Tag: Barrier to Care

Barriers & Facilitators who Impact Veterans’ Engagement with Mental Health Support

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Research Paper Title

The journey to professional mental health support: a qualitative exploration of the barriers and facilitators impacting military veterans’ engagement with mental health treatment.

Background

It is often claimed that military veterans are reticent to seek help for mental disorders, even though delayed treatment may impair recovery and impact the wellbeing of those close to the veteran.

This paper aims to explore the barriers and facilitators to accessing professional mental health support for three groups of veterans who met criteria for a probable mental health disorder and:

  1. Do not recognise a probable mental disorder;
  2. Recognise they are affected by a mental disorder but are not seeking professional support; or
  3. Are currently seeking professional mental health support.

Methods

Qualitative telephone interviews were conducted with 62 UK military veterans. Thematic analysis identified core themes along an illustrative journey towards professional mental health support.

Results

Distinct barriers and facilitators to care were discussed by each group of veterans depicting changes as veterans moved towards accessing professional mental health support. In contrast to much of the literature, stigma was not a commonly reported barrier to care; instead care-seeking decisions centred on a perceived need for treatment, waiting until a crisis event occurred. Whilst the recognition of treatment need represented a pivotal moment, the data identified numerous key steps which had to be surmounted prior to care-seeking.

Conclusions

As care-seeking decisions within this sample appeared to centre on a perceived need for treatment future efforts designed to encourage help-seeking in UK military veterans may be best spent targeting the early identification and management of mental health disorders to encourage veterans to seek support before reaching a crisis event.

Reference

Rafferty, L.A., Wessely, S., Stevelink, S.A.M. & Greenberg, N. (2021) The journey to professional mental health support: a qualitative exploration of the barriers and facilitators impacting military veterans’ engagement with mental health treatment. European Journal of Pscyhotraumatology. 10(1).1700613. doi: 10.1080/20008198.2019.1700613.

Book: Art and Science of Mental Health Nursing

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Book Title:

Art and Science of Mental Health Nursing: Principles and Practice.

Author(s): Ian Norman and Iain Ryrie (Editors).

Year: 2018.

Edition: Fourth (4th).

Publisher: Open University Press.

Type(s): Paperback and Kindle.

Synopsis:

This well-established textbook is a must-buy for all mental health nursing students and nurses in registered practice.

Comprehensive and broad, it explores how mental health nursing has a positive impact on the lives of people with mental health difficulties.

Book: Let That Shit Go

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Book Title:

Let That Shit Go: A 2021 Mental Health Planner & Workbook: Mental Health Planner 2021 – Self Care Planner 2021 – Anxiety Planner – Mental Health Journal – Mental Health Workbook.

Author(s): Elizabeth Keen Publishing.

Year: 2020.

Edition: First (1st).

Publisher: Independently Published.

Type(s): Paperback.

Synopsis:

Are you ready to improve your mental health… while also keeping your life organized and together – all in one place?

This unique book is a 2021 Planner and Mental Health Workbook all in one! Use this planner to keep track of your monthly, weekly and daily to-do’s while also taking charge of your mental health.

What’s inside…

PLANNER

  • 1 Page Yearly Calendar View: January to December 2021.
  • Monthly Calendar View: Space to keep track of events, write in holidays, etc.
  • Monthly Dividers: Beautiful floral design.
  • Monthly Snapshots: Keep track of monthly goals, monthly tasks and more!
  • Weekly Mental Health Assessment: Keep track of your sleep, mood, positives and negatives per week.
  • Daily To-Do’s: Space to keep track of daily to-do’s, tasks, etc.
  • Uplifting and helpful quotes and phrases featured on each monthly calendar.

MENTAL HEALTH WORKBOOK

  • All About Me: Start your journey to better mental health with writing prompts that help you better understand yourself, plan for your future self and so much more!
  • Self-Care: This section includes pages to create a self-care plan, provides you with self-care ideas, and more!
  • Anxiety Thoughts & Triggers: This section includes pages to help you identify the root of your anxieties and ultimately understand them. Also included: Trigger Tracker, Trigger Sources, Mood Chart, Thought Logs, and more!
  • Therapy Debriefs: Summarise your therapy sessions, jot down what you learned, what to discuss next time and more!

