http://library.um.ac.id/free-contents/downloadpdf.php/buku/focus-groups-as-qualitative-research-by-morgan-david-l-11476.pdf

Focus groups as qualitative research / by Morgan, David L.

We test whether significant differences in mental illness exist in a matched sample of Mental illness and the criminal justice system. In T. L. Scheid T. N. Brown (Eds.), A handbook for the study of mental health: Social contexts, theories. Find 9780521567633 A Handbook for the Study of Mental Health : Social Contexts, Theories, and Systems by Horwitz et al at over 30 bookstores. Buy, rent. A review of mental health problems in fathers following the birth of a child. for the study of mental health:Social contexts, theories, and systems (2nd ed., pp.

A Handbook for the Study of Mental Health: Social Contexts, Theories, and Systems

This paper considers the contemporary use of focus groups as a method of data collection within qualitative research settings. The authors draw upon their own experiences of using focus groups in educational and 'community' user-group environments in order to provide an overview of recent issues and debates surrounding the deployment of focus group methods and to pick out specific areas of contention in relation to both their epistemological and practical implications. Accordingly, the paper reflects on some of the realities of 'doing' focus groups whilst, at the same time, highlighting common problems and dilemmas which beginning researchers might encounter in their application. In turn, the paper raises a number of related issues around which there appears to have been a lack of academic discussion to date.

Focus group method and methodology: current practice and recent debate

Objectives To describe models of integrated care used in the United States, assess how integration of mental health services into primary care settings or primary health care into specialty outpatient settings impacts patient outcomes and describe barriers to sustainable programs, use of health information technology (IT), and reimbursement structures of integrated care programs within the United States. Data sources MEDLINE, CINAHL, Cochrane databases, and PsychINFO databases, the internet, and expert consultants for relevant trials and other literature that does not traditionally appear in peer reviewed journals. Review methods Randomized controlled trials and high quality quasi-experimental design studies were reviewed for integrated care model design components. For trials of mental health services in primary care settings, levels of integration codes were constructed and assigned for provider integration, integrated processes of care, and their interaction. Forest plots of patient symptom severity, treatment response, and remission were constructed to examine associations between level of integration and outcomes. Results Integrated care programs have been tested for depression, anxiety, at-risk alcohol, and ADHD in primary care settings and for alcohol disorders and persons with severe mental illness in specialty care settings. Although most interventions in either setting are effective, there is no discernible effect of integration level, processes of care, or combination, on patient outcomes for mental health services in primary care settings. Organizational and financial barriers persist to successfully implement sustainable integrated care programs. Health IT remains a mostly undocumented but promising tool. No reimbursement system has been subjected to experiment; no evidence exists as to which reimbursement system may most effectively support integrated care. Case studies will add to our understanding of their implementation and sustainability. Conclusions In general, integrated care achieved positive outcomes. However, it is not possible to distinguish the effects of increased attention to mental health problems from the effects of specific strategies, evidenced by the lack of correlation between measures of integration or a systematic approach to care processes and the various outcomes. Efforts to implement integrated care will have to address financial barriers. There is a reasonably strong body of evidence to encourage integrated care, at least for depression. Encouragement can include removing obstacles, creating incentives, or mandating integrated care. Encouragement will likely differ between fee-for-service care and managed care. However, without evidence for a clearly superior model, there is legitimate reason to worry about premature orthodoxy.

Integration of Mental Health/Substance Abuse and Primary Care

Men and women experience different kinds of mental health problems. While women exceed men in internalizing disorders such as depression and anxiety, men exhibit more externalizing disorders such as substance abuse and antisocial behavior, which are problematic for others. These differences also vary by race and social class: for example, African Americans possess better mental health and, thus, a smaller gender gap in psychiatric problems. What explains these differences? We concentrate on conceptions of gender and gender practices. Research on gender and mental health suggests that conceptions of masculinity and femininity affect major risk factors for internalizing and externalizing problems, including the stressors men and women are exposed to, the coping strategies they use, the social relationships they engage in, and the personal resources and vulnerabilities they develop. This chapter investigates explanations in these areas for gender differences both in general and by race and class.

Gender and mental health.

