Browsing by Autor "Nerea Almeda"

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A Comparison of Mental Health Care Systems in Northern and Southern Europe: A Service Mapping Study
(2018) Minna Sadeniemi; Nerea Almeda; José A. Salinas-Pérez; Mencía R. Gutiérrez-Colosía; Carlos R. García‐Alonso; Taina Ala-Nikkola; Grigori Joffe; Sami Pirkola; Kristian Wahlbeck; Jordi Cid
Mental health services (MHS) have gone through vast changes during the last decades, shifting from hospital to community-based care. Developing the optimal balance and use of resources requires standard comparisons of mental health care systems across countries. This study aimed to compare the structure, personnel resource allocation, and the productivity of the MHS in two benchmark health districts in a Nordic welfare state and a southern European, family-centered country. The study is part of the REFINEMENT (Research on Financing Systems’ Effect on the Quality of Mental Health Care) project. The study areas were the Helsinki and Uusimaa region in Finland and the Girona region in Spain. The MHS were mapped by using the DESDE-LTC (Description and Evaluation of Services and Directories for Long Term Care) tool. There were 6.7 times more personnel resources in the MHS in Helsinki and Uusimaa than in Girona. The resource allocation was more residential-service-oriented in Helsinki and Uusimaa. The difference in mental health personnel resources is not explained by the respective differences in the need for MHS among the population. It is important to make a standard comparison of the MHS for supporting policymaking and to ensure equal access to care across European countries.
A Systematic Review of the International Evolution of Online Mental Health Strategies and Recommendations During the COVID-19 Pandemic
(Research Square (United States), 2022) Nerea Almeda; Diego Díaz-Milanés; Mencía R. Gutiérrez-Colosía; Carlos R. García‐Alonso
Abstract Introduction: The global health crisis caused by the COVID-19 pandemic, which started at the beginning of 2020, has had a negative impact on mental health (MH). As a response to the pandemic, international agencies and governmental institutions providedan initial response to the population’s needs. As the pandemic evolved, the population circumstances changed, and some of these international agencies, such as the UN or WHO, updated their strategies, recommendations, and guidelines for the populations. However, there is currently a lack of information on the attention given to response strategies by the different countries throughout the beginning of the pandemic. Objectives: To evaluate the evolution of MH online strategies and recommendations developed by governments and related institutions to cope with the impact ofCOVID-19 on MH from the early stages of the COVID-19 pandemic to the vaccination period and to assess their current status. Methodology: An adaptation of the PRISMA guidelines to review online documents was used together with a questionnaire for MH strategies and recommendation assessment. Basic statistics and Student’s t test were used to assess the evolution of the documents, while a two-step cluster analysis was performed to assess the organisation and characteristics of the most recent documents. Results : Statistically significant differences were found both in the number of symptoms and mental disorders and MH strategies and recommendations included in the initial documents and the updated versions generated after vaccines became available. The most recent versionsare more complete in all cases. Regarding the forty-six total documents included in the review, the cluster analysis showed a broaddistribution from wide-spectrum documents to documentsfocusing on a specific topic. Conclusions: Governments and institutions have worked actively but unevenly on updating the MH guidelines, paying attention to actions related to bereavement, telehealth and domestic violence. Significant improvements have been made regarding Mexico’s guideline and the availability of comprehensive resources from England, Australia and the United States of America. The study supports the use of the PRISMA protocol adaptation and questionnaire for MH strategy and recommendation assessments as a standard by which to conduct longitudinal assessments of dynamic documents.
An international comparative analysis of the mental health care delivery system in remote areas: the Kimberley (Australia), Nunavik (Canada) and Lapland (Finland)
(Ubiquity Press, 2021) José A. Salinas-Pérez; Mencía R. Gutiérrez-Colosía; Petra Suontausta; Jacques Bertrand; Nerea Almeda; Mary Anne Furst; John Mendoza; Daniel Röck; Kristian Wahlbeck; Graça Cardoso
The International Journal of Integrated Care (IJIC) is an online, open-access, peer-reviewed scientific journal that publishes original articles in the field of integrated care on a continuous basis.IJIC has an Impact Factor of 5.120 (2020 JCR, received in June 2021)The IJIC 20th Anniversary Issue was published in 2021.
