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Ibell, Bernadette Mary, and res cand@acu edu au. "An Analysis of Mental Health Care in Australia From a Social Justice and Human Rights Perspective, With Special Reference to the Influences of England and the United States of America: 1800-2004." Australian Catholic University. School of Philosophy, 2004. http://dlibrary.acu.edu.au/digitaltheses/public/adt-acuvp113.25102006.
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The aim of this thesis is to analyze mental health care in Australia from a social justice and human rights perspective, in order to demonstrate that social justice as a philosophical manifestation of justice and fairness, is an essential ingredient in the theory and practice of mental health care. It is contended that the needs of the mentally ill would be most appropriately answered by the utilization of a Natural Law model, based on Finnis’s Natural Law theory. The Scope of the Thesis.The needs and care of the mentally ill are discussed, together with the treatment meted out to these vulnerable members of society since, approximately, the year 1800. Neither the criminally insane, nor the intellectually disabled are included in this discourse. Each group of people merits a thesis on its own: criminal insanity requires a debate to include the history, psychiatric and legal approaches to the subject, and current management of the insane. The intellectually disabled are not mentally ill; their ability to function as all round, naturally competent individuals is diminished by an inadequacy and/or impairment of their intellectual capacities. The needs of these two groups are far too broad and demanding to be included within the current thesis. Rationale for the Timeframe The timeframe, 1800 until 2004, has been established because it approximates to the transition from the end of the Classical through the Modern Age to the Post Modern Age, together with the predominance of Enlightenment philosophical theories, and the development of a scientific approach to medicine. Further, many politico-economic and social changes were taking place, associated with the Industrial Revolution. All are shown to have affected the introduction of asylumdom, and the institutionalization of those unable to participate actively in the industrial workforce. Of significant importance to the development of institutionalization for such marginal groups is the philosophy of Jeremy Bentham. Bentham espoused Classical Utilitarianism which will be shown to believe that the ultimate standard of utility is not the individual’s happiness but the greatest amount of happiness altogether. The thesis will demonstrate that this philosophical view prevailed from the beginning of the Industrial Revolution, with Benthamism influencing the sequestration of the unemployable into institutional life. Development of the Thesis.The thesis is developed against a background of prevailing philosophical, and other changes as stated above, including the medicalization of mental illness and the development of psychiatry as a branch of medicine. There is manifestation of many social injustices to those incarcerated in the asylum in all three countries under consideration: England, USA, and Australia. It is demonstrated that social justice and human rights of their work forces were disregarded by many employers at the time of the Industrial Revolution. Such values were, therefore, unlikely to prevail with regard to the mentally ill. Asylumdom continued with few changes in its practices until after World War II. It is shown that the predominance of post Enlightenment theories, together with further politico-economic, social and pharmaceutical revolutionary change followed the Second World War. Encouraged also by the founding of the United Nations and World Health Organizations as well as provision of the Declaration of Human Rights, circumstances led to the process of de-institutionalization of the mentally ill. The latter were decanted with apparently unseemly haste into a community ill prepared for such a change, and with little evidence of infra- structure to support the move. Need to conduct a National Inquiry. There was, then, a need to investigate what was now an overt issue of mental health care. The two subsequent inquiries by the Australian Health Ministers Advisory Council, (AHMAC) and the Burdekin Report, both focused on social justice issues, and addressed epidemiological, economic, sociological and justice considerations. Within the thesis, both investigations are critiqued against a Natural Law model, using Finnis’s Natural Law theory. It is demonstrated that contrary to Enlightenment principles of social justice as described by Miller, such a theory is eminently practical, and answers the needs of all members of the community, providing not merely ‘the greatest happiness for the greatest number’ but the common good of all Conclusion. Evidence shows that such a Natural Law theory is required to give a firm foundation to the needs of the mentally ill, especially at a time when relativism, economic rationalism and negative aspects of globalization prevail. Without such a basis the mentally ill are left insecure, uncertain and adrift in a world uncaring of their plight, while all the earnest exhortations espoused by Reports remain platitudes, subject to the whims of whatever government is in power. Our responsibilities to all our fellow human beings demand better from us than this.
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Wynaden, Dianne Gaye. "The primary carer's experience of caring for a person with a mental disorder in the Western Australian community: a grounded theory study." Curtin University of Technology, School of Nursing and Midwifery, 2002. http://espace.library.curtin.edu.au:80/R/?func=dbin-jump-full&object_id=15910.
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One in five Australians has a mental disorder and it is estimated that one in four families have a member who has a mental disorder. Since the 1960s there has been an 80 percent decrease in Australian institution-based mental health care. The majority of people who have a mental disorder are now treated in their local community and many of them live with their families. The change in the delivery of mental health care has seen the family emerge as one of the most important supports to their ill family member. While the changes in the delivery of mental health care have been based on human rights concerns, changes in mental health legislature, and economic factors, the multi-dimensional experience of being a primary carer of a person with a mental disorder remains relatively unexplored. The need for empirical evidence on the primary carer's experience is noted in both the scientific literature and from carers themselves and the principal aim of conducting this research was to address the identified need. This qualitative study, using grounded theory methodology, presents the findings of interviews with 27 primary carers and memos documented throughout the study. In addition, existing literature of relevance to the findings of this study is presented. A substantive theory of seeking balance to overcome being consumed is presented in this thesis. Using the grounded theory method the constant comparative analysis of data revealed that the basic social psychological problem shared by all participants was the experience of "being consumed". The problem of being consumed consisted of two stages: "disruption of established lifestyle" and a "sustained threat to self-equilibrium". Six conditions were identified as influencing participants' experience of being consumed.In order to address the problem of being consumed, participants engaged in a basic social psychological process of "seeking balance". When participants were engaged in this process they moved from a state of being consumed to one whereby they established and consolidated a balanced life perspective that incorporated their caregiving role. The process of seeking balance consisted of three phases: "utilising personal strategies to reduce the problem of being consumed', "restoring self- identity", and "reaching out to make a difference". In addition, data analysis identified the presence of a three phase sub-process entitled "trying to make sense of what was happening". Phases one of the core and sub- processes occurred primarily in the period prior to the time when a psychiatric diagnosis was made on the affected family member. Participants became engaged in the remaining two phases of the core and sub-processes when they became aware that their affected family member had a mental disorder. At the time of being interviewed for this study some participants were not yet engaged in the final phase of the process of seeking balance. Participants' experience of seeking balance was not related to the length of their caregiving experience but rather to their experience of seeking balance and the conditions influencing that process. Four conditions were identified as influencing participants' experience of seeking balance.
This thesis presents the substantive theory of seeking balance to overcome being consumed. While the findings support existing scientific literature, the substantive theory also presents a new insight on caring from the primary carer's perspective. In particular, the findings challenge health professionals to actively pursue strategies to reduce carers' experience of being consumed. The findings of this study have implications for service provision and clinical practice, policy and planning, research, education, the general population, mental health consumers, and carers.
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Descoteaux, Jill. "Dancers’ Reflections on Their Healthcare Experiences: Perspectives from Australia and the USA." Ohio University / OhioLINK, 2018. http://rave.ohiolink.edu/etdc/view?acc_num=ohiou1530538560639848.
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Paradies, Yin Carl. "Race, racism, stress and indigenous health /." Connect to thesis, 2006. http://eprints.unimelb.edu.au/archive/00002514.
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Grace, Sandra. "Integrative Medicine in Contemporary Australian Health Care." Faculty of Health Sciences, The University of Sydney, 2008. http://hdl.handle.net/2123/4048.
