Day 2 :
Keynote Forum
Kaj Bjorkqvist
Abo Akademi University, Vasa, Finland
Keynote: Low intensity intimate partner aggression in Ghana: support for the revised gender symmetry theory in an African country
Biography:
Kaj Björkqvist is Professor of Developmental Psychology at Åbo Akademi University, Vasa, Finland. He has published 13 books and more than 100 articles. He is former President of International Society of Research on Aggression. His research area is Human Aggression, including sex differences in aggression, school and workplace bullying, conflict resolution, media violence and cross-cultural comparisons. He is best known for his research on indirect aggression.
Abstract:
There is an ongoing controversy about whether there are sex differences regarding the use of different forms of intimate partner aggression (IPA). The traditional view, that men are more aggressive than women, has been referred to as gender asymmetry theory, while the theory that men and women are more or less equally aggressive has been called gender symmetry theory. Archer (2018) has suggested a revised gender symmetry theory, according to which gender symmetry holds only for low intensity aggression, while as far as high intensity aggression leading to injury or death is concerned, males are perpetrators to a higher degree than females. Furthermore, Archer suggests that gender symmetry should be expected to be found only in societies with a relatively high degree of gender equality. In developing countries, with a patriarchal society structure, such as African countries, gender symmetry should not be expected to occur. In this study, sex differences regarding the perpetration and victimization of low intensity IPA in Ghana were investigated. The sample consisted of 1,204 adults (mean age 44.1 yrs., SD-13.5), 602 males and 602 females. IPA was measured with the DIAS-Adult questionnaire. Males scored higher than females on being victimized by their partner from physical, indirect and nonverbal aggression, while females scored higher than males on being perpetrators of physical, indirect, nonverbal and cyber aggression. This is the second study to report men being more victimized by low intensity IPA than women in an African nation, thus finding support for Archer’s (2018) revised gender symmetry theory of IPA but showing that it holds not only in Western, but also in African countries with patriarchal structure.
Recent Publications
1. Björkqvist K (2018) Gender differences in aggression. Current Opinion in Psychology.
2. Makinde O, Björkqvist K and Österman K (2017) Mediating factors between overcrowding and adolescent antisocial behavior in Lagos, Nigeria. Pyrex Journal of African Studies and Development 3(3):24-30.
3. Ndoromo O, Österman K and Björkqvist K (2017) Sex differences in victimization from low intensity intimate partner aggression in South Sudan. European Journal of Social Sciences, Education and Research.
4. Nazar N, Österman K and Björkqvist K (2017) Religious tolerance, views on gender equality and bellicose attitudes: A study among Pakistani students from three types of schools. European Journal of Social Sciences, Education and Research.
Khademi J, Björkqvist K and Österman K (2017) A study of mental wellbeing of imprisoned women in Iran. European Journal of Social Sciences, Education and Research.
- Human Resilience | Mental health | Mental Health Rehabilation | Psychiatry & Mental health Nursing
Location: Rome, Italy
Session Introduction
Christine Lock
National Neuroscience Institute, Singapore
Title: Post-traumatic growth after ABI: a pilot study in a Singaporean cohort
Biography:
Christine Lock has research experience in behavioural science analysis and neurosurgical research. She has worked with governmental organisations concentrating on individual motivation and crisis response, and is currently doing clinical research specifically in patients with brain injury. Her interests include improving general mental health through systematic reviews of cognitive assessments and intervention efficacy.
Abstract:
Introduction. Acute brain injury (ABI) is often perceived as both a physically and psychologically traumatic event. The multiple deficits as a result of brain injury can change perceptions of self, relationships and general life outlook. Positively overcoming this adversity whilst assigning meaning to this struggle leads to the potential for post-traumatic growth. Cultural differences may influence coping processes, and post-traumatic growth after ABI has not been widely studied in Southeast Asian populations. We used two validated questionnaires on high-functioning stroke patients.
