Experiences and challenges faced by community mental health workers when providing care to people with mental illness: a qualitative study

Abstract

Background Mental illness is a major burden of disease worldwide. Community Mental Health Services (CMHS) are key to achieving community-based recovery for people with mental illness. In China, even though the community management of patients with mental illness is improving, the barriers faced by Community Mental Health Workers (CMHWs) are unclear. This study explores the difficulties and challenges in CMHS from the perspective of CMHWs. The results of this study may provide a practical basis for the training of CMHWs. Methods We carried out a qualitative study using an empirical phenomenological approach. Nine CMHWs were recruited from nine communities in Wuhan, Hubei Province, using purposive and snowball sampling. Face to face semi-structured in-depth interviews were conducted with them from December 27 to 28, 2019. Interview recordings were converted to text content by Nvivo 11.0 software and analyzed using Colaizzi’s phenomenological method. Results Three main themes were identified in this study: 1) Lack of role orientation leads to role ambiguity, 2) Failure to establish a therapeutic trust relationship with patients, and 3) Lack of communication and collaboration with various departments and peers. Seven sub themes were also identified. In these themes, CMHWs emphasized the importance of role clarity, therapeutic trusting relationships, and effective communication and coordination mechanisms. Conclusion Although China has made great efforts on the road to improving the quality of CMHS, several salient issues regarding CMHWs must be addressed to optimize the quality of services provided by CMHWs. Community mental health institutions should help CMHWs overcome these difficulties, by maximizing its value and promoting the development of CMHS.

The implementation of a community-centered first aid education program for older adults—community health workers perceived barriers

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The effect of smartphone distraction on depression among Chinese nursing students: the mediating role of rumination and social withdrawal

“…This poor distribution of attention can further stimulate negative emotions such as depression, anxiety, and helplessness [48] . At the same time, interpersonal communication skills being impaired are detrimental to establishing a trusting relationship between caregivers and patients and increase work stress [49] . As the screening rate of social withdrawal and SD among college students gradually increases, it will seriously affect the mental health development of nursing students [50] .…”

Community Mental Health Services in Japan:

“…This may lead staff to encounter heightened difficulties associated with "ambiguous roles" and "difficulty in establishing relationships with patients". 12 Given this background, it is expected that the number of visits will be influenced by the staffʼs work experience as an external factor, and by their attitudes toward their work as an internal factor. While previous studies have examined medical services such as home-visits by nurses, few studies have been conducted on administrative staff.…”