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Doctor of PhilosophyABSTRACT Integrative medicine (IM) is a dynamic and increasingly prevalent model of primary health care that combines complementary and alternative medicine with mainstream medicine. This research is about the practice of IM and its value to primary health care in Australia. It locates IM within Australian health care by revealing its processes and outcomes in terms of: practice styles, interactions between practitioners and clients and among practitioners, range of diagnostic and treatment options, and health benefits. In this research I examine the nature of integrative medicine (IM) in co-located primary health care practices and consider the influence that integrating mainstream medicine and CAM can have on the perceived quality of primary health care in Australia. My goal was to contribute the knowledge of the phenomenon of IM through a deeper understanding and interpretation of IM gained by investigating the perceptions of core stakeholders, in this case clients and practitioners of IM. This research was situated in the interpretive paradigm and used two research methodologies: hermeneutics (to interpret the value of IM as reported in the literature) and hermeneutic phenomenology (to understand meanings and significance that clients and practitioners attach to their experiences of IM). Data collection involved the collation of existing literature texts and by cumulative case studies (using semi-structured interviews and observation), focus groups, and key informant interviews. Using a blend of methodologies provided a rich and powerful means of understanding the processes and outcomes of IM through the interpretations of its core stakeholders’ lived experiences. In particular I sought perceptions of clients and practitioners of IM about their health and health care including assessment and treatment options, health outcomes, congruence with beliefs and values, collaborative practices and power sharing. Data analysis was conducted concurrently with and subsequent to data collection so that questioning, observation and textual interpretation were progressively guided by the data. A set of meta-themes emerged from the fusion of findings from all phases of the research. These meta-themes represented answers to key research questions. They are: • Power/authority • Mutual respect • Professionalism • Ontological perspectives • Duty of care. This thesis identifies IM practice styles according to different levels of client agency and degrees of power sharing that exist among CAM and mainstream medical practitioners. A theorised model based on the research findings which depicts quality of health care as a variable consequence of diverse practice styles of IM is produced in two parts: Part 1 acknowledges that IM is a variable phenomenon in practice with different levels of collaboration, power-sharing and quality of health care; Part 2 presents an optimum mode of IM practice. Authentically client-centred health care is at the core of all of these practice styles. This thesis has significant implications for the way IM is practised and for primary health care delivery more broadly. IM that is mutually respectful and genuinely collaborative is flexible, inclusive, and socially relevant and has a substantial and far-reaching contribution to make to the quality of primary health care.
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MURPHY, CATHRYN LOUISE School of Health Services Management UNSW. "INFECTION CONTROL IN THE AUSTRALIAN HEALTH CARE SETTING." Awarded by:University of New South Wales. School of Health Services Management, 1999. http://handle.unsw.edu.au/1959.4/17600.
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1,708 members of the Australian Infection Control Association were surveyed to describe the practices of Australian infection control practitioners. The study details the methods infection control practitioners use to co-ordinate and measure nosocomial infections as clinical outcomes of Australian infection surveillance and control programs. Administrators' and clinicians' perceptions of the elements and infrastructure of infection surveillance and control programs and the role of the infection control were measured in 316 hospitals in New South Wales, Australia. A literature review found that the development of Australian infection surveillance and control programs is behind that of U.S.A and the United Kingdom. The survey of the infection control practitioners identified that their role and duties varied between facilities as did the time allocated to infection control tasks. The survey of infection control practitioners demonstrated variation in their levels of skill, education and experience. Infection control practitioners' use and application of evidence and associated skills was examined and found to be limited in relation to clinical decision making and policy development. The survey also examined the methods infection control practitioners use to undertake surveillance of nosocomial infections. The methods reported indicated non-standard approaches to surveillance activity. A survey of administrators and clinicians in NSW hospitals was undertaken to identify variation in administrator and clinician perceptions and to describe their level of support for recommended essential infrastructure and criteria for infection surveillance and control programs and the role of the infection control practitioner in accordance with Scheckler's model. The survey indicated divergent views regarding the role of the infection control practitioner and the essential elements of infection surveillance and control programs. The study identified that education of infection control practitioners is necessary to facilitate standard approaches to co-ordinating infection surveillance and control activity. The development of Australian infection surveillance and control programs require a strategic alliance between stakeholders. to define essential elements of infection surveillance and control programs. In addition, the role of the infection control practitioner must be defined before key stakeholders can agree on the minimum skills, qualifications and experience required by an infection control practitioner.
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McCabe, Helen, and res cand@acu edu au. "The Ethical Implications of Incorporating Managed Care into the Australian Health Care Context." Australian Catholic University. School of Philosophy, 2004. http://dlibrary.acu.edu.au/digitaltheses/public/adt-acuvp48.29082005.
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AIMS Managed care is a market model of health care distribution, aspects of which are being incorporated into the Australian health care environment. Justifications for adopting managed care lie in purported claims to higher levels of efficiency and greater ‘consumer’ choice. The purpose of this research, then, is to determine the ethical implications of adapting this particular administrative model to Australia’s health care system. In general, it is intended to provide ethical guidance for health care administrators and policy-makers, health care practitioners, patients and the wider community. SCOPE Managed care emerges as a product of the contemporary, neo-liberal market with which it is inextricably linked. In order to understand the nature of this concept, then, this research necessarily includes a limited account of the nature of the market in which managed care is situated and disseminated. While a more detailed examination of the neo-liberal market is worthy of a thesis in itself, this project attends, less ambitiously, to two general concerns. Firstly, against a background of various histories of health care distribution, it assesses the market’s propensity for upholding the moral requirements of health care distributive decision-making. This aspect of the analysis is informed by a framework for health care morality the construction of which accompanies an inquiry into the moral nature of health care, including a deliberation about rights-claims to health care and the proper means of its distribution. Secondly, by way of offering a precautionary tale, it examines the organisational structures and regulations by which its expansionary ambitions are promoted and realised. CONCLUSIONS As a market solution to the problem of administering health care resources, the pursuit of cost-control, if not actual profit, becomes the primary objective of health care activity under managed care. Hence, the moral purposes of health care provision, as pursued within the therapeutic relationship and expressed through the social provision of health care, are displaced by the economic purposes of the ‘free’ market. Accordingly, the integrity of both health care practitioners and communities is corrupted. At the same time, it is demonstrated that the claims of managed care proponents to higher levels of efficiency are largely unfounded; indeed, under managed care, health care costs have continued to rise. At the same time, levels of access to health care have deteriorated. These adverse outcomes of managed care are borne, most particularly, by poorer members of communities. Further, contrary to the claims of its proponents, choice as to the availability and kinds of health care services is diminished. Moreover, the competitive market in which managed care is situated has given rise to a plethora of bankruptcies, mergers and alliances in the United States where the market is now characterised by oligopoly and monopoly providers. In this way, a viable market in health care is largely disproved. Nonetheless, when protected within a non-market context and subject to the requirements of justice, a limited number of managed care techniques can assist Australia’s efforts to conserve the resources of health care. However, any more robust adoption of this concept would be ethically indefensible.
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Sheehan, Kathleen. "Perceived coercion in mental health care." Thesis, University of Oxford, 2007. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.442968.
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Sandbulte, Natalie J. "Rural communities and mental health care." Theological Research Exchange Network (TREN), 2007. http://www.tren.com/search.cfm?p088-0180.
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Schultz, Sarah Robinson. "Health coverage without health care unmet mental health care needs among the publicly insured /." Connect to Electronic Thesis (CONTENTdm), 2009. http://worldcat.org/oclc/457147003/viewonline.
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Phillips, Elena [Verfasser]. "E-mental health – using digital technologies to advance mental health care / Elena Phillips." Hamburg : Staats- und Universitätsbibliothek Hamburg Carl von Ossietzky, 2021. http://d-nb.info/1235243931/34.
