Barriers to recovery and recommendations for change: the Pennsylvania Consensus Conference on psychiatry\u27s role.

OBJECTIVE: Recovery has emerged over the past decade as a dominant theme in public mental health care. METHODS: The 2006 Pennsylvania Consensus Conference brought together 24 community psychiatrists to explore the barriers they experienced in promoting recovery and their recommendations for change. RESULTS: Twelve barriers were identified and classified into one of three categories: psychiatry knowledge, roles, and training; the need to transform public mental health systems and services; and environmental barriers to opportunity. Participants made 22 recommendations to address these barriers through changes in policies, programs, and psychiatric knowledge and practice. CONCLUSIONS: The recommendations identify areas for change that can be accomplished through individual psychiatrist action and organized group efforts

Public mental health research in Europe:A systematic mapping for the ROAMER project

Background: As part of the ROAMER (ROAdmap for MEntal health Research in Europe) project, aiming to create an integrated European roadmap for mental health research, we set out to map the hitherto unmapped territory of public mental health research in Europe. Methods: Five electronic databases (CINAHL, Health Management, Medline, PsycINFO, Social Services Abstracts) were used for identifying public mental health research articles published between January 2007 and April 2012. The number of publications for each European country in five research domains (i.e. mental health epidemiology, mental health promotion, mental disorder prevention, mental health policy and mental health services) was analysed by population size and gross domestic product (GDP), and mean impact factors were compared. Results: In all, 8143 unique publications were identified. Epidemiology research dominates public mental health research, while promotion, prevention and policy research are scarce. Mental health promotion is the fastest growing research area. Research targeting older adults is under-represented. Publications per capita were highest in northwestern Europe, and similar trends were found also when adjusting the number of publications by GDP per capita. The most widely cited research origins from Italy, Switzerland, the UK, the Nordic countries, the Netherlands, Greece and France. Conclusion: In Europe, public mental health research is currently a matter of the affluent northern and western European countries, and major efforts will be needed to promote public mental health research in south and east Europe. In spite of a smaller public mental health research output, some Mediterranean countries produce highly cited public mental health research

Effectiveness is the gold standard of clinical research

Psychological treatments have been shown to be at least as effective (and sometime even more effective) than psychotropic medications for many psychiatric disorders, in particular anxiety disorders, depressive disorders, and personality disorders (American Psychological Association, 2013; Cuijpers, 2017). Effective psychological treatments are also cost-effective: their implementation in public mental health services is convenient in financial terms, with decades of studies consistently demonstrating a reduction in public spending for psychological health (Abbass, Kisely, Rasic, Town & Johansson, 2015). Therefore, it could be critical that psychological treatments whose efficacy is supported by strong empirical evidence can be delivered as a primary choice in public mental health services. We hope and believe that the time when a psychologist or a psychiatrist (especially if paid by the public mental health system) could provide any treatment he or she thought fit, even in the absence of any scientific evidence of its efficacy, is coming to an end. However, a recommendation should be made to be very careful in not equating the empirical support of a given treatment with the sole presence of randomized controlled trials (RCTs) that show its efficacy. This would be a mistake from both an empirical and a theoretical perspective, as it runs the risk of throwing out the baby with the bathwater. In other words, endorsing a perspective according to which a specific treatment should be promoted or rejected on the sole basis of findings from RCT studies runs the risk of putting clinical science back almost twenty years from the current more advanced understanding of the efficacy, effectiveness, and usefulness of psychotherapy (Dazzi, 2006; Dazzi, Lingiardi, & Colli, 2006; Leichsenring et al., 2016; Silberschatz, 2017)

Exploring the efficacy of evidence-based practice within public mental health agencies

The aim of this project was to explore the efficacy of evidence-based practice within public mental health agencies. It is hoped that this research project will create dialog surrounding evidence-based practice as well as push for a more clear understanding of it and its implementation in public mental health agencies

