UNASSIGNED: Addressing relevant determinants for preserved person-centered rehabilitation in mental health is still a major challenge. Little research focuses on factors associated with psychiatric hospitalization in exclusive outpatient settings. Some variables have been identified, but evidence across studies is inconsistent. This study aimed to identify and confirm factors associated with hospitalization in a specific outpatient population.
UNASSIGNED: A retrospective monocentric case-control study with 617 adult outpatients (216 cases and 401 controls) from a French community-based care facility was conducted. Participants had an index outpatient consultation between June 2021 and February 2023. All cases, who were patients with a psychiatric hospitalization from the day after the index outpatient consultation and up to 1 year later, have been included. Controls have been randomly selected from the same facility and did not experience a psychiatric hospitalization in the 12 months following the index outpatient consultation. Data collection was performed from electronic medical records. Sociodemographic, psychiatric diagnosis, historical issues, lifestyle, and follow-up-related variables were collected retrospectively. Uni- and bivariate analyses were performed, followed by a multivariable logistic regression.
UNASSIGNED: Visit to a psychiatric emergency within a year (adjusted odds ratio (aOR): 13.02, 95% confidence interval (CI): 7.32-23.97), drug treatment discontinuation within a year (aOR: 6.43, 95% CI: 3.52-12.03), history of mental healthcare without consent (aOR: 5.48, 95% CI: 3.10-10.06), medical follow-up discontinuation within a year (aOR: 3.17, 95% CI: 1.70-5.95), history of attempted suicide (aOR: 2.50, 95% CI: 1.48-4.30) and unskilled job (aOR: 0.26, 95% CI: 0.10-0.65) are the independent variables found associated with hospitalization for followed up outpatients.
UNASSIGNED: Public health policies and tools at the local and national levels should be adapted to target the identified individual determinants in order to prevent outpatients from being hospitalized.

暂无摘要。

This study explores Bangladesh\'s mental health services from an individual- and system-level perspective and provides insights and recommendations for strengthening it\'s mental health system. We conducted 13 in-depth interviews and 2 focus group discussions. Thirty-one participants were recruited using a combination of purposive and snowball sampling methods. All interviews and group discussions were audio-recorded and transcribed, and key findings were translated from Bengali to English. Data were coded manually and analysed using a thematic and narrative analysis approach. Stakeholders perceived scarcity of service availability at the peripheral level, shortage of professionals, weak referral systems, lack of policy implementation and regulatory mechanisms were significant challenges to the mental health system in Bangladesh. At the population level, low levels of mental health literacy, high societal stigma, and treatment costs were barriers to accessing mental healthcare. Key recommendations included increasing the number of mental health workers and capacity building, strengthening regulatory mechanisms to enhance the quality of care within the health systems, and raising awareness about mental health. Introducing measures that relate to tackling stigma, mental health literacy as well as building the capacity of the health workforce and governance systems will help ensure universal mental health coverage.

BACKGROUND: Youth mental health is a major health concern in almost every country. Mental health accounts for about 13% of the global burden of disease in the 10-to-19-year age group. Still there are significant gaps between the mental health needs of young people and the quality and accessibility of available services. Collaboration between health and social service actors is a recognized way of reducing gaps in quality and access. Yet there is little scientific evidence on how these collaborations are applied, or on the challenges of cross-boundary collaboration in the youth mental health space. This study aims to explore how collaboration is understood and practiced by professionals working in the Swedish youth mental health system.
METHODS: We conducted 42 interviews (November 2020 to March 2022) with health and social care professionals and managers in the youth mental health system in Sweden. Interviews explored participants\' experience and understanding of the purpose, realization, and challenges of collaboration. Data were analysed under an emergent study design using reflexive thematic analysis.
RESULTS: The analysis produced three themes. The first shows that collaboration is considered as essential and important, and that it serves diverse purposes and holds multiple meanings in relation to professionals\' roles and responsibilities. The second addresses the different layers of collaboration, in relation to activities, relationships, and target levels, and the third captures the challenges and criticisms in collaborating across the youth mental health landscape, but also in growing possibilities for future development.
CONCLUSIONS: We conclude that collaboration serves multiple purposes and takes many shapes in the Swedish youth mental health system. Despite the many challenges, participants saw potential in further building collaboration. Interestingly our participants also raised concerns about too much collaboration. There was scepticism about collaboration directing attention away from young people to the professionals, thereby risking the trust and confidentiality of their young clients. Collaboration is not a panacea and will not compensate for an under-resourced youth mental health system.

