NURS 7940-01: Final Scholarly Project I: Otterbein University
Evidence Worksheet
| Appendix A: Evidence Review Worksheet Assignment C | ||||||||
| Reinauer, C., Platzbecker, A. L., Viermann, R., Domhardt, M., Baumeister, H., Foertsch, K., Linderskamp, H., Krassuski, L., Staab, D., Minden, K., Kilian, R., Holl, R. W., Warschburger, P., & Meißner, T. (2021). Efficacy of motivational interviewing to improve utilization of mental health services among youths with chronic medical conditions. JAMA Network Open, 4(10), e2127622. https://doi.org/10.1001/jamanetworkopen.2021.27622 | ||||||||
| Conceptual framework or model | Design or method | Sample & setting | Major variables studied & their definitions if any | Outcome measurement(s) | Data analysis | Findings | Level of evidence | Quality of evidence: worth to practice |
| The study was based on the assumption that training healthcare workers in motivation training would improve the utilization of mental health services. | A cluster randomized clinical trial | The sample size was 164 youths with chronic illnesses, depression, and comorbid anxiety.
It was conducted in 10 pediatric practice centers. |
Independent variable- MI training for pediatricians  Struggling to meet your deadline ?Get assistance on NURS 7940-01: Final Scholarly Project I: Otterbein University done on time by medical experts. Don’t wait – ORDER NOW! Dependent variables- rates of uptake of psychological counseling, length of the interview, satisfaction from the interventions, and the type of mental health services utilized. |
Patient report on outcomes such as satisfaction with healthcare services, anxiety scores, and increased lengths in conversation. | Descriptive statistics, regression analysis, and logistic mixed-effects models were used. | The MI training did not significantly increase the uptake of psychological counseling compared with standard care. It was associated with increased periods of interview and decreased anxiety scores reported. | Level I | The randomized design and application of mixed-effects models described the clustering effects. The limitation is that a small sample size was used.
There are no associated risks or harms of implementing the study’s findings. The feasibility of the training relies on the resources available for training and implementation, the buy-in by healthcare providers, and patient participation. |
|
Reinauer, C., Platzbecker, A. L., Viermann, R., Domhardt, M., Baumeister, H., Foertsch, K., Linderskamp, H., Krassuski, L., Staab, D., Minden, K., Kilian, R., Holl, R. W., Warschburger, P., & Meißner, T. (2021). Efficacy of motivational interviewing to improve utilization of mental health services among youths with chronic medical conditions. JAMA Network Open, 4(10), e2127622. https://doi.org/10.1001/jamanetworkopen.2021.27622 The randomized clinical trial aimed to establish the efficacy of training workers in motivational interviewing to help increase the uptake of mental health services in the young population suffering from chronic illnesses. One hundred and sixty-four youths were involved in the study, and 10 pediatric centers were involved. However, the uptake rates of mental health services did not significantly improve after one year compared to giving these youths the usual care. More extended periods of conversation and lower anxiety scores were associated after the individuals were rescreened at 1 year. The study’s theoretical basis was that if workers were trained in motivational interviewing, the number of persons utilizing the healthcare services would significantly improve. Further studies are needed to determine the generalizability of the findings to other healthcare settings. |
||||||||
| Rugkåsa, J., Tveit, O. G., Berteig, J., Hussain, A., & Ruud, T. (2020). Collaborative care for mental health: A qualitative study of the experiences of patients and health professionals. BMC Health Services Research, 20(1). https://doi.org/10.1186/s12913-020-05691-8 | ||||||||
| Qualitative study | 7 general practitioners, 6 CMHC specialists, and 11 patients were included in the study.
The study was conducted in Oslo, Norway. |
The dependent variable was the patient and health professional experiences in the healthcare profession. The independent variable was the model of collaborative care. | Patient and healthcare experiences on the effectiveness of collaboration of care. | Stepwise deductive-inductive analysis of themes was used. | The study concluded that the patients and the healthcare professionals had positive experiences using the collaboration of care. | Level III | The study focused on the experiences of patients and professionals on the use of collaborative efforts in healthcare.