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Baker, Robin Lynn. "Primary Care and Mental Health Integration in Coordinated Care Organizations." PDXScholar, 2017. https://pdxscholar.library.pdx.edu/open_access_etds/3616.
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The prevalence of untreated and undertreated mental health concerns and the comorbidity of chronic conditions and mental illness has led to greater calls for the integration of primary care and mental health. In 2012, the Oregon Health Authority authorized 16 Coordinated Care Organizations (CCO) to partner with their local communities to better coordinate physical, behavioral, and dental health care for Medicaid recipients. One part of this larger effort to increase coordination is the integration of primary care and mental health services in both primary care and community mental health settings.
The underlying assumption of CCOs is that organizations have the capacity to fundamentally change how health care is organized, delivered, and financed in ways that lead to improved access, quality of care, and health outcomes. Using the Rainbow Model of Integrated Care (RMIC), this study examined the factors that impact organizational efforts to facilitate the integration of primary care and mental health through interviews with executive and senior staff from three CCOs. The RMIC focuses attention on the different levels at which integration processes may occur as well as acknowledges the role that both functional and normative enablers of integration can play in facilitating integration processes within as well as across levels. The following research question was explored: What key factors in Oregon's health care system impede or facilitate the ability of Coordinated Care Organizations to encourage the integration of primary care and mental health?
Using a case study approach, this study drew upon qualitative methods to examine and identify the factors throughout the system, organizational, professional, and clinic levels that support CCO efforts to facilitate the integration of primary care and mental health. Fourteen primary interviews were conducted with executive and senior staff. In addition, eleven secondary interviews from a NIDA funded project as well as twenty-four key CCO documents from three CCOs were also included in this study.
The RMIC was successful in differentiating extent of CCO integration of primary care and mental health. Findings demonstrate that normative and functional enablers of integration were most prevalent at the system and organization level for integrating mental health into primary care for these three CCOs. However, there was variation in CCO involvement in the development of functional and normative enablers of integration at the professional and clinic levels. Normative and functional enablers of integration were limited at all of the RMIC levels for integrating primary care into community mental health settings across all three CCOs.
The Patient-Centered Primary Care Home model provided CCOs with an opportunity to develop functional and normative enablers of integration for integrating mental health in primary care settings. The lack of a fully developed model for integrating primary care services in community mental health settings serves as a barrier for reverse integration. An additional barrier is the instability of community mental health as compared to primary care; contributing factors include historically low wages and increased administrative burden. System wide conversations about where people are best served (i.e., primary care or community mental health) has yet to occur; yet these conversations may be critical for facilitating cross-collaboration and referral processes. Finally, work is needed to create and validate measures of integration for both primary care and community mental health settings. Overall findings confirm that integrating primary care and mental health is complex but that organizations can play an important role by ensuring the development of normative and functional enablers of integration at all levels of the system.
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Iveson, Claire. "From primary care to mental health services:." Thesis, University of Liverpool, 2002. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.490634.
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Humbert, Kirsten. "Ministers as informal mental health care professionals." Thesis, McGill University, 2014. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=121432.
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Although not typically considered formal mental health care professionals, clergy are regularly contacted as a resource by people with mental illness. Little is known about the clergy's role in this capacity. The aim of this research is to explore the experiences and perspectives of Canadian ministers of the United Church in response to mental health issues using simple qualitative description. Three female and nine male urban ministers of the United Church of Canada were recruited to participate in semi-structured interviews. Interviews were audio recorded, transcribed, and analyzed by hand for relevant themes. Themes within the following three main topics emerged: how ministers served people with mental illness, ministers' experiences working alongside formal mental health care professionals, and remaining challenges and facilitators. Ministers reported providing various support services for people with mental illness. While ministers reported little direct collaboration, they reported regularly referring people with suspected mental illness to formal mental health care professionals. Finally, ministers cited an innate trustworthiness in their profession and their community as facilitators, while remaining challenges included limitations in terms of financial resources, time, trust between themselves and formal mental health care professionals, and trust between ministers and their colleagues. The findings of this research indicate that collaborative relationships should be encouraged between formal mental health care professionals and ministers of the United Church to better serve people with mental illness.N'étant généralement pas considérés comme des professionnels de la santé mentale, les membres du clergé sont régulièrement sollicités comme personnes ressources par des personnes atteintes de maladie mentale. On en connaît peu sur le rôle du clergé dans le domaine de la santé mentale. Le but de cette recherche est d'explorer les expériences et points de vue de pasteurs de l'Église Unie du Canada en réponse aux problèmes de la santé mentale à l'aide de la description qualitative simple. Trois femmes et neuf hommes pasteurs urbains de l'Église Unie du Canada ont été recrutés pour participer à des entrevues semi-structurées. Les entrevues ont été enregistrées, transcrites et analysées. Trois grands thèmes ont émergé : la façon dont les pasteurs mettent leurs services au profit des personnes atteintes de maladie mentale, l'expérience des pasteurs à travailler conjointement avec les professionnels des soins de santé mentale, et les défis restants et les mesures facilitant la prise en charge de ces personnes. Les pasteurs ont déclaré fournir divers services de soutien aux personnes atteintes de maladie mentale. Bien que les pasteurs aient signalé peu de collaboration directe des professionnels des soins de la santé mentale, ils ont déclaré leur diriger régulièrement des personnes soupçonnées d'être atteintes d'une maladie mentale. Finalement, les pasteurs ont déclaré avoir une confiance innée en leur profession et en leur communauté comme intervenants facilitateurs, bien que de nombreux défis se posent au niveau des ressources financières, du temps, de la confiance entre pasteurs et professionnels des soins de la santé mentale, ainsi que de la confiance entre les pasteurs et leurs collègues. Les résultats de cette recherche indiquent que les relations de collaboration entre les professionnels des soins de la santé mentale et les pasteurs de l'Église Unie devraient être encouragées pour mieux servir les personnes atteintes de maladie mentale.
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Gooding, Lewis D. "Care, community and the mental health nurse." Thesis, University of East Anglia, 2003. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.399844.
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Torres, Adriana. "SCHOOL-BASED MENTAL HEALTH CARE PROGRAM EVALUATION." CSUSB ScholarWorks, 2018. https://scholarworks.lib.csusb.edu/etd/655.
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This study aimed to determine if the Department of Behavioral and Mental Health at a local school district is improving the academic outcomes of the students it provides services to. The purpose was to evaluate its effectiveness in order to improve and expand services. This is important since schools have become a primary setting to address the mental health needs of children and youth. The research design consisted of a quantitative, one-group pretest-posttest as students’ outcomes were assessed before and after treatment. The data was analyzed using a paired samples t-test. The findings from this study demonstrated no statistical significance in students’ grades and attendance, thereby demonstrating the need for further research on this topic.
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Mangalore, Roshni. "Equity in mental health care in Britain." Thesis, London School of Economics and Political Science (University of London), 2007. http://etheses.lse.ac.uk/2702/.
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This thesis explores equity issues in the mental health field in Britain by initially developing a conceptual structure to define equity in mental health and then analysing data from three national psychiatric morbidity surveys to measure inequalities and inequities in both mental health and in the use of services. Standard methods are used for measuring income-related and social class-related inequalities with reference to many indicators of mental health which represent 'normative' or 'felt' needs for services. Inequity in the use of mental health services is also examined by relating use of services to needs. Analyses of income-related inequalities and equity are carried out with reference to the general population using data from the Psychiatric Morbidity Survey 2000 and with reference to the minority ethnic groups in Britain using data from the survey of Ethnic Minority Psychiatric Illness Rates in the Community 2000. Changes in social class-related inequalities and equity for the general population between 1993 and 2000 are examined using data from the Psychiatric Morbidity Surveys for those two years, in order to see if the policy and practice changes that took place since the beginning of the 1990s in the health and social care sectors had exerted any impact on equity in mental health. The three mental health surveys being cross-sectional do not permit the study of causal pathways between income and mental health. Therefore, in order to understand the links between living standards, health and health care utilisation patterns further, data from a longitudinal study, the British Household Panel Survey on general health are examined using robust theoretical and empirical models. The assumption is that many of the factors associated with general health are also associated with mental health and much of the model that links income, health and health care utilisation behaviour is likely to be relevant for mental health as well.