Methodology. We administered the Hospital Anxiety and Depression Scale (HADS) and Post-Traumatic Growth Inventory (PTGI) to 9 Singaporean ABI patients diagnosed with spontaneous brain haemorrhage between 2014-2017. Participants consisted of 8 females and 1 male, with an average age of 54.2 years. The PTGI consisted of five factors: 1) Relating to Others, 2) New Possibilities, 3) Personal Strength, 4) Spiritual Change, 5) Appreciation of Life.
Findings. Appreciation of Life and Relating to Others were the highest rated factors on the PTGI. Depression on the HADS displayed significant negative correlations with New Possibilities (r = -.814, p < .01) and Personal Strength (r = -.748, p = .02) on the PTGI. Within the PTGI, New Possibilities was positively correlated to Personal Strength (r = .895, p < .01) and Relating to Others (r = .736, p = .024). Relating to Others significantly correlated to Personal Strength (r = .723, p = .028).
Conclusion & Significance. In this pilot study of high-functioning stroke patients, we found that a renewed appreciation for life and social support were important factors contributing to post-stroke recovery and growth. Results also suggest that the development of new possibilities and perceived self-efficacy are related to fewer depressive symptoms. Further research can look into increasing sample size, and cross-correlations of multiple quality of life questionnaires for patients post-ABI.
References
1. Calhoun, L. G., & Tedeschi, R. G. (2009). Handbook of posttraumatic growth: research and practice (Vol. 1). Mahwah, NJ: Lawrence Erlbaum Associates.
2. Kuenemund, A., Zwick, S., Rief, W., & Exner, C. (2016). (Re-)defining the self – enhanced posttraumatic growth and event centrality in stroke survivors: A mixed-method approach and control comparison study. Journal of Health Psychology, 21(5), 679-689. doi:10.1177/1359105314535457
3. Mack, J., Herrberg, M., Hetzel, A., Wallesch, C. W., Bengel, J., Schulz, M., … Schönberger, M. (2015). The factorial and discriminant validity of the German version of the Post-traumatic Growth Inventory in stroke patients. Neuropsychological Rehabilitation, 25(2), 216-232. http://dx.doi.org/10.1080/09602011.2014.918885
4. Rana, M., Bullinger, M., & Rana, M. (2015). Coping with stroke: A prospective comparative cross-cultural research. Journal of Religion & Health, 54, 173-186. doi:10.1007/s10943-013-9797-8
5. Splevins, K., Cohen, K., Bowley, J., & Joseph, S. (2010). Theories of posttraumatic growth: Cross-cultural perspectives. Journal of Loss and Trauma, 15(3), 259-277. doi:10.1080/15325020903382111
Biography:
Yasuhiro Kotera has his expertise in mental health and positive psychology. As an accredited counsellor/psychotherapist, and having worked with various populations internationally, his research areas include occupational mental health, positive psychology for mental health, organisational applications of coaching/neuro-linguistic programming, and cross-cultural comparison. His Japanese blog, Kokoro no Rikutsu (Logic of Psyche), that introduces new psychological findings have 2,000 accesses every day. His recent project aims to develop a short psycholinguistic intervention to augment resilience, which would be suited for various workplaces.
Abstract:
Statement of the Problem: As awareness of mental health has been increasing internationally, a need for psychological care for mental health professionals and trainees has been highlighted. UK social work students suffer from high rates of mental health symptoms, and emotional resilience has become a required capacity in recent social work policies. Despite their high shame about mental health symptoms, research on positive psychological approaches to their mental health has been limited. Accordingly, this study aimed to (i) investigate the relationships between mental health symptoms, resilience, self-compassion, motivation, and engagement (ii) identify independent predictors for mental health symptoms, and (iii) examine positive psychological independent predictors as indirect pathways linking mental health symptoms and resilience. Methodology & Theoretical Orientation: One hundred and sixteen UK social work students completed five measures about those constructs. Correlation analysis, multiple regression analysis, and path analyses were conducted in order to address research aims of this study. Findings: Mental health symptoms were associated with resilience, self-compassion, and engagement (i). Self-compassion was a negative independent predictor, and intrinsic motivation was a positive independent predictor of mental health symptoms (ii). Path analyses revealed that while the direct effect of resilience on mental health symptoms was not significant, the indirect and total effects were significant; self-compassion was an independent predictor. Additional analyses confirmed that self-compassion directly predicted both mental health symptoms and resilience (iii). Conclusion & Significance: This is the first ever investigation into the mechanism of how resilience reduces mental health symptoms from positive psychological perspectives in this population. The findings can inform social work educators, practitioners, and researchers of the importance of self-compassion, and can help develop better approaches to the challenging mental health of UK social work students. The research paper is currently under review.
