Quantitative impact of mental health preparedness training for public health professionals

Coordinating and integrating mental health topics into emergency preparedness planning is a critical step for ensuring effective response to the psychological issues connected with trauma. In order to remedy the current lack of integration, potential response providers must receive effective mental health preparedness training. The current study provided mental health preparedness training to public health and allied health professionals in Kansas and assessed the impact of the training on perceived mental health preparedness knowledge. Participants included 157 potential first and secondary responders from public health and allied fields who attended one of 10 training presentations on mental health emergency preparedness. Pre- and post-presentation, participants responded to six Likert-scale questions about their perceived knowledge of topics and level of mental health preparedness. Questions addressed common psychological responses to disaster or terrorist events, stress reactions of specific populations, psychological resiliency, mental health preparedness integration, and level of agency preparedness. Post-training, participants reported statistically significant (p<0.001) increases in perceived level of knowledge on all topics. Participants were also significantly more likely (p<0.001) to report that their agency could respond to the mental health issues related to a disaster or emergency. The current study provides data about gaps in practitioner knowledge regarding mental health preparedness in Kansas. While the self-report nature of responses is a limitation, these findings serve as the first step toward producing and implementing effective mental health preparedness information and training on a wide scale.     

Dream work with children: Perceptions and practices of school mental health professionals.

In this study, 49 public school mental health practitioners (school counselors, school psychologists, and school social workers) completed a survey about working with students’ dreams. The majority of these practitioners reported having at least one student bring up dreams during counseling, more frequently with troubling dreams and nightmares or when coping with grief. Results showed that practitioners were less likely to talk about dreams with students who had been identified with an adjustment disorder, psychosis, or eating disorder; those who were oppositional or ill; and those who struggled with substance abuse problems. Although most practitioners did not feel competent working with children’s dreams and reported minimal training in dream work, they were interested in learning more about children’s dreams and potential uses of dream work in supportive counseling. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Distribution of mental health professionals working on site in English and Welsh general practices.

OBJECTIVE--To describe the nature and distribution of mental health professionals working on site in general practices. DESIGN--Postal questionnaire and telephone interview survey. SETTING--English and Welsh general practices. SUBJECTS--1880 general practitioners, of whom 1542 (82%) responded. MAIN OUTCOME MEASURES--Prevalence, types, and distribution of mental health professionals working on site among general practices. Factors predicting the presence of mental health professionals on site. RESULTS--The number of practices reporting the presence on site of each type of professional were 528 for community psychiatric nurses; 266 for practice counsellors; 177 for clinical psychologists; 132 for psychiatrists; 96 for psychiatric social workers; and 45 for psychotherapists. Mental health professionals tended to cluster together in practices more often than expected by chance alone. Practice characteristics which independently predicted the presence of a mental health professional on site were having four or more partners; being a training practice; and running stress, bereavement, or other mental health clinics. The proportions of practices with mental health professionals on site varied significantly among health regions. There was no association between the presence of mental health professionals on site and the location of practices, the social class mix of patients, or the estimated percentage of elderly patients or patients of non-European origin. CONCLUSIONS--Mental health professionals tend to cluster together, with a preponderance in larger training practices. Specialist mental health care provision within general practices is unevenly distributed. Further research is needed to determine whether this uneven distribution reflects differences in need or inequalities in the provision of mental health services.     

Alternative models of organisation are needed.

Anyone considering a fundamental rethink of the role of consultants risks exposing tensions in the medical profession that have characterised the development of medical practice since the 18th century. That tense story was one of beds and money, power and domination. Rethinking the role of consultants must now take into account the relationship between consultants and their specialist colleagues and general practitioners; examine the distribution of work between consultants and junior doctors; and relate the contribution of the consultant as specialist to that of other health professionals. After half a century of a national health service characterised by equity of access to care, we urgently need to debate the roles of those who work in it and in doing so to focus primarily on the needs of patients.