A national survey conducted in Lithuania indicates the tendecency, that the first contact with drugs is earlier from year to year. Also that more children and adolescents participate in substance abuse programs, who also suffer from severe conditions related with the usage of psychoactive substances. Aim of the study.Evaluating the organization of help offered in Lithuanian mental health care centres connected with the control of youth substance abuse. Objectives. 1. To overlook prevention and treatment system of youth substance abuse at primary mental heath care level. 2. To evaluate the organization of activities at mental heath care centres to control youth substance abuse. 3. To evaluate whether mental heath care centres cooperate with other institutions to provide better services for youth addicts especially to cope with related problems occuring. Methods. The analysis of Lithuanian law documents, anonymous questionaire sent to the directors of mental health care centres, statistic program SPSS 10.0 version. Results. In Lithuania prevention and treatment of substance abuse is being performed at 65 mental health care centres and is based on existing youth mental health care law. In Lithuania, no similar study has ever analyzed the situation for youth drug addicts and compared their needs for treatment and rehabilitation with offered services in mental health care centres. The survey showed that one third of the health care centres offer services that meet the... [to full text]

Thesis (M.A. (Clinical Psychology)) -- University of Limpopo, 2020 / The integration of mental health care (MHC) into primary health care (PHC) has been identified as a practical intervention to: increase accessibility to mental health care; reduce stigma and discrimination against people living with mental illnesses; improve the management of chronic mental illness; and, to reduce the burden of comorbidity of mental illnesses with other chronic illnesses. In the South African context, integrating MHC into PHC also seeks to respond to numerous legislative reforms, with the aim of providing comprehensive health care, particularly to previously disadvantaged populations. The aim of the present study was to explore the perceptions of facility managers in the Tshwane District (Gauteng Province) towards the integration of mental health into PHC. Fifteen participants from the Tshwane district facilities participated in the study. The participants were selected through a non-probability purposive sampling method. Data was collected through in-depth interviews using a semi-structured questionnaire, and analysed using the thematic coding approach. Significant findings suggested that the major hindrances to the realisation of the policy objectives may be due to: the lack of rehabilitation and psychotherapeutic services; insufficient skill and knowledge of mental health on the part of staff; insufficient or unsuitable practice space in the facilities; and, poor cooperation between South African Police Services, Emergency Medical Services and Primary Health Care. Inter-facility communication, district implementation support and policy knowledge has notably increased over the years and were deemed to be amongst the biggest enablers.

Providing mental health care to involuntary mental health care users (MHCUs) is challenging and an ethical adversity nurses often have to deal with. The literature, in general, indicates that nurses might possess coping and resiliency in the work environment where they are often faced with adversities. However there is a paucity of information regarding the resilience of nurses providing mental health care (MHC) to involuntary MHCUs. Therefore the research objectives explored the resilience of nurses using the Connor-Davidson scale (CD-RISC), to explore and describe how nurses cope and strengthen their resilience in providing MHC to involuntary MHCUs and to formulate guidelines to strengthen the resilience of these nurses to provide quality nursing care in the work environment where MHCUs are often involuntarily admitted. To achieve these objectives, the research followed both a qualitative and quantitative approach and an exploratory and descriptive design which was contextual in nature. A convenience sampling method was used to achieve a sample size of 28 participants, who were handed questionnaires to complete, containing demographical information, the CD-RISC and a narrative. A response rate of 85.7% was reached. Quantitative data was analysed by using the SPSS programme while data from narratives, for the qualitative data, were grouped and themed. The results in the first phase indicated that resiliency was high amongst participants, as the mean score of the CD-RISC was 79.9 out of a total score of 100; whilst only one participant scored below 50. The mean for the highest scores was on item 25 (pride in your achievements) (3.8) and item 10 (best effort no matter what) (3.6) and two critical aspects which scored low were item 18 (make unpopular or difficult decisions) and item 19 (can handle unpopular feelings) (2.3) amongst participants. Interestingly, the majority of participants (66.7%) do not have training in psychiatric nursing. In the second phase, two themes were identified from the questions. The first theme “Coping mechanisms” identified four methods to cope with involuntary MHCUs. These subthemes are “support system”, “knowledge, skills and experience”, “nurse-patient relationship” and “spirituality and selfcare”. The second theme “Resilience strategies” brought forth five subthemes as follows: “support”, “trained staff”, “security measures and safety”, “teamwork” and “in-service training and education”. Conclusions suggest that nurses are resilient to provide MHC for involuntary MHCUs. Furthermore, they take pride in their achievements and have passion for their work. On the contrary, they find it difficult to make unpopular decisions which affect others and to handle unpleasant feelings. This is indicative of internal conflict and difficulty in being assertive. Nurses take pride in their achievements and want to give nursing care that’s in the best interest of the MHCUs whilst they feel that they might not always be able to do so due to the involuntary nature of the MHCUs admission and treatment. Recommendations for nursing practice, namely guidelines to strengthen the resilience of nurses providing mental health care to involuntary MHCUs could be developed from the research findings. Facilitating assertiveness and a supportive environment might strengthen resilience and should be addressed by management and supervisors. Recommendations for nursing education and further research were also formulated. / MCur, North-West University, Potchefstroom Campus, 2015