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Figure. Parallel mediation model: Resilience as a predictor of mental health symptoms, mediated by self-compassion and intrinsic motivation. The confidence interval for the indirect effect is a BCa bootstrapped CI based on 5000 samples.
Biography:
Irad Eichler founded Shekulo Tov Group in 2005 and is the Group Chairman ever since. Shekulo Tov Group is a leading Israel organization for vocational recovery. He and his mental health professional at Shekulo Tov Group, such as CRO Hagar Aloush, developed integrative model in cooperation with Israeli Ministry of Health. His integrative model was awarded “Project Zero” prize for impactful social enterprises in early 2017, categorized under innovative practice 2017 on employment, work and vocational education and training. In addition, he is the founder of seven chairs, a platform for text support groups and the founder of Israeli social business school, an Israeli third age festival and a podcaster. He is a serial social entrepreneur and was announced by world economic forum as a social entrepreneur of the year 2008.
Abstract:
Statement of the Problem: Literature indicates that the extent of employment mobility among people with psychiatric disabilities is low, even though most of them want and can work. Furthermore, while supported employment has significantly improve competitive work outcomes throughout the world, it leads to sustained work in only 25-35% of persons with psychiatric disabilities, while most persons loss jobs within a few weeks/months after beginning them or never obtain competitive work.
Methodology & Theoretical Orientation: Shekulo Tov is a non-profit organization and a service supplier for the Israeli Ministry of Health for more than 3,000 service users. Shekulo Tov’s integrative model represents an essential change of perception vis-à-vis vocational rehabilitation. It is a formative shift from the two sequential approaches of “train, then place” or “place then train” to a simultaneous approach of “train and place”. The model’s continued development led to the formation of the Shekulo Tov Group which operates in large number of businesses and organizations as integrative units based in the community, who all embedded the model among Shekulo Tov Group businesses: Rebooks (second hand bookshops), Good Coffee (social cafes), and God Dog (dog walkers).
Findings: The integrative model has successfully transitioned more than 25% of service users from vocational rehabilitation to open labour market placements. Furthermore, the model has reduced service users’ preparative vocational training for open labour market placement from 4 years to 20 months.
Conclusion & Significance: Along on-going support, job applicants are offered vocational rehabilitation, skills and career development, training programs and are provided with necessary preparation and support to measure their vocational progress. This gives them a security net, especially in cases; they did not hold their job in the free market. In these cases, service users can temporally return to vocational rehabilitation while looking for a new job in the free market.
Recent Publications:
- Becker D, Whitley R, Bailey E L, Drake and RE (2007) Long-term employment trajectories among participants with severe mental illness in supported employment. Psychiatric Services (58):922-928.
- Hartnett HP, Stuart H, Thurman H, Loy B and Batiste LC (2011) Employers’ perceptions of the beneï¬ts of workplace accommodations: reasons to hire retain and promote people with disabilities. J Vocat Rehabil. (34):17–23.
- Kaye H S, Jans L H and Jones E C (2011) Why don’t employers hire and retain workers with disabilities? Journal of occupational rehabilitation (21):526-536.
- Mattila-Holappa P, Joensuu M, Ahola K, Vahtera J and Virtanen M (2016) Attachment to employment and education before work disability pension due to a mental disorder among young adults. BMC Psychiatry (16):143-155.
- Kuznetsova Y, Yalcin B and Priestley M (2017) Labour market integration and equality for disables people: A comparative analysis of Nordic and Baltic Countries. Social Policy Administration. (51):577-597.
