health

Correction to: Gender Differences and Prevalence of Mental Health Problems in Students of Healthcare Units The original version of this article unfortunately contained a typo in the author name. The co-author name should be Ahsan Ehtesham instead it was published as Ahsan Ehtisham.

Perceptions of Service Use Among Currently and Formerly Homeless Adults with Mental Health Problems Abstract This qualitative study used in-depth interviews to examine the service experiences of 52 currently and formerly homeless people with mental health problems. Thematic analysis identified five themes associated with positive and negative service experiences: (1) accessibility of services, (2) humanity in approach to care, (3) perceptions and relationships with other service users, (4) physical space and environment, and (5) outcomes of service use. Overall, minimal differences were found between currently and formerly homeless people with mental health problems, suggesting that both groups have the same wants and needs related to service use, including to be treated fairly and without judgment, receive needed support and assistance, and feel good following their service experience. However, both groups also described encountering barriers to accessing programs and navigating service systems; using services where they felt judged, unsafe, or uncared for; and having unmet needs following service use.

Affirmative Competence and Practices of Mental Health Professionals with LGB clients: An Ibero-American Study Abstract There are not many studies about affirmative competence and practices among mental health professionals working with Lesbian, Gay, and/or Bisexual (LGB) clients. Thus, the objectives of this research are to assess the levels of affirmative competence and practices of professionals in Ibero-American countries. The sample consists of 630 mental health professionals from various countries whose ages range from 22 to 75 years old, with a mean age of 41.46 years. The study utilizes the following measures: a socio-demographic questionnaire, the Sexual Orientation Counselor Competency Scale, and the Affirmative Practice Questionnaire. Results show that mental health professionals who present higher levels of Affirmative Competence are those who have higher levels of education and training on LGBT topics, show left-wing political affiliations, self-identify as LGB, and have no religious affiliations. Regarding Affirmative Practices, it was found that single participants show lower practices, and more studies are needed to better understand this result. Regression models demonstrate that Affirmative Practices and Competences are predicted by the hypothesized variables, namely, religious and political beliefs, and training/education. Hence, this study indicates that mental health professionals could undergo some type of academic or professional training and/or possess experience in regard to working with LGB clients, in order to enhance their approach when working with this population.

Optimization of Antipsychotic and Benzodiazepine Drugs in Patients with Severe Mental Disorders in an Intensive Case Management Program Abstract The Intensive Case Management (ICM) model is a community-based program for people with severe mental illness that may reduce hospitalization and increase retention in care. The aims of this study were to analyze changes in the antipsychotic and benzodiazepine dosage in 106 patients who participated in an Individualized Service Program based on the ICM model for at least 6 months and to assess the change in the number of patients taking a high or very high dose of an antipsychotic drug and the number receiving antipsychotic polytherapy. Both the average daily dose of antipsychotic and benzodiazepine drugs and the number of patients with high doses of antipsychotic and more than one antipsychotic drug decreased significantly. Implementing the ICM program in patients with severe mental illness could help to decrease adverse drug effects and health care expenditures.

Residential Transience Among Adults: Prevalence, Characteristics, and Association with Mental Illness and Mental Health Service Use Abstract This study examined the association between frequent residential mobility (i.e., residential transience) and mental illness, mental health service use, and unmet need for services. Data are from the 2010 to 2014 National Surveys on Drug Use and Health (n = ~ 229,600). Logistic regression models examined the relationship between proximal (past year) and distal (past 2–5 years) residential transience and past year any mental illness (AMI), serious mental illness (SMI), mental health service use among adults with mental illness, and unmet need for services. Adults with transience had greater odds of AMI and SMI than those without transience. Proximal and distal transience were unrelated to past year mental health service use among adults with mental illness, but the odds of unmet need for services were greater among adults with transience compared with those without, suggesting a level of unmet service need among those with transience.

Between the Inside and the Outside World: Coping of Ultra-Orthodox Individuals with Their Work Environment After Academic Studies Abstract This study has explored how ultra-Orthodox individuals cope when facing secular norms and values in their work environment. The study was conducted in Israel, where 614 ultra-Orthodox adults answered questions regarding demographic characteristics, identities, openness to the workplace, social environment, Brief Cope, community sense of coherence (CSOC) and Employee Satisfaction Inventory. Individuals in the main sectors of the ultra-Orthodox society reported higher CSOC and stronger religiosity while individuals from the minor sectors reported greater openness to the job's social environment. Demographics, coping strategies and CSOC were significant in explaining job satisfaction. The results will be discussed based on stress and coping theories and on the salutogenic theory.

