World Psychiatry 21:2 June 2022 services, based on evidencebased public policies and practices on a national level. International research groups, including scientists and service users from low and middleincome countries, are the key to the collection and timely dissemination of data on the best models and practices, with the goal to provide the evidence for sus tainable acute psychiatric care delivery.
{"title":"After the acute crisis – engaging people with psychosis in rehabilitation‐oriented care","authors":"D. Siskind, Alison Yung","doi":"10.1002/wps.20970","DOIUrl":"https://doi.org/10.1002/wps.20970","url":null,"abstract":"World Psychiatry 21:2 June 2022 services, based on evidencebased public policies and practices on a national level. International research groups, including scientists and service users from low and middleincome countries, are the key to the collection and timely dissemination of data on the best models and practices, with the goal to provide the evidence for sus tainable acute psychiatric care delivery.","PeriodicalId":49357,"journal":{"name":"World Psychiatry","volume":" ","pages":""},"PeriodicalIF":73.3,"publicationDate":"2022-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42935045","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
243 ate adaptations in psychiatric intensive care units, secure mental health services, emergency departments, and wards for other age groups. However, the staff short ages and considerable pressures faced by those working in mental health care also create considerable barriers for those im plementing interventions and undertak ing related research. A narrative review of the literature found a relatively small body of research on the use of closed circuits television (CCTV) to increase security for patients and staff in acute psychiatric units, but recognized the tradeoff with privacy. CCTV increased sub jective feelings of safety amongst patient and staff, but there was no evidence that it increased objective security or reduced vi olence. CCTV and, more recently, infrared cam eras have also been used to conduct close ob servations and monitoring of vital signs in patients, including in seclusion. Such tech nology can be less invasive for patients, reduce sleep disruption when making checks, and can be preferred by some pa tients as it avoids staff entering a person’s private space. This may reduce triggers for conflict and aggression, and subsequent psychological harm associated with con tainment measures. Video monitoring can also allow overstimulated patients to be left alone, while enabling staff to carry out their observations. On the other hand, the use of electronic surveillance can be seen as distancing and dehumanizing. Studies suggest that the main factor in comforting patients and re ducing trauma during an episode of se clu sion or restraint is contact and commu nication with staff. Symptoms of fear, dis trust or delusions can be worsened in some patients, and there are concerns that CCTV might increase paranoid thoughts or trig ger distressing memories of prior abuse involving videos. Video cameras might di rectly contribute to an atmosphere of de tachment, control and fear, which could promote occurrence of the very events that surveillance is supposed to reduce. Video ing patients, especially in distress, can fuel feelings of shame and touches the right to privacy. These concerns and the need for more re search are important, as the increasing avail ability and affordability of digital technol ogies has seen body worn cameras (BWC) being introduced to inpatient units, in emer gency departments and for paramedics in ambulances. BWCs are small devices that can be worn on clothing, which record sights and sounds in the vicinity of the wearer. Men tal health staff are being asked to wear BWCs and to switch them on dur ing inci dents, or sometimes at the request of a pa tient. It is hoped that the use of BWCs will defuse situations, reduce aggression, and increase accountability and evidence gathering around serious incidents. How ever, a recent systematic review of the liter ature identified only two lowquality eval uations of BWC use in mental health wards, with mixed results though some indication of
{"title":"Centering equity in mental health crisis services","authors":"Matthew L. Goldman, Sarah Y. Vinson","doi":"10.1002/wps.20968","DOIUrl":"https://doi.org/10.1002/wps.20968","url":null,"abstract":"243 ate adaptations in psychiatric intensive care units, secure mental health services, emergency departments, and wards for other age groups. However, the staff short ages and considerable pressures faced by those working in mental health care also create considerable barriers for those im plementing interventions and undertak ing related research. A narrative review of the literature found a relatively small body of research on the use of closed circuits television (CCTV) to increase security for patients and staff in acute psychiatric units, but recognized the tradeoff with privacy. CCTV increased sub jective feelings of safety amongst patient and staff, but there was no evidence that it increased objective security or reduced vi olence. CCTV and, more recently, infrared cam eras have also been used to conduct close ob servations and monitoring of vital signs in patients, including in seclusion. Such tech nology can be less invasive for patients, reduce sleep disruption when making