International Journal of Mental Health Systems最新文献

{"title":"Peer support working: a question of ontology and epistemology?","authors":"Michael John Norton","doi":"10.1186/s13033-023-00570-1","DOIUrl":"https://doi.org/10.1186/s13033-023-00570-1","url":null,"abstract":"<p><p>Mental health services are currently undergoing immense cultural, philosophical, and organisational change. One such mechanism involved in this change has been the recognition of lived experience as a knowledge subset in its own right. Within five Community Health Care Organisations [CHOs] in the Irish mental health services, 2017 marked a new era as the traditional statutory mental health service hired a total of 30 Peer Support Workers. Since then, additional Peer Support Workers were recruited along with the added addition of Family Peer Support Work. The purpose of such positions is to use their lived experiences and the knowledge subset within it to normalise experiences, break down hierarchical barriers and facilitate candid conversations that will allow the service user to progress on their own, self-defined recovery journey. Since it's inception into Irish mental health services, peer support has been line managed by a non-peer discipline. It is this where this paper highlights a potential problem. The paper raises concerns that the supervision conducted by these non-peer professionals could tamper, mutate and destroy the essence of peer support-the transfer and use of lived experience between service users. As such, a recommendation is suggested that the literature pauses discussions as to the mechanism by which lived experience is delivered and instead focus energies on identifying the ontological and epistemological position that underpins the experiences.One potential position to examine is that of constructionism as such knowledge is created or constructed through the fusion of life experiences and sub-concious thoughts and emotions experienced at a particular moment in time which are then entangled together with current information to create a narrative or story that can be therapeutic. It is through this philosophical exercise involviong/including existential themes that the essence of lived experience can be identified, protected, and nourished within mental health discourse.</p>","PeriodicalId":47752,"journal":{"name":"International Journal of Mental Health Systems","volume":"17 1","pages":"1"},"PeriodicalIF":3.6,"publicationDate":"2023-01-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9878775/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9182096","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Internalized stigma and associated factors among people with mental illness at University of Gondar Comprehensive Specialized Hospital, Northwest, Ethiopia, 2021.","authors":"Lamesa Melese Sori,&nbsp;Faisel Dula Sema,&nbsp;Masho Tigabe Tekle","doi":"10.1186/s13033-022-00567-2","DOIUrl":"https://doi.org/10.1186/s13033-022-00567-2","url":null,"abstract":"<p><strong>Background: </strong>Internalized stigma has been found to be high among people with mental illness (PWMI) and it results in poor treatment outcome, increased disability and high economic burden. So, this study was designed to determine the prevalence and associated factors of high internalized stigma among PWMI attending psychiatric follow-up at University of Gondar Comprehensive Specialized Hospital, Northwest, Ethiopia, 2021.</p><p><strong>Methods: </strong>A cross-sectional study was conducted among PWMI (n = 365), and internalized stigma was measured by using internalized stigma of mental illness 29 (ISMI-29) scale. The data was entered in to EPI DATA software (4.6.0.2) and analyzed by Statistical Package for Social Sciences version 20. A binary logistic regression was used to identify factors associated with internalized stigma and reported with 95% confidence interval (CI). P-value < 0.05 was considered as statistically significant.</p><p><strong>Results: </strong>The prevalence of high internalized stigma was found to be 27.9% (95% CI 23.1-32.6). A male gender (AOR = 0.332; 95% CI 0.175-0.629), occupation, specifically government employee (AOR = 0.309; 95% CI 0.118-0.809), life time substance use (AOR = 3.561; 95% CI 1.867-6.793), low self-esteem (AOR = 8.313; 95% CI 3.641-18.977), and history of hospitalization (AOR = 4.236; 95% CI 1.875, 9.570) were factors significantly associated with higher internalized stigma.</p><p><strong>Conclusion: </strong>The result of this study showed that there was an intermediate prevalence of high internalized stigma among PWMI at University of Gondar Comprehensive Specialized Hospital. The hospital needs to take immediate action to fight internalized stigma by focusing on females, people with low self-esteem, individuals with history of lifetime substance use, and people who have history of hospital admission.