Pub Date : 2014-11-01DOI: 10.1192/S1749367600004707
M. Prom, Jeffrey Stovall, Luis E. Bedregal, J. Phillips, M. Davidson
This study examines the role of the patient–provider relationship (alliance) and patient satisfaction in early patient withdrawal from mental health therapy in rural Peru. A prospective comparison of 60 patients demonstrated that early withdrawal was associated with the clinician’s, but not the patient’s, evaluation of the patient–provider alliance. This suggests that the satisfaction and alliance questionnaires typically used in high-income countries may not be effective in evaluating patient attitudes in this population, but may be useful for clinician evaluations of the alliance. Clinicians can use the Working Alliance Inventory to indicate the need for early intervention to prevent patient drop-out in middle- and low-income countries.
{"title":"Therapeutic alliance: satisfaction and attrition of patients from a mental health clinic in Ayacucho, Peru","authors":"M. Prom, Jeffrey Stovall, Luis E. Bedregal, J. Phillips, M. Davidson","doi":"10.1192/S1749367600004707","DOIUrl":"https://doi.org/10.1192/S1749367600004707","url":null,"abstract":"This study examines the role of the patient–provider relationship (alliance) and patient satisfaction in early patient withdrawal from mental health therapy in rural Peru. A prospective comparison of 60 patients demonstrated that early withdrawal was associated with the clinician’s, but not the patient’s, evaluation of the patient–provider alliance. This suggests that the satisfaction and alliance questionnaires typically used in high-income countries may not be effective in evaluating patient attitudes in this population, but may be useful for clinician evaluations of the alliance. Clinicians can use the Working Alliance Inventory to indicate the need for early intervention to prevent patient drop-out in middle- and low-income countries.","PeriodicalId":88529,"journal":{"name":"International psychiatry : bulletin of the Board of International Affairs of the Royal College of Psychiatrists","volume":"11 1","pages":"95 - 97"},"PeriodicalIF":0.0,"publicationDate":"2014-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"66154810","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2014-11-01DOI: 10.1192/S1749367600004719
Xiuqin Huang, Shijun Du, Sanju George
We studied Chinese psychiatrists’ understanding of gambling addiction, as well as their experiences of and confidence in assessing and treating these patients. To this end, we carried out a postal questionnaire survey of 110 psychiatrists working in China. A majority had seen people with gambling addiction in their practice but only 1 of the 110 psychiatrists had ever received any training in the management of the condition. A large majority of psychiatrists indicated that gambling addiction was an important public health problem and 71.8% said they would like to be more involved in its management. Much more needs to be done to improve the identification and treatment of gambling addiction in China.
{"title":"Gambling addiction in China: a survey of Chinese psychiatrists","authors":"Xiuqin Huang, Shijun Du, Sanju George","doi":"10.1192/S1749367600004719","DOIUrl":"https://doi.org/10.1192/S1749367600004719","url":null,"abstract":"We studied Chinese psychiatrists’ understanding of gambling addiction, as well as their experiences of and confidence in assessing and treating these patients. To this end, we carried out a postal questionnaire survey of 110 psychiatrists working in China. A majority had seen people with gambling addiction in their practice but only 1 of the 110 psychiatrists had ever received any training in the management of the condition. A large majority of psychiatrists indicated that gambling addiction was an important public health problem and 71.8% said they would like to be more involved in its management. Much more needs to be done to improve the identification and treatment of gambling addiction in China.","PeriodicalId":88529,"journal":{"name":"International psychiatry : bulletin of the Board of International Affairs of the Royal College of Psychiatrists","volume":"11 1","pages":"98 - 99"},"PeriodicalIF":0.0,"publicationDate":"2014-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"66154872","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2014-11-01DOI: 10.1192/S1749367600004690
D. Jimenez, Christina Alejandrina Eguiguren, Dominic Dougall, Bartłomiej Pliszka, Ian Hall
Mental health law in Peru is developing. The Peruvian Constitution enshrines important human rights principles in relation to people with mental health problems but the enactment of such principles into national legislation is very patchy. This means that people with mental health problems, especially those admitted to hospital, may not receive optimum care and may be at risk of having their human rights breached. In this article we consider how far the current national legislation meets these constitutional rights and what the legislation that is in development may ultimately achieve.
{"title":"Mental health law in Peru: work in progress","authors":"D. Jimenez, Christina Alejandrina Eguiguren, Dominic Dougall, Bartłomiej Pliszka, Ian Hall","doi":"10.1192/S1749367600004690","DOIUrl":"https://doi.org/10.1192/S1749367600004690","url":null,"abstract":"Mental health law in Peru is developing. The Peruvian Constitution enshrines important human rights principles in relation to people with mental health problems but the enactment of such principles into national legislation is very patchy. This means that people with mental health problems, especially those admitted to hospital, may not receive optimum care and may be at risk of having their human rights breached. In this article we consider how far the current national legislation meets these constitutional rights and what the legislation that is in development may ultimately achieve.","PeriodicalId":88529,"journal":{"name":"International psychiatry : bulletin of the Board of International Affairs of the Royal College of Psychiatrists","volume":"11 1","pages":"93 - 94"},"PeriodicalIF":0.0,"publicationDate":"2014-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"66154749","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2014-11-01DOI: 10.1192/S1749367600004720
Hilda Ho
Mental health services and legislation in Brunei Darussalam have undergone a period of development and reform. This paper describes the challenges met, recent innovations and priority areas for the next 10 years.
