Mediation analysis of severity of needs, service performance and
                        outcomes for patients with mental disorders

Roux, Paul; Passerieux, Christine; Fleury, Marie‐Josée

doi:10.1192/bjp.bp.116.184010

Cited by 10 publications

(28 citation statements)

References 38 publications

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“…Concerning service user outcomes, higher QOL and recovery scores in the "Metropolitan network: middle-age men with positive outcomes" (category 1) likely resulted from the greater availability and continuity of services in this network. Strong associations between quality of life, recovery and continuity of care were previously identified [57,58,87]. The substantial financial resources available to the Metropolitan MHSN would also have allowed for better follow-up of "Metropolitan network: middle-age men with positive outcomes", who were mainly affected by alcohol use disorders requiring ongoing and coordinated help from various resources such as MH services, SUD rehabilitation centers, primary care services, and support groups like Alcoholics Anonymous.…”

Section: Discussionmentioning

confidence: 93%

Relationships Among Structures, Team Processes, and Outcomes for Service Users in Quebec Mental Health Service Networks

Fleury¹,

Grenier²,

Bamvita

2020

International Journal of Integrated Care

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Background: Few studies have identified and compared profiles of mental health service networks (MHSN) in terms of structures, processes, and outcomes, based on cluster analyses and perceptions of team managers, MH professionals and service users. This study assessed these associations in Quebec metropolitan, urban and semi-urban MHSN. Methods: A framework adapted from the Donabedian model guided data management, and cluster analyses were used to identify categories. Study participants included team managers (n = 45), MH professionals (n = 311) and service users (n = 327). Results: For all three MHSN, a common outcome category emerged: service users with complex MH problems and negative outcomes. The Metropolitan network reported two categories for structures (specialized MH teams, primary care MH teams) and processes (senior medical professional, psychosocial professionals), and outcomes (middle-age men with positive outcomes, older women with few MH problems). The Urban and Semi-urban networks revealed one category for structures (all teams) and service user (young service users with drug disorders), but two for processes (psychosocial professionals: urban, all professionals: semi-urban). Conclusion: The Metropolitan MHSN showed greater heterogeneity regarding structures and team processes than the other two MHSN. Service user outcomes were largely associated with clinical characteristics, regardless of network configurations for structures and team processes.

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Section: Discussionmentioning

confidence: 93%

Relationships Among Structures, Team Processes, and Outcomes for Service Users in Quebec Mental Health Service Networks

Fleury¹,

Grenier²,

Bamvita

2020

International Journal of Integrated Care

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“…High variations in publication dates and countries were found (Table 4). The first study was published forty years ago [57], while the last one was recently published [58]. Since the first publication, the production of studies has been irregular.…”

Section: Resultsmentioning

confidence: 99%

“…In the Delany, Fletcher and Lennox study [59], it is used for testing the impact of the structure of shelter organizations on services-amenities and organizational relations. For Roux, Passerieux and Fleury [58], the purpose was to assess the service performance as a mediating factor between patient needs and outcome production. Finally, two papers aimed to identify determinants of long-term care services use [57] and trends in hospital and community care over 14 years [62].…”

Section: Resultsmentioning

confidence: 99%

Causal Modelling for Supporting Planning and Management of Mental Health Services and Systems: A Systematic Review

Almeda

García‐Alonso

Salinas-Pérez

et al. 2019

IJERPH

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Mental health services and systems (MHSS) are characterized by their complexity. Causal modelling is a tool for decision-making based on identifying critical variables and their causal relationships. In the last two decades, great efforts have been made to provide integrated and balanced mental health care, but there is no a clear systematization of causal links among MHSS variables. This study aims to review the empirical background of causal modelling applications (Bayesian networks and structural equation modelling) for MHSS management. The study followed the PRISMA guidelines (PROSPERO: CRD42018102518). The quality of the studies was assessed by using a new checklist based on MHSS structure, target population, resources, outcomes, and methodology. Seven out of 1847 studies fulfilled the inclusion criteria. After the review, the selected papers showed very different objectives and subjects of study. This finding seems to indicate that causal modelling has potential to be relevant for decision-making. The main findings provided information about the complexity of the analyzed systems, distinguishing whether they analyzed a single MHSS or a group of MHSSs. The discriminative power of the checklist for quality assessment was evaluated, with positive results. This review identified relevant strategies for policy-making. Causal modelling can be used for better understanding the MHSS behavior, identifying service performance factors, and improving evidence-informed policy-making.

