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Approximately 4 million U.S. service members took part in the wars in Afghanistan and Iraq. Shortly after troops started returning from their deployments, some active-duty service members and veterans began experiencing mental health problems. Given the stressors associated with war, it is not surprising that some service members developed such mental health conditions as posttraumatic stress disorder, depression, and substance use disorder. Subsequent epidemiologic studies conducted on military and veteran populations that served in the operations in Afghanistan and Iraq provided scientific evidence that those who fought were in fact being diagnosed with mental illnesses and experiencing mental healthâ€"related outcomesâ€"in particular, suicideâ€"at a higher rate than the general population. This report provides a comprehensive assessment of the quality, capacity, and access to mental health care services for veterans who served in the Armed Forces in Operation Enduring Freedom/Operation Iraqi Freedom/Operation New Dawn. It includes an analysis of not only the quality and capacity of mental health care services within the Department of Veterans Affairs, but also barriers faced by patients in utilizing those services.
Based on a five-year evaluation of an $80 million U.S. Army demonstration program, this first-of-its kind study explores the cost effectiveness of a managed care model of service delivery for children and adolescents with mental health and substance addiction problems. Contributions report on the quality, cost, and clinical outcome and raise critical questions about the effectiveness of mental health services and their delivery in community settings. Chapters describe new approaches to measurement and provide analyses assisting future research on managed care.
Ask for a definition of primary care, and you are likely to hear as many answers as there are health care professionals in your survey. Primary Care fills this gap with a detailed definition already adopted by professional organizations and praised at recent conferences. This volume makes recommendations for improving primary care, building its organization, financing, infrastructure, and knowledge baseâ€"as well as developing a way of thinking and acting for primary care clinicians. Are there enough primary care doctors? Are they merely gatekeepers? Is the traditional relationship between patient and doctor outmoded? The committee draws conclusions about these and other controversies in a comprehensive and up-to-date discussion that covers: The scope of primary care. Its philosophical underpinnings. Its value to the patient and the community. Its impact on cost, access, and quality. This volume discusses the needs of special populations, the role of the capitation method of payment, and more. Recommendations are offered for achieving a more multidisciplinary education for primary care clinicians. Research priorities are identified. Primary Care provides a forward-thinking view of primary care as it should be practiced in the new integrated health care delivery systemsâ€"important to health care clinicians and those who train and employ them, policymakers at all levels, health care managers, payers, and interested individuals.
With the emerging international consensus toward community care of the mentally ill, there comes a growing need for meaningful evaluation of services. Redressing the current lack of guidance this book describes how to do mental health service research. Contributors comprehensively review the most recent developments in research design, method and measurement at the level of both whole service systems and individual programs within mental health services. Practical descriptions of comprehensive evaluation projects illustrate each issue and many chapters examine important earlier advances in effective service knowledge as well as future work that will further develop our understanding of meeting patient requirements.
Bringing together treatment and referral advice from existing guidelines, this text aims to improve access to services and recognition of common mental health disorders in adults and provide advice on the principles that need to be adopted to develop appropriate referral and local care pathways.
Each year, more than 33 million Americans receive health care for mental or substance-use conditions, or both. Together, mental and substance-use illnesses are the leading cause of death and disability for women, the highest for men ages 15-44, and the second highest for all men. Effective treatments exist, but services are frequently fragmented and, as with general health care, there are barriers that prevent many from receiving these treatments as designed or at all. The consequences of this are seriousâ€"for these individuals and their families; their employers and the workforce; for the nation's economy; as well as the education, welfare, and justice systems. Improving the Quality of Health Care for Mental and Substance-Use Conditions examines the distinctive characteristics of health care for mental and substance-use conditions, including payment, benefit coverage, and regulatory issues, as well as health care organization and delivery issues. This new volume in the Quality Chasm series puts forth an agenda for improving the quality of this care based on this analysis. Patients and their families, primary health care providers, specialty mental health and substance-use treatment providers, health care organizations, health plans, purchasers of group health care, and all involved in health care for mental and substanceâ€"use conditions will benefit from this guide to achieving better care.
Risk assessment and management is a core element of mental health practice, and all nurses need to be aware of the risks surrounding them and their patients in order to create a safe working environment. This timely and accessible text explores how nurses can enhance their skills, and improve their practice so that risk is assessed and managed safely and effectively. Risk Assessment and Management in Mental Health Nursing explores issues including context and definitions of risk, risk assessment tools and techniques, strategies for preventing risk situations, suicide, self-harm, neglect, forensic aspects of risk, substance misuse, ethical considerations, , victimology, risk to others and risk to self. Special Features: Written in the context of latest policy developments such as the National Service Frameworks Discusses the role of the mental health nurse in the assessment and management of risk Explores an increasingly important and timely subject in mental health practice Practical focus, with case studies throughout Written by experts in the field
It is estimated that in the United States, 14-26 per cent of children under the age of 18 suffer from some type of behavioural, emotional or developmental problem. However, less than a third of these children receive any mental health care. This volume presents recent developments in policy, service and evaluation, and explores how more of these children can be reached and helped.
Mental Health Outcome Evaluation bridges the gap between traditional research and evaluation methods by presenting an alternative to the highly technical and statistical methods developed in the laboratory for mental health care professionals. It focuses on outcome evaluation of mental health services for adults, concentrating on the general principles that can be used to assess the service effectiveness of community health centers, clinics, and private practices. The book presents a formidable argument for descriptive outcome studies through its evaluation of the results and consequences of care and treatment as well as clinician ratings. It is written in a non-technical style, making it accessible to anyone in the mental health industry. - Addresses industry efforts to monitor and assess information about results and consequences of mental health care and treatment - Evaluates use of clinician ratings as outcome information - Offers accessible general principles for managers and mental health services researchers - Presents the best argument for descriptive outcome studies
Mental health and substance use disorders affect approximately 20 percent of Americans and are associated with significant morbidity and mortality. Although a wide range of evidence-based psychosocial interventions are currently in use, most consumers of mental health care find it difficult to know whether they are receiving high-quality care. Although the current evidence base for the effects of psychosocial interventions is sizable, subsequent steps in the process of bringing a psychosocial intervention into routine clinical care are less well defined. Psychosocial Interventions for Mental and Substance Use Disorders details the reasons for the gap between what is known to be effective and current practice and offers recommendations for how best to address this gap by applying a framework that can be used to establish standards for psychosocial interventions. The framework described in Psychosocial Interventions for Mental and Substance Use Disorders can be used to chart a path toward the ultimate goal of improving the outcomes. The framework highlights the need to (1) support research to strengthen the evidence base on the efficacy and effectiveness of psychosocial interventions; (2) based on this evidence, identify the key elements that drive an intervention's effect; (3) conduct systematic reviews to inform clinical guidelines that incorporate these key elements; (4) using the findings of these systematic reviews, develop quality measures - measures of the structure, process, and outcomes of interventions; and (5) establish methods for successfully implementing and sustaining these interventions in regular practice including the training of providers of these interventions. The recommendations offered in this report are intended to assist policy makers, health care organizations, and payers that are organizing and overseeing the provision of care for mental health and substance use disorders while navigating a new health care landscape. The recommendations also target providers, professional societies, funding agencies, consumers, and researchers, all of whom have a stake in ensuring that evidence-based, high-quality care is provided to individuals receiving mental health and substance use services.