checks, and can be preferred by some pa tients as it avoids staff entering a person’s private space. This may reduce triggers for conflict and aggression, and subsequent psychological harm associated with con tainment measures. Video monitoring can also allow overstimulated patients to be left alone, while enabling staff to carry out their observations. On the other hand, the use of electronic surveillance can be seen as distancing and dehumanizing. Studies suggest that the main factor in comforting patients and re ducing trauma during an episode of se clu sion or restraint is contact and commu nication with staff. Symptoms of fear, dis trust or delusions can be worsened in some patients, and there are concerns that CCTV might increase paranoid thoughts or trig ger distressing memories of prior abuse involving videos. Video cameras might di rectly contribute to an atmosphere of de tachment, control and fear, which could promote occurrence of the very events that surveillance is supposed to reduce. Video ing patients, especially in distress, can fuel feelings of shame and touches the right to privacy. These concerns and the need for more re search are important, as the increasing avail ability and affordability of digital technol ogies has seen body worn cameras (BWC) being introduced to inpatient units, in emer gency departments and for paramedics in ambulances. BWCs are small devices that can be worn on clothing, which record sights and sounds in the vicinity of the wearer. Men tal health staff are being asked to wear BWCs and to switch them on dur ing inci dents, or sometimes at the request of a pa tient. It is hoped that the use of BWCs will defuse situations, reduce aggression, and increase accountability and evidence gathering around serious incidents. How ever, a recent systematic review of the liter ature identified only two lowquality eval uations of BWC use in mental health wards, with mixed results though some indication of ","PeriodicalId":49357,"journal":{"name":"World Psychiatry","volume":" ","pages":""},"PeriodicalIF":73.3,"publicationDate":"2022-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42353548","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Muhammad Waqar Azeem, Howard Y. Liu, N. Imran, Bernardo Ng, Khalid Bazaid, Pronob K. Dalal, Mohan Issac, Afzal Javed
World Psychiatry 21:2 June 2022 WPA public health mission to emphasize the importance of risk factors and to adopt evidence-based preventive and rehabilitative interventions. The WPA Working Group on IDD has participated this year in the initiative called Rehabilitation 2030, sponsored by the WHO Department of Noncommunicable Diseases, Disability, Violence, and Injury Prevention, aiming to develop a package of rehabilitative interventions along with specified resource requirements for their delivery. The overarching goal is the improved care of persons with IDD across the lifespan, with a particular emphasis on LMICs. Following on these ground-breaking approaches in classification and evidencebased interventions, the Working Group is now promoting a second paradigm shift aiming to include training on IDD within mainstream psychiatry, once again with a particular emphasis on LMICs. Three important arguments justify this call. First, when polled about their knowledge on the impact of IDD, many trainees in psychiatry recognize the disproportionately high burden of co-occurring mental disorders in persons with IDD. Second, when offered opportunities to interact with persons with IDD during rotations, many trainees in psychiatry regard such experiences as highly formative and inspiring. Third, and most important, psychiatry as a profession has the potential to improve significantly the care for persons with IDD. Furthermore, the gap in mental health services for persons with IDD is too significant to be compensated by an ad hoc reliance on individual providers and families, and their resilience is not limitless. Moreover, within the context of the COVID-19 pandemic, persons with IDD are facing the utmost intensification of inequities in term of underlying medical liabilities, inability to socially distance, increased infection and mortality risks, challenges to participate in telehealth services, and ensuing social isolation and adverse mental health outcomes. The Working Group and the WPA leadership invite Member Societies to work collectively to enhance efforts for the development of inclusive training models in the mental care of persons with IDD. The Working Group is ready to provide awareness raising, training, and research collaboration to promote and disseminate effective services and thereby improve the lives and outcomes for persons with IDD. For this purpose, the Working Group is developing an open access handbook focusing on global aspects of the psychiatry of IDD, with authorship from both LMICs and high-income countries. In parallel, the Working Group is developing online educational materials summarizing the key aspects of psychiatric care in people with IDD. These resources will be accessible through the WPA educational portal in 2022. The WPA Working Group on IDD encourages systematic exposure to and experience in this area for all psychiatrists, so that they can adjust treatments for cooccurring mental disorders and avoid diagnostic o