{"title":"Mental healthcare in Brunei Darussalam: recent developments in mental health services and mental health law","authors":"Hilda Ho","doi":"10.1192/S1749367600004720","DOIUrl":"https://doi.org/10.1192/S1749367600004720","url":null,"abstract":"Mental health services and legislation in Brunei Darussalam have undergone a period of development and reform. This paper describes the challenges met, recent innovations and priority areas for the next 10 years.","PeriodicalId":88529,"journal":{"name":"International psychiatry : bulletin of the Board of International Affairs of the Royal College of Psychiatrists","volume":"11 1","pages":"100 - 102"},"PeriodicalIF":0.0,"publicationDate":"2014-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1192/S1749367600004720","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"66154915","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mental health services and legislation in Brunei Darussalam have undergone a period of development and reform. This paper describes the challenges met, recent innovations and priority areas for the next 10 years.
{"title":"Mental healthcare in Brunei Darussalam: recent developments in mental health services and mental health law.","authors":"Hilda Ho","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Mental health services and legislation in Brunei Darussalam have undergone a period of development and reform. This paper describes the challenges met, recent innovations and priority areas for the next 10 years.</p>","PeriodicalId":88529,"journal":{"name":"International psychiatry : bulletin of the Board of International Affairs of the Royal College of Psychiatrists","volume":"11 4","pages":"100-102"},"PeriodicalIF":0.0,"publicationDate":"2014-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/55/65/IP-11-100.PMC6735131.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41223173","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2014-11-01DOI: 10.1192/S1749367600004665
H. Burdett, N. Greenberg, N. Fear, N. Jones
Risk factors for poor mental health among UK veterans include demonstrating symptoms while in service, being unmarried, holding lower rank, experiencing childhood adversity and having a combat role; however, deployment to a combat zone does not appear to be associated with mental health outcomes. While presentation of late-onset, post-service difficulties may explain some of the difference between veterans and those in service, delayed-onset post-traumatic stress disorder (PTSD) appears to be partly explained by prior subthreshold PTSD, as well as other mental health difficulties. In the longer term, veterans do not appear to suffer worse mental health than equivalent civilians. This overall lack of difference, despite increased mental health difficulties in those who have recently left, suggests that veterans are not at risk of worse mental health and/or that poor mental health is a cause, rather than a consequence, of leaving service.
{"title":"The mental health of military veterans in the UK","authors":"H. Burdett, N. Greenberg, N. Fear, N. Jones","doi":"10.1192/S1749367600004665","DOIUrl":"https://doi.org/10.1192/S1749367600004665","url":null,"abstract":"Risk factors for poor mental health among UK veterans include demonstrating symptoms while in service, being unmarried, holding lower rank, experiencing childhood adversity and having a combat role; however, deployment to a combat zone does not appear to be associated with mental health outcomes. While presentation of late-onset, post-service difficulties may explain some of the difference between veterans and those in service, delayed-onset post-traumatic stress disorder (PTSD) appears to be partly explained by prior subthreshold PTSD, as well as other mental health difficulties. In the longer term, veterans do not appear to suffer worse mental health than equivalent civilians. This overall lack of difference, despite increased mental health difficulties in those who have recently left, suggests that veterans are not at risk of worse mental health and/or that poor mental health is a cause, rather than a consequence, of leaving service.","PeriodicalId":88529,"journal":{"name":"International psychiatry : bulletin of the Board of International Affairs of the Royal College of Psychiatrists","volume":"11 1","pages":"88 - 89"},"PeriodicalIF":0.0,"publicationDate":"2014-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"66154644","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2014-11-01DOI: 10.1192/S174936760000463X
N. Greenberg
The mental health of military veterans has been, and continues to be, a topic of heated political and journalistic debate. There is a well-documented impact of conflict upon the mental health of service personnel, and most nations have aimed to provide effective care for individuals who have fought for their country. However, as the three thematic papers in this issue demonstrate, the realities of service-related mental health are rather more complex than they initially appear.
{"title":"What’s so special about military veterans?","authors":"N. Greenberg","doi":"10.1192/S174936760000463X","DOIUrl":"https://doi.org/10.1192/S174936760000463X","url":null,"abstract":"The mental health of military veterans has been, and continues to be, a topic of heated political and journalistic debate. There is a well-documented impact of conflict upon the mental health of service personnel, and most nations have aimed to provide effective care for individuals who have fought for their country. However, as the three thematic papers in this issue demonstrate, the realities of service-related mental health are rather more complex than they initially appear.","PeriodicalId":88529,"journal":{"name":"International psychiatry : bulletin of the Board of International Affairs of the Royal College of Psychiatrists","volume":"11 1","pages":"81 - 83"},"PeriodicalIF":0.0,"publicationDate":"2014-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1192/S174936760000463X","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"66154899","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
James M Thompson, Mark A Zamorski, Deniz Fikretoglu, Linda VanTil, Jitender Sareen, Mary Beth MacLean, Pasqualina Carrese, Stewart Macintosh, David Pedlar
In the past 15 years in Canada, as in other nations, the mental health of veterans has emerged as a key concern for both government and the public. As mental health service enhancement unfolded, the need for wider population studies became apparent. This paper describes the renewal of services and key findings from national surveys of serving personnel and veterans.
