Assessing psychological health : the contribution of psychological strengths

Balanced assessment of mental health involves assessing wellbeing and strengths as well as psychopathology. The character strengths of curiosity, gratitude, hope, optimism and forgiveness, are assessed in 214 new undergraduates and their relationships to mental health, subjective wellbeing and self-esteem explored. Scoring the mental health scale for psychiatric caseness, case and non-case students did not differ in character strengths, positive affect or life satisfaction, supporting a dual-factor model. Hope pathways and gratitude predicted mental health. Gratitude, hope agency and exploratory curiosity predicted positive affect. Gratitude and hope agency predicted life satisfaction. Hope agency, hope pathways, exploratory curiosity and gratitude predicted self-esteem, with absorption curiosity a negative predictor. The benefits of assessing strengths are discussed and interventions designed to develop them. Keywords: character strengths; mental health; subjective wellbeing; dual-factor mental health model; self-estee

The development and initial validation of the Perinatal Mental Health Awareness scale in student midwives

Background & aim: Perinatal mental health problems have been demonstrated to impact upon maternal, and fetal/child outcomes. Despite the global evidence and a policy-driven responsibility for identification of these problems, research demonstrates that student midwives/midwives lack knowledge and confidence to assess, identify, and manage them. A similar context is evident for learning disabilities, despite the holistic care philosophy of midwifery. A brief assessment tool to identify knowledge and confidence defecits and strengths within a holistic care framework could support curriculum development. This study sought to develop a Perinatal Mental Health Awareness scale and evaluate its psychometric properties in student midwives.Methods: We employed a cross-sectional and exploratory instrument development and evaluation design to determine the measurement veracity of the new scale.Results: The scale demonstrated good psychometric properties, revealing three subscales mapping onto (i) mental health symptoms, (ii) physical/medical issues and (iii) learning disability. Results indicated a clear differentiation in scores across the subscales, indicating comparative deficits in mental health domains.Conclusion: Our findings facilitate confidence in the psychometric robustness of the measure. The scale enables student midwives to assess and compare different domains of midwifery practice, in line with a holistic model of midwifery care. A focus on physical health in midwifery education appears to disadvantage knowledge and confidence for managing mental health problems in a midwifery context. This valuable finding highlights the potential need for curriculum rebalancing. The measure offers the opportunity to assess and develop curriculum/training provision and monitor the effectiveness of subsequent curricular developments

Measuring Mental Health Literacy: Development of the Mental Health Awareness and Advocacy Assessment Tool

Background: Mental health literacy programs are a common community-based approach used to address the prevention of mental health issues on college campuses. Current assessment strategies used to evaluate the effectiveness of these programs often lack strong theoretical rational and psychometric rigor. Purpose: The purpose of this study was twofold. First, based upon extant literature, theory, and standard clinical practice, we propose a process-based model of mental health literacy that includes three macro factors—identifying mental health issues, locating empirically based resources, and responding to mental health issues—and three micro processes of how they unfold—acquiring knowledge, building self-efficacy, and applying skills (behavior). The second aim was to test the psychometric properties of a new tool created to evaluate this process-based model—the Mental Health Awareness and Advocacy Assessment Tool (MHAA-AT). Setting: Not applicable. Intervention: Not applicable. Research Design: A national sample of 296 college attending participants were recruited from Amazon’s Mechanical Turk. Participants responded to a demographic questionnaire and the newly developed MHAA-AT. Psychometric properties were examined through item response theory, exploratory factor analyses, and bivariate correlations. Findings: Results suggest the MHAA-AT is a sound measure and demonstrates appropriate item, person, and trait characteristics on declarative knowledge items, and single factor structures on self-efficacy and behavior items with moderate to high reliability and validity. While additional testing is need among other samples, results suggest that the MHAA-AT is a quality assessment tool. Keywords: College students; mental health literacy; item response theory; measuremen

Deafness Mental Health Needs Assessment: A Model

The success of any new program often depends on an accurate needs assessment of the population to be served. Program planning is particularly difficult for low incidence disabilities, such as deafness. This paper presents a model to assist practitioners in community mental health program planning for deaf adults. The model is applied to a large metropolitan community in the southwestern part of the United States. Several issues emerge as a result of applying this model and we make recommendations for more effective mental health service provision based on these issues