The limitations were that it used a small sample size. There is no identification of potential harms or risks associated with implementing the findings in the healthcare sector. |
|
| Rugkåsa, J., Tveit, O. G., Berteig, J., Hussain, A., & Ruud, T. (2020). Collaborative care for mental health: A qualitative study of the experiences of patients and health professionals. BMC Health Services Research, 20(1). https://doi.org/10.1186/s12913-020-05691-8
This qualitative study on the model involved psychiatrists and psychologists from a community mental institution in each general practice intervention. It explores the patient and professional experiences of the facilitators and barriers to collaboration in providing them with mental health services. |
||||||||
| Carbonell, Á., Navarro-Pérez, J. J., & Mestre, M. V. (2020). Challenges and barriers in mental healthcare systems and their impact on the family: A systematic integrative review. Health & social care in the community, 28(5), 1366–1379. https://doi.org/10.1111/hsc.12968 | ||||||||
| The study was informed by the barriers faced by different families in the mental health care systems and how they affect the utilization of the services. | Systematic Integrative Review of RCTs and Quasi-experimental Studies | Studies published with a peer-review process regardless of their study design and those published between 2015-2019 were included in the review.
The exclusion criteria were articles that were not peer-reviewed. |
The independent variables were the barriers and challenges faced by the healthcare system, while the dependent variable was the effect on the family. | The effects of the barriers and challenges on the family. | A narrative synthesis of the sources was done using inductive content analysis.
Open categorization was carried out to obtain the results. |
The review’s findings indicated that stigma associated with mental health issues limits the development of policies that guarantee the welfare of persons suffering from mental illnesses. It also established that the family system can help overcome the barriers and challenges faced by the healthcare system in providing high-quality mental healthcare. | Level II | The strength of this study is that it involved peer-reviewed articles from different sources.
No limitations were identified. |
| Carbonell, Á., Navarro-Pérez, J. J., & Mestre, M. V. (2020). Challenges and barriers in mental healthcare systems and their impact on the family: A systematic integrative review. Health & social care in the community, 28(5), 1366–1379. https://doi.org/10.1111/hsc.12968
The systematic review aimed to identify and analyze the barriers and challenges that influence the mental healthcare systems and how they impact families. The paper concludes that stigma associated with severe mental illnesses limits the development and adoption of policies that help to enhance the welfare of individuals suffering from these illnesses. It also notes that the family is one of the best resources to overcome the barriers and the barriers faced. |
||||||||
| Hansen, A. S., Telléus, G. K., Mohr-Jensen, C., & Lauritsen, M. B. (2021). Parent-perceived barriers to accessing services for their child’s mental health problems. Child and adolescent psychiatry and mental health, 15(1), 4. https://doi.org/10.1186/s13034-021-00357-7 | ||||||||
| The theoretical basis of this study was that most adolescents and children suffering from mental health issues are not in contact with specialized healthcare services. | Cross-sectional observation study | Parents of children aged 2 to 17 years with mental health issues were invited to participate in the study. Patients with unknown contact information were excluded. The study was carried out in North Denmark Region. | The dependent variable was the relationship between the barriers and challenges of accessing healthcare and the likelihood of children and adolescents accessing them. The independent variable was the barriers to accessing mental health services reported by the parents. | The ability of children and adolescents to access mental health services. | T-tests were conducted for continuous variables, and Fischer’s exact test was used for categorical variables. Logistic regression was used to identify the specific barriers associated with age and duration of the symptoms. | The study concluded that the most reason why these individuals did not have access to mental health services was that they did not have adequate information on where to seek these services; they also had a perception that most of the healthcare workers did not listen and that they were hesitant in referring them to other healthcare institutions. | Level III | The study’s strength is that it supplemented the quantitative data with qualitative information on why the parents endorsed a specific barrier.
