21 resultados para Mental Health
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ABSTRACT: Background: Childhood is a critical time for social and emotional development, educational progress and mental health prevention. Mental health for children and adolescents is defined by the achievement of expected developmental, cognitive, social and emotional skills. The development of child-adolescent mental health services (CAMHS) is a necessity for each country, not only as a prevention measure for the wellbeing of people, but also as an investment to the future of countries. Qualitative evaluation of services is the only way to ensure whether services function under quality standards and increase the possibility of better outcomes for their patients. This study examines the greek outpatient CAMHS against the British Standards of National Institute of Excellence for community CAMHS. The Standards assessed refer to the areas of Assessment, Care and Intervention. Objectives: The main objectives of the study are 1) to evaluate Greek outpatient CAMHS in the Attica region 2) to promote the evaluation process for mental health services in Greece. Methods: Due to the fact that Greek services are based on the British model, the tool used was the British self-review questionnaire of Quality Network for Community CAMHS(QNCC).The tool was translated, adapted and posted to services. Twelve out of twenty outpatient CAMHS of Attica (including Athens) responded. Data was collected and performed by the Statistical Package for Social Sciences SPSS. Results: The study resulted that the CAMHS examined, meet moderately the British Standards of 1) Referral and Access, 2) Assessment & Care planning, 3) Care & Intervention. Two out of twelve services examined, meet the standards of "Assessment and Care" in a higher percentage between 75% and 100%. Conclusions: The paper describes a satisfactory function of CAMHS in Attica prefecture taking into consideration the extremely difficult political situation of Greece at the time of the research. Strong and weak domains are identified. Also the translation and adaptation of British tools promote the evaluation process and quality assurance of Greek CAMHS.
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RESUMO: O Ministrio da Sade do Governo do Ruanda identifica a sade mental como uma rea de prioridade estratgica para a interveno em resposta alta carga dos transtornos mentais no Ruanda. Ao longo dos ltimos 20 anos aps o genocdio, o sector pblico reconstruiu sua Resposta Nacional de Sade Mental com base no acesso equitativo aos cuidados, atravs do desenvolvimento de uma Poltica Nacional de Sade Mental e novas estruturas de sade mental. A poltica de Sade Mental do Ruanda, revista em 2010, prima pela descentralizao e integrao dos servios de sade mental em todas as estruturas nacionais do sistema de sade e ao nvel da comunidade. O presente estudo de caso tem como objetivo avaliar a situao do sistema de sade mental de um distrito tpico de uma rea rural no Ruanda, e sugerir melhorias, incluindo algumas estratgias para monitoras as mudanas. Os resultados do estudo permitiro ao Ruanda reforar a sua capacidade para implementar o Plano Nacional de Sade Mental ao nvel dos distritos. O relatrio tambm ser til para monitorar o progresso da implementao de servios de sade mental nos distritos, incluindo a prestao de servios de base comunitria e a participao dos usurios, suas famlias e outros interessados na promoo, preveno, assistncia e reabilitao em sade mental. Este estudo tambm procurou avaliar o progresso da implementao dos cuidados de sade mental a nvel descentralizado, com vista a compreender as implicaes em termos de recursos desses processos. Foi realizada uma anlise situacional num local do distrito, baseado em entrevistas com as principais partes interessadas responsveis, usando o Instrumento de Avaliao de Sistemas de Sade Mental da Organizao Mundial da Sade (WHO-AIMS). Os resultados sugerem que os recursos humanos para a sade mental e servios de base comunitria de sade mental no distrito continuam a ser extremamente limitados. Os profissionais de sade mental so adicionalmente limitados na sua capacidade para oferecer intervenes de emergncia a pacientes psiquitricos e garantir a continuidade do tratamento farmacolgico a pacientes com condies crnicas. Para planejar efetivamente, de acordo com as necessidades da comunidade, sugerimos que o sistema de sade mental deve envolver tambm os representantes das famlias e dos usurios no processo de planificao de modo a melhorar a sua contribuio no processo de implementao das atividades de sade mental. Este estudo de caso do Distrito de Bugesera oferece a primeira anlise de nvel distrital dos servios de sade mental no Ruanda, e pode servir como uma mais-valia para a melhoria do sistema de sade mental, incluindo a advocacia para a melhoria da qualidade dos cuidados de sade mental a este nvel, aumentando o financiamento para a implementao de servios clnicos de sade mental e os recursos humanos disponveis para a prestao de cuidados de sade mental, principalmente a nvel dos cuidados primrios.--------------------- ABSTRACT: To deal with the high burden of mental health disorders resulting from consequences of the 1994 genocide against Tutsis, the Rwanda Ministry of Health (MoH) considers mental health as a priority intervention. For the last 20 years, Ministry of Health focused on rebuilding a national and equity-oriented mental health program responding to the population needs in mental health. Mental health services are now decentralized and integrated in the national health system, from the community level up to the referral level. This study assessed the situation of mental health services in one rural district in Rwanda. It was aimed at assessing the progress of implementation of mental health care at the decentralized level, focusing on resource implications and processes. This study is based on interviews conducted with key stakeholders, using the World Health Organization's Assessment Instrument for Mental Health Systems (WHO-AIMS). Findings show that human resources for mental health care and community-based mental health services of the assessed district remain extremely limited. Mental health professionals face limitation regarding the ability to provide emergency management of psychiatric patients and to ensure continuity of psychopharmacological treatment of patients with chronic conditions. To improve the implementation process of mental health interventions and activities, a planning process based on community needs and the involvement of representatives of families and users in planning process should be considered. The Bugesera case study on the situation of mental health services can serve as a baseline for improvement of the mental health program in Rwanda, in terms of quality care services, infrastructure and equipment, human and financial resources.
