Community Mental Health Journal最新文献

Mental health difficulties typically develop during adolescence, yet service utilization rates among youth are low. We sought to understand perspectives among Canadian youth accessing mental health services at an integrated youth services centre called Foundry. Forty-one semi-structured qualitative interviews were conducted with youth aged 15-24 years. A grounded theory framework was developed. Youth described emotional experiences of distress as catalysts to seeking mental health services. They also discussed challenges in understanding their own emotions as barriers to accessing mental health services. Gender identity and norms influenced participants' experiences of accessing services. Anxious emotions were predominantly associated with youths' experiences with seeking mental health services. Conversely, once at Foundry, over half the youth experienced positive emotions about help-seeking, with more than half of these youth continuing to access services post interview. Providing Integrated Youth Services like Foundry can increase service engagement and support adaptive emotional development for youth of all genders.

Despite the substantial capacity of qualitative and mixed methods research to advance healthcare and interventions knowledge, most large-scale health intervention trials exclusively use quantitative methods. The authors argue that qualitative research can optimize investments in these studies. As researchers within the Early Psychosis Intervention Network (EPINET), the authors highlight examples of how qualitative research has enhanced this national initiative, organizing them with a Learning Health System (LHS) framework to demonstrate the ways qualitative research can increase value at each phase of a health trial. They emphasize the critical need for integrating qualitative research from the beginning of health trials, ensuring its influence in decision-making, creating infrastructure to support it, and promoting meaningful representation within research teams. By illustrating the advantages of qualitative research in EPINET, they advocate for sustained commitment to qualitative research in health trials to maximize value in client and provider experience, cost, and population health.

Attitudes of Peer Support Workers are generally expected to be grounded in recovery philosophy. They may encounter resistance from Mental Health Workers, which tend to be more closely aligned with the medical model. We aim to investigate how PSWs relate in clinical contexts to some main aspects of medical model-based attitudes. This research is part of the larger ImpPeer-Psy5 project, involving 57 interviews with PSWs, MHWs, and service users. The findings presented here were derived from a qualitative sub-study with 5 more interviews and one focus group with MHWs. Some PSWs view psychiatric diagnoses as helpful for their own recovery and interactions with clients, while others find them reductive and stigmatizing. Similarly, PSWs hold varying opinions on psychiatric drugs, with some seeing them as beneficial and necessary, while others have critical views. MHWs' expectations on PSWs may not always align with their attitudes.

Adverse childhood experiences and intergenerational trauma are associated with a variety of negative health outcomes and are particularly prevalent among people of color and those living in rural communities. The social accelerator model offers a novel means of assisting organizations in scaling up their initiatives and increasing their impact. This study investigates the lessons learned from adapting the social accelerator model to address community-level trauma and build resilience in a rural setting. We conducted qualitative interviews with program staff and the initial cohort of participants of the Resilient Leaders Initiative: a trauma-informed social accelerator designed for public institutions in Edgecombe County, North Carolina. Participating community organizations included a local high school, church, and courthouse. In-depth interviews (n = 23) explored strengths, challenges, and perceived outcomes of the program and were thematically analyzed. The program's deep community ties generated strong relationships among the cohort and created a safe space for participants to address trauma. Those interviewed identified the virtual program's flexible structure as a key strength, but also reported experiencing confusion around roles, outcomes, and program language. A shared passion for building community resilience among participants and staff served as a key motivator throughout the program. Findings indicate that a flexible environment, strong interpersonal relationships, and deep community roots are essential to facilitating the creation of trauma-informed solutions among community organizations via the social accelerator model.

Introduction: Self-disclosure of lived recovery experiences is a cornerstone of peer support work. However, few studies have explored how early career certified peer specialists (CPSs) integrate or plan to integrate their own lived recovery experiences into their CPS work, or the challenges they expect to experience when doing so. In this qualitative study, we explore how early career CPSs use their lived recovery experience and challenges that accompany self-disclosure.

Methods: Qualitative data were collected as part of multistate, 3-year observational prospective cohort study of CPS graduate employment trajectories. We conducted in-depth, semi-structured interviews with a subsample of early-career CPSs about their transition to the workforce; this study reports on interview material focused on how participants use and expect to use their recovery experiences. Data were analyzed using thematic and content analysis informed by constant comparative methods.

Results: N = 25 individuals participated in an interview. While participants generally felt positive about sharing their personal recovery stories in their CPS role, some reported potential challenges they expect to experience, such as misalignment of recovery experiences or being re-traumatized when sharing their recovery stories with clients and coworkers.