{"title":"WPA Working Group on Medical Students: current initiatives and future priorities","authors":"Muhammad Waqar Azeem, Howard Y. Liu, N. Imran, Bernardo Ng, Khalid Bazaid, Pronob K. Dalal, Mohan Issac, Afzal Javed","doi":"10.1002/wps.20980","DOIUrl":"https://doi.org/10.1002/wps.20980","url":null,"abstract":"World Psychiatry 21:2 June 2022 WPA public health mission to emphasize the importance of risk factors and to adopt evidence-based preventive and rehabilitative interventions. The WPA Working Group on IDD has participated this year in the initiative called Rehabilitation 2030, sponsored by the WHO Department of Noncommunicable Diseases, Disability, Violence, and Injury Prevention, aiming to develop a package of rehabilitative interventions along with specified resource requirements for their delivery. The overarching goal is the improved care of persons with IDD across the lifespan, with a particular emphasis on LMICs. Following on these ground-breaking approaches in classification and evidencebased interventions, the Working Group is now promoting a second paradigm shift aiming to include training on IDD within mainstream psychiatry, once again with a particular emphasis on LMICs. Three important arguments justify this call. First, when polled about their knowledge on the impact of IDD, many trainees in psychiatry recognize the disproportionately high burden of co-occurring mental disorders in persons with IDD. Second, when offered opportunities to interact with persons with IDD during rotations, many trainees in psychiatry regard such experiences as highly formative and inspiring. Third, and most important, psychiatry as a profession has the potential to improve significantly the care for persons with IDD. Furthermore, the gap in mental health services for persons with IDD is too significant to be compensated by an ad hoc reliance on individual providers and families, and their resilience is not limitless. Moreover, within the context of the COVID-19 pandemic, persons with IDD are facing the utmost intensification of inequities in term of underlying medical liabilities, inability to socially distance, increased infection and mortality risks, challenges to participate in telehealth services, and ensuing social isolation and adverse mental health outcomes. The Working Group and the WPA leadership invite Member Societies to work collectively to enhance efforts for the development of inclusive training models in the mental care of persons with IDD. The Working Group is ready to provide awareness raising, training, and research collaboration to promote and disseminate effective services and thereby improve the lives and outcomes for persons with IDD. For this purpose, the Working Group is developing an open access handbook focusing on global aspects of the psychiatry of IDD, with authorship from both LMICs and high-income countries. In parallel, the Working Group is developing online educational materials summarizing the key aspects of psychiatric care in people with IDD. These resources will be accessible through the WPA educational portal in 2022. The WPA Working Group on IDD encourages systematic exposure to and experience in this area for all psychiatrists, so that they can adjust treatments for cooccurring mental disorders and avoid diagnostic o","PeriodicalId":49357,"journal":{"name":"World Psychiatry","volume":" ","pages":""},"PeriodicalIF":73.3,"publicationDate":"2022-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46104992","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
World Psychiatry 21:2 June 2022 provide a wide range of interventions. Vari ations among team practices suggest that it is hard to practice all elements or compo nents well, and that sometimes different components can compete, e.g., ensuring rapid response to new referrals vs. provid ing intensive care with frequent visits to current service users. Local adaptations are often necessary, and this may add to challenges in comparing complex inter ventions across sites and countries. Johnson et al’s overview describes a wide range of acute psychiatric care mod els used in various stages and contexts. For most of these models, there is a lack of researchbased evidence, and achiev ing evidence for all these models may not be possible. However, a possible path may be to use research models currently under development for complex interventions to study individual elements of acute psychi atric care. If such research could identify which elements are critical for what types of clinical effect, these elements could be applied and studied within various models and contexts. One dilemma of the increasing special ization and differentiation in mental health services, including acute psychiatric care, is the increasing discontinuity of care for service users who need services through several phases of illness. Models with more generic or integrated teams may secure more continuity in the personal relation ships between the service user and the service provider. Efficiency requirements focus on management of disorders, but often leave little room for the interaction of providers with persons with these dis orders. We need to know more about which out comes are most important for service users and what elements of acute psychi atric care contribute to the various out comes. As a part of this, it is important to better understand how continuity of care and therapeutic relationships contribute to positive patient experiences and out comes in acute psychiatric care, and how these two critical elements may be pro vided.
