WPA guidance on the protection and promotion of mental health in children of persons with severe mental disorders
PublisherBlackwell Publishing Ltd
MetadataShow full item record
AbstractThis guidance details the needs of children, and the qualities of parenting that meet those needs. Parental mental disorders can damage the foetus during pregnancy through the action of drugs, prescribed or abused. Pregnancy and the puerperium can exacerbate or initiate mental illness in susceptible women. After their birth, the children may suffer from the social disadvantage associated with severe mental illness. The parents (depending on the disorder, its severity and its persistence) may have intermittent or prolonged difficulties with parenting, which may sometimes result in childhood psychological disturbance or child maltreatment. This guidance considers ways of preventing, minimizing and remedying these effects. Our recommendations include: education of psychiatrists and related professions about the effect of parental mental illness on children; revision of psychiatric training to increase awareness of patients as caregivers, and to incorporate relevant assessment and intervention into their treatment and rehabilitation; the optimum use of pharmacological treatment during pregnancy; pre-birth planning when women with severe mental illness become pregnant; development of specialist services for pregnant and puerperal women, with assessment of their efficacy; community support for parenting by mothers and fathers with severe mental disorders; standards of good practice for the management of child maltreatment when parents suffer from mental illness; the importance of multi-disciplinary teamwork when helping these families, supporting their children and ensuring child protection; the development of child and adolescent mental health services worldwide.
KeywordChild and adolescent mental health services
Childhood mental disorders
Severe mental illness
Identifier to cite or link to this itemhttps://www.scopus.com/inward/record.uri?eid=2-s2.0-80053139374&doi=10.1002%2fj.2051-5545.2011.tb00023.x&partnerID=40&md5=883267d9188b5e2a53893d582d1f87ab; http://hdl.handle.net/10713/11856
Showing items related by title, author, creator and subject.
International Olympic Committee (IOC) Sport Mental Health Assessment Tool 1 (SMHAT-1) and Sport Mental Health Recognition Tool 1 (SMHRT-1): towards better support of athletes' mental healthGouttebarge, Vincent; Bindra, Abhinav; Blauwet, Cheri; Campriani, Niccolo; Currie, Alan; Engebretsen, Lars; Hainline, Brian; Kroshus, Emily; McDuff, David; Mountjoy, Margo; et al. (BMJ Publishing Group, 2020-09-18)Objectives: To develop an assessment and recognition tool to identify elite athletes at risk for mental health symptoms and disorders. Methods: We conducted narrative and systematic reviews about mental health symptoms and disorders in active and former elite athletes. The views of active and former elite athletes (N=360) on mental health symptoms in elite sports were retrieved through an electronic questionnaire. Our group identified the objective(s), target group(s) and approach of the mental health tools. For the assessment tool, we undertook a modified Delphi consensus process and used existing validated screening instruments. Both tools were compiled during two 2-day meeting. We also explored the appropriateness and preliminary reliability and validity of the assessment tool. Sport Mental Health Assessment Tool 1 and Sport Mental Health Recognition Tool 1: The International Olympic Committee Sport Mental Health Assessment Tool 1 (SMHAT-1) was developed for sports medicine physicians and other licensed/registered health professionals to assess elite athletes (defined as professional, Olympic, Paralympic or collegiate level; aged 16 years and older) potentially at risk for or already experiencing mental health symptoms and disorders. The SMHAT-1 consists of: (i) triage with an athlete-specific screening tool, (ii) six subsequent disorder-specific screening tools and (iii) a clinical assessment (and related management) by a sports medicine physician or licensed/registered mental health professional (eg, psychiatrist and psychologist). The International Olympic Committee Sport Mental Health Recognition Tool 1 (SMHRT-1) was developed for athletes and their entourage (eg, friends, fellow athletes, family and coaches). Conclusion: The SMHAT-1 and SMHRT-1 enable that mental health symptoms and disorders in elite athletes are recognised earlier than they otherwise would. These tools should facilitate the timely referral of those athletes in need for appropriate support and treatment.
