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Science can only offer a limited account of, and prescription for, mental health care. Yet the language of science and faith in the universal applicability of particular scientific methods to the craft of mental health care has come to permeate mental health practice communities. In this paper, the argument that many beliefs held by mental health professionals might be considered to be based on faith rather than science is presented, and the view that culture provides a useful lens for understanding mental health services and these paradoxes is proposed. Clearly there is a grand mental health narrative or colonizing influence of biological psychiatry that in various ways affects all mainstream mental health services. Local health services and professional communities might be considered subcultures. Understanding how mental health professions and practice are embedded in culture might be useful in considering how practice changes and why. Culture and caring practices are mutually embedded in localized subcultures. Therefore, a rich description of context and history is necessary in publication, presentation, or other communications to enable genuine understanding by a global audience. Viewing mental health practice in a cultural context highlights the importance of values and differences, and encourages humility in the face of ambiguity.

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WHAT IS KNOWN ON THE SUBJECT?: Personal recovery concept is dominant in mental health systems when service user involvement is emphasized; however, service user involvement in mental health research and practice does not exist in Egypt. Definitions of recovery from high-income and English-speaking countries should be carefully adapted to other settings. Nurses providing mental health care in Egypt generally do not have specialized mental health nursing qualifications. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE?: Both cultural and contextual uniqueness of Egypt as a Middle Eastern, low-middle-income country were clear in the findings of this paper. There are differences in the definition of family and service user engagement in the current study and in high-income countries. Seeking faith healers as a barrier to mental health recovery is culturally unique. Functional recovery prevails as a model in Egypt as there is limited service user involvement. Nursing values and code of ethics are consistent with enablers of mental health recovery. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Changing the pre-registration nursing education to prepare specialized graduates in mental health nursing. Training of mental health professionals on recovery approaches which involve service users is needed in Egypt. Mental health nurses in Egypt can use the current findings to implement national campaigns to raise public awareness of mental health problems. ABSTRACT: Introduction Recovery-oriented mental health practice is an emerging approach that aims to empower individuals to define their goals and take responsibility for their own recovery. However, mental health practice in Egypt is still custodial. Aim To explore perspectives of Egyptian mental health professionals on recovery. Method Semi-structured interviews were conducted with 15 mental health professionals identified through snowball sampling. Results The current study identified that functional recovery outweighed other definitions. Four facilitators of mental health recovery were identified: therapeutic relationship; family engagement; cultural sensitivity; and professionals' self-awareness. Six barriers to recovery were found, comprising mental health stigma and lack of awareness, seeking traditional healers, shortage of psychiatrists, cost of treatment, lack of training and effective rehabilitation programs. Discussion The concept of functional recovery predominates among nurses and other mental health professionals, which may be due to limited training and the historical lack of service user involvement in Egypt. Lack of support from family and society, inadequate training MHPs and perceived system inefficiencies are also major impeding factors for recovery. Implications for Practice There is a need for nurses to be involved in designing intervention programs targeting the general public and to support increased involvement of people with mental health issues.