An international comparative analysis of the mental health care delivery system in remote areas: the Kimberley (Australia), Nunavik (Canada) and Lapland (Finland)
(2021) José A. Salinas-Pérez; Mencía R. Gutiérrez-Colosía; Petra Suontausta; Jacques Bertrand; Nerea Almeda; Mary Anne Furst; John Mendoza; Daniel Röck; Kristian Wahlbeck; Graça Cardoso
Introduction Remote areas hold specific local and structural conditions that affect care availability and access, such as geography, population characteristics and service provision. Care in these areas is frequently scarce and fragmented and they are difficult to compare with similar areas in the same country. In order to plan effective integration, it is first necessary to perform a comparative analysis of the delivery system. This study aims to analyse the adult mental health service provision in three remote areas across the world. Methods The study areas are the Kimberley (Australia), Nunavik (Canada) and Lapland (Finland) between 2018-2019. These areas are characterised by extremely low population density and high relative rates of indigenous population. DESDE-LTC system was used for the standard description of the service delivery system for mental health care, in combination with socioeconomic and health context analysis along with geographical maps. Results The areas are deprived within their national contexts. Kimberley and Nunavik have a similar remoteness and their population centres are mainly connected by plane. Road passage in Kimberley and Lapland varies according to the season. Mental health services are mostly provided from the public sector completed with non-profit organisations. Specific cultural-based services for indigenous people have been identified in Kimberley, while every service is targeted to this group in Nunavik and none in Lapland. Kimberley has two specialised acute units in a general hospital. The consumers who require medium and long stay are referred outside of the area. There are no community residences in the area. Mobile outpatient services are more developed than in the other areas. Nunavik has two psychiatric beds in two general hospitals, while severe cases are referred to Montreal. Two psychiatrists visit the hospitals once a month. There are also several community residential settings. The remaining services are not specialised and deliver mental health first aid. Finally, a general hospital with one acute unit and two medium-long stay units is available in Lapland in addition to community residences. The care profile is completed with day care services, and balanced number of mobile and non-mobile outpatient care services. Discussions The mental health care in Lapland is self-sufficient and its care pattern is similar to other Finnish areas, while Kimberley and Nunavik are especial cases in their jurisdictions and depend on external facilities for severe and long-term cases. The nonexistence of day care provision in the latter areas seems to be related to the isolation and dispersion of the population centres. Conclusions Local contexts are essential in the study of mental health service provision. The knowledge provided may support decision-making for mental health policy and planning in remote areas. Lessons Learned So far, service provision in remote areas has not received much attention even though their especial psychiatric morbidity. It is necessary to take into account local context. Limitations Only universal access specialised services for adults have been studied. The results cannot be generalised to other remote areas with different characteristics. Suggestions for future research Analysis of relative technical efficiency, geographical accessibility and workforce capacity.
Changes in mental health system performance: the case of Gipuzkoa (Basque Country, Spain)
(Ubiquity Press, 2019) Nerea Almeda; Carlos R. García‐Alonso; José A. Salinas-Pérez; Álvaro Iruin Sanz; Luis Salvador‐Carulla
The International Journal of Integrated Care (IJIC) is an online, open-access, peer-reviewed scientific journal that publishes original articles in the field of integrated care on a continuous basis.IJIC has an Impact Factor of 5.120 (2020 JCR, received in June 2021)
Health risk behaviours, mental health and HbA1c: an overview of reviews of observational studies
(BMJ, 2025) Soumya Mazumdar; Nerea Almeda; Nasser Bagheri; Mark Daniel; Hossein Tabatabaei‐Jafari; Gweneth Leigh; Diego Diaz Milanes; Luis Salvador‐Carulla
This umbrella review highlights the significant association between HbA1c and key health risk factors underscoring the importance of observational studies, highlighting their ability to capture real-world conditions and complex interactions. While in agreement with existing study designs, this review provides convergent evidence of the critical role of HRBs in managing HbA1c levels.