The limitation is that it was a cross-sectional study and that the causality between access to mental health services and the parent-reported barriers could not be established. |
| Hansen, A. S., Telléus, G. K., Mohr-Jensen, C., & Lauritsen, M. B. (2021). Parent-perceived barriers to accessing services for their child’s mental health problems. Child and adolescent psychiatry and mental health, 15(1), 4. https://doi.org/10.1186/s13034-021-00357-7
This was a cross-sectional observational study carried out to identify the barriers parents perceived in accessing mental health services for their children and adolescents. Two hundred forty-four parents of children who were referred for outpatient psychiatric assessment were included in the study. The study aimed at identifying the potential areas that can be improved to increase healthcare utilization. Some perceived barriers identified included the long waiting times, stigma associated with mental health services, and lack of information about the services provided by the healthcare workers. |
||||||||
| Coombs, N. C., Meriwether, W. E., Caringi, J., & Newcomer, S. R. (2021). Barriers to healthcare access among U.S. adults with mental health challenges: A population-based study. SSM – Population Health, 15(PMC8214217), 100847. https://doi.org/10.1016/j.ssmph.2021.100847 | ||||||||
| Levesque’s conceptual framework was used. The study was conducted on the assumption that persons with complex mental health illnesses tend to be sophisticated patients, which may make the delivery of services difficult. | Cross-sectional study | Random adults with or without mental illnesses who had filled in the in-person survey administered to 35000 individuals were selected randomly from each household. Only American citizens were included in the study. | The primary independent variable was the mental health challenges, while the dependent variables were no usual source of care (NUSC) and barriers to healthcare. | The prevalence of barriers to healthcare among adult citizens in the U.S. with or without mental health challenges and the relationship between NUSC and mental health challenges. | Descriptive studies were applied in characterizing the sample under investigation.
Chi squares were used to establish the relationship between mental health care and the barriers to healthcare access. |
The study established that the most prevalent barrier to accessing health revolved around the affordability of the services. It also concluded that individuals experiencing mental health challenges were more predisposed to experiencing barriers in accessing healthcare and had no usual source of care compared to those who did not have these challenges. | Level III | The use of a large national dataset for the study was a strength. The limitations are that there is potential for self-reported data and recall bias.
The author provided no information concerning the harms and potential risks of using findings in the healthcare sector. |
| Coombs, N. C., Meriwether, W. E., Caringi, J., & Newcomer, S. R. (2021). Barriers to healthcare access among U.S. adults with mental health challenges: A population-based study. SSM – Population Health, 15(PMC8214217), 100847. https://doi.org/10.1016/j.ssmph.2021.100847
This was a population-based study of the prevalence of the barriers to accessing mental health services among persons with mental health challenges. The study established that individuals suffering from these mental health issues faced challenges in accessing healthcare secondary to logistical, financial, and social stigma. The authors suggest that the healthcare sector adopt relevant policies that champion addressing the existing barriers and enhance access to healthcare services for these vulnerable persons. |
||||||||
| Soltan, F., Cristofalo, D., Marshall, D., Purgato, M., Taddese, H., Vanderbloemen, L., Barbui, C., & Uphoff, E. (2022). Community-based interventions for improving mental health in refugee children and adolescents in high-income countries. The Cochrane Database of systematic reviews, 5(5), CD013657. https://doi.org/10.1002/14651858.CD013657.pub2 | ||||||||
| Phenomenological conceptual framework.
|
Systematic reviews of RCTs | The samples of the studies used in the review contained adolescent and child refugees who have received community-based mental health interventions.
These studies were conducted in school settings, temporary refugee shelters, accommodations, or camps. |
The independent variables were the health outcomes such as behavioral problems, PTSD, and symptoms of depression and anxiety.