BOOK DETAILS:

  • 8.5″ x 11″ – tons of space to keep track of your day-to-day details and track and improve your mental health!
  • 175 professionally designed black and white interior pages (front and back).

Book: Breaking the Barriers: Early Intervention to Mental Health Issues

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Book Title:

Breaking the Barriers: Early Intervention to Mental Health Issues.

Author(s): Lade Hephzibah Olugbemi.

Year: 2020.

Edition: First (1st).

Publisher: Independently Published.

Type(s): Paperback and Kindle.

Synopsis:

“If you don’t know what your barriers are, it’s impossible to figure out how to tear them down.” John Manning, author of The Disciplined Leader.

This is true about mental health in the community. Barriers to information and understanding have affected people with mental health issues, as well as their friends, work colleagues and family members. This book seeks to shed light on the many factors that causes barriers to preventing mental health problems. It demystifies the various issues surrounding mental health, especially within the Black, Asian and Minority Ethnic (BAME) communities. It also explores the various factors that trigger mental illness, the role of the media, religion and culture in complicating the barriers.

By reading Breaking The Barriers, you will become more aware of the various issues around mental health, and better equipped to overcoming the barriers.

What are the Challenges to Engaging in Late-Life Mental Health Research?

Published on by Andrew Marshall1 Comment

Research Paper Title

Engaging in Late-Life Mental Health Research: a Narrative Review of Challenges to Participation.

Background

This narrative review seeks to ascertain the challenges older patients face with participation in mental health clinical research studies and suggests creative strategies to minimise these obstacles.

Recent Findings

Challenges to older adults’ engagement in mental health research include practical, institutional, and collaboration-related barriers applicable to all clinical trials as well as more personal, cultural, and age-related patient barriers specific to geriatric mental health research.

Universal research challenges include:

  1. Institutional barriers of lack of funding and researchers, inter-researcher conflict, and sampling bias;
  2. Collaboration-related barriers involving miscommunication and clinician concerns; and
  3. Practical patient barriers such as scheduling issues, financial constraints, and transportation difficulties.

Challenges unique to geriatric mental health research include:

  1. Personal barriers such as no perceived need for treatment, prior negative experience, and mistrust of mental health research;
  2. Cultural barriers involving stigma and lack of bilingual or culturally matched staff; and
  3. Chronic medical issues and concerns about capacity.

Summary

Proposed solutions to these barriers include increased programmatic focus on and funding of geriatric psychiatry research grants, meeting with clinical staff to clarify study protocols and eligibility criteria, and offering transportation for participants.

To minimise stigma and mistrust of psychiatric research, studies should devise community outreach efforts, employ culturally competent bilingual staff, and provide patient and family education about the study and general information about promoting mental health.

Reference

Newmark, J., Gebara, M.A., Aizenstein, H. & Karp, J. (2020) Engaging in Late-Life Mental Health Research: a Narrative Review of Challenges to Participation. Current Treatment Options in Psychiatry. doi: 10.1007/s40501-020-00217-9. Online ahead of print.

What are the Challenges of Mental Healthcare during COVID-19?

Published on by Andrew Marshall1 Comment

Research Paper Title

Current and Future Challenges in the Delivery of Mental Healthcare during COVID-19.

Background

The USA is in the midst of the COVID-19 pandemic.

The researchers assess the impact of COVID-19 on psychiatric symptoms in healthcare workers, those with psychiatric comorbidities, and the general population.

They highlight the challenges ahead and discuss the increased relevance of telepsychiatry.

Methods

The researchers analysed all available literature available as of 25 March 2020, on PubMed, Ovid Medline, and PsychInfo.

They utilised the MeSH term “covid AND (psychiatry OR mental health)” and included all articles.

Duplicates were removed resulting in 32 articles, of which 19 are cited. Four additional references are included to examine suicide data. During the review process, an additional 7 articles were identified which are also included.

Results

Frontline healthcare workers are currently experiencing increased psychiatric symptoms and this is more severe in females and nurses. Non-frontline healthcare workers, as well as the general population, are experiencing vicarious traumatisation.