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Holland, Kate E., and n/a. "Conformity and resistance: Discursive struggles in the Australian mental health field." University of Canberra. Communication, 2007. http://erl.canberra.edu.au./public/adt-AUC20081022.153830.
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This research explores areas of contention in the mental heath field in Australia through a
qualitative analysis of voices and practices that can broadly be seen as talking with and
talking back to psychiatry. The thesis is informed by key shifts in thinking that underpin
postpsychiatry and analyses a set of materials through an interpretive lens of reading
psychiatry against the grain (Bracken & Thomas, 2005; Lewis, 2006). In particular, it
examines a failed ethics application to conduct research with people diagnosed with a mental
illness, an anti-stigma campaign, the practices of some prominent mental health organisations
in Australia, a conversation with two members of an emerging consumer/survivor network in
Australia, and a television documentary and online discussion forum about an antidepressant
medication. The research draws from discourse analytic methods and concepts from social
movement framing research to identify factors shaping conformity and resistance to
psychiatric doxa in the Australian mental health field.
The research identifies the discursive repertoires that characterise the mental health field as a
"game" in which competing perspectives vie for recognition. In relation to research ethics
committees, the thesis argues that deference to clinical expertise is a potential barrier to
cultural studies of psychiatry and a more inclusive agenda in mental heath research and
practice. Some practices for ethics committees to consider when reviewing research that
involves people who may have been diagnosed with a mental illness are proposed. The
research also identifies problematic features of anti-stigma campaigns that direct their efforts
toward protecting and promoting the discourse of biomedical psychiatry. A critique of this
type of campaign is offered in relation to perspectives from postpsychiatry and social
constructionism. On the basis of this research, it is argued that organisations that champion
"mental health literacy" are limited in their ability to give voice to the goals and priorities of
those who are calling for a more open, reflexive and democratic debate in mental health. The
central argument of this thesis is that elevating first-person and postpsychiatry perspectives is
necessary in order to interrogate and address the dominance of the medical model in
psychiatry and its consequences.
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Hasson, James M. "The ramifications of managed care in the behavioral health care setting in Berks County." Instructions for remote access. Click here to access this electronic resource. Access available to Kutztown University faculty, staff, and students only, 1997. http://www.kutztown.edu/library/services/remote_access.asp.
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Thesis (M.P.A.)--Kutztown University of Pennsylvania, 1997.Source: Masters Abstracts International, Volume: 45-06, page: 2943. Abstract precedes thesis as 1 preliminary leaf. Typescript. Includes bibliographical references (leaves 66-67).
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Eisenbrandt, Lydia L., and Jill D. Stinson. "The Need for Mental Health Professionals Within Primary Health Care." Digital Commons @ East Tennessee State University, 2016. https://dc.etsu.edu/etsu-works/7900.
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Mental health concerns are presented in primary care settings regularly, yet a majority of these issues go undetected or are misdiagnosed by primary care physicians (PCPs). This may be due to a lack of mental health training for PCPs during their medical education. Over time, medical school curricula have evolved to include mental health training in order to bridge this gap in the healthcare system and to more readily identify patients in need of mental health services. The current study investigated AMA-accredited medical school curricula from universities across the US and US territories (N = 170) who train physicians in primary care, family medicine, or other generalist tracks. Data on mental health training were collected from the public websites of each school. Results showed that most universities indicated at least some type of required mental health training (85.3%), which were either didactic or experiential in nature. Although this result appears encouraging, further examination reveals that this training was most often limited to only one 4-week psychology-related course and a 6-week psychiatry rotation. Overall, many universities indicated at least one required course (N = 95), and most universities reported a required psychiatry rotation (N = 135). Moreover, only 12.9% of the sample reported having at least both didactic and experiential training required. The implications of this are varied. First, PCPs often have only a short amount of time with their patients, reducing their ability to fully assess both medical and mental health. A lack of exposure to mental health needs may lead to missed opportunities for intervention and improvement in patient health. Second, it is important for mental health professionals to work closely with PCPs in primary healthcare settings in order to improve rates for detection and treatment of mental health problems. In addition to improved patient outcomes, having mental health professionals integrate within primary healthcare can serve to decrease the stigma associated with seeking mental health treatment, as well as reduce long-term healthcare costs. This can also increase access to care for those individuals who are unable to see a mental healthcare provider, especially in rural areas. Finally, overall health may improve in relation to better mental healthcare, since medical and mental health have been consistently shown to significantly influence one another.
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Irigoyen, Josefina. "Mental Health Care in McAllen Texas: Utilization, Expenditure, and Continuum of Care." Antioch University / OhioLINK, 2014. http://rave.ohiolink.edu/etdc/view?acc_num=antioch1398421681.
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Hall, Julie. "Using integrated care pathways in mental health care : a case study." Thesis, University of Nottingham, 2010. http://eprints.nottingham.ac.uk/12749/.
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Background: Integrated Care Pathways (ICPs) are prearranged processes of care which are being increasingly used to deliver mental health services. The literature reveals difficulties in their development and implementation, and a lack of empirical evidence to support their use. Aims: The aim of this research was to investigate how an ICP has been used to manage mental health care in one selected mental health Trust in England. Methods: A case study approach was adopted with several units of analysis. The views of healthcare professionals using semi structured interviews; the experiences of service users and carers using focus groups; contrasting hospital episode and performance statistics with a comparison Trust and documentary analysis of the ICP. Findings & Discussion: Of the healthcare professions, only nurses used the ICP. No professionals used the ICP to support clinical decision making and risk management. However, just over two-thirds (67.2%) of the interventions described in the pathway were delivered. There was no statistically significant difference when comparing performance indicators for an equivalent episode of care between the ICP Trust and non ICP Trust. Service user and carers' experiences revealed that peopled did not feel that their care was individualised to them, although amongst them they had different perceptions of the care process. Conclusions: Mental health ICPs need to reflect the relationships between stakeholders, variability of illness and individual ways of living if they are to provide a framework for managing care in the future that accords with the needs of people using mental health services.
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Burbach, Frank Robert. "Developing systemically-oriented secondary care mental health services." Thesis, University of Plymouth, 2013. http://hdl.handle.net/10026.1/1599.