{"title":"Out of the shadows: mental health of Canadian armed forces veterans.","authors":"James M Thompson, Mark A Zamorski, Deniz Fikretoglu, Linda VanTil, Jitender Sareen, Mary Beth MacLean, Pasqualina Carrese, Stewart Macintosh, David Pedlar","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>In the past 15 years in Canada, as in other nations, the mental health of veterans has emerged as a key concern for both government and the public. As mental health service enhancement unfolded, the need for wider population studies became apparent. This paper describes the renewal of services and key findings from national surveys of serving personnel and veterans.</p>","PeriodicalId":88529,"journal":{"name":"International psychiatry : bulletin of the Board of International Affairs of the Royal College of Psychiatrists","volume":"11 4","pages":"85-87"},"PeriodicalIF":0.0,"publicationDate":"2014-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6735134/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141728536","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2014-11-01DOI: 10.1192/S1749367600004628
M. Zahid, M. Alsuwaidan
The oil-rich member states of the Gulf Cooperation Council (GCC) attract large numbers of migrant workers. The reported rates of psychiatric morbidity among these migrant workers are higher than among nationals, while the mental health services in the GCC countries remain inadequate in terms of both staff and service delivery. The multi-ethnic origin of migrants poses considerable challenges in this respect. The development of mental illness in migrants, especially when many of them remain untreated or inadequately treated, results in their premature repatriation, and the mentally ill migrant ends up facing the same economic hardships which led to migration in the first place. The availability of trained interpreters and transcultural psychiatrists, psychologists and social workers should make psychiatric diagnoses more accurate. Suitable rehabilitation services are also needed.
{"title":"The mental health needs of immigrant workers in Gulf countries","authors":"M. Zahid, M. Alsuwaidan","doi":"10.1192/S1749367600004628","DOIUrl":"https://doi.org/10.1192/S1749367600004628","url":null,"abstract":"The oil-rich member states of the Gulf Cooperation Council (GCC) attract large numbers of migrant workers. The reported rates of psychiatric morbidity among these migrant workers are higher than among nationals, while the mental health services in the GCC countries remain inadequate in terms of both staff and service delivery. The multi-ethnic origin of migrants poses considerable challenges in this respect. The development of mental illness in migrants, especially when many of them remain untreated or inadequately treated, results in their premature repatriation, and the mentally ill migrant ends up facing the same economic hardships which led to migration in the first place. The availability of trained interpreters and transcultural psychiatrists, psychologists and social workers should make psychiatric diagnoses more accurate. Suitable rehabilitation services are also needed.","PeriodicalId":88529,"journal":{"name":"International psychiatry : bulletin of the Board of International Affairs of the Royal College of Psychiatrists","volume":"11 1","pages":"79 - 81"},"PeriodicalIF":0.0,"publicationDate":"2014-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1192/S1749367600004628","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"66154558","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2014-11-01DOI: 10.1192/S1749367600004689
Andrea Bahamondes, A. Barrera, Jorge Calderón, Martin Cordero, H. Duque
Chile does not have a mental health law or act, and no single legal body protecting those deemed to be afflicted by a mental disorder, setting standards of care and protecting and promoting their rights. Instead, pieces of mental health legislation are scattered about in different legal and administrative documents, including the country’s Constitution, Health Code, Criminal Code and Civil Code. Remarkably, mental health legislation was the object of virtually no change or amendment from the middle of the 19th century until the year 2001. New pieces of legislation have been issued since but, despite improvements in the protection of people suffering from a mental illness, a mental health law in Chile is still needed.
{"title":"Mental health legislation in Chile","authors":"Andrea Bahamondes, A. Barrera, Jorge Calderón, Martin Cordero, H. Duque","doi":"10.1192/S1749367600004689","DOIUrl":"https://doi.org/10.1192/S1749367600004689","url":null,"abstract":"Chile does not have a mental health law or act, and no single legal body protecting those deemed to be afflicted by a mental disorder, setting standards of care and protecting and promoting their rights. Instead, pieces of mental health legislation are scattered about in different legal and administrative documents, including the country’s Constitution, Health Code, Criminal Code and Civil Code. Remarkably, mental health legislation was the object of virtually no change or amendment from the middle of the 19th century until the year 2001. New pieces of legislation have been issued since but, despite improvements in the protection of people suffering from a mental illness, a mental health law in Chile is still needed.","PeriodicalId":88529,"journal":{"name":"International psychiatry : bulletin of the Board of International Affairs of the Royal College of Psychiatrists","volume":"11 1","pages":"90 - 92"},"PeriodicalIF":0.0,"publicationDate":"2014-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1192/S1749367600004689","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"66154706","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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