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RESUMO: O Royal College of Psychiatrists tem um programa de voluntariado internacional desde 2005. O interesse no Reino Unido tem crescido nos ltimos 15 anos com muitos projetos novos. Os benefcios para vrios pases tm sido reconhecidos. O que est menos claro so os benefcios da experincia para o Reino Unido e do programa de voluntariado do Royal College of Psychiatrists. O objectivo desta dissertao explorar os benefcios do voluntariado para o Sistema Nacional de Sade focando principalmente, mas no exclusivamente, o programa de voluntariado do Royal College of Psychiatrists. Nesta dissertao abordamos primeiro o contexto antes de discutirmos dois grandes estudos de psiquiatras e hospitais do Sistema Nacional de Sade no Reino Unido. Incluimos no estudo todos os psiquiatras registados como Voluntrios no Royal College of Psychiatrists e o Grupo de Interesse Especial associado. Foi ainda possvel incluir os Diretores Mdicos de todos os hospitais do Reino Unido. Os estudos foram desenhados para analisar as opinies dos Voluntrios do Reino Unido sobre os benefcios para os pases recetores de baixo e mdio rendimento e para o Reino Unido. Todos os 60 hospitais do Sistema Nacional de Sade foram inclu dos para analisar a opinio sobre Voluntariado. As limitaes dos estudos foram a baixa taxa de resposta, mas esta foi comparvel a outros estudos do College. provvel haver um enviezamento de resposta e favorecimento dos que esto envolvidos no Voluntariado. Os resultados mostraram um interesse forte no voluntariado e benefcios no Sistema Nacional de Sade, nas. reas de liderana, transculturalismo, gesto e recursos e capacidades pessoais. Os hospitais do Sistema Nacional de Sade valorizaram o voluntariado e, em contrapartida, o valor acrescido para competncias profissionais. Os obstculos contra o Voluntariado a nvel individual e dos hospitais foram maioritariamente de natureza prtica, tais como obter dispensa do trabalho, substituio no trabalho e custos. As implicaes destes estudos so que o programa de voluntariado do College precisa de ser fortalecido. Para assegurar que este trabalho continua necessrio existir uma sensibilizao nacional e maior responsabilizao sobre os benefcios para o Reino Unido e a nvel global. -------------------------- ABSTRACT: The Royal College of Psychiatrists has had an international volunteering programme since 2005. The interest in UK has grown over the past 15 years with many new projects. The benefits in various countries has been acknowledged. What has been less clear are the benefits of the experience back in the UK and of the Royal College of Psychiatrists Volunteer Scheme. The aim of this dissertation is to explore the benefit of volunteering to the NHS focusing mainly, but not exclusively on the Royal College of Psychiatrists Volunteering scheme. In this dissertation we first look at background information before discussing two large surveys of Psychiatrists and NHS Trusts in UK. We surveyed all those registered as Volunteers at the Royal College of Psychiatrists and the associated Special Interest Group. We also were able to survey the Medical Directors of all UK Trusts. The Surveys were designed to assess views of UK Volunteers of benefits to hosts in LMIC and back in UK. All 60 NHS Trusts were surveyed to assess the view of Volunteering. Limitation of the surveys were the low response rate but this was comparable to other College surveys. There is likely to be a bias in response and favour those who are engaged in the Volunteering agenda. Results showed a strong interest in volunteering and perceived benefits in NHS. These areas included leadership, transcultural, resource management and personal skills. NHS trusts valued volunteering and added value to professional competencies on return. Obstacles to Volunteering at individual and Trust level were mainly practical issues such as getting time off, cover and costs. Implications of these surveys are that the College volunteering scheme needs strengthening. There needs to be a National advocacy to ensure that this work continues and greater accountability as to benefits in UK and globally.
