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A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Mental Health".

Deadline for manuscript submissions: closed (30 June 2023) | Viewed by 11648

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Special Issue Editors

Dr. Bridget Bassilios

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Guest Editor

Melbourne School of Population and Global Health, The University of Melbourne, Parkville, VIC 3010, Australia
Interests: evaluating mental health care and suicide prevention reforms; investigating clinical and psychosocial outcomes of mental health treatment services and models; use of innovations (e.g., digital health) to address barriers to mental health care

Dr. Meredith Harris

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Guest Editor

School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane 4072, Australia
Interests: investigating clinical and psychosocial outcomes of mental health treatment services and models; evaluating mental health care reforms; understanding population patterns of mental health service utilisation and experiences of care

Special Issue Information

Dear Colleagues,

We invite you to contribute a manuscript to a Special Issue of the International Journal of Environmental Research and Public Health (impact factor 2.8; https://0-www-mdpi-com.brum.beds.ac.uk/journal/ijerph) focusing on primary mental health care including, but not limited to, innovations that optimise access, effectiveness, efficiency and quality.

Mental disorders are among the top two contributors to global burden of disease as measured in years lived with disability, affecting more than 125 million people worldwide in 2019. Primary mental health services that are universally accessible, effective, efficient and of high quality have the potential to help address this important public health problem. However, a substantial portion of people with mental health problems do not access treatment–some by choice and others due to various access barriers–and others do not attain the desired benefits of the treatment they receive. Among those who seek treatment, most do so in a primary care setting in which general practitioners (family physicians) are often the first point of contact. Primary mental health care involves psychological interventions, pharmacotherapy, referrals and follow-up care to treat or prevent mental disorders. It also includes suicide prevention services for at-risk individuals and their families. Primary mental health care services can be delivered face to face or, increasingly, via other modes of communication such as mobile devices. Around the globe, initiatives to improve the reach, quality and outcomes of primary mental health care are at various stages of development, with countries such as Australia and the United Kingdom leading the way and offering lessons learned to other similar countries.

Dr. Bridget Bassilios
Dr. Meredith Harris
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2500 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

mental disorders
health services
primary care
stepped care
service utilisation
health policy
evaluation
implementation
cost-effectiveness

Published Papers (4 papers)

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Research

11 pages, 299 KiB

Open AccessArticle

Implementing and Delivering Youth Mental Health Services: Approaches Taken by the Australian Primary Health Network ‘Lead Sites’

by Sanne Oostermeijer, Michelle Williamson, Angela Nicholas, Anna Machlin and Bridget Bassilios

Int. J. Environ. Res. Public Health 2022, 19(17), 10494; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph191710494 - 23 Aug 2022

Cited by 1 | Viewed by 1353

Abstract

Aim: This paper aims to report on effective approaches for, and early impacts of, implementing and delivering services for youth with, or at risk of, severe mental illness commissioned by 10 Primary Health Network (PHN) Lead Sites (reform leaders) in Australia. Methods: The following qualitative data sources were analyzed using a thematic approach: focus group consultations with 68 Lead Site staff and 70 external stakeholders from Lead Site regions; and observational data from one Lead Site meeting with a focus on services for youth with, or at risk of, severe mental illness and one national symposium that was attended by Lead Site staff and service providers. Results: The Lead Site staff described common effective strategies for implementing and delivering youth enhanced services as follows: building on existing youth services, establishing effective linkages with other local youth enhanced services, and providing complementary clinical and non-clinical services. Early impacts of youth enhanced services that were described by Lead Site staff and external stakeholders included: improved service quality and access, positive effects on consumers and/or carers (e.g., reduced symptomology), and sector-wide impacts such as improved service integration. Staff members from two Lead Sites also mentioned negative impacts (e.g., uncertainty of continued funding). Suggestions for future improvements by Lead Site staff and external stakeholders included: involving young people in service design and planning, improving service access, addressing clinical workforce shortages, improving data collection and usage, and establishing greater service integration. Conclusions: These findings highlight the necessity for collaborative and localized responses as well as service models that combine clinical and non-clinical care to address the needs of young people with, or at risk of, severe mental illness. Early impacts that were reported by stakeholders indicated that PHN-commissioned youth-enhanced services had positive impacts for consumers, carers, and the wider service sector. Full article

(This article belongs to the Special Issue Primary Mental Health Care)

12 pages, 1138 KiB

Open AccessArticle

Trends in Primary Mental Health Care Service Use and Subsequent Self-Harm in Western Sydney Australia: Policy and Workforce Implications

by Sithum Munasinghe, Andrew Page, Sandro Sperandei, Pankaj Gaur, Shahana Ferdousi, Haider Mannan and Vlasios Brakoulias

Int. J. Environ. Res. Public Health 2022, 19(6), 3382; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph19063382 - 13 Mar 2022