People with psychiatric comorbidities, and the general population, face increased psychiatric symptom burden. Migrant workers, the elderly, children, and the homeless may be disproportionately impacted. Suicide rates may be impacted.

Conclusions

The COVID-19 pandemic has resulted in a severe disruption to the delivery of mental healthcare.

Psychiatric facilities are facing unprecedented disruptions in care provision as they struggle to manage an infected population with comorbid psychiatric symptoms.

Telepsychiatry is a flawed but reasonable solution to increase the availability of mental healthcare during COVID-19.

Reference

Gautam, M., Thakrar, A., Akinyemi, E. & Mahr, G. (2020) Current and Future Challenges in the Delivery of Mental Healthcare during COVID-19. SN Comprehensive Clinical Medicine. 1-6. doi: 10.1007/s42399-020-00348-3. Online ahead of print.

PLA Navy Personnel in Relation to Attitudes & Barriers to Mental Healthcare

Published on by Andrew Marshall1 Comment

Research Paper Title

Attitudes and perceived barriers to mental healthcare in the People’s Liberation Army Navy: study from a navy base.

Background

The People’s Liberation Army (PLA, China) Navy is increasingly conducting military operations other than war overseas. Factors such as confrontations with pirates, special environments and long sailing times have resulted in mental health problems. However, the navy’s actual utilisation of mental health services is low.

This study examined members’ rate of willingness to seek help and the factors that act as barriers to willingness to seek mental health services in the PLA Navy.

Methods

This cross-sectional study was conducted at the Zhoushan Base, operated by the East Sea Fleet, between March 2019 and April 2019.

The researchers distributed a 12-item questionnaire to examine participants’ attitudes and perceived barriers to mental healthcare. They recruited 676 navy personnel. Participants’ willingness to seek help if they had mental health problems was also assessed.

Results

The response rate was 99%. A total of 88.44% of the sample reported being willing to seek help. Univariate analysis suggested that those not willing to seek help were more likely to agree with the items, ‘Mental healthcare does not work’ and ‘My unit leadership might treat me differently’ and all organisational barriers, and they were more likely to have concerns about ’embarrassment’ and ‘being weak’ than those willing to seek help.

After controlling for demographic characteristics, binary logistic regression analyses confirmed that a lack of knowledge regarding the location of mental health clinics and being perceived as weak were the main factors preventing participants’ willingness from seeking help.

Conclusions

Extensive efforts to decrease organisational barriers and stigma towards mental healthcare should be a priority for researchers and policymakers to improve the usage of mental health services.

Psychoeducation aimed at de-stigmatising mental health problems should be delivered and the accessibility and availability of mental health services should be increased.

Reference

Gu, R-P., Liu, X.R> & Ye, X.F. (2020) Attitudes and perceived barriers to mental healthcare in the People’s Liberation Army Navy: study from a navy base. BMJ Military Health. doi: 10.1136/bmjmilitary-2019-001396. Online ahead of print.

Would Strengthening Community Health Systems for Mental Health Improve Access & Increase Utilisation of Services?

Published on by Andrew Marshall1 Comment

Research Paper Title

Strengthening Mental Health Systems in Zambia.

Background

Studies in mental health care for low resource settings indicate that providing services at primary care level would significantly improve provision and utilisation of mental health services.

Challenges related to inadequate funding were noted as significant barriers to service provision, with the contribution of low knowledge of mental health conditions and stigma in the community.

This study aimed to explore the barriers to the use of mental health services in Zambia, suggesting health systems thinking approaches to solving these challenges.

Methods

Primary data were collected through individual interviews from 12 participants; primary caregivers, health workers from public health institutions that treat mental health conditions and policymakers and implementers.

The digitally recorded responses were transcribed and analysed using thematic analysis.

Results

Key barriers to care included inadequate funding, few human resources, poor infrastructure and stigma.

Barriers to care at policy, facility and individual or community level could be alleviated by strengthening the mental health system.

Engagement of community health workers and increasing efforts to sensitise the community about mental health would prove beneficial.