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Research has indicated that offering support and services for people who experience mental health problems and their families is a complex and contested area. Despite the controversies surrounding therapeutic interventions with families, it has now been recognised that relatives and other supporters of people with mental health problems should be included in their care. Whole- family interventions and partnership working with carers and families is now central to secondary care UK mental health policies and clinical practice guidelines. However, for many families/ carers this remains an aspiration rather than a reality. The way in which we successfully developed family focused mental health practice, as well as specialist family interventions (FI) for people who have been given a diagnosis of psychosis, has therefore aroused considerable interest. The Somerset Partnership NHS Foundation Trust has adopted a Strategy to Enhance Working Partnerships with Carers and Families, developed best practice guidance and has established two complementary workforce development projects - the development of specialist family intervention services and the widespread training of mental health staff to create a ‘triangle of care’ with service users and their families. This has resulted in widespread adoption of systemically informed, ‘whole-family’ practice. In response to the widespread difficulties experienced following other staff- training initiatives we developed specialist family interventions (FI) services by means of an innovative one-year course delivered in partnership with Plymouth University. This training initiative has been widely acknowledged for its novel integration of psycho-educational and systemic approaches and the effective in-situ, multi-disciplinary service development model. An advantage of this approach is that by the end of the course a local FI Service has been established and staff experience fewer difficulties in applying their new skills than people trained in other programmes. We then ensure the continued development of clinical skills by means of a service structure that emphasises on-going supervision. Regular audits of the service and in-depth research studies clearly indicate that the service is effective and highly valued by users. Our ‘cognitive-interactional’ approach, which integrates systemic therapy with psychosocial interventions (individual- and family-CBT) within a collaborative therapeutic relationship, enables us to meet the needs of families in a flexible, tailored manner. The FI teams are able to deliver early interventions for people with first episode psychosis, as well as meeting the NICE guidelines for people with longstanding symptoms. Recognising that many families do not require formal family interventions/ therapy, we also have been designing ‘stepped-care’ family intervention services. We have developed, and extensively evaluated, short training packages to enhance working partnerships with families throughout our mental health services. We have used this three-day package to train a range of community and inpatient teams. We have also encouraged family- inclusive practice with the establishment of a trustwide steering group, practice guidelines and the establishment of ‘family liaison’ posts to facilitate family meetings on inpatient units, as part of the assessment process. Both training initiatives explicitly focus on developing systemic thinking, by integrating CBT and systemic therapy. The involvement of families/ carers in the design and delivery of both training initiatives is also crucial.
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Eales, S. J. "Service users' experiences of liaison mental health care." Thesis, City University London, 2013. http://openaccess.city.ac.uk/13073/.
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Liaison mental health services provide mental health care, including assessment, interventions and sign posting to further specialist care, for those who present with mental health needs in non-mental health settings. Liaison mental health services in the United Kingdom most frequently exist within, but are not limited to general hospital provision. The commissioning of these services is however inconsistent, having developed in an ad hoc manner, and the evidence base for an appropriate structure remains limited. This thesis reports an extensive literature review which identifies that to date there has been no published detailed exploration of the experiences of service users of liaison mental health care. Only recently has research been published which tentatively identifies the ability of liaison mental health services to reduce costs to general hospitals of mental health presentations and co-morbidity. The empirical element of this programme of research is a study of the experiences of service users of a liaison mental health service, offered within a general hospital setting. The service users have experiences of both inpatient and emergency department care. The study utilises a secondary data analysis methodology to provide an in depth interpretation of these experiences. Data were analysed using a grounded theory constant comparative method. A core category of ‘negotiating and navigating the system’ emerged as service users’ experienced psychological distress as they attempted to manage their own resources and expectations as a personal safety net. It is only when this personal strategy fails to alleviate their symptoms that they attempt to find help from professional services within the general hospital. Gaining access to assessment by the liaison mental health service requires the service user to negotiate a complex system of care. This experience is represented in the study utilising a conceptual map of their journey, using the analogy of a road to explore the enablers and barriers to an effective experience of liaison mental health care. A model of liaison mental health care is required that ensures provision of educational support for non-mental health professionals within the general hospital setting. This education needs to acknowledge that those who are having their first experience of a mental health issue often do not know where else to seek help, other than the emergency department, because it represents the ‘front door’ of health care. The adoption of a comprehensive model of liaison mental health care is a priority for all general hospital settings in order to achieve improved service user experience, cost efficiency and integrated health care provision.
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Webb, Katie Louise. "Management of common mental health in primary care." Thesis, Cardiff University, 2014. http://orca.cf.ac.uk/66867/.
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Mental health is recognised as a global burden of disease and amongst the leading contributors to disability, with common mental health affecting one in six adults. The impact of these conditions on individuals and the economy are significant. Primary care is the first point of contact and general practitioners, as public health gatekeepers are of key importance in the recognition and management of these. It is suggested that general practitioners find consultations challenging, though it is not clear what these difficulties are. The aim of this thesis was to investigate what, if any, problems general practitioners experience with regards to the common mental health consultation. A scoping study and survey provided information on general practitioners’understanding of common mental health and its management. Another survey investigated the perceptions, beliefs and understanding of the general public in relation to common mental health and its management. A theory of planned behaviour study looked at factors that influenced general practitioners’ prescribing and referral behaviours. And finally, a triangulation study examined the findings from the programme of research with other key professionals who are also part of the pathway of care - primary care counsellors and clinical psychologists. Results of this thesis suggest that general practitioners do experience difficulties with the management of common mental health. Challenges were shown to be associated with the general practitioner’s role as the patient’s advocate, lack of knowledge and education, confidence, personal experience, patient expectation and management systems. Results also showed General practitioners’ and lay persons’ understanding of common mental health in everyday practice was different to that in public policy. General practitioner treatment management was shown to be in conflict with clinical guidelines. Furthermore, prescribing and referral behaviours were shown to be influenced by their attitude, significant others and whether they possessed adequate skills or knowledge.
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Szalacha, Laura A., Tonda L. Hughes, Ruth McNair, and Deborah Loxton. "Mental health, sexual identity, and interpersonal violence: Findings from the Australian longitudinal Women’s health study." BIOMED CENTRAL LTD, 2017. http://hdl.handle.net/10150/626105.
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Background: We examined the relationships among experiences of interpersonal violence, mental health, and sexual identity in a national sample of young adult women in Australia. Methods: We used existing data from the third (2003) wave of young adult women (aged 25- 30) in the Australian Longitudinal Study on Women's Health (ALSWH). We conducted bivariate analyses and fit multiple and logistic regression models to test experiences of six types of interpersonal violence (physical abuse, severe physical abuse, emotional abuse, sexual abuse, harassment, and being in a violent relationship), and the number of types of violence experienced, as predictors of mental health. We compared types and number of types of violence across sexual identity subgroups. Results: Experiences of interpersonal violence varied significantly by sexual identity. Controlling for demographic characteristics, compared to exclusively heterosexual women, mainly heterosexual and bisexual women were significantly more likely to report physical, sexual, and emotional abuse. Mainly heterosexual and lesbian women were more likely to report severe physical abuse. Mainly heterosexual women were more than three times as likely to have been in a violent relationship in the past three years, and all three sexual minority subgroups were two to three times as likely to have experienced harassment. Bisexual women reported significantly higher levels of depression than any of the other sexual identity groups and scored lower on mental health than did exclusively heterosexual women. In linear regression models, interpersonal violence strongly predicted poorer mental health for lesbian and bisexual women. Notably, mental health indicators were similar for exclusively heterosexual and sexual minority women who did not report interpersonal violence. Experiencing multiple types of interpersonal violence was the strongest predictor of stress, anxiety and depression. Conclusions: Interpersonal violence is a key contributor to mental health disparities, especially among women who identify as mainly heterosexual or bisexual. More research is needed that examines within-group differences to determine which subgroups are at greatest risk for various types of interpersonal violence. Such information is critical to the development of effective prevention and intervention strategies.
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Storms, Starr 1948. "An assessment of the mental health of mental health care workers in the public sector." Thesis, The University of Arizona, 1993. http://hdl.handle.net/10150/291732.
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The mental and emotional well-being of mental health care professionals can be jeopardized by burnout, a syndrome similar to depression and other affective disorders in its symptomology and effects. A questionnaire designed to assess mental health and burnout was developed using various assessment tools from the mental health care community to obtain information about health habits, stressors, coping skills, personal history, and length of service. Forty-seven workers at a public mental health facility responded to the questionnaire. The results of this study suggest that approximately 20% of mental health care-givers are experiencing high degrees of burnout and mental disease. Neither personal history or long-term service appears to contribute to the burnout. Workers new to the field seem to be at greatest jeopardy. Control coping mechanisms were found to be more effective than escape coping mechanisms in combating stress and mental illness.