A web-based information system for a regional public mental healthcare service network in Brazil

Acknowledgements We would like to thank all the participating representatives of public mental health services for their invaluable contribution to this system development and implementation and the XIII Regional Health Department of Sao Paulo state for their support. Funding: This study was funded by the ‘Conselho Nacional de Desenvolvimento Científico e Tecnológico’ (CNPq) and ‘Coordenação de Aperfeiçoamento de Pessoal de Nível Superior’ (CAPES)—Science Without Borders Programme.Peer reviewedPublisher PD

Indicators for Public Mental Health: A Scoping Review

Background: To monitor population mental health, the identification of relevant indicators is pivotal. This scoping review provides a comprehensive overview of current indicators representing the various fields of public mental health core topics. It was conducted as a first step to build up a Mental Health Surveillance for Germany. Methods: We conducted a systematic MEDLINE search via PubMed. This search was supplemented by an extensive examination of the websites of relevant national as well as international institutions in the context of public mental health and an additional internet search via Google. To structure the data, an expert-based focus group identified superordinate topics most relevant to public mental health to which the identified indicators could be assigned to. Finally, the indicator set was screened for duplicates and appropriate content to arrive at a final set. Results: Within the various search strategies, we identified 13.811 records. Of these records, a total of 365 records were processed for indicator extraction. The extracted indicators were then assigned to 14 topics most relevant to public mental health as identified by the expert-based focus group. After the exclusion of duplicates and those indicators not meeting criteria of specificity and target group, the final set consisted of 192 indicators. Conclusion: The presented indicator set provides guidance in the field of current concepts in public mental health monitoring. As a comprehensive compilation, it may serve as basis for future surveillance efforts, which can be adjusted and condensed depending on the particular monitoring focus. Our work provides insights into established indicators included in former surveillance work as well as recent, not yet included indicators reflecting current developments in the field. Since our compilation mainly concludes indicators related to mental health in adults, it should be complemented with indicators specific to children and adolescents. Furthermore, our review revealed that indicators on mental health promotion and prevention are underrepresented in current literature of public mental health and should hence be focused on within future research and surveillance.Peer Reviewe

The development of public mental health in Malta

Public health practitioners in Malta have been drivers of public mental health reform throughout the last twenty-five years. However, early political and financial support for the implementation of policy and strategy dwindled over the years. Whilst services continued to expand, these were not matched with the adequate injection of human and financial resources. Twenty years later, the mental health service is still experiencing problems of underfinancing as reflected by the dire state of the psychiatric hospital infrastructure, poor leadership, management and accountability structures, and a largely insufficient albeit dedicated workforce. In 2012, the enactment of the new Mental Health Act and the establishment of a Commissioner for Mental Health recharged a national focus on mental health. Mental health is now a subject for the local media, the public is more receptive, NGOs and professionals are more vocal, the significance of mental health in schools, homes, and the workplace is taking root, and the subject has gained increasing political will, culminating with the launch of a Mental Health Strategy document for consultation in December 2018. This is our window of opportunity to ensure that policies and strategies are now translated into resources and action that reap sustained improvement in population mental health and well-being for this and future generations.peer-reviewe

PUBLIC MENTAL HEALTH IN POST-COVID-19 ERA

Transmission of the 2019 novel coronavirus (COVID-19) has now rapidly spread around the world, which has alarming implications for individuals and communities, in particular for public mental health. Significant progress has been made in the prevention and control of the COVID-19 pandemic in China, but the psychological crisis caused by the epidemic is still not over and may continue to exist. The public mental health in the post-COVID-19 era should not be ignored. This article provides early warning for the public\u27s mental health in the post-COVID-19 era by listing the characteristics and duration of the public mental health crisis following the SARS outbreak. In addition, based on the current situation, specific methods and measures are proposed in order to provide effective reference for the prevention and control of psychological crisis caused by the COVID-19 epidemic