The independent variables included the various components of community-based interventions such as art therapy, cognitive behavior therapy, and art therapy. |
The primary outcome measures were the symptoms of PTSD, depression, and behavioral problems. The secondary outcome measures were the satisfaction of the individuals with the intervention, participation, and functioning of the individuals, and the quality of life enjoyed. | RCTs used narrative synthesis. Data relating to the individuals’ characteristics were extracted. | The findings indicated that community-based mental health interventions could enhance the health outcomes of adolescent and child refugees in high-income countries.
The interventions can decrease symptoms of depression, anxiety and improve the overall well-being of the individuals. |
Level I | The systematic review includes randomized control trials (RCTs), considered a high-level type of evidence. It also had data from individuals with various characteristics, enhancing the findings’ generalizability. The limitation was that there was heterogeneity of the studies selected in terms of their interventions and the outcome measures employed, making it different to compare the findings of the various studies. |
| Soltan, F., Cristofalo, D., Marshall, D., Purgato, M., Taddese, H., Vanderbloemen, L., Barbui, C., & Uphoff, E. (2022). Community-based interventions for improving mental health in refugee children and adolescents in high-income countries. The Cochrane Database of systematic reviews, 5(5), CD013657. https://doi.org/10.1002/14651858.CD013657.pub2
The Cochrane Collaboration conducted a systematic review assessing the effectiveness of community-based strategies in improving the mental health status of children and adolescents in refugee camps in high-income countries. It includes 38 studies with diverse study designs, characteristics of the participants, and the interventions used. It concluded that community-based interventions could improve the health of individuals by decreasing the symptoms of PTSD, anxiety, and depression. The study is considered high-level evidence because it is a systematic review and reviews RCTs, also regarded as superior evidence. Some limitations of the study include heterogeneity of the different studies making it challenging to compare the results. More studies are required to confirm the study’s findings and identify effective interventions for improving the mental health of these individuals. |
||||||||
| DeSa, S., Gebremeskel, A. T., Omonaiye, O., & Yaya, S. (2022). Barriers and facilitators to access mental health services among refugee women in high-income countries: A systematic review. Systematic reviews, 11(1), 62. https://doi.org/10.1186/s13643-022-01936-1 | ||||||||
| N/A | Systematic review with RCTs and Quasi-experimental studies | Studies focused on the access to mental health services by refugee women were included in the systematic review. The sample size varied across the studies included in the systematic review. | N/A | The study aimed to identify barriers and facilitators these women face in accessing mental health services in these countries. There was no specific outcome measure determined. | A textual narrative synthesis was carried out, grouped by the study type, the objectives, the characteristics of the participants, and the outcomes. | The study identified several barriers to accessing mental healthcare services, such as language barriers, stigma, lack of trust in healthcare givers, legal status, financial constraints, lack of information about available services, and transportation issues.
Some of the facilitations included the availability of language translators, provision of culturally sensitive care, and education of the individuals about the available services. |
Level II | The study’s strengths include a comprehensive strategy to search for the documents, a thorough assessment of the articles, and a narrative synthesis approach.