Providing mental health care to involuntary mental health care users (MHCUs) is challenging and an ethical adversity nurses often have to deal with. The literature, in general, indicates that nurses might possess coping and resiliency in the work environment where they are often faced with adversities. However there is a paucity of information regarding the resilience of nurses providing mental health care (MHC) to involuntary MHCUs. Therefore the research objectives explored the resilience of nurses using the Connor-Davidson scale (CD-RISC), to explore and describe how nurses cope and strengthen their resilience in providing MHC to involuntary MHCUs and to formulate guidelines to strengthen the resilience of these nurses to provide quality nursing care in the work environment where MHCUs are often involuntarily admitted. To achieve these objectives, the research followed both a qualitative and quantitative approach and an exploratory and descriptive design which was contextual in nature. A convenience sampling method was used to achieve a sample size of 28 participants, who were handed questionnaires to complete, containing demographical information, the CD-RISC and a narrative. A response rate of 85.7% was reached. Quantitative data was analysed by using the SPSS programme while data from narratives, for the qualitative data, were grouped and themed. The results in the first phase indicated that resiliency was high amongst participants, as the mean score of the CD-RISC was 79.9 out of a total score of 100; whilst only one participant scored below 50. The mean for the highest scores was on item 25 (pride in your achievements) (3.8) and item 10 (best effort no matter what) (3.6) and two critical aspects which scored low were item 18 (make unpopular or difficult decisions) and item 19 (can handle unpopular feelings) (2.3) amongst participants. Interestingly, the majority of participants (66.7%) do not have training in psychiatric nursing. In the second phase, two themes were identified from the questions. The first theme “Coping mechanisms” identified four methods to cope with involuntary MHCUs. These subthemes are “support system”, “knowledge, skills and experience”, “nurse-patient relationship” and “spirituality and selfcare”. The second theme “Resilience strategies” brought forth five subthemes as follows: “support”, “trained staff”, “security measures and safety”, “teamwork” and “in-service training and education”. Conclusions suggest that nurses are resilient to provide MHC for involuntary MHCUs. Furthermore, they take pride in their achievements and have passion for their work. On the contrary, they find it difficult to make unpopular decisions which affect others and to handle unpleasant feelings. This is indicative of internal conflict and difficulty in being assertive. Nurses take pride in their achievements and want to give nursing care that’s in the best interest of the MHCUs whilst they feel that they might not always be able to do so due to the involuntary nature of the MHCUs admission and treatment. Recommendations for nursing practice, namely guidelines to strengthen the resilience of nurses providing mental health care to involuntary MHCUs could be developed from the research findings. Facilitating assertiveness and a supportive environment might strengthen resilience and should be addressed by management and supervisors. Recommendations for nursing education and further research were also formulated. / MCur, North-West University, Potchefstroom Campus, 2015

Despite the existence of effective treatments, mental health care disparities exist in the availability, accessibility, and quality of services for racial and ethnic minority groups. People living with serious mental complaints often resist engaging in treatments and experience high rates of dropout; poor engagement can lead to worse clinical outcomes. Addressing the complex mental health care needs of racial and ethnic minorities warrants considering evidence-based strategies to help reduce disparities. This systematic review sought to provide an analysis of published literature about the barriers and effective strategies in identifying and treating minority patients with mental health disorders. The practice-focused question of this systematic review was: What are the barriers and effective strategies to identification and treatment of mental health disorders among minority populations. This project was guided by PRISMA and SQUIRE guidelines and Fineout-Overholt and Melnyk’s appraisal form, comprising 11 studies published between 2014 and 2019, identified through Thoreau, Cochrane, CINAHL with Medline, EBSCO, and ProQuest, SAMHSA and PubMed databases. The systematic review results recommend intervention strategies such as integrated/collaborative care, workforce diversity, providers in minority neighborhoods, improving providers’ cultural skills, and stigma reduction to help reduce mental health care disparities. These findings are significant to lowering the gap in practice and can be used by the entire health care system to improve mental health care, thereby leading to a positive social change. Implementing these strategies would benefit patients, families, their communities, and the entire health care delivery system.

