Self-directed behavioral family intervention: Do therapists matter?

Behavioral family intervention is an effective form of intervention for the prevention and treatment of a wide range of emotional and behavioral problems in children. There is a growing need to address the accessibility of these services. This paper reviews the literature on self-directed interventions designed to help parents manage difficult child behaviors. Evidence regarding the efficacy of interventions is reviewed, and some of the difficulties associated with self-directed programs are discussed. The Self-directed Triple P and Teen Triple P-Positive Parenting Programs are highlighted as examples of efficacious and effective behavioral family interventions fitting into a larger multi-level model of family intervention. The discussion of the efficacy and effectiveness of self-directed Triple P has implications for service delivery of parenting programs

Are attitudes towards mental health help-seeking associated with service use? Results from the European Study of Epidemiology of Mental Disorders

To investigate the prevailing attitudes towards mental health help-seeking in Europe, their correlates, and whether these attitudes are associated with actual service use for mental health problems. Data were derived from the European Study of Epidemiology of Mental Disorders, a survey representative of the adult population of six countries: Belgium, France, Germany, Italy, the Netherlands and Spain (n = 8,796). The World Mental Health Composite International Diagnostic Interview was used to assess attitudes and DSM-IV diagnoses. The attitudes referred to beliefs that the respondents would seek professional help when faced with a serious emotional problem, would feel comfortable talking about personal problems with a professional, would not be embarrassed if friends knew about the professional help, and respondents' perceived effectiveness of mental health care. Almost a third of the respondents held the view that professional care was worse than or equal to no help when faced with serious emotional problems. Female gender, being younger than 65 years of age, high income, living in Spain or Italy, presence of mood disorder and previous service use were associated with at least two of the four assessed attitudes towards mental health help-seeking. All four attitudes were significantly associated with mental health care use, also after adjustment for previous service use. The low perceived effectiveness of professional care calls for serious action aiming to improve the visibility and credibility of the mental health care sector

Clinical and economic predictors of quality of life in dementia

• To date, multivariate analyses of quality of life (QoL) in dementia are relatively rare (Banerjee et.al_2009). This study aimed to measure QoL of persons with dementia and their family-caregivers. • The study also examined what interventions from primary and secondary care in New Zealand are helpful for enhancing QoL and what these interventions cost

Pilot study of methods for assessing unmet secondary health care need in New Zealand

AIMS: In this pilot study, the primary aim was to compare four potential methods for undertaking a national survey of unmet secondary healthcare need in New Zealand (one collecting data from GPs, and three from community surveys). The secondary aim was to obtain an estimate of the prevalence of unmet secondary healthcare need, to inform sample size calculations for a national survey. METHODS: An electronic system was set up for GPs in Christchurch (Pegasus PHO) and Auckland (Auckland PHO) to record cases of unmet need as encountered in clinics. For the community surveys, a questionnaire developed by the authors was administered to people from the same electoral wards as the GP clinics. Three modes of questionnaire administration were trialled: online, telephone and face-to-face interview. Random population sampling from the Māori and General Electoral Rolls was used to identify eligible survey participants until there were approximately 200 respondents for each method in each city. Data collection took place from November 2015 to February 2016. RESULTS: GP reports: Pegasus PHO: 8/78 eligible practices recorded 28 cases of unmet secondary healthcare need in 10 weeks. Auckland PHO: 3/26 practices participated and recorded no cases in three weeks. Surveys: 1,277 interviews were completed (online 428, telephone 447, face-to-face 402). For primary healthcare, 211/1,277 (16.5%) had missed a GP visit because of cost (online 25.0%, telephone 11.6%, face-to-face 12.9%). For secondary healthcare, 119/1,277 (9.3%) reported unmet healthcare need that had been identified by a health professional (online 11.2%; telephone 9.2%; face-to-face 7.5%). Of these, 75/119 (63.0%) required a consultation, and 47/119 (39.5%) required a procedure. Completed interview rates as a percentage of names on the Electoral Roll were low (online 8.8%, telephone 15.4%, face-to-face 13.9%), affected by changed addresses and lack of listed telephone numbers. The response rate for those with valid phone numbers was 47.6%, and for those with valid addresses was 31.5%. CONCLUSIONS: Using the Electoral Rolls to identify respondents is problematic. For a national survey, random population sampling by address, similar to the method employed for the New Zealand Health Survey, but giving respondents a choice between face-to-face and phone interviews, is proposed. Asking GPs to record data on unmet need for secondary care was not successful. Our pilot study suggests there is sufficient unmet secondary healthcare need in New Zealand to merit a national surve

The contest for a community diagnostic laboratory contract in New Zealand: The influence of neo-liberalism in the public health sector

Introduction: The purpose of this paper was to examine the management of contracting for a diagnostic laboratory health service for the Auckland region in New Zealand, using the concept of governmentality. Methods: Our aim is to provide an overview of a recent case of neoliberal policy implementation, to illustrate how unintended and costly policy outcomes can occur. Results: Despite the effort of government to improve management of the public health sector, analysis of this case reveals the potentially disruptive effects and costs of neo-liberal reform policy. Conclusions: In this study, the costs of neo-liberal reform appear to have unintentionally prevailed over benefits for those the system was designed to serve. Contribution to knowledge: This research has practical implications in that it provides insight into potential and costly outcomes when implementing public health service policy. © W. S. Maney & Son Ltd 2014