The Phenomenon of "Hearing Voices": Not Just Psychotic Hallucinations—A Psychological Literature Review and a Reflection on Clinical and Social Health Abstract The phenomenon of hearing voices is currently a much-discussed topic, both in the field of research and in the field of care services. The majority of people who report "hearing voices" do not subsequently receive services or receive a diagnosis of psychopathology. This topic raises questions for professionals in the health field about the lack of tools that can help illuminate the phenomenon. The purposes of this work are (a) to highlight the psychological studies that approach the phenomenon in a non-psychopathological way and (b) to determine which concepts could aid the comprehension of the phenomenon. The method consists of a systematic review of the literature that characterizes the phenomenon of hearing voices from a non-pathological perspective. The literature offers different theoretical approaches to interpret the phenomenon in a way that is not necessarily pathological and presents new tools for examining the phenomenon. For example, a few studies state that it is possible to coexist with voices, while others indicate that it is necessary to know how to manage voices. We highlighted and discussed several concepts that can support doctors, psychiatrists and practitioners in understanding "hearer" patients, particularly attention to the context of belonging, attention to language, and the role of the sense-making process.

Suicide Risk and Depression in Individuals with Chronic Illness Abstract The study aims to determine the suicide risk and depression in individuals diagnosed with chronic illnesses. The sample of the study comprised of 286 persons. The Information Form developed by the researchers on the basis of the models available in previous research, Suicide Probability Scale (SPS) and Beck Depression Scale (BDS) were used to collect data. Mann Whitney U-test, Kruskal Wallis test and Pearson correlation analysis were used to evaluate the study data. The mean score of the individuals participating in the study with reference to Suicide Probability Scale were found to be 68.80 ± 9.94 and that with reference to Beck Depression Scale 15.68 ± 9.91. Also, a significant positive relationship was found between the mean scores regarding SPS and BDS scales (r: 0.601, p: 0.000 < 0.05). The SPS and BDS mean scores of individuals who said they had poor mental health, low quality of life and low economic status and that of those who had no support from their families were found to be high in respect of statistical significance. In accordance with these findings, chronic illness is a risk factor that might induce depression and suicide ideation and attempt. According to the statistical analysis, the results of this study shown that people with poor mental health, poor quality of life and low economic status and those who had no support from their families especially had more vulnerable to depression and suicidal behaviours compared with other people.

Interplay of Self-efficacy and Social Support in Predicting Quality of Life in Cardiovascular Patients in Pakistan Abstract The primary objective of the present study was to assess independent and interactive relations of perceived social support and self-efficacy with four quality of life (QOL) domains namely physical, psychological, social, and environmental in cardiovascular disease (CVD) patients from a South Asian region. Participants were 172 (age 22–60 years) patients recruited from three major government sector hospitals from the fifth biggest city of South Asia. It was found that overall CVD patients had a better QOL in psychological and environmental domains compared to social and psychological. Furthermore, findings from hierarchical regression analyses indicated that perceived social support and self-efficacy were positively associated with the four QOL domains. Besides main effects, a synergistic interaction between social support and self-efficacy emerged indicating that perceived social support was strongly associated with physical and social QOL in CVD patients who had higher self-efficacy levels, while, perceived social support was weakly associated with the physical and social QOL in CVD patients who had lower self-efficacy levels.

The Cost-Effectiveness of the Improving Access to Psychological Therapies (IAPT) Programme in Severe Mental Illness: A Decision Analytical Model Using Routine Data Abstract This is the first site level economic evaluation of the Improving Access to Psychological Therapies programme for severe mental illness (IAPT-SMI) that is funded by NHS England. It also aims to illustrate the challenges involved in evaluations based on routine data with low internal validity. Six IAPT-SMI pilot sites treated 1 of 2 clinical groups: (i) psychosis or bipolar disorder; (ii) personality disorder. A decision analytical model nested in a before-after framework- the same patients 12 months after treatment versus 12 months before treatment—was used to compare the cost-effectiveness of IAPT-SMI with treatment as usual (TAU). IAPT-SMI appears to be more costly overall but save non-psychological treatment costs. There is evidence it may improve function and lower incidence of harmful behaviour. However, there is a need for evaluations with a more conventional study design that measure a more comprehensive array of resource use and clinical outcomes.

Alexandros Sfakianakis
Anapafseos 5 . Agios Nikolaos
Crete.Greece.72100
2841026182

6948891480

alsfakia@gmail.com