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8 results

  • Bringing together the World Health Organization's QualityRights initiative and the World Psychiatric Association's programme on implementing alternatives to coercion in mental healthcare: a common goal for action

  • Neeraj Gill, Natalie Drew, Maria Rodrigues, Hassan Muhsen, Guadalupe Morales Cano, Martha Savage, Soumitra Pathare, John Allan, Silvana Galderisi, Afzal Javed, Helen Herrman, Michelle Funk
  • Journal:
    BJPsych Open / Volume 10 / Issue 1 / January 2024
    Published online by Cambridge University Press:
    05 January 2024, e23
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  • Background

    Stakeholders worldwide increasingly acknowledge the need to address coercive practices in mental healthcare. Options have been described and evaluated in several countries, as noted recently in major policy documents from the World Health Organization (WHO) and World Psychiatric Association (WPA). The WHO's QualityRights initiative promotes human rights and quality of care for persons with mental health conditions and psychosocial disabilities. A position statement from the WPA calls for implementation of alternatives to coercion in mental healthcare.

    Aims

    We describe the engagement of both the WHO and WPA in this work. We discuss their mutual aim to support countries in improving human rights and quality of care, as well as the differences between these two organisations in their stated goals related to coercion in mental healthcare: the WHO's approach to eliminate coercion and the WPA's goal to implement alternatives to coercion.

    Method

    We outline and critically analyse the common ground between the two organisations, which endorse a similar range of rights-based approaches to promoting non-coercive practices in service provision, including early intervention in prevention and care and other policy and practice changes.

    Results

    Advocacy and action based on an agreed need to find practical solutions and advances in this area have the power to build consensus and unify key actors.

    Conclusions

    We conclude that persons with lived experience, families, mental health professionals and policy makers are now coming together in several parts of the world to work toward the common goals of improving quality, promoting human rights and addressing coercion in mental health services.

  • Chapter 1 - Introduction: Poor, Excluded, and Unequal

  • Jed Boardman, King's College London, Helen Killaspy, University College London, Gillian Mezey, St George's Hospital Medical School, University of London
  • Book:
    Social Inclusion and Mental Health
    Published online:
    24 November 2022
    Print publication:
    08 December 2022, pp 1-20

  • Summary

    This introductory chapter outlines the structure of the book and some of the themes that appear throughout the book. The themes include intersectionality, the role of social factors in causing and maintaining mental ill-health, the need for a public mental health approach, and the role of mental health professionals and services in facilitating social inclusion. We discuss why social exclusion violates social justice and social solidarity, and put forward ten reasons why mental health professionals should be concerned with social exclusion.

  • Perspectives: involving persons with lived experience of mental health conditions in service delivery, development and leadership

  • Charlene Sunkel, Claudia Sartor
  • Journal:
    BJPsych Bulletin / Volume 46 / Issue 3 / June 2022
    Published online by Cambridge University Press:
    12 May 2021, pp. 160-164
    Print publication:
    June 2022
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  • Globally, there has been an emphasis on the importance and value of involving people with lived experience of mental health conditions in service delivery, development and leadership. Such individuals have taken on various roles, from peer support specialists and other specialised professions to leadership in mainstream industries. There are, however, still obstacles to overcome before it is possible to fully include people with lived experience at all levels in the mental health and related sectors. This article discusses the benefits, both to the individual and to the public, of involving persons with lived experience in service delivery, development and leadership.

  • Changes in Access to Australian Disability Support Benefits During a Period of Social Welfare Reform

  • ALEX COLLIE, LUKE R SHEEHAN, TYLER J LANE
  • Journal:
    Journal of Social Policy / Volume 51 / Issue 1 / January 2022
    Published online by Cambridge University Press:
    23 February 2021, pp. 132-154
    Print publication:
    January 2022

  • The Disability Support Pension (DSP) is the major Australian government financial benefit program for people of working age with medical conditions and disabilities that restrict work capacity. Between 2012 and 2018 a series of policy reforms sought to restrict the growth in DSP payments and encourage more people with some work capacity to seek employment. We characterise changes in three markers of access to disability financial support over the reform period (1) DSP recipient rates (2) DSP grant (approval) rates and (3) the rate of unemployment benefit receipt in people with impaired work capacity. Results demonstrate a significant reduction in DSP receipt and grant rates, and significant increase in the rate of unemployment benefit receipt in working-age Australians with work disabling medical conditions and disability. These changes were not distributed uniformly. People whose primary medical condition was a musculoskeletal or circulatory system disorder demonstrated greater declines in DSP receipt and grant rates, while there was a more rapid increase in unemployment benefit receipt among people with primary mental health conditions. Some trend changes occur in periods during which new disability assessment and pension eligibility policies were introduced, though our ability to attribute changes to specific policy changes is limited.