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“…Therefore, the confounding factors controlled in the mediation analysis were: age, length of employment, and education. Partial mediation was assumed if the mediation path model produced a significant direct effect [51]. Complete mediation was assumed if the mediation path model did not produce a significant direct effect [51].…”

Section: Mediating Variablesmentioning

confidence: 99%

“…Partial mediation was assumed if the mediation path model produced a significant direct effect [51]. Complete mediation was assumed if the mediation path model did not produce a significant direct effect [51]. The total effect is the sum of the direct effect and the total indirect effect.…”

Section: Mediating Variablesmentioning

confidence: 99%

Association between probable posttraumatic stress disorder and quality of life in emergency service workers: a mediation analysis using a third potential model with both in parallel and in series effects; a cross-sectional study

Noda¹,

Asano²,

Shimizu³

et al. 2020

Preprint

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Background The present study used a third potential model with both in parallel and in series effects to identify mediators influencing the association between probable posttraumatic stress disorder (PTSD) and quality of life (QOL). In addition, we sought to clarify how stress-coping behaviors influence components of QOL. Methods Participants were 220 emergency service workers. PTSD was assessed using the Impact of Event Scale-Revised (IES-R). QOL was assessed using the MOS 36-Item Short-Form Health Survey (SF-36). Mediation analysis and moderated mediation analysis of interaction effects with a third potential model were used to examine the effects of stress-coping (Brief COPE scores), social support (Multidimensional Scale of Perceived Social Support [MSPSS] scores), and resilience (Connor-Davidson Resilience Scale [CD-RISC] scores) on the association between probable PTSD and QOL. Results The mediation analysis with confounders suggested an acceptable model fit. The moderated mediation analysis did not indicate differences in the moderators. IES-R scores were significantly positively associated with Active coping, Venting, and Positive reframing in Brief COPE scores and were significantly negatively associated with MSPSS scores. Active coping, Venting, and Positive reframing in Brief COPE and MSPSS scores was significantly positively associated with CD-RISC scores, which were significantly positively associated with SF-36 scores. A sensitivity analysis comparing the results between the full information maximum likelihood method and the list-wise deletion method indicated that the 95% confidence interval included zero and a good model fit was not maintained for indices of coping strategies in Venting and Positive reframing in Brief COPE scores. Conclusions Active coping in response to stressful situations is an important behavior for maintaining good mental health among emergency service workers. In addition, Active coping in stress-coping and social support may have strengthened participants’ resilience, and resilience may have improved QOL. However, Positive reframing and Venting might have confounded the results because they exhibited a Not Missing At Random data distribution. Screening of mental health and QOL should include simultaneous assessment of stress-coping, social support, and resilience. Although the present findings are suggestive, because this was a cross-sectional study, causal relationships between PTSD and QOL mediated by three mediators could not be confirmed.

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Mediation analysis of severity of needs, service performance and outcomes for patients with mental disorders

Abstract: Poorer service performance has a negative impact on outcomes for patients with the highest needs. Ensuring more efficient services for patients with high needs may help improve their recovery and quality of life.

Cited by 10 publications

References 38 publications

Relationships Among Structures, Team Processes, and Outcomes for Service Users in Quebec Mental Health Service Networks

Relationships Among Structures, Team Processes, and Outcomes for Service Users in Quebec Mental Health Service Networks

Causal Modelling for Supporting Planning and Management of Mental Health Services and Systems: A Systematic Review

Association between probable posttraumatic stress disorder and quality of life in emergency service workers: a mediation analysis using a third potential model with both in parallel and in series effects; a cross-sectional study

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