The limitations are that it did not include studies from middle and low-income countries, limiting the generalizability of the findings. |
| DeSa, S., Gebremeskel, A. T., Omonaiye, O., & Yaya, S. (2022). Barriers and facilitators to access mental health services among refugee women in high-income countries: A systematic review. Systematic reviews, 11(1), 62. https://doi.org/10.1186/s13643-022-01936-1
This systematic review examined the facilitators and barriers to accessing mental health services among women who are refugees in high-income countries. Some of the barriers identified include language barriers, stigma, lack of trust in the services provided, lack of information about the available services, financial constraints, and issues with transportation, among others. The facilitators identified included the availability of translators and education of the individuals about the mental health services available. |
||||||||
| Quirke, E., Suvalo, O., Sukhovii, O., & Zöllner, Y. (2020). Transitioning to community-based mental health service delivery: Opportunities for Ukraine. Journal of market access & health policy, 8(1), 1843288. https://doi.org/10.1080/20016689.2020.1843288 | ||||||||
| The study focused on identifying the mechanisms of financing mental health care that can be adopted to enhance the delivery of mental health services. | Systematic review with RCTs and Quasi-experimental studies | A total of 66 sources were included. The settings of the study were in Ukraine and focused on Eastern European countries | N/A | The potential changes to the financing and organization of mental health services in the government would facilitate the delivery of the services in community settings. | Literature reviews | The study established that increased funding of the healthcare sector could improve the effectiveness of community-based interventions in increasing the accessibility of mental health services. | Level II | The strength is that the study included articles from different sources, such as peer-reviewed journals. |
| Quirke, E., Suvalo, O., Sukhovii, O., & Zöllner, Y. (2020). Transitioning to community-based mental health service delivery: Opportunities for Ukraine. Journal of market access & health policy, 8(1), 1843288. https://doi.org/10.1080/20016689.2020.1843288
This was a systematic review of the potential changes the government would make on the financing and organization of the health system that would improve the delivery of mental health services to the communities. It concluded that increased funding would increase the availability of resources to ensure that healthcare workers offer these individuals high-quality mental health services. |
||||||||
| Killaspy, H., Harvey, C., Brasier, C., Brophy, L., Ennals, P., Fletcher, J., & Hamilton, B. (2022). Community-based social interventions for people with severe mental illness: A systematic review and narrative synthesis of recent evidence. World Psychiatry: Official journal of the World Psychiatric Association (WPA), 21(1), 96–123. https://doi.org/10.1002/wps.20940 | ||||||||
| The study’s theoretical basis was to explore whether the effects of an intervention vary depending on the population under study and identify the factors that may affect the findings of these studies. | A systematic review of RCTs | The authors reviewed 336 papers.
The inclusion criteria were those studies that explored community-based social interventions for individuals above 18 suffering from severe mental illnesses (SMI). The exclusion criteria were those studies conducted in other environments besides the community settings. These studies focused on people with depressive or anxiety disorders and never reported significant findings on any pertinent social outcomes. |
The dependent variables were social outcomes such as community-based social interventions for the individuals such as schizoaffective disorder, bipolar disorder, and major depressive disorders with psychotic features. | The level of satisfaction, acceptability, and engagement of the individuals after implementing the community-based social interventions. | The authors included a diverse range of quantitative, qualitative, and mixed methods research reporting on the effectiveness and implementation of interventions. | The study concluded that implementing community-based social interventions for persons with SMI effectively improved the social outcomes of the individuals, such as the quality of life, social networks, social functioning, and social support. The authors recommend that community-based models of care and strategies to support social inclusion should be adopted in mental health systems. | Level I | The limitations were that majority of the studies were heterogenous, making it difficult to compare the results. |
| Killaspy, H., Harvey, C., Brasier, C., Brophy, L., Ennals, P., Fletcher, J., & Hamilton, B. (2022). Community-based social interventions for people with severe mental illness: A systematic review and narrative synthesis of recent evidence. World Psychiatry: official journal of the World Psychiatric Association (WPA), 21(1), 96–123. https://doi.org/10.1002/wps.20940
The article is a systematic literature review focused on community-based social interventions for adults battling severe mental illnesses. The authors conclude that these social interventions are essential in improving social support, social networks, quality of life, and the overall functioning of the individuals. The heterogeneity of the studies made it challenging to compare the findings of the studies included in the systematic review. The authors recommend that to achieve positive mental health outcomes in these individuals, the government should adopt and prioritize community-based models of care. |
||||||||
| Tawfik, D. S., Scheid, A., Profit, J., Shanafelt, T., Trockel, M., Adair, K. C., Sexton, J. B., & Ioannidis, J. P. A. (2019). Evidence relating health care provider burnout and quality of care: A systematic review and meta-analysis. Annals of internal medicine, 171(8), 555–567. https://doi.org/10.7326/M19-1152 | ||||||||
| The study’s theoretical basis was that healthcare worker burnout negatively influenced patient care quality. | A systematic review of quasi-experimental studies | 123 publications that consisted of 142 different study populations were included in the systematic review. 241,553 healthcare workers were included in the studies. | The independent variable was worker burnout, while the quality of care was the primary dependent variable. | The outcome measures were self-reported errors, the quality of care, and low scores in patient safety. | Two reviewers independently selected studies, extracted measures of association between burnout and quality of care, and assessed potential bias using the Ioannidis (excess significance) and Egger (small-study effect) tests. The study used a random-effects model to estimate summary associations between burnout and quality of care | The study concluded that burnout in healthcare workers was associated with the commission of errors, poor quality of care, reduced patient satisfaction, and decreased patient safety. | Level I | the strength of the study is that it included a large sample size of healthcare workers, and statistical tests were applied to assess potential bias.
