Which Mental Health Service Is An Advanced-level Function?
The WHO "Guidance on community mental health services: promoting person-centred and rights-based approaches", released in June 2021, provides examples of community-based mental health care that is both respectful of human being rights and focused on recovery.
Here are some examples.
Community outreach services
Atmiyata, India
Atmiyata is a community volunteer service that identifies and supports people experiencing distress in rural communities of Gujarat state in western Bharat.
The Gujarat branch of Atmiyata was established in 2017 in the Mehsana commune of Gujarat state, dwelling house to 1.52 million people and 645 villages, following a successful pilot project in 41 villages of Maharashtra State in 2013-2015.
Volunteers have the following roles: to enhance sensation in the customs well-nigh mental health issues; to place individuals experiencing distress and provide 4-half-dozen sessions of counselling; to refer people who may accept a severe mental health condition to the public mental health service; and to support people in need with access to social care benefits.
Atmiyata Gujarat was evaluated in 2017 over a period of eight months using a stepped wedge cluster randomized controlled trial. Results showed that recovery rates for people experiencing distress were clinically and statistically higher in people receiving support from the Atmiyata service compared with the control. Improvements in depression, feet, and overall symptoms of mental distress were seen after iii and eight months. Significant improvements in functioning, social participation and quality of life were reported at the end of viii months.
Atmiyata Gujarat was initially funded by Grand Challenges Canada merely at present receives support from Mariwala Health Initiative, in partnership with Altruist, a local non-governmental organisation funded past the Regime of Gujarat and TRIMBOS Institute.
Credit: Amiyata, Gujarat
Community-based mental health centres
CAPS, Brazil
In Brazil, community-based mental health centres are known as Centro de Atenção Psicosocial (CAPS). They are the cornerstone of the community-based mental wellness network and are well integrated at the principal care level. CAPS III services cater for adults every bit well as children and adolescents and provide 24-hr service in areas with a population greater than 150 000.
CAPS 3 Brasilândia operates 24 hours a day, 7 days a week. The service is managed past the social system, Family unit Health Association (Associação Saúde da Família). Like all CAPS III services, the centre provides continuous, tailored customs-based mental health care and support, including crunch services.
CAPS III Brasilândia is designed to create a construction and environs similar to that of a home. Structurally, the centre has indoor and outdoor common areas for socializing and interacting with others, a dining area, private counselling rooms, a group activities room, chemist's shop, and female and male person dorms, each with four beds, where people who are in crisis or need respite can stay for up to xiv days. The eye also holds activities and events in the customs using public spaces such as parks, customs leisure centres and museums.
A 2020 evaluation of CAPS 3 Brasilândia plant that the services offered are consistent with a human rights and recovery-oriented approach. The Eye has as well been assessed using the World Wellness Organization'south QualityRights assessment toolkit and was evaluated as fully compliant with all WHO cardinal standards, including the physical and social environment of the service, quality of care, respect for informed consent to admission and treatment, not-use of coercive practices and the promotion of customs inclusion for people using the service.
CAPS services are delivered and funded under the Unified Health Arrangement of Brazil with no cost to users. Operational costs (50-70% of total cost of service) are covered by the federal government with the remainder provided past the municipality.
Credit: CAPS, Brazil
The Aung Clinic is a community-based mental health service located in Yangon, Myanmar. The Dispensary provides emergency drib-in services to long-term therapy and offers an extensive range of support activities for people with mental health conditions and psychosocial disabilities. The service supports over 200 individuals and their families per year and is the only service of its kind in the country.
The Aung Clinic receives people experiencing a range of mental health conditions, such as depression, bipolar disorder, post-traumatic stress disorder, psychosis and substance use disorders. The Clinic is open daily for treatment and provides outreach services to individuals and their families, with follow-up by phone and online back up if needed. Emergencies are responded to outside of regular hours and on weekends.
People are welcome to attend during the day, including those who are homeless, just there are no overnight stays. By spending daytime hours at the clinic, people in crisis are frequently able to avoid hospitalization.
The Clinic conducts assessment and offers private counselling, group therapy, medication, vocational skills preparation and peer support groups for service users and their families. Talk therapy, family therapy and mindfulness are all used. The Clinic also advocates for the rights of people with mental health weather and psychosocial disabilities, working closely with schools, employers, and local organizations.
An unpublished 2020 qualitative evaluation of 20 people visiting the Clinic indicated positive results. The art therapy and group therapy sessions were seen to exist particularly valuable. Service users spoke of finding credence at the Clinic and feeling more able to manage mental wellness weather condition since attending.
The Aung Clinic is a not-turn a profit service; its services are provided complimentary to users. It opened in 2010 without external funding and has expanded in recent years with funding from the Open Society Foundations.
Credit: Aung Clinic, Myanmar
Crisis services
Tupu Ake, New Zealand.
Tupu Ake is a peer-led, crisis admission service located in Papatoetoe, a suburb of South Auckland, offering brusque stays and a 24-hour interval support programme.
Tupu Ake was established as a airplane pilot recovery house service in 2008 by the nongovernmental organization, Pathways Health, a national provider of community-based mental health services and one of the outset mental health services in New Zealand to provide an alternative to infirmary access. Serving a region of 512 000 people, Tupu Ake offers short stays of upwards to i week for a maximum of 10 people, and a twenty-four hours back up plan for up to v people.