Viewed by 2207

Abstract

Background: This study investigated the trends in primary mental health care (PMHC) service use and hospital-treated self-harm in Western Sydney (Australia). Methods: A data linkage study and descriptive ecological study of PMHC referrals investigated the trends in referrals, treatment attendance, hospital-treated self-harm, and health care practitioners (HCPs) for the period of 2013−2018 (n = 19,437). Results: There was a substantial increase in referrals from 2016. The majority of referrals were females (60.9%), those aged <45 years (71.3%), and those presenting with anxiety or affective disorders (78.9%). Referrals of those at risk of suicide increased from 9.7% in 2013 to 17.8% in 2018. There were 264 (2.2%) cases of subsequent hospital-treated self-harm, with higher rates among those at risk of suicide and those who attended <6 sessions. The number of HCPs per referral also increased from 2013, as did waiting times for treatment initiation. Conclusion: Individuals presenting to PMHC services at risk of suicide, and who subsequently presented to a hospital setting following self-harm, were more likely to either not attend services following a referral or to attend fewer services. This trend occurred in the context of an increase in the number of clients per HCP, suggesting workforce capacity has not kept pace with demand. Full article

(This article belongs to the Special Issue Primary Mental Health Care)

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17 pages, 1148 KiB

Open AccessArticle

Treatment Preferences for Pharmacological versus Psychological Interventions among Primary Care Providers in Nepal: Mixed Methods Analysis of a Pilot Cluster Randomized Controlled Trial

by Anvita Bhardwaj, Dristy Gurung, Sauharda Rai, Bonnie N. Kaiser, Cori L. Cafaro, Kathleen J. Sikkema, Crick Lund, Nagendra P. Luitel and Brandon A. Kohrt

Int. J. Environ. Res. Public Health 2022, 19(4), 2149; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph19042149 - 14 Feb 2022

Cited by 4 | Viewed by 2575

Abstract

There is increasing evidence supporting the effectiveness of psychological interventions in low- and middle-income countries. However, primary care providers (PCPs) may prefer treating patients with medication. A secondary exploratory analysis of a pilot cluster randomized controlled trial was conducted to evaluate psychological vs. pharmacological treatment preferences among PCPs. Thirty-four health facilities, including 205 PCPs, participated in the study, with PCPs in 17 facilities assigned to a standard version of the mental health Gap Action Programme (mhGAP) training delivered by mental health specialists. PCPs in the other 17 facilities received mhGAP instruction delivered by specialists and people with lived experience of mental illness (PWLE), using a training strategy entitled Reducing Stigma among HealthcAre ProvidErs (RESHAPE). Pre- and post- intervention attitudes were measured through quantitative and qualitative tools. Qualitative interviews with 49 participants revealed that PCPs in both arms endorsed counseling’s benefits and collaboration within the health system to provide counseling. In the RESHAPE arm, PCPs were more likely to increase endorsement of statements such as “depression improves without medication” (F = 9.83, p < 0.001), “not all people with depression must be treated with antidepressants” (χ² = 17.62, p < 0.001), and “providing counseling to people who have alcohol abuse problems is effective” (χ² = 26.20, p < 0.001). These mixed-method secondary findings from a pilot trial suggest that in-person participation of PWLE in training PCPs may not only reduce stigma but also increase PCPs’ support of psychological interventions. This requires further investigation in a full-scale trial. Full article

(This article belongs to the Special Issue Primary Mental Health Care)

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19 pages, 391 KiB

Open AccessArticle

Working with Young People at Risk of Suicidal Behaviour and Self-Harm: A Qualitative Study of Australian General Practitioners’ Perspectives

by India Bellairs-Walsh, Sadhbh J. Byrne, Sarah Bendall, Yael Perry, Karolina Krysinska, Ashleigh Lin, Maria Michail, Michelle Lamblin, Tina Yutong Li, Sarah Hetrick and Jo Robinson

Int. J. Environ. Res. Public Health 2021, 18(24), 12926; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph182412926 - 08 Dec 2021

Cited by 3 | Viewed by 4202

Abstract

General Practitioners (GPs) play a crucial role in the identification and support of young people at risk of suicidal behaviour and self-harm; however, no studies have explored GPs’ perspectives, approaches, challenges, and resource needs when working with this cohort in an Australian setting. This was a qualitative study where fifteen GPs (M_age = 45.25 years) from multiple clinics in Western Australia took part in semi-structured interviews, and data were analysed thematically. Seven main themes were identified: (1) working with young people has its unique challenges; (2) screening and assessment tools can help to manage uncertainty and discomfort; (3) going beyond tools–the dialogue and relationship are most important; (4) there are limits to what we can offer in the time available; (5) the service access and referral pathways lack clarity and coordination; (6) the provision of mental health support should not fall on GPs alone; and (7) more comprehensive training in suicide and self-harm is needed. The findings highlight a number of opportunities to enhance care and better assist GPs working with young people who present with suicidal behaviour and self-harm, including considerations for conducting assessments, targeted resources such as training, and system and service improvements. Full article

(This article belongs to the Special Issue Primary Mental Health Care)

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