The limitation was that most of the studies included in the review were observational and cross-section, making it difficult to determine causality. |
| Tawfik, D. S., Scheid, A., Profit, J., Shanafelt, T., Trockel, M., Adair, K. C., Sexton, J. B., & Ioannidis, J. A. (2019). Evidence relating health care provider burnout and quality of care: A systematic review and meta-analysis. Annals of internal medicine, 171(8), 555–567. https://doi.org/10.7326/M19-1152
The article is a systematic literature review that estimates the relationship between the exhaustion of healthcare workers and the quality of care provided to patients. It concluded that healthcare provider burnout led to increased patient safety incidents, inferior quality of care, and reduced satisfaction of the patients. The authors also established that there was evidence of bias in the report, which crippled the replication of the findings in other realms of healthcare. It also recommends the essence of further studies to establish effective interventions that can help to decrease burnout experienced by healthcare workers and how the outcomes of the patients can be improved. |
||||||||
| Key themes
1. Barriers and challenges to the accessibility of Mental Health and Psychiatric services 2. Strategies to improve Mental Health Services utilization 3. Community-based interventions for persons suffering from Severe Mental Illnesses (SMI) |
||||||||
BUY A PLAGIARISM-FREE PAPER HERE
Introduction
Communities with ethnic and racial disparities, low socioeconomic status, and isolated geographically often face barriers to accessing mental and psychiatric services. In clinical practice, healthcare workers have ensured that these communities are engaged and provided adequate mental health services. They have served as educators, providers of comprehensive services, and advocates of these communities. There is a collaboration between different healthcare workers in developing culturally sensitive interventions based in the communities to promote mental health in these individuals. In the future, nurses can rely on technology such as telehealth to help reduce the geographical gaps in access to high-quality mental health services. Suppose the access to mental health services for underserved communities is addressed. In that case, the overall mental wellness of these individuals will improve, and there will be equity in the access to services by all, regardless of geographical location or socioeconomic status.
General Problem
The general problem is that there are people still unable to access mental health services despite the increased awareness raised by healthcare workers. The situation necessitates that the nursing practice focuses on the advocacy and engagement of patients and communities unable to access mental and psychiatric health services (Kates et al., 2019). Healthcare workers must build trust and good therapeutic relationships with patients to provide culturally sensitive services. They also need to deeply understand these individuals’ challenges and tailor the interventions accordingly to meet their unique needs (Purtle et al., 2020). If the community members are engaged, the nurses can identify their challenges and increase awareness about mental health, helping to promote early prevention and diagnosis of mental health issues (Purtle et al., 2020). This approach can help to empower the communities to take charge of their health.
Communities and patients that do not have access to mental and psychiatric services often delay being diagnosed, receive inadequate treatment for their conditions, and do not have access to support for their health conditions. They are likely to experience severe symptoms of the illnesses, prolonged hospitalizations, and a reduction in overall well-being (Carbonell et al., 2020). Through timely, appropriate interventions, their health can be improved. The overall quality of life and a reduction in the relapse of mental health conditions can be achieved through coordination of care and patient education.