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RESUMO: Objetivo Avaliar a qualidade dos servios de sade mental e a situao dos direitos humanos no Hospital de Sade Mental de Kabul (KMHH) e fornecer recomendaes para o desenvolvimento de um plano de melhoria, actualizao e reviso da Poltica, Estratgia e Plano Nacionais de Sade Mental,. Mtodos A avaliao foi realizada em Janeiro de 2015 no KMHH e na Burn Ward do Hospital Tercirio de Isteqlal por uma equipa multidisciplinar usando Qualidade Direitos Tool Kit da OMS. Antes da avaliao, o protocolo foi aprovado pelo Institutional Review Board e obtido o consentimento informado de cada entrevistado. Realizaram-se entrevistas com 16 utentes do servio, 17 funcionrios do hospital e 7 familiares, alm da reviso de documentos e da observao das unidades de internamento do KMHH e das interaes interpessoais entre funcionrios do hospital e utentes do servio. A comisso de avaliao reviu tambm a documentao e observou a Unidade de Queimados do Hospital Tercirio de Isteqlal, a fim de avaliar e comparar a paridade entre as duas instalaes. Aps a avaliao, todos os membros da comisso se reuniram e puseram em conjunto todas as concluses num relatrio final. Resultados Encontrmos algumas lacunas graves no nvel de prestao de servios e no respeito pelos direitos humanos dos utentes dos servios e dos seus familiares. Uma srie de polticas, diretrizes e procedimentos relacionados com os direitos humanos dos pacientes estavam ausentes. O ambiente teraputico e o padro de vida eram inadequados, existia m qualidade do atendimento e dos servios prestados, os utilizadores enfrentavam violaes do direito ao exerccio da capacidade legal e da liberdade pessoal, eram quimica e fisicamente (uso de correntes) contidos e expostos a abusos verbais, fsicos e emocionais, e havia grande nfase no tratamento institucional. Todos estes aspectos foram considerados como extensa violao dos direitos humanos dos utentes de servio do KMHH. Concluso Os servios disponveis para utentes dos servios de sade mental apresentam alguns problemas devido desconfiana e falta de consciencializao sobre os direitos das pessoas com doena mental e precisam ser alterados de forma positiva. A Lei de Sade Mental existente difere muito das recomendaes da Conveno sobre os Direitos das Pessoas com Incapacidades (CRPD) e requer reviso e adaptao de acordo com esta Conveno. -------------------------------- ABSTRACT: Objective To assess the quality of mental health services and human rights condition in the Kabul Mental Health Hospital (KMHH) and provide recommendations for development of an improvement plan and to update and revise the National Mental Health Policy, Strategy and Plan. Methods The assessment was conducted in January 2015 in the KMHH and the Burn Ward of Isteqlal Tertiary Hospital by a multidisciplinary team using WHO Quality Rights Tool Kit. Before the assessment, Institutional Review Board approval and informed consent from each interviewee were obtained. Interviews were conducted with 16 service users, 17 hospital staffs and 7 family members in addition to documents review and observation of inpatient units of KMHH plus interpersonal interactions between hospital staff and service users. The assessment committee reviewed the documentation and observed the Burn Ward of Isteqlal Tertiary hospital in order to measure and compare parity between the two facilities. After the assessment, all committee members gathered and synchronized all findings into a final report. Results There were some serious gaps on service provision level and respecting human rights of service users and their family members. A series of policies, guidelines and procedures related to patients human rights were absent. Inadequate treatment environment and standard of living, poor quality of care and services, violations of the right to exercise legal capacity and personal liberty, being chemically and physically (e.g. chain) restrained, being exposed to verbal, physical and emotional abuse, and emphasis on institutional treatment were all extensive human rights violation that service users were experiencing in KMHH. Conclusion The available services for mental health service users are questionable due to mistrust and lack of awareness about rights of people with disabilities and need to be positively changed. Existing Mental Health Act has a large number of disparities with the CRPD and requires revision and adaptation in accordance to CRPD.
