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Welfare Reform on the Web (December 2009): Mental health services - overseas

Health services, psychiatry and citizenship in a globalizing world: a perspective from Ireland

B.D. Kelly

Health Policy, vol. 93, 2009, p. 48-54

The late twentieth century saw the intensification of significant migration at a global level. There were notable increases in inward migration to the Republic of Ireland, which was traditionally accustomed to people leaving to settle abroad. Given human beings' profound attachment to culture, it seems reasonable that, in the case of transnational migration, host societies should co-operate with refugee and migrant groups in re-shaping public services to optimise their appropriateness to the shared linguistic heritage and historical traditions of such groups. This is particularly relevant to services that address complex states of psychological distress.

Integrating mental health into primary care in Sverdlovsk

R. Jenkins and others

Mental Health in Family Medicine, vol. 6, 2009, p. 29-36

Common mental disorders, especially depression, have gone largely undiagnosed by polyclinic staff and area doctors in Russia. This paper describes a multi-component initiative designed to facilitate the integration of mental health into primary care in Sverdlovsk oblast. The initiative comprised a detailed` situation appraisal, policy dialogues with oblast and federal bodies, design and implementation of a training programme for primary care doctors, adoption of the curricula by key bodies responsible for medical training, development of an oblast standard on depression, and adaptation and dissemination of the WHO primary care guidelines for mental disorders.

Integration of child mental health services to [sic] primary care: challenges and opportunities

V. Eapen and R. Jairam

Mental Health in Family Medicine, vol.6, 2009, p. 43-48

Professionals are currently faced with rapidly increasing need for child mental health services and changing models of provision. This provides a window of opportunity for the creation of new and improvement of existing services. This paper examines the challenges to, and opportunities for, integration of child mental health services into primary care.

Integration of mental health into primary health care in Uganda: opportunities and challenges

F.N. Kigozi and J. Ssebunnya

Mental Health in Family Medicine, vol.6, 2009, p. 37-42

This paper describes the opportunities for and challenges to the integration of mental health into primary care in Uganda, as identified by a larger study of the policy interventions required to break the vicious circle of mental ill health and poverty. A policy of integration of mental health into primary care has been developed at the national level, but not effectively implemented district health managers.

Psychiatrist-consumer relationships in US public mental health care: consumers' views of a disability system

S.J. Tanenbaum

Disability and Society, vol. 24, 2009, p. 727-738

The US public mental health service is a disability system, serving consumers who are seriously and chronically ill, functionally disabled and living on welfare benefits. This study explores, through focus groups, the perceptions of these consumers of their relationship with public sector psychiatrists. These relationships run the gamut of compliance, collaboration and contention. Psychiatrists are always significant in consumers' lives: some are valued and appreciated while others are tolerated or resented. It is argued that relationships would be improved and the likelihood of success of clinical care increased by the economic and political empowerment of consumers.

Removing barriers to work: building economic security for people with psychiatric disabilities

M. Morrow and others

Critical Social Policy, vol. 29, 2009, p. 655-676

The reform of the social welfare and mental health care systems in British Columbia has been guided by the tenets of neo-liberalism, that is, less government and more restrictive access to state welfare benefits. In order to qualify for disability benefits in this context, a person with mental health problems has to demonstrate their permanent inability to undertake paid work. There is no room for provision of the personal and social supports that might make paid work an option. However, economic security is essential for mental health recovery, and supported employment and social enterprises can offer work opportunities to people with psychiatric disabilities. Community-based supported employment programmes and the emerging social enterprise sector offer hope of inclusion to people with mental health problems outside the margins of government-sponsored services.

Working across borders to promote positive mental health and well-being

D. Heenan

Disability and Society, vol.24, 2009, p. 715-726

Recent reviews of mental health services in the North and the Republic of Ireland have demonstrated the need for urgent action. Years of neglect and underspending, coupled with ineffective and inappropriate strategies, have led to a crisis in Irish mental healthcare. The prolonged conflict in Northern Ireland contributed to the health and social disadvantages suffered by those living in the border regions. Communities living in both jurisdictions exhibited similar problems. The peace process and the political settlement in 1998 provided a framework for developing cross-border co-operation, but in the absence of high level political support little has been achieved. This research demonstrates that there is a willingness on the ground to develop existing synergies with a view to building sustainable networks and partnerships, but this has not been supported by appropriate funding, policies or strategies.

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