Changing practice to support self-management and recovery in mental illness: application of an implementation model

Author Version made available in accordance with the publisher's policyHealth services introducing practice changes need effective implementation methods. Within the setting of a community mental health service offering recovery-oriented psychosocial support for people with mental illness, we aimed to (a) identify a well-founded implementation model and (b) assess its practical usefulness in introducing a new program for recovery-oriented self-management support. We reviewed the literature to identify implementation models applicable to community mental health, and having corresponding measurement tools. We used one of these models to inform organisational change strategies. The literature review showed few models with corresponding tools. The Promoting Action on Research Implementation in Health Services (PARIHS) model and the related Organizational Readiness to Change Assessment (ORCA) tool were used. PARIHS proposes prerequisites for health service change and the ORCA measures the extent to which these prerequisites are present. Application of the ORCA at two time points during implementation of the new program showed strategy-related gains for some prerequisites but not for others, reflecting observed implementation progress. Additional strategies to address target prerequisites could be drawn from the PARIHS model. The PARIHS model and ORCA tool have potential in designing and monitoring practice change strategies in community mental health. Further practical use and testing of implementation models appears justified in overcoming barriers to change

Quality of life in people with Type 2 diabetes in relation to deprivation, gender, and age in a new community-based model of care

Objectives. To evaluate changes in health related quality of life (HRQL) for individuals with Type 2 diabetes following the introduction of a new community-based model of care. Methods. A survey method was used in which HRQL, Problems Areas In Diabetes (PAID) and demographics were assessed before and 18 months after introducing the new service. Results. Overall HRQL and PAID scores were lower than published levels in individuals with diabetes but remained stable during the transition to the new model of care except for the bodily pain domain and deteriorating PAID scores for older patients. Four domains of SF36 health showed deterioration in the highest socio-economic groups. Deterioration was also observed in males, most notably mental health, in patients aged 54 years or less, 75 years or more and patients from socio-economic groups 1 and 2. HRQL was lowest at baseline and follow-up in socio-economic groups 6 and 7. Low levels of distress in patients across all deprivation categories was observed but remained stable over the transition. Conclusions. HRQL and distress associated with diabetes remained stable following the introduction of the new community-based model of care except for deterioration in the bodily pain domain and deteriorating PAID scores for older patients. Relevance for Practice. (i) Health related quality of life assessment is practical and acceptable to patients. (ii) In clinical governance terms it is good practice to monitor the impact of change in service delivery on the health of the patients in your care. (iii) Screening with health related quality of life tools such as generic and disease specific tools could help identify health problems otherwise undetected within current clinical care. Systematic identification of the most vulnerable groups with Type 2 diabetes should allow care to be better targeted

Estimating a preference-based index for mental health from the Recovering Quality of Life (ReQoL) measure : valuation of ReQoL-UI

Objectives There are increasing concerns about the appropriateness of generic preference-based measures to capture health benefits in the area of mental health. This study estimates preference weights for a new measure, Recovering Quality of Life (ReQoL-10), to better capture the benefits of mental health care. Methods Psychometric analyses of a larger sample of mental health service users (n = 4266) using confirmatory factor analyses and item response theory (IRT) were used to derive a health state classification system and inform the selection of health states for utility assessment. A valuation survey with members of the UK public representative in terms of age, gender and region was conducted using face-to-face interviewer administered time-trade-off (TTO) with props. A series of regression models were fitted to the data and the best performing model selected for the scoring algorithm. Results The ReQoL-UI classification system comprises six mental health items and one physical health (PH) item. Sixty-four health states were valued by 305 participants. The preferred model was a random effects model, with significant and consistent coefficients and best model fit. Estimated utilities modelled for all health states ranged from -0.195 (state worse than dead) to 1 (best possible state). Conclusions The development of the ReQoL-UI is based on a novel application of IRT methods for generating the classification system and selecting health states for valuation. Conventional TTO was used to elicit utility values that are modelled to enable the generation of QALYs for use in cost-utility analysis of mental health interventions