Longitudinal Patterns of Early Mental Health Service Utilization in a Medicaid-insured Birth Cohort and the Impact of Continuity of Care on the Quality of Pediatric Mental Health TreatmentPennap, Dinci; Zito, Julie Magno (2018)Background: The prevalence of pediatric mental health (MH) diagnosis and treatment have expanded in the U.S. We assessed the longitudinal patterns of incident diagnosis and new psychotropic medication use in a Medicaid-insured birth cohort. Additionally, continuity and quality of MH service utilization were assessed in a publicly-insured pediatric population. Quality care was defined by the 2009 Children's Health Insurance Program Reauthorization Act (CHIPRA) mandated children's health care quality measures. Methods: We applied longitudinal designs to Medicaid claims data from a Mid-Atlantic state (2007-2014). Using Kaplan-Meier estimators we assessed the cumulative incidence of MH service use in a cohort of newborns (aim 1). We assessed the association between relational patient-provider continuity of care and: 1) emergency department (ED) visits or hospitalizations in the 12 months following first MH diagnosis among 3-16 year olds (aim 2); and 2) the quality of follow-up care among 6-12 year old new users of ADHD medications (aim 3), using logistic regression models. Quality was defined as having ≥1 follow-up outpatient visit in the 30 days following medication initiation and ≥2 follow-up visits in the 270 days after the first follow-up visit, with a total medication supply of ≥210 days. Results: By age 8, 19.7% and 10.2% of the birth cohort (n=35,244) had received a MH diagnosis or psychotropic medication, respectively. Among medication users, 80.5% received monotherapy, 16.4% received 2 medication classes, and 4.3% received ≥3 medication classes concomitantly for ≥60 days. Compared to children with high CoC, the odds of ED visits was significantly higher among youths with low CoC [Odds Ratio(OR)=1.27; 95% CI=1.13-1.41] and low CoC was associated with greater odds of hospitalization [OR=1.17; 95% CI=1.06-1.29]. Compared to those with low CoC, children with higher continuity of care had greater odds of meeting CHIPRA initiation- [OR=1.41; 95% CI=1.25-1.60] and continuation-phase [OR=1.45; 95% CI=1.29-1.64] visit-based measures. Conclusions: Early exposure to psychotropic medications and prolonged duration of use have implications for long-term safety, highlighting the need for safety and outcomes research in pediatric populations. Our findings suggest a need for more research in the areas of quality assessment and continuity of care among youths with mental health conditions.
Perspectives among mental health providers regarding rehospitalization of the chronically mentally illAnderson, Denise Lynn; Belcher, John R. (1995)Rehospitalization of persons diagnosed with chronic mental illnesses has been a problem since deinstitutionalization. While there has been little agreement among researchers, practitioners, families and consumers as to what is needed to improve this problem, it has been addressed frequently in mental health literature. The purpose of this qualitative 'grounded theory' field study was to explore perspectives of different levels of community mental health providers (i.e., directors, supervisors and direct service providers) (n = 15) from different community agencies regarding rehospitalization of persons diagnosed with chronic mental illnesses. Semi-structured interviews were conducted with each participant in three rounds of data collection. The data was coded and categories were collapsed into themes. As themes reached saturation, they were negotiated and refined into the working hypotheses. This method of constant comparative analysis allowed for negotiation of the final working hypotheses to develop 'grounded theory'. The results indicate there are differences and similarities among levels of community mental health providers regarding rehospitalization. Similar perspectives among participants included their view of needs for new and improved programs and increased education to decrease rehospitalizaton. Participants view multiple community mental health agencies as having strengths and limitations. Lack of perceived influence by persons in direct hierarchical line of authority was another commonalty. Differences were related to the scope of the providers' view, providers' perceived significance of impact on consumers, and level of openness regarding views and opinions. The results also reveal that different perspectives exist among agencies related to awareness of outside influences impact on their work with consumers. Implications of these findings include recommendations for both practice and research within this community mental health setting, as well as, to the social work profession. Recommendations for the setting in which the research was conducted include to further explore the findings of the study, specifically, the reported frustration regarding lack of team work among different agencies within the mental health system. Finally, social work research is encouraged to build knowledge and address problems from a social work perspective. It is recommended that further research be conducted from a social work perspective in the area of mental health.