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Green, Susan Elizabeth. "Mental health policy implementation : a case study." Thesis, University of Birmingham, 2000. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.368414.
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Beecham, Jennifer Kate. "Community mental health services : resources and costs." Thesis, University of Kent, 1996. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.319222.
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Jhangiani, Surita. "Punjabi immigrant women’s narratives of mental health and health care utilization." Thesis, University of British Columbia, 2011. http://hdl.handle.net/2429/34465.
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Indian Punjabis constitute a large proportion of the immigrant population in the Lower Mainland of BC. By 2031, it is anticipated that South Asians will be the largest visibility minority group in Canada (Statistics Canada, 2005). As a result, the mental health needs of this population may soon have a large impact on mental health providers. The present study investigated how Punjabi immigrant women constructed the meaning of mental health through the following research questions: 1) How do Punjabi immigrant women define concepts related to mental health and illness?; 2) How are mental health services accessed and utilized by the participants?; 3) In what ways do the existing mental health services meet or fail to meet the needs of the participants?; 4) How can these services be made more culturally accessible?; and 5) How is mental health defined by prominent mental health organizations? Drawing from feminist post-colonial theory and utilizing a critical qualitative approach, the first segment of this study was a narrative analysis of qualitative interviews that enabled an understanding of the participants’ views of mental health and experiences accessing mental health services and; the second segment of the study critically analyzed documents pertaining to the meaning of mental health as defined by three prominent mental health organizations. The results of this study suggested that the participants’ conceptions of mental health shared some similarities with Western models. The meanings that the participants constructed for various concepts, and their underlying metaphors, however, differed from Western models of mental health. Further, cultural conventions and perceptions often affected how participants’ viewed mental health issues and the type of help they sought. Recommendations, limitations and challenges, and future directions are discussed. As critical research, the results of this study contribute to the ongoing development of a culturally responsive approach to health care provision.
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Polaha, Jodi, and J. Hodgeson. "INTRA-Disciplinary Care: Can Mental Health Professionals Work Together in Primary Care?" Digital Commons @ East Tennessee State University, 2011. https://dc.etsu.edu/etsu-works/6767.
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Excerpt: Last fall, I sat through an uncomfortable board meeting. I was charged to work with a Clinical Social Worker, Licensed Practicing Counselor, a Counseling Psychologist, and a Licensed Nurse Practitioner to develop an integrated care training program as part of a rural workforce development project.
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Fleming, Brian James. "The social gradient in health : trends in C20th ideas, Australian Health Policy 1970-1998, and a health equity policy evaluation of Australian aged care planning /." Title page, abstract and table of contents only, 2003. http://web4.library.adelaide.edu.au/theses/09PH/09phf5971.pdf.
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Mitchell, Penelope Fay. "Mental health care roles and capacities of non-medical primary health and social care services : an organisational systems analysis /." Connect to thesis, 2007. http://eprints.unimelb.edu.au/archive/00003854.
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Eyongherok, Arrey Irenee. "Mental Health Disparities Among Minority Populations." ScholarWorks, 2019. https://scholarworks.waldenu.edu/dissertations/7639.
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Despite the existence of effective treatments, mental health care disparities exist in the availability, accessibility, and quality of services for racial and ethnic minority groups. People living with serious mental complaints often resist engaging in treatments and experience high rates of dropout; poor engagement can lead to worse clinical outcomes. Addressing the complex mental health care needs of racial and ethnic minorities warrants considering evidence-based strategies to help reduce disparities. This systematic review sought to provide an analysis of published literature about the barriers and effective strategies in identifying and treating minority patients with mental health disorders. The practice-focused question of this systematic review was: What are the barriers and effective strategies to identification and treatment of mental health disorders among minority populations. This project was guided by PRISMA and SQUIRE guidelines and Fineout-Overholt and Melnyk’s appraisal form, comprising 11 studies published between 2014 and 2019, identified through Thoreau, Cochrane, CINAHL with Medline, EBSCO, and ProQuest, SAMHSA and PubMed databases. The systematic review results recommend intervention strategies such as integrated/collaborative care, workforce diversity, providers in minority neighborhoods, improving providers’ cultural skills, and stigma reduction to help reduce mental health care disparities. These findings are significant to lowering the gap in practice and can be used by the entire health care system to improve mental health care, thereby leading to a positive social change. Implementing these strategies would benefit patients, families, their communities, and the entire health care delivery system.
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McLoughlin, Pauline. "Unhealthy places : examining asylum seeker mental health in the Australian mandatory detention environment /." Title page, table of contents and abstract only, 2004. http://web4.library.adelaide.edu.au/theses/09HS/09hsm4789.pdf.
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Dusenberry, Jean Lee. "A Mental Health Care Center for Grady Memorial Hospital." Thesis, Georgia Institute of Technology, 1994. http://hdl.handle.net/1853/24137.
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Casey, Kathleen Barbara. "HIV counselling, mental health and psychosocial care in Thailand." School of Psychology - Faculty of Health and Behavioural Sciences, 2007. http://ro.uow.edu.au/theses/73.
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Rationale: International research has demonstrated that in order to retain a skilled and healthy cadre of willing health-workers there is a need to monitor and develop strategies to mitigate adverse impact of this work and improve the quality and effectiveness of client and patient mental health care. Aims: (i) Monitor and evaluate Thailand’s national HIV mental health and psychosocial care program. (ii) Measure the impact of HIV mental and psychological care on health care providers. (iii) Examine the relationship between occupation-related psychological morbidity and the recruitment, training, clinical supervision and work-practices of HIV mental health service providers. (iv) Develop, implement and evaluate a training curriculum that addresses the demands of the HIV client population in Thailand. Method: In Study 1, 826 government hospitals, 1000 government health centres, and 1135 non-government organisations and private providers participated in: semi-structured, key informant interviews; focussed group discussions; and criterion-referenced appraisals of health policy and service delivery. Study 2, a small exploratory, qualitative study, utilised a schema of five key stressors commonly associated with HIV care to analyse responses gained from HIV counsellors and employed semi-structured interviews and focussed discussion groups. Study 3, a cross-sectional study, explored the relationship between training, work practices, Locus of Control of Behaviour and the self-reporting of signs and symptoms of psychological distress. 803 HIV counsellors completed a series of questionnaires including the Thai version of the General Health Questionnaire (GHQ-28), the Locus of Control of Behaviour Questionnaire and the Thai HIV Counsellors Survey (THCS). Study 4 involved the development, delivery and evaluation of a series of short courses designed to train 79 health workers to provide HIV counselling. The training was evaluated by pre and post knowledge examinations and anonymous evaluations. Results: Study 1 found that policy and legislation failed to adequately guide the practitioner in a number of key areas including: testing and counselling of minors; testing without informed consent; confidentiality of medical records and disclosure of HIV status; and “duty of care” in terms of threatened suicide or harm to others. Furthermore, it was found that epidemiological data had not been adequately considered in terms of providing specific psychological support services, and developing counselling curriculum, and that the conduct of Thai based psychological and operations research had been limited. Whilst there was good national coverage of HIV testing counselling services, psychological services to address HIV issues across the disease continuum were limited and frequently provided by individuals without adequate training. There does not appear to be any systematic mechanism for monitoring and evaluating HIV mental health and psychosocial care. This study also revealed that Thailand is limited in its ability to provide adequate HIV field-experienced, trained mental health care personnel who can teach in the necessary languages that would enable sharing of the Thai health sector experience within the region. Study 2: The respondents identified a number of workplace stressors including: fear of contagion; client-professional boundary issues; difficulties with being identified as working in the sphere of a highly stigmatised disease; the experience of multiple losses, in a context of perceived inadequate training; role expansion; and perceived lack of recognition and reward. Participants also identified a number of work and socio-cultural influences which were perceived to mitigate the impact of the work. Study 3: Failure to take up counselling duties after training was primarily associated with counsellors having too many competing non-counselling duties (31.2%; n=108), and being deployed to other workplaces in a non-counselling capacity (22.8%,n=79). Over 81% (n=441) of respondents who indicated that they were continuing to work as counsellors reported signs and symptoms of psychological disturbance on the GHQ-28 screening at a level that warranted further mental health assessment. There was a significant positive correlation between GHQ-28 “caseness” and Locus of Control of Behaviour scores (r =.118; p<.001). Decisions to leave counselling were positively associated with self reported psychological disturbance (r =.324; p<.001) and the perception that their work was not helpful to clients (r =.108; p<.001). Study 4: The results clearly showed that the curriculum, and method of training resulted in both perceived and measured change in knowledge and skills and were reported to have resulted in improvements in the trainees’ perceived self confidence to meet the demands of their clients. Conclusion: The studies identified the many challenges inherent in providing effective HIV counselling, mental health and psychosocial services in Thailand. This research suggests that delivering HIV psychosocial care services in Thailand has potentially an adverse impact on: the health and well being of care providers; the quality of care received by clients and patients; and ultimately on the ability of the health system to retain its skilled personnel.