When individuals cannot access mental and psychiatric services, there is a rise in healthcare disparities, which can later burden healthcare organizations. When the conditions are not prevented and diagnosed early, individuals will seek healthcare services in the emergency departments or present to the other hospital departments with severe acute symptoms of the disease (Kates et al., 2019). The latter increases the healthcare workers’ workload, increases healthcare costs, and challenges the institution in providing high-quality services to the patients (Kates et al., 2019). Addressing this problem can help reduce unnecessary hospitalizations and decrease costs associated with care.
The Problem of Interest
The specific problem is limited access to and underutilization of mental and psychiatric health services in underserved communities. This problem has perpetuated disparities the communities face in access to healthcare services. The communities are unable to access holistic and equitable services. The current nursing practice focuses on providing individuals with care in traditional healthcare settings like hospitals and clinics. Even though most individuals can access services from these settings, those living in geographically isolated areas may fail to benefit from these services. Some barriers that increase the inaccessibility to healthcare services include stigmatization surrounding mental health services, lack of means of transportation and financial constraints these individuals face (Coombs et al., 2021). A culturally sensitive and comprehensive approach to address this problem is also lacking.
The healthcare workers have not understood the unique economic, social, and cultural challenges facing underserved communities, which is essential to tailoring interventions to meet their healthcare needs. The current allocation of resources to the healthcare systems does not help bridge the gap in access to healthcare services. The current practice has overlooked community-based preventive approaches to mental health conditions. People have to rely on emergency departments to manage their conditions and when seeking follow-up services, which places a burden on the healthcare system and impedes the provision of high-quality services.
Identification of the Problem of Interest
A needs assessment, objective analysis of data, and evaluation of different outcomes relating to the quality, allocation of resources, and satisfaction of the patients were carried out. A needs assessment is essential to understand the needs of the individuals in the underserved communities. Quantitative and qualitative data is gathered from different healthcare providers, community members, and relevant organizations in the communities. Some barriers to access to healthcare services identified include lack of transportation, financial constraints, geographical isolation of the communities, and cultural stigmatization. Health utilization patterns, epidemiological reports, and data on health disparities were utilized in objective data analysis to provide a quantitative image of the disparities in access to mental health services. There was an apparent disproportionate representation of the communities regarding the high frequency of emergency department visits for individuals with mental health issues, delayed diagnoses, and limited follow-up care.
Incident reports and staff survey analysis were used to assess the impact of limited access to mental health services on the satisfaction and safety of the patients. There were higher frequencies of adverse events, reduced morale of the healthcare workers, and high dissatisfaction among the patients in the underserved communities. The current practice and allocation of resources were assessed to ascertain if it is evidence-based and if the resources are utilized effectively. Literature was reviewed to provide more information on addressing the problem. There is a need for culturally sensitive services, community-based interventions, and telehealth to enhance community access to healthcare services (Cleary et al., 2019). Financial analysis to assess the impact of the limited access to services indicated that potential financial savings could be achieved if the access to mental health services in underserved communities is increased.
Parameters of the Problem
The parameters of the limited access to mental health services in underserved communities entail the population impacted and the healthcare system. Healthcare workers are affected as they try to ensure that they provide patients with holistic and equitable care to all individuals. They have to ensure that they use the limited resources efficiently, address the issues of stigmatization and develop strategies that increase the engagement of the affected communities (Cleary et al., 2019). Patients in underserved communities directly face the effects of limited access to mental health services. They face a delay in diagnosing their conditions, difficulty getting support in managing their condition, and limited treatment options (Kassam et al., 2021). They are likely to face severe symptoms, a reduction in overall well-being, and an increase in readmission rates.
The support systems and families of the patients may face burdens in ensuring that their loved needs get the essential care they need; they may be drained emotionally and financially while doing this (Carbonell et al., 2020). Healthcare institutions are forced to deal with the workforce shortage, limited allocation of resources, and the development of essential interventions to address the disparities in accessing healthcare services. The financial constraints make it challenging for these institutions to provide high-quality, comprehensive care to the communities.