Resumo:
RESUMO: Este estudo procurou documentar a perspectiva (s) dos utentes de sade mental e das associaes de prestadores de cuidados sobre a prestao, o papel e a contribuio de servios de sade mental da comunidade tal como foram percebidos por um nmero de informadores-chave, incluindo os utentes do servio mentais e os prprios prestadores de cuidados. O caso especfico da Sociedade Sade Mental do Gana (MEHSOG) foi o foco deste estudo. O modelo foi o de um estudo de caso, utilizando discusses de grupo e entrevistas com informadores-chave como instrumentos de recolha de dados. Estas ferramentas de colheita de dados foram complementadas por observaes dos participantes e pela reviso de documentos da MEHSOG e dos vrios grupos de apoio da comunidade de auto-ajuda que compem a associao nacional. O estudo revelou que os utentes dos servios de sade mental e seus prestadores de cuidados constituem um importante grupo de partes interessadas na prestao de servios de sade mental da comunidade e no desenvolvimento de polticas que tenham em conta as necessidades e os direitos das pessoas com doena mental ou epilepsia. O envolvimento da MEHSOG promove a mobilizao de membros e famlias relacionadas com a doena mental de beneficiar de servios de tratamento bem organizados com um impacto significativo na melhoria da sade e da participao dos utentes dos servios e seus prestadores de cuidados primrios em processos de tomada de deciso da famlia e na comunidade processos de desenvolvimento. Os utentes dos servios por beneficiarem de tratamento, e os prestadores de cuidados primrios, por se tornarem mais livres e menos sobrecarregados com a responsabilidade de cuidar, podem passar a envolver-se mais em atividades que melhoramo seu estado, o de suas famlias e das comunidades. A advocacia dos membros da MEHSOG para conseguir que a Mental Health Bill se transforme numa Lei foi tambm um desenvolvimento significativo resultante da participao ativa dos utentes do servio em chamar a ateno para uma nova e inclusiva legislao de sade mental para o Gana. Entre os fatores e oportunidades que permitiram aos utentes dos servios de sade mental e aos prestadores de cuidados primrios de pessoas com doena mental apoiar activamente a prestao de servios de sade mental comunitria e o desenvolvimento de polticas conta-se a contribuio da sociedade civil do Gana, particularmente o movimento da deficincia, e os esforos anteriores de ONGs em sade mental e dos profissionais de sade mental para ter uma nova lei em sade mental. Observmos um certo nmero de desafios e barreiras que actuam de forma a limitar a influncia dos utentes dos servios de sade mental na proviso da sade mental comunitria e no desenvolvimento de polticas. Entre elas o estigma social contra a doena mental e pessoas com doena mental ou epilepsia e seus cuidadores primaries um factor chave. O estigma tem alterado a percepo e as anlises do pblico em geral, especialmente dos profissionais de sade e das autoridades polticas afetando a priorizao dos problemas de sade mental nas polticas e programas. Outro desafio foi a deficiente infra-estrutura disponvel para apoiar servios de sade mentais que assegurem aos utentes permanecerem em bom estado de sade e bem-estar para serem advogados de si prprios. A recomendao do presente estudo que os movimentos de utentes dos servios de sade mental so importantes e que eles precisam de ser apoiados e encorajados a desempenhar o seu papel como pessoas com experincia vivida para contribuir para a organizao e prestao de servios de sade mental, bem como para a implementao, monitorizao e avaliao de polticas e programas. ------------------------------------ ABSTRACT: This study sought to document the perspective(s) of mental health users and care-givers associations in community mental health service provision and their role and contribution as it was perceived by a number of key informants including the mental service users and care-givers themselves. The specific case of the Mental Health Society of Ghana (MEHSOG) was the focus of this study. A case study approach was used to with Focus Group Discussions and Key Informants Interviews being the data collection tools that were used. These data collection tools were complemented by participant observations and review of documents of the MEHSOG and the various community self-help peer support groups that make up the national association. The study revealed that mental health service users and their care-givers constitute an important stakeholder group in community mental health service provision and development of policies that factor in the needs and rights of persons with mental illness or epilepsy. MEHSOGs involvement in mobilising members and education families to come forward with the relations with mental illness to benefit from treatment services were well made a significant impact in improving the health and participation of service users and their primary carers in family decision-making processes and in community development processes. Service users, on benefiting from treatment, and primary care-givers, on becoming freer and less burdened with the responsibility of care, move on to engage in secure livelihoods activities, which enhanced their status in their families and communities. The advocacy MEHSOG members undertook in getting the mental health Bill become Law was also noted as significant development that was realised as a result of active involvement of service users in calling for a new and inclusive mental health legislation for Ghana. Enabling factors and opportunities that enabled mental health service users and primary care-givers of people with mental illness to actively support community mental health service provision and policy development is with the vibrant civil society presence in Ghana, particularly the disability movement, and earlier efforts by NGOs in mental health in Ghana long-side mental health professionals to have a new law in mental health. A number of challenges were also noted which were found to limit the extent to which mental health service users can be influential in community mental health service provision and policy development. Key among them was the social stigma against mental illness and people with mental illness or epilepsy and their primary carers. Stigma has affected perceptions, analyses of the general public, especially health practitioners and policy authorities that it has affected their prioritisation of mental health issues in policies and programmes. Another challenge was the poor infrastructure available to support enhanced mental health care services that ensure mental health service users remain in a good state of health and wellbeing to advocate for themselves. The recommendation from the study is that mental health service user movements are important and need to be supported and encouraged to play their role as persons with lived experience to inform organisation and provision of mental health services as well as design and implementation, monitoring and evaluation of policies and programes.