{"title":"Activities and technologies: developing safer acute inpatient mental health care","authors":"Alan Simpson","doi":"10.1002/wps.20967","DOIUrl":"https://doi.org/10.1002/wps.20967","url":null,"abstract":"World Psychiatry 21:2 June 2022 provide a wide range of interventions. Vari ations among team practices suggest that it is hard to practice all elements or compo nents well, and that sometimes different components can compete, e.g., ensuring rapid response to new referrals vs. provid ing intensive care with frequent visits to current service users. Local adaptations are often necessary, and this may add to challenges in comparing complex inter ventions across sites and countries. Johnson et al’s overview describes a wide range of acute psychiatric care mod els used in various stages and contexts. For most of these models, there is a lack of researchbased evidence, and achiev ing evidence for all these models may not be possible. However, a possible path may be to use research models currently under development for complex interventions to study individual elements of acute psychi atric care. If such research could identify which elements are critical for what types of clinical effect, these elements could be applied and studied within various models and contexts. One dilemma of the increasing special ization and differentiation in mental health services, including acute psychiatric care, is the increasing discontinuity of care for service users who need services through several phases of illness. Models with more generic or integrated teams may secure more continuity in the personal relation ships between the service user and the service provider. Efficiency requirements focus on management of disorders, but often leave little room for the interaction of providers with persons with these dis orders. We need to know more about which out comes are most important for service users and what elements of acute psychi atric care contribute to the various out comes. As a part of this, it is important to better understand how continuity of care and therapeutic relationships contribute to positive patient experiences and out comes in acute psychiatric care, and how these two critical elements may be pro vided.","PeriodicalId":49357,"journal":{"name":"World Psychiatry","volume":" ","pages":""},"PeriodicalIF":73.3,"publicationDate":"2022-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45680582","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"No service is an island: towards an ecosystem approach to mental health service evaluation","authors":"A. Rosen, L. Salvador-Carulla","doi":"10.1002/wps.20963","DOIUrl":"https://doi.org/10.1002/wps.20963","url":null,"abstract":"","PeriodicalId":49357,"journal":{"name":"World Psychiatry","volume":" ","pages":""},"PeriodicalIF":73.3,"publicationDate":"2022-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44531394","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mental disorder is reported to account for almost a third of global disease burden as measured by years lived with disability (YLDs). On the other hand, mental wellbeing results in broad positive impacts. Effective public mental health interventions exist to treat mental disorder, prevent associated impacts, prevent mental disorder from arising, and promote mental wellbeing and resilience. However, only a minority of those with mental disorder receive treatment, with far lower coverage in lowand middle-income countries (LMICs). There is even less coverage of interventions to prevent associated impacts of mental disorder, and negligible coverage of interventions to prevent mental disorder, or promote mental well-being and resilience. This implementation gap represents a breach of the right to health, and results in population-scale suffering and associated economic