Anders Sørensen
Nordic Cochrane Centre, Denmark
Title: Psychiatric drug withdrawal: A psychotherapeutic affair
Biography:
Anders Sørensen is a Clinical Psychologist and Researcher at Cochrane Collaboration, has recently (article underway) scrutinized the research literature on psychiatric drug withdrawal. He is working in close collaboration with the psychiatrists, doctors and pharmacists considered experts in the field, providing him with medical knowledge which, in combination with his background in clinical psychology, enables him to help long-term psychiatric patients withdraw and reach a medicine-free life. By his experience, this transition is without exception always beneficial when done in the right way, at the right pace and with the appropriate psychotherapeutic help, which primarily centers on teaching emotion regulation skills, the lack of which makes the sedated, drug-induced state emotionally attractive. He never uses the diagnostic system, but consistently evaluates his patients’ wellbeing (or the lack thereof) by in-depth interviews on the goals and values that matter to the patient, formally measured as quality of life; which improves after withdrawal.
Abstract:
Because of withdrawal symptoms, there is reason to believe that many patients continue psychiatric drugs long-term not because they are effective in treating their disorder, but because they cannot get off them. Numerous medicated patients report harms so debilitating that their quality of life is substantially impaired. Combined with the compelling research showing that psychiatric drugs can indeed cause iatrogenic “mental illness” (drug-induced conditions that mimic the symptoms of genuine mental illness), we hypothesized that the route to wellbeing for long-term patients may go through discontinuation of the drugs, thus qualifying withdrawal as a clinical intervention. We investigate this in a cohort of patients allegedly labeled “chronic patients in need of life-long drug treatment” by their doctor – primarily because withdrawal symptoms were misinterpreted as relapse. We prove them wrong by providing individualized psychotherapy-assisted gradual tapering for as long as needed, explaining the nature of withdrawal symptoms and helping to get through the emotional pain by teaching emotion regulation skills. In the process we measure quality of life, withdrawal symptoms and the patients’ experiences of going through withdrawal. With this procedure, we (preliminarily) find that: reaching complete cessation is indeed possible, even for long-term and poly-pharmacy patients that this transition to a medicine-free life is accompanied by a substantial improvement in quality of life, and; that withdrawal can get so long-lasting and emotionally difficult that it qualifies as a genuine psychotherapeutic affair, thus making withdrawal of psychiatric drugs an intervention in itself. Therefore, patients cannot be expected to go through it alone, and we should make it a priority in mental health to comply with rather than oppose these patients’ legitimate wishes for coming off psychiatric drugs, as this – when done in the right way – can improve quality of life.
Recent Publications:
- Moncrieff J (2006) Why is it so difficult to stop psychiatric drug treatment? It may be nothing to do with the original problem. Medical Hypothesis 67(3):517-23.
- Jakobsen J C, Katakam K K, Schou A, Hellmuth S G, Stallknecht S R and Leth-Møller K, et al (2017) Selective serotonin reuptake inhibitors versus placebo in patients with major depressive disorder. A systematic review with meta-analysis and trial sequential analysis. BMC Psychiatry 17(1):58.
- Nielsen M, Hansen E H and Gøtzsche P C (2012) What is the difference between dependence and withdrawal reactions? A comparison of benzodiazepines and selective serotonin re-uptake inhibitors. Addiction 107(5):900–8.
- Rosenbaum J F, Fava M, Hoog S L, Ascroft R C and Krebs W B (1998) Selective serotonin reuptake inhibitor discontinuation syndrome: a randomized clinical trial. Society of Biological Psychiatry 44(2):77-87.
- Leo J R and Lacasse J (2005) Serotonin and depression: A disconnect between the advertisements and the scientific literature. PLoS Medicine 2(12):1211-16.
Geraldine Maughan
Limerick Institute of Technology, Ireland
Title: An exploration of the value of Marte Meo therapy in improving resilience and attachment relationships between caregivers and their children
Biography:
she has received certificate in Counseling, Psychology and Psychotherapy. she became an accredited Marte Meo Therapist (improving communication and relationships between caregiver’s and young people). she completed MA in Therapeutic Child Care. she is currently pursuing her PhD study at Trinity College Dublin. she is the Founder and Director of ASCEND which is a recent development in LIT research group.