“The implementation gap prevents our nation from reaping the benefit of billions of US tax dollars spent on research and, more important, prolongs the suffering of millions of Americans who live with mental disorders.”—President's New Freedom Commission on Mental Health 2003. Despite the development of effective treatments, depression is still ranked as one of the top ten causes of disability worldwide according to the World Health Organization. It often takes years if not decades to translate evidence-based depression treatments into nonacademic, community-based practices. This research-to-practice gap can lead to millions of dollars of funded research being wasted when the treatments themselves never reach the populations in need [1]. Without a clear strategy to foster implementation and acceptance at the community provider level, a “voltage drop” is experienced when an evidence-based depression treatment developed in tightly-controlled academic settings is then introduced into real-world settings [2]. Moreover, current clinical trials populations are still highly selective (<5% of the diagnosed population) despite the movement towards “community-based research.” There is a paucity of effective strategies or implementation approaches for getting effective treatments for depression and other mental disorders off the academic shelf and into the hands of those who need them. Subsequently, there is a need for further cross-disciplinary research on effective processes to facilitate the uptake of evidence-based treatments in real-world practices. Implementation science is an emerging field poised to address the organizational, provider, and patient-level barriers to the adoption of new treatments for depression as well as for other conditions. The National institute of Mental Health defines implementation as the “use of strategies to adopt and integrate evidence-based health interventions and change practice patterns within specific settings [3].” This current issue explores novel approaches based on implementation science for enhancing the uptake of depression treatments. The articles address a range of concepts, both at a higher level on tools for and theories of effective implementation and at the practical level of lessons learned on the ground. This series of articles also focuses on implementing evidence-based programs to improve depression outcomes particularly for underserved populations including lower income patients, adolescents, and women with postpartum depression. Four articles describe the application of implementation theory and measures to inform changes in mental health practice in general and for depression treatment in particular. J. K. Benzer et al. describe barriers and facilitators to coordinated mental health care in primary care settings. Key findings were used to refine an implementation theory for coordinated depression care included the importance of organizational factors such as resources, provider training and workflow designs, and an understanding and appreciation of mental health and primary care practice boundaries. Two additional articles describe complementary approaches for engaging providers in the implementation of new mental health treatments. E. Aisenberg et al. describe a process for building a community-academic partnership to implement telephone cognitive-behavioral therapy for rural Latinos. The article points to how such partnerships can facilitate the adaptation of evidence-based practices in community settings by garnering frontline participant feedback on which elements need to be changed to implement a more scalable and culturally appropriate program. Similarly, D. E. Goodrich et al., using the Enhanced Replicating Effective Programs implementation framework, describe the implementation of an outreach program for Veterans with mental disorders, and what lessons were learned in regards to activating and empowering providers to “lead from the middle” and work within their systems to facilitate patient access. In addition, the paper by A. J. Lewis et al. describes how qualitative data can be applied to develop fidelity and implementation measures to assess update of a family-focused depression intervention. Providers are key stakeholders in the implementation process, yet few studies have focused on the development of effective implementation strategies to facilitate provider training in and sustainability of using evidence-based depression treatments. Three of the papers in this special issue address the challenges in training clinicians in new mental health treatments, and whether training leads to long-term adoption and use of these practices, in particular, problem-solving therapy (PST). J. A. Cartreine et al. describe a web-based training program to further disseminate PST training to novice clinicians and whether long-term coaching by more experienced providers to further boost training effectiveness might be needed. In the paper by R. M. Crabb et al., clinicians undergoing training in PST were followed over to assess the long-term impact of the training on adoption and spread. S. W. Stirman et al. identified key reasons for variation in cognitive behavioral therapy training outcomes across community-based practices and the importance of garnering feedback from frontline providers prior to implementing training initiatives. Additional studies in this issue involved the implementation of depression treatments, notably in real-world populations. J. A. Waxmonsky et al. found that implementing a depression chronic care management programs in a public sector health plan led to significantly reduced depression severity over a 12-month period with a modest increase in health care costs. R. R. Dopp et al. present results of a novel program for adolescents with depression, demonstrating an alternative way to address mood symptoms that in turn also address other major chronic conditions such as obesity. Finally, B. P. Yawn et al. present a systematic review of postpartum depression treatment programs in which the most effective components included formal psychiatric evaluation, colocation of mental health care, and tracking of long-term outcomes. Ultimately, implementation science can inform the adoption and adaptation of effective depression treatments, primarily through a better understanding of the importance of building partnerships with end-users such as health care organizations and frontline providers, understanding barriers to adoption of effective treatments at these levels, and developing interventions that use organizational strategies such as collaborative care or systematic training programs to facilitate adoption. Moreover, there will be additional opportunities for researchers and practitioners to apply the lessons learned from this emerging field to develop more effective and practical depression treatments from the beginning, as well as the use of provider and health care organization-level strategies to ensure their adoption and sustainability in the real world. To this end, new skills will need to be acquired, including the measurement of factors facilitating or impeding treatment uptake, especially at the provider and system level using both qualitative and quantitative methods, application of nonrandomized controlled study designs that take into account variations in provider and organizational differences, as well as the inclusion of real-world patient populations that to date are not well-represented in depression clinical trials. Moreover, by placing greater emphasis on partnerships, frontline provider input, and practical treatment strategies, mental health implementation researchers will be poised to lead the development of the next generation of effective depression treatments. Amy M. Kilbourne Mark Williams Mark S. Bauer Patricia Arean