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Goodwin, Simon Christopher. "Community care : the reform of the mental health services?" Thesis, University of Sheffield, 1988. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.387717.
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Henderson, Jeanette. "Constructions, meanings and experiences of 'care' in mental health." Thesis, Open University, 2004. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.399758.
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Mazza, Jessica. "Organizational culture in children's mental health systems of care." [Tampa, Fla] : University of South Florida, 2008. http://purl.fcla.edu/usf/dc/et/SFE0002351.
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Hungerford, Gabriela Marie MS. "Characterizing Community-Based Usual Mental Health Care for Infants." FIU Digital Commons, 2016. http://digitalcommons.fiu.edu/etd/2609.
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Infants who experience multiple risk factors, such as preterm birth, developmental delay, and low socioeconomic status, are at greater risk for mental health problems. Mental health interventions for infants typically target infants from high-risk groups, and there is strong evidence that some intervention programs for infants can prevent long-term negative outcomes and promote long-term positive outcomes. Despite emerging research and federal initiatives promoting early intervention, minimal research has examined community-based mental health services during infancy. Improving the effectiveness and efficiency of routine care requires close examination of current practices. The current study characterized current usual care practices in infant mental health through a survey of mental health providers. Provider, practice, and client characteristics, provider use of intervention strategies and intervention programs, and provider attitudes toward and knowledge of evidence-based practices are described. Study findings are discussed in the context of previous usual care research. Implications and directions for future research are discussed.
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Wolff, Jan. "Patient-specific resource intensity of inpatient mental health care." Thesis, King's College London (University of London), 2016. https://kclpure.kcl.ac.uk/portal/en/theses/patientspecific-resource-intensity-of-inpatient-mental-health-care(0e6cd3ef-b97b-48f5-a5c0-28d8d1191a23).html.
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Understanding differences in resource use between patient groups is required for decision- making in clinical practice and health care policy. The overall aim of this research project was to show whether patient-specific resource use of inpatient mental health care can be inferred from patient characteristics. This aim was subdivided into four objectives, namely 1) to analyse the association between patient characteristics and length of stay, 2) to synthesise current scientific knowledge considering the association between patient characteristics and per diem resource use, 3) to analyse differences in per diem staff time use between patient groups and 4) to analyse patient-specific determinants of total per diem hospital costs. A systematic review was carried out to synthesise the current knowledge. Data of consecutively sampled patients were used to analyse the association between length and intensity of care and patient and service characteristics. A work time study was used to measure differences in staff time use. Eight potential cost drivers were identified on the basis of previous studies. Strong and significant effects on length and intensity of care were found in both patient and service characteristics. It was neither possible to reliably predict length of stay nor to reliably predict the intensity of care. Idiosyncrasies of inpatient mental health care might have hindered the identification of patient groups that are homogenous in terms of resource use. Decision makers in clinical practice and health policy should be aware of potential differences in resource use between apparently similar patients.
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Lombo, Nocawa Philomina. "Mental health care practitioners' perceptions of mental illness within the isiXhosa cultural context." Thesis, Nelson Mandela Metropolitan University, 2010. http://hdl.handle.net/10948/1179.
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This study sought to explore the perceptions of mental health care practitioners’ perceptions on mental illness within the isiXhosa cultural context. A qualitative exploratory descriptive and contextual design was used for the study. A non-probability purposive sampling method was used to select eight participants from Komani Hospital in Queenstown. Data was collected through semi-structured interviews. The services of an Independent Interviewer were used to avoid any bias as interviews took place where the researcher is employed. All interviews were transcribed verbatim and the data collected was analyzed according to Tesch’s eight steps of data analysis as described in Cresswell (1994:155). The researcher utilized services of an Independent Coder who verified the identified major themes. Four major themes emerged from the analysis of the interview: Mental health care practitioner’s perceptions of mental illness, perception of the causes of mental illness within the isiXhosa cultural context, mental health care practitioners’ views in the management and treatment of mental illness and suggestions put forward to improve the services to mental health care users. The major findings of this study were the lack of knowledge of culture of mental health care users. It is recommended that it would be proper if there could be co-operation between mental health care practitioners and traditional healers by working together as a team.
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Weekes, Jennifer D. "The Relationship of Self-Care to Burnout Among Social Workers in Health Care Settings." Thesis, Walden University, 2014. http://pqdtopen.proquest.com/#viewpdf?dispub=3613578.
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Self-care is critical in minimizing the symptoms of burnout among human services professionals, but specific information on the role of self-care among social workers in healthcare settings is limited. This correlational study was designed provide a fuller understanding of this relationship. Orem's theory of self-care and the theory of reasoned action and planned behavior served as the theoretical foundations of this study. The sample included 185 members of the National Association of Social Workers, who volunteered to participate in this study. Participants completed online versions of the Maslach Burnout Inventory and Self-Care Assessment Work Sheet. Correlation and analysis of variance (ANOVA) were performed to test research hypotheses concerning associations between self-care and aspects of burnout among social workers in healthcare settings. The results showed that higher levels of self-care were significantly correlated with lower scores on measures of emotional exhaustion and depersonalization and higher scores on measures of personal accomplishment. No significant differences were found by practice setting in mean ratings of specified self-care activities. More years of social work practice were associated with lower burnout. Implications for positive social change include highlighting the need for self-care to prevent burnout, promoting health and wellbeing among social workers, and saving organizations the costs associated with employee burnout. Future research on self-care and burnout will be beneficial to the profession to expand current literature and highlight trends between social work practice and client populations served.
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Frahm, Kathryn. "FAMILY SUPPORT AND MENTAL HEALTH CARE QUALITY IN NURSING HOMES SERVING RESIDENTS WITH A MENTAL HEALTH HISTORY." Doctoral diss., University of Central Florida, 2009. http://digital.library.ucf.edu/cdm/ref/collection/ETD/id/3096.