UNASSIGNED: Recently, the Saudi government has proposed several initiatives to promote mental health, including the national program named Wazen. The objective of this study was to observe the performance of mental hospitals using a balanced scorecard through this federal program.
UNASSIGNED: Secondary quantitative analysis was implemented utilizing the Wazen report program data in 2022. The report adopted a balanced scorecard (BSC) concept. The study focused on 19 mental health facilities (Eraddah Hospitals) in the Ministry of Health (MOH) regions. The MOH\'s annual statistical report for 2018 and 2022 was reviewed to explore more about beds, staff, and the number of new mental disorder cases. Data were analyzed using Microsoft Excel 365 and the Statistical Package for Social Sciences (SPSS Version 25) software. Mental health hospitals were classified into three categories.
UNASSIGNED: Most rural hospitals had lower performance in the yellow threshold value that might need improvement. The data shows that the mean of all hospital performance in some domains ranged, yielding 70% staff engagement and 77% continued educational activity, indicating unsatisfactory performance across public mental health services. The means score of access to care was 97.0% and 94.7%, marking the better mental health services provided. Between 2018 and 2022, there was a significant rise in the prevalence of mental disorders, as evidenced by the number of new patients and outpatients indicated by specific mental diseases, including conditions of psychological development (F80-F98).
UNASSIGNED: The high quality of mental healthcare is manifested by therapeutic ethos with a high degree of interaction between professional careers and service users. The former is enhanced by highly educated, competent, compassionate, self-aware, and specialized healthcare professionals in mental health. When assessing mental healthcare services, we recommend considering providers\' and professionals\' conditions for successful implementation in alignment with patient experience.

Mental health system responsiveness (MHSR) is one of the important indicators in measuring the performance of mental health systems. Recognizing this function can be effective in responding appropriately to the needs of People with Pre-Existing Psychiatric Disorders (PPEPD). This study aimed to investigate MHSR during the COVID-19 period in PPEPD in Iran. Using stratified random sampling, 142 PPEPD who were admitted to a Psychiatric Hospital in Iran one year before the onset of the COVID-19 pandemic were recruited for this cross-sectional study. Participants completed a demographic and clinical characteristics questionnaire as well as a Mental Health System Responsiveness Questionnaire through telephone interviews. The results show that the indicators of prompt attention, autonomy, and access to care were reported as the worst-performing and the confidentiality indicator as the best-performing. The type of insurance affected the access to care and the quality of basic amenities. MHSR has been reported to be poor in Iran in general and this problem worsened during the COVID-19 pandemic. Considering the prevalence of psychiatric disorders in Iran and the degree of disability of these disorders, structural and functional changes are needed for adequate MHSR.

This article presents the historical transformation of the mental health system and policies in the case of Turkey and discusses the challenges to their effective implementation. The mental health system in Turkey has undergone a series of reforms in three periods, namely, the institutionalization of psychiatry and hospital-based mental health services in the mid-19th century, the introduction of first-generation community-based mental healthcare services in the 1960s, and the policy of deinstitutionalization after the 1980s. In this transformation process, certain initiatives have been implemented with the participation of interested actors across periods and small but important improvements. A draft has been prepared after a series of studies were conducted with regard to mental health policies and plans. However, no results have been obtained. The necessity of the mental health law has been clear. A notion that has been known is that the mental health law, which offers a holistic perspective, positively influences the functioning of the mental health system in terms of service users and providers. However, whether or not it actually pursues these intended improvements has been subject to doubt. Until now, no mental health law has been effectively implemented in Turkey, and measuring and evaluating in which aspects the law will be successful and where it will fail have been impossible. Turkey continues to be in need of a mental health law is practical and in line with international standards for the rights of patients and supervision against coercive measures.