</p>","PeriodicalId":47752,"journal":{"name":"International Journal of Mental Health Systems","volume":"16 1","pages":"58"},"PeriodicalIF":3.6,"publicationDate":"2022-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9805673/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10815398","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"University students' use of mental health services: a systematic review and meta-analysis.","authors":"T G Osborn, S Li, R Saunders, P Fonagy","doi":"10.1186/s13033-022-00569-0","DOIUrl":"10.1186/s13033-022-00569-0","url":null,"abstract":"<p><strong>Background: </strong>International estimates suggest around a third of students arrives at university with symptoms indicative of a common mental disorder, many in late adolescence at a developmentally high-risk period for the emergence of mental disorder. Universities, as settings, represent an opportunity to contribute to the improvement of population mental health. We sought to understand what is known about the management of student mental health, and asked: (1) What proportion of students use mental health services when experiencing psychological distress? (2) Does use by students differ across health service types?</p><p><strong>Methods: </strong>A systematic review was conducted following PRISMA guidelines using a Context, Condition, Population framework (CoCoPop) with a protocol preregistered on Prospero (CRD42021238273). Electronic database searches in Medline, Embase, PsycINFO, ERIC and CINAHL Plus, key authors were contacted, citation searches were conducted, and the reference list of the WHO World Mental Health International College Student Initiative (WMH-ICS) was searched. Data extraction was performed using a pre-defined framework, and quality appraisal using the Joanna Briggs Institute tool. Data were synthesised narratively and meta-analyses at both the study and estimate level.</p><p><strong>Results: </strong>7789 records were identified through the search strategies, with a total of 44 studies meeting inclusion criteria. The majority of included studies from the USA (n = 36), with remaining studies from Bangladesh, Brazil, Canada, China, Ethiopia and Italy. Overall, studies contained 123 estimates of mental health service use associated with a heterogeneous range of services, taking highly variable numbers of students across a variety of settings.</p><p><strong>Discussion: </strong>This is the first systematic quantitative survey of student mental health service use. The empirical literature to date is very limited in terms of a small number of international studies outside of the USA; studies of how services link together, and of student access. The significant variation we found in the proportions of students using services within and between studies across different settings and populations suggests the current services described in the literature are not meeting the needs of all students.</p>","PeriodicalId":47752,"journal":{"name":"International Journal of Mental Health Systems","volume":"16 1","pages":"57"},"PeriodicalIF":3.1,"publicationDate":"2022-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9758037/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10398014","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Mental Wealth perspective: crossing disciplines to understand the value of collective mental and social assets in the post-COVID-19 era.","authors":"Kristen Tran,&nbsp;John Buchanan,&nbsp;Yun Ju Christine Song,&nbsp;Sebastian Rosenberg,&nbsp;Jo-An Occhipinti,&nbsp;Ian B Hickie","doi":"10.1186/s13033-022-00568-1","DOIUrl":"https://doi.org/10.1186/s13033-022-00568-1","url":null,"abstract":"<p><strong>Background: </strong>A reconceptualised global strategy is key as nations begin to shift from crisis management to medium- and long-term planning to rebuild and strengthen their economic, social and public health systems. Efforts towards measuring, modelling, and forecasting Mental Wealth could serve as the catalyst for this reconceptualization. The Mental Wealth approach builds systemic resilience through investments which promote collective cognitive and emotional wellbeing. This paper presents the theoretical foundations for Mental Wealth. It presents, for the first time, literature across the disciplines of health and social sciences, economics, business, and humanities to underpin the development of an operational metric of Mental Wealth.