Biomedical subjects

Harry Minas

Publications and source records attributed to Harry Minas.

7 recordsLinked to original sources

PubMed2006

Ethnic minority community patients and the Better Outcomes in Mental Health Care initiative.

OBJECTIVE: To compare general practitioners registered under the Better Outcomes in Mental Health Care initiative (BOiMHC) and those not registered, in addressing mental disorders in members of ethnic minority communities (EMCs). METHODS: We conducted a cross-sectional survey of 597 Melbourne metropolitan general practitioners, leading to 311 meeting criteria for having seen EMC patients with a mental disorder in the last 3 months. Comparisons were made between those registered (n = 61) and those not registered (n = 205) within the BOiMHC on measures of difficulties in: accessing bilingual allied health, accessing interpreters, accessing translated materials, patient compliance, accessing guidelines for working effectively with interpreters, accessing guidelines on cultural and migration factors affecting mental health. RESULTS: Significantly less of those registered in the BOiMHC endorsed problems of access to bilingual allied health, interpreters and translated materials compared with those not registered. No differences between groups were observed in relation to access to guidelines and patient compliance. Those registered with the BOiMHC reported significantly less problems than those not registered. The most prevalent problems of the full sample included lack of access to bilingual allied health (70%), access to translated materials (58%) and low EMC patient compliance with mental health assessment and treatment (64%). CONCLUSIONS: Possible impacts of the BOiMHC appear to be modest in relation to EMC patients with mental disorders. The BOiMHC may require additional strategies for its application to EMCs, especially for patient engagement in mental health assessment and treatment. There is a need for a more comprehensive evaluation of EMC issues within the BOiMHC.

Allied Health Occupations↗

PubMed2006

Cultural attribution of mental health suffering in Chinese societies: the views of Chinese patients with mental illness and their caregivers.

AIMS AND OBJECTIVES: This study examined the cultural attribution of distress in the Chinese, the special role of the family in distress and the specific emotional reactions within distress dictated by culture. METHODS: This phenomenological study illustrated the narrative representation of the experiences of suffering by the Chinese patients with mental illness. Twenty-eight Chinese-Australian patients and their caregivers were interviewed together in their homes. They were invited to talk about the stories of the patients' experiences of suffering from mental illness. The interviews were recorded and transcribed to be further analysed according to the principles of narrative analysis. RESULTS: The results of case narration indicated that (1) because of the influence of Confucian ideals, interpersonal harmony was the key element of maintaining the Chinese patients' mental health, (2) Chinese patients' failure to fulfil cultural expectations of appropriate behaviours as family members contributed to disturbance of interpersonal relationships and (3) Chinese patients' failure to fulfil their familial obligations contributes to their diminished self-worth and increased sense of guilt and shame. CONCLUSIONS: The findings of the present study suggest that Chinese people's well-being is significantly determined by a harmonious relationship with others in the social and cultural context. Psychotherapy emphasizing an individual's growth and autonomy may ignore the importance of maintaining interpersonal harmony in Chinese culture. The results of this study contribute to the essential knowledge about culturally sensitive nursing practices. An understanding of patient suffering that is shaped by traditional cultural values helps nurses communicate empathy in a culturally sensitive manner to facilitate the therapeutic relationship and clinical outcomes.

Adaptation, Psychological↗

PubMed2005

Quality, risk management and governance in mental health: an overview.

OBJECTIVE: To consider the origin, current emphasis and relevance of the concepts of quality, risk management and clinical governance in mental health. CONCLUSIONS: Increasingly, health service boards and management teams are required to give attention to clinical governance rather than corporate governance alone. Clinical governance is a unifying quality concept that aims to produce a structure and systems to assure and improve the quality of clinical services by promoting an integrated and organization-wide approach towards continuous quality improvement. Many psychiatrists will find the reduction in clinical autonomy, the need to consider the welfare of the whole population as well as the individual patient for whom they are responsible, and the requirement that they play a part in a complex systems approach to quality improvement to be a challenge. Avoiding or ignoring this challenge will potentially lead to conflict with modern management approaches and increased loss of influence on future developments in mental health services.

