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The history of the care of the mentally ill in Britain, which has been broadly reflected in Western Australia since 1826, can be conveniently, if simplistically divided into a number of epochs. Each epoch is characterised by a particular focus or paradigm of clinical management, which prevails over a period of time but is then followed by a comparatively short period of rapid change to a new paradigm. Such changes are shaped by a number of forces, but three categories can be readily identified. These are: concepts of mental illness; reactions of administrative systems and the attitudes of medical practitioners. As the concept of the nature of mental illness has changed, succeeding epochs have evolved to a more humane and enlightened approach to the mentally ill. Nevertheless, each management paradigm has failed to deliver the expected 'cures' and the consequent reduction in the burden of illness. Each has been replaced by a new and radically different paradigm, often at enormous cost, but there has been no progressive evolution towards a system that incorporates measures that have proven value. In recent years 'Community Care', has failed in such a manner that there have been strong arguments that it should be abandoned. At the same time there is evidence that a new paradigm 'Primary Care Psychiatry' is emerging as government policy. The challenge is to preserve the best elements of community care and integrate Primary Care Psychiatry into the broader framework. The best chance of achieving this is to develop a gradual, evolutionary process, built on consensus between psychiatrists, general practitioners and administrators. / The purposes of the present research are threefold: to develop a conceptual model for an optimal community based mental health service. Then by examining the views of general practitioners, psychiatrists and administrators, determine the degree of congruence of these views. This is achieved by a qualitative study comprising extended interviews with 24 GPs, 15 psychiatrists and 11 administrators. This approach is chosen over a more broadly based, structured questionnaire approach for two reasons. Firstly, the views expressed in informal face to face interviews are more likely to be true expressions of opinion, especially when these are critical. Secondly, by using a comparatively unstructured approach, the stakeholders are able to express views on issues that they consider important. Finally, the areas of consensus and disagreement are analysed and recommendations made on strategies to develop a plan for a practical, viable service in a local area.

Despite growing evidence that anxiety can be a significant problem in late-life, information regarding the use of mental health services by older adults for anxiety is lacking. The current research project consists of three studies focusing on this issue. The first study examines the rates of mental health service use among older adults with anxiety disorders and high levels of anxiety symptoms, as well as individual characteristics associated with this use. The second study examines various aspects of social support as correlates of anxiety disorders in older adults, and the role of social support as an enabling resource for mental health service use. Finally, the third study examines three important outcomes of service use among older adults: treatment satisfaction, perceived treatment effectiveness, and dropout. The data for these studies came from the Canadian Community Health Survey: Mental Health and Well-Being (CCHS 1.2), a national population-based survey that includes 12,792 respondents aged 55+ years. This research found that older adults with significant anxiety were less likely to use services than those with mood disorders, and that indicators of need for services were the strongest predictors of use. Lower levels of functional social support were related to the presence of anxiety disorders among older adults, and lower levels of perceived emotional/informational support and positive social interactions predicted greater use of services for adults throughout the lifespan. Finally, older adults were generally satisfied with services, perceived them as helpful, and were likely to remain in treatment. Analyses indicated that individual characteristics likely play only a small role in these outcomes. In general, this project provides new and important information that can inform policy, clinical work, and future research regarding late-life anxiety.

Despite growing evidence that anxiety can be a significant problem in late-life, information regarding the use of mental health services by older adults for anxiety is lacking. The current research project consists of three studies focusing on this issue. The first study examines the rates of mental health service use among older adults with anxiety disorders and high levels of anxiety symptoms, as well as individual characteristics associated with this use. The second study examines various aspects of social support as correlates of anxiety disorders in older adults, and the role of social support as an enabling resource for mental health service use. Finally, the third study examines three important outcomes of service use among older adults: treatment satisfaction, perceived treatment effectiveness, and dropout. The data for these studies came from the Canadian Community Health Survey: Mental Health and Well-Being (CCHS 1.2), a national population-based survey that includes 12,792 respondents aged 55+ years. This research found that older adults with significant anxiety were less likely to use services than those with mood disorders, and that indicators of need for services were the strongest predictors of use. Lower levels of functional social support were related to the presence of anxiety disorders among older adults, and lower levels of perceived emotional/informational support and positive social interactions predicted greater use of services for adults throughout the lifespan. Finally, older adults were generally satisfied with services, perceived them as helpful, and were likely to remain in treatment. Analyses indicated that individual characteristics likely play only a small role in these outcomes. In general, this project provides new and important information that can inform policy, clinical work, and future research regarding late-life anxiety.

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No description available.