</p><p><strong>Discussion: </strong>An approach which embeds social and psychological dimensions of prosperity, alongside the economic, is needed to inform the effective allocation of investments in the post-pandemic world. The authors advocate for a transdisciplinary framework of Mental Wealth to be applied in innovating population-level policy interventions to address the growing challenges brought on by COVID-19. Mental Wealth highlights the value generated by the deployment of collective mental assets and supporting social infrastructure. In order to inform this position, a review of the literature on the concepts underpinning Mental Wealth is presented, limitations of current measurement tools of mental and social resources are evaluated, and a framework for development of a Mental Wealth metric is proposed.</p><p><strong>Conclusion: </strong>There are challenges in developing an operational Mental Wealth metric. The breadth of conceptual foundations to be considered is extensive, and there may be a lack of agreement on the appropriate tools for its measurement. While variability across current measurement approaches in social resources, wellbeing and mental assets contributes to the difficulty creating a holistic and generic metric, these variations are now clearer. The operationalisation of the Mental Wealth metric will require comprehensive mapping of the elements to be included against the data available.</p>","PeriodicalId":47752,"journal":{"name":"International Journal of Mental Health Systems","volume":"16 1","pages":"56"},"PeriodicalIF":3.6,"publicationDate":"2022-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9742032/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10687208","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Experience of psychologists in the delivery of cognitive behaviour therapy in a non-western culture for treatment of substance abuse: a qualitative study.","authors":"Abrar Hussain Azad,&nbsp;Shahzad Ali Khan,&nbsp;Ijaz Ali,&nbsp;Hina Shafi,&nbsp;Nisar Ahmed Khan,&nbsp;Shaaray Abrar Umar","doi":"10.1186/s13033-022-00566-3","DOIUrl":"https://doi.org/10.1186/s13033-022-00566-3","url":null,"abstract":"<p><strong>Background: </strong>Psychotherapy is the preferred form of treatment for psychological disorders worldwide. Cognitive behaviour therapy (CBT) is one of the most widely used psychotherapies due to its proven efficacy for psychological disorders, including substance abuse. However, CBT was developed in the West according to the culture of developed countries. Therefore, it requires cross-cultural adaptation for non-Western countries. Pakistan is one of the developing non-Western countries where substance use disorders are increasing at an alarming rate. Despite the proven efficacy of CBT for substance use disorders, there is a dearth of its utilization in Pakistan. Therefore, in the present study, in-depth qualitative interviews were conducted with CBT practitioners in Pakistan to understand barriers and challenges in this regard. The study was a part of a broader project aimed at cultural adaptation of CBT for people with substance use disorders (SUDs) in Pakistan.</p><p><strong>Methods: </strong>In-depth qualitative interviews were conducted with CBT practitioners (N = 8) working in rehabilitation centres and hospitals in Islamabad, Pakistan. Thematic content analysis was conducted to develop core themes from the data.</p><p><strong>Results: </strong>CBT for SUDs requires some adjustments according to Pakistani culture for successful utilization. The challenges in providing CBT for SUDs revolved around three main themes, i.e., the mental health system, societal practices, and therapeutic issues, and 10 subthemes.</p><p><strong>Conclusion: </strong>In order to utilize the benefits of CBT for SUDs in Pakistan, cultural adaptation is necessary as an initial step. However, its delivery requires stringent modifications in the health care system to address these challenges.</p>","PeriodicalId":47752,"journal":{"name":"International Journal of Mental Health Systems","volume":"16 1","pages":"55"},"PeriodicalIF":3.6,"publicationDate":"2022-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9703777/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10328446","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Do improved structural surroundings reduce restrictive practices in psychiatry?","authors":"Astrid Harpøth,&nbsp;Harry Kennedy,&nbsp;Morten Deleuran Terkildsen,&nbsp;Bettina Nørremark,&nbsp;Anders Helles Carlsen,&nbsp;Lisbeth Uhrskov Sørensen","doi":"10.1186/s13033-022-00562-7","DOIUrl":"https://doi.org/10.1186/s13033-022-00562-7","url":null,"abstract":"<p><strong>Background and objectives: </strong>There is sparse evidence that modern hospital architecture designed to prevent violence and self-harm can prevent restrictive practices (RP). We examine if the use of RPs was reduced by the structural change of relocating a 170-year-old psychiatric university hospital (UH) in Central Denmark Region (CDR) to a new modern purpose-built university hospital.