The Systemic Assessment Clinic, a novel method for assessing patients in general adult psychiatry: Presentation and preliminary service evaluation

The traditional model of psychiatric assessment and diagnosis can be criticised as reductive. We developed an innovative model for psychiatric assessment of adult patients referred to our adult mental health team, the Systemic Assessment Clinic, incorporating the principles and techniques of systemic family therapy and dialogical practice into standard psychiatric assessment. We conducted a service evaluation, comparing prospective use of mental health services for patients assessed either in the Systemic Assessment Clinic or in standard assessment. Patients assessed in the Systemic Assessment Clinic had more favourable outcomes than those in standard assessment: they were significantly less likely to need multiple follow-up treatment appointments with a psychiatrist and to be re-referred to mental health services once discharged, indicating reduced healthcare costs. Satisfaction rates for participants attending the systemic assessment clinic were high. Our service evaluation gives preliminary evidence that the Systemic Assessment Clinic could be a potential new model for psychiatric assessment; further evaluation is warranted in a randomised controlled trial

Outcomes of the Implementation of the Mental Health Recovery Measure in the DeKalb Community Service Board Population

The relationship between mental health and public health has been debated for decades. But when services are delivered through publically funded mental health clinics, it clearly becomes a public health endeavor. One of the latest trends in mental health service delivery is the recovery concept. Developed in the 1990’s, the recovery concept represents a paradigm shift where successful treatment is defined by self-awareness, self-care, and self-fulfillment. Furthermore, patients are encouraged to assess their own progress in the recovery process. There are currently nine unique assessment tools to measure recovery progress, including the Mental Health Recovery Measure (MHRM), which was used in this study. The current study followed the implementation of the recovery model in the DeKalb Community Service Board (DeKalb CSB). DeKalb CSB has 12 locations that serve 10,000 patients with mental illness, substance abuse, and developmental disabilities each year. Only patients with primary diagnoses of mental health or substance abuse disorders were considered for this study. Implementation of the MHRM began in December 2008 and included all DeKalb CSB patients, however only new DeKalb CSB patients were considered for this study. During 13 months of data collection 960 clients completed 2 assessments and 196 completed 3 assessments. A new consumer is defined as someone who has just completed the intake process and has no record of previous service at DeKalb CSB. The current study examined trends in MHRM data in the DeKalb CSB population; and offered recommendations for future implementation

Developing a framework for mental health management of project management practitioners in architecture, engineering and construction project organizations

Complexity of Architecture, Engineering and Construction (AEC) project designs that involve managing multiple projects concurrently, network of project management practitioners (PMPs) from different organisations, engagement of project stakeholders and multiple contractors spurred the proliferation of poor mental health. Considerable amount of mental health research focused on organisational supports and coping mechanisms as proximal strategies for promoting positive mental health. While acknowledging the significant contributions of the previous studies, scant attention has been placed on distant practices, which is organisational design practices responsible for the sources of mental health problems in AEC projects. Addressing poor mental health through the lens of organisational design would open a new scholarship on how different organisational dimensions in a project based organisation contributes to mental health management outcomes, which in turn improve mental health. It would further shift concentration on individual analysis to project organisational unit analysis by identifying mental health management indicators for assessing the performance of the AEC project organisation. Therefore, the key research problem identified is how to develop a mental health management framework that promotes positive mental health through organisational design concept in AEC project organisations. The aim of this study is to develop a holistic mental health management framework to monitor, measure, assess and improve the mental health of PMPs in AEC project organisations. To achieve the aim and objectives of this research, a theoretical model was developed to explain the mental health management in AEC project organisations through the integration of institutional theory, agency theory, resources based theory (RBT), contingency theory and complexity theory. The findings of this study made significant contributions to the body of literature in mental health management and AEC by innovatively applying organizational theories: institutional theory, agency theory, resources based theory (RBT), contingency theory and complexity theory to interpretation of organizational design concept in addressing mental health problems in AEC project organizations. The identified mental health management indicators provide comprehensive understanding of indicators for assessment of mental health management practices, which assist organization managers in detecting dysfunction in the implemented mental health management practices in AEC projects