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RESUMO: Santa Lcia pequena ilha de pas em desenvolvimento com recursos limitados e confrontada com uma srie de desafios socioeconmicos que exigem solues criativas e inovadoras. comprovado que a combinao de recursos entre setores para estabelecer os determinantes social, econmico e ambiental da sade so uma estratgia til para melhorar a sade da populao, principalmente a sua sade mental. Este estudo, o primeiro do seu tipo em Santa Lcia, procurou examinar at que ponto a disponibilidade de uma poltica nacional de sade mental levou a ao intersetorial para o fornecimento de servios e promoo da sade mental. Alm disso, o estudo examinou o nvel de colaborao intersetorial que existe entre as agncias que prestam cuidados diretos e servios de suporte para pessoas com doenas mentais e problemas srios de sade mental. O estudo tambm teve como objetivo identificar os fatores que promovem ou dificultam a colaborao intersectorial e gerar recomendaes que possam ser aplicadas para pases muito pequenos e com perfis socioeconmicos semelhantes. Os dados gerados a partir de trs (3) fontes foram sintetizados para formar uma viso ampla das questes. Uma avaliao da poltica de sade mental de 2007, uma avaliao que identifica at que ponto a ao intersetorial atualmente deixa a prestao de servios de sade mental e a administrao de entrevistas semiestruturadas nas mos de gestores do programa de diferentes agncias em todos os setores. O estudo concluiu que, apesar da disponibilidade de uma poltica de sade mental, que articula clara e explicitamente a colaborao intersetorial como rea prioritria para ao, quase no existe no sistema de fornecimento atual do servio. Os provedores de servios em todos os setores reconhecem que h os benefcios da colaborao intersectorial e com entraves significativos em relao colaborao intersetorial, que por sua vez, impede uma abordagem nacional para o planejamento e o fornecimento do servio. A colaborao intersetorial no ser possvel se os prprios setores dependerem da abordagem direta do setor da sade ou se a atmosfera geral for ofuscada pela estigmatizao das doenas mentais.------------------------------------------------------------------------ABSTRACT: Saint Lucia a small island developing country with limited resources, is faced with a number of socio-economic challenges which require creative and innovative solutions to address. Combining resources across sectors to address the social, economic and environmental determinants of health has proven to be a useful strategy for improving population health in particular mental health. This study, the first of its kind for Saint Lucia sought to examine the extent to which the availability of a national mental health policy led to intersectoral action for mental health promotion and service delivery. In addition the study examined the level of intersectoral collaboration which actually exist between agencies which provide direct care and support services to people with mental illnesses and significant mental health problems. The study also aimed to identify the factors which promote or hinder intersectoral collaboration and generate recommendations which can be applied to extremely small countries with similar socio-economic profiles. Data generated from three (3) sources was synthesized to form a broad picture of the issues. An evaluation of the mental health policy of 2007, an assessment of the extent to which intersectoral action currently exist in mental health service delivery and the administration of semi-structured interviews with program managers from different agencies across sectors to identify implementation issues. The study concluded that despite the availability of a mental health policy which clearly and explicitly articulates intersectoral collaboration as a priority area for action, very little exists in the current service delivery system. Services providers across sectors acknowledge the benefits of intersectoral collaboration and that there are significant barriers to intersectoral collaboration, which in turn hinders a national approach to service planning and delivery. Intersectoral collaboration is not possible if sectors themselves are dependent on a top-down health sector driven and dominated approach, or if the general atmosphere is clouded by stigmatization of mental health illnesses.