</p><p><strong>Methods: </strong>The dataset includes all admissions (N = 19.567) and RPs (N = 13.965) in the self-contained CDR one year before and after the relocation of the UH. We compare RPs at the UH a year prior to and after relocation on November 16th (November 2017, November 2019) with RPs at the other psychiatric hospitals (RH) in CDR. We applied linear regression analysis to assess the development in the monthly frequency of RPs pre- and post-relocation and examine underlying trends.</p><p><strong>Results: </strong>At UH, RPs performed decreased from 4073 to 2585 after relocation, whereas they remained stable (from 3676 to 3631) at RH. Mechanical restraint and involuntary acute medication were aligned at both UH and RH. Using linear regression analysis, we found an overall significant decrease in the use of all restrictive practices at UH with an inclination of -9.1 observations (95% CI - 12.0; - 6.3 p < 0.0001) per month throughout the two-year follow-up. However, the decrease did not deviate significantly from the already downward trend observed one year before relocation. Similar analyses performed for RH showed a stable use of coercion.</p><p><strong>Conclusion: </strong>The naturalistic features of the design preclude any definitive conclusion whether relocation to a new purpose-built psychiatric hospital decreased the RPs. However, we argue that improving the structural environment at the UH had a sustained effect on the already declining use of RPs, particularly mechanical restraint and involuntary acute medication.</p>","PeriodicalId":47752,"journal":{"name":"International Journal of Mental Health Systems","volume":"16 1","pages":"53"},"PeriodicalIF":3.6,"publicationDate":"2022-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9677911/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10322643","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mechanisms of action for stigma reduction among primary care providers following social contact with service users and aspirational figures in Nepal: an explanatory qualitative design.","authors":"Bonnie N Kaiser,&nbsp;Dristy Gurung,&nbsp;Sauharda Rai,&nbsp;Anvita Bhardwaj,&nbsp;Manoj Dhakal,&nbsp;Cori L Cafaro,&nbsp;Kathleen J Sikkema,&nbsp;Crick Lund,&nbsp;Vikram Patel,&nbsp;Mark J D Jordans,&nbsp;Nagendra P Luitel,&nbsp;Brandon A Kohrt","doi":"10.1186/s13033-022-00546-7","DOIUrl":"https://doi.org/10.1186/s13033-022-00546-7","url":null,"abstract":"<p><strong>Background: </strong>There are increasing initiatives to reduce mental illness stigma among primary care providers (PCPs) being trained in mental health services. However, there is a gap in understanding how stigma reduction initiatives for PCPs produce changes in attitudes and clinical practices. We conducted a pilot randomized controlled trial of a stigma reduction intervention in Nepal: REducing Stigma among HealthcAre Providers (RESHAPE). In a previous analysis of this pilot, we described differences in stigmatizing attitudes and clinical behaviors between PCPs receiving a standard mental health training (mental health Gap Action Program, mhGAP) vs. those receiving an mhGAP plus RESHAPE training. The goal of this analysis is to use qualitative interview data to explain the quantitative differences in stigma outcomes identified between the trial arms.</p><p><strong>Methods: </strong>PCPs were randomized to either standard mental health training using mhGAP led by mental health specialists or the experimental condition (RESHAPE) in which service users living with mental illness shared photographic recovery narratives and participated in facilitated social contact. Qualitative interviews were conducted with PCPs five months post-training (n = 8, standard mhGAP training; n = 20, RESHAPE). Stigmatizing attitudes and clinical practices before and after training were qualitatively explored to identify mechanisms of change.</p><p><strong>Results: </strong>PCPs in both training arms described changes in knowledge, skills, and confidence in providing mental healthcare. PCPs in both arms described a positive feedback loop, in which discussing mental health with patients encouraged more patients to seek treatment and open up about their illness, which demonstrated for PCPs that mental illness can be treated and boosted their clinical confidence. Importantly, PCPs in the RESHAPE arm were more likely to describe a willingness to treat mental health patients and attributed this in part to social contact with service users during the training.