1: Interventions Flashcards
Where do mental health disorders rank in their years lost to disability?
7th globally
How common are mental health disorders globally?
1 in 8 people / 13%
What are the top 2 mental health conditions that lead to years lost to disability?
depression & anxiety
What proportion of people with moderate cases of mental disorders receive treatment in the UK?
35%
What proportion of people with severe cases of mental disorders receive treatment in the UK?
65%
What is the proportion of people with mental health disorders that access support service in China, Nigeria & USA
11% of severe cases in China (middle income)
21% of severe cases in Nigeria (low income)
59% of severe cases in USA (high income)
What proportion of the world’s population live in middle & low income countries?
85%
What are 4 barriers to mental health care in low/middle income countries?
- Limited resources of healthcare
- Shortage of trained workforce
- Financial cost to families
- Mental Health stigma
What are 3 barriers to mental health care in high income countries?
Treatment still not to adequate standards
Increased demand for services
Not reaching the people who need the most support
define: mental health stigma
when someone views the individual affected by mental health difficulties in a negative way because of it.
define: internalised or self stigma (mental health disorders)
Self-stigma involves emotionally/cognitively absorbing the negative beliefs about the self, largely based on shame, accepting stereotypes, and alienating oneself from others
define: social stigma (mental health disorders)
Ignorance/prejudice by family, friends and community lead to additional burdens, including discrimination, exclusion, economic burden and hardships in accessing adequate care
define: structural stigma (mental health disorders)
Laws, policies, and practices result in the unfair treatment of people with lived and [living] experience of mental health difficulties. Professionals contribute to stigmatisation through conscious or unconscious biases
How do beliefs about emotional balance lead to difficulty in people discussing their problems?
Perceiving that mental health difficulties are due to a lack of emotional balance leads people to believe others may get aggravated by talking about the issues
How does shame act as a barrier to people taking about their mental health issues?
Perceiving that mental health difficulties as a ‘weakness’ of character or personality flaw that reflects and impacts on the family due to the significant role of family in one’s life
How can spirituality cause problems in seeking mental health support?
Attributing conditions to spiritual causes and therefore seeking guidance via spirituality etc.
What do interventions aim to do?
provide treatment & reduce risk
What is a pre-emptive intervention?
prior to usual treatment
What are the 3 types of pre-emptive interventions?
Universal - for everyone
Selective - for a group seen to be at-risk
Indicated - for individuals seen to be at-risk
What are the 5 levels of interventions in the social-ecological model?
policy- community- institutional- interpersonal- intrapersonal
What is a problem with relying on random-control based trials for deciding on interventions?
Ethnoracial/ethnocultural minorities are not well represented in RCTs, so the validity of ‘evidence based interventions’ for particular understudied/underserved groups is unclear
How does the UK mental health system work?
Mental health teams in the UK are structured around primary, secondary and tertiary care in the National Health Service (NHS). Uses a stepped-care model to improve access to treatment for common mental disorders via primary care or self-referral.
STEP 1: Primary care/GP
STEP 2: Low intensity service - mild to moderate
STEP 3: High intensity service - moderate to severe
STEP 4: Chronic/ complex
What are the benefits of the IAPT?
Decreased waiting times
Client’s condition improved (58% to 67%)
Recovery improved (43% ->51%)
What are the criticisms of the IAPT
Only half of referred patients go onto treatment
Unclear if its interventions tailored enough to meet the actual complexity of its clientele
Unclear if IAPT prevents need for onward referral to secondary care (as originally envisaged)
How does therapist adaptivity lead to changed in effectiveness?
therapists who adapted to client’s individual needs were perceived as more effective than those who did not
What factors outside of the therapy impact psychological change?
Individual’s own goals, expectations and sense of stigma