Australia↗

PubMed2005

Reflections on clinician leadership and management in mental health.

OBJECTIVE: To review the role of clinician leadership in the management of mental health services. CONCLUSIONS: The literature suggests that clinician leadership is increasingly regarded as an essential element in the effective introduction of innovation and improved quality of clinical care by those who manage mental health services. Psychiatrist leaders have a role to play in ensuring that service change and innovation is based on sound clinical values, is developed in partnership with clinicians and is understood and supported by psychiatrist colleagues. Clinician leaders require clear vision, commitment and courage. The support of their colleagues is essential if the psychiatric profession is to have influence on future development of mental health services.

Australia↗

PubMed2005

Leadership for change in complex systems.

OBJECTIVES: To examine clinician leadership for change from the perspective of complexity. METHODS: The core features of complex adaptive systems are described and examples of these characteristics are identified in Australia's mental health system. The implications of conceiving of the mental health system as a complex adaptive system are explored. CONCLUSIONS: It is concluded that there is value in conceiving of Australia's mental health system as a complex adaptive system and that such a conception provides useful guidance for leadership for change and for management.

Australia↗

PubMed2005

Mental health research in general practice.

OBJECTIVE: To explore problems in carrying out a mental health research project in the general practice setting. METHOD: Open-ended interviews were conducted with general practice stakeholders, focusing on impediments to the conduct of mental health research in general practice and possible means for improving the participation of general practitioners in such research. Participants in the consultations were members of five divisions of general practice, senior staff within an academic department of general practice, four general practitioners and a research group engaged with general practice research. The discussions were recorded in detailed interview notes, and key issues and themes emerging from consultations were derived by the researchers. RESULTS: Three main themes summarized most of the issues reported through the consultations, including structural issues (e.g. disruption of practice, time limitations and lack of remuneration), process issues (e.g. researcher-general practice communication, researcher-imposed issues and need for partnerships) and content issues (e.g. study design, study procedures and methods). CONCLUSIONS: The consultations revealed similar findings to previously published reports concerning general practice research, with an emphasis on the need for partnerships between researchers and general practice organizations in the conduct of such research.

Family Practice↗

PubMed2004

Depression and anxiety: a comparison of older-aged Greek-born immigrants and Anglo-Australians.

OBJECTIVE: To compare depressive and anxiety illness in an older-aged sample of Greek-born (GB) immigrants who were likely to have been excluded from the National Survey of Mental Health and Wellbeing due to their lack of fluency in the English language and for whom rates of mental disorder are unknown, with a comparably recruited sample of Anglo-Australians (AA). METHOD: One hundred and forty-six GB and 146 AA respondents with a mean age of 68 years living in Melbourne and recruited through social clubs, completed the Beck Depression Inventory-II (BDI-2) and the State-Trait Anxiety Inventory (STAI) in addition to socio-demographic and other background questions. RESULTS: Greek-born respondents exhibited higher depression and anxiety scores and reported more depressive and anxiety symptomatology than the AA respondents. More GB respondents (17.1%) were likely to be included in the moderate to severe BDI-2 depression categories than AA (4.1%). Greek-born respondents (43.1%) were more likely to be included in the higher anxiety categories (i.e. score 41-80) of the STAI than the AA (15.8%). However, when controlling for health, economic and social factors there was no difference in the BDI-2 measures between the two groups. Despite controlling for these factors the GB still scored more highly on STAI measures than AA respondents. CONCLUSIONS: No differences were found between groups on measures of depression once controlling for age, education and occupational level, current financial status, marital status, household composition, current work status, physical health and stress. Such factors were also shown to influence group-differences anxiety but they not entirely explain group differences. Higher anxiety in GB respondents were likely to have been determined through the effects of additional but unmeasured cultural and immigrant status factors. Psychological morbidity in immigrants is best accounted for by considering the influence of social, health and other living conditions in addition to the effects of culture or immigrant status.

Aged↗