Abstract:
Aim: The purpose of this qualitative study was to explore the value of Marte Meo therapy in establishing, re-establishing and supporting attachment and resilient relationships between caregivers and their children. These researches examined previous works on attachment theory and suggest ways in which the Marte Meo method may provide a practical application of this theory.
Methods: There was a brief history of attachment theory and a review of relevant literature which includes such theorists as Bowlby, Ainsworth, Main, Stern, Schore and Aarts and makes reference to others in the area of attachment. A qualitative approach was decided upon whereby the methods chosen were as follows; two focus groups and three interviews were convened. Applying an interpretive approach, thematic analysis led to a number of themes to emerge. Direct quotes authenticated the research and gave it an experiential aspect.
Results: The findings suggest that Marte Meo therapy clearly supports caregivers to form attachments with their children throughout the developing therapeutic relationship between caregiver and therapist, through the information given to caregivers from the analysis of their film and through the selection of pictures which allow caregivers to see their child, often for the first time.
Conclusions: In light of this research, it would seem Marte Meo Therapy should not be assimilated into attachment theory or any other theories, its effectiveness may lie in its practical nature and concreteness. Research participants suggested Marte Meo therapy as an intervention is sometimes overlooked because it has not been researched or written about in a significant way.
Recent Publications
1. Howe D (2005) Child Abuse and Neglect: Attachment, Development and Intervention. Basingstoke: Palgrave Macmillan. doi: org/10.1007/978-0-230-80239-1
Vaidehi Chilwarwar
Tata Institute of Social Sciences, India
Title: Exploring resilience among adolescents: analysis of three case vignettes
Biography:
Vaidehi Chilwarwar is a Research Scholar; pursuing PhD at School of Social Sciences-Tata Institute of Social Sciences. She is currently involved with studies related to resilience among adolescents. She is a Clinical Psychologist and completed Master of Philosophy from TISS in the year 2017.
Abstract:
This paper explores the life journey of adolescents to comprehend the construct of resilience. The phenomenon of resilience was explored from three adolescents residing at a socially and economically deprived neighborhood of Janta Nagar, in Mumbai, India. A phenomenological approach was adopted to understand resilience as a subjective experience shaped by a shared identity of deprived adolescents. Purposive and snowball sampling was used to select participants. Focused group discussions were held to investigate the risk conditions among adolescents of the community. In-depth interviews were conducted to collect data that elicited information on the subjective positive outcomes. The narratives of one female and two males aged 12, 13 and 14 years were analyzed thematically. Mother’s illness, physical injury and life-threat (kidnap) were the crucial risk conditions in the lives of these adolescents, respectively. Being responsible, courageous and having aspirations were found as predominant resilient processes among the three adolescents, respectively. Individual traits of optimism, assertiveness, self-confidence, empathy and gratitude, community elements like family, bystander, and neighbors were found as crucial elements for promoting resilience factors. As a phenomenon, resilience was argued to be culturally and contextually embedded.
Recent Publications:
- Masten A S (2001) Ordinary magic: Resilience processes in development, American Psychologist 56(3):227–238.
- Reis S M, Colbert R D and Hébert T P (2004) Understanding resilience in diverse, talented students in an urban high school. Roeper Review 27(2):110-120.
- Ungar M (2008) Resilience across Cultures. The British Journal of Social Work, Oxford University Press. 38(2):218-235.
- Ungar M (2011) The social ecology of resilience: addressing contextual and cultural ambiguity of a nascent construct. American Journal of Orthopsychiatry 81(1):1–17.
- Ungar M and Liebenberg L (2011) Assessing resilience across cultures using mixed methods: construction of the child and youth resilience measure. Journal of Mixed Methods 5(2):126-149.
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Inbar adler -ben dor & Noa Gal-Or Teperberg
Amitim program, The Israel Association of Community Centers (IACC), Israel
Title: Reconstructing a story from a therapeutic narrative to a narrative for social change; an innovative model for social change with people who cope with serious mental illness in the community
Biography:
Inbar adler -ben dor and Noa Gal-Or Teperberg are working at Amitim program, The Israel Association of Community Centers (IACC), Haifa University, Israel.
