SSM. Mental health最新文献

Objectives

Informed by the Medical Research Council's process evaluation framework (Moore et al., 2015), this study explored the experiences of a newly developed brief compassion-focused intervention for trainee mental health professionals (tMHPs).

Design

A qualitative approach was taken, using semi-structured interviews analysed with thematic analysis (Braun and Clarke, 2006).

Method

The intervention was developed and planned in collaboration with key stakeholders. The intervention was piloted by delivering it to tMHPs at course centres in England as part of their core teaching programme. Qualitative methods were employed to explore the experiences of the intervention using in-depth semi-structured interviews (n = 19).

Results

Whilst several suggested improvements were recommended by participants, the experience of the intervention was generally good. Participants reported finding the intervention helpful and described positive changes they subsequently noticed in themselves and their work. Factors facilitating engagement with and implementation of the intervention, such as interactive and experiential content, were discussed as improving experience. Conversely, contextual factors, such as multiple demands and levels of support, were most consistently spoken about as preventing participants from being able to make use of the intervention.

Conclusions

The brief compassion-focused intervention was largely perceived to be helpful and valuable. However, some aspects of the intervention and the context in which it was delivered were discussed as creating barriers to engagement and implementation, thereby impacting experience. These findings have several clinical implications and highlight areas for further research.

Background

Psychiatric patients are vulnerable to disruptions caused by the Corona Virus Disease 2019 (COVID-19) pandemic. This study aimed to investigate the effects of the pandemic on mental health symptoms and suicidality among these patients during lockdowns.

Methods

This repeated cross-sectional study utilized data from “Psychological distress and Coping in Patients in Community Mental Health Centers during COVID-19 pandemic (PsyCo-COVID-19) " study, conducted in two phases between June–July 2020 and March–April 2021. It included 261 participants from six Community Mental Health Centers (CMHCs) who completed a digital questionnaire, including Norwegian version of Mini International Neuropsychiatric Interview Plus (M.I.N.I. Plus), Hopkins Symptoms Checklist (HSCL-25), Post-traumatic Stress Disorder Checklist (PCL-5).

Results

A higher percentage of patients reported PTSD during the second phase of lockdown (47.4%) compared to the first phase of lockdown (33.7%). A third of participants (33.7%) reported high levels of suicidality. Moderate to severe effects of pandemic on mental health were associated with a significantly higher risk of suicide (AOR = 3.12; 95% CI: 1.50, 6.48; p = 0.0001), while having children (AOR = 0.35; 95% CI: 0.16, 0.76; p = 0.008) and being employed (AOR = 0.44; 95% CI: 0.23, 0.84; p = 0.013) were protective factors. Non-Norwegian background was associated with a higher risk of suicide (AOR = 2.59; 95% CI: 1.08, 6.19; p = 0.032).

Conclusion

High prevalence of suicidality was found among patients in CMHCs in Norway, with a significant association with self-reported worsening of mental health. PTSD and suicidality increased significantly during the second phase of lockdown, emphasizing the lasting impact of the pandemic on mental health. Targeted interventions and support services are needed for psychiatric patients during times of increased stress and uncertainty. Healthcare providers should be aware of the increased risk of suicide and provide appropriate support and interventions to prevent adverse outcomes.

Loneliness results from unfulfilled social relationship expectations (SREs). Little research has investigated how SREs vary by culture and context, how loneliness is experienced in rural Southeast Asia, and how loneliness relates to care provision in later life. The current study qualitatively explored the understanding of loneliness, contextual differences in the content, avenues, and obstacles for SREs, and care provided by Myanmar and Thai people living at the border in Chiang Rai. Data were analysed using thematic analysis. Between November and December 2022, 10 focus group discussions were held with 17 migrants from Myanmar and 33 older people from Thailand. Emerging themes from the focus groups shed light on how loneliness differs between cultures and contexts. Loneliness was experienced particularly at night, when people thought about their unmet relationship expectations. Having “nothing to do” and overthinking were closely related to the experience of loneliness, whereas engaging in activities, including caregiving, alleviated loneliness. Compared to Myanmar adults, Thai older adults were more likely to have family members nearby but less likely to share personal problems and feelings of loneliness with others. Fulfilling the SREs of proximity, generativity, and respect was more challenging for Myanmar migrants, who had been unable to return home for years while struggling with financial insecurity.

This study assessed perception and experience of trained primary health care workers in using a mobile app-based version of the WHO mental health gap action programme (mhGAP) Intervention Guide in the assessment and management of people with mental health conditions in primary care in Nepal. A qualitative study was conducted with primary healthcare workers who were trained in using the WHO mhGAP mobile application in Jhapa, a district in eastern Nepal. Semi-structured interviews were carried out with 15 healthcare workers (3 females and 12 males) nine months after the training. Interviews were audio recorded, transcribed and translated into English for the thematic qualitative data analysis. Health care workers (HCWs) found the mobile app helpful to verify and confirm their assessment and diagnosis. The other benefits reported by the participants were: bringing uniformity in diagnosis and management of mental health conditions across primary healthcare facilities; reminding the HCWs specific assessment questions; creating awareness on the importance of psychosocial intervention; improving the interaction between patients and service providers; and the importance of follow-up care. Despite these advantages, lack of clarity about report submission modality; lack of electricity or internet connectivity; and low technology literacy among older HCWs were some of the barriers in using the app. The major recommendation made by the HCWs for the guide included revision of the assessment process and system; inclusion of a chat function with supervisors; minimizing the amount of patients’ data to be collected in the app; and addition of conversion and anxiety disorders to the app. This study concludes that the mobile decision support application could be acceptable and feasible in primary care settings if the suggested modifications are incorporated, in addition to addressing other systemic issues facing the primary care-based delivery of mental health services.