Impact of a long-term policy on mental health system performance and stability: the case of Bizkaia (Basque Country, Spain)
(Ubiquity Press, 2019) Nerea Almeda; Carlos R. García‐Alonso; José A. Salinas-Pérez; Carlos Pereira Rodríguez; Luis Salvador‐Carulla
The International Journal of Integrated Care (IJIC) is an online, open-access, peer-reviewed scientific journal that publishes original articles in the field of integrated care on a continuous basis.IJIC has an Impact Factor of 5.120 (2020 JCR, received in June 2021)
Mental health planning at a very early stage of the COVID-19 crisis: A systematic review of online international strategies and recommendations
(Research Square (United States), 2020) Nerea Almeda; Carlos R. García‐Alonso; Luis Salvador‐Carulla
Abstract Background: Mental health care systems have been dramatically affected by COVID-19. Containment measures have been imposed, with negative consequences on population mental health. Therefore, an increase in both symptomatology and mental disorder incidence is expected. This research aims to identify, describe and assess the empirical background on online strategies and recommendations developed by international organizations and governments to cope with the psychological impact of COVID-19 at a very early stage of the pandemic. Methods: The PRISMA guidelines were adapted to review online documents. A new questionnaire was developed to identify the existence of common patterns in the selected documents. Questions were classified into three domains: COVID-19 information, mental health strategies and mental health recommendations. A two-step cluster analysis was carried out to highlight underlying behaviours in the data (patterns). The results are shown as spider graphs (pattern profiles) and conceptual maps (multidimensional links between questions). Results: Twenty-six documents were included in the review. The questionnaire analysed document complexity and identified their common key mental health characteristics (i.e., does the respondent have the tools for dealing with stress, depression and anxiety?). Cluster analysis highlighted patterns from the questionnaire domains. Strong relationships between questions were identified, such as psychological tips for maintaining good mental health and coping with COVID-19 (question nº 4), describing some psychological skills to help people cope with anxiety and worry about COVID-19 (question nº 6) and promoting social connection at home (question nº 8). Conclusions: When fast results are needed to develop health strategies and policies, rapid reviews associated with statistical and graphical methods are essential. The results obtained from the proposed analytical procedure can be relevant to a) classify documents according to their complexity in structuring the information provided on how to cope with the psychological impact of COVID-19, b) develop new documents according to specific objectives matching population needs, c) improve document design to face unforeseen events, and d) adapt new documents to local situations. In this framework, the relevance of adapting e-mental health procedures to community mental health care model principles was highlighted, although some problems related to the digital gap must be considered.