costs. The gap has further widened during the COVID-19 pandemic. The United Nations (UN) Sustainable Developmental Goals have set a target of universal coverage by 2030 which includes treatment and prevention of mental disorder and promotion of mental well-being. The most recent World Health Organization (WHO) Mental Health Atlas highlighted that “global targets can be reached in 2030 only if there is a collective global commitment over the next 10 years across Member States to make massive investments and expanded efforts at the country level relating to mental health policies, laws, programmes and services”. Public mental health involves a population approach to improve coverage, outcomes and coordination of interventions to treat mental disorder, prevent associated impacts, prevent mental disorder from arising, and promote mental well-being and resilience. This aims to support efficient, equitable and sustainable reduction in mental disorder, promotion of population mental well-being, and achievement of the UN Sustainable Developmental Goals target of universal coverage by 2030. The WPA Action Plan 2020-2023 promotes public mental health as a guiding principle. A Working Group on Public Mental Health has been then established, including experts such as J. Allan, F.K. Baingana, J. Campion, Y. Huang, A. Javed, N. Lamb, S. Levin, C. Lund, M. Marmot, S. Saxena, T. Schulze, E. Sorel, H. Tu, P. Udomratn, and M. van Ommeren (observer). The Working Group highlighted that public mental health is not well defined or understood, with some languages having no terms for it. This contributes to lack of action on relevant issues. The Group agreed upon the definition outlined above, which is reported on the Group webpage of the WPA website (www.wpanet.org/publicmental-health) and in a recent publication. The main objective of the Working Group is to improve implementation of public mental health interventions in four ways. The first is to raise awareness, value, acceptance and prioritization of this area in national health policies. The second is to promote national assessments of public mental heal
据报道，以残疾生活年数(YLDs)衡量，精神障碍几乎占全球疾病负担的三分之一。另一方面，心理健康会产生广泛的积极影响。目前存在有效的公共精神卫生干预措施，以治疗精神障碍，预防相关影响，预防精神障碍的产生，并促进精神健康和复原力。然而，只有少数精神障碍患者得到治疗，低收入和中等收入国家的覆盖率要低得多。预防精神障碍相关影响的干预措施覆盖面更少，而预防精神障碍或促进精神健康和复原力的干预措施覆盖面则可以忽略不计。这一执行差距是对健康权的侵犯，并造成全民痛苦和相关的经济代价。在2019冠状病毒病大流行期间，这一差距进一步扩大。联合国可持续发展目标设定了到2030年实现全民覆盖的目标，其中包括治疗和预防精神障碍以及促进精神健康。世界卫生组织(世卫组织)最新的《精神卫生地图集》强调，"只有会员国在今后10年作出全球集体承诺，在国家一级就精神卫生政策、法律、规划和服务进行大规模投资并扩大努力，才能在2030年实现全球目标"。公共精神卫生涉及一种人口方法，以改善治疗精神障碍的干预措施的覆盖面、结果和协调，预防相关影响，预防精神障碍的产生，并促进精神健康和复原力。其目的是支持有效、公平和可持续地减少精神障碍，促进人口精神健康，并实现联合国可持续发展目标中到2030年实现全民覆盖的具体目标。《2020-2023年行动计划》将促进公共精神卫生作为一项指导原则。随后成立了一个公共精神卫生工作组，成员包括J. Allan、F.K. Baingana、J. Campion、Y. Huang、A. Javed、N. Lamb、S. Levin、C. Lund、M. Marmot、S. Saxena、T. Schulze、E. Sorel、H. Tu、P. Udomratn和M. van Ommeren(观察员)等专家。工作组强调指出，公众心理健康没有得到很好的定义或理解，有些语言没有这方面的术语。这导致在有关问题上缺乏行动。该集团同意上述定义，该定义已在世界环境署网站(www.wpanet.org/publicmental-health)的集团网页和最近的一份出版物中公布。工作组的主要目标是通过四种方式改进公共精神卫生干预措施的实施。首先是在国家卫生政策中提高对这一领域的认识、重视、接受和优先次序。第二是促进国家对公共精神卫生未满足需求和所需行动的评估，然后为政策制定和执行提供信息。第三是促进公共精神卫生培训，包括通过数字平台，通过确定不同部门需要采取的行动以及澄清核心课程、培训目标和里程碑，支持精神科医生和其他专业人员解决公共精神卫生实施方面的差距，特别是在中低收入国家。公共心理健康培训的例子在上述小组网页上有重点介绍。第四，支持制定综合公共精神卫生方法，包括通过与初级卫生系统和一般卫生系统合作，进行疾病管理和预防。进一步的目标包括:a)与感兴趣的国家合作，以确定的资金促进这些方法;(b)在公共精神卫生议程上与其他组织合作——迄今为止，这些组织包括经济合作与发展组织(经合组织)、联合国国际儿童紧急基金会(儿童基金会)和世卫组织;(C)通过出版物、演讲和培训(也在网上提供)传播与公共精神卫生有关的工作;(d)支持在《2020-2023年世界行动计划》的其他领域采取公共精神卫生办法，包括儿童、青少年和青年精神卫生、合并症管理以及与其他组织建立伙伴关系。工作组已经出版的出版物包括一篇关于整个领域的社论，涉及2019冠状病毒病大流行的公共精神卫生方法的文章，以及关于解决公共精神卫生实施失败所需行动的论文。工作组成员已经并将在2021年和2022年世界精神病学大会上发言，并将在英国皇家精神科医学院2022年国际大会的公共精神卫生专题讨论会上发言。 为了就解决公共精神卫生执行差距所需采取的行动达成共识，工作组成员被邀请撰写一篇卫生政策文章，其中建议采取以下六项行动:a)通过评估未满足的需求、估计扩大覆盖面带来的影响和相关经济效益，以及开展合作，来说明公共精神卫生的必要性7。Karim Z, Javed A, Azeem MW。[J]中华医学杂志2022;38:320-2。8. Imran N, Haider II, Mustafa AB等。中东当代精神病学2021;28:45。9. Arora R, Mukherjee SD。[J]中华医学杂志，2011;31(2):357 - 357。10. 汉基尔A，汤姆A，易卜拉欣H等。中华精神病杂志2020;32:135-8。11. Ibrahim H, Tom A, Youssef A等。中华精神病学杂志[J]; 2009; 33(2): 391 - 391。
