Community Mental Health Journal最新文献

Research indicates high prevalence rates of adverse experiences in people experiencing first-episode psychosis. Despite recommendations that mental health staff should routinely ask about adverse experiences, documentation indicates these are not being recorded in service-users' clinical records across different mental health settings. This study audited 48 service-user records in a UK early intervention in psychosis (EIP) community mental health service to examine how often, where, and by whom adverse experiences were recorded. Searching for 22 adverse experience terms, 64.6% of clinical records documented at least one adverse experience, with 80.6% reporting more than one. The profession that most often recorded adverse experiences in service-users' clinical records was psychiatrists. While EIP services may document adverse experiences more frequently than other community mental health settings, recorded rates remain lower than expected based on previous research prevalence rates. Further studies should consider adverse experiences recording across UK EIP services to ensure service-users with adverse experiences receive appropriate support.

People with mental health challenges and problematic substance use may experience low quality of life (QoL) because of illness-related factors and psychosocial stressors. Evidence indicates that regular exercise can improve QoL for people with a range of mental health and substance use issues, and Accredited Exercise Physiologists (AEPs) provide evidence-based exercise interventions for people with a range of health conditions. This study examined QoL changes in people with mental health challenges and problematic substance use while engaged in an AEP service. The service was implemented over three years and involved weekly group exercise sessions and health education. Linear mixed-effects models were used to evaluate trajectories of QoL total score and each dimension (independent living, pain, senses, relationships, mental health, coping). A total of 295 participants were inducted, with 161 completing at least two assessments. QoL improved by 5.8% per year (95%CI: 1.8-9.8%), predominantly in mental health and coping dimensions. This study demonstrates the feasibility and adoption of AEP services to inform service planning for improving QoL in people with mental health challenges and problematic substance use.

In mental health, joint crisis plans facilitate advance care planning between clinicians and patients who experience psychiatric crises. Little research focuses on advance care planning with migrants with mental health problems. This study investigated clinician and interpreter perspectives on the use of joint crisis plans in intercultural and multilingual settings. Focus groups were conducted: two with mental health clinicians (6 participants per group) and two with interpreters (5 to 6 participants per group). The participants in the study identified several challenges associated with using joint crisis plans for patients with a migration background: Diverging ideas about mental health etiologies and roles in decision-making processes; patients' fears of undesirable interferences between joint crisis plans and administrative procedures for residence permits; language barriers; and the collaboration with interpreters. However, interpreters are also found to play a central role by fostering patients' trust in the clinicians and the joint crisis plan.

Mental health consumers experience challenges in accessing regular physical healthcare. Staff working in mental health settings are well-positioned to address the issue; however, they often face significant barriers in delivering physical healthcare. The primary aim of this study was to identify important factors that support mental health staff to address the physical health of consumers; the secondary aim was to evaluate the utility of using a modified nominal group technique (NGT). Four main methodological modifications to standard NGT methods were made: (i) theoretical models (COM-B and Theoretical Domains Framework) were used to frame the NGT process, (ii) idea generation and ranking steps were conducted outside NGT sessions, (iii) both in-person and online groups were offered, and (iv) participants contributed to interpretation and dissemination of the findings. Individuals with expertise in the mental health sector participated in one of two NGT sessions, either in-person (n=13) or online (n=8). Considering Australian public mental health services, participants responded to the question: "What is needed for staff to optimally address physical health within their role?". Additionally, participant experiences and acceptability of this modified NGT process were evaluated through follow-up interviews (n=6). A total of 55 concepts were generated within COM-B components: capability (n=18), opportunity (n=26), and motivation (n=11). Highest-ranking key concepts were awareness (capability), leadership support (opportunity), and beliefs (motivation). Qualitative data indicated that the modified NGT method was effective, particularly when using a framework to guide ideas generation; however, the additional time commitment may reduce feasibility.

This within-region service comparison examines the long-term sustainability and outcomes of the Open Dialogue (OD) approach in routine psychiatric service in the Länsi-Pohja Hospital District, Finland (Western Lapland catchment area). Originating in the 1980s, OD emphasizes immediate response, social network involvement, continuity of care, and dialogical practice. While OD was implemented district-wide by 1990, the municipalization of outpatient services in the late 1990s led to fragmentation. This study compares treatment processes, user experiences, and outcomes between services that remained under hospital district governance and a previously municipalized unit recently reintegrated into the district. Data were drawn from the PSILEAPS project, including surveys of 117 service users and their staff conducted between 2022 and 2023. Follow-up data was collected in 2024 by reviewing case records to determine whether service users remained in treatment 1-2 years after the survey and whether treatment ended by mutual agreement. Descriptive analyses used inverse probability weighting to account for baseline differences. Findings indicate that hospital district-run units delivered more OD consistent care, with greater family involvement and use of home and network meetings. In hospital district-group these elements were rated more positively by users and staff, and treatment in this group was associated with mutually agreed treatment endings at follow-up. Despite shared origins and similar intake systems, structural differences associated with the development of distinct treatment cultures and outcome patterns. Beyond structural reforms and access to services, maintaining the core principles of OD may depend on organizational stability and sustained support for a certain treatment culture.

Healthcare and social service providers working with homeless populations may face unique stressors while performing their jobs, such as working in places not meant for human habitation and in unpredictable environments. While these issues are well-known, there is no formal assessment tool to gauge sense of physical safety among homeless service providers. The current study was conducted to determine the reliability and validity of a self-report assessment that measures feelings of safety at work among healthcare social service providers. The Homeless Assistance Safety Perceptions (HASP) inventory is a 16-item questionnaire that was developed and administered to 1,273 Veterans Affairs (VA) employees of homeless programs across all VA catchment regions. Preliminary assessments found that the HASP inventory has good internal consistency and content validity although further evaluation is needed. To our knowledge, this measure is the first instrument validated to measure perceptions of workplace safety among providers working with homeless populations.

This scoping review explores the alignment between clinical supervision models and the values underpinning Peer Work within the mental health sector. Peer Work, grounded in lived experience and principles of empowerment, mutuality, and recovery, has become an integral component of mental health services in Australia and internationally. Despite its growing presence, Peer Work lacks a defined supervision framework tailored to its unique ethos. Using the PRISMA-ScR methodology and Arksey and O'Malley's five-stage framework, 2,434 records were screened, resulting in 23 studies that met the inclusion criteria. These studies were analysed against the six foundational pillars of Peer Work as defined by Mind Australia. Findings indicate that while several clinical supervision models, such as the Seven-Eyed Model, DBT-informed supervision, and strengths-based approaches demonstrate theoretical alignment with Peer Work values, practical implementation remains limited. Recovery orientation and empowerment were the most commonly aligned themes, while trauma-informed care and inclusivity were less frequently addressed. The review highlights a critical gap in supervision tailored to Peer Workers and calls for further qualitative research and co-designed frameworks to ensure supervision practices uphold the integrity of Peer Work. Without such development, there is a risk of diluting Peer Work's transformative potential within traditional clinical systems.