Mental health planning at a very early stage of the COVID-19 crisis: A systematic review of online international strategies and recommendations
(2020) Nerea Almeda; Carlos R. García‐Alonso; Luis Salvador‐Carulla
<title>Abstract</title> <bold>Background:</bold> Mental health care systems have been dramatically affected by COVID-19. Containment measures have been imposed, with negative consequences on population mental health. Therefore, an increase in both symptomatology and mental disorder incidence is expected. This research aims to identify, describe and assess the empirical background on online strategies and recommendations developed by international organizations and governments to cope with the psychological impact of COVID-19 at a very early stage of the pandemic.<bold>Methods:</bold> The PRISMA guidelines were adapted to review online documents. A new questionnaire was developed to identify the existence of common patterns in the selected documents. Questions were classified into three domains: COVID-19 information, mental health strategies and mental health recommendations. A two-step cluster analysis was carried out to highlight underlying behaviours in the data (patterns). The results are shown as spider graphs (pattern profiles) and conceptual maps (multidimensional links between questions).<bold>Results: </bold>Twenty-six documents were included in the review. The questionnaire analysed document complexity and identified their common key mental health characteristics (i.e., does the respondent have the tools for dealing with stress, depression and anxiety?). Cluster analysis highlighted patterns from the questionnaire domains. Strong relationships between questions were identified, such as<italic> psychological tips for maintaining good mental health and coping with COVID-19</italic> (question nº 4), <italic>describing some psychological skills to help people cope with anxiety and worry about COVID-19</italic> (question nº 6) and <italic>promoting social connection at home</italic> (question nº 8).<bold>Conclusions: </bold>When fast results are needed to develop health strategies and policies, rapid reviews associated with statistical and graphical methods are essential. The results obtained from the proposed analytical procedure can be relevant to a) classify documents according to their complexity in structuring the information provided on how to cope with the psychological impact of COVID-19, b) develop new documents according to specific objectives matching population needs, c) improve document design to face unforeseen events, and d) adapt new documents to local situations. In this framework, the relevance of adapting e-mental health procedures to community mental health care model principles was highlighted, although some problems related to the digital gap must be considered.
Mental Health Planning During the COVID-19 Crisis: A Systematic Review of Online International Strategies and Recommendations
(2020) Nerea Almeda; Carlos R. García‐Alonso; Luis Salvador‐Carulla
<title>Abstract</title> Background Mental Health care systems have been dramatically affected by COVID-19. Containment measures have been imposed with negative consequences on population mental health. Therefore, an increase in both symptomatology and mental disorders incidence is expected. This research aims to identify, describe and assess the empirical background on online strategies and recommendations developed by international organizations and governments to cope with the psychological impact of COVID-19. Methods A new questionnaire has been developed to identify the existence of common patterns in the selected documents. Questions were classified in three domains: COVID-19 information, mental health strategies and mental health recommendations. The PRISMA statements were adapted to review online documents. A two-steps cluster analysis was carried out to highlight underlying behaviors in data (patterns). Results were shown by using spider graphs (pattern profiles). Multidimensional links between questions were identified and assessed by conceptual maps. Results 26 documents were included in the review. The questionnaire assessed document complexity and identified key mental health issues (i.e. tools for dealing with stress, depression and anxiety), which show a high agreement level among them. Cluster analysis highlighted the existence of common patterns in the selected question domains. Strong relationships between individual questions were also identified such as, for example, <italic>include psychological tips for maintaining good mental health and coping with COVID-19</italic> (question nº 4), <italic>describe some psychological skills to help people cope with anxiety and worry about COVID-19</italic> (question nº 6) and, finally, <italic>promote social connection at home</italic> (question nº 8). Conclusions When fast results are needed to develop health strategies and policies, rapid reviews associated to statistical and graphical methods are essential. Results obtained from the proposed analytical procedures are relevant to a) classify the documents about the psychological impact of COVID-19, b) develop new documents according to the selected objectives for matching population needs, c) improve psychological interventions in a pandemic, and d) adapt new documents to local situations. The relevance of adapting e-mental health to community mental health care model principles was highlighted. For developing e-mental health potential, some problems related to the digital gap, stigma and ethical issues must be considered.
Modelling mental healthcare improvement in highly integrated care systems: the case of the Basque Country (Spain)
(Ubiquity Press, 2021) Carlos R. García‐Alonso; Nerea Almeda; José A. Salinas-Pérez; Mencía R. Gutiérrez-Colosía; Luis Salvador‐Carulla
The International Journal of Integrated Care (IJIC) is an online, open-access, peer-reviewed scientific journal that publishes original articles in the field of integrated care on a continuous basis.IJIC has an Impact Factor of 5.120 (2020 JCR, received in June 2021)The IJIC 20th Anniversary Issue was published in 2021.