No description available.

The nursing team in a mental health care facility is a known dynamic at every hospital, rehabilitation centre and out-patient unit which enables these units to be functional. Currently nursing teams function in a challenged environment in mental health care facilities. The National Department of Health in South Africa states that one of the priority areas in the core standards of health care is to improve values and attitudes of health care professionals. One of the ways to accomplish this is that leaders at all levels should be positive role models to staff to encourage a culture of caring and positive attitudes that supports service delivery. However, mental health care in practice is in contradiction to this ideology of how mental health should function. In reality, regular involuntary treatment, minimal patient contact with therapists, negative attitudes, pressure of beds not being available as well as regular seclusions due to unmanageable situations are experienced in practice. The aim of this study is to explore and describe the role of the nursing unit manager to improve nursing teamwork in a mental health care facility in Gauteng in order to improve the quality of health care. A qualitative, explorative, interpretive descriptive and contextual design was selected to address the research question at hand. Non-probability, purposive sampling was used. A focus group discussion was held (n=8) and graphic team sculptings were done with each participant (n=9). The state of the current nursing team was described and explored as well as the practical intervention aimed at improving nursing teamwork. Data of the focus group was analysed using content analysis. Graphic team sculptings were analysed by interpretation analysis. The results of this research study indicated that nursing teamwork is influenced by various factors that can be categorized as organisational-, unit specific- and unit manager specific factors. There might be a negative organisational culture and negative attitudes of team members. There is uncertainty in the hierarchy structures, below the unit manager that causes power struggles, this has an effect on the responsibility and accountability in the absence of the unit manager. Individual team member’s needs constant supervision and direction to complete their daily tasks. The unit managers feel like there is poor support from top management. The general ward assistants and administrative clerks is seen as part of the team, although they are not directly involved with patient care, they contribute to the teams functioning. Mental health care facilities are overcrowded and this increases the workload of the nursing team. Trust and cohesion within the teams is low with poor communication between team members due to clique formation. The unit manager plays a vital role through leadership, collaboration, fair delegation and guidance. Individualism and diversity should be embraced. The unit managers acts as a role model and leader that bring the teams together and solve problems, facilitates effective communication and involves all the team members in decision making. / MCur, North-West University, Potchefstroom Campus, 2014

The nursing team in a mental health care facility is a known dynamic at every hospital, rehabilitation centre and out-patient unit which enables these units to be functional. Currently nursing teams function in a challenged environment in mental health care facilities. The National Department of Health in South Africa states that one of the priority areas in the core standards of health care is to improve values and attitudes of health care professionals. One of the ways to accomplish this is that leaders at all levels should be positive role models to staff to encourage a culture of caring and positive attitudes that supports service delivery. However, mental health care in practice is in contradiction to this ideology of how mental health should function. In reality, regular involuntary treatment, minimal patient contact with therapists, negative attitudes, pressure of beds not being available as well as regular seclusions due to unmanageable situations are experienced in practice. The aim of this study is to explore and describe the role of the nursing unit manager to improve nursing teamwork in a mental health care facility in Gauteng in order to improve the quality of health care. A qualitative, explorative, interpretive descriptive and contextual design was selected to address the research question at hand. Non-probability, purposive sampling was used. A focus group discussion was held (n=8) and graphic team sculptings were done with each participant (n=9). The state of the current nursing team was described and explored as well as the practical intervention aimed at improving nursing teamwork. Data of the focus group was analysed using content analysis. Graphic team sculptings were analysed by interpretation analysis. The results of this research study indicated that nursing teamwork is influenced by various factors that can be categorized as organisational-, unit specific- and unit manager specific factors. There might be a negative organisational culture and negative attitudes of team members. There is uncertainty in the hierarchy structures, below the unit manager that causes power struggles, this has an effect on the responsibility and accountability in the absence of the unit manager. Individual team member’s needs constant supervision and direction to complete their daily tasks. The unit managers feel like there is poor support from top management. The general ward assistants and administrative clerks is seen as part of the team, although they are not directly involved with patient care, they contribute to the teams functioning. Mental health care facilities are overcrowded and this increases the workload of the nursing team. Trust and cohesion within the teams is low with poor communication between team members due to clique formation. The unit manager plays a vital role through leadership, collaboration, fair delegation and guidance. Individualism and diversity should be embraced. The unit managers acts as a role model and leader that bring the teams together and solve problems, facilitates effective communication and involves all the team members in decision making. / MCur, North-West University, Potchefstroom Campus, 2014