</p><p><strong>Conclusions: </strong>Our qualitative research identified testable mechanisms of action for stigma reduction and improving clinical behavior: specifically, recovery stories from service users and social engagement led to greater willingness to engage with patients about mental illness, triggering a feedback loop of more positive experiences with patients who benefit from mental healthcare, which further reinforces willingness to deliver mental healthcare. Trial registration ClinicalTrials.gov identifier, NCT02793271.</p>","PeriodicalId":47752,"journal":{"name":"International Journal of Mental Health Systems","volume":"16 1","pages":"37"},"PeriodicalIF":3.6,"publicationDate":"2022-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9367153/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10057055","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Conceptualization, detection, and management of psychological distress and mental health conditions among people with tuberculosis in Zambia: a qualitative study with stakeholders' and TB health workers.","authors":"T Mainga,&nbsp;M Gondwe,&nbsp;R C Stewart,&nbsp;I Mactaggart,&nbsp;K Shanaube,&nbsp;H Ayles,&nbsp;V Bond","doi":"10.1186/s13033-022-00542-x","DOIUrl":"https://doi.org/10.1186/s13033-022-00542-x","url":null,"abstract":"<p><strong>Background: </strong>In recent years, there has been increased recognition of the need to integrate mental health services into routine tuberculosis (TB) care. For successful integration, policymakers need to first understand the practices of TB health workers in the management of mental health conditions, including depression, anxiety, and psychological distress, and use this to decide how best mental health services could be delivered in tandem with TB services. In this qualitative study we aimed to understand how TB health workers and other stakeholders viewed mental health conditions linked to TB and how they screened and treated these in their patients.</p><p><strong>Methods: </strong>The study draws on qualitative data collected in 2018 as part of the Tuberculosis Reduction through Expanded Antiretroviral Treatment and Screening for active TB trial (TREATS), conducted in eight urban communities in Zambia. Data were collected through 17 focus group discussions with local health committee members (n = 96) and TB stakeholders (n = 57) present in the communities. Further in-depth interviews were held with key TB health workers (n = 9). Thematic analysis was conducted.</p><p><strong>Results: </strong>TB stakeholders and health workers had an inadequate understanding of mental health and commonly described mental health conditions among TB patients by using stigmatizing terminology and overtones, for example \"madness\", which often implied a characterological flaw rather an actual illness. Psychological distress was also described as \"overthinking\", which participants attributed to psychosocial stressors, and was not perceived as a condition that would benefit from mental health intervention. There were no standard screening and treatment options for mental health conditions in TB patients and most TB health workers had no mental health training. TB Stakeholders and health workers understood the negative implications of mental health conditions on TB treatment adherence and overall wellbeing for TB patients.</p><p><strong>Conclusions: </strong>TB stakeholders and health workers in Zambia have a complex conceptualisation of mental health and illness, that does not support the mental health needs of TB patients. The integration of mental health training in TB services could be beneficial and shift negative attitudes about mental health. Further, TB patients should be screened for mental health conditions and offered treatment. Trial registration number NCT03739736-Registered on the 14th of November 2018- Retrospectively registered- https://clinicaltrials.gov/ct2/results?cond=&term=NCT03739736&cntry=&state=&city=&dist.</p>","PeriodicalId":47752,"journal":{"name":"International Journal of Mental Health Systems","volume":"16 1","pages":"34"},"PeriodicalIF":3.6,"publicationDate":"2022-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9275023/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10721378","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Using participatory action research to pilot a model of service user and caregiver involvement in mental health system strengthening in Ethiopian primary healthcare: a case study.","authors":"Sisay Abayneh,&nbsp;Heidi Lempp,&nbsp;Brandon A Kohrt,&nbsp;Atalay Alem,&nbsp;Charlotte Hanlon","doi":"10.1186/s13033-022-00545-8","DOIUrl":"https://doi.org/10.1186/s13033-022-00545-8","url":null,"abstract":"<p><strong>Background: </strong>Little is known about actual involvement or how to achieve service user and caregiver in mental health systems strengthening in low-and middle-income countries. This study describes the processes and explores involvement experiences of participants in a pilot study of a new model of service user involvement in mental health system strengthening in a rural district in southern Ethiopia.