PurposeThe purpose of this article is to examine synergies between a eudaimonic model of psychological well-being (Ryff, 1989) and mental health practice. The model grew out of clinical, developmental, existential and humanistic perspectives that emphasized psychological strengths and capacities, in contrast to the focus on emotional distress and dysfunction in clinical psychology.Design/methodology/approachConceptual foundations of the eudaimonic approach are described, along with the six components positive functioning that are used to measure well-being. These qualities may be important in facilitating the recovery experiences, which are of interest in Mental Health and Social Inclusion.FindingsFour categories of empirical evidence about eudaimonia are reviewed: how it changes with aging, how it matters for health, what are its biological and neurological underpinnings and whether it can be promoted. Major contemporary forces against eudaimonia are also considered, including ever-widening inequality, the enduring pandemic and world-wide strife. In contrast, encounters with the arts and nature are put forth as forces for eudaimonia. The relevance of these ideas for mental health research and practice is considered.Practical implicationsEnormous suffering defines our contemporary world. Such realities call for greater attention to factors that undermine as well as nurture the realization of human potential, the core of eudaimonic well-being.Originality/valueMental health is often defined as the absence of mental illness. The novelty of the eudaimonic approach is to define mental health as the presence of well-being, assessed with different components of positive functioning.

Back to table of contents Previous article Next article Book ReviewFull AccessThe Essential Guide to Group Practice in Mental Health: Clinical, Legal, and Financial FundamentalsJay M. Pomerantz, M.D.Jay M. PomerantzSearch for more papers by this author, M.D.Published Online:1 Nov 1998https://doi.org/10.1176/ps.49.11.1501AboutSectionsView EPUB ToolsAdd to favoritesDownload CitationsTrack Citations ShareShare onFacebookTwitterLinked InEmail This book will have a place on my desk close to DSM-IV and the Physicians' Desk Reference; it is that useful for clinical practice in the late 1990s. Just as the other two books have periodic updates, I expect this guide to group practice to have future editions.These sentiments come not from a newcomer to mental health group practice, but from someone actively involved in a large multidisciplinary group (within a larger, multispecialty organization) doing at-risk contracting for the past seven years. The value of the book to a clinician just starting out in group practice, small or large, incorporated or not, is potentially much greater.The theme of this book is "collaboration." The authors have scanned the literature and talked with leaders of various successful group practices to find out the administrative and clinical methods that foster collaboration. The use of a "collaborative cube" to represent the three important axes of an organization—scope, integration, and governance—is innovative and useful. The book contains detailed information on legal structures, business plans and budgets, financing, ways to collect appropriate clinical and financial data to facilitate management, bidding on at-risk contracts, and employing consultants.A major and very thoughtful section of the book deals with designing collaborative clinical services. That is the part of the book that gets it on my desk. The ideas of time-effective treatment, parsimony, and the life-span developmental model are not new, but somehow seem especially clear in this chapter. I also appreciate and want to have close by me Dr. Steenbarger's field interviews with various leaders of successful collaborative models. Fortunately, there is no attempt to gloss over problems.My only criticism of the book is that it does not sufficiently warn mental health professionals about accepting a separate path for themselves. Recent history reveals neglected and underfunded separate state hospitals for mental patients. Likewise, the current behavioral health carve-out phenomenon, featuring both separation of service delivery and fierce price competition, has resulted in a decline in the percentage of the health care dollar devoted to behavioral health—10 to 12 percent under indemnity insurance versus a current 3 to 4 percent under managed care. The introduction of subcapitation for competing mental health groups, detailed in the book, may provide even fewer behavioral health dollars.What will be left for patients and providers? In any future edition of the book, Budman and Steenbarger might include a section that discusses and illustrates strategies to avoid carve-outs of behavioral health. Can local, collaborating mental health professionals operate under a budget within physician hospital organizations, provider sponsored organizations, multispecialty independent practice associations, and health maintenance organizations? Will such local, integrated arrangements forestall the continuing downward spiral in money for behavioral health? Even more to the point, how does one facilitate clinical collaboration within multispecialty "supergroups" to ensure optimal, cost-effective care of the psyche and the soma?Budman and Steenbarger's book is helpful, whether one takes the direction they recommend or another route to collaborative practice. The Essential Guide to Group Practice in Mental Health is must reading for anyone who subscribes to Psychiatric Services.Dr. Pomerantz is in private practice in Longmeadow, Massachusetts, and is a lecturer in psychiatry at Harvard Medical School.by Simon H. Budman and Brett N. Steenbarger; New York City, Guilford Press, 1997, 318 pages, $45 FiguresReferencesCited byDetailsCited byNone Volume 49Issue 11 November 1998Pages 1501-1501 Metrics History Published online 1 November 1998 Published in print 1 November 1998