Conclusions

Strengthening the community health systems for mental health could improve access and increase utilisation of services.

Reference

Munakampe, M.N. (2020) Strengthening Mental Health Systems in Zambia. International Journal of Mental Health Systems. 14:28. doi: 10.1186/s13033-020-00360-z. eCollection 2020.

What are the Perceptions of Mental Health and Perceived Barriers to Mental Health Help-Seeking Amongst Refugees?

Published on by Andrew Marshall1 Comment

Research Paper Title

Perceptions of Mental Health and Perceived Barriers to Mental Health Help-Seeking Amongst Refugees: A Systematic Review.

Background

Despite elevated rates of psychological disorders amongst individuals from a refugee background, levels of mental health help-seeking in these populations are low.

There is an urgent need to understand the key barriers that prevent refugees and asylum-seekers from accessing help for psychological symptoms.

This review synthesises literature examining perceptions of mental health and barriers to mental health help-seeking in individuals from a refugee background.

The researchers analysis, which complies with PRISMA reporting guidelines, identified 62 relevant studies.

Methods

Data extraction and thematic analytic techniques were used to synthesise findings from quantitative (n = 26) and qualitative (n = 40) studies.

Results

They found that the salient barriers to help-seeking were:

  • Cultural barriers, including mental health stigma and knowledge of dominant models of mental health;
  • Structural barriers, including financial strain, language proficiency, unstable accommodation, and a lack of understanding of how to access services, and
  • Barriers specific to the refugee experience, including immigration status, a lack of trust in authority figures and concerns about confidentiality.

Conclusions

The researchers discuss and contextualise these key themes and consider how these findings can inform the development of policies and programmes to increase treatment uptake and ultimately reduce the mental health burden amongst refugees and asylum-seekers.

Reference

Byrow, Y., Pajak, R., Specker, P. & Nickerson, A. (2020) Perceptions of Mental Health and Perceived Barriers to Mental Health Help-Seeking Amongst Refugees: A Systematic Review. Clinical Psychology Review. 75:101812. doi: 10.1016/j.cpr.2019.101812. Epub 2019 Dec 24.

Are there Differences in Sources of Help & Barriers to Care in Deployed vs. Post-Deployment Environments?

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Research Paper Title

Mental Health Service Utilization and Perceived Barriers to Receiving Care in Deployed Soldiers.

Background

Scant research has examined mental health treatment utilisation and barriers to care in deployed US soldiers.

This study aims to assess mental health treatment utilisation in deployed soldiers, including providers used and barriers to care.

Methods

US Army soldiers (n = 2,412) in a combat environment were surveyed on psychiatric symptoms, mental health help received, sources of care, and perceived barriers to care by Mental Health Advisory teams from 2009 to 2013.

Results

Of the 25% of soldiers at mental health risk, 37% received mental health help, with 18% receiving help from a provider. Non-provider sources of care were utilised significantly more frequently than providers.

Soldiers at mental health risk reported significantly greater anticipated career-related stigma, organisational barriers to care, self-reliance views, and negative attitudes toward care, yet these constructs did not differ between who did or did not receive help.

Soldiers who received help from providers exclusively reported significantly more anticipated career-related stigma and fewer organisational barriers to care than those that received no help.

Soldiers who spent no time living outside the forward operating base and soldiers with six or more types of combat exposures were more likely to receive help.

Conclusions

Prevalence of common psychopathology and receipt of care in a combat environment was similar to previous reports from post-deployment settings.

Non-provider sources of care were more frequently utilised as compared to an in-Garrison report.

Findings suggest important differences exist in sources of help and barriers to care in deployed vs. post-deployment environments.

The hypothesised barriers to care did not preclude receiving any help, however, less than one-half of soldiers at mental health risk received help.

Thus, future research should identify factors that have the greatest influence on help seeking behaviour in both deployed and Garrison settings.

Reference

Nugent, K.L., Riviere, L.A., Sipos, M.L. & Wilk, J.E. (2020) Mental Health Service Utilization and Perceived Barriers to Receiving Care in Deployed Soldiers. Military Medicine. pii: usaa019. doi: 10.1093/milmed/usaa019. [Epub ahead of print].