Bakgrund: En av tre kvinnor i europeiska Unionen (EU) har upplevt psykisk misshandel av en partner. sjuksköterskan kan ställas inför flera olika etiska dilemman om våld-i-nära relations-problematik kommer fram i mötet med en misshandlad patient. Syfte: Att beskriva sjuksköterskors strategier och handlingsberedskap i mötet med den misshandlade kvinnan i den psykiatriska vården. Metod: En kvalitativ studie med semistrukturerade intervjuer genomfördes och analyserades med kvalitativ innehållsanalys med en manifest ansats. Resultat: Åtta sjuksköterskor inom psykiatrin mellan 26-67 år deltog i studien. Självutveckling, tillit, och debriefing var viktiga strategier i mötet med den våld-i-nära-relationsutsatta kvinnan. Självutveckling handlade om behovet av temadagar och vikten av självinsikt. Tillit handlade om att vara närvarande, miljöns och timingens betydelse, samt att våga fråga om våld-i-nära-relation. Debriefing handlade om hur sjuksköterskan hanterade och gick vidare med svaren, och om betydelsen av kollegialt samarbete och egenterapi. Konklusion: Sjuksköterskor använder sig av flera strategier i mötet med den våldsutsatta kvinnan inom psykiatrin, men uttrycker ett behov av vidareutbildning, alltifrån temadagar till längre utbildningar.

Non-compliance to treatment remains one of the greatest challenges in mental health care services, and knowledge about how to improve this is still a problem. The aim of this study is to critically synthesize the best available evidence regarding interventions to promote psychiatric patients’ compliance to mental health treatment. This study aims to provide the clinical practitioner with accessible information on interventions to promote psychiatric patients’ compliance to mental health treatment. Systematic review was chosen as a design method to identify primary studies that answer the following research question: What is the current evidence on interventions to promote psychiatric patients’ compliance to mental health treatment? Selected electronic databases that were accessible were thoroughly searched: SA-Nexus (NRF), ProQuest, EBSCOhost Platform, ScienceDirect, Web of Knowledge, Cochrane Library, Sabinet and Google Advanced Scholar were searched for primary studies that were published from 2001 to 2011. Primary studies in any language with an abstract in English were included in the search results. The following key words were used in the search: intervention, mental health treatment, psychiatric treatment, compliance, adherence, psychiatric patients, mental health care user and combinations thereof. Pre-determined inclusion and exclusion criteria were applied during the selection of studies. Sixteen studies (n = 16) were included for critical appraisal of methodology and quality using standard instruments from the Critical Appraisal Skills Program (CASP), the (JHNEBP) John Hopkins Nursing Evidence-Based Practice Research Evidence Appraisal Tool and the American Dietetic Association’s (ADA) Evidence Analysis manual. Finally only fourteen studies (n = 14) were identified as evidence that answers the literature review question appropriately. Evidence extraction, analysis and synthesis were conducted by means of the evidence class rating and grading of strength prescribed in ADA’s manual (ADA, 2008:62). The research was evaluated, a conclusion was given, limitations were identified and recommendations were formulated for nursing practice, education and research. Study findings indicated several interventions that can improve patients’ compliance in mental health treatment. Adherence therapy and motivational interviewing techniques during in-hospital stay improved the compliance of psychiatric patients. The use of Meds-help Pharmacy-based Intervention and Treatment Adherence Therapy Program for all Healthcare Professionals improved compliance to treatment for severely mentally ill. A Treatment Initiation and Participation Program and the use of Management Flow Sheet Interventions for Depressed Patients in Out-Patient Settings improved overall compliance of depressed patients in out-patient settings. Community mental health nurses trained in Medication Management improved psychiatric patients’ compliance to treatment at the community health care centres. Antipsychotic medication combined with therapeutic antipsychotic psycho-social interventions improved compliance of treatment for early-staged schizophrenia patients in out-patient settings. The use of Risperidone injections during the provision of home care and the long-acting injectable antipsychotic and atypical antipsychotic treatment used for schizophrenic patients served to improve compliance of mental health treatment in out-patient settings for schizophrenic patients. It is thus recommended that nurses should be exposed to clinical training regarding treatment compliance interventions of mental health care users during formal nursing education to enhance the mental health care practice and stimulate more innovative research on treatment compliance on the clinical field. / Thesis (M.Cur.)--North-West University, Potchefstroom Campus, 2012