Italy has been severely affected by the COVID-19 pandemic, consequently producing a heavy burden on the Italian National Health Service. From February 2020 until the end of the same year, the Italian Mental Health System (MHS), comprising an extensive network of community services, was subjected to a significant decrease in standards of care followed at the beginning of 2021 by a slow return to usual levels of activity. Data reported in the present article highlight how the Italian MHS - as was the case in the majority of countries-was largely unprepared for this emergency, suggesting an impelling need to develop appropriate supplementary national plans with the aim of preventing similar situations from developing in the future. The upheaval caused by the pandemic has highlighted the need to reinforce, both at a local and national level, the organization and standards of care of the Italian MHS in order to protect and support the mental health of patients with severe mental disorders, health workers, and the general population, thus preventing a potential \"pandemic\" of mental disorders.

OBJECTIVE: The Mental Health Gap Action Program (mhGAP) was launched by the World Health Organization (WHO) in 2008 to address the lack of care of people in low and middle-income countries The purpose of this narrative review is to examine Mental Health Gaps in the management of Schizophrenia in Malaysia.
METHODS: A search was conducted using the five keywords in the following databases: Embase, MEDLINE, Web of Science, PubMed and Google Scholar.
RESULTS: A review of the mental health system in Malaysia was conducted through the lens of the mhGAP context with a particular focus on Schizophrenia. Gaps in service delivery and lack of fidelity to evidence-based practices to this population of patients are examined in context of social security and health coverage, evidenced-based practices in Schizophrenia and health and allied delivery systems.
CONCLUSIONS: and Implications for Practice: Mental health service delivery and associated systems in Malaysia are found wanting in several aspects of mental health management of schizophrenia. There is an urgent need for a thorough review and realignment of the management of Schizophrenia by all stakeholders involved in the multi-sectoral inter-system delivery of services to people with schizophrenia i.e. Mental health professionals, Social Welfare officers, policy makers, local and federal government agencies involved in education, employment, transport and housing.

BACKGROUND: The publication of the World Health Report of 2001 by the World Health Organization (WHO) raised awareness of mental health worldwide. It reported a higher burden of mental illnesses in developing countries, with fewer resources to address the conditions. Since then, many initiatives have been taken in Cameroon to improve the mental health of the population, but these efforts lack local scientific evidence to support them. This study aims to describe the mental health services available in the West Region of Cameroon and to provide evidence-based support to this process.
METHODS: We used the World Health Organization Assessment Instrument for Mental Health systems (WHO-AIMS) version 2.2 to collect, analyze, and report the data on mental health services offered in 2020 in the West Region of Cameroon. We extracted our data from the registers of 10 mental health facilities of the region, and we interviewed the staff in these facilities and at the Ministry of Public Health.
RESULTS: The region is divided into 20 health districts, of which six offered mental health services. As a whole, Cameroon had a mental health policy, mental health plan, but no mental health legislation or emergency plan. There was no specific budget for mental health in the country. In the West Region there were not any psychiatrists. Mental health services were provided by nurses, psychologists, general practitioners, and neurologists. There were 1.87 human resources in mental health facilities per 100,000 population, of which 1.4 were nurses. 1 in 1.4 of these nurses worked in the main city. There was no formal link of mental health services with other sectors and no publication in the previous five years about mental health in the region referenced on PubMed.
CONCLUSIONS: In 2020, the access to mental health services in the West Region of Cameroon was inequitable. The approach to mental health system development was not inclusive and not supported by enough scientific evidence.