Considerando as recomendações do modelo de cuidado pautado na atenção psicossocial e as dificuldades relacionadas ao núcleo de cada profissão no campo da saúde mental, neste estudo propôs-se analisar a percepção de enfermeiros e demais membros da equipe multiprofissional sobre as ações de enfermagem no cuidado em saúde mental. Como referencial teórico foram utilizadas as concepções de \"campo\" e \"núcleo\", propostas por Campos (2000), com a intenção de diferenciar o conjunto de saberes e práticas comuns de todos os profissionais da equipe daqueles específicos da enfermagem. Trata-se de estudo qualitativo, descritivo, transversal, sendo a população do estudo os profissionais de todos os Centros de Atenção Psicossocial e Ambulatório de Saúde Mental do município de Bauru, SP. Foram utilizadas três diferentes técnicas de coleta de dados, a saber, entrevista semiestruturada, questionário com perguntas fechadas e grupo focal. A entrevista foi realizada com todos os enfermeiros e analisada segundo procedimentos metodológicos da análise de conteúdo. O questionário foi aplicado a todos os profissionais das equipes e foi analisado utilizando estatística descritiva. E o grupo focal contou com pelo menos um participante de cada categoria profissional, exceto terapeuta ocupacional, médico e fonoaudiólogo.Os resultados foram divididos em dois grandes temas: atuação da equipe nos serviços de saúde mental e dificuldades do enfermeiro na execução das ações de saúde mental. Notou-se que a percepção de toda a equipe multiprofissional, inclusive a do enfermeiro, enfatizou proximidade com \"o corpo físico\" dos usuários e os procedimentos técnicos relacionados. Ações de campo foram mencionadas como atribuição do enfermeiro também, porém, desafios para tal desempenho foram ressaltados, entre eles: formação deficitária, dificuldades pessoais, estereótipos profissionais, infraestrutura do serviço e falta de delimitação do núcleo das profissões pelos próprios profissionais.O presente estudo pode subsidiar a construçãode processos de trabalho interdisciplinares e auxiliar na delimitação das ações específicas da enfermagem no cuidado em saúde mental, agregando contribuições singulares aos serviços e à identidade profissional dos enfermeiros / Considering the recommendations of the care model based on psychosocial care and the difficulties related to the core of each profession in the field of mental health, this study proposed to analyze the perception of nurses and other members of the multiprofessional team on the actions of nursing in mental health care. As a theoretical reference, the field and core conceptions proposed by Campos (2000) were used with the intention of differentiating the set of common knowledge and practices of all the professionals of the team from those specific to nursing. This is a qualitative, descriptive and transversal study, which subjects were the professionals of all Psychosocial Attention Centers and Mental Health Ambulatory of Bauru city, in São Paulo, Brazil. Three different data collection techniques were used: a semi-structured interview, a questionnaire with closed questions and a focus group. The interview was performed with all the nurses and analyzed according to the methods of content analysis. The questionnaire was applied to all the professionals of the teams and was analyzed using descriptive statistics. And the focus group had at least one participant from each professional category, except occupational therapist, doctor and speech therapist. The results were divided into two main themes: the team\'s performance in mental health services and the nurse\'s difficulties in performing mental health actions. It was noted that the perception of the entire multiprofessional team, including the nurse, emphasized proximity to the \"physical body\" of users and technical procedures associated. Field actions were also mentioned as a nursing attribution, but some challenges for such performance were highlighted, among them: lack of training, personal difficulties, professional stereotypes, infrastructure and lack of delimitation of the professions core by the professionals themselves. The present study may support the construction of interdisciplinary work processes and assist in the delimitation of specific actions of nursing in mental health care by adding singular contributions to services and the professional identity of nurses

The purpose of this research study was to explore Mexican women’s perceptions about utilizing mental health services and to explore the barriers encountered during the process. Previous research suggested Mexican women’s diverse experiences when seeking and utilizing mental health services. The study used a qualitative approach with open-ended and closed-ended questions. The sample size of this study was fifteen individuals who self-identified as Mexican women who reside in Southern California recruited using a snowball approach. Major themes identified included Mexican family values and beliefs, cultural barriers, structural barriers, Mexican women’s strengths, and community suggestions for social work practice. This study highlighted their perspective on mental health, cultural and structural barriers, their personal experiences of utilizing mental health services, techniques on managing difficult situations, support systems, identified mental health symptoms, coping methods, cultural values and suggestions to improve mental health services in the general Latino community.

Purpose: The first objectives of the current study was to determine whether disparities exist in mental health and mental health service use between minority and majority Canadian Francophone and Anglophone communities both within and outside of Quebec. The second objectives was to examine if official language minority-majority status was associated with the presence of common mental health problems and mental health service utilization.<p> Methodology: The current study used data from the Canadian Community Health Survey: Mental Health and Well-being, Cycle 1.2.7 Two main comparisons were made: Quebec Francophones to Quebec Anglophones, and outside Quebec Francophones to outside Quebec Anglophones. Twelve-month and lifetime prevalences of mental disorders and mental health service use were examined through bivariate analyses. Logistic regression analyses determined whether official language minority-majority status significantly predicts mental health problems and mental health service use using the Determinants of Health Model8-10 and Andersens behavioural model.11-13<p> Results: Very few significant differences were found between official language groups both outside and within Quebec, though some notable differences were found between Quebec and outside Quebec: Anglophones and Francophones outside Quebec had a higher prevalence of poor mental health and low life satisfaction compared their respective language counterparts in Quebec. Respondents from outside Quebec had a higher prevalence of consulting with a psychiatrist than respondents from Quebec. There was no significant association between membership in an Official Language Minority Community and mental health problems, and mental health service use. Implications: Although our results indicate that very few differences exist between official language minority and majority groups, these findings remain important and can help aid key stakeholders redirect resources and develop policies and programs towards areas and geographic locations wherein health disparities exist.

From September 2000 through May 2001, a team of two psychologists and two psychology graduate students (myself included) from the University of Saskatchewan delivered a variety of psychological services to a remote reserve community in northern Saskatchewan via telehealth from the Royal University Hospital in Saskatoon. Using telehealth, we provided psychoeducational information, therapy, assessments, case consultations and support services to Aboriginal health workers in this community. The present study is an evaluation of the use of telehealth in the delivery of psychological services to remote reserve communities. A semi-structured interview was employed to gain knowledge about the experiences of people involved in this telehealth project as well as the insights, thoughts and beliefs of Aboriginal and non-Aboriginal mental health workers regarding the use of telehealth with remote communities. In total, eight interviews were conducted for this study. Results indicate that although telehealth technology was seen as positive, psychology is often perceived in a negative manner by Aboriginal people. Due to this disconnection between Aboriginal people and Western psychology, psychological service provision with telehealth needs to be considered in conjunction with building relationships and trust in the community. Despite the difficulties, the results indicate that there is much that can be gained by providing psychological services to remote Aboriginal communities via telehealth.