Abstract:
The approach of therapeutic narrative suggests that people will retell their story to themselves and then retell it to others in their environment (Zilber, Tuval-Mashiach & Lieblich, 2008). In contrast to this approach, we aim to present a model of narrative reconstruction for social change in people with serious mental illness (SMI), aiming to combine a reduction in self-stigma (Roe & Davidson., 2005) and in social stigma. The model we shall present is part of the Amitim program (by the Israeli Ministry of Health and the Israeli Association of Community Center), which offers social rehabilitation services in the community for people with SMI, and the promotion of personal recovery and social change (Halperin & Boz-Mizrahi, 2009). Over the last decade Amitim program has reached 75 cities nationwide and gives service to 3000 people with SMI.
Amitim's story reconstruction model includes several dimensions: first, the narrative is approached through several baseline questions: who is the audience, what is the purpose, and what is the message we want to convey by telling the recovery story (Green & Brock, 2000; 2002). The story is then externalized to a text, and the narrators (i.e., people with SMI) learn to tell it in a way that enables listeners to accept it (Carlson & Erickson, 2001), and to promote social change. This, in turn, causes the narrators to build a new identity and learn to mediate their story to both themselves and their environment (Roe et al., 2014), i.e., the manner in which they re-build their story for the audience, enables them to reconstruct it within themselves. In the proposed workshop, we aim to delineate different formats for using this model with people with SMI, while discussing the dilemmas that arise and providing examples based on video interviews with participants.
References
Carlson, T. D., & Erickson, M. J. (2001). Honoring and privileging personal experience and knowledge: Ideas for a narrative therapy approach to the training and supervision of new therapists. Contemporary Family Therapy, 23(2), 199-220.
Green, M. C., & Brock, T. C. (2000). The role of transportation in the persuasiveness of public narratives. Journal of personality and social psychology, 79(5), 701.
Green, M. C., & Brock, T. C. (2002). In the mind's eye: Transportation-imagery model of narrative persuasion.
Halperin, G., & Boz-Mizrahi, T. (2008). The Amitim program: an innovative program for the social rehabilitation of people with mental illness in the community. The Israel journal of psychiatry and related sciences, 46(2), 149-156.
Roe, D., & Davidson, L. (2005). Self and narrative in schizophrenia: time to author a new story. Medical Humanities, 31(2), 89-94.
Roe, D., Hassonâ€Ohayon, I., Mashiachâ€Eizenberg, M., Derhy, O., Lysaker, P. H., & Yanos, P. T. (2014). Narrative enhancement and cognitive therapy (NECT) effectiveness: A quasiâ€experimental study. Journal of clinical psychology, 70(4), 303-312.
Mashiach, R., & Lieblich, A. (2008). The embedded narrative: Navigating -Zilber, T. B., Tuval1069.-(6), 104714 ,Qualitative inquiry through multiple contexts.
- Poster Presentations
Location: Rome, Italy
Session Introduction
Jan Edmund Celie
Ghent University, Belgium
Title: The depression conundrum and the advantages of uncertainty
Biography:
Jan E. Celie is a clinical psychologist/psychoanalyst with a private practice. His main perspective on treatment is a Freudian-Lacanian perspective. He has been puzzled and fascinated at the same time, by the rising prevalence figures for depression worldwide. Five years ago, at the age of 50, he went back to research and study at the Faculty of Psychology of the University of Ghent (Belgium). In 2018, following upon this research, he will defend a doctoral dissertation in which he develops mainly three arguments: the diagnostic construct of depression lacks scientific foundation; and neither the psychotherapeutic nor pharmacological EBTs for depression are as firmly ‘evidence-based’ as their proponents claim. He suggests that, rethinking depression globally, we might need to abandon our faith in treatment, and focus on societal origins and preventive measures; – which is largely a matter of politics.