Village health volunteers (VHVs) are the backbone of primary healthcare in many low-and-middle-income countries, including Thailand, where healthcare professionals are scarce. Previous studies looking at their role have been broader and lacked a specific mental health focus. In 2019, Thailand introduced a policy endorsing a recovery orientation in mental health care, however, the potential for VHVs to implement the approach remains underexplored. This study aims to: [1] describe VHVs' mental health practices, [2] explore stakeholders' perspectives on these practices, and [3] understand stakeholders' views on their potential to deliver recovery-oriented community care. This exploratory qualitative study involved nineteen semi-structured interviews conducted between August 2023 and March 2024 in a rural subdistrict of Northern Thailand. Participants included ten VHVs, four nurses, four caregivers, and one individual with mental health conditions. Purposeful and snowball sampling techniques were used. Reflexive thematic analysis was used to analyse interview data. Official documents related to VHVs' job descriptions, training, and recruitment policies were also examined to understand the scope of the role. The analysis identified three main themes: [1] Mental health practices and roles perceptions, highlighting variability among VHVs; [2] Organisational constraints on mental health practice in the community, demonstrating limited policy support and training for VHVs; and [3] Factors influencing the implementation of recovery-oriented approaches by VHVs, including barriers such as stigma and workload, and enabling factors such as specialist training and professional support. This study reveals that VHVs in Thai rural communities prioritise physical health due to policy adopting a biomedical approach and limited training on providing mental health care. A range of culturally adapted approaches are needed to expand and enhance the contribution that VHVs can make to improving the quality of life of individuals experiencing mental health conditions in rural communities in Thailand.

The Objective of the present study was to analyze the scientific production of the 10 years (2005 -2015), highlighting the practices in Mental Health in PHC implemented through public policies.Method: integrative literature review, with research in LILACS and SCIELO databases.The descriptors Mental Health, Primary Care; Basic Attention and Public Policies.Full Text were included; Main subject; Country / Region as subject, only studies carried out in Brazil; Languag e: English Spanish and Portuguese; Year of Publication (2006 to 2015) and Subject of the Journal.Through this study, it was possible to identify 22 studies focused on the subject of Mental Health in Primary Care, which were categorized into 4 main themes: Matrix support, Biomedical Model, Importance of community health agent (CHA) and Implementation of Public Policies in Mental Health.The main practices in Mental Health highlighted are the matrix support, which in most studies is considered as an important tool for the effectiveness of mental health services in primary care, network articulation, co-responsibility of the teams involved in care, municipal management.

Decolonial and liberation psychology aims to understand and address the social and epistemic injustices in our mental health systems, practices, and research agenda. To advance this goal, we advocate for deeper engagement with traditional healing systems practiced by various Indigenous Peoples and cultural groups around the world. In this article, we consider examples of Indigenous healing from Canada, China, Singapore, and the United States, to address a central question: What can we learn from these unique Indigenous healing traditions to inform mental health practices globally? Comparison shows that all these practices involve communal healing rituals grounded in spiritual, religious, and cultural knowledge systems related to embodied ways of knowing and that are embedded in social-ecological systems, including kinship, ancestral ties, and filial connections to the cosmology. To support further development of decolonial practice, it is crucial to attend to the complex interactions of cultural identity and sociocultural (relational, communal, political, and spiritual) factors underlying healing traditions in Indigenous communities. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

In 2004, the American Academy of Pediatrics (AAP) Board of Directors formed the Task Force on Mental Health and charged it with developing strategies to improve the quality of child and adolescent mental health* services in primary care. The task force acknowledged early in its deliberations that enhancing the mental health care that pediatricians and other primary care clinicians† provide to children and adolescents will require systemic interventions at the national, state, and community levels to improve the financing of mental health care and access to mental health specialty resources. Systemic strategies toward achieving these improvements are the subject of other publications of the task force: “ Strategies for System Change in Children's Mental Health: A Chapter Action Kit ” (chapter action kit),1 “Improving Mental Health Services in Primary Care: Reducing Administrative and Financial Barriers to Access and Collaboration,”2 and “Enhancing Pediatric Mental Health Care: Strategies for Preparing a Community.”3 The task force also recognized that enhanced mental health practice will require competencies not currently achieved by many primary care clinicians; in the policy statement “The Future of Pediatrics: Mental Health Competencies for Pediatric Primary Care,”4 the task force collaborated with the AAP Committee on Psychosocial Aspects of Child and Family Health to outline these competencies and propose strategies for achieving them. This report offers strategies for preparing the primary care practice itself for provision of enhanced mental health care services. The task force proposes incrementally applying chronic care principles to the care of children with mental health and substance abuse problems as primary care clinicians apply them to the care of children with chronic medical conditions such as asthma. Most primary care clinicians will find that significant gaps exist between their current practice and the proposed ideal. The task force offers guidance in … Address correspondence to Jane Meschan Foy, MD, Department of Pediatrics, Wake Forest University School of Medicine, Medical Center Blvd, Winston-Salem, NC 27157. E-mail: jmfoy{at}wfubmc.edu