Objective To explore the experience of providing and receiving primary care from the perspectives of primary care health professionals and patients with serious mental illness respectively.
 
Design Qualitative study consisting of six patient groups, six health professional groups, and six combined focus groups.
 
Setting Six primary care trusts in the West Midlands.
 
Participants Forty five patients with serious mental illness, 39 general practitioners (GPs), and eight practice nurses.
 
Results Most health professionals felt that the care of people with serious mental illness was too specialised for primary care. However, most patients viewed primary care as the cornerstone of their health care and prefer-red to consult their own GP, who listened and was willing to learn, rather than be referred to a different,GP with specific mental health knowledge. Swift access was important to patients, with barriers created by the effects of the illness and the noisy or crowded waiting area. Some patients described how they exaggerated symptoms ("acted up") to negotiate an urgent appointment, a strategy that was also employed by some GPs to facilitate admission to secondary care. Most participants felt that structured reviews of care had value. However, whereas health professionals perceived serious mental illness as a lifelong condition, patients emphasised the importance of optimism in treatment and hope for recovery.
 
Conclusions Primary care is of central importance to people with serious mental illness. The challenge for health professionals and patients is to create a system in which patients can see a health professional when they want to without needing to exaggerate their symptoms. The importance that patients attach to optimism in treatment, continuity of care, and listening skills compared with specific mental health knowledge should encourage health professionals in primary care to play a greater role in the care of patients with serious mental illness.

https://www.bmj.com/content/bmj/330/7500/1122.full.pdf

Patients' and health professionals' views on primary care for people with serious mental illness: focus group study

Background and Objectives: More than 30% of patients with serious mental illness in the United Kingdom now receive all their health care solely from primary care. This study explored the process of managing acute mental health crises from the dual perspective of patients and primary care health professionals. Methods: Eighteen focus groups involving 45 patients, 39 general practitioners, and eight practice nurses were held between May and November 2002 in six Primary Care Trusts across the British West Midlands. The topic guide explored perceptions of gold standard care, current issues and critical incidents in receiving/providing care, and ideas on improving services. Results: Themes relevant to the management of acute crisis included issues of process, such as access, advocacy, communication, continuity, and coordination of care; the development of more structured care that might reduce the need for crisis responses; and issues raised by the development of a more structured approach to care. Conclusions: Access to services is a complicated yet crucial feature of managing care in a crisis, with patients identifying barriers at the level of primary care and health professionals at the interface with secondary care. The development of more structured systems as a solution may generate its own ethical and pragmatic challenges.

Managing crisis:the role of primary care for people with serious mental illness

Aims This paper reports the evidence base and expert opinion on the abilities and organisational development needs of primary care trusts (PCTs) to commission mental health services. Methods Thirteen papers or reports relevant to the research aims were identified through the search strategy and twelve senior health service managers, clinicians and users (71% of those approached) agreed to the telephone interview. Results The evidence base on commissioning identified five key barriers to effective commissioning from a PCT perspective, including a lack of resources particularly time and money, staff training needs, a lack of priority for mental health and commissioning at the grass roots level, issues around effective partnership working and the need for strong and informed leadership. The evidence base also identified four key areas that PCTs need to address if they are to be fit for purpose in commissioning mental health services including infrastructure changes, a skills training programme, mechanisms to encourage greater partnership working and a development programme that includes the new primary care mental health workforce. Conclusions Although the evidence base suggests there are a number of barriers to overcome to achieve good quality PCT commissioning of mental health, many experts in the field are positive about the capacity and capability of PCTs to address the commissioning agenda and see it as an opportunity rather than a threat. PCTs now have the ability to commission locally focused and user-centred services that could lead to improved quality of life for a traditionally socially excluded sector of society.

http://mhfmjournal.com/open-access/barriers-and-organisational--development-needs-for-effective-primary-care-trust-commissioning-of-mental-health-services.pdf

Helen Sorohan

Papers

Patients' and health professionals' views on primary care for people with serious mental illness: focus group study

Managing crisis:the role of primary care for people with serious mental illness

Barriers and organisational development needs for effective primary care trust commissioning of mental health services

The role of the practice nurse in primary care mental health: Challenges and opportunities

illness: focus group study primary care for people with serious mental Patients' and health professionals' views on