</p><p><strong>Methods: </strong>We applied a case study design using participatory action research (PAR). The PAR process comprised of three stages, each with iterative activities of plan, act, observe and reflect. Two stakeholder groups, a Research Advisory Group (RAG) and Research Participant Group (RPG), were established and collaborated in the PAR process. Data collection involved process documentation of meetings and activities: attendances, workshop minutes, discussion outputs, reflective notes, participatory observation of sessions, and in-depth interviews with 12 RPG members. We analyzed the process data descriptively. Thematic analysis was used for qualitative data. Triangulation and synthesis of findings was carried out to develop the case study.</p><p><strong>Results: </strong>The stakeholder groups identified their top research priorities, developed an intervention and action plan and made a public presentation of preliminary findings. Key mechanisms used for inclusive participation included capacity building and bringing together diverse stakeholders, anchoring the study in established strong community involvement structures, and making use of participatory strategies and activities during the PAR process. Four themes were developed about experiences of involvement in PAR: (i) expectations and motivation, (ii) experiences of the dynamics of the PAR process, (iii) perceived impacts of involvement in the PAR process, and (iv) implementation challenges and future directions.</p><p><strong>Conclusions: </strong>This case study demonstrated the feasibility and acceptability of implementing a complex model of service-user involvement in mental health system strengthening in a resource constrained setting. More needs to be done to embed service-user involvement into routines of the primary healthcare system, alongside sustained support and strengthening multi-stakeholder collaboration at multiple levels.</p>","PeriodicalId":47752,"journal":{"name":"International Journal of Mental Health Systems","volume":"16 1","pages":"33"},"PeriodicalIF":3.6,"publicationDate":"2022-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9275138/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9765260","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Why did China's mental health law have a limited effect on decreasing rates of involuntary hospitalization?","authors":"Yarong Ma,&nbsp;Jie Zhang,&nbsp;Robert Rosenheck,&nbsp;Hongbo He","doi":"10.1186/s13033-022-00543-w","DOIUrl":"https://doi.org/10.1186/s13033-022-00543-w","url":null,"abstract":"<p><strong>Background: </strong>China's Mental Health Law (MHL) implemented in 2013 required increased consideration of the rights of people with mental illness and was expected to lead to a reduction in involuntary hospitalization (IH). This study aimed to examine the rates and correlates of IH in a large psychiatric hospital in Guangzhou from 2014 to 2017 after the implementation of MHL and a structured assessment of the need for IH.</p><p><strong>Methods: </strong>Unduplicated electronic medical records concerning all inpatients admitted to the hospital with a primary psychiatric diagnose were examined. Diagnostic, sociodemographic and socioeconomic data were used to identify correlates of IH using bivariate chi-square tests followed by logistic regression analysis.</p><p><strong>Results: </strong>Of 10, 818 hospitalized patients, there was a significant but small increase, from 71.6 to 74.9% in rates of IH in the years after a structured assessment of need for IH was implemented. Logistic regression analysis showed IH was positively associated with being younger, having a local residence, and a diagnosis of bipolar disorder, schizophrenia spectrum disorders or a substance abuse disorder as compared to those diagnosed with major depressive disorder.</p><p><strong>Conclusions: </strong>IH did not decrease over the first four years after the implementation of China's MHL and a structured assessment in 2013 perhaps, reflecting the initiation of a systematic assessment of the need for IH and the relatively low number of psychiatric beds in this area.</p>","PeriodicalId":47752,"journal":{"name":"International Journal of Mental Health Systems","volume":"16 1","pages":"32"},"PeriodicalIF":3.6,"publicationDate":"2022-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9250239/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9536622","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}