Nursing directors in mental health services hold important leadership positions that include responsibility for the nursing workforce. The comprehensive or generalist approach to undergraduate nursing education consistently poses significant recruitment problems. Specialisation in mental health within Bachelor of Nursing programs has been suggested as a potential solution. This paper presents the views and opinions of mental health nursing directors regarding undergraduate specialisation. A qualitative exploratory study was undertaken. Thirteen nursing directors from Queensland Mental Health Services participated in an in-depth telephone interview. The data were analysed thematically. Nursing directors were very supportive of specialisation in mental health at the undergraduate level. Thematic analysis revealed four main themes: perceived advantages of the specialist stream; knowledge and experience; increased recruitment; and commitment. Nursing directors are important stakeholders in educational preparation for practice in mental health settings. The research participants described many potential benefits to undergraduate specialisation. Their voice provides an important contribution to this issue.

Mental Health Practice in Geriatric Health Care Settings emphasizes the major research and clinical findings realized in five years of research on mental health issues in older urban medical patients, many of whom represent minority groups. Chapters cover the high comorbidity of health and mental health problems in geriatric patients, neuropsychological (or cognitive) assessment, depression, alcohol abuse in health care settings, emerging behavioral medicine issues, and family relations and their tie to medical settings. As a practitioner, you’ll find this book helps your practice by representing the first assessment and treatment techniques normed and validated on minority elderly. If you’re a professional working in the mental health system, you’ll see how to expand your services to health care markets.Mental Health Practice in Geriatric Health Care Settings devotes three chapters to neuropsychological assessment--first, a review of major principles; second, a new test battery for minorities; and third, extensive review on how to use test results in clinical decision making. Other chapters provide valuable information on: the analysis of outcomes for one thousand 60--103-year-olds a new validated behavioral treatment method for depression methods of detection and treatment of alcohol abuse emerging issues in behavioral medicine, including competency assessments; anxiety and pain disorders; and shaping the referral process family relations and health care, including caregiving and nursing home placement nursing home consultation and survival strategies in health care systemsAs Author Peter A. Lichtenberg describes in the Introduction, each chapter in Mental Health Practice in Geriatric Health Care Settings is multidisciplinary, empirically and statistically investigated, and focused upon urban elderly. &#8220;In addition, the major objectives are to provide clinicians with new understandings and new assessment and treatment knowledge to utilize in their practices. Finally, this book is hoped to provide clinicians [with] information about emerging trends in the field, and effective strategies for practice in healthcare settings.&#8221;

On the basis of activities of a federally funded national center for school mental health, review of literature on principles for best practice in child and adolescent mental health and school health, and consultation with national experts and family members, a set of 10 principles for best practice in school mental health was developed. A survey was developed enabling 1–6 point Likert ratings (“clearly unimportant” to “clearly important”) for each of the 10 principles. With an original sample of 426 people involved in education, school health or mental health, all 10 principles were strongly endorsed, receiving mean ratings ranging between 5.10 and 5.75. On the basis of qualitative feedback from this survey and interactive forums, language for 9 of the 10 principles was revised and a survey reflecting these changes was developed and administered to a validation sample of 86 respondents. As with the original sample, endorsements of the principles were strong, with mean ratings ranging between 5.45 and 5.79. Findings are discussed in relation to advancing interconnected agendas related to quality assessment and improvement and empirically supported practice in school mental health.

The future of occupational therapy in mental health has been a topic of reflection and debate. The Education and Research Board (now the Education and Practice Board) of the College of Occupational Therapists created a Working Group to develop a position paper on the way ahead for research, education and practice in mental health. Following consultation, the Working Group reviewed literature, examined current research and surveyed practitioners, managers and educators. From these findings, recommendations have been made which will create a firmer evidence base for the practice of occupational therapy in mental health, leading to a more effective use of the expertise of occupational therapists and an improved service for users.

The introduction of social constructionism to social work education has added an important dimension to traditional methods of social work pedagogy. This paper discusses several social constructionist principles relevant to the field of mental health and applies them to the contexualization of major issues in mental health practice. A model for teaching is proposed that integrates the voices of clients, families, and providers with several socially constructed dichotomies seen as historically and culturally relevant to current social work practice in mental health.