Conclusion and Transition
Limited access to mental and psychiatric health services in underserved communities negatively impacts the safety of the patients. A delay in access to health services can lead to severe symptoms of the condition, increase the risk of self-harm and make the patients vulnerable to crises. If the individuals in these communities do not receive timely interventions, they will likely face poor mental health outcomes and develop adverse events. The quality of care provided to these communities is likely to be affected. Lack of culturally sensitive approaches, inadequate follow-up care, and insufficient treatment options contribute to poor health outcomes (Cleary et al., 2019).
Patients with mental health conditions suffer for an extended time, have decreased overall well-being, and face reduced functionality. More resources will be required to provide sophisticated care when patients present with severe conditions at the hospitals. The healthcare system is burdened, the available resources are strained, and the financial costs associated with care increase. Limited access to services has physical, emotional, and spiritual effects on the community members. The impact of the mental health condition on their well-being and self-care can ultimately affect their physical health, making them less functional.
The significant effects of the limited access to healthcare services in underserved communities necessitate an evidence-based practice and quality improvement project. This project can help to improve the safety of the patients, increase the quality of care, promote the overall well-being of the individuals, and decrease the costs associated with care. By addressing the barriers to access to mental and psychiatry health services, implementing evidence-based interventions, and ensuring that the services are culturally sensitive, the EBP/QI project can increase the satisfaction of the patients, improve their overall health and ensure that there is equitable access of healthcare services to all individuals regardless of the geolocation or socioeconomic status.
PICOT Question
In underserved communities facing limited access to mental and psychiatry health services (P), what is the effect of community-based strategies and interventions (I), compared to the provision of healthcare services in traditional hospital settings (C), on access to comprehensive and timely mental and psychiatry health services (O) within one year (T).
References
Carbonell, Á., Navarro‐Pérez, J., & Mestre, M. (2020). Challenges and barriers in mental healthcare systems and their impact on the family: A systematic integrative review. Health & Social Care in the Community, 28(5), 1366–1379. https://doi.org/10.1111/hsc.12968
Cleary, M., West, S., Arthur, D., & Kornhaber, R. (2019). Change management in health care and mental health nursing. Issues in Mental Health Nursing, 40(11), 1–7. https://doi.org/10.1080/01612840.2019.1609633
Coombs, N. C., Meriwether, W. E., Caringi, J., & Newcomer, S. R. (2021). Barriers to healthcare access among U.S. adults with mental health challenges: A population-based study. SSM – Population Health, 15, 100847. https://doi.org/10.1016/j.ssmph.2021.100847
Hartley, S., Raphael, J., Lovell, K., & Berry, K. (2020). Effective nurse-patient relationships in mental health care: A systematic review of interventions to improve the therapeutic alliance. International Journal of Nursing Studies, 102(1). https://doi.org/10.1016/j.ijnurstu.2019.103490
Kassam, S., Serrano-Lomelin, J., Hicks, A., Crawford, S., Bakal, J. A., & Ospina, M. B. (2021). Geography as a determinant of health: health services utilization of pediatric respiratory illness in a Canadian province. International Journal of Environmental Research and Public Health, 18(16), 8347. https://doi.org/10.3390/ijerph18168347
Kates, N., Arroll, B., Currie, E., Hanlon, C., Gask, L., Klasen, H., Meadows, G., Rukundo, G., Sunderji, N., Ruud, T., & Williams, M. (2019). Improving collaboration between primary care and mental health services. The World Journal of Biological Psychiatry, 1–18. https://doi.org/10.1080/15622975.2018.1471218
Purtle, J., Nelson, K. L., Counts, N. Z., & Yudell, M. (2020). Population-based approaches to mental health: history, strategies, and evidence. Annual Review of Public Health, 41(1), 201–221. https://doi.org/10.1146/annurev-publhealth-040119-094247
Struggling to meet your deadline ?
Get assistance on
NURS 7940-01: Final Scholarly Project I: Otterbein University
done on time by medical experts. Don’t wait – ORDER NOW!