Abstract:
According to the WHO (2012), the prevalence of unipolar depressive disorders is rising, even in those places where mental health treatments are widely available. The WHO predicts that these disorders will be the leading contributor to the global burden of disease by 2030. This sobering projection fits poorly with how psychological treatments for depression are presented in the mainstream scientific literature: as highly effective therapies, based upon a sound understanding of the causes of distress. There is a clear discrepancy between the rising prevalence figures on the one hand, and the confident claims of this effectiveness research on the other. This discrepancy prompts a set of complex interlinked questions, which we have called ‘The Depression Conundrum’. In search of a partial answer, the aim of our study was to critically analyse five meta-analytic studies investigating the effectiveness of psychological EBTs for depression, all of which had been published in high impact factor journals. Our examination established a number of methodological and statistical shortcomings in every study. Furthermore, we argue that the meta-analytic technique is founded upon problematic assumptions. The implications of our analysis are clear: decades of quantitative research might not allow us to conclude that psychological EBTs for depression are effective. The uncertainty and questions raised by our findings might act as a catalyst to broaden the way in which depression and associated therapies are researched. In addition, it might contribute toward a more vigorous and interdisciplinary debate about how to tackle this soon-to-be global public health priority number one.
Paulette Sides Sasser
Duquesne University School of Nursing, USA
Title: Integration of behavioral and mental health care into primary care clinics: a program evaluation
Biography:
Paulette Sides – Sasser has completed her Doctorate in Nursing Practice with a focus on the integration of mental health into primary care systems. This Project Level Program Evaluation includes three components: Context Evaluation; Implementation Evaluation and Outcome Evaluation. Post doctorate work includes the implementation of the recommended quality assurance program and associated pilot studies, development of new staff education instruments and recommendations for innovative staff roles to address the most the most commonly cited barrier to full integration identified by extensive literature search of international publications. This will be the first implementation of a complete integration program in New Mexico, USA. Additional expertise relevant to this submission include management of community mental health clinics and psychiatric emergency services, and provision of clinical specialist services at the University of New Mexico Hospitals. Acted as a clinical expert for the National Medicare Reimbursement Pilot to establish regulations for primary care.
Abstract:
Fragmentation of physical, mental, and chemical dependency care delivery systems has led to significant gaps in care for individuals with severe mental illness and substance use disorders. A shifting international focus to chronic illness and the default provision of mental health care demands new approaches. In the US, the rise in numbers of those identified with mental health conditions has risen, while the resources to care for those patient have declined, creating a gap in service to a vulnerable population. This DNP project is a program evaluation of an integrated behavioral health and mental health program provided by a Patient Cantered Medical Home Primary Care Clinic. This DNP Project’s purpose was to evaluate the impact of the implementation of integrated behavioral and mental health services within a primary care clinic on patient’s adherence to the treatment plan, staff and patient experiences and cost of care for patients with severe mental illness. Qualitative and quantitative data was collected 12 months prior to and after the program change which included the addition of a licensed mental health expert and workflow adjustments. Upon completion of data collection and analysis, results showed that the integration of mental health into primary care has had a positive impact on patient adherence to treatment, patient satisfaction and staff satisfaction.
Rima Kavalniene
Vilnius University, Lithuania Panel Discussion
Title: Depression, anxiety and satisfaction with primary health care: is there any connection?
Biography:
Rima Kavalniene is pursuing her PhD at Vilnius University Medical Faculty in Lithuania. She works as Family Doctor in Primary Health Care Clinic. She is interested in current issues of Mental Health in Primary Health Care. Her PhD is about finding connection between some sociodemographic factors as well as most common mental diseases and patient satisfaction with primary health care services.
Abstract:
Background & Aim: Anxiety and depression are among the most common psychiatric disorders in primary health care (PHC). These diseases are associated with disability and poor quality of life. There is high comorbidity between anxiety, depression and other chronic somatic diseases. Anxiety and depression are also associated with worse treatment outcomes and higher amount of complications in chronic somatic diseases. However, connection between this diseases and patient`s satisfaction with PHC services has not been previously well studied. The main aim of this study is to determine the connections between depression, anxiety and patient`s satisfaction with PHC services.