{"title":"WPA Working Group on Public Mental Health: objectives and recommended actions","authors":"J. Campion, A. Javed","doi":"10.1002/wps.20981","DOIUrl":"https://doi.org/10.1002/wps.20981","url":null,"abstract":"Mental disorder is reported to account for almost a third of global disease burden as measured by years lived with disability (YLDs). On the other hand, mental wellbeing results in broad positive impacts. Effective public mental health interventions exist to treat mental disorder, prevent associated impacts, prevent mental disorder from arising, and promote mental wellbeing and resilience. However, only a minority of those with mental disorder receive treatment, with far lower coverage in lowand middle-income countries (LMICs). There is even less coverage of interventions to prevent associated impacts of mental disorder, and negligible coverage of interventions to prevent mental disorder, or promote mental well-being and resilience. This implementation gap represents a breach of the right to health, and results in population-scale suffering and associated economic costs. The gap has further widened during the COVID-19 pandemic. The United Nations (UN) Sustainable Developmental Goals have set a target of universal coverage by 2030 which includes treatment and prevention of mental disorder and promotion of mental well-being. The most recent World Health Organization (WHO) Mental Health Atlas highlighted that “global targets can be reached in 2030 only if there is a collective global commitment over the next 10 years across Member States to make massive investments and expanded efforts at the country level relating to mental health policies, laws, programmes and services”. Public mental health involves a population approach to improve coverage, outcomes and coordination of interventions to treat mental disorder, prevent associated impacts, prevent mental disorder from arising, and promote mental well-being and resilience. This aims to support efficient, equitable and sustainable reduction in mental disorder, promotion of population mental well-being, and achievement of the UN Sustainable Developmental Goals target of universal coverage by 2030. The WPA Action Plan 2020-2023 promotes public mental health as a guiding principle. A Working Group on Public Mental Health has been then established, including experts such as J. Allan, F.K. Baingana, J. Campion, Y. Huang, A. Javed, N. Lamb, S. Levin, C. Lund, M. Marmot, S. Saxena, T. Schulze, E. Sorel, H. Tu, P. Udomratn, and M. van Ommeren (observer). The Working Group highlighted that public mental health is not well defined or understood, with some languages having no terms for it. This contributes to lack of action on relevant issues. The Group agreed upon the definition outlined above, which is reported on the Group webpage of the WPA website (www.wpanet.org/publicmental-health) and in a recent publication. The main objective of the Working Group is to improve implementation of public mental health interventions in four ways. The first is to raise awareness, value, acceptance and prioritization of this area in national health policies. The second is to promote national assessments of public mental heal","PeriodicalId":49357,"journal":{"name":"World Psychiatry","volume":" ","pages":""},"PeriodicalIF":73.3,"publicationDate":"2022-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41996450","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
regarding the efficacy of various treatments. But this study also shows an important role for psychiatrists in managing, and supervising, the long-term neuropsychiatric effects of COVID-19.