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The prevalence of mental health disorders among the nursing home population is well recognized. However, providing adequate mental health services for nursing home residents who need them remains a challenging endeavor. The social support of family has long been recognized as a key resource for older adults with a mental health history and older adults residing in nursing homes. The purpose of this study is to examine the quality of mental health care provided for nursing home residents with a mental health history and to determine if family support influences the quality of their mental health care accounting for other facility resident and facility organizational characteristics. The study utilized a retrospective, cross-sectional design with 2003 national Online Survey Certification and Reporting (OSCAR) facility data merged with the resident-level Minimum Data Set (MDS) resulting in N=2,499 nursing homes. Guided by the convoy model of social support and socioemotional selectivity theory, descriptive statistics and exploratory factor analysis were used to create a profile of facility level data of nursing home residents with a mental health history, explore the role of family support, and determine if items within the OSCAR and MDS databases could respectively be used to measure mental health care quality and family support. Overall, it was found that families have a positive relationship with their relatives and are involved in their lives. Additionally, items within the OSCAR and MDS databases could be used to measure mental health care quality and family support. Finally, facility organizational characteristics explained more variation in the quality of mental health care than did facility resident, family support, or market characteristics. In sum, to enhance the quality of mental health care in nursing homes, partnering with families may be an important tool to meet resident needs.Ph.D.
Other
Health and Public Affairs
Public Affairs PhD
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Croake, Sarah. "State mandates for mental health parity an effective tool in reducing unmet need for mental health care? /." CONNECT TO ELECTRONIC THESIS, 2008. http://dspace.wrlc.org/handle/1961/4557.
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Ryan, John Joseph. "Strategy transformation and change : changing paradigms in Australian Catholic health and aged care." Curtin University of Technology, Graduate School of Business, 2001. http://espace.library.curtin.edu.au:80/R/?func=dbin-jump-full&object_id=12141.
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When I was younger I always conceived of a room where all these (strategic) concepts were worked out for the whole, company. Later I didn't find any such room .... The strategy (of the company) may not even exist in the mind of one man. I certainly don't know where it is written down. It is simply transmitted in the series of decisions made (Quinn 1978: 7). How do organisations in the Australian Catholic Health and Aged Care sector transform shared strategic thinking into formulated strategy? This research has investigated strategy formation, which can be defined as the process whereby the insights and thoughts of the key players in Catholic health and aged care are converted into formulated strategies. Specifically, the research analysed a major strategic amalgamation of the health and aged care operations of the Catholic Church in Australia, identified as Integration 2000. The concept of social constructs of meaning for the key actors is the fundamental perspective of this research. This required a constructivist ontology. The epistemology is interpretivist, and set out to provide a description of perceptions of the key actors as they engage in the formation of strategy. Defenders of interpretivism argued that the human sciences aim to understand human action (Schwandt, 2000:191). A qualitative methodology has been used to provide a plausible interpretation of the conversion process commonly referred to as strategy formation.A purposive sample was obtained. The data collection methods included qualitative interviews, attendance as an observer at two of the three day National Conferences of Catholic Health Australia and document analysis (see Chapter Three).A key focus of the research was the identification of planning models used to set the strategic context of organisations in Catholic health. The research showed that the prescriptive design and planning models were not used to plan broad strategy, but to implement strategies already formed by an emergent/learning process which, in Mintzberg et al's (1998) terms, would fit the learning, cultural and environmental schools of thought. Pinpointing a strategy school may not be a particularly fruitful exercise in this particular arena. It assumes that the distinctive act of deciding the future shape and the strategic management context of organisations charged with fulfilling a sacred mission can be classified into one school or another. The research also explored the perceptions of the Integration 2000 process, including the compatibility between the espoused philosophies and values of Catholic health and aged care and the behaviours evidenced during the Integration 2000 process. A diagnostic model was used to perform this evaluation. Rather than uncovering major discrepancies, this revealed some differences and some potential challenges.
The espoused philosophies and values of Catholic health and aged care are those of compassion, collaboration, sense of community and, of course, financial viability. Pre-Integration 2000, particularly in health care, theories of organising and practices reflected values of independence and competitiveness, both between and even within religious orders. The findings from post-Integration 2000 suggested that theories of organising and practices were becoming more aligned with the original and continuing values, at the same time as responsibility for sustaining these values was being handed over from religious to lay trusteeship. There are still some outstanding issues before the Integration 2000 process achieves its objectives. The progress to date in bringing together so many components of such a disparate sector attests to the strength of the underlying value systems of Catholic health and aged care.
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Chou, Caroline. "Selfies for Health Care." Scholarship @ Claremont, 2019. https://scholarship.claremont.edu/cmc_theses/2277.
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Presently, self-tracking applications are used to help patients with chronic illness management. For example, applications ask users to track mood through online diaries or snap photos of their food content in order to analyze patterns correlated to their chronic disease. Although these health care applications are on the market today, there still exists a fundamental challenge in motivating participants to consistently update and enter information. Therefore, the focus of this thesis is on reducing the fatigue from using these applications. Pulling from user social media data will almost completely eliminate the capture burden placed on participants, since users will only have to continue to use social media as they regularly do.
Instead of analyzing manually inputted data, patterns can be found between social media data and chronic diseases. A Microsoft Research team found indicators in public user Twitter data associated with the onset of a depressive episode. They were able to create a predictor tool, predicting the onset of a depressive episode, with 70 percent accuracy. Using this research alongside expert feedback, our aim is to design an interface used by both clinician and patient that will provide them with a timeline marking spikes in Twitter indicators correlated to a patient’s depressive episode.
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Weekes, Jennifer D. "The Relationship of Self-Care to Burnout Among Social Workers in Health Care Settings." ScholarWorks, 2011. https://scholarworks.waldenu.edu/dissertations/1115.
Full textAbstract:
Self-care is critical in minimizing the symptoms of burnout among human services professionals, but specific information on the role of self-care among social workers in healthcare settings is limited. This correlational study was designed provide a fuller understanding of this relationship. Orem's theory of self-care and the theory of reasoned action and planned behavior served as the theoretical foundations of this study. The sample included 185 members of the National Association of Social Workers, who volunteered to participate in this study. Participants completed online versions of the Maslach Burnout Inventory and Self-Care Assessment Work Sheet. Correlation and analysis of variance (ANOVA) were performed to test research hypotheses concerning associations between self-care and aspects of burnout among social workers in healthcare settings. The results showed that higher levels of self-care were significantly correlated with lower scores on measures of emotional exhaustion and depersonalization and higher scores on measures of personal accomplishment. No significant differences were found by practice setting in mean ratings of specified self-care activities. More years of social work practice were associated with lower burnout. Implications for positive social change include highlighting the need for self-care to prevent burnout, promoting health and wellbeing among social workers, and saving organizations the costs associated with employee burnout. Future research on self-care and burnout will be beneficial to the profession to expand current literature and highlight trends between social work practice and client populations served.
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Rentler, Caitlin R. "Stigma and its association with the utilization of mental health services among adults with mental illness." Thesis, California State University, Long Beach, 2013. http://pqdtopen.proquest.com/#viewpdf?dispub=1524152.
Full textAbstract:
Research has shown that people with mental illness who seek treatment from mental health services have improved quality of life. The objective of the study was to evaluate the influence of stigma on people with mental illness, and how stigma can affect the person's decision to seek treatment for his or her mental condition.
The objected was assessed using secondary data from the 2009 Adult California Health Interview Survey. The initial filtering of the respondents was unable to be performed because Human Subjects Protection laws protect sensitive information from being released in public use data files. I redeveloped my study, focusing primarily on the association between respondents with feelings of depression and whether or not they have health insurance coverage for mental health services.
The results of the analysis proved to be statistically significant, which led to speculation that, even with mental health insurance coverage, the low rates of mental health service utilization was most likely attributed to the impact of stigma. Future research should be conducted on the effects of primary care mental health integration, and how this increased parity impacts the utilization of mental health treatment options.