Methodology: 889 patients in PHC centers were randomly selected and asked to fill out the questionnaire. Patients came to their PHC centers for variouse reasons. Patient satisfaction questionnaire, short version (PSQ-18, Marshall and Hays), was used to determine patient satisfaction. The Hospital Anxiety and Depression scale (HAD, Zigmond and Snaith) was also used. Data analysis was performed using the SPSS 24.0. A ρ-value<0.05 was considered as indicative of statistical significance.
Findings: 887 questionnaires were used in data analysis. Both anxiety and depression subscales strongly correlated with each other (Spearman`s correlation coefficient 0.742) (ρ<0.001). Also, the worse estimates of both anxiety and depression subscales correlated with the worse overall score and all subscales of PSQ-18 (Spearman`s correlation coefficient -0.462 and -0.536 respectively) (ρ<0,001). The linear regression analysis of all data (the dependent variable was total PSQ-18 score) showed that the major factor leading to poorer satisfaction with PHC services was a higher depression subscale score (ρ <0.001) (Table 1). The correlation between anxiety and PSQ-18 score has gone.
Conclusion: The presence of depression leads to poorer satisfaction with PHC services. Depression is a strong factor influencing patients' perception of PSP services, which sometimes can be masked and stay unnoticed among the other factors.
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a. Dependent Variable: Total PSQ-18 score
Table 1: Regression Analysis Coefficientsa.
Recent Publications:
1. Sundquist J, Ohlsson H, Sundquist K and Kendler KS (2017) Common adult psychiatric disorders in Swedish primary care where most mental health patients are treated. BMC Psychiatry. (17): 235. doi: 10.1186/s12888-017-1381-4.
2. Buszewicz M J (2011) Improving the detection and management of anxiety disorders in primary care. Br J Gen Pract. 61 (589): 489-490.
3. Sadeniemi M, Pikola S, Pankakoski M, Joffe G and all (2014) Does primary care mental health resourcing affect the use and cost of secondary psychiatric services? Int J Environ Res Public Health. 11 (9): 8743-8754.
4. Wandell P, Carlsson AC, Gasevic D, Wahlstram L and all (2016) Depression or anxiety and all-cause mortality in adults with atrial fibrilation – A cohort study in Swedish primary care. Ann Med. 48 (1-2): 59-66. doi: 10.3109/07853890.2015.1132842.
5. Treating depression and anxiety in primary care (2008) Prim Care Companion J Clin Psychiatry. 10 (2): 145-152.
- E- Poster
Location: Rome, Italy
Session Introduction
Supaporn Sritanyarat
Fort Sunpasitthiprasong Hospital, Thailand
Title: Let’s talk before the onset of depression in Thai troops: situational analysis and developmental program for mental health promotion
Biography:
Supaporn Sritanyarat recently working at Mental Health Center, Thailand.
Her research mainly based upon Mental Health & Human Resilience.
Abstract:
Improving mental health and preventing mental illness such as depression are complementary strategies which, along with the treatment and rehabilitation of people with mental disorders, can significantly improve health and well-being. This is a combined study between the Mental health Center 10 and Fort Sunpasitthiprasong Hospital. It aims to describe the situation of mental health problem in Thai troops who are in deployment at the Thai-Cambodia border and to develop a program for mental health promotion. Severe depression, stress, and suicidal attempts are major mental health problems in Thai troops who are currently deployed in the field. Moreover, successful suicides have a great demoralizing effect on the rest of the troops. Therefore, stakeholders such as military doctors, nurses, medical corps, and troops have gathered to discuss and analyze the root cause of these problems. The resultant finding shows that there is a lack of sufficient psychological preparation for the troops before deployment. Currently, there are only screening tests for stress, depression, and suicidal tendency. Thus, the stakeholders have set up a program for building psychological resilience in pre-deployed Thai troops, namely, LIFE. (L=living with purpose, I=in positive ways, F=friendly connections E=Empowerment for all). Preliminary implementation of this program has shown to be effective in providing troops with the appropriate psychological support during deployments. Further adjustment would be needed in order for us to come up with a comprehensive and complete manual for this program.