{"title":"Repurposing fluvoxamine, and other psychiatric medications, for COVID‐19 and other conditions","authors":"E. Lenze, A. Reiersen, P. Santosh","doi":"10.1002/wps.20983","DOIUrl":"https://doi.org/10.1002/wps.20983","url":null,"abstract":"regarding the efficacy of various treatments. But this study also shows an important role for psychiatrists in managing, and supervising, the long-term neuropsychiatric effects of COVID-19.","PeriodicalId":49357,"journal":{"name":"World Psychiatry","volume":"21 1","pages":"314 - 315"},"PeriodicalIF":73.3,"publicationDate":"2022-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43415290","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
World Psychiatry 21:2 June 2022 care system has been used to estimate the optimal workforce in full time equivalents in acute wards and acute day care in the Basque Country (Spain), and the relative technical efficiency of service provision in catchment areas, including both acute and nonacute services. Impact analysis is another key compo nent of the evaluation in mental health care. This should not be limited to endpoint re sults on individuals. Major attention should be paid to the process of implementation and the analysis of the readiness, usability, adoption and penetration of a new service in real world environments. The empha sis on fidelity should be balanced with the need for adaptation to local con texts. Additional mention should be made of the role of international networks in pro moting new models of care and imple mentation. Relevant examples are the Crisis Now/Recovery International glob ally growing network of facilities, which provides welcoming, peerpartnership and firmly communitybased service fa cilities, not backed as yet by published rigorous research; the ICIRCLE consor tium, that promotes community models in urban environments; and the EUCOM model of community care in Eu rope. The broader biopsychosociocultural innovations have evolved with an empha sis on complexity science, codesign with lived experience and family expertise, hu man rights facilitation and community based recovery approaches. Attempts to fragment and undo costeffective commu nitybased reforms are often accompanied by demands for evermore hospital beds. These hospitalcentric views should no long er prevail over responsive, wholistic ecosys tems, integrating community and hospital components. Transforming acute mental health care towards community models exceeds men tal health systems, heralding broader reform of general acute health care and support systems towards community care. To keep ontrack with previous advances, the eval uation of the mental health sector acute care should adopt a health care ecosystem perspective, including systematic assess ment of the service delivery systems, their impact on processes, outcomes, workforce, and especially service users and families, val orizing lived experiences.
{"title":"Acute psychiatric care: the need for contextual understanding and tailored solutions","authors":"Kuruthukulangara S. Jacob","doi":"10.1002/wps.20964","DOIUrl":"https://doi.org/10.1002/wps.20964","url":null,"abstract":"World Psychiatry 21:2 June 2022 care system has been used to estimate the optimal workforce in full time equivalents in acute wards and acute day care in the Basque Country (Spain), and the relative technical efficiency of service provision in catchment areas, including both acute and nonacute services. Impact analysis is another key compo nent of the evaluation in mental health care. This should not be limited to endpoint re sults on individuals. Major attention should be paid to the process of implementation and the analysis of the readiness, usability, adoption and penetration of a new service in real world environments. The empha sis on fidelity should be balanced with the need for adaptation to local con texts. Additional mention should be made of the role of international networks in pro moting new models of care and imple mentation. Relevant examples are the Crisis Now/Recovery International glob ally growing network of facilities, which provides welcoming, peerpartnership and firmly communitybased service fa cilities, not backed as yet by published rigorous research; the ICIRCLE consor tium, that promotes community models in urban environments; and the EUCOM model of community care in Eu rope. The broader biopsychosociocultural innovations have evolved with an empha sis on complexity science, codesign with lived experience and family expertise, hu man rights facilitation and community based recovery approaches. Attempts to fragment and undo costeffective commu nitybased reforms are often accompanied by demands for evermore hospital beds. These hospitalcentric views should no long er prevail over responsive, wholistic ecosys tems, integrating community and hospital components. Transforming acute mental health care towards community models exceeds men tal health systems, heralding broader reform of general acute health care and support systems towards community care. To keep ontrack with previous advances, the eval uation of the mental health sector acute care should adopt a health care ecosystem perspective, including systematic assess ment of the service delivery systems, their impact on processes, outcomes, workforce, and especially service users and families, val orizing lived experiences.","PeriodicalId":49357,"journal":{"name":"World Psychiatry","volume":" ","pages":""},"PeriodicalIF":73.3,"publicationDate":"2022-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46270311","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
331 rative advocacy and leadership; b) public mental health practice; c) public mental health train ing and improving population knowledge; d) improving coverage of public mental health interventions through settings-based approaches, integrated approaches, digital technology, maximizing existing resources, and focus on highreturn interventions; e) a rights approach, legislation and regulation; f) public mental health research, including that focused on implementation.
{"title":"The ICD‐11 is now officially in effect","authors":"P. Pezzella","doi":"10.1002/wps.20982","DOIUrl":"https://doi.org/10.1002/wps.20982","url":null,"abstract":"331 rative advocacy and leadership; b) public mental health practice; c) public mental health train ing and improving population knowledge; d) improving coverage of public mental health interventions through settings-based approaches, integrated approaches, digital technology, maximizing existing resources, and focus on highreturn interventions; e) a rights approach, legislation and regulation; f) public mental health research, including that focused on implementation.","PeriodicalId":49357,"journal":{"name":"World Psychiatry","volume":" ","pages":""},"PeriodicalIF":73.3,"publicationDate":"2022-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41953066","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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