  • Barriers and facilitators for treatment-seeking for mental health conditions and substance misuse: multi-perspective focus group study within the military

  • Rebecca Bogaers, Elbert Geuze, Jaap van Weeghel, Fenna Leijten, Dike van de Mheen, Piia Varis, Andrea Rozema, Evelien Brouwers
  • Journal:
    BJPsych Open / Volume 6 / Issue 6 / November 2020
    Published online by Cambridge University Press:
    25 November 2020, e146
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  • Background

    Globally, millions are exposed to stressors at work that increase their vulnerability to develop mental health conditions and substance misuse (such as soldiers, policemen, doctors). However, these types of professionals especially are expected to be strong and healthy, and this contrast may worsen their treatment gap. Although the treatment gap in the military has been studied before, perspectives of different stakeholders involved have largely been ignored, even though they play an important role.

    Aims

    To study the barriers and facilitators for treatment-seeking in the military, from three different perspectives.

    Method

    In total, 46 people participated, divided into eight homogeneous focus groups, including three perspectives: soldiers with mental health conditions and substance misuse (n = 20), soldiers without mental health conditions and substance misuse (n = 10) and mental health professionals (n = 16). Sessions were audio-taped and transcribed verbatim. Content analysis was done by applying a general inductive approach using ATLAS.ti-8.4.4 software.

    Results

    Five barriers for treatment-seeking were identified: fear of negative career consequences, fear of social rejection, confidentiality concerns, the ‘strong worker’ workplace culture and practical barriers. Three facilitators were identified: social support, accessibility and knowledge, and healthcare within the military. The views of the different stakeholder groups were highly congruent.

    Conclusions

    Barriers for treatment-seeking were mostly stigma related (fear of career consequences, fear of social rejection and the ‘strong worker’ workplace culture) and this was widely recognised by all groups. Social support from family, peers, supervisors and professionals were identified as important facilitators. A decrease in the treatment gap for mental health conditions and substance misuse is needed and these findings provide direction for future research and destigmatising interventions.

  • Dismantling the social safety net: social security reforms, disability and mental health conditions

  • Jed Boardman
  • Journal:
    BJPsych Bulletin / Volume 44 / Issue 5 / October 2020
    Published online by Cambridge University Press:
    17 July 2020, pp. 208-212
    Print publication:
    October 2020
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  • This article examines the effects of UK welfare reform since 2008 on people with mental health conditions and disabilities. The results have been profound, particularly during a time of economic austerity, damaging the social safety net and pushing many vulnerable people into poverty and hardship. It has perpetuated inequalities and increased the social exclusion of disabled groups. The holes in the safety net require repair, alongside extensive social policy reform to both protect and empower people with disabilities and long-term conditions.

  • CHAPTER 4 - Access to early pregnancy care

  • Edited by Tahir Mahmood, Philip Owen, Sabaratnam Arulkumaran, Charnjit Dhillon
  • Book:
    Models of Care in Maternity Services
    Published online:
    05 July 2014
    Print publication:
    01 November 2010, pp 34-47

  • Summary

    Early pregnancy services should be modelled in such a way that they are accessible to deal with all the problems of early pregnancy, such as bleeding and medical conditions such as hyperemesis gravidarum, and also to facilitate routine antenatal care before the 12th week of pregnancy. The National Institute for Health and Care Excellence (NICE) antenatal care guideline recommended that booking with maternity services should take place before 12 weeks of pregnancy. The model of care for all early pregnancy events should be composed around the women's journey. It is important to have local care pathways in place for initial assessment, investigations for contributing causes and focused treatment. All clinical staff must undertake regular, written and documented audited training for the identification and initial management of referral for serious medical and mental health conditions that may affect pregnant women or recently delivered mothers.