Conclusion: That study participants held mixed feelings about sharing lived experience suggests that the peer support workforce needs early career professional support, such as peer-to-peer supervision models that focus on CPS wellbeing, in addition to job performance.

MHPs are exposed to the emotional and psychological suffering of their clients on a daily basis, which can take a toll on their own well-being. This study examines the significance of various socio-demographic factors-such as marital status, years of experience, work sector, socio-economic status, and type of MHP-on compassion fatigue, resilience, and coping strategies of MHPs in India. Burnout was found to be higher among single MHPs, while MHPs living with their loved ones demonstrated higher levels of compassion satisfaction and resilience. MPhil & doctoral-level practitioners reported higher levels of secondary traumatic stress, while master's-level practitioners exhibited higher levels of avoidant coping. Job satisfaction was positively correlated with compassion satisfaction and resilience and negatively correlated with burnout and secondary traumatic stress. No significant differences were found based on years of experience or working hours per day. The findings highlight the complex interplay of sociodemographic variables among MHPs.

Traditional medical models have given way to recovery-oriented approaches over the years in the management of individuals with serious mental illnesses. However, very little is known about such recovery-based models in the Indian context. This qualitative study used a phenomenological approach to explore the experiences and meanings of recovery among individuals with serious mental illness in southern India. Purposive sampling with maximum variation was used to recruit participants. In-depth interviews were conducted with ten participants, using a semi-structured interview guide. Thematic analysis resulted in three themes: "The illness journey," "Life minus illness = Recovery," and "It takes a village to recover,". Illness and recovery seemed to be two sides of the same coin with the context playing an influential role in the perceptions of recovery. The term "recovery" seemed to be a misnomer giving the impression that one is expected to return to an illness free state.

Mental health recovery takes place in a social and material world. However, socio-material contexts have often been absent from recovery studies. The present study was conducted in Norway, a Scandinavian welfare country. We interviewed people at meeting places who had experiences as service users, focusing on their experiences of becoming well, and analyzed their recovery stories using an assemblage framework. Our analysis identified four constitutive dimensions that promote mental health recovery: an atmosphere of togetherness, doings as more than the act, personal development, and integration in society. We discuss how these dimensions might be seen as social, relational, and material forces that create important micropolitics that challenge the individualistic professionalization of the recovery concept.

This qualitative service evaluation aims to provide in-depth insights of service providers' perspectives of a new integrated community mental health service piloted in one NHS Integrated Care Board locality in South West England, UK, considering to what extent the service is meeting the mental health support needs of adults who are in between primary and secondary care services. In total, 21 semi-structured remote interviews were carried out in June-August 2023 with service providers and lived experience representatives. The evaluation was carried out through a researcher in residence -placement. Qualitative analysis drew on framework and thematic analysis, which was completed using Nvivo 20. Thematic analysis drew on a framework of context, mechanisms and intended or unintended consequences. These showed that service providers' positive expectations of the service were undermined by insufficient integration, which was evident from the imbalances in information flow and presence of pre-existing provider specific practices. The evaluation found several improvement opportunities: a need for deepening integration beyond the initial service development phase; aligning working practices with service delivery aims and ensuring that new services are not rolled out prematurely before service delivery practices have been fully developed.

There is no consensus on the definition of recovery of people with psychosis. This may be attributed to the broad concept including clinical, functional and personal recovery domains and the diverse interests of stakeholders involved. We hypothesized that service users, informal caregivers and healthcare professionals would exhibit differences in prioritization, reflecting varying roles and viewpoints. Through an open online anonymous questionnaire, stakeholders shared their perspectives on most important aspects of clinical, functional and personal recovery and on facilitators and barriers of recovery. Stakeholder collaboration in study design and interpretation enhanced the study's robustness. The answers on open questions of respondents were categorized for statistical analyses to compare the answers between respondent groups on the different aspects of recovery. 226 stakeholders participated. While commonalities prevailed, distinctions emerged in recovery domain priorities. Service users and informal caregivers accorded equal importance to clinical, functional and personal recovery, whereas healthcare professionals emphasized clinical recovery. Regarding functional recovery, service users seemed to focus on practical issues while informal caregivers addressed the underlying causes. Disparities were notable in the role of healthcare that was considered as both a facilitator or a barrier to recovery, with informal caregivers prioritizing aspects of healthcare more frequently as most important than healthcare professionals. While commonalities prevailed, we identified several differences in prioritizing recovery domains among stakeholder groups. Awareness and understanding of these differences is crucial for effective communication and collaboration between stakeholders in recovery-oriented healthcare. The study underscores the need for ongoing dialogue between stakeholders.