An contained evaluation was conducted in 2017 based on qualitative interviews with service users and other stakeholders including staff from Tupu Ake, Pathways and the District Wellness Board. The results showed people using the service experienced positive outcomes in terms of levels of self-decision and an increased power to cope with their experiences. Guests reported higher levels of satisfaction with care and shorter average lengths of stay at Tupu Ake than infirmary inpatient units. The evaluation highlighted the positive role Tupu Ake played in repairing relationships with family unit and social networks, and the welcoming environment provided by the villa and grounds.
Tupu Ake is gratis of accuse to individuals using the service equally it is fully funded by New Zealand's public wellness organisation.
Credit: Wise Management Services Ltd, courtesy of Tupu Ake
Hospital-based services
BET Unit of measurement, Norway
Previously part of the locked psychosis unit at Blakstad Hospital, a large urban psychiatric hospital in Asker, Kingdom of norway, in 2018, the BET Unit of measurement became an independent open-door service available 24 hours a day, seven days a week. The unit is equipped with six beds and provides treatment and support to an average of 6-10 people per month. The service has most twenty employees, including a psychiatrist and two psychologists. Treatment includes group and private sessions and physical activeness. Most individuals living close by go home every weekend.
Typically, people referred to the BET Unit – past general practitioners, outpatient clinics and inpatient wards from other hospitals – have previously experienced numerous or lengthy intensive inpatient admissions, without improvement. Many have received multiple diagnoses, from psychosis to personality disorders, have had a substance utilise disorder, have repeatedly self-harmed or attempted suicide, take used multiple psychotropic drugs for prolonged periods of time, or take been subject area to coercive interventions in mental health services.
The BET concept invites individuals to acknowledge and accept frightening thoughts and feelings, and manage them with more functional coping strategies, rather than relying on avoidance strategies such equally self-impairment, inactivity and hyperactivity, starvation and overeating, dissociation, and harmful utilize of legal and illegal drugs.
A 2017 study constitute that individuals who used the service had fewer admissions to psychiatric and full general hospitals in the 12-month period after belch from BET, compared with the 12-month period before access. Ane qualitative study of users of the BET Unit found that participants displayed fewer symptoms of mental health conditions, a significantly improved level of functioning and had re-established connections with their families. Some had restarted teaching or returned to work. Some had stopped using medication birthday.
The BET service has been publicly funded for 20 years as part of the public wellness care system.
Peer support services
Users and Survivors of Psychiatry, Kenya
Users and Survivors of Psychiatry in Kenya (USP-K) promotes and advocates for the rights of persons with psychosocial disabilities through peer back up to its members and training on cocky-advancement and man rights.
Since its inception in 2012, USP-K peer support groups take expanded to xiii groups in six counties beyond Kenya.
Equally an example, the Nairobi Mind Empowerment Peer Support Grouping brings together individuals with lived experience of mental health conditions or psychosocial disabilities.
The group supports people in becoming autonomous in their decision-making and 24-hour interval-to-twenty-four hour period lives by helping people to think through and make decisions nigh their employment situation, living arrangements and wellness care and treatment. The group also helps members access social and disability benefits and economic empowerment programmes. It supports them through mental health crises and helps them programme for potential future crises in a way that ensures that the utilise of coercive measures or practices are avoided.
Independent qualitative inquiry on the USP-K Nairobi Mind Empowerment Peer Support Grouping involved observations of peer support group meetings, focus group discussions and interviews with carers and USP-K staff. The study plant that the peer back up groups and members specifically promoted members' agency and autonomy.
The USP-Grand umbrella arrangement provides initial seed funding for new groups for the beginning two to three years.
Supported Living Services
KeyRing, United kingdom of great britain and northern ireland of Uk and Northern Republic of ireland
KeyRing was established in 1990 to provide time-limited independent simply supported living arrangements for people experiencing mental wellness conditions. Today KeyRing has more than a hundred networks in about l local authority areas across England and Wales. Networks of support consist of 10 or more ordinary homes located inside walking distance of each other. Housing is either rented from local government or housing associations or endemic past members.
Each network ensures that KeyRing members accept control and responsibility over their lives by living in a place of their own, as well equally contributing and beingness continued to their local community.
Customs volunteers live in KeyRing accommodations inside the network location and provide support to members with day-to-day activities, such equally managing bills and budgeting and accompanying them to appointments for education and employment. Community Connections Volunteers share their cognition and skills and with network members.
Since the first evaluation in 1998, KeyRing has consistently received positive reviews of the quality of its service and its cost-effectiveness. A 2018 evaluation by the Housing Learning and Improvement Network concluded that each yr the presence of the KeyRing networks led to: 30% of members avoiding a psychiatric inpatient admission; 30% fewer cases of homelessness; 25% of members no longer requiring weekly visits from community psychiatric nurses or social workers/intendance coordinators; and 20% of members no longer requiring weekly drug/substance misuse worker visits.
The service is funded by the social care upkeep of UK local authorities, which is allocated by the cardinal government. Since cuts to central government funding in 2010, other sources of funding have been sought to finance the service. People using the service also contribute, if their income is above a certain threshold.
Credit: Sean Kelly for KeyRing Living Support Networks
Source: https://www.who.int/news-room/feature-stories/detail/community-based-mental-health-services-using-a-rights-based-approach
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